Tag Archives: Aaaahr En!

It’s Complicated

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So Rhonda’s ex is unable to take care of the children during what is usually his time, at least for this week if not longer, due to some health problems.  Naturally this is the ONE weekend wherein I accepted some on-call shifts, resulting in a five-day death-march through the land of the night shift, so sleep deprivation was already my chosen lifestyle for the duration.

Since Rhonda can’t afford to take any more time off from work, ditto myself, we’re just having to patch together what arrangements we can for tomorrow and the next day.  Since naturally this is ALSO the Monday that I happen to have a job interview, it’s become a complicated affair with a cast of many players.  Ordinarily I’d just come home and sleep and wake up and get the youngest from the babysitter and then meet the bus for the older one, but instead I’ll be dashing off to the interview, a friend’s teenager will meet the bus, and I’ll grab the youngest on my way home.  Then I’ll pay off the teen, craft a delicious meal of take-n-bake pizza or similar, shovel the exhausted spawnlets into bed (since they will have been dropped off at the sitter’s at 530am by Rhonda on her way to work), and attempt to nap before leaving for work at 10pm.  Rhonda will arrive home at 830pm, shovel herself into bed (for our hour and a half of together time, probably spent talking about the events of the day and whining about not seeing one another since very early Saturday morning), and the cycle begins anew for Tuesday minus the teen and the dashing around to interviews.

I expect that by Thursday, when I get off work for the week, I will be gibbering, hysterical, and thoroughly unpleasant (I know, different from usual in what way?).  I will communicate in grunts, whistles, and clicking noises, and prod people into doing what I want via pointed stick.

But the night shift differential at the oncall place is twice what I expected, and we can really use the extra scratch, and it will all be over with in a few days.  Right?  Right?

The dog that trots about

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Once upon a time my mom and I had a poster with a bunch of sayings on it and one of them was, “The dog that trots about finds a bone.”  A quick google search of this attributes it to either Golda Meir or gypsies.  Whatever.

I love my job, and the people I work with, and I’m paid well, but ugh.  The nights are playing such hell with my body, and it’s only .6 FTE, which means less in the way of benefits.  Certainly if I can wait around long enough I can get a full time gig there, as it is seniority based, but the question is, can I wait that long?

At this point it’s a perfectly adequate job, we’ll manage on it, but each week is an ordeal of hoping I can sleep the day after a night shift, and living the topsy turvy life is not coming easy.  Perhaps with some practice…

In the meantime, I am Facebook friends with some of the people I’ve worked with at MegaCorp Mental Health, Inc., and got a heads up that a full time job was in the offing.  So I applied for it.

There are a few conditions that must be met before I’ll consider it, but looking is free, and I’ve put in a lot of time at MegaCorp.  None of that means anything on any official level but it’s familiar territory, at least.

And as someone said to me recently, if opportunity is knocking, shouldn’t I at least answer?

They like me! They really like me!

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So I got hired at .6 FTE at one of the places I work oncall.

I have to tell you, friends and neighbors, the relief I feel is almost palpable.  Sweet, slightly sticky, and smelling faintly of vanilla and cinnamon.  Yes, relief is basically the emotional equivalent of a Cinnabon.  No longer will I have to scrounge up three shifts a week, or worry about getting sick and missing a whole week of work (which happened recently and cost us hundreds of dollars).

It is a night shift, which isn’t ideal, but on the bright side the shifts are on good days for me schedule wise and there is that tasty five-bucks-an-hour differential to wallow in.

I’m just going to blow my own horn for a minute too.  Today I finished up my training in admissions.  Admitting a patient to detox is really not that terribly complicated, in my opinion.  You fill out some paperwork, sit with the client and ask a shitload of questions, and then decide whether to medicate them for any of their detox symptoms.  You send them back to the special waiting room (where they watch movies on a nice big flat-screen tv and are given snacks or lunch while they wait) and finish their paperwork, call report to subacute, and hand their finished documents to the clerks who put it into a chart for you.

People, this is not hard.  The most challenging part is remembering to put their vital signs in about four different places.  Oh, and placing TB test injections.  It ain’t rocket surgery.

