It is still crazy to me how different this hospital is from what I am used to. I really don't think they have any money to update things. I guess its around 150 years old. One of my shifts last week I was the 'med nurse' meaning I didn't have a patient assignment I just helped give all the medications to all the patients on the unit.
I have now attempted writing what I am going to say next like 10 times.
One patient had a medication due around 11. So I grabbed it and got all geared up with my PPE. I was going in to the room of an 89 year old man who was on palliative care. He had COVID and was DNR. I had taken care of him a few shifts before. I walked into his room and said his name as cheery as I could while I shut the door. When I saw him he didn't look good. But you see, people that are actively dying never look good. Um, see this is when I wish I was a writer and could say this more eloquently. But I looked at this man and I waited for him to take a breath and it never came. So I felt for his pulse and it wasn't there. He was gone.
I have done post mortem care a couple times so I knew the routine. But I have never been the person to find someone no longer breathing. It didn't really hit me about what had happened until later, like now as I am writing this.
I went and told his nurse that I was pretty sure he was dead. Apparently, there the proper terminology is expired. But I don't like that. It sounds like he was just an old fruit that had gone bad or some old milk that had expired. Anyways, it is so insane to me that he wasn't on any type of monitors to know the exact moment that he passed. That no one was there with him at that moment. He was all alone. And I just think if maybe he was on monitors someone could have been in there with him. This isn't just because of COVID. I think a lot of adult hospitals do this. It's just extra weird right now because no family could be in there.
It's such a weird time, people are dying all alone. I have heard stories since I have been here about nurses walking in and finding their COVID patients dead on the floor or in the bathroom. This is a virus that affects peoples oxygen levels, when they start to drop it goes fast!
Yesterday, I was on their tele floor, which I love, because then I can see what is happening with my patients hearts and oxygen levels. I had a 42 year old female with COVID that was on a BiPAP machine, this helps push the oxygen into her lungs. When we would lay her flat to help get her clean her oxygen sats would drop to the 60s!! That is so scary for me! That is when I would be calling a rapid response for help back home. But with these patients it is kind of their normal. I mean you still have to watch them and make sure their levels come back up. But it happens slowly and it makes me very anxious waiting for it.
I don't really know where I am going with this post. Death is a part of nursing. I knew this when I signed up all those years ago. And I figured I would see this when I signed up to come to New York. Good news is the hospitals COVID numbers have gone way down. When I first got here the number was over 120 now its 25. They have discharged over 600 COVID patients. Everyone is saying that I am a hero coming here to work and they are so proud of me. But honestly, the hard part is over. I missed all that. I feel like I am doing just everyday nursing. And I shouldn't be considered a hero.
Saturday, May 9, 2020
Thursday, May 7, 2020
The Big City Fail
Well I learned that I am not a big city girl. I decided to venture out and go to the city to see what it was like. And let’s just say I failed. The weather was kind of chilly and I didn’t bring a light weight jacket so I thought I’d stop at Target and buy like a workout jacket. I figured it’d be easier to just go to the one in the city since I was going there anyways. Wrong. So I found target then drove around in a circle a couple times trying to find parking. I don’t really understand the meter parking so I thought it would be easier to park in a garage. I pull into one a couple blocks from Target and attempt to back into a spot. I look over and there is a guy who is standing there telling me to stop. Apparently they park your cars for you. I walk to Target. It has an escalator in it! So I’m thinking this is the coolest target ever. But it’s not. I try to find the workout clothes and they literally have like 3 tank tops and a couple leggings. No jackets. I go check out the cute clothing area. Nothing there either. So I end up buying a long sleeve button up. Then I see they are selling masks in packs of 10. I hate wearing the cloth ones I have for a long period of time because they get like moist from me breathing. I decide to buy a pack of these. I also grab a buffalo chicken wrap because I’m thinking I could have like a little picnic in Central Park. Target is close to the Empire State Building so I walk to that to check it out. It’s a really tall building, I guess that’s neat. I get back to the partaking garage and learn I now have to pay $45. I was parked less than an hour. So that’s one fail. Next I decide to drive and see the World Trade Center building. It’s closed and I turned onto a road that was for cleared personnel only, meaning cops, so I have to do a U-turn with a cop right behind me. That was awkward.. and fail number two. I drove through Times Square just to see it. Last spot for the day was Central Park. I almost parked on the street. I went to read the meter thing but again it was confusing. And the sign said commercial parking only until 3:00. I got nervous and just thought the garage would be easier. I walked around Central Park a bit and then found a nice big rock in the sun to sit on for my little picnic. I got out my chicken wrap and the closer I looked at it I realized there was mold all over it!! So there goes my picnic plan. Then the clouds come in and the stupid button up long sleeve shirt wasn’t warm enough. I haven’t eaten all day and I’m starving and just over it all. I decided to just give up on the city and go home. I get back to the parking garage and learn this time I have to pay $75!!!! Like what??! I was there for 50 minutes. And that my friends was fail number 3.
