RN Orientation: Week Three

I have survived five shifts and have completed my third week of orientation (first 1.5 weeks were classroom orientation). My unit is absolutely hopping! In one day my preceptor and I discharged all five of our patients and then admitted another four (in those same rooms!) before our shift was up. My head was spinning!

One thing I'm really struggling with is feeling hypoglycemic (hungry, tired, weak, irritable, unable to concentrate) during late morning and mid-afternoon and late afternoon. My preceptor and I will be in an alcove charting and discussing stuff and my eyes will glazed over and I know I'm not really absorbing all that she's saying. It's really frustrating. I am really trying to get to bed early so that I'm getting at least 7 hours of sleep. My unit really does encourage nurses to take their lunch break (30 min), but my body needs food much more frequently than every 5-6 hours, but it's tough when I'm not in control of what happens next (my preceptor does) and I'm afraid I'll miss something if I take a quick break. 

 I'm researching and thinking through what I can take to work food-wise that will help keep my blood sugar up that won't require any food prep (like heating up) and that I can possibly have in my pocket for those moments when I start to feel that edgy feeling. I've never learned to like coffee, so any caffeine would be a diet soda...which I really don't want to consume on a regular basis or in large quantities. I know caffeine is not the answer and neither is sugary food (although it does help short-term). I can feel crappy with a blood glucose of 80, which is not considered hypoglycemia. However, someone suggested that it can be the rate at which the blood glucose falls that can make a person feel crappy. My blood glucose tests have always been fine and my doctor has never been concerned, and the advice is always to eat several smaller meals throughout the day to keep glucose levels relatively consistent. That's easy when you can stop what you are doing to grab something to eat, but now I'm working 12 hour shifts and don't always have the convenience of stopping what I'm doing to go grab a snack!

So I probably need to go see my doctor and find out if there are further tests or recommendations. But first I think I'm going to start doing a better job of writing down when I eat, what I eat and when I start to feel crappy...and what helps or doesn't help... and maybe I'll even get a glucometer to keep track of my levels throughout the day.

I'd like to drop some pounds and I'm hoping that with the increase of activity (36 hours a week on my feet), that I will be able to. Unfortuately, there's no time to hit the gym on the days that I work - there's only time for sleeping, eating (barely) and working. But that means that I will HAVE to get to the gym on my days off and pay attention to what I'm eating...and not eating crap (sugar) when I feel like crap. Easier said than done.

Hopefully in time I will adjust to twelve hour shifts and figuring out what works for me. Right now it's just tough because I'm paired up with another nurse who has grown accustomed to shifts and knows what SHE needs to do to keep her energy up. We were a bit disorganized this past week for a variety of reasons and I'm hoping we can be a bit more organized this week. Here's hoping.

Aside from the above, I'm getting to see and DO a lot and learn a lot of new stuff! There is no way for nursing schools to teach us everything. Every hospital and every unit, has their own way of doing things (admissions, discharges, charting, etc...). I am fortunate that my hospital moved in to a nice new facility and really thought through the design and made really smart decisions about patient rooms, and access to meds/supplies, which can significantly cut down the amount of trips (and wasted time) to/from the supply room!

Aside from my patient care, I also have a number of classes that I have to take during my orientation period that are related to my unit. Since I'm working on a Telemetry unit, I am scheduled to take classes on topics such as EKGs and dysrhythmias and a handful of other classes that are cardiac and neuro (stroke) related. This coming week I'll be taking a class to prepare for a change in how physician orders are entered and retrieved (we currently work with electronic and paper charts and will soon go to just electronic).  It'll be a very good change and hopefully will save time for everyone...not to mention saving money and trees and counter space at the nurse's station!!

I've been adding some more links to articles on the side bar. I decided to break down the topics into: New Nurse General Tips, 12 Hr Shift Tips, and Night Shift Tips. When I find articles that I want to come back and read, I will link them there...but reality is that I haven't necessarily read them in their entirety (or even followed the tips). As I get time to read them, I may end up removing some if they end up repeating each other or end up useless.