My first my own patient

This was an exciting day for me in my nursing career. It was my very first my own patient day. On Monday when I had my meeting with the nurse educator on my unit she said that she thought it was time for me to take over the complete care of a patient. I still worked with my preceptor, but I was the primary nurse. Talk about exciting. And it is cool because the timing of this event was perfect. On Monday I was feeling by the end of the day that I was to the point where I could learn quickly from being the primary care giver. I just waited and it fell into place. Or actually was put into place. :)
The day was a great one and full of learning experiences. Small but valuable. I didn't have my patient up in the chair yet when cardiac rehab came up to work with her. They were fine about it, especially because they had not given me a specific time, but I was still sad to have forgotten I needed to have her up before they came. I will now never forget that cardiac rehab likes the patient to be up when they get there if possible. Then after the rehab session, what should my pt call me into the room with but severe chest pain - radiating to left arm and jaw, she felt nauseous and was short of breath - classic chest pain. Let me tell you I was so thankful that I had read over the chest pain protocol for my floor that very morning. And thank goodness for preceptors. . . And nitroglycerine. But I remembered protocol and the meds to give, and she was ok an hour later. Time can almost crawl by when all you have are meds, but once someone is possibly having cardiac arrest in front of your eyes, time flies by and you wonder where it went. I also learned that I was better at keeping my cool this time than the last time this happened. I felt better because I knew what was expected of me. I also learned today that chest pain is really not that exciting on a cardiac floor. In fact, because there were not any changes in the 12-lead EKG strip, we did not even call her doctor. Chest pain is ok. Chest pain that is treated before oxygen deprivation results in cardiac death is a regular occurance on my unit. It took a while to settle the patient back down because she was upset that she would now have to stay in the hospital longer than before. But over all it was a great expereince. Lots of learning happening. I am going to love the day when I can think clearly and problem solve without panicking first. :)
Today I also had a Bosnian who spoke no English. His family left a list of 8 words that might come in handy in finding out what he needs. We are trying to figure out exactly what is wrong with him, it is a little more complicated than it originally appears. This pt. is really great though. We are getting to where we can communicate pretty well through motions, a few key words, and sound effects. Today I was beeping like the monitor to try to explain that when he heard the alarm go off he needed to put his oxygen mask back on. It took a few demonstrations, but I am pretty good at this whole beeping and miming thing. :) I may offer my services as an interpretor for those rare people for whom we have no interpretor on staff or call for their rare language needs. I think I kept him entertained. By the end of the day I had this huge stoic man waving back at me and giving me the thumbs up sign when I walked past his doorway in the hall. I love my job.
It is pretty amazing how much better your pt. and family receive care and respond to you if you take a little time in the beginning to establish a really good rapport. I love working with the families that come in. It is time-consuming, but when everyone is at ease, the pt. does so much better. I am beginning to have bigger aspirations about my career. I am still pondering them. Several are very appealing though. I hope I live long enough to carry out a couple of them. :)
Tonight I came out victorious in a battle with a cochroach for dominion over the living room. He kept scuttling out of dark corners all evening until he met his fate at my hand, delivered by one of Rachel's flip-flops. He was huge and ugly. I don't mind most bugs, but I do hate cochroaches. I think it is partially due to the horrible crunch their shell makes when you smash them, and partially due to the fact that I woke up one morning while I was at school and found one in my hair. That is a horrible start to a morning let me tell you.
I am singing in a Christmas cantata performed by the church that I have been attending so far. It is fun to be singing again. There are several songs that I like and the people are really fun. The director is pretty good too.
I have also been meeting lots of families with young children at church. Last week I babysat for a couple with 2 l ittle girls and a 14 month old boy. Tomorrow night I am keeping three little girls. I think soon I will be able to fill all the off days I want with child-care. And that makes me happy because I don't like life quite as much if I can't be in constant contact with children and babies. :)
It is turning to fall here. I hope it is breathtaking. Lots of people say it is not going to be a very good fall here because it has been so warm right up until we have started getting frost. I am optimistic however that my first coastal fall will be a beautiful one.
There is so much more I want to write, but not tonight. I am exhausted from my day and need some sleep/ This is my third day in a row at work. So glad tomorrow I am off and don't sit until evening. I can rest and catch up. I have been feeling old because my ankles, knees, and back ache after 12 hours on my feet. I have go to invest in some good shoes. I feel arthritic tonight. I think I will go prop up my feet. :) More to come I am sure.

*** So this is a slightly edited version of my post. I read over my post this morning and it was pretty crazy. I guess I was more tired than I felt at the time. The subject matter jumped so randomly from topic to topic, and the composition and spelling were atrocious. I have just made a few necessary revisions because many of the sentences made no sense to me this morning and were definitely not what I was trying to say. I made a few absolutely necessary editions and I will try not to compose that late at night again. I find it interesting that I included my late-night battle with a cockroach. Sorry if it is a little gross. :)