Wednesday, July 01, 2009

1 month old

Today is day 20 of taking team for me. And I have made it through 1 month, yeah!

Took the team with the rooms far from the nursing station again today. Started with 6 patients. There was 1 discharge near noon and 1 new admission around 1pm, and thus the total remained 6 at the end of the shift. Managed to create the blank pharmacy billing forms and but not medications to-do list right before report passing.

2 SN (L and I), 1 HCA M and 1 SEN IV as runners (SEN IV on my team), the SSN R was in-charge. The admin staff M was also on-duty. The morning started with a snit, see minor things below. Fortunately I moved on quickly and got on with the tasks of the day. Besides her regular runner duties, SEN IV offered to help me with one perineum swap and PP wash, so that saved me some time. Served medications on-time, assisted 3 doctors on their rounds, discharged 1 patients with patient education, completed pharmacy billings, completed ward billings, answered call-bells, answered phone calls to the ward, PS for pharmacy supplies and collected the supplies, reviewed case notes, trace lab reports and documented events into nursing notes. As I had 3 IVs and 1 nebulizer due near the end-of-shift peak (1+ pm), I decided to avoid the last minute rush by completing my flowcharts and taped my team report at 12+ pm. There was again a new admission around 1+ pm when SEN IV was busy with taking the 2 pm vital signs, and I was busy with the IVs and nebulizer. In the end, SEN IV did the admission assessment, SN L transcribed the doctor's orders and labelled the tests to be done, SSN R called up for the diagnostic staff for action, leaving the medications for me to follow-up. Luckily I taped the team report in advance, so I passed the new case verbally and followed up with the new case's medications at 2+ pm while the afternoon staff listened to the taped report.

There are minor things that happen that I don't mention. One example would be this morning. SN L missed her bus and would be slightly late for work. For the past 2 days, SN L and I have been on the same shift. She took the team with the rooms far from the nursing station while I took the team with the rooms near the nursing station. However, our team assignments were switched over this morning. Since it would be easier for her to continue with the cases that she is familiar, especially given that she was rushing on her way to work, I offered to SSN R (as in-charge) that I do not mind switching teams. SSN R did not acknowledge the good intention of my offer, instead she gave an irritated reply to stick to the assignment book. I decided to treat it as a miscommunication at work and leave things as that. From my experience of the nursing culture, the more one tries to clarify in an unfavourable situation, the worse matters become. This is a reflection of how others interpret your intentions due to their own thoughts and past experience.

Another snit at the end of my shift today. My preceptor was in-charge for the afternoon shift. She feedback to me on items to note and improve. For some reason, I acknowledged but did not thank her for the feedback. Think she did not take it so well.

Today has been an ok day for me, despite the commotion over the confirmed H1N1 case under SN L's team. Had time for tea and toilet break, although I only ate lunch at around 2:40pm after my shift was over.

Last month I disciplined myself to blog daily about my shift, to de-stress and also to give myself a realistic tally of the good days, the moderate ones and the bad. Given that my shifts are now more stable with moderate ones like today, I have decided to discontinue my self-enforced daily blogging. I still get "newbie doubts" of course, but they are not so overwhelming as in the earlier part of my 1st month. I hope that with time I will be develop into a capable colleague and build good relations with my colleagues.

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