Monday, August 22, 2011

What Did I Get Myself In To?

I just finished a weekend of work and let me tell you, it was LONG. I was so exhausted last night, I went to bed at 10 and didn't get up until 10 this morning! I probably could have slept longer, too, but I didn't want to feel like I wasted a whole day ;)

Typically, each nurse gets 3 babies to care for. As an intensive unit, nurses can't have 6 patients like they do on basic nursing floors because the care level required is extensive. (Not taking a dig on floor nurses, they are the bomb.com because they CAN handle a 6 patient load. There is no way that even with all of my organizational skills that I would be able to handle 6 patients! They are AWESOME.) My orientation nurse (We'll call her JD for Jane Doe :) I don't want to be giving out too much info!) is awesome, so awesome that they constantly give her the hardest assignments because they know she can handle it and still give quality care to all of the babies. I don't mind it at all because I get to learn a lot about really sick kids. I also think that's why I leave everyday feeling totally overwhelmed :) On Friday, we had 2 of the same kids we'd been having, plus one new one. When I walked in, she asked me if I'd like to take all 3 today. Sooo, I took care of one chronic (has been there a few months), one gastroschesis baby (intestines outside the body), and one vented baby. I am proud to say I handled all of them, stayed on time with my care, and even helped re-intubate the vented baby! JD was impressed as well :)

I love my job and even though it's overwhelming, I love it for reasons like this: On Saturday, we admitted a baby who was too young. So young that it's eyes were still fused together. Can you imagine how tiny that is? On Sunday, JD and I were assigned to care for this baby. It wasn't on a ventilator so it was having to breathe for itself. Unfortunately, it was having a hard time doing that and spent most of the morning with many apneic episodes. (Note: lungs are the last thing to develop..there is no way this baby's lungs were developed enough to be breathing on its own...) JD decided that because this baby was so sick, I would care only for this one baby today and she would take the other two. I literally spent all morning keeping this baby breathing. The baby would do okay for a few minutes but then just got tired. Finally, the doctors decided to intubate. Thank goodness:) This tiny little baby could breathe now! Once on the vent, you could see the little eyes trying to open up and finally they did! They blinked a little bit and it was the coolest experience to know that you were there the first time a baby sees the world.

I will say though, that I was so nervous to be caring for this baby before it was put on the vent! I haven't had my neonatal resuscitation course yet and JD was like, "just keep the baby alive! I'll be back in a few!" I looked at her and said, "JD! Are you serious? Okay this is making me too nervous!" JD has a lot of confidence in me and I did in fact keep the baby alive :)

JD did pull me to the side later in the day though to tell me that I'm doing a great job. She said that she knows they give her hard assignments because she can handle them, but that they are hard for an orientee, let alone a new grad! A lot of the times, other orientees are sitting around doing nothing because they have one baby to care for and then nothing to do. All of our babies are so sick that we are constantly doing something and never get to sit down. JD sees all of this but also said that she's glad I was put with her because I'm smart and a hard worker and I am handling the assignments great and she doesn't know that any of the other orientees could do it!

I'm not bragging on myself, but it is really, really nice to hear that. I do leave work some days things "what in the world did I get myself in to?" but knowing that I'm doing a good job, even when I feel like I'm not makes me feel a little better. And being an advocate for these tiny little things makes it all worth it!

One last thing: we had a normal newborn come in for simple monitoring and I looked at that thing and thought, "gosh that's a big baby!" In reality, it was only 6 lbs. which is almost on the low side of healthy newborns! I've been hanging out with too many little ones lately that the normal size ones seem huge! ;)

Friday, August 12, 2011

Randoms!

Well, I don't know about y'all, but I am more than ready for fall to be here! I know you aren't supposed to wish the time away, but I literally stood in my closet this morning for like 10 minutes looking longingly at the cute sweaters I can't wear yet! Our A/C has been acting up ever since David went to Germany (when it actually broke and they came and "fixed" it) so we are currently getting a new one installed. Marley loves people and he thinks everyone is here to play with him so I had to tell you this story.

There are 2 guys here putting in the new A/C unit. Marley was at the bottom of the stairs and one of the guys wanted to come down and Marley was sitting there barking at him and wagging his little nub...cute little boy just wanted to play! Well, I heard the guy stop on the stairs and Marley kept barking so I called his name. The guy on the stairs said, "does he bite???" Umm...no sir, he's about 5 pounds soaking wet but it sounds like you are a little afraid of him.

It just cracked me up that this huge guy was scared of my 5 lb. rat ;)

*My first day of work! Although, now I have a few pediatric scrub tops so I'll have to take pictures of those later! They are soooo darn cute!*

In other news, I am still loving my job. I still leave everyday feeling completely overwhelmed, but I love what I do so I'm pushing through it. :) All of the nurses assure me that it is completely normal to feel that way and they would be concerned if I didn't feel overwhelmed.

I had my first poop attack yesterday :) There is one sweet, sweet little baby who is just so sick that I have been taking care of. He's been sedated since he was born and they just took him completely off sedation this week so now he's one whole pound of attitude ;) They've also started increasing his feedings so mix his attitude with his bowel habits and you've got a potential mess on your hands! Because he's so sick, we try not to touch him too much and usually change his diaper when we do vital signs/assessments. Well, I went to change him and he'd pooped a little in his diaper..."good boy!" I said to him. I usually put the clean diaper underneath the dirty diaper so if they do start pottying, there is something else there to keep the bed clean. So I had everything in place and I lifted his legs to clean his bottom and....he SHOT a LINE of poop all the way across his isolette!! I was just stunned. How could someone so little create such a force that it shot out like that?! It was so funny and we ended up having to change all of his sheets. So much for my diaper theory :)


I also had the brilliant thought that once I was out of school I wouldn't have anymore books to read or tests to do. Wrong. Our nurse educator has delivered 2 new books for me to read and one of them belongs to a set of like 3 that I have to read. Each chapter had a test that I have to do and turn in! Yay....


