My first day as a travel nurse

I am here, on the unit, ready to start my first day of being a travel nurse.  I had two days of classroom orientation where I learnt all about codes of conduct and took HIPPA tests and fire safety.  All those wonderful things that each hospital has to have all employees do.  I was also given a NICU information guide that explains some of the guidelines in this NICU such as the visiting policy, when IV tubing gets changed, when baths are given, oxygen settings, etc.  I read over these guidelines before my first day.

I am going to get two days of orientation on the unit then I will be on my own.  I found my preceptor and introduced myself.  She was in the middle of getting report on our three babies, so I grabbed some paper and started making notes.  One thing I noticed right away is the babies have different times that their cares are due, timed 30 minutes apart.  I was told that the parents know when their babies “touch times” are and try to time visits to coincide.  After report it is time to start the cares.

I was told in orientation that all meds and breast milk are scanned at the bedside prior to giving to the baby and that another nurse must also check all meds and breast milk.   My preceptor brought a COW
(computer on wheels) to the bedside and I am ready to sign in and learn how to scan.  Or, maybe not as my codes are not working.   In the end, my preceptor signed in and I am doing everything under her name.  Next lets try the computer charting and see if those codes work, and, they do!  I am
discovering that computer charting here is different, no work list to remind me what to chart next, that means I will be writing myself a checklist.    

Caring for the babies is something that I do know how to do, just have to learn all the ways that it is different here. There are different residuals that are acceptable, different things to chart, different positioning aides, etc. I am also discovering new meds that I have not given before and that donor breast milk is widely used here. 

My first day ends with me feeling that I have much to learn and only two days to do it and when am I supposed to care for the babies when I have so much charting to do?

Family, children turning into adults

Leaving my children and grand-children behind was a very hard thing to do.  As my children grew up, they, one by one, left me.  But I have never left all of them behind at once.  I thought I had it all planned out, plenty of time to see everyone and spend time playing with my grand-children.  But mother nature had other ideas: two major snow storms, me getting sick and Amandoria being stuck at
the hospital for a week.  In the end we planned one night in Tulsa where five of my children and their families could all get together with me and Nelson. Since it was also almost Amethysts birthday we celebrated that also. 

I loved spending time with my family, loved playing with my grand-children.  There is nothing like walking in a room and seeing those little faces light up with smiles, the rush of Mimi’s from all their
mouths and the race to get to me first. Being oldest Kaylee always wins but Ariah comes in a close second.  Emily always hangs back and when they are done she comes in for her hugs and kisses. She is so soft and cuddly.  Leeanna doesn’t walk yet but I am sure she will join in soon.

Watching the interaction between them as they play together and how they are comfortable with all their aunts and uncles was comforting. Knowing that they are happy and loved by all makes leaving them easier for me.

I didn’t get to spend as much time with Anthony and my mom as I wanted. They both live 120 miles away.  We went there and had lunch with them and spent some time, but not enough.  I also regret that I did not get to see my little Kiera.  But at least Papa got to visit with her.

We have a unique family, one that started almost 16 years ago when Nelson and I said “I do”.  I had 4 children and Nelson had a son.  We did not yet know about his daughter.  Then one day the phone call
came to announce he was the proud father of a 13 year old.  Adding Alyson into our family was an adventure.  There was never a moment when she was not loved and wanted, it just took her a little time to know it. Now she fits as if she has always been with us.  I love my large family and the way it keeps growing and filling love into all the crevices of our lives.

I love knowing that my children, though now all adults, are growing and gaining the knowledge of what it means to truly be a family.  The part that family has played in their lives has changed as they have matured.  They have gone through many phases, from I need everyone, to I need no one, and on
to everyone needs me.  I think most of them are now in the stage of I need some, some need me, and it changes depending on the needs.  In other words, understanding that life really is a combination, not
all one.

As adults, my children have started jobs, spent time in the military, started college, gotten married, gotten divorced, had children, had heartaches and found the love of their lives. I believe that some of them have started to settle into life and have found their niche, while others are still searching for it.  I want to be there to gently guide them on their way, yet let them make their own final decisions and let
them know that it really has to be theirs.  I am hoping that my time away from them will bring them closer to each other. That they will more fully understand the special connection between siblings. 

I miss my family, I love my family.

My experiences at the Saint Franics NICU

My last day at Saint Francis Hospital was bittersweet. Leaving my friends and the Neonatal Intensive Care Center was not easy.  This is where I started my nursing career, where I learnt what it meant to be a nurse, where I laughed in the good times and where I cried during the sad.  

I remember my first day in the NICU, my first patient was a 23 weeker.  Meaning the baby was born at 23 weeks gestation.  I watched this baby grow and go home with his family.  In the past two years, I have taken care of lots of  babies, I have met many parents and have fallen in love with many babies.  There are always those special babies, those that make you smile when you see them and their parents.  Those babies that you just want to hold and cuddle with all night long.  Sometimes these are the babies that start out as “touch me nots”, babies that cannot even handle a touch without having
desaturations and / or bradycardias.  Watching these babies grow and mature and knowing that God has touched them is something that is beyond words.   

