The Intensive Art

My Europe trip is drawing ever nearer. I feel as though I’m in limbo; refusing to start any long-term projects, or even short-term projects for that matter. I still need to take my ACLS course (a very expensive and time-consuming task that has been hanging over my head for months.) While ACLS is not mandatory on my unit, it is certainly expected. Actually, it’s really not even expected so much as socially unacceptable to not have it under your belt.

I also need to finish my critical care nursing certificate. All I have left is a case study (approximately ten pages), and several self-assessment exercises and papers.

Yes, all of this is being put off until after my Europe trip. It’s amazing how much life must be put on hold for a five week trip. But, they must be finished and completed eventually. After all, since I’m not “popular” in my ICU, I need to be certified. But that, my friends, is a completely different post–perhaps to be entitled “the rationing of knowledge based on popularity.”

Perhaps that could even be a Masters thesis? “Cronyism versus Meritocracy in nursing”

Yes, I definitely have a lot to say on the subject.

I’m also considering taking some liberal arts courses through a distance education university. I’m craving some humanities: philosophy, art history, languages. All of these are so severely lacking in nursing school. These are the courses that make university university. I feel cheated, and am thankful for the half a degree in humanities I did before getting my bachelors of nursing.

And, on an increasingly random note, I finally certified for PA catheters a couple months ago. Can I just say, I think these things are absolutely freakin’ cool! I truly wish they weren’t going out of fashion so quickly.

I guess I’m just a numbers type of guy. I love “nursing the numbers,” however appropriate it is or is not. I love watching the monitor: blood pressure, heart rate, PAP, wedge, CI, etc. and adjusting, readjusting, discontinuing, and adding different medications. I love the slight tweaks and changes made in a desperate attempt to get just the right numbers.

I never have been, and I never will be good at the interpersonal nursing. Then again, it is less appropriate for a man to be hugging people, or putting his arm around them, or even patting them on the shoulder and saying, “there there.”

I digress though, because that, too, is an entirely separate post as well.

So, simply, I felt a need to post on my blog. I didn’t have a subject in mind when I started writing–I just started writing. That is why I ended up with a scattered and random post.

But heck! At least I posted!

This is in no way a promise to start posting regularly again, but I felt the need to post some sort of update. I’ve lost my inner drive to blog. I may get it back someday, and I may not. To anyone out there still listening, I give you a great big “hello!”

LIFE

I have moved out of my apartment and into a condo a short ways out of the city. I bought it at a very expensive price–and then the economy tanked. My condo is now worth $35,000 less than I payed for it. But, in general, that is my luck when it come to finances. Perhaps I could charge money to disclose exactly what financial decisions I make: what stocks I buy, what I’m investing in, where I’m buying real estate etc. I’m sure people would pay a mint, knowing that if they do the exact opposite, they will be millionaires.

But I love living out here in this little town. I love my thirty minute country drive past baby cows and marshy ponds to get to work. I love the freshness of the air and the sweet smell of farmland. Unfortunately, I miss the city life. I truly was meant to live smack dab in the middle of a bustling downtown. I will survive.

TRAVEL

Next week I am going to Victoria, BC (otherwise known as one of my favorite places on the planet). It’s just for a few days, but I hope it will rejuvenate my body, spirit, and mind. I can’t wait to watch the crashing waves, and browse the quirky shops. I look forward to breakfast at Rebar and lunch at the blue carrot cafe. Whale watching and ghost hunting are definitely in order.

In even bigger news, I am planning a six week whirlwind tour or Europe starting in October and lasting six weeks. This is an absolute dream trip. The excitement that it stirs in me is absolutely indescribable. I will be going to England, France, The Netherlands, Germany, Czech Republic, Austria, Italy, and Spain. I will be traveling backpacker style with lots of trains and hostels involved.

WORK

Well, I’m hating/loving work these days. I often feel incredibly incompetent–even after a year. I have given up on feeling adequate at my job and embraced the feeling of being completely useless compared to the doctors and senior nurses. Perhaps one day I will think to myself, “holy crap! I think I’m actually capable of doing this to the standards of my coworkers, charge nurses, and educators,” but that day seems to be getting farther and farther away, rather than closer.

