November 22nd, 2008
Chronicle #55: Sharper shooting
pauerish was lost in reality at 05:22 PM on November 22, 2008 in Nursing Chronicles.
I was challenged again by several IV insertions in the unit today. Since I'm the senior staff nurse during the shift, junior nurses are privileged to ask me to help them during IV insertions (na hindi ko naman talaga tatanggihan especially if it's a difficult case). I'm really glad that they consult me and ask for help during such instances because I feel experienced but I do keep my humility when I have to tell them that I can't do the insertion (because of reasons like: demanding patients and parents watching over their kid). I'm just happy today that I was able to do an insertion on a 2-year-old pediatric patient. I was quite please with my work because the resident who tried the insertion before me failed to shoot the vein. Hehe. Nakakaboost ng self-esteem and ego na rin on the side. I'm looking forward to more challeging insertions. I'm now thinking if there is a direct relationship with the length of tenure to the determination and skill of initiating IV lines.
Searching for reality in Brisingr by Paolini
I am currently feeling drained
November 21st, 2008
Are They Worth It?
pauerish was lost in reality at 06:28 PM on November 21, 2008 in Sugar, Spice and everything nice.
Matagal ko na silang nakikita sa NBS shelves pero hindi ko mawari kung bibili ako o hindi...to buy or not to buy, that is the big question. Pero game na kaya ako na basahin sila ngayong nalaman kong ang istorya ay tungkol sa vampires? Nyaiks, never ako naging fan ni Anne Rice at hindi ko alam kung magugustuhan ko ang mga vampires sa series na ito. Nothing has appealed me more than Harry Potter and the Inheritance Series which I grew fond of lately. Game na kaya ako? Okay lang kaso ang mahal--its a whopping 3000+ for the whole series kaya I'm left with the one and only question of:
Sino kayang napakabait na magreregalo sa akin ng:
Hmm, am I that good to reward myself with these stuff??? or eto nalang:
November 20th, 2008
Chronicle #54: Extra Challenge
pauerish was lost in reality at 04:21 PM on November 20, 2008 in Nursing Chronicles.
As a nurse here in the Philippines, one has to learn and master the art of juggling tasks between 8-13 patients per shift for private hospitals and as many as 25-50 patients for government run ones. Sometimes the task of taking care patients becomes too much of a burden in institutes where there is a shortage of experienced nurses. It's a sad fact that one of the least compensated jobs here in the country is that of nurses and other allied health professions (Let's exclude doctors because we all know that they earn bigtime when they get to be consultants). No wonder that the exodus of nurses has become severe that the brain drain has turned into a brain hemorrhage.
When I started working as a registered nurse, I realized how heavy the responsibility nurses have on their shoulders. During the first several weeks in the hospital, there were days when I wished that I had a different profession. There were days that it took me all the strength that I had to get up from bed and get ready for work. There were days when I counted the hours till my shift ends. It was really difficult adjusting at first. I got sick at times, my back pain worsened and eventually I got hospitalized for a long time and was terminated from work. Depression seeped in after several weeks and I had a difficult time dealing with the losses that I had. I recovered after four grueling months after series of psychotherapy and medications. When I had the strength to pick up the scattered pieces of myself, I went to apply to another hospital and was luckily accepted. TMC gave me another chance at life, another chance to prove myself as a nurse. As expected, adjustment was difficult but was less compared to my previous work. During the probationary period I nearly burnt out because of the patient load. I struggled to love my work, to love my patients, to love my co-workers and especially to love myself. It took sometime to work through the system but eventually, with dedication and patience I was able to pass the probationary period and was regularized after six gruelling months of hardwork.
When I look back at all the things that I have done during the last two years as nurse, I can say that I have done so much to deserve more than a tap on the back. When we have trainees or new nurses on the floor, I always ask them the big question which is "Do you really want to be a nurse?" I ask them this not to scare them away but to make them realize the responsibility they are given as health care professionals. I ask them this as a measure of their committment to their chosen profession. In the two years that I have spent in The Medical City, I've learned a lot more than pathophysiology, pharmacology and the like. I've learned to value patience and hardwork. I've learned how to manage patients, juggling them between tasks and ensuring that our service exceeds expectations. I learned how to be humble and own my shortcomings as a nurse.
Lately, the unit has been quiet because one wing is closed (due to construction) meaning that our census only totalled to 18 patients. I enjoyed working with only 5-6 patients per shift and I am proud to say that I have given my patients the best care I can give. It only proves that less patients equals more care. I'm not saying that we cannot render quality care when we have more patients, what I'm pointing out is that we, nurses are able to function better when our loads are rational. With less workload, I am able to interact morewith my patients, organize nursing tasks, chart better and have time for personal needs such as toileting and eating. Deep within the recesses of my soul, I want to change the system. It's difficult to make things happen. It's difficult to ask the hospital management to do such because of the cost of hiring more nurses. I don't know where to turn to but I am hoping that the government will do something about our ailing health care.
