A (Work) Day in the Life

I meet so many people with the work I do, and I’m forever curious. If I had the time, I could listen for hours about my patients lives and histories. I love learning about what has shaped them into the people they are, and knowing how they got here can make the difference between understanding and frustration. One of my favorite things to ask is what they did/do for a living. If I have time, I also like to find out what a typical day is like on the job.

So, now it’s my turn. Here’s what a (mostly) normal work day looks like for me.

 

Job Title: RN, Cardiac Stepdown

Shift: 7pm – 7am

 

3:30-4:00pm  – This is when my alarm goes off, I glare at it, snooze it a few times, and then grudgingly crawl out of my nice, warm bed. These blankets know me, and I am frequently loath to leave them. However, since I have an hour drive to work I need a bit of an earlier start than my coworkers that live closer in.

4:00pm – From this point onward I’m usually doing three or four things simultaneously. Right now it’s usually something along the lines of heating up breakfast, boiling water for tea, putting together the final odds and ends for lunch and getting dressed. Taking care of my face usually takes about 20 minutes (looking at you, seb-derm), and the rest of my getting ready about 5. I don’t wear makeup, and I usually just slick my hair back and twist it into a knot at the base of my skull.

5:00-5:15pm – Time to hit the road! I have no appetite when I wake up (never have, probably never will), so I try to throw together something for breakfast that I can eat while I drive. If I try to make myself eat before I leave, I tend to get nauseated. Depending on whether I’ve had time to do my Bible reading for the day, I’ll sometimes listen to that on the way. Otherwise, I vary between radio, audiobooks, and putting my iPod on shuffle depending on my mood and state of alertness. Audiobooks keep me awake better than anything else, so they’re my go-to when I’m on day 3 or 4 and ready to drop in my tracks.

6:00-6:20pm – Arrive at the hospital, and find a parking space. On the weekends, its not too bad. On the week days it can be a little ish even this late in the day, as we share parking space with another facility. I gather my gear, make sure my name badge is on (I’ve had to run back for it more than once) and hike on in. It’s a short elevator ride to the 4th floor. Once there, I get my assignment for the shift and put everything in my locker.

6:20-7:00pm – Here is usually where I take a quick scan through my patient’s charts and get a bit of an overall look at what’s been going on with them. If there’s anything that needs to be addressed or I have a question for the day shift nurse(s) I’ll write that down. At 6:36 we can start clocking in and tracking down the people we need report from.

7:00-8:00pm – The work begins! If a patient has something that needs addressed, I’ll do that as soon as possible, otherwise, I spend this time going through medications lists to see who needs what, checking telemetry (heart monitors!) for rates and rhythms and assessing my patients. We usually start out a shift with anywhere from 3-5 patients. If it’s 5, we know that unless we transfer a patient, we won’t be getting any admissions that night. If it’s 3? …..well, depends on how busy the ER is. There have been nights I’ve had a transfer and two admissions.

8:00-10:00pm – Wherein I run in circles like a chicken with its head cut off. Things aren’t aways that bad, but this is our busiest time. We’re trying to get medications passed, bedtime blood glucose checked, shift assessments done, and any pressing problems taken care of. This is when patient family members will be calling for an update on their loved one, and the doctors are putting in their final orders before the night on-call takes over. It is also one of the times that we more frequently move patients between units.

10:00-12:00pm – Charting time! Depending on where we are in our care, most of my coworkers and I can be found parked in various corners or at the nurse’s desk charting. And charting. And charting. Thankfully, our whole system is computerized, so once you learn it it’s fairly easy to navigate. Still, depending on the acuity of the patients, I’d say a good 1/3-1/2 a shift is spent staring at a screen clicking and typing.

12:00-4:00am – This is……time. I’d say free time, but that is wholly inaccurate. If our patients are going to sleep, they usually do that here. If anything is going to go spectacularly south, it’s going to happen here. 2:00am is the bane of my existence if I have a patient that is even a little bit unstable. Codes (respiratory/cardiac arrest), deaths, and abrupt and dangerous changes in condition tend to happen in the middle of the night or at shift change – personally I’ve seen more in the middle of the night. Throughout the night we are also going around hourly to check on all our people. We maintain drips, IV fluids, give pain medications, reposition people, and far, far more than that. Somewhere in there, if nothing is going too crazy, we take 30 minutes to stop and inhale a bit of lunch.

4:00-5:00am – Finish any remaining charting, because crunch time is coming, people! I’ll make sure that everything that needs to be done IS done, I have my necessary notes and know all the pertinent information about my patients, and gather any morning medications that weren’t brought up from pharmacy the evening before.

