Infratentorial
getting there

One month off of ICU orientation. Functioning on my own (always asking questions of course still), learning a lot. Not yet confident but it is building.

There is a “Mean Girls” vibe between medical ICU and surgical ICU nurses. The surgical nurses are “smarter, and take care of more critical patients” and medical nurses “deal with whatever comes in the door, it’s surprising when they get sick patients.” I stay away from shit talk like this, but definitely notice an animosity or PMS-like vibe from nurses that I don’t work with.

Go figure, that’s every profession to some extent, I guess?

My favorite patient so far had SVC syndrome secondary to lung cancer. No, the one with West Nile encephalopathy was my favorite. No, it was the pulmonary hypertension guy who’s PA pressures were 100/55 all day. Interesting! 

too much

new job, heightened accountability, more critical patients, whilst taking BSN classes with no more than 5 days off between classes until they’re all over in January 2013…

it’s overwhelming, it’s dragging my mood and energy down..

..but I guess it can be done.

At least I’ve made a few friends and feel like I’m learning slowly but surely at work?

Life goes on. 

For now.

TRYING TO PSYCH UP MY COWORKER TO HELP ME TURN AND CLEAN MY PATIENT
Firsts

The world seeks relief with booze or drugs, only to find the situation has not changed. Tina read the Psalms.

I am not religious or spiritual. I more often indulge in the former to cope with life’s stresses. And maybe reading scripture doesn’t change the situation either.. but it’s an interesting thought.

First code yesterday. Rib-crackin,’ two central lines placed at the bedside, 7 liters of fluid given, 90-minute kind of code (he actually coded three times total). And, though pressor dependent now, he is alive 24-plus hours later.

I was told by my MICU preceptor (and manager) that I did an excellent job- I responded fast and communicated well. I mostly agree.

I am lethargic after two 12-hour days with that patient, but am excited to review his ABGs and other labs, X-rays, Swan line numbers, code drugs given, and much more.

He is 52 years old and though he is still in severe septic shock, he might pull through this.

After the code: 

insulin drip

amiodarone drip @ 1 x6h then at 0.5

dobutamine drip @ 2.5

vasopressin drip @ 0.04

epinephrine drip @ 5

levo drip @ 30

neo drip @ 200

What a day!

dead

First patient death in 14 months of practicing.

Not sure how I feel about it yet but wow, did it happen fast!


Once we removed the pressors and vent, it took 16 minutes. Sad but good to experience.

the power of Y-O-U

If my 60 year old father, who recently lost his vision, can achieve a seventh degree black belt in Tae Kwon Do…

..then I can succeed at anything. I will adjust to this new nursing specialty.

I am a 24 year old “adult.” But after hearing about an achievement like his, I am reminded that my dad is superman


go big or go home

Arrived in CA successfully.

Finding a place to live + starting a new job + starting classes at the same time..

..that’s one way to ease into a new environment

beaches and ICU, here I come

MICU job offered and accepted- I start in less than 3 weeks. Commence frantic panic mode, as I have to pack most of my midwest life up and haul it to southern CA. No place to live yet but I hope my friends in the area will let me crash with them temporarily. 

If time allowed it, I would love to drive cross-country, but I think I’ll have to proceed quicker and have the damn car shipped. And have oodles of suitcases and packages sent to me from here.

So for now I am temporarily homeless, but not jobless.

I know myself well and will probably be just as buried in school and work in CA as I am here…but I will have a whole new world to explore and probably get lost in.

MICU is making me sweat- I pine to work in an ICU, and now that I will be doing so I am anxious, like a new grad all over again. I’m sure the 3-month orientation will be helpful.

California here I come. As for the next two weeks I can anticipate packing, filling out HR paperwork, saying goodbye to friends, and feeling glared at by coworkers as they wait for my impending departure. Fun!

Best wakeup call ever

Night nurses sleep during the day and don’t like being woken up.

This phonecall, however, interrupted my sleep in a welcome way.

Job interview.

MICU, Southern CA.

Friday.

So that’s where I will spend my tax refund dollars!

life moves fast

I did one day shift as a favor for a nurse I work with, and I LOVED it. Different pace than nights, I was cracked-out tired after having worked all night, but I LOVED it. We had nursing students, and having one assigned to me reaffirmed how much I love teaching. What a great few hours!

Potential job opportunity- MICU position in CA. Talked to the recruiters, still have my current job for now. I don’t want to get ahead of myself but if this goes through, all I need to do is give 2 weeks notice at my current job, pack a suitcase and book a one-way fight. Exciting!

Staying here would be great, too. Whether it’s out of state or elsewhere in my current city, it’s time for a new living arrangement for me.

Best South Park episode by the way. Or AWESOM-O (this is how I spend my free time when I am not buried in work or school).