So as usual I am ready for a change in my nursing career path. I am bored and done with pre-op nursing. I am ready for something different but have no clue what that should be. I have been thinking that Float Nursing is the only thing I should be doing. I do not get bored, the job/floor is always different every time I go into work, I set my own schedule, and there is NO nurse drama that I have to continuously  deal with each time I go to work. It is a perfect fit for me. I stopped floating when Chris lost his job 2 years ago.  I needed to go full-time in order to have health insurance, and since then I have not found anything that I want to do ALL the time, every day, for years and years to come.

So what now…I have sought out several other job opportunities but none have panned out. I am trying to get into the Texas Health Care System because in 2012 they will have completed a Keller, TX hospital…just 3-5miles from my house! SCORE! There would be no more hwy traffic (i hate hate hate traffic) and with the past ice storms it would be a lot less stressful to drive 5miles vs 15miles across multiple bridges. And Chris could even join me for lunch! (and deliver flowers..hint hint! haha) So fingers crossed we shall see what happens next in my nursing career path!

check out what the new Keller Hospital will look like…

http://www.texashealth.org/body.cfm?id=3394

I will keep ya updated!!

I will never be able to say again that “I’ve never had the flu.” When the nurse practitioner swabbed me for flu this last Tuesday I just knew she was wasting my money on a test that would come back negative. So I patiently waited for the results and the antibiotic prescription I would need for my self diagnosed upper respiratory infection. WRONG. The test came back positive. CRAP. Good news…I was a good nurse and took myself to the doctor as soon as I felt bad with a fever and I caught it before 24hours. So I started on Tamiflu and waited for all of this to pass. A couple of days off from work is always a plus too, even if you do feel slightly bad. The next day I felt better but why go back to work and get my patients sick…right? I gathered my sick person items and settled on my couch!

I kept Chris at bay because my parents were coming up for our church’s grand opening of our new building and I didn’t want him to get sick and then my parents get sick. It was probably the longest time ever that we hadn’t kissed or hugged. He was so cute and said…”Can I kiss you on the back of the neck?” I also think it was the most he had ever washed his hands in his life. haha

So when I thought I was in the clear what happens…I get worse. I got a full blown sinus infection and felt worse than I did with the flu! Luckily this wasn’t contagious, it just meant I couldn’t have as much fun with my family as I would have hoped. I think everything turned out ok and my parents weren’t too bored.

So for all those out there during this cold/flu season Please! Please! Please! cough and sneeze into your sleeve, wash your hands constantly, and be pro-active about about your health! It not only protects you but those around you!

Ok…let me just start by saying this is completely intended to make you a better patient the next time someone is drawing your blood or starting an IV.

Rule #1: Let me start the IV where I want to! Do not tell me your IV can only go in the bend of your arm (AC: anticubital), and for me to not put it in the back of your hand! Trust me you want me to stick you where I know it will be a sure hit, unless you don’t mind if I for whatever miss. oops! Now I bet you would have rather let me start it where I wanted to in the first place!

I know what I am doing…so let me do my JOB!

Rule #2: Do Not tell me what needle I can use or should use. I can use whatever size needle I want too… most of the time, so you better behave yourself! Just kidding! But please do not expect to have the smallest needle known to man when you are going in for surgery. We have to use a LARGE needle in order for you to receive the medications quickly and effectively while you are in the LaLa Land of your anesthesia! Some places (like my hospital) are nice enough to use Lidocaine with Sodium Bicarb, which not only deadens the skin it takes the sting out of it so you don’t feel that large needle entering your vein!

the 2 on the right are the one’s most used on adults: 18g (green) & 20g (pink) needles

Rule 3#: Do Not move your legs or reposition yourself while I am starting your IV. We have to set up our IV kit and most of the time it is going to placed in your lap, which is playing the role of our table. Plus the blood tubes, IV line, syringes, etc…

Stay still until the IV is in your arm and nicely secured. By moving your legs you have just dumped everything (in the above pic) onto the floor, which only slows everything down or complicates matters. So please stay still and take yourself to your “special” place if getting an IV freaks you out!

Rule #4: Do Not JERK! If you jerk when I poke you with the tip of the needle you risk injuring yourself and me! I do not know if you are carrying around some unknown disease or not! So again stay very very still!

OUCH!

There are plenty more rules that I am sure I could come up with but for the time being, this is it! This is also me venting my frustrations about people who are not good patients and insist that they know more than I do. I have been a nurse, starting IV’s for 7.5 years now, give me some credit! And now I  start 10-15+ IV’s a day. Be a GOOD patient and let us do our jobs! I promise we DO NOT want to stick you more than we have too!!!

there are graphic pictures included…

So in my new job, I pre-op a lot of different people who are having different procedures. It could be a total knee or hip replacement, plastic surgery, hernia repair, tonsillectomy, etc…however the most I tend to see  is an excision (cutting/removiving) of a melanoma of some kind. At first I was excited to pre-op these patients because most of them didn’t need a lot of blood work or an EKG, but then I started realizing how many people were having melanoma’s removed. The melanoma’s were also not your typical expected melanoma, like what I studied and had drilled into my nursing brain in school.

