What I find challenging about the nursing profession is, apart from dealing with the patients and their relatives, is knowing the disease and the disease process. What are the symptoms and how to deal with it. A lot of patients do not throw questions at the doctors as they seem to be intimidated. So as soon as the doctor steps out of the patient’s room, the patients and relatives begin to bombard you with questions regarding the patient’s confiment.
Since I am just new to this profession, I really find it hard to answer most of their questions that is why I always tell myself to find time researching. As much as I want to dedicate some time to it, my physical and mental strength are always drained right before I punch out. I almost always miss my bus stop especially when I came from PM shift.
I wish I could squeeze in the research task. I have to. I am planning to take my master’s degree so I need to improve my pacing.

I was really pleased by the turn out of my shift. Although it was pretty toxic, I managed to rise above the occasion. One of the toughest parts of my duty was starting an IV line to a patient who’s due for coronary angiogram. Being in the pit for almost three months already, the staff nurses are expecting me to manage simple IV insertion tasks considering that I am a certified IV therapy nurse. In single attempt, I was able to get through the vein successfully. As I emerged from the patients room, the bedside nurse told me that the IV line of my other patient has gotten out of the vein. He tried repositioning and pushing saline but there was resistance. I also tried that same but it was a failure. I had no choice I had to reinsert. It was a success.
I noticed though that my eyes were getting dry then making me uncomfortable during the IV insertions. I guess the best eye cream could help my eyes relax. I need them to be in best shape at all times.

I started my rounds almost 9:00 pm already and the way I assesed my patients, I thought that I will not be hitting the marker on time. I had so much on my plate: constant chest pain, difficulty breathing, IV line out needed reinsertion, IV line to be started, osterized feeding residual, status post chest tube thoracotomy removal with pain at the insertion site, unstable vitals, stat orders from attendings and fellows and early case of coronary angiogram plus three patients due for suppository insertion. Whew! I cannot believe I managed all these and was able to finish my chart on time. The endorsement, including the equipment inventory, was finishedbefore 8:30 am.
I am really getting the hang of it. Although, I envy the other bedside nurse and the charge nurse because they were able to catch some sleep in the wee hours of the morning.

I have had 4 straight PM shifts last week and yesterday was the break to those crazy shifts and now, I am back on PM shift. It’s really hard to adjust on sleep pattern. I just woke up and I still feel sleepy. I am thankful that there’s no pimple breakout as yet but I think I will be needing an age spot cream to prevent those crow’s feet from showing up this very early.

I was furious yesterday. For one, I ended up having 7 patients and another, a male pervert patient patted me on my butt twice. They said he was a doctor but he does not look like one. He is extremely obese confined in bed requiring total care in terms of oral and body hygiene. They said he’s been coming in and out of the hospital for quite a while already. Instead of me having pity on his condition, I tended to hate him. I left the charged nurse for his diaper change and I called upon his bedside nurse to assist him. Maybe that moron has overdosed some testosterone cream making him act that way. It was not the first time that he did that to a nurse. As a precaution, he is being assigned to male nurses.

Yesterday was my last of my straight PM shifts (7pm to 7am) and I am glad that I managed to survive, somehow. I will be on AM shift tomorrow (7am to 7pm) after my two days off and yet I still feel the need to get energized. I have slept all day yesterday and I got up almost lunch time today.
Unlike my colleagues, I do not hate this effin’ job. It is still rewarding, I just hope that I have all the time in the world to carry out my duties without missing any of it. Or in reality, I just hope I could manage my time effectively so I could get to finish all my tasks on time and get home early.

After the first blow to my nursing career another one comes in. I just got word from my headnurse about the medication error I have committed. I can sense her frustration in her voice and she actually voiced it out. As the tears were about to escape from my eyes, she grabbed my hand and brought me to the locker room. She asked me how I feel. I just sobbed. I feel so frustrated about myself. I am beginning to think, am I really fit for the job? What if the panel has made a mistake in choosing me over a thousand of candidates?
How am I supposed to save lives?
I feel like Kelly on Hawthorne. I lack the confidence but shall I give up? Did I buy myself one-way ticket to hell? Even if I did not, there’s no use to cry over the mistakes in the major decision that I have made about my career change. I have to move on. I promise myself that I will rise to the occasion. I will not be a failure. I owe it to myself more than anyone else. I just need some gut.
God help me.

After a month of being an orientee, I still feel new to the nursing career. I still have not gotten the hang of the job description and as I carry out my duties, I am thinking that nurses are indeed the unsung heroes of the hospital. They are the ones up on their feet 24/7 that translates to being the heartbeat of the hospital and yet they are underpaid. The tasks are physically and intellectually demanding and I am thinking that if the job is the same as the one abroad, I would rather fly out for a greener pasture as the salary is not enough to support he expenses for medications for the illness or injuries that one might develop in performing her duty.
This just crossed my mind as I was at patient’s bedside doing the morning care. I might consider doing the Dallas job search search as suggested by a colleague is who about to test the nursing career in the US.

