I'll see you in the ICU!

my bipolar preceptor

Maybe because today is Friday the 13th, maybe because it's the 3 year anniversary of my mom's death, I don't know...but today was a tough day.

I'm on my lunch hour and forty-five minutes. This is because we start at 7am and she likes to take her lunch at 11, and she doesn't stop at all, all day long, so she adds her one 15 minute break to that hour and a half...then, she doesn't leave when I do (so she sends ME off at 11, but leaves herself at noon) then when I come back from my lunch hour and forty-five, I sit around for another hour or so, farting around on the computer, looking at my email, reading up on procedures...

whatever.

So, last week my preceptor was realy sort of down. Very laconic, curt even. I'd ask her stuff and she wouldn't even answer me.

Yesterday she was ecstatic, almost orgasmic, all day. Laughing a little too loudly when others were upset about something (one of the Fellows was really mad that an admission hadn't been reported to him before they came and she was cackling)

Sheesh. Was she on some mood elevating drugs? It sure seemed like it.

She was up up up (as Homer Simpson said "The dizzying highs, the terrifying lows...the creamy middles...")

Only, no creamy middles. It's all highs and lows with her.

Yesterday I got a ton of info, got to do a bunch of stuff and it was all good.

Today, she sort of cornered me in the med room and said she was surprised I didn't know about certian things with the IV pumps. She acknowledged the things I'm good at (mechanics, like understanding the swan ganz and how to zero it) but things like the IV pumps, and the fact that I didn't know where something was going to hang on a patient that has about fifty lines.

Again:
Whatever.

She said she wants me to get more confident, yadda yadda, and basically this means giving meds by myself, which I know my school is dead against. But she really wants me to despite the warning in the preceptor handbook.

Again:
Whatever.

Now I know why yesterday she said "why don't you go into teaching, or research?"

Nice. Is that your way of saying that I'm not up to the task?

I'm supposed to be LEARNING here, not coming here to show off what I already KNOW.
I don't KNOW SHIT yet. I can't get her to understand this. The other nurses are asking me why she's treating me like an orientee.

She's in her fifties, and has been nursing since her teens, I guess...it's all she knows so everything is so natural to her.

Evan, the night nurse was also in the ETP program and this morning before she showed up, I asked him where it all came together for him. He said it was really the orientation that did it.

anyway, instead of a nap today, I spent my lunch hour looking up the Swan Ganz catheter again, because though I haven't done it in a week, I know I'll be expected to do it again today, by myself, no prompting. (and of course, she didn't even notice I was there, after lunch, let alone quiz me or let me do the swan ganz thing.)

Also, she asked me to list the effects of digoxin toxicity, which I did, (either bradycardia or tachycardia, usually ventricular, leading to poor cardiac output and therefore things like shortness of breath, poor perfusion so mental status changes, syncope, etc) and then she said, "No, no, no; those are the effects of digoxin toxicity...what do you want to tell the patient to report to you if they start feeling, those other things are too late. So I said "palpitations, heart rate changes, dizziness..."

She told me to go look them up.

I did.

It said "Shortness of breath, changes in heart rhythm, Fainting (syncope), change in mental status,palpitations...etc."

She also got after me because I had pulled out a med that was discontinued from a patient's regimen...let me preface this by saying that I can't get into the computer, so I have to rely on HER to get ME the med list and times of delivery.

I copied the time that was written on HER sheet, in pen by her...as she told me to do.

So we go up and down on this merry go round, me trying to figure out what she wants, while getting what I need (to learn some shit.)

This is so hard.
I'm thinking maybe a CCU is a bad idea for the year off working...I might try to find a micu or sicu to go to. We'll see. I'm hoping they'll be as good training for the Anes program. I'd like to continue adding to what I'm learning here, but the thing that scares me is that Cardiac Patients are so damned acute, and on so many things, that I feel like I'll never learn enough in the next month to be a viable candidate at a CCU, let alone a CTICU.

Still, it's not as bad as what a few of my friends are going thru.

Jean?
HAAAALP!
:)

posted by sketchmonkey @ 9:46 AM