the warm-up

What a hectic day!

I woke up early to get to the home where I'll be doing 1:1 pedi and spent four hours or so learning about the daily routine and how to provide care to the client. Mom showed me what my morning routine would be. Empty the humidifier's collection reservoir, refill the humidifier with sterile water, break down the feeding bag, wash the g-tube connector (they only get one per week so it gets washed and lavaged between uses), hang a fresh feeding bag for the evening, and help the client get ready for preschool. I got to suction the client numerous times (the client needs to be suctioned frequently, I think the longest I saw the client go without suctioning was 20-30 minutes) and spent a lot of time playing with the client. Next in the routine I help get the client ready for school. The parents do a -lot- to make this job easier. They pack all the supplies, make sure his portable suction kit is outfitted with extra trachs, suction catheters and gloves. They pack the feeding kit and pre-mix the formula (mixed with liquefied hard boiled egg-yolk), get them bathed and dressed and keep all of their supplies well-organized.

I'm consistently impressed by the level of skill and organization that they exhibit in caring for their child. So impressed, in fact, I was startled when I learned they aren't even drinking-age! Far more mature than most people my age, but then I'm told having a special-needs child can lead people to grow up fast.

I learned a lot in those four hours, got briefed on the school routine and received a lot of insight into the client's personality and preferences. I also finally learned what the Dx is. SLOS. The client exhibits an easy affect, and playing with them and getting a feel for the level of mobility and stimulation preferences/thresholds in the relaxed home environment was a good intro to being responsible for them in the school environment.

When I was done, I swung by the office to fill out a timecard and picked up a bunch of flowsheets for the charting, since my first full day on the job is going to be soon. When this happens, another agency nurse will stop by after we get back from school to do an intake/admission assessment, which will be instructive to watch. Eventually I'll probably be able to do these as well for the agency.

While I was at the office, they noticed I hadn't gotten my PPD yet, I was planning on getting it done during my physical, but that wasn't soon enough, since it was scheduled for the same day as the admission assessment. The Boss told me to swing by a local pharmacy where other Agency nurses were giving out flu shots. I swung down to the pharmacy only to find that the RN giving the shots is the mother of someone I went to high school with! She was happy to see me, and even happier to find out that I was the RN she got the phone call about to give the PPD. She didn't even know I was an RN! One of the CNAs employed by my agency there also just started the clinical program I graduated from. If that wasn't weird enough, I met ANOTHER nurse from this same agency at a wedding last night! Small world.

Somewhere around this time we all realized my physical (scheduled by my nursing home job) conflicted with the pedi case, so I called up and canceled the physical, planning on rescheduling it for a later day. The HR manager from the home care agency called me back and told me -not- to cancel it, because the later date was too late. So, I call the occupational health center and un-cancel my physical. I call back the agency only to find that they wanted to pay for me to have a physical TODAY, and that I did, in fact, have to cancel the physical and reschedule.

When the dust settled, I had left three contradictory voicemails with the desk of the HR representative from the nursing home, who's out of the office until after the pedi admission assessment. My head was spinning! I was extremely apologetic in the last voicemail, hopefully this doesn't screw up the nursing home gig (they're going to teach me venipuncture, damnit!)

I've been running around all day, it's nice to finally be able to settle into my seat at the coffee shop and just veg out for a bit. I guess this is a taste of things to come, now that I'm about to go from not working for almost two years to working 52 hours a week (and making over 60k/yr)!

Oh, before I forget, any of your nursey types out there who have 1:1 pedi experience, share your insight!

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