I'll see you in the ICU!

finally...

came home this morning and konked out just before 9:00. I felt myself fading like I haven't done in a while--the knowledge that in T-60 I would be out like a light and nothing was going to wake me. I got myself between the sheets and sure enough, didn't wake until just before 3:00 PM.

My sleep has been so screwy, and my schedule for everything all topsy-turvy. I've decided to make 3:00 like my 7:00 am. Wake up, have an espresso, my Omega fatty acid supplements, make a late lunch for the hubby who's been tiptoe-ing around (and getting the dog to be quiet) all morning, and then the morning ablutions.

Finally, a schedule. Some regularity!

Last night I was in a deep, deep funk leading up to going to work. I worked with Wilma, a very nice Philipina in her 50s, maybe, but looking like she's in her mid 30s. She's quiet, and she's always tired, so I mostly let her pretend she was looking at the cardiac monitors while she dozed off, and did my thing on my own. Later she checked my paperwork.

I take the patient's flow sheets into their room, and write down their urine output for the hour, write down their vital signs, check them, turn them if need be, etc, and somehow this helped me stay on top of the charting. Ironically, both my patients last night were history of EtOH abuse, one with urosepsis and pancreatitis with a possible hx of un-dx DM.

So, the deep funk: I like Wilma and she managed to get me out of the funk because she always makes me smile. All day I had been thinking about how much I dislike this place...how I'm not learning anything remotely acute care, but rather their system for paperwork flow. This is a huge part of nursing, I'm aware, but I NEED a year's worth of acute care stuff. Columbia's Anesthesia program won't care if I know how to take off orders, or how to admit a patient, or discharge them. They are going to want to know if I can recognize someone who's about to head south fast, and what to do about it. (I don't.)

So, while my friends in NY have all JUST finished up 20 week residencies with classrooms and preceptors to ask questions to, I've just been learning where the linens are, who to call to page an orderly, where to take a body after patients die, etc.

Yesterday I came to the harsh realization that I've been miserable because of "Expectations." In the Buddhist sense attachment (to anything, ideas, hopes, expectations) breeds suffering and I sure have been doing that. I guess I was expecting I'd be picking up some stuff, learning some acute care stuff, when in fact they've overworked me to get me to learn to "prioritize and manage the load of two patients."

While they smile and say "let me know if you need help" they gladly refuse it to you when you ask and say "nope, you have to learn to do that for yourself." or if you ask them a question about a situation, med or pathophysiology, they say "Well, what do YOU THINK it is?"

Fucker...if I had the first inkling, or time to look shit up, wouldn't I do that before asking you?

Then the monster comes out of my head and I clamp down. I put my head down and work without asking anymore questions. I just try to make it thru my shift and my mind goes to its happy place: Back at Columbia, sitting in a classroom, in the anesthesia program with all this behind me.

Funny, eh? My happy place has become Columbia...yes, that's how bad it is NOW.

Ah, the snow, and crappy food...the lack of organization and bullshit. The good ol' days!

So, I came to the crap decision yesterday that no matter what, I have to find a new ICU placement. One with a residency, proper classroom setting, books, hand outs, organized curriculum...in short: UCSF.

Those nurses are on top of stuff. It's odd how during the first two classes, I was ahead of them as far as EKG and recognizing cardiac arhythmias, but during the hemodynamics class, a short month later (they had been continuously going to critical care classes, and I was returning for a second class) they were leaps and bounds ahead of me. Blew me out of the water with their quick answers when I was in the complete dark about what the lecturer was going on about.

But I know how to take off orders.

excellent.

So, I updated my resume, and I will see if I can get into the next training cycle at UCSF. When I quit this job, I'm going to go in and tell my nurse manager that I've found a critical care program that I want to attend. They had said they would look for a program for me to attend, but instead they've been sending me to these peicemeal courses hear and there which don't add up to the same thing.

She'll object, saying I need to run it by the education department and our boss will have to approve the spending and they've already spent X amount on my courses, while walking away from me, but I'll say "no...I'm resigning to go attend a critical care course offered by another hospital. Thanks for everything."

BWAH ha ha ha.

That's going to be awesome. I know this is petty, but it's pay back for all the shit they've been putting me through.

I will undoubtedly lose the ability to go back to Columbia...maybe. Becuase they won't understand what I was doing at this ICU for 6 months and if it was bad enough to leave, why should they count it? OR I will have to obligate myself to a year's service and then won't be able to return to New York and lose my spot.

Then it comes to why I was in a funk: If I lose my spot, I have to reapply to all sorts of schools all across the nation. I have to RE-ask everyone for letters of reference. Think on that one--I'll have how much experience? and have to ask people "hey, as a new nurse, would you recommend me for this?"

That in itself is going to take a few years.
And my health will probably deteriorate to the point where I can't endure school anymore, the hours, the sleep deprivation...what in my 50s?

So the funk comes from being trapped midway, in a place I hadn't even intended for more than a year for myself. My fate's been decided for me in a place I never wanted to be.

Originally, I was going to go for my NP in Acute care. At least, with MS, I could be an Acute Care NP. I would do some bedside assessment, go back, write a few things in the chart, and leave. This job is so god damned physical that it was a crap shoot I'd be able to do it for even a year.

I'm spent.

So, there is the funk for you. Imagine if you had come to the realization that you're probably going to be trapped indefinitely at a job you never picked, on your way to another job you WERE hoping for.

We'll see what UCSF says. At the very worst, I'll reapply to UCSF and go back to the idea of Acute care NP. I've heard it's easier to get into UCSF once you have a BSN.

that's all I have to say about that.
Be well, peeps.


I think I see your problem, here...you have no brain.

posted by sketchmonkey @ 3:12 PM