***
I had a patient who underwent explore laparotomy due to small bowel obstruction secondary to post-operative adhesions. I will confess that she was a difficult patient at first and I hated her for that. She had so many contraptions that prohibited her from moving about--an NG tube to a gomco suction, a JP drain, a subcutaneous drain, two IV lines a foley cath and a big post-op incision on her abdomen. Despite the fact that she was a demanding patient, I took care of her with all my might. I took it as a challenge and eventually I won her support and won her heart as well. At times, it is difficult to understand patients but when we look at it at another angle, when we look at the situation from their standpoint, we'll realize why they act in such way, why they become demanding. After handling her for three days I told her that I'd be gone for quite some time because I'll be going on leave. I felt that she was sad about me leaving however, at the back of my mind I was pleased because somehow I know that I have done a good job taking care of her. At this time I am not sure if she has been discharged already. I will be coming back to work on Saturday and hopefully she's not confined anymore.
***
Hindi na ako takot maginsert ng IV sa pedia patients nandyan man o wala ang bantay/parents sa bedside. Ang lakas na ng loob ko ngayon maginsert na pinapatulan ko na ang children below 3 years old. Pero pag tipong 1 year old lang eh hinahayaan ko na ang resident ang maginsert, baka kasi maburdahan ko lang ang kamay o paa ng patient. Kakaiba pa naman ang feel ng gauge 24/26 na neoflon compared sa venflon na pang adults. Mahirap din minsan maginsert sa pedia kasi matataba pa ang mga kamay at paa. Pinakikiramdaman ko rin muna kung toxic ba ang parents o hindi kasi baka sabihin eh pinagpapraktisan ang kanilang mga chikiting.
***
I had some blood test done early this morning. As I had expected, the med tech had a difficult time locating viable veins under the thick adipose tissues that I have. Hehe. She ended up picking the veins on my left had and filled up 3 different colored vials. The experience made me all the more frustrated in shedding some weight.
***
I'd be retaking my IELTS on December 6th and I'm nervous. It's has been two years since I had taken the exam which had expired already. HCCA was kind enough to lend me a review manual for the exam and tomorrow I'd be taking a dry-run exam in preparation for the actual one. I had a 7.5 during the first exam and I'm hoping to get an 8 or higher. Hehe, dream high!
Searching for reality in Brisingr by Paolini
I am currently feeling accomplished
November 19th, 2008
A Few More Cups
pauerish was lost in reality at 03:55 PM on November 19, 2008 in Sugar, Spice and everything nice.
I am a coffee addict.
When I am on duty, I start the day with a tumbler of coffee with 2 packets of instant coffee in it. I usually have an iced cofee in the morning and another during lunch time. I found it as a good way of keeping me alert and awake especially when I had a hard time sleeping during the night before. When I have extra cash, I go to Starbucks after my duty and enjoy a Java Chip or a Dark Cherry Frappucino.
I saw Ted's entry about the Starbucks planner just a while ago. It's really quite disappointing that the freebies are gone now. A few years back, you could get a free drink almost every month. Oh well, I guess they have to cut costs during these hard times. I have 5 more stickers to get and hopefully by December I'd get to have my planner.
Searching for reality in Brisingr by Paolini
I am currently feeling calm
November 8th, 2008
You Got to Move It Move It!
pauerish was lost in reality at 07:41 PM on November 8, 2008.
After splurging at Sbarro's and doing some window shopping, Leah, Mark and I watched:
Feel good movie...funny with lots of crazy antics with a tinge of love story on the side and lots of courage on the crust.
Searching for reality in Paolini's Brisingr
Trying to see reality through Celebrity Duets
I am currently feeling cheerful
November 5th, 2008
Collection Begins
pauerish was lost in reality at 10:03 PM on November 5, 2008.
November 4 is the day when Starbucks' sticker collection for the 2009 planner begins. The planner comes in three colors--blue, black and red. It looks like the planner 3 years ago without the free drink coupons with it. This year, only 16 stickers are required to get the planner. I'm hoping that I'll get one before the end of the year. They also have a new drink for this season which is the Dark Cherry Mocha Frappe. It tastes good but I like the Dark Mocha Frappe better.
November 4th, 2008
Chronicle #53: Rounds
pauerish was lost in reality at 06:23 PM on November 4, 2008 in Nursing Chronicles.