I’m still working in a 25 bed ICU that cares for Trauma, burn, neuro, and med/surg patients. I think part of the difficulty is that, since the ICU lacks any sort of specialization, the amount of knowledge and learning required seems endless. The more I learn, the more incompetent I feel.

Well, that’s about all that’s going on. Hopefully I won’t wait so long to update!

“Have a good break!” I said, half meaning it, half wishing I didn’t have an extra patient for the next hour.

“Oh wait!” My break buddy said, turning on foot, “I have the code pager.” She held it out toward me expectantly, but then hesitated and pulled it back toward her, “oh wait! Are you done the training? Are you certified?” She asked. 

“I sure am!” I said proudly, “I’d be happy to hold it!” It was true, it did excite me. The novelty hadn’t worn out yet. I took the pager from her so that she wouldn’t have to worry about it while she was on break.

I had been certified to be a part of the code blue team for a couple months. I had carried the pager for many twelve-hour shifts, but it had never gone off while in my care. I was starting to joke that if all of our beds were full, I was the obvious choice to carry the pager. Nothing ever happened while I was on the code blue team.

So, I clipped the pager to my scrubs, displaying it proudly, and went on with my job. I was sure there was no chance a code blue would be called. 

Overhead, I heard the rapid response team called. I took note, since these “pre” codes often turned into full blown code blues.

About five minutes later, at approximately 01:00, in between dumping urine and typing the amount into the computer, the pager cried out.

Beep beep beep beep beep beep beep beep 

I slowly turned the pager over–It was flashing green. 

Flash flash flash flash,

The pager said: Code blue, unit 138

“Code Blue Unit 138, Code Blue Unit 138″ The hospital speaker system shouted. 

OH SHIT!!! That would be me!!!

I turned around and ran toward the crash carts, passing the unit clerk who was turning the key at her desk to lock all the hospital’s elevators, I heard the unit clerk’s familiar voice calling out over the PA system, “Code blue Unit 138, Code blue unit 138!”

I was met by two RTs, an NA, and two other RNs at the crash cart. I started the timer and grabbed the clip board with the blank forms for charting: a little too eager to ensure that I would be the charter, and nothing else.

Another nurse unplugged the cart and someone else grabbed the elevator keys. And we were off! At some point, the junior resident had joined us.

Now I was calmer. From here on in, all I needed to do was chart. If for some reason I needed to do more, I knew exactly what to do and when. I just had to go into automatic mode. 

The elevator was full of laughter as we all rode up to the thirteenth floor with the crash cart. Nothing like a little levity to diffuse a crisis.

We arrived on the unit, and, guided by the floor nurses, turned the corner into the room. The rapid response team was already hard at work. CPR was in full progress, and the defibrillator pads and ECG leads from the rapid response team’s crash cart had already been attached. 

“Wow” I thought to myself. “That floor nurse is giving some of the most impressive CPR I’ve ever seen.

I saw another nurse, a young woman, possibly 23 years old. She was absolutely stunned. She moved like the air was made of drying cement. Her eyes were red as though she had been fighting back tears. She looked on in horror. I knew she was the patient’s primary nurse. I have been in her shoes before. It’s horrible.

I looked down at my blank page. I had gone through this a million times in my head, but I was still drawing a blank. What the hell do I write? Yes! I remembered. Start with the time we arrived, and the elapsed time on the clock. 

He was already intubated. Later I discovered that there just happened to be an on-duty anesthesiologist on the unit when the code was called. I’m sure he was intubated in no time.

“What was the initial rhythm?” I asked the rapid response team?

“Asystole”

“Shit” I thought as I checked it off. 

The ICU fellow, who was our  code leader had also arrived before us and started ACLS, “Can we check the rhythm again? Stop CPR.” he asked, incredibly calmly.  

The rhythm looked like sinus tachycardia

“Someone check for a pulse.” I saw several fingers reach for different possible pulses.

There was no pulse.