5:00-6:30am – Go time! This is when we finish prepping anyone that is going for a procedure or surgery later in the day, pass early morning medications, check morning blood glucose and do a final run through to make sure that nothing was missed in the last 12 hours. If a patient is going for surgery, Pre-op will often call for report around 5:45 if they’re the first case, and come get the patient between 6:00 and 6:15.

6:30-7:??am – Day shift starts straggling in, looking about as awake and alert as we feel; which is to say, usually not at all. I’ve had report to the oncoming shift take anywhere from 10 minutes to almost an hour. It all depends on the nurse, the complexity of the patient(s), and whether or not I’ve had time to actually finish everything that should be done (or if I’m still working on it =/ ). After report, I’ll take one last look through my charts to make sure I’m not missing anything, and then I’ll go clock out. On a good, streamlined morning with no hiccups, I can be gathering my things and be ready to go by 7:00. On OTHER mornings, it can be closer to 8:00 before I’m done punching out and scurrying for my car.

8:00-8:30am – This is when I usually get home, traffic permitting. There have been a few mornings with accidents that backed things up for up to 30 minutes, and the highway I take is rural enough that there really aren’t any good detours. Winding through the gravel roads would take longer than waiting.

8:30-9:00am – Bed time! After breathing a sigh of relief (another night done!) the first and only thing I do before collapsing is go take a long, hot shower.

9:00am-4:00pm – Think twice before trying to wake me. If you’re not family, work, or my alarm and the issue is not life-or-death you run the risk of traumatic dismemberment (see: telemarketers). That risk rises exponentially with each consecutive day I work.

 

SO! A very generalized work night, on which there are always variations. Some nights, I all but run my feet off. Other nights I twiddle my thumbs for several hours. Still other nights are one emergency after another until the on-call has given up on any kind of sleep, and all but sets up camp on our floor.

With the 12 hour shifts, thankfully we only have to work 3 days a week. There are times when it turns into 4 or 5 though, when someone is sick and one or two other nurses are on vacation – but these are the exception rather than the rule.

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The World Through My Eyes

OR: My Life as an INTJ Female

CHILDHOOD

As a child, it really doesn’t occur to you that your way of life and concept of the world differs so much from the majority. I was no exception, and I kept that for much longer than most INTJ girls would for one simple fact – all of my siblings are male. There was very little exposure to the idea that little girls were supposed to be giggly, empathetic and, well, girly. I spent most of my time out in the woods or the barn with my brothers; climbing trees, making up stories, plotting our next pirate raid on the kitchen, and generally being a tomboy. Our mother, wonderful woman that she is, let me be myself without recrimination. I had one doll and a tea set and they spent most of their time in my possession gathering dust on their respective shelves.

Once I reached school age, it began to become apparent that I wasn’t quite what most people considered ‘normal’ for a girl. I had no interest in clothes, or jewelry and makeup, or giggling over boys. I half-taught myself to read in kindergarten while my peers were shrieking as the boys chased them around the playground with whatever insects they could find. When my teacher realized what I was doing, she found some workbooks for me and proceeded to give me direction and a challenge to work for. In a years time, I was reading at a 4th grade level and extremely frustrated with my 1st grade cohorts who were still stumbling over ‘and’ and ‘the.’ My Elementary School had a reading program to encourage new readers – I had to be discouraged, as I was spending all of my free time holed up in the library. Books were my best friends, and I was quickly discovering that interaction with giggly, shrieky, diva-like human beings was extremely draining. I avoided my female classmates like the plague. When I did get kicked outside, I would usually make a beeline for the soccer field and insinuate myself into whatever game was currently in progress. Order and sense at last!

Until Middle School came along, homework was an unknown thing. It swiftly became the bane of my existence, as it cut into my evenings at home where I usually read whatever I could get my hands on. On the other hand, I discovered the Middle/High School Library. It got to the point that the librarian would scout through the library about 10 minutes before class was supposed to start in order to make sure I wouldn’t be late. Again. There was a permanent pass on the checkout desk with my name on it.

I always seemed to collect people here and there that would attach themselves to me for a while (much to my bemusement) and then wander off, but I finally made one good – loyal – friend.

Life was great. And then puberty hit me like a tank.

ADOLESCENCE

The worst part of being a teenager was abruptly discovering that my physical being and emotions were beyond my control. Nothing about either could be planned for, and that was incredibly distressing. Up to this point, life moved in predictable patterns that could be adjusted with minute planned interference. Now it seemed that the world had gone mad.

I withdrew from nearly everything that was not school, family and church, and threw myself into studying. Art classes were something I adored, once I had a good and competent teacher that was willing to take a few risks I was determined to excel. Physical activity a la weight training and running physically exhausted me to the point that I could actually shut down my overactive mind for a short time afterward – blissful silence at last. Music became another safe haven, and I loved (still love) to spend hours at the piano immersed in the patterns and rhythms of playing.