This is normally what you see in textbooks, pamphlets, magazines, etc. and might even hear from your primary care doctor’s office on what to watch out for:

Yea…this is all I was watching out for until I started this job. Mind you I am as pale white as you could imagine and so is my husband. So white and pale that our dermatologist said that we MUST come in once a year to have our moles, freckles, skin in general checked out. And to wear SUNscreen. We keep an eye out for anything that looks like the above pic but I wasn’t expecting some of the things I have witnessed in my current job.

Most of us think that this is what you should be concerned about:

A dark, weird, gross, ugly black spot growing on our skin…right?

Not this:

This looks like a normal freckle…much of what my husband’s shoulders look like, freckle-y! This in fact is a melanoma.

I have so far seen melanoma’s being removed from a person’s head, nose, ear, neck, flank (back-area), finger, but today I took care of someone with a melanoma of the nail.

He had to have his nail removed and probably scraped. He had thought he had just hit his hand/finger or something and it was a bruise. WRONG! It is a type of melanoma called: Acral lentiginous melanoma

Another lady, who was a nurse and knows the above table (diameter, color, asymmetry, border) said she just had a pink spot that wasn’t going away, thought it was a scar, turned out to be a melanoma, and had to be removed.

I did some research and turns out you can have melanoma’s in a lot of unexpected places:

Your eye-

Your mouth-

And other places (your buttock) you don’t check or know to check-

I don’t tell you this and/or blog about this to scare you into hypochondria (which is sometimes hard being a nurse), but rather to inform you on the importance of taking your skin serious, as much as you would your heart, cholesterol, blood sugar, weight, etc…

So please go see a dermatologist…whether you are as PALE white as me, Hispanic, black, Indian, etc….we all can get skin cancer and it so easily caught if you are watching and being health conscience. Trust me (being a previous oncology nurse) cutting off one small unusual freckle is better than months of chemo, radiation, and thoughts of dying when you could have just called up your doc!

Since starting my new job I have made quite a few friends (aka: my coworkers), and this beats sitting all by myself in the hall at my make-shift desk. The people I work with are fun, quirky, team-oriented, and good at what they do. They have pot-luck dinners once a month to celebrate the birthdays. I started pre-op  September 1st so darn it I missed my turn…so I thought. This past Monday we had the monthly pot-luck and they added me to the September birthday group! Awesome! and I got a gift too! Amazing!

Starbucks! YEA!!! pumkin spice lattes for sure! Thanks gang it was super sweet of you to think of me, being so new to the group and all! I was sincerly touched.  It feels great to be a part of such an amazing team of nurses!

Here are some of the peeps I work with…

I still LOVE my job!!!

Today was my first day off orientation, and not to brag but I was only on orientation for 4 days before being released. Technically, I pre-op’ed a patient on my first day all by myself. So, I think to myself this morning…”hmmm, I can do this, I think?”

Well let’s just say I became very FRUSTRATED

and very quickly! My second patient had a very unorganized chart. The tech brought the patient to me before I was ready and organized myself. The MD orders were NOT clear (or legible). Our charge nurse entered labs on this patient that were not clearly ordered and I had to get them anyways, just in case I was not seeing something I should have been seeing. (even though one of my preceptors looked at the chart and agreed with my assessment of the unnecessary lab orders). Then the nurse anesthetist and anesthesiologist came up and started digging through my chart that was not ready for them, and started talking to the patient when I hadn’t even do so yet. To top that off the OR nurse and the doctor then came to visit with the patient (this is not a good thing… to not be ready to send the patient back to surgery when the MD arrives is a no, no!) So yea, I was frustrated to say the least. It wasn’t that my co-workers left me to suffer a doctor lashing, they too were busy trying to hurry along patients.

I sent the patient off to surgery (10min) late and must have appeared quite flustered to those around me, who kept saying it was okay and that it just happens like that sometimes. I decided to brush myself off and not quit my job over one stressful moment…ha!

I continued to pre-op patients and the rest of the day went smoothly, without any dramatic glitches…

and I still LOVE my new job!

So, this last Friday was fundraiser day for The American Heart Association’s Heart Walk 2010 at our hospital. I was in charge of (or came up with doing) the bake sale. I posted cute signs around the hospital as reminders for my co-workers to either bake or bring money to buy the tasty treats. I have to admit this bake sale started out as a wanna-be competition between me, Paige, and our CNO, Eldon. The 3 of us are always baking and bringing our baking craftsmanship up to work to show off and receive praise. ha! Sad to say the competition didn’t pan out due to  complications (lack of judges and genius on how to come up with appropriate judging score cards). So we sucked up our pride of who would win and just sold our treats for the betterment of society’s heart health!

here is what I baked…

I made chocolate chip cookie cupcakes, and I must admit they were delish! A patient’s family member saw me taking them down to the bake sale and said she wanted to buy all of them and give them to the post-surgical unit nurses. I didn’t even get to sell them to my co-workers or show them off, but I did make $40 for them (over the asking price for sure!). I guess since it was for charity I shouldn’t worry about whether or not other people thought they were tasty. They were bought right?

