The RN Travelogue

I was pretty happy that they gave me some time off from work. Usually, when you are negotiating your contract, you request dates that you want to have off. It's in the contract then, they can't make you work those dates. Somehow, it didn't occur to me that I might want my 30th birthday off, or any time around it. I did email the scheduling person on the unit for an informal request, but there weren't any guarantees. Fortunately, she turned out to be a kind person and gave me five days off.

This will be something that Jess and I will have to work on more vigorously in the future. It's one of the things that you learn as a travel nurse, usually mid-assignment, and then you have to wait until the next assignment to take advantage of it. We didn't request any long weekends off together, so that will certainly have to be remedied next time, so that we have a better schedule.

I've been gradually getting more and more comfortable here at the Swiss Cheese. I've become familiar with the unit now, so it doesn't take me nearly as long as it did in the beginning. I did have an unfortunate experience, however, right after my first entry about this particular hospital.

Just to refresh, I had the worst orientation I've ever had. My one orientation day was before my computer training, and the entire day was spent either coding my one patient or trying to keep him from coding again. I had no idea where to even find the med cart for my next shift, much less how to find all the equipment and supplies. That's another thing to remember for the future--I will demand another orientation day (I should have gotten two anyhow) if my first day sucks.

So, the next shift just kicked my butt. I had two very busy patients, and I ran from room to room, trying to keep my head above water. I couldn't expect much help, it was a terrible day for everyone, they were running around themselves. I survived, however, and even managed to get all my work done. Tired but satisfied, I left, and didn't think much more about that day, considering it my true orientation day. That following weekend, I actually had a really good weekend, and was starting to feel good about the place, I was just starting to like it. Beware of such feelings.

I also worked that following Monday, a week after that frenetic day. This particular day was going well, I was helping people out, I got three nice IV placements, people were laughing and joking with me. I was feeling pretty good. Then, the manager of the floor comes and finds me, asking me for a moment to talk. No problem, I thought.

Once in her office, the needle that popped my bubble came out straight out. "Aaron, we've had a family complaint about you," she started right in.

Oh, yeah?

"Remember last week? Well, the wife of your patient said you made her feel uncomfortable."

Really? How?

"Oh, for nothing wrong. She came and told us that a traveler named Aaron had taken care of her husband, and he had seemed very disorganized. She said that you'd turned her husband by yourself, and that you didn't spend enough time in the room explaining to her what was going on with her husband. She's a nurse, too, and she said she just felt very uncomfortable about you."

Oh. Well, I'm sorry about that. (Note to self: never tell any family member, especially one who purportedly has experience in the medical world, that you're a traveler, until you really trust them. Which is never. There is no benefit to telling them, and they will use it against you if they want. Plus, would I have had this meeting if this lady had thought I was staff? )

"Oh, and since you're in here, we had one of our E-ICU nurses stop by with a complaint."

(In this unit, being the technologically advanced unit that it is, they have cameras that can watch you do all your work, and occasionally a voice comes on and asks questions and makes, um, suggestions. ICU nurses and doctors are the ones watching you. Talk about Big Brother. It's awesome.)

"Yes, apparently that day your patient's O2 sats were 89%, and you weren't doing anything about it. In fact, you appeared to be priming a tube feed bags. When she asked you (via the camera speaker) if you needed help, you simply said that he was doing fine. She thought that tube feeds must be more important to you than respiratory status."

(Apparently the wrong answer to give. I'm from the respiratory world, though, and for me, an O2 sat of 89% is just fine, especially with someone with chronic lung disease. True, I was aware of the sat reading, but I wasn't alarmed, and I was continuing to monitor it while I did other work

By this point, I was starting to see a pattern develop here. I wasn't going to get anywhere from trying to defend myself, so I simply puckered up and starting kissing. At the Big D, I always scorned those who sucked up to management, but I'm getting pretty good at it as a traveler. Two big lessons I've been practicing hard here: kissing butt and flying under the radar. The kissing butt part comes in when you don't succeed at flying under the radar, which is evidently not my strongpoint.

Anyhow, this meeting turned out to be one about how I had not done anything necessarily wrong, but by the exacting standards of this unit, I hadn't done things necessarily right either. I did point out that I had gotten a terrible orientation, that I really didn't get an orientation at all, which she admitted to be true. Then I told her that I had not gotten a lunch that day, it had been that busy, and that I couldn't find anyone to help me out when I needed it. I didn't point out that I'm not the type to sit in the room and hold the wife's hand and console her. Hey, your husband smoked his whole life, what did you think was going to happen? I'm a tough love kind of guy.

What I really got out of this meeting was that they have their eye on me here, much more than at the Y. This place is very confident in their superiority over any other place, that much is transmitted in most interactions with management I've had. That makes flying under the radar all the more important.

Either that, or getting better at brown nosing. I helped withdraw on a patient last week (we extubated the patient from the ventilator, which resulted in his death a half hour later). I made sure that I handed out a lot of hugs and condolences to the family. Normally I would have anyhow, I felt very bad for them, and they were very nice people. Given the recent meeting, this time I made sure to give out the hugs in the hallway.

Despite this less than pleasant interaction, I have been starting to enjoy my time here. I stay very busy, which isn't a bad thing. I have been able to listen to the doctors talk about some very interesting diseases and treatments. Also, since this is the major trauma unit of the hospital, I've personally taken care to two patients who I was able to read about or watch on the local news from incidences of the previous evening. That's pretty fun.

Besides, when I start to get comfortable with a place, I start to let my personality out a little, and a little of my humor. I've kept it on a tight rein here, but it's nice to be able to start to converse with people, to talk to the staff and have a little fun. Of course, my true humor will never make an appearance here, well maybe on my last day…

Until next time, be safe.