It took most of my higher Middle School years and most of High School to come to terms with Things As They Were. The one friend I had stayed around, and we became close to inseparable, opposites though we were. Then, when it finally seemed like life was leveling out and becoming a new sort of normal, the bottom dropped out of my world again.

There was a family at church that had started attending when I was around 8. They had become a very integral part of our church – he was one of our ministers – and to me they were a second family. I had worked for them for 4 summers by that point, and trusted and accepted them implicitly. So it was a shock when they called a meeting one Sunday evening and informed us, our congregation as a whole, of a few things. According to them, we were conniving, hypocritical goats on the fast track to hell, and they weren’t going to put up with it any more (the short, Cliff-notes version).  So they walked out.

For me that was the first, and to date the worst, betrayal I have ever experienced. It came out of nowhere – I had no reason to suspect that they loathed us so much. They had given no indication of what they actually thought beforehand. Then, even after all of that directed at everyone in the room, that minister had the gall to tell me that they still thought of me as a daughter. At the time I couldn’t say anything as I was too stunned, but that hurt worse than the rest. Later, when I had a chance to stop and sort through my emotions and thoughts, I realized that it was because of the fact that I had grown up ‘knowing’ that family does not betray itself or abandon its members. From my parents down to my youngest brother, we all had each others backs. For someone I considered family to tell us we were a waste of their time and effort? Despicable.

That was the first time I ever cried in public. It was also the first time I removed anyone from my life with the delicate precision of a brain surgeon. I have yet to regret it.

ADULT

I did end up working for that family for another two years. Jobs were extremely scarce in the area where I grew up, so once you had one you hung on to it tooth and claw. Thankfully it was seasonal work, so from November to March I was able to stay at home and muster my courage and determination for the next year. In that time I was still looking for another job but not sure what I wanted to do, or if I’d even be able to find anything.

My maternal Grandmother had hip replacement surgery the winter of the year I turned 20, and with my Grandpa steadily failing due to Parkinsons, she needed someone to stay with them for the first month or so if she was going to go home instead of a rehab. I had nothing else to do, so I volunteered (and was partly volun-told by Mom) to help. I spent four and a half weeks with them, and discovered that I had a fascination with the medical field. I didn’t have to do much besides change the dressing on the incision, but I soaked up everything the home health nurse, physical therapist and everyone else who came to my Grandparents house was happy to teach me. Once I got home, I informed my parents that nursing was something I wanted to try, and started researching.

Ironically enough, it was my employer that pointed out an avenue I hadn’t even considered: CNA.

In September of 2010, I was 21 and on my way from Michigan to Arkansas. People still look at me askance when I tell them that I knew no one here, had no connections, and just picked up and moved anyway. By myself. I worked as a CNA in a nursing home for almost 5 years as I put myself through college for my ADN. In that time I met a tremendous amount of people, and figured out a good many things about myself and the rest of the world as it reacted to me. The church I attended was quite a bit different than the one at home. It had a much narrower view of what was acceptable for a woman in personality, occupation and life goals. I nearly gave one of the ministers a coronary when I informed him that it was NOT my life’s dream, ultimate goal, and all-consuming reason for my existence to get married and have a passel of small people; and that NO, nursing was not my version of hanging in limbo, twiddling my thumbs and waiting for that to happen. I intended (still do) to go places and DO things, thankyouverymuch. He promptly assumed that something had gone horribly wrong in my childhood – abuse – and tried to ‘correct’ this alleged problem accordingly. Now, I do have problems, but that was never one of them and his assumption infuriated me on behalf of my parents. He, an extrovert, had spent maybe 48 hours in total with two introverts and their introvert adult child and assumed that he knew everything there was to know about their relationship. As a whole, my family is very formal and polite in public – which is anywhere that is not home or contains people that are not family – and affectionate only in private, so I’m sure to someone used to emoting all over the place it looked like a very strained alliance at best. The only strained alliance, if it can even be called that, is with him. He may think he knows me, but after that fiasco he only knows OF me.

 By the time I hit the last semester of nursing school, I’d discovered Myer Briggs and realized that the reason that I felt odd and out of sync with the world was because I was. I also finally come to grips with the realization the the rest of the world – aside from a few new friends, one of which is ALSO a female INTJ, the other two are INFJ and INFP respectively  – was simply not going to take me as is and had developed a facade or two in self-defense. I was someone else at work, closer to an ambivert, and another person entirely when dealing with people from church. The only places people didn’t judge me for being ME were in the relative safety and quiet of my dorm room, at college, or with my equally introverted friends. They were experiencing much of the same recrimination I was for simply living as themselves, and none of us were going to tell about the masks we wore.