Since I am an overachiever when it comes to baking, I did put together another treat for the bake sale with my leftovers from the cupcakes. I made chocolate chip doozies (2 choc chip cookies with buttercream icing in the middle) which were AMAZING, if I do say so myself!

My cookies sold fast as well, and I am just glad I could participate in earning some money for the Heart Walk.

Here are some action shots from the day…

this was not only fundraiser day it was my BIRTHDAY! and chris surprised me with…

I was super surprised!

This was also my last day as the myelogram nurse…this is my replacement, Lisa. I’m definetly glad she is taking over and I can move on!

Our crazy Friday celebration time!

It was a fantabulous day and I could not have asked for more…but wait I had an awesome birthday weekend to follow! Yea me and 29 years!

these are the faces i have been making lately!

It is official I am moving to Pre-Op. Once again, I am changing jobs. I will no longer be the Myelogram nurse at Baylor Surgical Hosptial. Hallelujah & Amen!!! It was good while it lasted, and was a much needed break from Oncology, however, it is now time for me to move on. This should be my last week in my current position, if the girl taking my position, Lisa, feels comfortable starting next Monday. Crossing my fingers!

I am looking forward to working with people again (i’m talking co-workers). I have been all alone in the hall with a makeshift-wannabe desk. All the action would take place down in the actual nursing station, and I would always miss the jokes, pranks, and just plain conversation. They would say “come work down here…” but that was impossible. I had to call patient’s and if they were cuttin’ up in the nursing station I wouldn’t be able to hear if the patient had had a heart attack, seizure, etc before…so I never moved down there. This left me all alone with only the passer-by’s to say hello to (maybe).

I will now be mixed in with my co-workers in pre-op, surgery nurses, and post-op nurses! yea!

so needless to say I am…

I am playing on a co-ed softball league with my co-workers from Baylor Surgical Hospital. When asked if I wanted to join the team I quickly said, YES, I would love too! Our first game was this last Thursday, we lost, but had fun…at least I did! We had several practices before the first game and only at one practice did everyone show up. We are a mix of people who have played and not played (ever!). We played a team that should NOT have been in our division, which is the “rec” league, aka: we aren’t serious just want to have fun league. This team was running double plays, and their center fielder threw the ball from the center field fence into 3rd…NOT us! So that is why we lost, even though I think we played fantastic considering the lack of focused practicing beforehand.

Here of some pics that Chris took of me playing…

During this phase of the game as I am running to second I decide to go ahead and run to third. That’s when I get caught in a softball “pickle,” which is when someone is in a rundown between bases. I don’t know what I was thinking!! I definitely wasn’t going to slide into third. I did, however, make it safely to 3rd with an roar from the crowd and my teammates in screams of excitement…they were probably glad I didn’t cost them an out in my moment of braveness! ha! I was sucking air for sure. I’m a little out of shape when it comes to short sprints. whoa!

Here are some pics of my teammates…

Kevin our pitcher.

John playing first.

Jessica playing third.

Santos playing short stop.

I hope our next game is more successful with a win! I love Thursdays, and I love that I have DVR since all the good Thursday night shows are about to start up…haha! Stay tuned for more softball stories…

Every once in a while a sweet patient comes into your “nursing” life, and not only are they sweet, but they do something above and beyond to show their appreciation.

In my current job this doesn’t happen very often because I am only taking care of my patient’s for approximately 4 hours, and then they go home. In the last month I have received two cards mailed to my hospital with attn: Jana (me) written on it. Both expressing their thanks for my care and kindness. (I’m not bragging but I am really nice…haha!) It helps that I too have suffered from chronic neck pain and can sympathize with their pain, discomfort, depression related to continuous pain, etc…even though I pray I never have to go through the amount of pain most of my patient’s have.

So one of the patient’s that mailed me a card had his surgery at my hospital as well. His wife saw me in the hall (my office) and just was beside herself to see me and just went on and on about the care I gave her husband during his myelogram procedure…

Here is the kicker…I didn’t remember her or her husband (the patient) at all. I recognized her face but could not place her for the life of me. (really out of character for me, ask chris) Of course I felt horrible, but smiled and acted like I knew exactly who she was…then she says, “when my husband goes to see his doctor for his follow-up I’m going to bring you a DrPepper cake”….(what?!?! I don’t need a cake! I don’t remember who you are!–thinking to myself).  I then say “You don’t have to do that, or go to that much work, your card and words are enough”…

She didn’t listen and today she brought me an entire 9×13 DrPepper cake…

You feel absolutely horrible when this happens…not remembering your patient or their family! You give the same care to all of your patients and never know what kind of impact you might have on them, because it’s your job! And when someone goes out of their way for you in return, you feel pretty darn special!

Even though cake is not on my diet…I had to have a piece! They made it for me right?!?! It was quite tasty for sure…