It's my tuRN

Henry got a splinter last week.

(my first thought was, I wonder where he got that? When I reviewed our day it went something like this...played outside in the sandbox near the wooden frame of the herb garden, used the garden rake and shovel to plant bulbs, played at our neighbor's house with a wooden swing, jumped on her tampoline, used sticks as toys, etc. Finding the culprit for said splinter would be hard to pinpoint during one afternoon's adventure.)

Henry lingered between two opposing schools of thought after discovering the splinter. "Fix it! But don't TOUCH it, Mama!" The doctor kit came in handy for debriefing after Papa removed the splinter. George got the job because 1. he's very good at it and 2. he wouldn't have Grant to entertain while attempting the procedure.

Henry was able to remove the multitude of splinters that Papa and I acquired during our evening meal. Each time assuring us that "it won't hurt at all. Doesn't that feel better?" Grant caught on quickly to some physical assessment skills, as well. No matter what tool Grant has in his hand, just open and say "ah" and he'll shove some medical equipment down your throat (note the reflex hammer being used as a tongue depressor below). He's very thorough.

Speaking of medical equipment, physical assessment, and procedures. I started my new job last week. (surprise, stay-at-home mom joins the work force!) That's right, in an effort to continue some attempt at balancing my life (remember my Lenten journey?) I have obtained a VERY part time job to allow for some professional development, adult conversation, and a few hours during the week where no one will call me mommy.

It's a RN triage position at an urgent care clinic. I'll work 4-10pm every other Monday night, and on the off weeks I'll try to pick up a per diem shift. Think headset phone calls, computer scheduling, and a few IV starts. For now it keeps my foot in the door (or, just a toe, given the number of committed hours) and provides a few hours of respite from the kids. Last week I did a full week of orientation, so George was home with the boys during his week of vacation, being Mr. Mom. Our role reversal was truly "walking a mile" in each other's shoes, so more stories to come about our revelations.

Where did July go?

Oh boy, aside from the guest blogger for that last post - those aunties who love to tease - I haven't been very diligent about keeping the blog updated. Then again, given all that has happened recently, I'm not surprised!

Quick notes about Henry:

• He has started having pureed solid foods and absolutely loves the taste of everything we've fed him from sweet potatoes and carrots to applesauce, pears and bananas. Now we just need to find a good balanced diet for him so he doesn't struggle so much with gas and other tummy troubles. (I'm sure that when he's older he'll love that I've posted information about his GI system on a semi-public forum!) That's what happens when he has a nurse for a Momma. We nurses are always concerned with that sort of stuff.

• He figured out how to roll from his back to his tummy. Then he forgot how to get from tummy to back. I've gone into his room in the middle of the night when he wakes up for feeding only to be very confused by what body part I'm grabbing as I sleepily try to wrestle him from his bed because he landed face down. As soon as he gets all this rolling over coordinated, I have a feeling we'll begin the "chasing" phase of parenting.

• The "Henry safe" zone has grown considerably. Gone are the days of holding him on my lap during meals. His range is impressive as he's discovered that these opposable thumbs are incredibly useful for snatching up anything within a 12 inch radius. And his most recent trick is switching objects from hand to hand. It is fascinating to watch him do these things - yay milestones!

• Henry almost sits by himself. Its so funny to see him in a position besides lying down. He is trying very hard to stay upright by himself, but when the balance gives way, the weebles wobble and over he goes.
  

Our most exciting development lately has been navigating the housing market to buy our first house!! We are working on finalizing paperwork to purchase this home, and barring any unforeseen circumstances, we will close September 30th.

Back in the Saddle Again

I returned to work over the weekend. It was actually nice to be back and see some of my work friends and be able to share pictures and stories of Henry with them. I shortened my leave by two weeks so I could head back to work and give my two weeks notice. This way I wouldn't have to worry about time off for George's graduation and getting my hours in before we leave for Wisconsin. So it feels good to know that my time is limited in the MICU and just enjoy a few days of adult time before returning to full time work as a mommy.

Thankfully, George has had good "Mr. Mom" time with Henry, who decided to cut him some slack and drink from a bottle and take naps. At least for the first two days he did this...the third day in a row I think Henry was missing his momma because he fussed all afternoon and was pretty cuddly when I got home. Twelve hour shifts are such a long time to be away from baby! George did bring him to the hospital over my lunch hour so I could feed him and see him.