Generally, I was told, a newbie such as myself would be given one intake to do and depending on how badly they screwed that up, they might — might — be given a second.

Naturally, because I am Slightly Above Average ™, I did three.  And still got out of there half an hour early.  Even with the construction-snarled traffic that made me twenty minutes late getting back from lunch.

But, it’s not like I’m a real nurse.  🙂

It’s Tuesday

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Which means The Game is down for maintenance.  Rhonda is home, having been called off, and Elder Spawn is here a day early, so we three sit jacked in to our laptops in full TimeWasting mode.

We have errands to run today, and there is always yard work to do, cleaning, tending to the tedious upkeep of the home, etc.

When it gets to be a drag I remind myself how much more rewarding it is to keep up this home, with its yard and its three bedrooms and its laundry facilities, than it was to swill out the cramped, crappy apartment we squeezed ourselves into for that last year of nursing school.  Let us be grateful for that which we have, for so often it is better than what we used to have, not to mention we are lucky to have anything at all.  (Don’t make me tell stories about that cardboard box we lived in, in the middle of the intersection, and how it was up hill both ways in the snow and all that)

Tomorrow afternoon we depart for camp, wherein we shall be Camp Nurses, that our offspring might play in the healthful and fascinating out-of-doors.  We’re trying to remember why we thought this would be fun, in that we must all sleep (ha!) in the same room and there is (gasp!) NO INTERNET, but since we’ve committed to it I guess we should see it through.  I understand we might sit around the table manipulating small pieces of pasteboard emblazoned with arcane symbols, which strikes me as an odd pastime for a church camp, but we’ll just see how this “cribbage” thing works anyway.

And now to pack the several hundred items required for Adequate Parenting, including but not limited to SPF 9billion sunscreen, first aid kits (we are nurses after all), flashlights, jellybeans, flyswatters, crayons, graham crackers, bowling balls, dry socks, turnip twaddlers, yogurt squirters, etc.  Wish us luck!

In case you wondered

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What a detox nurse does…  I work for two different types of detox programs, one is hospital-run and one is a subacute rapid detox serving basically anyone that comes in the door.  It’s run by an agency that serves the homeless and disenfranchised of Metropolis.  This agency provides housing and all kinds of other assistance; detox is just one of the many services they have.

I haven’t really gotten a good feel for who comes to the hospital-run program and why, or how, or who pays for it.  Nor am I really sure who pays for the subacute rapid detox either, except that they request insurance information from anyone who has it.  One must also be a resident of Metropolis or at least of its state, or else pony up nearly a grand up front.

Let’s just imagine a day in rapid detox, shall we?

Firstly, if you want to avail yourself of the detox you must begin by appearing in its lobby at an appointed early hour each morning, consecutively.  It is considered a measure of your motivation that you continue to appear, day after day, until you get in.  This may take a few days, or may occur very quickly if you meet certain magical parameters: you are more than a little sick from detox (dopesick, they call it, for the opiate users, or going into DT’s if you are an alcoholic), you have nowhere safe to go, you are prone to seizures or DT’s.  I have attended this call and seen a few very twitchy people in the lobby, as well as the huddled masses that mostly just look tired and like they don’t feel that great. I have seen others taken away in ambulances to be stabilized before they can come back to their bed at the detox.

Say you make the magic cut, and finally you are in.  You are taken back to an assessment room and if you are quite ill, once you sign the consent form you may be medicated immediately.  Otherwise you are assessed, a history is taken, vital signs, urine drug screen.  You are asked what exactly you are detoxing from and how often/how much you have been using, as well as when  you had your last fix/drink/whatever.  You are given several opportunities to get rid of any substances of abuse that you might have on you; should you fail to do so and it is found among your things back in the unit, you will be escorted out immediately and may not be permitted back in the future.  Once you are finished with the assessment process, you are taken to a shower and given clean scrubs to wear.  Your clothing is laundered while you are in the program so you can leave wearing clean clothes.  For some of the clients this is a nice luxury.