“Looks like we have PEA.” The ICU fellow stated, “Resume CPR”

One of our nursing attendants took over CPR–it was faster and harder. I suddenly realized how quiet the room was. Just the quick, staccato THUD THUD THUD of the CPR. 

I dutifully wrote it all down, along with when meds were ordered and when they were administered. The first half of my charting was ridiculously messy with webs of arrows, crossed out items, and illegible scribbles. By the second half I had created a system (how’s that for adaptability!) and things started looking great.

I turned to the primary nurse, still in shock, “Have you called the family?” She shook her head no, “Have you called his attending physician?” She shook her head no again.

Another nurse behind her said, “I’ll call both.” She said it with a sense of duty and ran out. She must have been the charge nurse, although she wasn’t possibly any older than the primary nurse. I realized at that time that there was an audience of all the unit’s nurses standing there watching us.

I heard the cart nurse yell out, “Can someone prime me a normal saline line, mix a bicarb infusion…and I need some flushes!” I saw them scatter.

Orders kept getting called out calmly, “epi, bicarb, atropine. ” And I kept writing them down.

One of the floor nurses asked me where she knew me from. I showed another my neat combination pen/pen light. A couple jokes were told. Again, levity in a crisis, but it was still surreal. 

“Stop CPR and check the rhythm.” It looked like sinus tachycardia. 

“I feel a pulse!!!” Someone cried. It was the RT who had been bagging the patient the whole time. His hands must be cramped! He had reached down to check the carotid artery.

“Me too!” Shouted someone with their fingers in his groin. “I have a femoral pulse!”

“Geeze,” said our ICU fellow, “I was just about to call it. Someone call the ICU and make sure our bed’s ready. How long was he down?”

“Almost fifteen minutes.” I croaked. I knew this man was very old and chronically sick. I was secretly hoping we could let him go and spare him the torture of ICU. 

I heard the breaks on the bed flip off, and away we went. ”I need the primary nurse to come with us!” I yelled out. 

“OK” the primary nurse said nervously. I knew just how intimidating it was to come down to the ICU and give report. Especially on night shift when you have ten patients and you’re expected to know every last detail about this one patient–which you never do.

We silently travelled through the bowels of the hospital. The only noise was me continuing to question the primary nurse. “What’s the primary diagnosis? Allergies? Was it witnessed?”

Arrival back on the unit was like returning from war; everybody’s heads popped out of their bedsides to see what was coming down the row, curious about the code blue. The rest of the shift was spent telling the story over and over. ICU nurses are such a curious bunch.

We settled him into bed.

“I can’t feel a pulse!” Someone says. 

“Shit!” I yell.

“No no no, I have a femoral pulse.”

“I think I will make sure the code cart is at the bedside.” I say.

“Good idea” Someone else said as I ran for the cart.

I gave a report to the patient’s new nurse, detailing the events of the code. It was at this point I started to feel amazed that it was me giving report. A year ago, as a floor nurse, I dreamed of being on the code team, but now it was a reality. It was still incredibly surreal.

And then I went back to work as though nothing had happened. I inputed the amount of urine I had dumped just before the code was called into the computer. 

I gave the code pager back to its rightful owner.

Twenty-four hours later, he still hadn’t woken up. Anoxic brain injury was clearly present and extensive. Studies showed a massive heart attack, with barely any cardiac function remaining. Treatment was withdrawn and he died quietly and quickly.

Today I found his obituary. It was possibly the smallest obituary I have ever seen. Still, I cut it out as a keep sake to remind me of my very first time  I was called to a code blue.

It is a right of passage in my intensive care unit to become a member of the code blue team. Some people avoid it like the plague, and others crave it like cold water–living and thriving on the experience.

In my hospital, the code team is made of employees of the ICU itself. Three nurses with “lighter” assignments are given code pagers that are clipped to their scrubs and worn as a status symbol for all the world to see. Having the code pager proves to the world that you are no longer one of the new ICU nurses, that you have survived many stressful months of training, and that you are deemed trustworthy and knowledgeable enough to deal with an absolute crisis.

