Sunday, September 22, 2013

Fall Season is Upon Us!

To all my NICU nurses, moms, friends and people just visiting my blog: 

Fall season is upon us, so I've added a little store if you'd like to do a little shopping while you read! See the bottom of this blog for Megan's Little Store. Thanks! 

Megan

Thursday, September 19, 2013

Challenge Accepted!

Friday, the 13th of all days to be a NICU nurse in a level 3...and I accepted my challenge with a brave face.

 I woke up just before I had to stroll into work for my long weekend. I'm usually still groggy on my first day back from a lovely, long stretch of off days. I wasn't looking forward to this particular weekend simply because it was the annual NICU lake trip and since it was my required weekend to work, I had no one to switch days with me so I could go. I guess the lake is more favorable given the choice to work or spend the weekend with some crazy NICU nurses! Not only that, but my hubby was on his way to watch the Green Bay Packers in Wisconsin, ANOTHER trip I missed because of the lake trip. Oh well, there were babies that needed to be taken care of and there will always be more lake trips and football games. 

I glanced at the assignment sheet. Next to my name was written, 25 weeker, Vent 1:1, 5. Which meant this infant requires one on one care because of how critical it is. An infant on a 5 status basically means put your big girl pants on, pull your bootstraps up and get to work! I was given a lengthy report, and began to feel overwhelmed with the sheer amount of information being given. "Wow," I thought. "I'm in for it." 

My fave patients are the micropreemies. I've always said that I liked the sick ones. They really are great experience for new nurses and you become stronger in so many ways. This baby was sick. So sick, that it had been coded a couple times but was able to remain stable on the ventilator after  successful resuscitation efforts. This little one was on so many medications. It's MAR was 6 pages long and was given everything from meds to keep it's BP up to meds that stopped seizures and meds for sedation. The infant also needed constant monitoring of blood gasses and labs, so those had to be drawn constantly and pending lab results the infant needed blood products and IV fluid changes. The infant also had physical characteristics that made the docs suspect something was genetically wrong. I never left the bedside and this was only my first day of three. 

Three days per week may not seem like a lot for people outside of the healthcare field. But in those three days nurses work 12 + hours per day and if you're lucky you get to sit down for a 30 minute lunch. 

Day 2 and day 3 were just as busy as the first day. I would go home after a long shift, utterly exhausted, using all my efforts to simply keep this baby alive and comfortable by suctioning, repositioning the ET tube and the infant, all while being as delicate as possible. For the parents, as mentioned in an older post, I'm a stickler for a clean incubator! But with this there were so many wires and equipment that it was hard for me to organize it all. Not only that, but there was so much going on with the actual patient that my bed organization was the last thing on my priority list. But I managed a clean "office"area :) (That's what I call my incubators). 

I would go home after my shifts and my mind would race and race. I couldn't turn off the questions about this baby and I kept thinking what would happen when I returned? Would  it still be alive? Have I done all I could as a nurse? So many thoughts were present and I couldn't get answers unless I was at work which made me almost not want to leave the unit! I was anxious when I got home because I became so involved with this baby. I a was mentally rooting for her to live and I, to do everything I could. It was like we were a little team, working together. I would make a simple change and she would tell me if it was working for her by her vital signs. lab values and activity and I would adjust things accordingly. In a very short time I became involved quickly, telling her, "With all this work I've done for you, you owe me to live, girl." I wanted to see her months from now go home with her family. 

Monday morning I gave report and left the NICU around 0730. I arrived home around 0800 and got ready for bed. I was exhausted and glad to have the day off. Still, those questions lingered, preventing me from falling asleep so I watched TV for a bit and slowly drifted off into a much needed dreamland on my living room couch. 