The first time that a baby passed while I was in the NICU was in the old unit.  It was the middle of the night and the family was at the bedside.  The unit became quiet, all the nurses knew what was happening and we watched as the baby was coded.  I realized that the entire unit was quiet.  Not a baby was crying. In those few minutes as the baby passed I felt a calmness and I wondered if the babies could sense an angel in our presence? 

During orientation, I made my first friend in the NICU.  We were both new nurses and started our NICU careers together.  Now we are starting our travel nurse careers together.  It is amazing that both of these were completely unplanned.

I made so many close friends in the NICU. Without naming names, I am sure you know who you are.  There is “Booby juice checker”,youPublish Post got that name one night when everyone around you had to have breast milk checked.  You grew to be my closest friend in the NICU and I am really going to miss you. Another close friend, I worked next to the first time in the “family room” in the old unit.  We spent time together whenever our schedules worked out.   Nelson and I loved hanging out with you and your husband.  We will keep our friendship alive and see each other whenever possible.

When I was still on orientation during the day, I was told there is a secretary on nights that is wonderful and will make your life easier.  When I met this man, he made me feel at ease
and made it easy to ask for anything without feeling like I was interrupting.  This person grew to be a good friend.  We gave each other a hard time, lots, but it was all in fun and I will miss him.  By the way, just want you to know, your scrubs match!

There are so many more wonderful nurses, respiratory therapists, and secretaries that
made my experience at Saint Francis a warm and wonderful experience.  Thank you to everyone.  I will you.

Reflections....

Prior to moving into the RV, we lived in a 2500 square foot, 4 bedroom home.  We had lived there for almost 5 years and had done extensive remodeling.  Last summer, to prepare for our new adventure, we listed our home for sale.  After several months on the market without a sale, we made the decision to rent it instead. 

The process of moving everything out and making the decisions on what to do with what, had to be done.   Each item in the home has a memory attached to it and at times making those decisions came hard.  When I came to all the items that had belonged to my father, I was torn.  One part of me wanted to keep them with me but realistically that was not possible.  I first decided to put them with all the pictures, but then the more I thought of that, I realized I was being selfish.  I finally gave them to my sister to keep. Well, almost everything, I kept my grand-parents wedding rings.  They fit Nelson and I perfectly!  No, we are not wearing them, but I wanted to keep them with me.  My grandparents passed before I was born, but from what I have been told, they had a long and happy marriage.  Maybe the wedding rings fitting us is a sign of a long and happy marriage for us. I know this sounds goofy, but some things make no sense.

Up to this point, I don’t think it really sunk in that we would be homeless, more or less.  We have sold homes before and I remember leaving them for the last time and bottling up the memories for the future. But this time, as I walked thru the empty home, I did not feel that disconnect, that this is the end and the memories are done here feeling.  Maybe because we are renting the house and not selling it and I know that I will be back again. 

One of the memories I did bottle up was a time before we moved in, we went to the home with our oldest grand-daughter who was 18 months old at the time.  There is a small shelf in the master bedroom closet to hold shoes and she loved to go sit on it with that big beautiful smile on her face.   I also remember my daughters getting ready for proms, the revolving door period of kids moving in and out as they grew into their adult lives, the addition of each grand-child and son-in-law that made our family larger and happier.  I remember the fun back yard parties with all of our friends and family, the longs days and nights studying to become a nurse, the late night hot tub parties.  We had a wonderful time in this house that we made into a home.

Now, it’s time for more memories and the future looks bright!

The road to travel nuring and choosing my first assignment

To get my nursing license in other states took some advance planning.  Unlike Oklahoma, several of them require finger printing and detailed background checks.  In Oklahoma, the background check consisted of filling out a piece of paper, paying money, and then 15 minutes later getting the paper back stamped that you passed.  I am sure if anything showed up things would have been different.  J

I started, back in December, working on getting a license in Arkansas, California, New Jersey, and New York.  These states do require fingerprints and extensive back ground checks.  The procedure was started by printing out all the required forms and requesting fingerprint cards from each state.  I made the decision to move my official residence to Arkansas so that I could have a compact license there.  A compact state means that that state has made an agreement with other states to honor their nursing license.  It is very convenient for nurses.  As of now there are 24 states that honor this agreement.

It took about 2-3 weeks to get the fingerprint cards in.  New Jersey required 2 sets.  I decided to work on getting my Arkansas license first.  The paperwork was filled out and fingerprinting was done, then I had to go buy cashiers checks.  One to send to Oklahoma to verify that I had a license (that cost $40.00) and a second one to Arkansas to get my license there.  I also paid extra to get a temporary license.  I was told it would take up to a month to get my temporary license.  Imagine my surprise when after mailing it on Monday, my temporary license arrived Friday.  Since the temporary license is also compact I was ready to start the search for an assignment.

