I just want to scream in frustration. I have been staying in the ward after my shift for at least two hours. It is because my shift was not enough to fulfil my duty. We have 5 level 2s and so many high level 1s in the ward. To top it all off, the relatives are annoyingly demanding. I know that they want only the best for their loved ones but most of them are already going way over board. You have to make them understand that they are not the only patients in the ward.
I called the ward this after to check my sked tomorrow. I spoke with the then charge nurse and he quickly told me that he will just text me my sked because they were about to intubate one of our level 2 patients. I told myself that level 2 will be lessened but to my surprise. I got a text from my senior that although the said patient was intubate, the patient’s daughter who is a doctor fought her way to keep the patient in the ward.
Hospital and sanitation policy states that intubated patients should be placed in the ICU for close monitoring and it requires the expertise of ICU nurses.
Aaargh…
If someone says that nurse’s work is easy, that person has to be exposed to our lives.

Being in a cardiac nurse, I am expected to perform certain tasks when the need arises. At first I was dumb scared to lay my hands on certain equipment like the ecg machines but as time goes by, I am putting on a confident face. It is now a breeze to take ecg tests on patients at bedside when the graphics people are busy. This way, the doctors are able to see and assess the patients quickly.

I am just a little over a year of being a staff in our ward and I am really surprised that I am structured to precept a new staff for a day. I think there was a mix up in the scheduling. My headnurse must have overlooked it and she just can’t admit her mistake. I have bypassed three staff nurses and preceptorship is a task not a promotion. This means that like any other trainings, all will be undergo one according to tenure.
I am not a people person that is why I tried my hardest to be a good preceptor. I am strict when it comes to fulfilling tasks and if things do not go my way, I tend to snap. Good thing that I was able to keep my composure. I hope that the new staff was able to peek through my brain and pick all the good stuff.

My initial plan after graduating from nursing school is to get my master’s degree. I told myself that right after landing a job in the hospital, I will make a way to fulfil that plan. Problem is, the 12-hour shift in the hospital is very taxing both physically and mentally so how on earth I could drag myself into graduate school?
I learned from that she is currently getting her online master’s degree. Like some online business degree program, major university are now offering master’s program in nursing as they understand the situation of the professional nurses. Yeah, getting in to the hype of online business degree is not a bad idea.

The constantly changing shift in the hospital has created a disturbance on my sleep pattern. It is hard for me to get in bed before 12 midnight and as a result it is hard for me to get up so early in the morning. Counting sheeps never worked for me. I am thinking of popping some sleep pill to tuck me to bed before the crack of dawn.

I was the charge nurse last night and part of my duty is to report to the nurse supervisor on duty and answer to his or her questions during his round.
The first patient in our ward is our resident patient who was long diagnosed with Parkinson’s Disease. She has been with us since July of this year. It is really ironic that just when I thought that I knew that patient so well, I was stunned to hear the supervisor’s question: What is Parkinson’s? I knew that it is a neurologic generative disease but I was really taken aback by the question.
I knew that it has something to do with the dopamine and the muscle conduction but my brain seemed to lose its coordination.
I must get up where I stumbled.

I did not attend the ward’s party for three reasons: first, I had to come home early in preparation for the church’s thanksgiving worship service the following morning. Second, we do not celebrate Christmas so there is no reason for me to be in the Christmas party. Lastly, I do not feel like sharing the moment with my headnurse. I really hate her for officially ruining my plans for the new year.
The ward staff was grouped into senior, junior and orientee which I did not get. Why do we always have to observe seniority in the ward? We are supposed to be treated equally because our job descriptions are the same. Last year, I did not get the chance to be included among the blesses ones to get five days off and to make the matter worse, I was put on AM sift on the December 31st then on the PM shift the next day. It was really traumatic for me to get home there because our place home to people who have great affection for firecrackers.
My point being? We do not celebrate Christmas and New Year is the only holiday that we celebrate. Being on the bottom of the junior list, I was the last to pick the schedule and for crying out loud, what was left was the reliever’s sked. It means that I will be reporting for work both on Christmas and New Year. As I have mentioned being on duty on Christmas is not a big deal for me. I am after the New Year off.
Being the pessimist me, my thinking was right. My sked sucks big time. I appealed to my headnurse via SMS stating my litany over the freaking holiday sked. She caved in just to make it worse. I was given the PM sked on the 30th then AM shift on January 1st. Okay so I will be coming home safe early on the 31st then head directly to bed and sleep then get up and then sleep again because I need to be up early on the 1st. So basically, I will not be celebrating New Year with the family.
What a heartless and inconsiderate person!

While it is a shame, I admit that I lack knowledge to satisfy the inquisitive minds of the panellists, the head nurses and the division chief of the special areas.
I was asked to research on the following questions that I failed to answer. I know that I already got the grade for the pre-channelling interview and I know that the purpose of me having to research on these is to leave an indelible mark in my mind. So here the questions go:
1. Give three signs and symptoms of digitalis toxicity
According to medlineplus.com:
Signs and symptoms:
a. Irregular heartbeat or arrhythmia ( I answered tachycardia and then…mental blackout)
b. Confusion
c. Loss of appetite
d. Nausea and vomiting
e. Palpitations

2. Where is the JP drain (tip) insertion site located?
I was told by our Top 2 participant in the CCC that it is placed in the pericardial sac but I tried looking for its exact location on the net and it is taking me forever to get a specific answer. I need to ask a thoracic cardiovascular surgeon for this. I’ll get back to you on this
3. Purpose of CVP insertion
• According to healthsystem.virginia.edu Central venous pressure (CVP) is good approximation of right atrial pressure , which in turn is a major determinant of right ventricular end diastolic volume (or the preload of the right ventricle.) Recall that right atrial pressure (and thus central venous pressure) is a reflection of :
> Cardiac function
> Venous return to the heart
On the other hand, according to nursing-nurse.com the CVP monitor or insertion aims:
a.To serve as a guide for fluid replacement in seriously ill patients.
b.To estimate blood volume deficits.
c.To determine pressures in the right atrium and central veins.
d.To evaluate for circulatory failure (in context with total clinical picture of a patient)
Browsing through its purpose, CVP

The last leg of our critical care course which is the pre-channelling interview was over. Out of the six questions, I only managed to answer 2 which means I have to take home fours questions which answers I have to research on. They are due for submission tomorrow before 9:00 am.
I felt stupid yesterday. You cannot buy time during the interview as the question will be skipped and they will proceed with the next question.
I was not the only one went home with assignments. All of us actually have to research on something.

He was among our new orientees. While we despise the other one for being overly nice and over doing things as if he knows everything and to my words: he puts us in a bad light, the other one has emerged to be a total a**hole.
He acts as if he knows everything and does not want to listen to criticism or suggestions. Okay I get it, I have my share of “snaps” but this one is different. I am trying to stick to the standard so that no one would howl at me for doing something wrong or for not doing anything at all. I guess his orientation is wrong and I do not want to teach people who are not willing to learn. One thing is for sure though, I would not allow someone to drag me down because of his incompetency and yeah, lack of communication skills.