When the pager goes off, you simultaneously hear a hospital-wide announcement that a code blue is being called. The announcement and the pager both give you details on exactly where the code is taking place. Also at the same time, our unit clerk receives a phone call from the switchboard with the same information, which she/he announces to the ICU. The unit clerk also has a neat, fancy key that she/he inserts into a keyhole right at the front desk. With one turn of that key, every elevator in every part of the hospital immediately drops to the main floor and stays there, urgently waiting for the code team to arrive.

The three nurses with pagers drop whatever they are in the middle of doing and run. All of the hospital’s crash carts live in the ICU, so that is the first stop. A code timer on the crash cart is started, the elevator keys are grabbed, and then the team runs with the crash cart to the code blue.

Once they arrive on the floor, the code team is directed to the proper room, which is already cleared of furniture, equipment, and roommates. The code team truly doesn’t know what they’ll find until they turn the corner into the patient’s room. It could be a full blown cardiac arrest, or an infinite number of other possibilities: exsanguination, seizure, loss of consciousness, etc.*

There are three nurses on the code team. The first nurse charts (usually the newest nurse). This person is responsible for maintaining a record of who, what, when, where, why, and how. For example, the code leader will ask when the last dose of epi was. Or, more commonly, will wait for the charter to inform him when it’s been three minutes. The second nurse (usually the most experienced nurse) has the most feared job of running the cart. This involves: applying the defibrillator pads, working the monitor, defribrillating/cardioverting/pacing, getting supplies from the cart, drawing up meds, and more or less leading the nursing team. The third nurse is responsible for IV access, pushing meds, and starting infusions.

Also at the code will be the most senior ICU resident available, who immediately becomes the code leader. Occasionally, the patient’s attending physician will be present and will take the code leader position, but this is usually left to the senior ICU residents as this is considered their specialty and they are often there first. The code leader intubates, and then simply calls out calm, short, simple, timely orders , “Stop compression, check for pulse, what’s the rhythm? start compressions, epi, atropine, bicarb,” and on and on in the proper ACLS order. 

If luck is with us, there will only be two or three junior residents, but often there are ten to twenty residents and med students in the room. Generally they just stand there and observe. The ICU residents often take part: starting a femoral line, or finally getting a chance to intubate. Sometimes, the code leader will spontaneously turn to the ICU resident and say, “So, Dr. Panickedlookinyoureyes, what do you want to do?

There’s usually at least a couple RTs present. They assess and maintain the patient’s airway, draw an ABG, start bagging, and set up the intubation equipment in a blink of an eye. They will monitor sats, and observe for spontaneous breaths. 

We also bring nursing attendants along. The vast majority of the time, they are responsible for administering proper CPR.

The code team always recruits the floor staff as gophers. They run back and forth, quickly and eagerly grabbing any medications or equipment needed. They are reminded to call the patient’s attending physician and family. 

Meanwhile, back in the ICU, nurses scurry around, preparing a bed for the potential new arrival. There are three outcomes of a code blue: the patient dies, the patient lives and stays on the floor (rare), or the patient lives and comes to the ICU. 

To be continued…

******

*Of note, we have a rapid response team that attends any situation in which a patient is deteriorating, but death is not necessarily imminent. They try to help the patient and prevent a code blue from being called. Often we hear the rapid response team called, and then immediately following, we hear a code blue called if the situation is more dire than expected, or if the patient rapidly deteriorates.

You know you’re having a bad night when you find yourself saying:

“OK, fine! Let’s make a deal! You can tell me to ‘FUCK OFF’ as long as you say please at the end!”

There have been a lot of ups and downs in my first year in the ICU. My intention was to thoroughly document every incident in my blog. It didn’t work. I found myself struggling with ICU nursing and nursing in general. My great blog had been decimated through lack of posts and interest from this here writer.

A year later (well, ten and a half months), I find myself looking to write again. I am ready to start putting thoughts onto paper regularly again. But this time, I seek simplicity and cleanliness, rather than clutter and flashiness. It is a fresh start (although the archives will reveal my blogging baggage), meant to show the maturity of a nurse that has finished his starting years as a nurse and has landed comfortable on his feet.