I had done extensive research on travel companies trying to make a decision on who to go with.  In the end, I made the decision based on who could get me assignment, who called me back when I called, and last, but not least, who had the best compensation package.

Today I had to make a choice between Austin, TX and Lebanon, NH.  New Hampshire did have a better compensation package, but I was having a problem finding a place to stay.  I spent several hours on the internet and phone looking for an RV park near the hospital.  I finally located one 27 miles away.  There are other parks in the area but they don’t open till the first of May.

I also researched Austin and found several parks that were within 20 miles of the hospital.  There are some that have heated pools and spas. 

I finally made the decision that I would be submitted to both places and see which one I received an offer from. 

I had an interview with the hospital in Austin and received a formal offer.  So it looks like we are off to Austin.  I would still like to go to New Hampshire, maybe in the summer.

Organization in the RV

Organization is paramount when living in the RV.  Everything has to have a place and be in it or things can get out of hand quickly.

We had several areas that had to be organized.  Kitchen, paperwork, bathroom, makeup and hair care, closets, videos and cd’s.

To solve paperwork problems, I purchased two small plastic file folder boxes from Wal-Mart.  One has all the household papers and miscellaneous paperwork and the other holds everything for my nursing career. The boxes fit in the space between the wall and sofa. 

Since my husband is in college and doing it all online right now, I had to come up with a plan for him also.  The answer seems to be placing a plastic bin next to his recliner which is set next to the dining room table. His text books are in the bin, easily retrievable.  His laptop sits on the table beside him and is also easily accessible. A power strip surge protector solved the problem of all the electronics needs.  The printer has found a home on top of the table.  There is still room on the table to eat if we want to. 

There are three drawers under the TV area where we keep pencils, pens, staplers, checkbooks and other office supplies.

The bathroom required a lot of planning. We have a lot less room.  The medicine cabinet is in a corner so we have a triangle shape.  The problem of everything moving around was solved with small plastic trays.  Everything organized. 

I love makeup and have a lot of it.  I bought a 3 drawer plastic bin, the small one that is made to sit on a desk.  My makeup and skin care products are in the drawers and my lighted makeup mirror sits next to it.  These are both placed on the small dresser in the bedroom.

I already had a 3 ring binder that holds cd’s.  It has a zipper to keep everything contained.  Since we do not have room for all the containers, I removed the DVD’s and the cut out the basic information on the movie.  I then placed these inside the slots in the binder.  Not an ideal situation but a real space saver.  

I have saved the kitchen for last, even though I organized it first.  I gave away most of my dishes to my daughters before we moved into the RV, so I had to buy new ones.  Oh the sacrifices I make for my family.  I really don’t want to break anything and was concerned about the dishes bouncing while going down the road.  I protected the plates and bowls by putting shelf liner padding between each dish. I cut it to fit.  Someone gave me the idea to buy dividers from Wal-mart.  I bought the ones that are made to put in dresser drawers.  They are adjustable and work great for my glasses and mugs.  The last thing I do before closing the doors and driving away is to place all the sofa throw pillows on top to help keep the dishes from moving. 

I will say that I miss my dishwasher! 

I know this is a boring blog but I promise a more interesting one is coming.

Living in the RV during a blizzard

Today we are sitting in the middle of a blizzard! The weather reports for the last week have been warning of this storm and this time the reports were correct.  We have over 14 inches of snow!  

Going back a few days, it was time to prepare for the storm.  Since we had experienced a small snow storm in Arkansas last week we did not go into the preparations blind.

Nelson had a few chores to do and so did I.  My main chore was the grocery shopping.  I had to get it done on Sunday since I was scheduled to work Monday night.  I went to Wal-mart and entered the frenzy of pre-storm shopping.  At first I thought bad things about Nelson since I was there by myself. J Then I realized that since I am a patient person and he is not, its’ better this way.  I finally made my way home with my bags and put everything away.  It was a good thing that I got the shopping done Sunday.  I woke up Monday sick and am still sick now.  Hopefully will be feeling better soon.

Nelson had the chore of getting the RV ready for the storm.  We had moved the RV the day before to a better spot in the park.  We now have great internet and cable signals.  Using some of the lessons we learned from our trip to Arkansas last week he set about getting it ready. When he hooked up the heated fresh water hose, he noted that the faucet was not protected.  He bought some pipe insulation to wrap around it.  Our space is cement and the sewer connection is on cement but between the two is grass.  We noticed the trailer beside us used 2x4’s to go between and set his sewer hose holder on it to keep the hose flowing downhill.  Seems like a good idea, so Nelson copied that.  He also checked the generator and confirmed that it was working and had gas in it in case we lost power. 

We debated what to do about the slides.  I looked on line and found conflicting reports.  Some sites say close them and some say leave them open.  We looked around the park and most trailers kept their slides open.  We made the decision to leave them open also.  Only time will tell if that was the right thing to do.

With the trailer ready it was time to sit back and enjoy the show from mother nature, and it was awesome!!!