Maybe I’ll go back and try again and trust me if I’d do I will not be driving I will be figuring out public transportation!
Maybe I’ll go back and try again and trust me if I’d do I will not be driving I will be figuring out public transportation!
Thursday, April 30, 2020
My fight song
Well I had my first days on my own. And I survived and I didn't cause harm to any one.
Day one I was with another traveler that started with me. It helped that we were both a little lost. I did feel bad because I had the easier assignment. I had all COVID positive patients and they were decently healthy otherwise.
I start the day by going into the nursing administration office to get my assignment. Then I get my PPE (personal protective equipment) for the day. This hospital is blessed to have enough PPE for every employee. I get a new N95 mask every day and new surgical mask. The only thing that I reuse is the jumpsuit cover thing and the face shield. I really should take a picture to show you what I am talking about. But it's weird to ask them to take a picture of me. Anyways, I put on all my gear and go to the unit I am assigned to.
Day one I am assigned to a make shift unit that they opened for COVID. It used to be a sleep study/wound care unit. This unit has nothing. I am running my IV meds without a pump, and by pump I mean the machine that infuses the medication over the correct amount of time. It's so hard for me to explain to my non nursing people reading this. All the supplies are as organized as they can be but just not as organized as I am used to. They receive donations, thank goodness, but the gloves are all different and the medications don't always scan. It is just pandemic nursing. Again, it's hard to explain. Day one goes pretty well. I have one kind of rude man that just wants to get out of the hospital and is receiving mixed messages from all his doctors. I forgot that grown ups can be so rude and confrontational. I have no control over whether people are discharged or not but patients love to take out their frustrations on nurses. Also, these doctors are SO busy. And don't have time to sit and chat with their patients. It is so different from Children's Mercy. But I am remembering that this is adult nursing. Doctors don't seem to spend the time in the patients room or if the plans change, the doctor doesn't go update the patient. See, I went to check on this man and he was asking about his discharge paperwork and I told him he wasn't going to be leaving today and he got mad because the doctor had told him he would discharge him. But that was before the doctor spoke to me and I told him that the patients other doctors were not okay with him going home. So I am the person that relays the bad news and I am the person that gets yelled out. This isn't just a COVID thing.. I was in this situation all the time when I did adult nursing. I feel like I am rambling but this is a reason I hate adult nursing. Back to COVID nursing. My patients are all on oxygen, out of breath when that get up to go to the bathroom and coughing. I can't walk them in the halls because they cant leave their rooms. They can't have any visitors. I ask them if they need anything and they say well their is nothing you can get me and they aren't wrong. I can get them water, maybe, on day one this unit didn't have water or ice!! The rooms are hot and it doesn't seem like the AC is working. The patients with COVID can't have fans in their rooms because it puts the staff at risk for spreading all those germs around in the air. I feel like I could type for ever and ever about my day.