About an hour later, I awoke with a startle thinking I was still at work. I took myself up to my bed and attempted to fall back asleep but my mind wouldn't let me. 1400 rolled around and I was still staring at the ceiling. Somewhere between those times, I took a bath to try and relax but my mind was overpowering every attempt to just simply close my eyes. I was too anxious and all I wanted to do was get back to work and see what was going on with that baby. I even tried Facebook chatting with my sister until I got a text message from a co-worker, "Parents decided to withdraw care on your baby today. " "Head ultrasound came back with a grade 4 headbleed." Now I REALLY wasn't going to sleep. 

The infant passed that Monday morning as soon as they withdrew all care. I don't really need to express the sheer disappointment and sadness I felt. For a new NICU nurse, it was a reality check. You can't save them all. I thought, "But we've had plenty of 25 weekers that have gone home." Nothing really bothered me before until now. For some reason, I was truly and deeply affected by this. It was odd for me. I never reacted this way to a patient, even those that have passed. I think it was because of the sheer will for me to help her live. It was the thought that, "We can save her." Sunday night I thought she was smooth sailing. ABGs were the best they had been, I thought they could even D/C her BP meds. She was tolerating care. I thought she was in the clear. But because of the severity of her headbleed, there was nothing we could do further. 

Sad. 

Looking back, this was the best and most challenging experience I've had as a nurse and I'm thankful for it. I had learned new skills that I'd never done before and my confidence has grown despite not being able to save her life. These babies are why we are NICU nurses and I'm grateful for them, good and bad outcomes. I grew as a nurse in those three days and am left with a new appreciation for just being able to live. It sounds cliche, but that baby fought so hard to have what comes easily to others. Life is truly, truly precious. 

Be THANKFUL if you have life today. 



Sunday, September 8, 2013

Happiness. Joy. Love.

Growing up, most of us have probably heard of the saying, "If you do what you love, you'll never work a day in your life." I have my NICU job, yes. I love it but sometimes there are days I want to hide in the linen closet and curl up in a ball. At the end of a long shift my legs ache, you could use the oil on my face to fry chicken and I'm so tired that coffee doesn't help. Currently, my husband and I (newlyweds) are working on the next chapters in life, children and buying a house and so he comes to me with the idea. "Hey, can you work more?" Ugh...now before you judge my hubby, he works 60+ hours a week on average. He's a police officer and they have an abundant supply of off duty gigs that pay somewhere in the range of 25-30$ per hour, sometimes cash money at the end of a job. It's wonderful if we want to go on a trip or buy something expensive. He'll work a few off duty jobs and those expenses never touch our bank accounts. 

Sometimes the off duty jobs are easy and there are plenty out there. All my husband has to do is contact someone and he can have a job that night. A lot of the jobs require little effort. The officer can just watch a building for security purposes. They can sit in their cars, read books and watch movies to pass the time until their time is over or if something happened. I wish nurses had those options! We can use our expertise in many ways! I wish nurses had the option to have a chill off duty gig for about the same wage we make hourly on our regular jobs. 

It's easy for my husband to say, "Can you work more?" because for him...working more is usually not really "working." For me to work more, it would likely mean to get another job, and ideally, an additional PRN job because that's where the most money is made. But with the PRN job means applying and interviewing, if you get that far, then waiting for the call back to be hired. Next, you'd go through orientation...and you'd start working. You would go to this PRN job likely after you've worked a full week on your regular unit and if the nurses were friends of yours, they wouldn't give you the most difficult patients because you're only there every once in a while. Some days may be slow but there are days when you would bust your ass and take names. My point, having an additional nursing job is not as easy as a police officer's "extra job." So I've been doing some thinking and I'm definitely a woman who looks for better solutions to life's problems. There is always a better way if you're not happy with something in your life or when things just need to be tweaked a little.

I started to ponder and think...something I do too much. Then I asked myself, "What would be my ideal way to make extra money?" Something effortless, fun, easy and enjoyable. Something that defines who I am, like a hobby! I did some research on those jobs...nothing nursing related showed up in the search results! Imagine that. I was waiting for the feeling of. "YES! That would be fun!" and I found it. 

