Meriwhen the RN

The acuity in outpatient has ramped up dramatically.  I'm not sure if it's a comet passing nearby or something in the water, but the last couple of weeks have been off the chain.  It's not so much the increase in admissions...in fact, admissions is a good thing as that means job security.  It's that some of our patients are coming in so sick or are decompensating so rapidly that we're having to send them inpatient.  We've even had to call several codes, which in outpatient is rather surprising.  Not many people show up to outpatient shows...I'm guessing because they think it can't be that bad if it's outpatient.  Also, I secretly think they don't believe they've heard it.  "A code....WHERE?"

ICU always shows and God bless them.  Everyone else...hit or miss.

In all fairness, the codes in outpatient are nowhere as volatile as inpatient codes, so it's not as though the entire hospital needs to show up.  Almost all the ones I've witnessed have been handled with minimal problems.  There was only one that I thought might really go south on us...fortunately, we were able to get the patient safely to the unit.

So between increased census, higher acuity, and staffing changes, it's been rather busy.  Plus the fact that on the days off from work, I'm up to my neck either in history or gerontology.  I don't think I'm going to see inpatient work until September at this rate. 

I was recruited again.  Another staffing agency contacted me after seeing my resume to discuss full-time psych nursing placement options.  I will decline for now--with school and the baby, I can barely give my first agency anything--but tell them that I will definitely talk to them in the spring.  Hopefully they'll still be interested in me for other things, but right now I can't give them anything.  I'm stretched pretty thin as it is.  

Such is life.

Mind you, I'm still seriously considering the refresher course/LTAC, M/S or SNF route after the baby.  As I was telling my new grad--who is actually no longer a new grad!--the other day, I want to give medical nursing a try to see what I'm missing...if I'm missing anything.  And a year's experience could only help me in my career.  Of course, it'll be a challenge finding a place with shifts that will work for me, especially with an infant, but I'll cross that bridge when I come to it.