July in the PICU

July was a big month for me in regards to my career in the PICU.

I didn't work for 2 whole weeks!! 

And while that sounds counterintuitive as to how that could be huge for my career, it truly was.  Because while I wasn't physically working in the PICU, I was working in Prague, Czech Republic.

That's right...July was the BIG Noise Study Poster Presentation at the Sigma Theta Tau International Nursing Research Conference. I'm not going to say too much about it in this July recap because I will have a whole post on it, but it was an incredible experience!

I was able to meet a lot of great people, from a lot of different countries.  I was able to get my feet wet with poster presenting.  And hello, I was able to go to Prague!

After Prague, Jon and I headed off to Italy where we were able to spend about 2 days in Rome, and a week in Cinque Terre.  We stayed for 3 nights in Vernazza, and 3 nights in Monterosso.  All I have to say about Cinque Terre now is if you haven't been, you MUST go.  It needs to be on everyone's top 3 places to visit before you die list!

 

Outside of traveling, there were some other highlights of July.  But let's not kid ourselves...nothing that could compare to Prague and Italy!

 

We started the month by spending a relaxing 4th on a rooftop in the city with some good friends, a once in a lifetime view of fireworks from about 45 towns all at once  (unless of course, we go there next year!), an amazing homemade rubarb pie, and a few glasses of good wine. Now that's a good 4th to me!

I then went on the next week to participate in the 4th Annual Critical Care Bootcamp.  It was my second time participating, and let me tell ya it was about 1000 times better this year!  Myself and one of my co-workers who started about a year before me were initially signed up to learn how to be instructors for upcoming years, but we were signed up too late. So we went as participants.  And while we were both initially dreading it, it was actually a fabulous learning experience.

As uncomfortable as Simulation Labs can be (who wants to pseudo-take care of a manequin that talks to you while the rest of the class is watching you through the one way mirror!), they take you so far outside your comfort zone that you truly remember those lessons! 

And it was also very exciting to see how far I've come in the last year.  I've grown in my confidence, in my knowledge, and in my patient care overall.  Since the rest of the group were brand new APNs and fellows, for the first time ever, I actually felt like I had a bit of a leg up.  It was a short, small...very small, leg, but I'll take it.  That never happens, so yes, I relished in it just a bit : ) 

So there ya have it.  PICU in July.  You know, a little bit of Bootcamp, a little bit of holiday partying, and oh a little trip to Europe!!

 

What crazy, fun, memory making things did you do in July???

The PICU in June

I figured since I'm so behind on my blogging, I'd do a few summer recaps on the PICU. And maybe include a few personal things because really that's what keeps a PICU Nurse Practitioner sane...the things outside of work!

So today I invite you to revisit June.  Because really, who doesn't love June!?  It's probably my very favorite month of the year!  It's the first month that truly feels like summer to me (at least where we live).  It's the month I was married in.  It's just a great month!

My mom has been asking for about a year for a picture of me in my lab coat at my desk...so there ya go mom!  I absolutely LOVE having my own desk, with my own pictures...and my own phone extension! So much fun!

Highlights of June:

-Jon and I celebrated our 8th Anniversary on June 4th...hello, am I even OLD enough to be married for 8 years!? What!?

Mmm, what better anniversary dinner than
lobster tail, scallops and risotto with great wine!

And what better way to celebrate than in PJs,
no makeup and glasses...classy I tell ya!

 

 

 

-I took a couple of days of PTO...just because : ) now that's nice! And it allows time for things like farmers markets, long bike rides, and runs with my hubby who swears he's not a runner...but I'm slowly convincing him otherwise : ) 

-I did my first educational session with a group of nurses at a pediatricians office with one of my old co-workers and great friend.  While I have always known that I love...LOVE...teaching, this just reinforced it!  It was so much fun being able to teach "Pediatric Emergencies" to a group of nurses, through a little bit of lecture and a lot of interactive games, a scavenger hunt, and a cut throat relay! What a great evening!