Day 2 I was assigned to the Telemetry Unit. I loved that my patient are on monitors that I can see outside their rooms. See, I am used to being able to see a patients heart rate and oxygen saturation if it is a concern. And oxygen is a big deal with COVID patients. The day before I had patients on oxygen that was being adjusted but I wasn't able to see what was happening or what their levels were because they weren't on continuous monitoring. It is just way different from my comfort. Their tele unit is like their step down unit so their patients are very sick. When we were getting report in the morning we found out there was a patient that had just passed away. Her body was still in the room in the bed for a few hours that morning. It was so weird walking by that room knowing someone was dead in there. It is a crazy time. This unit is also disorganized. I asked if it was always like this and they said no, it was just pandemic nursing. Everyone was doing the best they could. I feel so bad for these nurses. They have told me stories about how they had to take care of 6 patients on their own. I heard that nurses in the ICU were taking care of 4 patients at once. I heard about a nurse being on a make shift unit all by herself with a care assistant and 10 patients. I can not imagine what these nurses have gone through. They have seen patient after patient pass away or crump and get sent to the ICU. The hospital starting playing Fight Song by Rachel Platten every time a person is discharged. It honestly is kind of annoying but I have to remind myself that that is a person that survived, this a person that is going home to see their family again. It is all just crazy and weird and overwhelming. And I'm not only learning a new charting system and how to contact doctors and which doctors have residents and who have texting capabilities and getting back into being comfortable with adults, which would all be a lot on its own, but I also am learning how to take care of a whole new disease process.
Lets just say for the first two days were a lot.
16 more shifts.
Day one I was with another traveler that started with me. It helped that we were both a little lost. I did feel bad because I had the easier assignment. I had all COVID positive patients and they were decently healthy otherwise.
I start the day by going into the nursing administration office to get my assignment. Then I get my PPE (personal protective equipment) for the day. This hospital is blessed to have enough PPE for every employee. I get a new N95 mask every day and new surgical mask. The only thing that I reuse is the jumpsuit cover thing and the face shield. I really should take a picture to show you what I am talking about. But it's weird to ask them to take a picture of me. Anyways, I put on all my gear and go to the unit I am assigned to.
Day one I am assigned to a make shift unit that they opened for COVID. It used to be a sleep study/wound care unit. This unit has nothing. I am running my IV meds without a pump, and by pump I mean the machine that infuses the medication over the correct amount of time. It's so hard for me to explain to my non nursing people reading this. All the supplies are as organized as they can be but just not as organized as I am used to. They receive donations, thank goodness, but the gloves are all different and the medications don't always scan. It is just pandemic nursing. Again, it's hard to explain. Day one goes pretty well. I have one kind of rude man that just wants to get out of the hospital and is receiving mixed messages from all his doctors. I forgot that grown ups can be so rude and confrontational. I have no control over whether people are discharged or not but patients love to take out their frustrations on nurses. Also, these doctors are SO busy. And don't have time to sit and chat with their patients. It is so different from Children's Mercy. But I am remembering that this is adult nursing. Doctors don't seem to spend the time in the patients room or if the plans change, the doctor doesn't go update the patient. See, I went to check on this man and he was asking about his discharge paperwork and I told him he wasn't going to be leaving today and he got mad because the doctor had told him he would discharge him. But that was before the doctor spoke to me and I told him that the patients other doctors were not okay with him going home. So I am the person that relays the bad news and I am the person that gets yelled out. This isn't just a COVID thing.. I was in this situation all the time when I did adult nursing. I feel like I am rambling but this is a reason I hate adult nursing. Back to COVID nursing. My patients are all on oxygen, out of breath when that get up to go to the bathroom and coughing. I can't walk them in the halls because they cant leave their rooms. They can't have any visitors. I ask them if they need anything and they say well their is nothing you can get me and they aren't wrong. I can get them water, maybe, on day one this unit didn't have water or ice!! The rooms are hot and it doesn't seem like the AC is working. The patients with COVID can't have fans in their rooms because it puts the staff at risk for spreading all those germs around in the air. I feel like I could type for ever and ever about my day.
