Whoa. I got some really unexpected news tonight at work. My boss informed me that I am to start training to be charge nurse. She didn't ask if I wanted to, just told me. Then said that I was already on the schedule to start January 1st. I'll have 3 shifts precepting with that day's charge nurse. In some ways, it's cool... a bit more money, don't have to take patients. In others, not so cool... having to make sure staffing is adequate, crunching numbers, fixing problems. I'm most scared of being confronted with a problem that I can't deal with. Or doing the numbers wrong and leaving us short for the next shift. I'm most worried about coding patients on other floors.... Coding patients in CCU is stressful, but at least I know where everything is and who I'm working with. If a code is called on another floor, I have to run up there and hope that I can do a good job. Or at least hope that the ER doc has beat me up there, thereby freeing me from having to "run" it :-) I should mention that I wouldn't be in charge every time I go to work. I don't actually know how often I would be... once or twice a week?

So that should be interesting. Tonight, I was flex RN. I carried a beeper and all the floors paged me for various reasons... IV's to be started, NG's to be put in, accompanying monitored patients to be transferred, admit notes to be done, preparing patients for surgery, answering general questions. It's typically a neat thing to do, but it is a LOT of walking. Dave reminded me to put on my Sportbrain today, but I didn't feel like it... but now wish I had. I walked A LOT!! My legs are quite sore. Anyway, I got called to start an IV on a patient and was told that she pulled out her previous IV because she was "confused." Okay, I say and walk in, only to be told by said patient to get the hell out, go home and go to bed. Ha. Needless to say, despite my most manipulative charms, she was not in the least bit interested in having an IV started (and kept thinking I was saying that I wanted to start "an idea." "Where can you possibly put an idea into me?" she'd say.) The hapless RN taking care of her gave me an exasperated look when I told him that I couldn't start her IV, because confused or not, she was refusing. It's just a feeling you get from people, and I guess circumstance plays into it as well. Sometimes confused patients tell you they don't want you to do this or that, but you HAVE to... even to the point of having other RN's physically restrain them. But she was lucid enough that I thought doing that would be a bit excessive. She was VERY adamant. About an hour later, I get a call to start an IV on that floor again, only to be told that it was the same patient! I patiently reminded them that I'd already been down that road and wasn't planning on going back... she said no, she didn't want it, it's her choice, end of story. No, they say ... now her husband's in there and says she'll cooperate. So I go back in and she's indeed all smiles and after explaining what I was about to do, she looked to her husband, who confirmed that I was not in fact some wacko off the street looking to find a pincushion. As soon as I started to take her arm to put the tourniquet on, she pulled away abruptly and firmly informed me that she was not actually going to have anything to do with this IV starting stuff. Go ahead and start one, missy, but not on me. I inwardly groaned again, but her husband said something or other to her, and she calmed right down and let me do my thing. Pretty soon, she was being as cooperative as could be and I started the IV with no problem. When I was done, she held out her other arm and asked if I needed that one too. When I said no, she looked at her husband and asked if he was going to hurry up and pay me before I left. He said that it was already taken care of, but she kept insisting that he stop wasting my time and reimburse me. It was at that point that I ducked out gracefully (okay, my pager went off at the utmost perfect time).

That's probably enough for now. Good night :-)