After a few months off, I was wondering how I might feel about work as a nurse. For sure, after my experience in the hospital and having my own nurses care for me, I'm fairly certain that ICU nurses truly earn their money. We work hard and have a lot to do during our shift. Not that other nursing fields are any less busy, but as the name suggests, the intensive care unit is certainly intense! I admit, I felt a little rusty after not thinking like a nurse for several weeks, but I have some really supportive co-workers who were happy to assist me when I needed it.

Week 39

Here's a photo of me as Nurse Charlotte. Again, not very flattering, but I'm thinking that any good picture of a pregnant person has required special lighting, make-up, and camera filter. I have none of these.

Oh, and this picture was taken after working two days in a row of very busy 12 hour shifts.

The following is a very typical conversation for me at work lately.
Me: Hi, I'm Charlotte, I'll be your nurse today.
Patient: When are you due?
Me: Next week.
Patient: What?!? (wearing a very shocked look)
Me: That's right, I have 7 days left, give or take.
From here the conversation usually follows every other conversation with strangers...
No. I don't know if its a boy or a girl.
Yes. Its my first.
I don't look big? I sure feel big.
Ok. You can feel my belly if you really want to. For a brief minute.

It is pretty amusing to me how many people want to rub the baby belly. Personal space has become very limited. Both outside and in. Baby toes are poking their way around, looking for the escape hatch. ha!

So Week 39. Here I am. Just wishin'...and hopin'...(makes you think of that song, right?) and thinkin'...and prayin'

My next doctor's appointment is Friday and we'll see what he says about how long he's going to leave me in this state. He alludes to induction, after week 39. Of course, that is all dependent on my body showing a few more signs of readiness to deliver. Right now, no sign. Just plannin'....and dreamin'...

Week 38

Here's the Week 38 photo, including the new life-saving wrist brace that now allows me to sleep at night and not awaken in the morning (or middle of the night) with excruciating pain. Yay!

To tell the truth, this photo has been on the camera for a couple of days, but the battery was dead (or I should say batteries -- the back up one also not charged) so the camera would not stay on long enough to download to the computer. I guess this is a good lesson for us. Note to self: Make sure the batteries are all charged up before we REALLY need them -- ya know, for anything important coming up. Like the birth of our first born!

People at work this week are convinced that the baby has dropped. Looking at the new photos of me, I sort of have to agree...though symptoms really haven't changed too much.

Speaking of work, its becoming increasingly difficult. I'm going to attempt to get through one more week, after that I can't make any guarantees!

Weekend of Work

I realize that the last few posts have been focused mainly around working for me. To be quite honest, its all I've really been up to since George has been away, so bear with me. Additionally, I've also been more "career-active" lately because I've finally had the opportunity to attempt a few certifications. Last weekend, I became ACLS (advanced cardiac life support) certified. I've only been trying all year to accomplish this and have had some obstacles with scheduling and other conflicts, so I was thankful it finally worked out. This is especially useful because our unit rotates "Code Call" (code blue: when a person is in cardiac or respiratory arrest) with the cardiac intensive care unit, and technically, you're not supposed to go unless you're certified. So now I'm official.

The other opportunity I took advantage of was attending a CCRN review course. CCRN is a certification for critical care nurses that is sponsored by the American Association of Critical-care Nurses (AACN). It was something I'd been considering, but sitting in the classroom for two 8 hour days of lecture isn't very appealing when you work the night shift and would struggle to stay awake. Now all I have to do is take the test. There's a little question as to whether I'm eligible or not (I have the appropriate number of contact hours, but its unclear as to whether they would consider eligibility for a nurse that has only a year + of experience). Apparently, they want a minimum of two years experience. Oh well, it was certainly a good review, regardless.

Don't worry, I did inform the woman organizing the class session that it would probably be wise to put that information in the brochure, as paying a fee for the class, sitting through two days of lecture, and getting a "pass-guarantee within 90 days" from the company that hosts the seminar is a little irritating if one is not eligible to sit for the exam.

One last remark for this post, I learned a valuable lesson this weekend. I worked a "double" on Saturday to alleviate some short staffing on the night shift (meaning, I worked from 7am to 11pm - staying over my shift for 4 hours for a grand total of 16 hrs) with the caveat that I would turn around and come back Sunday at 11am to stay until 7 pm. Unfortunately, no matter how smooth my day was on Saturday, my legs and body disagreed with this schedule the next day. Oh the aches and pains! So I won't be doing that again, as I simply don't have access to good pain relief in my pregnancy state (I don't care what the commercials say, extra strength tylenol leaves much to be desired!).