-I started precepting...again.  This time as a nurse practitioner.  I remember after being a nurse for a year and being asked to precept for the first time, I thought "Are you crazy...I've only been a nurse for ONE year!? I'm not smart enough to precept!!"  And this time around as a nurse practitioner I thought "Boo ya, I got this!'  BA HA HAAAAA...NOT!!!! I actually thought the exact same thing as the first time around! But it turned out to be a good experience...one in which the orientee and I both learned a lot! And once again reinforced how much I love teaching.

-And June ended on a very dirty note.  Literally.  At least this time it was dirty mud outside of work...and not the many types of "dirty" that the PICU can (and has!) bring!

A few befores..while we were still clean : )

And after...just a little dirty : ) Stef and I have been besties since I was born.  Meg and I besties since, well highschool...and frenemies for 6 years before that : )  Oh the memories we've made, and are still making! I love it!

So that was my June.   How was yours??

 

ICU Psychosis

ICU Psychosis is a very real thing.  I see patients with it all of the time.

And I think that I've had it the entire summer.  That's why I haven't blogged since May!

OK, that's most likely not the reason I haven't been blogging.  In actuality I think there are a lot of reasons.  My differential diagnosis (if you will : ) includes but is not limited to:

1.) It's summer...who wants to stay inside and stare at a computer when you can be outdoors and enjoy the short lasting sunshine!

2.) The amount of night shifts I'm required to do increased starting at the beginning of summer, and I feel like lately a majority of my job is spent on nights and weekends....YUCK! If I blogged about that, you'd be depressed.  Because it makes me that way. And I may scare away some new grads or students who want to go into the PICU.

3.) There's just a lot going on, both in worklife and real life.  And some has been fun and exciting, and others more emotional and challenging.  And since I'm not one to process emotions very quickly or easily, it's best I figure that out before it spews on a page for the world to see : ) 

But I'm back.  I started this blog as a way to document the many adventures that I had as a nurse, and now as a nurse practitioner.  And I want to continue to do so.  I want to retire one day, and be able to look back at the many fun and sometimes funny memories that life in the PICU brings.  And even the not so fun, or downright sad memories are important because they have helped shape me into the Nurse Practitioner I am today. 

So I enter the (almost) fall with a renewed energy in work, in life, and in blogging.  Thanks for sticking with me during my hiatus.  And to the sweet reader "Anonymous" who commented back in July to make sure I was ok...thank you!  Yes, I'm ok. 

I'm better than ok.  And I have A LOT to catch you all up on.  But rather than cramming it into one blog (because that would really turn into a mini-novel, and nobody wants that!), I will try to get you updated i
n short spurts. 

So as I leave you today, all I can say is buckle up because it has been, and will continue to be, one bumpy, crazy, and most definitely adventure-filled ride on this road I call being a PICU Nurse Practitioner.

PICU Questions

I've had a majority of the last several weeks off of work and while I'd love to say they were days off spent on vacation, or doing something amazing (or even productive), they weren't.  They were taken off for health reasons, but now I'm back.  Back to work, and back to blogging about work. 

And I must say, I am glad to get back into the swing of things.  I wasn't really looking forward to waking up at 5 am every morning again, or even the stress that the PICU occasionally (ok, frequently) holds, but once I went back to work last Thursday and Friday, I was reminded how much I truly love it.

How much I truly love the patients that I care for.  How much I love my co-workers.  How much I love the feeling of a long day of work being over...and yet how productive and gratifying that long day can be!

And now that I'm back, I've had a few questions on the blog that have gone unswered in my absence. Ironically, as I read through them today, I realized they were some of the same questions that a friend from church who is going into her 3rd year of nursing school asked this morning.

And I love answering these questions.  I love watching the excitement of a nursing student, or brand new nurse.  I remember back to the days that I was in undergrad, still trying to decide what it was exactly that I wanted to do.  Make sure the pediatrics, and the PICU more specifically, was right for me.

