Normally I’d be typing something lame in the trend of “wow, it’s been a long time since I wrote on here!” But no, I refuse to allow myself to get into this pathetic habit of apologizing to the unknown internet audience abyss every time I feel like writing on this blog after taking a multi-month hiatus. I’m a busy girl people, deal with it.

So…wow though, a lot has changed. I’ll start with my personal life and then wrap back around to this whole nursing thing that I do. Things in New City are still foreign and weird compared to my cozy little suburban enclave that I’m accustomed to, yet strangely I find myself feeling more at ease here these days. Suppose that happens after being somewhere for so many months. It’s been…just about 6 months now that I’ve been renting this room in this skinny little house. I miss windows. I miss grass. I miss not feeling claustrophobic in my own space. But most of all, more than ANYTHING, I miss having a guaranteed place to park when I come home at night. Never again shall I take that for granted, EVER.

It’s not all bad though, and the stress of living here has admittedly decreased since Laura signed the lease. My former roomie, Megan, whom I’ve always been rather estranged to due to our 12 year age difference and the fact that she practically lives with her boyfriend two blocks away, is moving out this weekend to live with said boyfriend. Thus I went through a very stressful/frantic time period not long ago when I was trying desperately to figure out how to find someone to take over her part of the lease (she’d been subletting from me) since there’s no way I can afford this place on my own while still maintaining any semblance of my standard quality of life (which is not extravagent by any means). So via a mutual friend from college who lives one neighborhood over, I was introduced to Laura and now she’s moving in once Megan is out.

Although I am not the one moving and although I won’t be here for any of the moving out/moving in process thanks to the Thanksgiving holiday (of which I truly am VERY thankful indeed), I am surprised to find that it is still a lot of work on my part to facilitate this exchanging of roommates. They don’t know each other, so I’m playing middleman between the two in order to accommodate each girl’s needs with their moving process. This includes working out when Megan will be totally clear of the house so that Laura can move in. This is tricky for me because I feel I must still be welcoming to Megan at the house and sensitive to the fact that she has paid to be here through the end of the month, but that I must also juggle the reality that Laura must be completely moved out of her old place and into ours before December 1st. All of this is complicated by the fact that Megan and I have very different work schedules and she rarely ever comes by the house to see the notes I leave her or the bills she needs to pay or the forms I need her to sign for us to switch the cable out of her name. So although the major stress of finding a new roommate is over, I am still feeling the stress of the situation and just want it to be all over with.

I am also unsure how things will be in the house once Laura is here. She made me nervous last night when she came to leave the security deposit money for Megan because she had to sit there and figure out her finances for 20 minutes in order to be able to write the checks. Perhaps I am just more sensitive and private about my finances, but it made me uncomfortable to sit with this girl I don’t know that well who is moving into my house and will be sharing half of the household bills while she demonstrated financial dishevelment. If she’s having money issues, I don’t want to know about it. Just figure it out before we hang out and handle it on your own time.

Speaking of hanging out, we have hung out on several occasions and get along well, however I am not used to having a roommate who is around a lot or who wants to hang out. My previous roommates, even in college, were not very social and didn’t want to hang out very much, but Laura seems like she’s a bit more of a partier and someone who will want to come home and do stuff together. It sounds great in some ways, but it also sounds kind of…exhausting. I guess I’ve gotten comfortable with a quiet house and being by myself a lot in the evenings. Regardless of that, I am looking forward to this new experience! Once the move is all settled, that is…It will be very weird to come home December 1st after Thanksgiving at home and to walk into my house with all new furniture all of a sudden.

I can’t wait for Thanksgiving. I have not had 4 days off in a row since before I started my job on June 23 of this year. There is also a possibility that I may get 4 days off in a row for Christmas, although that is unsure as of yet. I like my job, but I do need time away sometimes. This week was admittedly better than last week (which was hell), and I can tell that I’m doing well in my nurse internship. Esther and I will come off of orientation on January 19, 2009 – FINALLY! After that we will be full-fledged OR nurses flying solo without preceptors and we will finally be able to self-schedule our shifts. I hope that I can do 12 hour shifts since that would give me more opportunities to be flexible with my visits home.

Since starting in June, we have been rotating through all of the surgical services offered at our hospital – two weeks circulating in each, then two weeks scrubbing in each. This arrangement has afforded me invaluable training in scrubbing, which as I’m told by more experienced OR nurses is hard to obtain as an OR nurse. The surgical services that I’ve been through so far are: General, Vascular & Eyes, Orthopedics, GU/GYN, and right now I’m in Plastics & Burns. Next I have Neuro, and then I’m done!

Yesterday was my first look at a really bad burn (greater than 70% of the body) and I think it was pretty much the most horrific thing I have ever seen in my entire life. Charred flesh, muscle, tendon, bone…I was literally standing next to the bed thinking “I’m looking at a corpse.” And sure enough, that poor man died later that day. Nursing can present you with strange emotions though. When I heard today that my patient from that case had passed away, I was relieved and grateful. I felt that it was more merciful that he had died then than living even a moment longer in the shape his body was in and the pain he must have felt. You never expect to be thankful that someone had died though, especially as a nurse who’s goal in life is to save and improve lives, however I’m finding that sometimes the kindest thing you can do for a patient is to let them go.

