I will warn you that this post may contain some gore... (Katrina this notice is mainly for your delicate stomach)
I fricken love being a nurse! That being said I have only been on the unit 3 times. I was really nervous after accepting a job on a burn unit mostly because I have never seen a burned body, EVER. What if I couldn't handle it? I am not feeling confident that I can deal with it, let me tell you the adventures of my first week of working hard for some money.
There has been an influx of new Graduate Nurses like myself on the unit that I am joining. Luckily there is another chica who is just starting with me. We were able to spend our first day just watching what people do in the various parts of the unit. There is an ICU side of the unit with 8 beds and regular side for less acute patients with 16 beds. They use the regular side for overflow from other units so I have some experiences with non burned patients. I have quickly learned that I need to eat a hearty breakfast before working. Lunch breaks are delayed until 2-3pm on most days and I have seen some stuff that makes me squirm a bit.
Day One: 6:30am I learn how to clock in (Important skill since I like to get paid) But the hospital I work for is really strict, you need to swipe your badge between 6:27-6:33. If you don't get there in that magic window you get an "occurrence". It's a long explanation but you are allowed only a few occurrences before oyu get in trouble. There are a ton of things you can do that will earn you these "occurrences". NIGHTMARE, I have enough to worry about.
SO back to my work adventures. They started me out in the hydrotherapy room. Sounds like a day at the spa, right? WRONG unless your idea of relaxation is having your flesh scrubbed off. Thank goodness the first victim wasn't too badly burned. The hydrotherapy room is referred to as the Tank and it has a fancy tub with a lift, metal beds with hoses coming out of the ceiling for spraying down patients, french fry lights to keep them warm and other goodies to help hose down these people. This patient was only burned on their arms and back and a bit of the neck. Luckily they had this patient intubated and well medicated so they didn't feel what was going on. The skin looked like a really bad sunburn. Red, peeling, water blisters and soot. That's when I saw the nurses take out some surgical scissors and popping all the water blisters, ewww! Next they took wash cloths with soap and water and scrubbed this patient down. Skin and junk was just flaking off. I guess I never imagined that I would need to rub down this raw flesh. Oh I forgot to mention that since burn patients are at such high risk for infection you need to gown up in full PPE for this hose down process. So not only am I feeling a bit squeemish but I'm wearing a plastic gown that makes me feel like i'm in a rubber suit, hair net, mask, face shield and 2 pairs of gloves. I'm sweating bullets and I'm not even doing anything but watching the nurses do all the hard work. Then someone notices that the patients is shivering and feels cold. CRANK UP THE HEAT LAMPS! (Am I in hell? it feels like it) I was so relieved to be called out of that room to help turn a patient. This is when I reached the next level of ewww. This poor patient was severely burned and had a skin graft over their entire face. It looked like a mask of skin with eye and mouth cut outs just placed on top of their face with bloody crusty bits all around the scalp and ears where the staples had been placed. It was gross and sad. Then the finale to my day. I was called back into the hydrotherapy room (WHY ME!?!) This was the peak of grossness but I survived it thankfully. This is where I realized I should have eaten a better breakfast. Who wants to be the new girl who passed out on her first day? Good thing it didn't happen to me. This patient was severely burned on their entire backside and they needed to change the dressings from the skin grafts. Fortunately this patient was put under for this procedure because it looked REALLY painful. Their entire back and bum were red raw like meat. They needed to remove the dressings which looked like strips of sausage casing that was laid over the skin. The dressings were all dried and stuck on so they had to wet them down and peel them off. Unfortunately part of the skin graft was shredding so they had to staple the edges of the graft on this red raw flesh, yikes! I've never seen skin like this. LUNCH TIME, yeeesssss! Not much will kill my voracious appetite.