So today I'm going to take a bit of time to answer a few of the questions I've missed today.  If I've answered some of these in the past, you can just skip it.  Or, if you've been a nurse for awhile (or a few days!) and want to chime in, feel free. I think the more nurses students can talk to, the more prepared they will feel once done with school entering into the real world!

Q: Why did you pick the PICU?

A: I think to best answer this, I have to start with why I picked pediatrics in general.  In nursing school early on, I narrowed my choices down to Labor and Delivery/Mother Baby, and Pediatrics.  I did an internship after my third year of nursing school and didn't get my first choice Peds, but rather my second choice Mother/Baby with a couple of weeks experience in L&D.  While initially I was disappointed, I am SO glad I had this amazing experience.  It was not my clinical rotation in nursing school that showed me I didn't truly love L&D, it was the internship that did that.  So while I had a great time in Mother/Baby, there were many things that just made it not right for me.
    
     So that narrowed it down to Peds for me.  And then I applied for a nursing assistant job at the Children's hospital in my town and the position just happened to be in the ICU.  Now let me just say, I didn't necessarily have an interest to work in an ICU setting.  Although I also didn't have a disitnerest.  I just didn't really know much about it.

    So I took the job, liked the people (although hated the nurse assistant job b/c you don't get much hands on with the patients!), and decided, "Yeah I think I'd love this as a nurse."  So once I was done with shool, it was an easy decision.  Why work on a general pediatric floor, or a specialized pediatric floor when I could work in the PICU where I already worked? 

     I have to say looking back onto my nursing journey,  I feel like while there was some decision making, there was a lot that just fell into my lap.  And luckily for me, it has worked out well.  Better than I could have even planned it, I suppose!

Q:  What are the top 3 things that you love about the PICU?

A: 1.) The amazing patients and families that I get to work with, get to know, and spend a lot of time with.  I guess this could fall into "top 3 things I dislike about working in the PICU" if the family is crazy, or the child is a total brat, but for the most part I absolutely love the relationships that are formed in the PICU that cannot compare to any other unit.

2.) The adrenaline, the stress.  Don't get me wrong, there are many days where I think "Why in the world did I not just pick a desk job!?"  But really, I know myself.  And I know that I would be bored out of my mind if I didn't work in an environment that is as exciting, exhillarating, adrenaline filled, which can often translate to stressful, as the PICU. 

3.) I love working with kids of all ages, from neonates to young 20s (and ocassionally we do see some older) with all kinds of diagnoses. I love coming into work knowing a little bit about a lot of topics (although hopefully as I get more experience, it will turn into knowing a lot about a lot of topics!).  I love that my job focuses on the body as a whole, and not just focusing on one organ.  I love that no two days look alike in the PICU.  So I guess to sum it up, I love the diversity that the patients and diagnoses bring into the PICU.

Q: What are the top 3 things that you dislike about the PICU?

A: 1.) Death.  I hate seeing kids die. Sometimes it is bittersweet because the kid has been suffering for so long.  But in the end of it all, I hate watching parents watch their child die.  But it's a part of working in the PICU.  And if I can be a light, provide support, or just a presence to the families of these little angels, than I consider myself one lucky person to be able to have a job that has such a high calling and responsibility.

2.) Night shift.  I hated working nights as a nurse, and I hate it as an APN.  I would love to say, "Yeah, I kinda sorta dislike nights" but really that's an outright lie.  I hate them. HATE them!  I hate staying up past midnight on any given day...New Years is a stretch for me!  I hate the way that I feel at 3 am after already having been up for 20 hours.  I hate even more how I feel at 9 am when the bed is calling my name and I'm not yet home, after being up for 26 hours. But that too is a part of the PICU.  The PICU will never close down just because it's late. Or a weekend. Or a holiday.  The PICU will always need excellent nurses, regardless of the shift. 