Day 2 I was assigned to the Telemetry Unit. I loved that my patient are on monitors that I can see outside their rooms. See, I am used to being able to see a patients heart rate and oxygen saturation if it is a concern. And oxygen is a big deal with COVID patients. The day before I had patients on oxygen that was being adjusted but I wasn't able to see what was happening or what their levels were because they weren't on continuous monitoring. It is just way different from my comfort. Their tele unit is like their step down unit so their patients are very sick. When we were getting report in the morning we found out there was a patient that had just passed away. Her body was still in the room in the bed for a few hours that morning. It was so weird walking by that room knowing someone was dead in there. It is a crazy time. This unit is also disorganized. I asked if it was always like this and they said no, it was just pandemic nursing. Everyone was doing the best they could. I feel so bad for these nurses. They have told me stories about how they had to take care of 6 patients on their own. I heard that nurses in the ICU were taking care of 4 patients at once. I heard about a nurse being on a make shift unit all by herself with a care assistant and 10 patients. I can not imagine what these nurses have gone through. They have seen patient after patient pass away or crump and get sent to the ICU. The hospital starting playing Fight Song by Rachel Platten every time a person is discharged. It honestly is kind of annoying but I have to remind myself that that is a person that survived, this a person that is going home to see their family again. It is all just crazy and weird and overwhelming. And I'm not only learning a new charting system and how to contact doctors and which doctors have residents and who have texting capabilities and getting back into being comfortable with adults, which would all be a lot on its own, but I also am learning how to take care of a whole new disease process.
Lets just say for the first two days were a lot.
16 more shifts.
Monday, April 27, 2020
Day 2
Before I keep writing on here, let's get one thing clear... I am not a writer by an means. I write like I talk. Not eloquent or professional sounding or even smart sounding. You should be able to tell by that last sentence. I just wanted to throw that out there before all the judgements come in.
Now we can get to the good stuff..
Today was my first day at the hospital. The morning was spent on hospital orientation, getting our badges and getting fit tested. We didn't get to the units till 2 pm. So that's 5 hours of orientation and I am back tomorrow with my own patient load!! yeah you read that right. After 5 hours of shadowing I am going to be responsible for my own 3-4 patients. Grown up adult patients. I haven't done that in like 3 years. The anxiety is real! When I first got to the floor and my preceptor starting talking about COVID patients and how they can go down hill really fast, I thought.. yeah this was a mistake. Why did I, the nurse who hates respiratory cases, come to take care of patients with a serious respiratory disease. The nurse started talking about her patient who this morning was on 5 liters nasal cannula and got up to go to the bathroom and he O2 sats dropped to 87%. In my mind I was thinking okay big deal. 87%. Thats nothing, he will pop back up.. She, on the other hand, said she talked with the doctor and they wanted to switch him over to a venti mask with 12 liters of oxygen and 50% FiO2. Now family I know you are like what does all this mean.. and see that's the issue... I don't know either. I mean I do but usually respiratory therapists are there to help with this. At this hospital the nurses go ahead and initiate this stuff. Luckily, all that venti mask stuff is color coded and easy to figure out!! I am praying that I can handle this. It will for sure be a learning experience.
Also, all the media is real, the N95 masks HURT. It is constant pressure on your cheeks, just below your eyes. I only had it on for 5 hours, I can not imagine how a 12 hour shift will feel. While we are talking about masks, lets go over my full attire for work. I will now be wearing a jumper/coveralls that go over my scrubs, then a washable backwards lab coat looking thing. And on my face is a N95 mask, then a regular surgical mask over that, and either my glasses or science lab type glasses then a face shield. In addition to all of that I have booties over my shoes and a very classy hairnet. Of course gloves are also part of the assemble. Needless to say, there is zero point in putting make up on or doing my hair for the next 6 weeks. Even though I am making fun of the look, I am so very thankful that this hospital has supplies to keep all of its healthcare staff safe.
Now we can get to the good stuff..