Day 2: To get new nurses ready to work on the floor you have a 12 week orientation where you are paired up with an experienced nurse who kind of shows you the ropes and makes sure you are competent enough to fly solo. I got paired up with the nicest nurse. She's super nice, not any of that "Nurses eat their young" crap that they terrorized us with in the ACE program. In fact all the nurses on the unit that i've met have been uber friendly, nice and welcoming. I couldn't have picked a better hospital to be at. And it's not just the nurses that are friendly, the doctors, residents, respiratory, PT, OT, EVERYONE IS NICE! I was quickly reminded again that I needed to eat a better breakfast. We ran around like crazy people on the regular side of the unit with a full house and my preceptor trying to get caught up. We didn't get to escape to lunch till 3:30. Right before that we needed to help take down a dressing of a patient that had severe burns to both their feet. They had placed skin grafts on the feet and the doctors wanted to take off the bandages and remove the staples. Here I am ready to chew my arm off and I had to gown up in the PPE outfit that makes me sweat like I have my own personal sauna, how up this patient's leg while my preceptor removed what looked like 100 staples from each foot. I was hot, sweaty, famished and I had to stare at her plucking all these staples off this patient's foot, in between his toes, red raw flesh that was bleeding and skin getting stuck on some of the staples. Good gravy I thought I was going to lose it. I had to take a visual break and stare at the ceiling for a bit so I didn't crumble on the floor. I was so glad it was over mostly so I could eat some lunch. I have yet to find something that takes my appetite away from me. This was my first time working a full 6:30-7:30 shift. To say I was exhausted doesn't accurately describe how tired I was at the end of the day. Run over by a herd of cattle and then hit by a million trains hits closer to home. I am so lucky that Nate's Mom lives close to the hospital and lets me crash in her spare room when I need it. I drove to her place, ate a jar of pickles and went straight to bed by 8:45. I was up again at 5:15 for day 3 of work.
Day 3: Today I had my first experience on the ICU side of the unit. To be honest I never had any desire to work on the ICU side, I would much rather be a floor nurse but that's not an option on this unit, you have to float to both sides. I felt slightly more comfortable since I had seen some basic things the day before. I was in charge of doing assessments and doing meds for 2 patients and charting some basic things. By the end of the day I was pulling meds from the Accudose by myself and giving IV push meds to patients without anyone watching me. I felt like a real nurse for the first time. IT WAS SO COOL! There was even some excitement. They sent me into a room to watch a patient who was getting intubated because I hadn't seen that yet. They kept the crash cart outside the room just in case things took a turn for the worse. The patient had a lot of co-morbidities and wasn't doing too well to begin with. Shortly after the tube was inserted the vital signs started dropping. I've never seen such low vital signs (mostly because I was with healthier people) Soon you could sense something was going to happen. There was already a lot of people in the room to assist with the intubation but soon people just started collecting. There were 10 nurses in there with a handful of doctors, respiratory, anyone who could lend a hand and they proceeded to call a code. People were lining up to do chest compressions, the resident was calling out drugs to be infused, other people were keeping track of time, documenting. It was really cool to see how everyone was working together, it wasn't how I imagined it to be. Everyone was working quickly but it wasn't the crazy chaos I had imagined. Regardless, I am TERRIFIED of code situations. I worry that I'll freak out or get emotional. Someone is literally dead and you need to do something quickly to pull them back or they will be gone forever. Unfortunately in this case the patient did not come back. It was really sad but since I didn't know this person, they weren't my relative it wasn't quite as shocking to my system. I'm just hoping that when the time comes to do chest compressions in future codes that I don't become weepy/crazy/emotional/psycho.
Overall I had really enjoyed work so far but I'm still adjusting to some of the work hazards such as the funky smells that come from patients. Quite a few of the patients have fecal catheters. Just because your poo is traveling in a tube from your bum to a bag doesn't mean that the smell is contained. IT'S STILL THERE!, Dead body, healing flesh, ointments and stale urine just hang in the air. Thank goodness for doors. I wish I had Heather's secret talent to plug her nose without using her hands. I just have to breath out of my mouth. It is also hospital policy to wash your hands before you enter and room and after you leave EVERY TIME. Forgot to grab an extra towel? Need to grab a flush in the med room? Have to grab an extra hand out in the hallway? You better put some sanitzer on your hands before you walk out of that room and re-enter. Even if it's for a second, your hands might still be wet with purell from exiting before you need to reapply to enter another room. Have you tried putting gloves on while they're still wet with hand sanitizer? #Realworldproblems. #Lifeofanurse. There are secret hospital spies that watch to make sure you do it, you can be fired if you are caught too many times not following the rules. I feel like my hands must be sterile given the pounds of Purell hand sanitizer that I spread on them during the duration of a shift. I don't even want to think about what I'll have to do it I get a paper cut. YOWZA!
I am an aquarius who likes long walks on the beach and the flicker of candle light. If you haven't noticed yet, Just kidding! I'm a Vermonter who has left my beautiful home state in search of adventure. This blog contains all of my favorite things, mostly food so that my family back home can keep tabs on me. Mom & Dad I'm still alive!!!! Side note: I am terrible at spelling and grammar. There are bound to be typos all over this blog. It's like Where's Waldo. If you look hard enough you will find an error.