3.) The stress.  Yes, I know that this also fell into my favorite things category, but I couldn't come up with another 3rd thing.  And thinking about it, while stress can be very beneficial, drive people to do great things, and to overcome fears, there are also negative things that can follow stress.  So it's for the negative reasons that this also is falling into my 3rd thing I dislike category.

Q: Have you ever work in, or floated to a different unit? How does it compare to the PICU?

A:  No, I have never worked as a nurse in another unit.  And as an APN, we don't "float" in my hospital.  But, when working as a bedside nurse I did float to several other units.  And they were all VERY different.  I worked in the NICU most of the time that I floated, and let me tell you while the two units share 3 letters, it's the first one that truly separates them into two totally different worlds.  Teeny, tiny babies, that don't look much like babies, are just not my cup of tea.  But most NICU nurses absolutely love their jobs.  To each their own!

I also floated to the Hematology/Oncology floor twice and highly disliked it.  I can't imagine being surrounded by kids with cancer all day.  Yes we see terrible things in the PICU.  But we see a vast variety of terrible.  Cancer all day, not my thing.

And then I floated to several other floors that specialize in various other things such as Pediatric Surgyer, Endocrine, Neurology, etc.  And while I didn't mind working on these floors for the day, I just didn't like the environment that a non-ICU floor holds.  I guess I like taking care of the sickest of the sick.  I like being able to give all my care and attention to one or two kids and really getting to know them, rather than being spread thin and caring for 5 or 6 patients.

So how's that for a "Welcome Back" party!?!?  Just a long-winded hello!

But I hope for the nursing students out there, or the nurses who are in an area that they are not completely happy with and are considering the PICU, thanks for sticking it out to the very end.  And I hope that I've helped you to see that the PICU is where it's at!!

Yes, there will be bad days.  But if being a part of a team that heals the sickest of the sick kids is something that excites you, the PICU is the place for you. 

I know without a doubt, despite having 3 (and sometimes 33!) things that I dislike about the PICU, it truly is the right place for me!

Funny Orders

There are some days that seem mundane, and then you just happen to stumble on orders like the following:

NURSING COMMUNICATION: "No oral fluid by mouth"

And then the rest of your day is spent laughing it up with the co-workers and poking fun at the APN that wrote it (who in her defense was febrile and throwing up...yes, shortly after we found this out we sent her home!).

Oh, and the best part was having a contest to see who could come up with the wittiest remark or finishing that sentence.  

Do you think you would win??? Let's hear your best.  And I may just tell you some of our funniest!

Nursing Interviews

As mentioned in my last post, today's topic is interviewing.

Now it doesn't matter if you are interviewing for your very first nursing job straight out of undergrad, your first APN job after already having been a nurse, or even your 20th interview as a medical professional, interviewing can be tough.

Without the right amount of preparation, good intentions can really go south in the interview room.

So here is a list of 5 things that I have done, or read about, or seen as I have interviewed others, in order to best prepare you for that big interview and get you that job!

1.) Know Your Stuff: Know the company that you are wanting to work for- what is their mission and vision? What are some of their values? What is the culture like?  Most of this information can be found on a hospital's website and will be valuable as you go throughout your interview.  When your professional mission, your vision, your values and goals align with the business, this is very attractive.

2.) Dress Professionally:  This is just my personal opinion, but I think that whether you are interviewing for a nursing position or APN position, you should dress to impress.  And this generally means a suit.  Some people will say it's ok for nurses to wear dress pants and a "nice shirt" but I think if you really want to make an impression, the full suit will make you stand out.

For one of my interviews I wore a pencil skirt with a button down shirt, and suit jacket.  Another intverview I wore the same jacket with a different shift underneath, and black dress pants.   And let me further tell you, just because you have an interview and need to dress professionally, does not mean spending a ton of money before you are even making it.  That pencil skirt and suit jacket that I wore above cost me $12 at a thrift store in my area.  There are deals all over...you just have to find them!