I have this weekend off so today I cleaned the whole downstairs. I mopped all of the floors, vacuumed, cleaned the bathroom, kitchen counters. The upstairs needs to be done, but I'm not sure if I'll do it tomorrow or wait until next week. I don't get to spend too much time with David these days so I think we will do something fun tomorrow :) One thing that I hate is clutter. Two of our rooms downstairs (our future office and my future craft room...yes!) are just full of junk that we have no place to store right now. A lot of papers need to be filed, but I think it's pointless to do it when we'll just have to re-do it later! We have a "desk" and an old dining room hutch so I think when Dave gets home I'm going to get him to help me set up a make-shift office so we can start organizing some of the papers. We'll need to make a run to Target to get some filing cabinets. And I'm sure we'll find some other things at Target because I can never go in there without buying more than what I came for! :)


My friend Ashley got hooked on iced coffee from her sister-in-law and now she's got me hooked on it, too! So I've got myself a cup and I'm going to start tackling those NICU books :) I hope everyone has a wonderful weekend!


Monday, August 8, 2011

NICU

*I would love to post pictures on this blog about things I've seen and done over the last 4 weeks, but I obviously can't do that :) I don't even feel right google searching NICU stuff and using pictures I've seen there. So that being said, I'm sorry this post is picture-less!*

Life has been so busy now that I have a J-O-B. 12 hour days can kick your butt pretty quickly :) I have to get up at 4:50 in the morning in order to make it to work by 6:45. And recently I haven't been leaving work until around 7:45pm! That is a loooonnngg day. By the time I get home, all I do is eat dinner and go to bed, haha! :)

But I wouldn't trade it...I absolutely LOVE my job. So I wanted to post a little about it.

I just started week 4 of orientation yesterday, so I'll back up to weeks 1-3.

Week 1-3.5: I was stationed in the NICU 2 for these couple of weeks. NICU 2 is where the "almost ready to go home" babies go. Obviously there are exceptions as some of the babies are there for >6 mo. depending on their needs and some babies end up back in NICU 1 if something goes wrong. But for the most part, this is where the "grower/feeders" stay. Grower/feeders are just the babies who have overcome their more serious obstacles and are just working on feeding through bottles or breast, keeping their weight up, making sure they can keep a good temp, etc. All the things they need to be able to do to go home and stay healthy. The first day I started, there were 80 babies in the NICU...that's a lot of babies! But my preceptor was amazing and showed me a good routine in order to get everything accomplished in a timely manner. Some days, we would have 2 hour "breaks" between feedings and assessments! We actually stayed caught up on charting. In NICU 2 I did assessments, changed diapers, held babies, fed babies, bathed babies, and helped teach parents how to do all of that as well. It may be one of the greatest places on earth! It is so cool to see a parents who are terrified to hold their infant slowly learn that they can actually take care of this tiny human.

During the beginning of my third week, I got called to the nurse manager's office and both NM's were in there. I thought, "Oh Lord, I'm already in trouble!" Haha :) But they just wanted me to know that I had already received a recognition from a parent during my second week of orientation. The mom wanted me to know that I am a great nurse and she was so glad that I took the time to explain things to her, was so gentle with her baby, and helped her learn certain things to do. One of the NM's said that parents in the NICU don't say positive things about nurses unless they absolutely mean them, so I was pleased that someone thought enough of me to say something. It definitely gave me hope that I will learn how to be a good nurse soon, ha!

Week 3.5-4: Halfway through my third week, I started in NICU 1. This is where all of the really, really sick babies are. A completely different experience. I worked 3 days in a row and left feeling completely overwhelmed each day. How in the WORLD am I going to learn everything I need to know in order to care for these babies?? Luckily, my NICU 1 preceptor is amazing (30+ years in NICU) and knows her stuff. I am learning so much from her. She taught me how to put in an IV my first day and I got it on my first stick. She was so proud of me...you can imagine how small baby veins are, it would be pretty difficult to stick those tiny things! But I'm pushing through the nerves and being overwhelmed and doing everything I can to become a good nurse. I know it has to be frightening for some parents to know someone so inexperienced is caring for their baby (with supervision...). So far in NICU 1 I've given a vaccine, cared for a ventilated baby, put in an IV, calculated meds on IV pumps, cleaned up lots of spit up ;), gotten an extremely dusky/purple, apneic baby to "come back" and breathe again, cared for 1 lb babies, full-term babies with respiratory issues, cared for babies on CPAP and HFNC, started phototherapy on bili babies, and have seen lots of crazy family dynamics.

I am excited and thrilled to be where I am, but this is definitely an eye-opening experience. I know feeling overwhelmed will pass once I figure out my way of getting things done, but it is scary to be the only one around when a baby starts going downhill. It would be for anyone and most of the nurses I have run in to are more than willing to help.

Luckily, I have 2 days off to catch up on my rest, then I'll be back at it again on Wednesday :) Sorry I've been MIA lately, but I'm just trying to get things settled and unfortunately it means a break from the blogging world every once in a while. Plus, I've been thinking about creating a whole new blog once David and I get married to document our life together...thoughts on that??