On the unit you are expected to participate in groups, although you may be excused from them if you are too sick to attend, as many people are in the first couple of days.  This program utilizes acupuncture and it is mandatory for all clients, which I find very interesting.  Otherwise the day goes like so:  your vitals are taken at 8am or so, and based on an assessment of your symptoms you may be medicated according to a protocol.  Alcohol detox is done via Librium dosing, while opiates are detoxed using Suboxone.  Depending on your dosage, you may be re-assessed in as little as one hour.  All day the assessments take place and the medication is handed out accordingly.  Meals are provided as are all toiletries and basic needs.  The beds are in large dorms, all the men in one room and all the women in the other, no real privacy.  It’s not luxurious but it’s quiet and it’s clean.

Lest you consider that this is cushy for the addict, let me tell you: this just rounds the corners off the detox.  It’s still miserable.  They sweat, they shake, they are nauseous and vomit and have diarrhea.  They get monster headaches and high anxiety.  It would be easier for them to go out and use, that would take all of this away, but they are here trying to kick it.

I have met people who have been drinking a fifth of hard alcohol a day for years, who have been shooting up heroin for months, who slept last night in a dumpster and apologize for stinking; who have lost their homes and their children and their spouses and their jobs and their health.   Some of them try to pursue every medication we can offer and argue with us, others just look tired.  Most of them have  a little spark of hope.  Some will go on to inpatient programs or outpatient programs.  Some are trying to get their kids back from the state.  Some of them are just young kids who made some bad decisions and are not too far into it yet, others are older and more beaten down — but they still have hope.  It’s amazing, they still have hope.  They have guilt, and shame, and fear, and sorrow, and depression, and hope.

My job is to be kind, with an eye for fairness, to assess and to medicate and to monitor and to keep them safe.  I don’t have to judge them for being addicts, although a healthy dose of reality is not considered to be out of bounds.  I heard a young, hipster heroin addict tell another nurse she should not eat meat, “It’s, like, so not healthy for your body.”  “Oh,” she responded, “but injecting heroin into your body is okay?  Yeah, I thought so.”

Many of the staff, from nurses to techs to janitors to clerks, are in recovery themselves, from alcohol, from drugs, from gambling, from some combination of these things.  They speak of it frankly and without shame.  I feel almost at a disadvantage sometimes, because I grew up pretty sheltered and pretty disinterested in drugs and alcohol aside from some (occasionally rather spectacular, it must be admitted) social drinking.  Hell, I don’t even smoke.

Once you’ve made it through the protocol for your particular substance you are considered stable and will have met with a counselor to consider your options from here.  Those counselors do their best to line the clients up with services of some kind after they leave the detox.  Most clients don’t make it all the way through the program on their first shot; most will leave once they feel better, but many of them will return several times, each time staying longer, each time staying clean longer after leaving.  Some will never stay clean and will return occasionally when their misery exceeds their ability to medicate it away on their own.   The clients are almost without exception very polite and grateful to be there in detox.

Am I  a real nurse?  Well, I’m helping people who need help.  You be the judge.

Coming to terms

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So when I was in high school, lo these many eons and centuries ago when dinosaurs roamed the earth, I went to a magnet school.  The program I went to was a health occupations program, and at the end of that particular ordeal I announced that I was neeeeeeeever gonna be a nurse.

And twenty-odd years later I entered nursing school.

Okay fine, things change.  It’s all good.

And while I was in nursing school, people would ask me if I was going to be a psych nurse.  After all, I had all those years of working in community mental health.  And so I announced that I was neeeeeeeeever gonna be a psych nurse.

And then I graduated, and a few things happened.  First, I put in about a bazillion applications, but thanks to the crappy economy there are not a lot of internships and there are a lot of hiring freezes and so forth.  New nurses, aside from the lucky few and those with connections and so forth, generally have to be satisfied with jobs in long term care and that sort of thing.  I graduated with honors, and my practicum was a regional burn center — and that’s a hard environment!  But I couldn’t even get a phone call, an interview, anything.  Just emails, “Thanks but no thanks.”  It was like I didn’t exist, and all the work of the past three and a half years was just so much spitting in the wind.

Then I began to hear the complaints of my fellow students who did land jobs in long term care and med/surg nursing.  The patient load is all but unmanageably heavy, they are rushing around for 12 hours at a time terrified that they are missing something important.  Orders get missed, they can’t spend any time really learning about their patients’ issues, and more than one has told me that they hate their job.  But also that they suspect that all nursing jobs are like this.  It’s hard work.