It is meant to also show the maturity of a blogger that has “done it all,” from devastating angstful “dear diary” writing, to attempts at professionalism, from striving for popularity, to panicking about just how visible, and therefore vulnerable, blogging makes him feel. So…

******

I’m a sucker for a long term blog theme; like a television story arc that lasts a season–finding resolution in the last episode of the year. My theme is indefinite, finding its end whenever, wherever, and however it’s ready. Much like the way my “new ICU nurse” theme found its end after only a couple months. Or, perhaps if we’re sticking to the television theme, it was canceled due to irreconcilable differences amongst its staff of one.

This time I’m seeking balance. My nursing career has seemed very one-sided as of late, focusing purely on the science of nursing. Each day, I can be found studying graphs, tables, and lists of scientific concepts. An there’s always the hands-on technical learning: Jugular venous bulbs, PA catheters, Oscillators, CRRT, cool guards. There’s always a new machine to master.

And one can never forget the endless parade of critical care medications to absorb as religion.

What’s missing is the Art of Nursing. WAIT! Don’t groan and run away, fearful of a nursing school style rant about some random psychosocial aspect of nursing. Instead, I’m going to make this very simple.

When I think of art, I think of paintings. I love Jan Van Eyck, Picasso, Monet, and Dali. These are all masters of the art of painting. But none of them is like the other, they are so very different in style and form. They are creators of entire complex styles of art.

Masters of the art of nursing are also complex. They all have their own style and way of nursing. They are all distinct in the way that they enact their role. You see, the art of nursing is what makes us different from each other as nurses. Otherwise, we would all just look and act like robotic drones.

Artful nursing is what lives between the lines and pages of our policies and procedures. It is the magic and mystery that lives invisibly between the graphs and diagrams within our scientific text books.

The art of nursing is finding a way to connect two tubes together that don’t necessarily belong together–but absolutely need to be together. It’s the out-manipulating a manipulative patient. It’s the hours spend washing the blood out of a trauma patient’s hair and brushing it until it shines. To one nurse, it is the micromanagement of every last detail–leaving nothing out, and to another it is seeing the big picture and knowing when to let go of the details.

My favorite vision of the nurse as an artist is literally as an artist. The bedside is our canvass and our patient is our medium. Some nights we spend hours positioning body parts, applying pillows in a very specific way, folding the blanket perfectly, positioning the IV poles at just the right angle, Organizing bedside tables and work stations, washing patients and applying creams and ointments to create the sight and smell of perfection. When finished, the patient looks peaceful, quiet, and absolutely presentable–ready for the beauty of life or the restfulness of death. Or, as in the ICU’s case, something in between the two.

As I see it, the art of nursing happens when the science of nursing doesn’t have an answer for how we do our jobs. However, It does rely on a strong foundation of the science of nursing so that we may “let go” of the black and white that rules our career and threatens to demoralize and overwhelm.

******

This art of nursing is where I’m finding peace in my career. When my creative energies are put to the task, I feel a rush of joy that re-energizes my soul. This is where the power of nursing is born and thrives.

So, here’s to my new theme! May it bring these same feelings of joy and creativity to my website.

I just turned off the fans, closed the windows, and turned on the heat. I am absolutely sure that this would be the first time in about four months that any of these activities occurred. I am, after all, a lover of cold weather and gloomy skies. The summer months are spent reaching in desperation for a cool breeze and a drop of rain. I have my limits though, and I am currently curled up in my new hoodie and my favorite blanket.

I have been away from my world on a quick vacation for almost a week, just arriving back on Sunday evening. That was following by two twelve hour days shifts Monday and Tuesday. Today, Wednesday, is my first day to put up my feet, drink cup after cup of expensive tea, and reflect upon my life.

A few updates! Firstly, I was nominated for post of the day over at The Rising Blogger by Laura at Adventures in Juggling. If you look at the top left of my blog, you will see the award button that I earned. The post that was nominated and chosen was A Dark Place. I am infinitely grateful and honored. Thank you SO much to both of you!