I graduated in the spring of 2015 and took my RN-NCLEX three weeks later. Within four months time, I had also moved twice (once out of the dorm to the upstairs of a friend of a friends house, the second time to my current apartment), changed jobs (behavioral interview and all), bought a different car and found a different church that didn’t care that I wasn’t ‘normal’ by society’s standards. It was rather novel to have a job where I could be myself without people asking what was wrong with me, and a church that accepted me as I was without expecting anything other than living for God where I was with what I had.

A year as passed since then and it’s been a good one. The first I’ve had in a while. I’m finally comfortable in my own skin again because I don’t feel like I have to hide from anybody. There have been times when, as an introvert in what is logically an extrovert’s field, I’ve questioned my sanity over my career choice. Mostly I’ve just lived – and I love it.

 – If you are an INTJ (or any type of introvert, really), how do people react to you? How do you react to them, especially when they tell you that they think there’s something wrong with you when you’re just being yourself?

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Greetings and Salutations!

If you managed to find this post, then I likely got this blog off the ground. Probably. If I didn’t, well. Welcome anyway.

Who am I? And what is this all about? If you’re already here then you might as well know. Here goes – and in the process you’ll probably learn a few things that most people probably don’t know about me. BANZAI!

 

  1. I am an introvert. MBTI tests me out as an INTJ. In other words, I have all kinds of ideas and plans and schemes that don’t make it any farther than the inside of my head for the simple fact that my mouth won’t cooperate to communicate them. And I collect information like a packrat. Welcome to my infodump. I’ll probably talk more here than I do on any given week.
  2. I am a RN. Most people that are even slightly acquainted with me know this already, as it is such an integral part of my life. I work the night shift on a Stepdown Unit, and I don’t bother to flip between nights and days on my days off. It’s too hard on my system to do that for long. As of now, I’ve been licensed for 1 year and 4 months, so I’m still just a baby!  Before you even ask, NO I will not give advice, diagnose or even attempt to prescribe. GO SEE YOUR DOCTOR! Anything you see around here related to medical will be my personal experience only, and is not meant to diagnose or treat anything!
  3. I am an avid cross stitcher, crocheter, knitter, and all around fiber hobbyist.I absolutely LOVE creating things and watching a picture unfold in the process is one of the best perks. You’ll likely be seeing the progress and end results of my latest bouts of inventive insanity.
  4. I own a hedgie. I find it hilarious that when I tell people that I have a hedgehog, they mistake me to mean that I own a pet of some sort that I call Hedgehog. Nope. He’s a squishy double handful of spikes and sass with a wet, wiggly nose and enough curiosity for 10 cats.
  5. I love to cook. And I love to experiment as I cook. There are two problems with that. The first is there is only myself and my housemate to feed. She eats like a bird, and when I’m working (or caught up in one of my hobbies) I forget to eat. This problem is compounded by the fact that I tend to make enough for an army at a time – residual habit from growing up with three brothers with bottomless stomachs. Second, I rarely write my concoctions down as I’m in the process of making them, and it is annoyingly hard to remember just what was added when you’re in the process of, say, using up all the veggies in the fridge before they start taking on life of their own. One of these days I’ll learn.
  6. I write, occasionally. This was something I did more in High School, when I still had free time I didn’t know what to do with. I still do once in a while, but at this point in time I lack enough motivation to do more than a bit of a short story at a time. Too many other things vying for my attention, what hey?
  7. I draw, slightly more than I write. The damper was put on that while I was in Nursing School, and I never recovered from that. Now and then I’ll pick up a pencil and doodle something, but it hasn’t been quite the same.
  8. I read like my life depends on it. Books were the first and best friends I ever had – see introvert – and they feed my craving for knowledge. I have a deep and abiding fondness for fantasy, sci-fi and the classics but given the time I will read just about anything I can get my hands on. All time favorite author? Karen Hancock.
  9. I have seborrheic dermatitis from the nape of my neck to the end of my sternum. I’ve had it since shortly after I hit puberty.  With over a decade of experience of what does and does NOT work, I finally got it under control. I will happily share these secrets with you, once I have all of my information compiled.
  10. I am a Christian. Christian as in Follower of Christ. My life is His – everything I do reflects that in one way or another. I believe the Bible as written, full stop. Likely, I will end up posting a few things about why I do what I do, especially the ones I get a lot of questions about from my coworkers, patients, and random strangers on the street. I expect I’ll also step on some toes in the process.

 

SO! That’s me in about 3,000 words. And….a very large block of text. Congrats on making it through!

Ciao!

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