3.) Make an Impression: You only get one chance to make a great first impression.  That's part of my reasoning for dressing in a suit.  But the other parts of making a great impression include making eye contact from the very first greeting, shaking hands with a firm handshake (really, who likes shaking a limp noodle!?), smile, breathe and relax.

The more relaxed you are, the better you will be able to listen, and since you will be so prepared for the questions (we'll get to that in a minute), you will come across as confident.  Who doesn't want to hire someone who is dressed professionally, has a firm handshake, smiles a lot, makes great eye contact, and throughout the interview breathes easy, appears relaxed and attentive, and answers each question confidently??? Oh yeah, you are so getting this job!

4.) Prepare for Questioning:  One of the nice things about interviewing is that many of the same, or similar questions are asked.  This is not to say that a curve ball can't be thrown at you, but with preparation of common questions, if a new one does pop up, you will be prepared for it.  And one of the best ways to be prepared for answering these questions is to practice.  Practice by yourself out loud, practice in front of the mirror, and practice in front of family and friends who can give you some feedback.

So what are questions to be prepared for???
     *"Tell me about yourself"- this is a common opener.  The interviewer wants to see how you will handle a very open ended discussion.  This is not the time to tell your entire life story.  Rather, keep your answer concise, but include information about your education, your pertinent work experience, career goals, and a little bit about your personality.  It is essentially like doing a quick run through of your CV/resume.

     *"Why did you go into nursing?"- this is your time to be honest and give a good story. Certainly "for the $" is never an appropriate response, nor is that the truth...if you think you'll be a baller you may want to turn back now! Let them know why nursing is your calling, because truly this is the case for nurses.

     *What would your previous boss/co-workers/peers say about you? How do people describe you?- This is a time to discuss your positive traits that will make you an asset for their team.  Things like team player, hard-worker, dedicated, loyal all reflect well.  But only discuss things that truly are reflective of your personality.

     *Describe a difficult situation and how you handled it?- this one should be rather easy...if you've gone through nursing school you've most likely had a difficult family member, nursing mentor, preceptor, etc. Just describe the situation, but most importantly show how well you handled it using team work, honesty, great communication, etc (whatever is appropriate for the situation).

     *Describe a situation in which you had conflict with a co-worker and how you handled it?- and really, who hasn't had a co-worker who hasn't given you problems.  BUT- if you haven't, you can always describe a situation in which great communication was required to work things out.  Employers love to hear and see an employee who knows how to handle themselves with grace, and has great communication.

     *What are your biggest weaknesses?- Now is definitely not the time to pretend to be perfect...you don't want the interviewer to add "Liar" to your list after you've stated nothing!  Everybody has flaws, and the interviewer is trying to understand what yours are and more importantly how you respond to them.  However, you can present the flaw, or weakness, as a positive.

Eg: At times, I can be a "people-pleaser" which doesn't always translate in me standing up for myself, however it allows me to focus on providing great service to my patients. (for those of you that know me, I'm certainly not a people pleaser, but this is just an example).

Another example: I have a type A, perfectionistic personality which can come across as intimidating to peers, and I tend to hold others to the same high standard, but  I get the job done excellently.

*How would you handle a parent of a patient who is not happy with the care received?
*How would you handle a patient who constantly complains of pain?
*What are your career goals?
*How do you handle stress?
*What is the most rewarding about being a nurse? The least rewarding?
*Describe your ideal job and work environment.

There are going to be a lot of questions thrown your way.  Again, preparation is the key here.  Just make sure to listen to each question, take a deep breath, and answer confidently.

5.) Leave a lasting impression- not only do you need to make a great first impression, but you need to make a lasting one. This includes asking great questions at the end of the interview, continuing to make eye contact, staying positive throughout the entire interview, and ending with another smile and firm handshake.  Then, its a great idea to send a thank you. In today's age of technology, a simple email after the interview to thank them for their time, and remind them how you would be the perfect candidate for the job is appropriate.  However, this is only the first step.  A hand written note 3 or so days after the interview will make a big statement.  Again, it's all about making yourself stand out from the rest, and leaving that lasting impression.