Nursing stories

I think there are a few stories from my nursing experiences that I will never forget. This week, I've been blessed with two.

This week, I cared for the oldest person I have ever met. She was 104 years old. Unfortunately, she passed way on my shift, but I found myself completely amazed when thinking about how much she must have seen since 1903.

The other experience was a patient who self-extubated. When a person is intubated (meaning they have a tube into their lungs and on a ventilator to help them breathe) we take safety precautions to ensure they do not remove the tube on their own. This consists of placing the patient in soft wrist restraints, as a minimum to tie their hands to the bed and prevent them from reaching up and pulling it out. In addition, I even had mitts on my patient (they cover the hands and prevent someone from grasping anything). I was going to grab a quick breakfast snack, reported off to another nurse, checked the patient (who was sleeping, restraints intact) and returned 15 minutes later to discover he somehow, despite the necessary precautions, had managed to remove the tube. Fortunately, in this case, he did fine without it and managed to remain off the ventilator throughout the day. However, I still have to report this in an official "occurrence report" that gets sent to my manager. Of course, only the day before the entire unit received an email from our manager about how last month we had 2 self-extubations and a fall. This was unacceptable, yadda yadda yadda. So I don't relish the thought of having to explain this to my manager, but I am very thankful that the patient did well after this incident! The kicker is that this patient had severe lung disease due to smoking and the first thing he says to me is "can I have a cigarette?"

Perhaps there is a greater lesson here, too. Preparation for parenthood. No matter how much we try to maintain our patient's safety, we cannot be completely responsible for their actions. I imagine the same is true for children.

Working blues

Work has sure caused some undue stress lately. For a time, there was uncertainty about whether I would actually be going to the day shift, as people on midnights keep quitting, having personal tragedies, or surgeries. While I am desperate to join the land of the living and function as a normal person with waking and sleeping hours that mimic the majority of the working world, I am also afraid for my co-workers on the night shift.

Not only does working short-handed bring down staff morale, but the system of moving people to days has a small flaw. Generally, the list is formed with seniority providing priority to those who wish to switch shifts. However, this leaves many inexperienced nurses behind by default. Recently, we've had an influx of new grads (those that graduated in May, oriented on days during the summer, and transitioned to nights a month or so ago). As a group, they are very hard-working, intelligent, and caring individuals. Nonetheless, when they have questions, they need a resource to turn to for answers. Therein lies the problem. In general, the resources have been relocated to the day shift. Though I'm flattered that I am considered a "seasoned" nurse after a short year of experience in the MICU, it also says a lot about the potential dangers involved in patient care when this is the case.

Additionally, I was becoming quite irritated with the inconsistent answers I was getting about whether my schedule would, in fact, change to days, being that the new schedule wasn't out, but would start in a weeks time. So, I went to talk to my manager. Apparently, I must have come across pretty strongly, as she thought I would quit if I didn't get day shift. So, day shift it is. Though the thought of transferring had crossed my mind, I figured it wasn't worth the hassle to find a new position and go through orientation, only to be on maternity leave in February. So now I'm feeling guilty about the assertiveness and what that means for the night shift. I certainly didn't intend for things to work out this way. Bummer.

In addition, last week I had a rather frustrating experience with a patient. I cared for a 21 year old with cerebral palsy. He was about the size of a 2 year old, and truly belonged in the Pediatric Intensive Care unit as we simply don't have the equipment readily available to suit his needs. However, the PICU was full, or short nurses, so he was in the MICU. I spent half my night just gathering the right size of equipment (blood pressure cuffs, needles for starting IV's, drawing blood gases, etc.) and adjusting my expectations for blood pressure measurement, urine output, heart rate, etc. for pediatric guidelines. I have to admit, it was nice to care for a small person. When it came to repositioning and moving him, since he was so small, it didn't hurt my back and I could do it myself.

This experience was a slight wake up call that nursing school was, in fact, a year ago and there is stuff I'm surprised I remember, and stuff I'm afraid I've forgotten. It also reminds me that there are other types of nursing out there which pique my interest. The longer I stay in an adult ICU setting, I wonder if it would be more challenging to enter these new areas later down the road.

Day Shift!

Hooray! This is the official announcement that I'm going to be working the day shift starting in November. I'm looking forward to a more normal schedule and regular sleeping habits!