People who know me well, know I love animals. I could never work for a vet or a shelter, however. If I'm going to have a second job, it has to be a happy environment, all the time. I researched animal jobs and found some places where they board animals when people go on vacations. I thought this would be a wonderful place to spend my free time! The drawback was the pay rates. Obviously, you can't make a nurses salary walking dogs and playing with cats. That's something I'm ok with and believe it or not, my husband is, too. The extra income would be small, but it's still extra income. 

What matters the most to me is that I would enjoy it. We all should do things we LOVE and if you get paid in the process, that's only the added benefit. We should have hobbies and surround ourselves with people, places and things that make us smile and bring joy to our world. Work doesn't have to be work if it brings you a special purpose. Many may not understand what I'm saying or why I would want to make extra money working with animals, but it's not about what others think. It's about me and anyone reading this. We go through life doing things we don't like. We go to jobs we hate. We marry people for the wrong reasons. We are depressed, anxious, tired. We often times neglect what we really want out of life, work at some place because we are obligated and want a  big paycheck. But to me, it's the little things and it's about enjoying life. I have my career which I love and it's my passion, that's already been established. My job makes me happy. I love the patients and my co-workers but if having another job means less time with my husband, being more tired from working more hours and just bringing additional stress, then it's not worth it. 

I'll close with this...

Find a career that you love, then work on you, define yourself with friends, hobbies and things that make you happy and if someone wants to pay you for having fun, then that's your extra special, little life bonus :) 


Tuesday, September 3, 2013

Back on Topic Now!

So lately, if you've been reading along, you may have noticed the last couple of posts have been not about NICU nursing. There has been so much going on lately and I've needed to take care of myself but now that we're back at the swing of things, I'll make a post about none other than one of the greatest things in my life, MY JOB AS A NICU NURSE! There has been a lot going on at the farm, but not a lot of admissions. We've hit a lull in babies, especially the micro-preemies and critical babies. I hadn't had a difficult baby in a long time and then I got one. A one on one. Everything went well though, I was nervous because not only has it been forever since I had a one on one, but I also have never had an art line and a baby on Versed and Fentanyl. Those are the babies that remind me why I do what I do... and when the night with them goes well, I feel like Superwoman walking out of the unit after a long shift! When everything with that baby moves in the positive direction: ABGs are great, so we wean, labs are good, no apnea, bradys or desats etc...it can be great for a nurses morale because you feel like you've fixed the current problems for the night. Yes, the baby has a long way to go but you've contributed positively in it's care. It's a great feeling when things go in your favor.

But what about when things don't go in your favor no matter what you do? It can be awful and make you feel like a bad nurse. You take it home and can't shake the questions...what if I would've just did this or why did that happen? Sometimes it's not about what you do or could do, it's just the baby. Then another element to your hectic shift, the oncoming nurse comes to you for report and you have to tell her the mess she's just walked into. She huffs and puffs and questions you, you being the new nurse and she the oldest, of course she knows everything and obviously more than you! But you go home and beat yourself up, maybe cry a little but tomorrow is a new day. Things happen and you move on. You do the best you can and if you've given it your all, then that's what matters. No matter what the next nurse says about your care. You can't take it personal and should stand up for yourself!  

... I'll end with that. :)



To My Dad

It’s not just what you did that day, it’s what you’ve done for 29 years. You’ve taught me that my opinion never mattered to you and you’ve always downplayed my emotions when you were mad at me. You think I haven’t listened to you. You think there is something wrong with ME. But what you fail to see is that I have tried and I’m normal. 

