[bey-thos, -thaws, -thohs]–noun, 1.) a ludicrous descent from the exalted or lofty to the commonplace; anticlimax.
Throughout my internship I was often given the most difficult patients on the unit. And as I blossomed from a fragile seedling root-bound in a plastic sprouting tray to a plant hardy enough for transplant, my preceptors stepped further and further back, allowing me to manage my patients, my way, developing my practice. At the end I was virtually on my own as my preceptors often were called to fulfill other functions on the unit.
And I did well. I managed some truly tough assignments, and my patients were the better for my care. I admitted countless CABG's. And those turned into redo CABG's, or extremely sick CABG's. And then it was IABPs, and LVADs, and impellas, culminating with admitting heart transplants and double lung transplants. On my own.
My unit and my internship experience turned out to be everything it was advertised to be. I was excited when I came off orientation to be on my own, ready to save the world. Or at least whatever train-wreck heart surgery came out of the OR suite that day.
Our unit is very busy right now, and higher acuity patients than usual. Right now we have 2 double lungs, 2 heart transplants, 2 LVADs, and an impella. One of the heart transplants went on ECMO yesterday, and there is another heart transplant, and lung transplant scheduled for today. This is on top of the run of the mill CABGs. 21 beds, 21 patients.
With all this glorious acuity, for the past 3 nights I've been assigned...
**drumroll please**
A blind VAT with cancer, on the unit for 33 days because he has a creatinine of 7.5 while making copious urine, pneumonia that won't heal, and he can't hold his sats above 85% without a venti and nasal cannula.
And a recent stroke victim who had an AVR and came down with a serious case of pump-head. He's so unpleasantly confused he's pulled nearly every tube and line possible, while restrained. He's been on the unit for almost 3 weeks now.
And for the 3 weeks I've been off orientation? Exactly the same kind of patients, night after night.
Grind your soul into the asphalt slightly-too-sick-for-the-floor confused med-surg patients. EXACTLY the kind of patients I busted my ass to get hired into a high acuity unit to AVOID.
I get that I'm new. I do. I really, really do.
But come ON.
Nursing is nursing.
ReplyDeleteHaving worked in every unit but ob/gyn and surgery it really is not that much different.
Med/surg, tele, oncology, ed, and the icu's. They will all keep you busy. Enjoy the patients who sound relatively easy to you, because next week you will be saying how did I end up with these two train wrecks.
When I was travel nursing I often was assigned the admitted ED patients / pts no one wanted for similar reasons.
ReplyDeleteLow man/woman on the totem pole is a frustrating place to be, my friend. Sorry you're not being challenged to your abilities!!
:|
I know exactly what you mean. When I was a brand new ER nurse, I constantly got assigned to "the hole", a group of rooms where the slightly too sick for the floor, confused med- surg patients were! I feel your pain.
ReplyDeleteIt will get better!
Here's the thing: there is still so much that you don't know. And I mean this with all the respect you deserve. Your unit is actually doing you a favour -breaking you in gently. There is a BIG difference between managing a complicated patient with your preceptor as a back up (regardless of how infrequently you used them) and being completely on your own.
ReplyDeleteMy unit threw me into the deep end, and left me on my own to sink or swim. I sank. Level 1 Trauma Centre; Pediatric ER; ICU patient; Intubated; actively dying. And not a single person to help me out. I left there in tears, vowing never to return.
Take the opportunity to become more comfortable with the paperwork, the patients, and your co-workers. Yes, it may seem boring now, but in a year or two you'll realize the boring patients are the ones that keep you sane.
I like what Jessica has to say, she sounds wise.
ReplyDeleteYour time will come to shine XY, just be patient. What's funny is I have a feeling you're going to be biting your words come next week, and you get those two train wrecks like NPO says. :-)Keep us posted.
You're earning your stripes, hun. We all have to. Sucks, but it's true.
ReplyDeleteYour turn will come. Promise.
"I get that I'm new. I do. I really, really do. But come ON."
ReplyDeleteDefinitely understand what you feel. But every nurses happened to pass to this stage, eh. :)