It still surprises me how large the response was to that particular post, earning me more hits and more comments than anything I have written before. I cringe every time I read it; it seems so overly melodramatic and whiny. But, truthfully, it was exactly what I was feeling at the time, and why. Things have improved since then, and going on a nice vacation to my favorite city on the entire planet helped immensely. I feel much calmer and relaxed now, with a slight bit of renewed energy.

The problem is that my vacation was not even seven days long and was a result of a place in my schedule where I had a few days off, not as a result of me taking vacation time. I have six weeks of vacation saved up that I simply cannot take. Vacation time is a HUGE struggle on our unit as there are too many people to fill all vacation requests. To get a feel for it, people that were asking for a week off during weird times such as November or February were rejected. All but those with the most seniority get the privilege of rest.

I am feeling energized, with my biggest source of energy being that I have made a new plan for myself that I hope will work out. I have two more courses until I have completed my critical care certificate (out of five courses), so I want to finish that. I want to finish all possible certifications in the ICU. I want to complete my ACLS and become a proficient member of the code blue team. I want to finally write my test to become a certified critical care nurse (you know, and get all those fancy letters after my name).

Once I have completed all these goals, I would like to enter a Masters degree program and truly move on in my career. I’m looking at a few universities, but I certainly have my favorite. I have no interest in being a Nurse Practitioner, but am rather more passionate about the theoretical side of nursing, particularly the qualitative research side. I’d like to enter a thesis based program and work on a big project for a couple years and hopefully end up in a PhD program. Then I can be Dr. NurseSean…

I’m simply coming to the realization that bedside nursing is not something I want to do for the rest of my career. I’m already cranky and feeling burnt out after only a two and a half years. I just don’t have the endurance to make it for 35 years. My hat is off to everyone who does!

Whenever I’m at work, I look around and I see happy people that love their job. I often fool myself into thinking I love my job (or perhaps I really do at those times), but if I dig deep and answer truthfully, as previous posts have shown, I’m just not happy. But I feel that in order to make it as a nurse researcher, you need to work as a bedside nurse. You need this experience to study the experiences of nursing properly and with credibility.

At least I have a sense of humor about it all. Yesterday, I had two patients (not typical in a Canadian ICU…we generally have one). Both patients had been waiting several days for a bed to open up on the floor. One patient was particularly agitated (to put it mildly) and was, as a result, a handful. However, both patients were very low acuity and were nowhere near the sickest patient you see, even as a floor nurse.
I was the only person doubled, so when the charge nurse had to find a spot for one of our new employees, still in training, she put her with me so that I would have help. She was particularly awesome as she was reaching the end of her several months of preceptorship. I took one patient and she took the other, with the goal of being as independent as possible.

I couldn’t help but notice the snickers of other nurses, clearly rolling their eyes, and talking behind my back, shocked that I would be “training” someone new. I use the word training lightly because frankly, a first year nursing student could have cared for her patient, and she needed no help or guidance at all.

All of a sudden I’m hearing choruses of, “but you don’t know what you don’t know!”

Yes, yes, I know, it was inappropriate, but I once again reiterate, I’m new to the ICU, not new to nursing. I’ve had many students and new orientees with me. And, I repeat, these patients were really not sick enough for the ICU.

I sent one of my patients to the floor: the agitated one, yay! One nurse said, with a definite snicker, “oh good, you can help me for a minute, you have no patient now since you discharged yours.”

“Yes I do, I was doubled.”

“Please! The new person is taking care of her, I doubt you don’t even know what her lungs sound like.” She quickly responded, challenging me, I had fallen into her trap. Yup, I could definitely tell she thinks I’m an idiot. I wonder to myself: when will people stop treating me like an idiot, maybe I am an idiot…why won’t someone just tell me if I suck at this job so I can move on with my life!!!

“Yah, I do know what her lungs sound like, they’re quite clear, just a bit diminished to the left lower quadrant…pneumonia.” I guess I did know. I felt vindicated. She didn’t respond.

Where, oh WHERE do people get these holier-than-though attitudes? Oh I could go on and on…I won’t.

