Wednesday, August 21, 2013

Reactivating

I am not good about maintaining this blog, which is unfortunate because after my generation dies only the internet will remember us. However, I am currently embarking on a degree in American Sign Language (don't worry, still a nurse, still love it, just want to communicate better with patients) and have been assigned to keep a blog for my latest class. Strange things may appear here over the next few months related to that, so nobody panic.

Meanwhile, what have I been up to? Back in January I took a job at a local hospital. The jail paid the bills for a while and the work was interesting, but for reasons unrelated to inmates it was a hostile work environment and I am not sorry to have shaken its dust from my feet. My current job is on an orthopedic and post-surgical unit, which is much, much better than I could possibly have guessed. 

We get mostly patients who received joint replacements (hips, knees, and shoulders) and therefore work with a lot of physical and occupational therapists and a battery of equipment designed to increase mobility in a new joint patient.Other patients are those who had appendixes (appendices?) and gallbladders whisked out and the occasional hysterectomy. 

This differs from classic med-surg (regular sick and hurt people) in two key respects. Firstly, my patients typically stay 1-3 days, whereas it is not uncommon for a med-surg patient to stay for a week or even several. Think a little old lady with pneumonia or a person with a chronic bowel complaint. Secondly, and perhaps more importantly, my patients are not usually sick. They are healthy people who have elected to have a joint replaced, or otherwise-healthy people whose appendix suddenly jumped ship. They are, however, people with a fresh surgical wound. This means that we are meticulous about hygiene and cleanliness, because not only do we want to keep these patients from contracting any of the illnesses that may be present in the rest of the hospital, but we also do not want their surgical sites to become infected.

My only beef with this job is the patient:nurse ratio is too high, normally 5:1 or even 6:1. For your purposes, since I am required to see each patient hourly, you receive approximately 6 minutes of my time an hour, during which I chart furiously on the computer in your room, before I must run to the next patient and do the same. If you are comfortable, do not have to use the bathroom, have everything you need within reach, and just want to watch TV or nap, this is fine. But if you are getting medication, need help to restroom (and if you have a new hip this will take a long time), or have a concern or a question you want to discuss, I need much more time to dedicate to you. 

I want each patient to feel like my only patient, and if I have six at a time, that's simply not happening. It's a shame, but it's also fodder for another post, so we'll leave it there for now.