Today is the first day of the few several times that I am to be OIC in our unit. I wasn't able to sleep well last night because of the thought of a busy and problematic shift. I was anxious of being responsible of staff nurses and auxillaries for the first time ever in my stay at TMC. Nevertheless, everything was baseless after I survived today's heavy task. I had senior staff nurses with me that made the shift easier to manage. My patience was even tested by the seems to be endless regimen of browsing and checking patients' charts as well as making rounds and making sure that all patients are attended to. I had to know whether consultants had already made rounds and residents are updated regarding our patients. I was to make sure as well that procedures are carried out with ease. It made me realize the weight of the responsibility that head nurses and supervisors carry every single day. Now that I had a taste of what it is to be a team leader, I am somewhat adamant to officially be one. I enjoyed the task at hand but I felt like I want being a staff nurse for the moment. However, if I am to grow career-wise, I have no option but to face the reality that someday, I'd be a head nurse or a clinical instructor even. No escaping there for me is there? Dreaming high it is!
***
I've just finished Eldest las night around midnight and I am surprised by the turn out of the book's ending. I turns out to be that Eragon is Murtagh's younger brother, the rationale behind the book's title. In the ending, Murtagh revealed that they have the same father, Morzan and that the Zar'roc, (the sword given by the Rider Brom to Eragon which means 'misery'), happens to Morzan's and should be rightfully given to Murtagh, the elder son. I was also surprised that another dragon came into the picture named Thorn whose rider is Murtagh as well. I'm excited to start Brisinger (which means fire in the ancient language) tonight and hopefully I'd finish it at the end of this week...or month, hehe. Grabe, I'm now hooked to the Inheritance series as I was to JK Rowling's Harry Potter. Christopher Paolini is indeed a precocious writer, making a very early debut in the literary field.
Searching for reality in Paolini's Brisingr
Trying to see reality through Family Feud
I am currently feeling bouncy
October 23rd, 2008
Adrenaline Junkie
pauerish was lost in reality at 01:20 PM on October 23, 2008.
I'm done with Eragon weeks ago and now I'm reading Paolini's book two, Eldest. It's been taking me more time than usual to finish Eldest because I'm overcomed with the urge to slack and sleep. I'm on a 5-day vacation right now which will be due on Saturday. It's a very nice experience being away from work just for a couple of days, ridding myself of the busy unit, demanding patients and unending doctor's orders. Sometimes I wish that I could be on vacation for a longer time, like, a month or two so that I could power up and recharge internal batteries once again.
Senior na ako sa unit. Sometimes, I can't help but rant about the neverending work na paulit-ulit nalang every single day. When you wish for excitement naman eh sobra sobra as in yung tipong muntik na kayong magcode ng 2 patients consecutively within the same shift. Hay, last week, just after morning endorsements, we had a post-craniotomy patient who seized twice about 30 minutes apart, followed by a code of a nearby 84-year-old patient who had chronic congestive heart failure. Pauwi na dapat si post-craniotomy patient. It was a very very toxic shift. Good thing na I had my IV insertion skills intact that I was able to secure an IV line after the patient seized. However, I failed with the CHF patient thrice. Collapsed na kasi ang mga veins ni lola, hindi ko na kineri. At eto pa, napaCPR pa ko ng di oras, sampa sa bed ang drama with the mega baliktad pa na cardiac board in place. Super mega dami ng tao sa unit when we sounded the code. It was as if all the medical residents and interns in the hospital were in the patient's room. Warla! Mabuti nalang hindi pa kami umuwi at natulungan pa namin ang morning shift. We got out of the unit around 10am already. We were so tired and hungry that Leah and I treated ourselves to Pancake House after the intense adrenaline rush.
***
Last October 13 nga pala eh
TWO YEARS na ako sa MEDICAL CITY.
Yehey! Pwede nang mag-resign anytime! 
October 8th, 2008
Never Too Late
pauerish was lost in reality at 12:26 PM on October 8, 2008.
Eragon's been on bookstore shelves for quite some time now. There has been a movie based on it already which showed two years ago. It's just now that the book has attracted my senses and boy, it has captured me from the moment I read the prologue. It's a story about Eragon, a young boy at 15 who found a polished blue stone which turns out to be a dragon's egg. It's kind of a combination of The Lord of the Rings and Harry Potter where magic exists and extra-human beings live. The story keeps on evolving page per page and as one goes along it, one will wonder how a 19-year old Paolini was able to write a book with a plot so complex. As of now I'm almost halfway through the book and I rate it a 5/5, which is of course still subject to change depending on how I will like the succeeding chapters.
Searching for reality in Eragon by Paolini
I am currently feeling bouncy
