Overtime

Here's what I think--I think I'm going to actually garden this year.
The house is a mess. Working 4 days in a row is almost impossible to do, and keep sane. Jay warned me I would go crazy if I continued to do this. I think he might be right. I'm taking some time off next week, thank goodness. The kids will be gone. Everyone I meet and see seems like an imposition. Everyone an annoyance. I don't know how people live the way they do, self included. People seem too close. Their smells bother me, their hair, their conversation. Everyone looks foolish. Everyone is too fat or too thin, or too loud. I'm becoming a fascist.
The worst offender, of course is myself.
I don't want people to talk to me, sound itself is almost intolerable.
I felt better after I sat for awhile, but it's safe to say, I think, that my nerves are pretty raw.
By the fourth day of work, my inner dialogue is almost unbearable. Mondays. I hate Mondays. The most self-righteous, patronizing group of nurses work Mondays.
Wiz calls them the Monday Saints.
"Ahh...the saints of the unit, so clearly aware of their superiority--what would we do without them?"
Ughhh. They are insufferable, the bunch of them.
$564 I get for dealing with them.
Monday money.
Who are the Monday saints?
There's Regina, who I've told you about before. The one who refuses patients. There's Nathan--29, self-righteous, full of advice, always delivered in this folksy way, with the subtext of "you suck"--i.e. "Did you want her in the chair that long?"
There's Walter. Who puts Jesus into every sentence. Such as "do you think we have enough nurses to handle another admission?"
"I think we do, but it doesn't matter if I think so, it matters if Jesus thinks so."
or.."How's your wife doing after her gallbladder surgery? Is she getting better?"
"Jesus is making her better."
or "Achoo!"
"Bless you, if it is what Jesus wants."
or..."How are you?"
"I believe I am well, but I know I am blessed by Jesus."
SHUT UP!
Jesus...
It's my orientee's second to last week. Then she's out on her own. I'm not sure how much I actually like her. She's a good, reasonably competent nurse but I'm finding she has this strange, almost psychotic blind spot when it comes to her own errors. For example, last week, we had an admission--septic, pressures falling, and we were starting pressors. She didn't check or label her lines and started the dopamine at the same rate the maintenance IV fluid was written for--a dose that would have probably outright killed the patient in about 15 minutes. Because I'm on top of her, I caught it, but when we discussed it at the end of the week, she had completely rewritten the incident in her mind.
"the drugs we use are scary," she said.
"Yes, they are. You found that out the hard way, didn't you? We had a near miss."
"Yes we had that dopamine hanging and we didn't know whether it was ours or whether it had come from the other hospital."
"No, that's not the incident I'm talking about."
"Well, don't you remember?" she asks. "There were two bags and you were running them both?"
"No, " I said slowly. "That isn't what happened."
"Yes it is."
"No it isn't. Let me remind you--you started to run the dopamine at the same rate as the IV fluid because you hadn't checked or labeled your lines."
"I don't think that's what happened...." she started to get really defensive.
"That is exactly what happened. Do you remember it now?"
"I don't remember it that way."
I started to feel exasperated.
Finally, I got her to admit what happened. But the incident, and our review of it, really has me worried.
Things move so fast in our unit that mistakes or almost mistakes are bound to happen. It's why we have so many checks and double checks and it's why we try to cultivate a blame-free atmosphere. It's got to be a place where you can admit to mistakes, or lack of knowledge, so that everyone can bring their best to treating the patients. If she covers or reframes, she'll screw someone up, and the hostile blankness in those opaque brown eyes really bothered me.
During rounds, the Dragon did a terrible thing.
I was letting my orientee handle rounds, and she was interrupting inappropriately--this is another thing that bothers me about her--she doesn't listen to other people.
He turns to me and in the middle of her sentence he growls, "You don't like her very much, do you?"
I was taken aback. I don't. But I thought I was covering it.
"Of course I like her!" I mean, what do you say?
"She doesn't like you very much," he says to my orientee. "You'd better step it up."
Well, two points for the Dragon, I guess. But...I'd rather be putting a nurse I could trust out there. I really think there's something a little wrong with this one. But how do you quantify that? She's hitting all her marks...
well that's my 1/2 hour.