Today was my first day at the hospital. The morning was spent on hospital orientation, getting our badges and getting fit tested. We didn't get to the units till 2 pm. So that's 5 hours of orientation and I am back tomorrow with my own patient load!! yeah you read that right. After 5 hours of shadowing I am going to be responsible for my own 3-4 patients. Grown up adult patients. I haven't done that in like 3 years. The anxiety is real! When I first got to the floor and my preceptor starting talking about COVID patients and how they can go down hill really fast, I thought.. yeah this was a mistake. Why did I, the nurse who hates respiratory cases, come to take care of patients with a serious respiratory disease. The nurse started talking about her patient who this morning was on 5 liters nasal cannula and got up to go to the bathroom and he O2 sats dropped to 87%. In my mind I was thinking okay big deal. 87%. Thats nothing, he will pop back up.. She, on the other hand, said she talked with the doctor and they wanted to switch him over to a venti mask with 12 liters of oxygen and 50% FiO2. Now family I know you are like what does all this mean.. and see that's the issue... I don't know either. I mean I do but usually respiratory therapists are there to help with this. At this hospital the nurses go ahead and initiate this stuff. Luckily, all that venti mask stuff is color coded and easy to figure out!! I am praying that I can handle this. It will for sure be a learning experience.
Also, all the media is real, the N95 masks HURT. It is constant pressure on your cheeks, just below your eyes. I only had it on for 5 hours, I can not imagine how a 12 hour shift will feel. While we are talking about masks, lets go over my full attire for work. I will now be wearing a jumper/coveralls that go over my scrubs, then a washable backwards lab coat looking thing. And on my face is a N95 mask, then a regular surgical mask over that, and either my glasses or science lab type glasses then a face shield. In addition to all of that I have booties over my shoes and a very classy hairnet. Of course gloves are also part of the assemble. Needless to say, there is zero point in putting make up on or doing my hair for the next 6 weeks. Even though I am making fun of the look, I am so very thankful that this hospital has supplies to keep all of its healthcare staff safe.
Here goes nothing
Day 1 of New York Living
Woke up this morning thinking WHAT DID I DO??? Tons of doubts running through my head about making this decision. But I got up and drove to the hospital just map out the route.. think I took the worst way possible so that was a waste of time. Then I went to the grocery store. There was a line outside down the street. That was fun. Surprisingly, they did have everything I needed in the store! After the shopping was done...more anxiety. The place I am living has valet parking. Meaning I just drive my car up the valet podium, they park it and keep my keys. So my anxiety is how do I unload my groceries in that situation. I have 10 bags. Can I take multiple trips? But then that leaves my car sitting there, blocking the way possibly. So, do I just power through and carry all the bags in at once? That's what I decided to do. Immediately, my next thoughts are what if this is the wrong way to go about it. What if the concierge sees me or I run into someone in the hallway. Will they judge me for carrying 10 grocery bags at once? . . . Seriously, this is the silly stuff I think about. Now why did I think a girl with this much anxiety about simply carrying groceries inside should move to New York in the middle of a pandemic????? IDK It will be interesting to see how the next 6 weeks go.
Woke up this morning thinking WHAT DID I DO??? Tons of doubts running through my head about making this decision. But I got up and drove to the hospital just map out the route.. think I took the worst way possible so that was a waste of time. Then I went to the grocery store. There was a line outside down the street. That was fun. Surprisingly, they did have everything I needed in the store! After the shopping was done...more anxiety. The place I am living has valet parking. Meaning I just drive my car up the valet podium, they park it and keep my keys. So my anxiety is how do I unload my groceries in that situation. I have 10 bags. Can I take multiple trips? But then that leaves my car sitting there, blocking the way possibly. So, do I just power through and carry all the bags in at once? That's what I decided to do. Immediately, my next thoughts are what if this is the wrong way to go about it. What if the concierge sees me or I run into someone in the hallway. Will they judge me for carrying 10 grocery bags at once? . . . Seriously, this is the silly stuff I think about. Now why did I think a girl with this much anxiety about simply carrying groceries inside should move to New York in the middle of a pandemic????? IDK It will be interesting to see how the next 6 weeks go.
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