Saturday, March 28, 2015

Night shift

Nurse. The word conjured up such different images before I actually became one. I pride myself in working my way up, gaining experience as a nursing assistant, phlebotomist, LPN, RN, and now BSN. You may not know what the different titles mean or represent.  Simply put it boils down to level of education. Nursing assistants require a quarter at a technical college; whereas, a BSN has competed a bachelors degree at the university level. The education as it applies to nursing goes far beyond that as well. 

I've mentioned differences between the hospital I spent 14 years at in the Pacific Northwest(PNW) and the hospitals I've worked at here in Australia. One thing that has required a fair amount of getting use to is scheduling. In the PNW I was hired to work a specific shift such as day(0700-1530), evening(1500-2330) or night(2300-0730). For the majority of my professional career I worked day shift. I also had a set schedule which would repeat itself every two weeks. Here the sifts are early(0700-1530), late(1300-2130), and night(2100-0730).  There are two nurses who are permanent staff in my ward who have set schedules. There are also a handful of nurses who only work night shift. As for the rest of us, the schedules change monthly and its always a mystery as to what shifts you'll be working. It's not uncommon for nurses to work a late shift followed by an early shift followed by a late and then another early. 

This week I worked a late followed by two night shifts. I'm used to a system where seniority means you have the benefit of not having to work nights. It's okay here though because everyone does it. There are no favorites all the nurses have to do their time. It's also nice too because in the PNW there was a gap or split between shifts. Those who worked evenings often had no clue what the morning routine and struggles were, just as those who worked days couldn't relate to the struggles of the night nurses. Here there is a great sense of "team" in part because of the bed layout... having six patients in one room means several nurses go in and out of that room every day and get to know a little bit about all the patients weather they are designated to each other or not. 

Working every shift also contributes to this team environment. You know the struggles of each shift because you work each shift. It's also fabulous that the two hour overlap between early and late shifts means that there's double the staff during one of the busiest times of the day. If the nurse working early had a rough morning she'll at least be able to get a lunch break when the late nurse arrives and can attend to any documentation she may have had to delay giving priority to hands-on patient care. 

I have to admit that working night shift makes me feel old. After a couple night shifts I get pretty worn out. Patients don't sleep through the night... Who knew? And when things digress, they do so quickly. I'm thankful I had a good stretch of shifts. 

•••       •••     •••
On my first night I cared for someone with tumers that don't have a good prognosis. This person was in good spirits and said "I'm not scared to die. I've got wonderful people in my life and I'm surrounded by love." There was calm in the voice speaking this. They were not words spoken to persuade their owner into believing them. They were truth. Unfortunately, sleep evaded this person until around 6am. 

Now this is where I appreciate what I learned and experienced while Sam was going through chemo. 

This patient was to have a potentially invasive procedure at some point during the day. It's expected that patients going for surgery shower some time during the night before their surgeries. Showering this patient hadn't even crossed my mind due to the nature of the procedure. However, after being told repeatedly that it was a rough night and sleep didn't arrive until a mere hour prior, the nurse working the early shift felt the need to wake this person and insist they get out of bed to shower. I was beyond irritated and later found out I wasn't alone in this irritation. 

I'm glad I've learned to be able to assess and prioritize what to do for those in my care. I don't want to say "bend the rules," because it's not, not really. It's more being able to be human and not so hard nosed and superior as to ignore humanity. If nothing else, I learned this first hand from how different nurses responded to different situations that came up when Sam was an inpatient. My practice improved after being on the receiving end in the healthcare system. 

•••     •••     •••
That night I had taken the train to and from work. On the way home I rested my head on the seat in front of mine and dozed off only to wake with each stop. I scooted next to the window, rested my head upon it and only woke myself up three times before arriving at my destination. There were a couple times it was my own snoring that woke me. I was too tired to be embarrassed and chucked to myself thinking of how some people appreciate church services in the same manner. 

When I reached my destination I was thankful I hadn't missed it. The passenger who had been sitting a few rows ahead of me turned and stared at me before turning to disembark. I can only assume my snoring might have disturbed him too. It actually makes be laugh a bit. 

•••      •••     •••
On my second night I learned this patient who had fasted and been awake all night only to be so rudely bossed about in the morning ended up not having the dumb procedure anyway. Instead a meeting of loved ones and many doctors took place to discuss things. When I made my rounds and saw this person my heart ached. There was no longer a calm. Instead there was an electricity in the air, urgency, fear, unrest, and negativity lingered heavily. Due to my patient load(16 patients: 2 nurses) and some other "fires" that needed to be priority, it took a while before I could address the whole person and not just this patient's physical pain.