This has made me very passionate about the importance of everyone making their wishes known in case of a health emergency such as this poor man’s. Everyone should make a serious consideration of what kind of life saving measures they would wish to have made in their behalf should something happen to them and their family have to make those horrible calls. At least if the family knows what you wanted and did not want, they can feel at peace in making those hard decisions in a moment of extreme emotional turmoil and pain. Issues like organ donation, DNR orders, living wills, advanced directives…I could really be an advocate for these things.

My experiences in nursing, and particularly now that I’m in the OR on a daily basis, have also made me feel strongly about the importance of blood donation. As nurses, we hear/see/feel the blood shortages when they occur. It can be very frightening to know that if you use up what you have for a patient, there may not be more available when it’s needed. For this reason, I went yesterday to the Blood Drive being held on my hospital’s campus and tried to donate. Sadly I was turned away for a hemoglobin that was just shy of their desired level, but I’m proud that I tried. In college I would go every other month with a girlfriend and became a Blood Bank member. Even got a neat little certificate when I reached the 1 Gallon donation mark. So if you can give, please – GIVE.

Anyway, I’ll get off my soapbox now. Going back to my nurse internship training now. In September we had 4 new nurse interns start. This is the group that Esther and I were originally scheduled to begin with, however when nurse recruitment gave us all the option of starting in June instead, we were the only 2 that accepted that option. And now I’m even more glad that I did! Even though we were still cramming for our nursing boards while starting the new job, Esther and I had a smoother start in the nurse internship program than the new 4 people have had.

When we started, we were the only 2 new people on staff who were being oriented and precepted on a daily basis. For the 4 new nurses, however, they entered our OR during a time when there’s me & Esther, the 4 of them, 3 new scrub techs, 2 scrub students, and 2 new “experienced” OR nurses (who suck). So that’s 13 new people who are all orienting at the same time, and the OR staff is completely overwhelmed. When Esther & I started, our preceptors were patient and gentle with us and our lack of knowledge. The 4 new nurse interns have essentially been thrown to the wolves though since the staff is tired of having to train new people constantly while not receiving additional pay for it.

Also, when I started Belinda the Educator was new and had more free time to spend with Esther and I to direct our placements and our education. Now that she is in the thick of things with her role, she is often pulled away from the OR for meetings and education training programs, leaving the new interns with very few people to turn to for help when things go badly. Belinda is trying the best she can to provide them with the experiences they need and to pair them with preceptors who are members of the permanent OR staff (rather than travelers or people fresh off orientation themselves), but there are so few people on our permanent staff right now (helloooo nursing shortage!) that it is very difficult for her in addition to the other responsibilities the hospital administration has placed on her shoulders.

I am grateful that although it was hectic when I started in June since we didn’t have our educator for the first month, we still had a smooth start and positive first exposures to our surgical service rotations. It’s painful to watch the 4 new interns struggle while getting started in the current negative atmosphere that has pervaded our OR due to higher case loads, more staffing problems, and higher stress levels throughout. Despite these challenges, I would have to say that they are all doing remarkably well overall. When Belinda and the 6 of us nurse interns meet to discuss everything, it often ends up being more of a group therapy session than a debriefing or opportunity to learn from each other’s surgical experiences. It’s organized chaos in the OR, that’s for sure.

I know that at most other hospitals, nurses in the OR do much more circulating than scrubbing, but I really enjoy scrubbing because I learn more about the surgical procedure since I’m actively taking part in what is happening and it requires me to pay attention to what is happening. I also like scrubbing because you get to know the surgeons better and because you have complete control over the back table. I guess that’s part of my territorial control freak coming out, but I like having a space that is just mine to manage, whereas when you circulate you are often running around like a chicken with its head cut off trying to get everything done around the surgical field.

Knowing how to scrub for any kind of case will make me very marketable whenever I decide to leave my current hospital, which is excellent because although it’s a good place to be and very highly respected, I want to go back home. The big hospital that I used to work at has 26 operating rooms and does open heart surgery, which would be great experience in comparison to the mere 10 operating rooms that I’m floated between currently (which don’t do any cardio-thoracic surgery at all). Once I move back, I know I will appreciate my hometown in a way I never did before after having this time away. Everyone who’s ever been away from home will tell you that, and it’s true. There are many wondrous, beautiful, amazing places in this world, but like Dorothy said in the Wizard of Oz – there’s no place like home.

When I do move home, I think I will remain in the OR for another year. I’m still up in the air about whether to do this or whether I should try to go straight into an ICU setting since I need critical care experience in order to apply to CRNA programs, but since moving home (by which I mean, moving back in with my parents for a few months prior to the next step) will be tumultuous enough, I think I should stick with OR jobs for awhile. That way I at least will have a clue what I’m doing when I go to a new hospital while I’m in the midst of my rather big personal life transition. Plus that way OR nursing will truly be cemented in my head so that if I leave it and then decided later in life to return, I will know what to expect and how to do the job basics. Good plan.