MGS RADAR

My nursing training is coming to an end, it’s almost unrealistic to me because I can remember the first day in nursing school, the first patient I washed, my first room I got for myself, the first patient that died in my care (though, very late in my whole career), my first CPR, my first emergency suction, my first intubation assisting, my first intravenous line, my first intramuscular injection.

In the first year I knew nothing, I thought I knew something but I didn’ knew shit

In the second year, I thought I knew everything but everything was “limited” to a small ammount of patients

In the third year, I have so much knowledge and doesn’t really know how to put it into action, frankly I feel like in my first year where I didn’t knew shit!
People are telling me, after you get your R.N. title the whole training starts from the beginning, limited to a one month frame.

People outside the hospital see me as a kind of medical expert, in the Fire Department they think of me as some kind of medical hero who knows everything. How many times I have been asked “Do you know what that could be?”and the only thing I could say was a list of probable diagnoses.

I’m applying for intensive care nursing jobs, and it’s quite unusual because the general public of nurses think you have spent some time on the regular floor to earn yourself some credibility then you can transfer to intensive care.

I want to take a shortcut, some people advice me not to do it , some of my mentors say do it, what do you have to lose?

If I think of myself a few months from now on and I see myself on the regular floor with 30-40 patients, I’m a little bit afraid. I’m not sure if I can handle this “good” which means according to my standards. I have high standards to myself, but I don’t tell anybody about them because I think development and skill starts in your own mindset, deep inside yourself you should be your worst and strictest critic, but you don’t have to tell anybody about it!

If I think of myself a few months from now on and I see myself on the Intensive Care Unit or in the Anaestesiology Nursing Department which is in some aspects more demanding, I KNOW that I can handle it.

It’s a little bit crazy, around monitors, suction tubes, intubated and sedated patients on a thin line between life and dead with thoausands of infusion pumps and solutions…I feel comfortable !

A CPR-Emergency is the worst nightmare for any nurse working on the floor, if a code blue is coming in they sweat blood and they have a natural tendency to “hate” it. Even though it sounds a little bit strange and weird, during a CPR or code blue I’m in my business. I’m still a little bit shaking during CPR’s BUT in fact everytime I take an act, I feel comfortable and “like” doing it. Sometimes it’s just crap, sometimes the humanity is fucked up but I like it.

I can watch a patient’s monitor for hours. I get hypnotized by watching the curves, the ECG , the blood pressure which raises everytime I touch the patient. I can watch the pressure - meters on the breathing - apparatus for hours, adjust the monitors, listen to the patients breathing. I like calculating the fluids, I like working with medications, drawing up syringes - Nursing the numbers and having a challenge.
I’m far away from knowing everything for working on the floor, but I won’t be good at it. On the floor I’m only average because the surroundings only allow me to do “average” work. And I don’t like average work, I want to give my best and I think from all the wards and all the patients I worked with that THIS is my place at least for the next 2 years!

I really don’t care about the money, beginners salary is so fucking bad, I could get more money at McDonalds (I think , don’t know) and my plan of reducing my hours is not worth the money. At an university clinic I’d get 1966,00 € which is around 1400 - 1300€ taxated salary. Around 15000 € per year left for me. There is a plus for nightshifts , weekends and public-holiday working, but in my paying level it’s ridiculous. Nursing is nothing that will get me rich…

I don’t know how I can bring this to a boss-friendly level and sell it to them, but this is my idea!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]

A 12 year old male patient presents in the Emergency Department with acute abdominal pain in the whole abdominal region. The pain started around 8:00 at the same day of presentation in school, has no specific details and can’t be relieved by positional change.

Pt. states, that he ate a sandwich at school, then cornflakes at home and rice in the evening and ate 2 cheeseburgers despite abdominal pain plus slight discomfort or nausea.

At the time of presentation (around 23:00)  he denies any kind of nausea.

Abdominal exam shows no pain to pressure , visible and papable meteorism (air in the stomach and intestines) no masses. Auscultation indictates elevated peristaltic movement.

The father of the patient insists on clincial admission due to “things” he read in the magazines
The pt. is asked why he decided to ate these “heavy” things due to abdominal pain, pt. states he just was hungry and “forgot about the pain….
Diagnostics:
Physical Exam and Assessment of patient

Nursing:
Pain relieving positional change

Therapy:
Pt. recieves one tablet of Simeticon

Sometimes I just think, that mytime is wasted despite the fact that I can’t change it!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]