Being a nurse does not just begin with vital signs taking and recording, patient assessment, medications and does not end with charting.
The nursing reponsibility involves knowing the disease process the medications, its mechanism of action, side effects and the precautions.
A female in her early 30s was admitted with complains of right upper abdominal pain. Tests revealed that she has cholelithiasis and cholecystitis.
According to medterms.com cholelithiasis is “the presence of stones in the gallbladder or common bile duct. The process of formation of such stones. From the Greek roots chole, bile + lithos, stone.”
On the other hand. cholecystitis refers to the “inflammation of the gallbladder, a complication of gallstones which are formed by cholesterol and pigment (bilirubin) in bile.”
Bile according to answers.com is a bitter, alkaline, brownish-yellow or greenish-yellow fluid that is secreted by the liver, stored in the gallbladder, and discharged into the duodenum and aids in the emulsification, digestion, and absorption of fats. Also called gall.
There are a few doctors who are thoughtful enough to share the diease process to the patients. So they (patients) end up at a loss as soon as the doctor steps out of the patient’s room. Most of the time, the nurses are the one being asked about for the information they need to know.
My patient was informed by her attending that she needs to undergo explore laparoscopy to remove the gallstones in order for the bile to have patent way to the colon. Otherwise, gallbladder will be filled with bile and sign and symptoms will worsen. Chronic gallstone disease may lead to fibrosis and loss of function of the gallbladder and predisposes to gallbladder cancer.

I was on the PM shift. I came in almost an hour before my shift. I want to have enough time to browse through my patients’ charts. As I looked at the board for my patient assignment, I was not surprised to see that I have 2 level 2 patients out of the 4 assigned to me while the other bedside nurse has only 1 level one patient out of four. I was appalled though that I will be receiving the first admission should there be any. The division of labor is really not fair. Then again, my only consolation for playing the underdog for the next 6 months is that, the bedside and the charge nurse are not allowed to go home without me. A fair deal.
The outgoing bedside nurse get to endorse the concerned patients to me just before the grand endorsement happened. I asked her to slow down a bit as I list down the medications of each patient but she commented that I should come in early to do it. Bitching out aside, I asked her that the reason I came in early is for me to do that exactly but she asked me to make an early endorsement. She rested her case because I was not gonna take it sitting down.
In almost a month of being an orientee, I could say that this was the most smooth shift. We call it suave shift. At 4:30 a.m. I was done doing my final vitally signs, input and output monitoring and charting! I was only waiting for my 6:00 am osterized feeding and medications. This was my best shift ever! Until the admission group called in as there was a patient that will come in from another hospital. Aaargh, admission is the most toxic job for me as there are so many forms to fill out plus there is the task of doing the patient assessment. I am kinda obsessed with the assessment part as I do it thoroughly from head to foot including the patient’s medical background. This was the comment of my preceptor and I am guilty for that, if that is a sin. The patient came in at 5:30 a.m. and I hurriedly but thoroughly did the assessment. At 6:10 a.m. I was done with it, I hurriedly prepared my feeding and medications. At 7:00 a.m., I was done with all of it. I set aside the task of finishing the documentation for the patient who just arrived. I had to make the endorsement for my four other patients. At almost 8:00 am my other patient who will undergo coronary angiogram buzzed for help. She pooped and the daughter needs assistance for a diaper change. As soon as I finished changing her diapers, I went back to the endorsement table. The same patient buzzed again after ten minute. This time she wants to have her hair shampooed and she is level one patient. This means that even though is on complete bed rest, she does not have any contraptions and her Glasgow coma scale or GCS is 15. But in the private ward, you cannot say no to a patient’s request. Technically, she is no longer my patient but since the endorsement is still ongoing, she is still under my care. I went in to shampoo her and as I was patting her hair dry already she insisted on having her daughter to do it for her. My ears flapped in joy.
My preceptor handed me a time table giving me an idea what tasks should be done by when. I looked at him with my eyes speaking “seriously?”. He told me that it was just a suggestion and he does that to all the orientees that he handles. He noticed that I was quiet finishing the newly admitted patient’s chart and I was not laughing at his jokes. He began filling out some forms for me while the other bedside nurse was chitchatting with some nurses from the other ward. It was nearly 9:00 a.m. I was done doing all the charts and as I told them to go home already, they insisted on waiting for me.
Nurses are like diamonds. Undergoing trainings and real life experiences are like series of tests in fire to make them as polished and as priceless as they could ever be. I am hoping though that I could withstand the tests.