I’ve tried to have a relationship with you since I was born and you whooped me with a belt and made me pee on myself when I wouldn’t stop crying as a baby. I have tried since I was in elementary school and you whooped me for not getting my multiplication tables correct. I’ve tried since middle school when I was in 7th grade and you told me the only way I could get a CD was if I got rid of my acne. I have tried to accept you for who you are but you will never accept me for who I am. I've tried for you, but always neglecting my needs in the process. I’ve continued to try and trust that you can give me what I need out of a dad, but through the last 29 years you’ve continuously let me down. You’ve hurt me so bad but then act like it never happened. You’ve tried to buy my love with clothes and tell me to say how great of a dad you are. 

I always thought that once I was old enough you would understand me. You would accept me for the individual I am, for the beautiful daughter I’ve grown into. But you don’t no matter how much you say you do. You can’t accept me. You don’t have it in you. I have no hope in you, even if you were to read this. You can’t see the emotional cycle you’ve put me through in this life. You do no wrong in your eyes. 

I don’t trust you. I told you the last time you blew up on me, that you can’t say things you don’t mean. You say hurtful, hurtful, horrible things that I can’t forget. You don’t apologize, instead you offer money. I told you last time you blew up on me that this was my last straw. I warned you. I’ve given you chance after chance after chance. I’m out. 

I had no choice but to be around you growing up, but now I have a choice and you don’t like it. You can’t control me in any way, shape or form and you cannot take one OUNCE of credit for me today. You’ve given me one thing. You’ve given me the knowledge to not ever rely on anyone without expecting something in return. You’ve ruined my idea of what it’s like to trust someone when they give out of the goodness of their heart because you never did that. You gave money and expected verbal praise. You had no control over my successes no matter how much you think that where I am today is because of you...that’s just another one of your characteristics of your mental disorder. Another is that you think you’re God’s gift to the world and your children.

 The best thing about being me today is that I don’t NEED you or anybody to take care of me. It became the most liberating feeling to only have to rely on me. I feel like a freed slave. A slave that’s free from the shackles of control, judgements, money, conformity and having no voice. I can be me and not give a damn. I can be me and not have to worry if I’m doing what you want me to do or if it looks right in your eyes. I can make my own choices. I can choose who to love and have in my life, as well. What I don’t choose is to continue to have you put me down and think you can hurt me over and over. What I have chosen is the acceptance that you will never change. I have accepted that I will never have the dad that I want or thought I had. I have accepted that you will never apologize for the things you’ve said or acknowledge that you were ever wrong at one point in time. I’ve also accepted the most important thing...I don’t trust you. I don’t trust you won’t hurt me again even if by some chance in heaven you begged and pleaded saying you would never cause me chaos and you loved me for who I am, that you accept me and my life and won’t try to change me. You’re word means as much to me as the next passing stranger. 

You’re not the dad I thought I knew. I don’t know you at all. I don’t like the person you are nor how you’ve treated me. You’ve messed me up in so many ways, you couldn’t even begin to make up for the losses you’ve cause me. Today, however, is a new day. It’s a day of revelation and a day of acceptance of the truth of things. It’s a day that I choose me and claim my own happiness. It’s a day of mourning over the loss of what I’ve tried to have for 29 years. It’s a day of sadness but with that sadness is a beam of light. The light being my liberation of no longer letting you hurt me, that it’s not ok anymore and if that means loving you at a distance, then so be it. If it means not having you in my life to reclaim my happiness then that’s ok. I choose to be happy and surround myself with people who love me for me and bring positivity in their relationships with me. 

If you read this, you’d say I was insane (as usual). You’d put a guilt trip on me, saying, “how could you not have your dad in your life?” When the question you should be asking is, “why did you let your daughters slip away?” Why would you do that? Why would you let that happen? How can you not accept your wrong and try to be better when I’ve tried so hard for so long to be how you wanted me to be and could never win? I’m done fighting now. I don’t have any left. So the best thing for me to do is learn from your example. People say you can’t pick your family, which is true. But just because they are your family, doesn’t mean you can let them take advantage of you. You don’t have a free pass. Well, you did, but you don’t anymore.