I must have been living under a big boulder, because I did not hear about the gloomy end of the world predictions until the night before it's anticipated arrival.
That night also happened to be my first solo flight at my new job. Interestingly, to me anyway, are the parallels I could draw between these two events in my life.
My first day alone was not catastrophic in the sense that earthquakes threatened to twist and snap the building in half. That I could have handled. No, what really happened was far worse.
I'm kidding, of course.
However, my end of the world came in the compressed version of an 8 hour afternoon shift where the clock was the enemy.
Tick-tock.
Twenty-five patients. Twenty-five sets of medications to pass. Eight hours. Sounds doable, right? Yes, if you're a seasoned, veteran nurse. However if you're new, like me, eight hours is the equivalent of eight minutes. Or something like that.
In a perfect world, the patients would all be in their rooms, anticipating my every move, eagerly awaiting their medications. But no. Life is not that simple.
And so the games begin.
First, Mrs. Smith. (The names have been changed to protect the privacy of the patients, under a court of law, so help me God.) A quick check in her empty room tells me all I need to know. Mrs. Smith is who knows where, and who knows how I'm going to find her, because I don't even know what she looks like. (Remember, I'm new, and I don't know many of the patients yet.) Yes, these people have a life, and could be out socializing with other residents in the facility, in the activities room doing, well, activities, and whatever else. The important thing for me is that Mrs. Smith needs her insulin before her dinner, but before I can give it to her, I need to stab her finger and check her blood glucose (fancy schmancy word for blood sugar) levels. If it is too low, and I give her the insulin anyway, she will be found face down in her dinner tray. I enlist the help of a nursing aid, who, next to God, is the most important person for a new nurse.
Mrs. Smith is found and wheeled back to me for the obligatory needle stabs. And while I have her captive I am also able to do a quick assessment on her and give her the necessary medications.
I'm feeling pleased with myself. Until I look at that clock. I quickly realize that I am going to have to pick up the pace. Twenty-five minutes to find and take care of Mrs. Smith. I pause to do some rapid mental math. At the rate I'm going, I will be giving 5:00pm meds at midnight.
Tick-tock.
My next patient/resident is a sweet, friendly elderly woman. I want to hug and kiss her for simply being in her room, but I refrain. I quickly tell her I will be right back with her medications. Upon my return, I find her sleeping soundly. A few hearty shoulder nudges startles her awake. To my surprise, she apologizes to me for falling asleep. I reassure her that sleeping is a good thing (Martha said so). As I hand her her pills and cup of water, I'm feeling smug. I'll be done with "Mrs. Jones" in under ten minutes.
Mrs Jones has other plans.
For the next five minutes, she prattles on about her roommate, her breakfast, the weather, her great-grand babies and the state of the nation. I listen politely, trying hard not to think about that darn clock.
Tick-tock.
On the plus side, as I listen to her talk, I am able to do a quick neurological assessment. She is orientated to person, place and time (she knows who she is, she knows where she is, and knows what day it is.) These are all good things.
I politely explain that I have to be going now, lots of other medications to give, and all. Mrs. Jones apologizes again for "being such a chatterbox." Little does she know how much I still love her for simply being in her room.
And my shift goes on.
As difficult as it can be to identify all of these new patients and residents at the nursing and rehabilitation facility, I have bigger mountains to climb.
The Med Cart.
For those still with me, the med cart is a rolling cart in which all of the patients medications are stored in neat little drawers. And what a bewildering array of medications there are. One drawer is devoted entirely to over-the-counter medications. Bottles upon bottles of everything a body would need are in this drawer. Some have names I've never heard of before, and finding them is akin to going on a treasure hunt. When I do finally put my hands on the desired bottle, I feel as though I've won a contest in a game show. I'm still waiting for my Brand New Car!
Tick-tock.
Each patient has their own section of medications, and each medication is individually sealed in "blister pack" bubbles. Simply pop the desired pill out and into a cup and viola, you have your pill. I wish.
Some actually are that easy, but the vast majority have to be cajoled, prodded, and basically poked with brute force to remove pill from plastic bubble. I glance up at the clock and begin to break into a sweat as I realize that time is not on my side. And most importantly, the 'five rights' have to be enforced at all times:
The right medication
The right patient
The right dose
The right time
The right route
Plus a new right someone recently threw in just for giggles: The right for the patient to refuse their medication.
Now that is fun. Spending all the time, work and effort, making sure each T is crossed and each i is dotted, only to discover that Mr. Smith absolutely refuses to take any pills, because his doctor said he doesn't have to any more. (Which, of course isn't true, and I have to spend the next five minutes trying to convince Mr. Smith to take said pills for his own good.)
And what do you think happened? You are correct. Mr. Smith didn't like this new nurse butting into his private life, and refused his medication. So, new nurse walked out of Mr. Smith's room with her tail between her legs.
Tick-tock.
I will not continue with any more details. I think you get the idea. Some med passes went rather smoothly. Some were a bumpy ride. Crushing medication and mixing with pudding does not a disguise make. But I tried.
In the end, I was battered and bruised by that damn clock.
But I survived, and, more importantly, so did my patients.
So help me God.
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