So there it is...my 5 tips on acing your nursing or APN interview.  I'd love to hear from you if you've recently gone through this. What were the things that helped you the most? Anything you'd do differently??

PICU Job Interview

I am going to say something that if a co-worker of mine read would make them freak out...so here's to hoping that none of my co-workers actually read this...or, rather, for the ones that do, make sure you read til the end!

Let me preface this with saying, I am not looking for a new job.  I love what I do.  I absolutely love the PICU.  And I love my co-workers.  Repeat, I am not looking for a new job!

Now that that is out of the way, I had a phone interview last week for a brand new, very exciting PICU APN position.  This new position is at a brand new, state of the art facility.

The benefits package literally made my jaw drop- it not only included a $30,000 pay raise, but two round trip airline tickets to anywhere in the world per year, great medical and dental insurance, a housing stipend that would cover rent in full each month, a transportation allowance covering all monthly costs, and a small food stipend each month!

It would be a job working alongside some of the worlds greatest intensivists, researchers, and faculty out there.

At this point, I'm sure you're thinking "Why in the world is she not blogging about accepting this new, amazing position!?!?"

Oh wait, I guess I didn't mention WHERE this new job was.

Qatar.

Never heard of it?  I hadn't before a couple weeks ago when I saw a House Hunters International episode on it.

But prior to that, nope, never heard of it.

Qatar is a small peninsula in western Asia, bordered to the south with Saudia Arabia.  It's one of the richest areas in all of Asia, and despite what I might have pre-judged, is one of the safest areas of the world, with extremely low crime rates.

While I have always wanted to go to a third world county (although this is most definitely first world) to work for a year or so, Qatar was not what I had in mind.

If I were at a different point in my life, if we weren't where we were at in our fertility journey, then perhaps this offer would have me on a jet plane across the world in just 7 short months time.

But, I ultimately am saying no to this position...have said no!

So why the interview then, you ask?

Well, I got the initial call with some basic info that wooed me.  It piqued my curiosity.  And then I realized I have gone through so few interview processes in my life, that perhaps I would benefit from a few more.

I interviewed for my job at my current hospital in the PICU as a nursing assistant which was barely an interview- it was about 4 questions and they mostly consisted of "You in school for nursing?- yes; You sure you want to work here? yes."

After that, I had my foot in the PICU door, and my RN interview was just as short, and mostly spent discussing thoughts of transitioning roles.  Not a real interview.

And then for my current position, I had 6 interviews with various APNs and physicians which lasted all day, but really only 1 of them actually asked me true interview questions. One interview was spent with the attending telling me stories about his four kids.  Another interview was spent with the attending telling me how many mice he killed during his residency research project, and all the joys of that research.

So I really have not had an interview process in a professional manner.  And not that I'm looking for a new job (just wanted to reiterate that again!), I think it was something that I should go through. Even if on the phone.  Interviewing for a dream like job in a not so dream like place.

Seeing as I am going to Prague to present my research in just a few months, and will certainly be put on the spot then with tons of questions, so this would serve as a warm-up.

And it certainly did.

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I started this post with the intent on discussing interviews.  And look at the *long* turn that it has taken. So rather than get into the nitty gritty of the actual interview now, I'll save that for the next post.

But I am very aware of the anxiety that can be felt surrounding formal, professional interviews.  There is so much unknown.

Whether you are in nursing school and looking to interview for an internship.  Or you are a new graduate nurse looking for that first job.  Or, you just finished grad school, and are starting all over as an APN.

Whatever the case may be, interviews are a big deal.  And you should most definitely be prepared for them. There are many ways to do that, and many ways to help relieve the anxiety.

So while that was what I initially set out to discuss on this post, I clearly got side tracked.  So I am leaving you in anticipation until my Interview Part II discussion (to be coming soon).  But if you have specific questions regarding interview specifics, let me know and I will make sure to include them!