We had a good talk. It's hard. You know, my Grandma Lois wold come with Auntie Marge and visit Sam in the hospital and ask "Why not me? I've had a full life. I'm ready." Sam healed and Grandma's dementia took more and more of her away. When she died my heart ached so badly even though in my head I knew she had been ready. I tear up missing her even though I know she's in heaven free of earthly struggles and pain. 

I'm thinking it might have been similar for this person. One can be ready to leave this world; however, our loved ones may not be ready to say goodby. Seeing their pain and struggle to come to terms with this can evoke quite the internal struggle. End of life issues are hard enough, compounded with exhaustion and pain(which worsens with anxiety) it is really not a great situation. 

I was so thankful to be able to take the time to listen and comfort this person and not just address pain or carry out treatments. Calm rententered the room and a short time later sleep came as well. This person woke once during this longer second night shift. When walking back to their room, this person paused, caught my attention and said "thank you." It wasn't the phrase one uses when going through the grocery check out or when a door is held open. It had a much deeper meaning which was not wasted. 

At various times in my career Ive pondered if I made the right career choice. On bad days I've stayed awake due to lingering stress and wondered what other career could I possibly do, picturing myself making chocolate treats in a beachside shop, selling hand made goods, or moving to a cabin in the mountains and just spending the days in the sun watching the kids play...daydreams are always sunny and shiny. Right? Thankfully nights like last offer confirmation that I'm where I should be. 

Thursday, March 26, 2015

Good news

Here's the new addition to our home:

Not pictured are two leaves to expand the table. A table may not seem like much; however, it makes the dinig area feel warmer. It just makes it feel more welcoming and home like. I was joking with Mike that we're touring adelaide via the local classifieds. 

Due to the cooling weather we've purchased some cool weather clothes for James. The new shirts were tossed in the wash. His new hat stayed on his head until swim lessons. 
Who needs a shirt when you've got a good warm hat, right?!?

I had a parent teacher conference with Sam's teacher this afternoon. He shared some of her writing with me and said he loves how creative and expressive she is.

Being in this 3/4 class has been fabulous so far as it is just the right challenge for her. 

I spoke to the teacher about her age and grade assignment (3rd). As they only initiated the age cut off for students starting in 2014 she is the oldest 3rd grader and 6 of the 4th graders are younger than her. He looked at her reading levels and spelling age and will be talking to the powers that be to see if she can be classified as a 4th grader. This news made her evening. Hopefully the decision will be made that will be the best fit for Sam. 

Tuesday, March 24, 2015

A few good finds.

It was a lot of work, but I did get Myles' quilt top finished in time to clean the house before our quarterly home inspection. 

I'm pleased with how it turned out. Myles'favorite color is orange, so the focus fabric was a no brainer; however, the background fabrics were a bit tricky as masculine fabrics are a challenge to find. 

I had been hoping to get more done on my stretch of days off. Somehow motivation and energy evaded me until I realized I hadent taken my thyroid medicine for about three weeks. Perhaps that is why I've felt the need to sleep nearly 10 hours a day and haven't lost as much weight as I'd hoped being on this diet program and overall feeling blah. 

To James' great disappointment our recient trip to the various consignment stores did not yield any new toys. We did manage to find a couple other treasures. Daddy found some new books and I found two twin wool blankets and a jacket for Sam. 

The wool blankets were in "like new" condition. I paid $12,50 each which was a no brainer for the quality. As we're expecting visitors this winter I'm sure they'll be quite useful. 

Summer is certain on its way out. It's funny how relative temperatures can be. For the first time in months our windows and doors are all tightly shut. My sister in Michigan insisted this is not cold and then sent a scream snapshot of what the wearer is like there. 
I can't argue with that. 

In September I picked up some new long sleeve jammies for James as they were on clearance to make room for summer merchandise. I reciently got them out and prewashed them. He was so excited he could barely wait for them to dry. Last night he excitedly put on his new jammies. 
It reads, "HOW DO YOU TUCK IN A SUPERHERO?" To say he loved them would be an understatement. 

Sam was thrilled with her new jacket from Salvos. It's down and quite light. I'm hoping it will be warm enough for her this winter. I think it'll be fine though as Sam is one who would prefer to be a bit chilly over being too hot anyday. 

As per their usual, even though both kids had been tucked in, 40 minutes later this was the scene. 
I've tried every method I can possibly think of to get the kids in bed and settled at a reasonable time. I can only assume their bedding is lined with Teflon as tucking them in just doesn't stick.