I am no stranger to hard work and I’m not lazy.  I’d rather be busy than not, and I like the idea of doing something worthwhile.  But there has to be a limit.

Finally I started applying for those jobs that I had not really considered before, and thanks in part to my lengthy work history I got a few interviews and — at last! — a couple of oncall jobs.  One of them is psych nursing.  Some things I’m not that keen on, such as 8 hour shifts instead of 12, but the pay is surprisingly about the same as a med/surg hospital job, and I’m finding that… well… (whispers) I’m kind of enjoying it.  There isn’t really a lot of downtime, it’s a busy environment, and managing psychiatric and detox (and both) patients is not a lot of fun sometimes, but it’s important work.

It turns out that I’m a psych nurse.

Well, At Least I Have Options.

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So, I didn’t get that full time position I was hoping for.  It was down to me and one other person, and the other person got it.  Probably they had more nursing experience than I do, which is to say “any nursing experience at all.”  The person who interviewed me could not have been nicer, and while I’m really kinda bummed, I’m also glad I have other options.

I was unable to stay up all night studying for my drug test — and many thanks to those of my friends who suggested I do so — due to having a sick kid on my hands.  (The elder spawn woke up suddenly hollering and blubbering with what later became fairly clear was a rapid and unpleasant stomach virus.  She is still running a temperature but appears to be doing all right now.)  Nonetheless, I managed to pee in the cup with fair accuracy and will probably begin orientation at oncall position #1 in about a week.

Tomorrow I will have orientation at the other oncall position that I accepted, and Saturday I’ll be instructed in How Not To Get Beaten Up By Patients.  Always an exciting subject! And one dear to my heart, as Not Getting Beaten Up is among my very top priorities in life, particularly at work.

On a completely unrelated topic, it is raining to beat hell outside right now, like blowing-sideways-gullywasher-rainstorming.   The Very Loud Frogs that live a street over are singing their approval of the weather.  I love this place in the spring.

Employ me, O I implore you

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So, I’ve taken an oncall position — thus earning me the right to say, I Am An Employed RN.  Never mind that I haven’t started.  I pee in the cup tomorrow.

There’s a lot of peeing in cups when you’re looking for a job as a nurse.  I’m okay with that since I am not particularly interested in abusing substances (other than chocolate which is still perfectly legal).  They teach us in nursing school that nurses are at somewhat higher risk than the general public for substance abuse issues due to high stress, availability of substances, etc.  This doesn’t frighten me a whole lot since as I said, it’s not interesting to me.  I don’t even take most of the painkillers actually prescribed to me.  And I’m one of those people who hates to get in trouble.  God, I’m a pain in the ass goody two shoes…

Today I’m supposed to be getting a call from another place that is going to offer me a position.  Not sure what kind of position, or the salary, but I’m supposed to attend an orientation on Wednesday which does inspire a certain amount of confidence that I will be offered a position. ~~Update: I am now an oncall at this place too, which is what they hire new nurses at. Yay me! ~~

And I’ve begun the complicated and arcane application process at the local VA hospital, which involves calling someone, getting an email, filling part of it out and submitting it online, then printing the attachments out (including the one you filled out online) and submitting the hard copies by mail with your transcripts (if your GPA was above 3.5, which mine was YAY ME)  and a note from your mother.  (Okay, not the note from your mother.  I was just kidding about that.)  Then you wait for the powers that be to decide you are worthy, as with any other application process.  I’m thinking of lighting some candles, burning some incense, doing a little mojo dance, whatever it takes.

You know that “nursing shortage” they’re always talking about?  Yeah, not so much around here, where there are several nursing schools churning out new grads every three months, and not so much right now with the Current Economic Climate being what it is, i.e. a giant wad of crapola.  Hospitals all want you to have a year of  acute care experience but nobody will hire you to get the experience you have to have to get hired….

Nonetheless, I am employed, and perhaps full time employment will be forthcoming.  Kindly cross your fingers and spit into the wind for me, or whatever it is you people do.  You’ll be glad you did!  Or at least I will.