This post is incredible, and definitely worth echoing and sharing! A great find, if I do say so myself–and I do say so myself by the way…

One of the benefits of being away from bedside nursing is that I’ve had time to reflect on my own performance. How could I have been better? What simple precepts would have helped? Being out of the “fog of war” has given me a clearer view of what’s right and what’s wrong in health care. Our culture doesn’t offer much positive encouragement for the nursing profession. That’s a costly shame, as many Baby Boomers soon will discover. To help out, I’ve come up with eight ways to become a better nurse.

1. Pay attention to how you perceive your patients
2. Intend nothing but the best for your patients
3. Speak the truth in a way that echoes your wisdom, not your darkness
4. Act on the facts but respect your intuition
5. Live your life as a connection to something greater than yourself
6. Work through your hardest times, not against them
7. Mind your mind: its power to destroy is its power to heal
8. Focus on the moment, not the past

Some of us are cut for bedside nursing, some of us aren’t. I think if you’re in bedside nursing and enjoy what you do then you’re a Jedi Knight who commands more respect than you probably receive.

For those of you who don’t quite enjoy what you do, think about your reasons for what you do. Consider the eight precepts (or make up your own) and see if anything changes for the better. You have more options than you realize.

Feel free to add your own suggestions for becoming a better nurse. If I get to 101, I’ll post your thoughts here and promote the living shit out of the list.

I hope the list I’m offering here helps you to become a better nurse, a better person, a better part of our quickly-changing world.

This post has come at an important time in my career in which I am particularly struggling with bedside nursing. It has given my a lot to think about over the next few days as I take a short rest from work (does five days count as rest?)

A powerful post! Here’s the original item link:

8 Ways to Become a Better Nurse : phil baumann /*rn*/

In the next couple months, I will be CRAZY busy!

In the next couple weeks, I will be oriented to code blue stuff and will be expected to be part of the code blue team. More anxiety…awesome…

In September I renew my nursing registration. This involved gathering documents, writing learning plans/goals, proving that I met last years goals, etc. Not to mention the $400 it costs!

In September, I also start the next course in my critical care certificate program. This time I will be studying pathophysiology. Crap, another $600.

In October, I have both BCLS and ACLS. Apparently, ACLS comes with a text book to read and study. I love to learn, but this is getting ridiculous! Oh yes, and that’s another $375

All on top of a full time job that is constantly threatening to destroy me with anxiety, fear, and frustration.

Did I mention I was moving into my new condo in October? Yes, I have to find time for that too…not to mention all the money for furniture and lawyer feets etc.

I think I’ll plan my next vacation right now!!! Oh wait, I won’t have any money left for one…

My dog ate yet another power cord for my MacBook yesterday. between my iBook and MacBook, he’s chewed three cords over two years. Unfortunately, I didn’t notice it wasn’t working until my laptop gave me the low battery warning, despite being plugged in–meaning I had no computer all of a sudden, without warning!

PANIC!

I was forced to use my iPod Touch for 24h as my main internet access. I don’t have an iPhone yet as I’m still on a contract with my current phone. Plus, the plans here in Canada are WAY overpriced and not even unlimited. Even further, I really REALLY don’t want to have a three year contract with the one and only company that sells them.

For now, the iPod touch is just fine. I really have no good use for the phone part of it at this time. It seems that wherever I go, there is a perfectly fine wireless collection. And I don’t have any plans for cool live-blogging from helicopters or the middle-of-nowhere.

But, what I did discover was that it was, besides a couple exceptions, a perfectly good substitute for a full blown computer. Now that apps are downloadable, it is even more simple to use…particularly when it comes to facebook and twitter. Even google has an app now that makes using google reader easier. I just couldn’t watch the Big Brother live feeds, and I couldn’t join my favorite java chat room.

Hey CBS/Big Brother! I would pay VERY well for an application that allows me to watch the live feeds on the go with my iPod touch. I swoon at the idea!

Two more shifts until I leave for beautiful Victoria, British Columbia for four days.This jewel of a city is my destination of choice–for living. I was intending to move there last year, but it simply didn’t happen. It continues to remain my dream and I am considering applying there for grad school.

Ahhhhh…such dreams…

Time to start making some road-trip music mixes!