Yesterday was my orientation onto the new unit, new instructor, new everything. It can be pretty challenging to change gears like we do as we move from one rotation immediately into the next. Especially given the circumstances from the last instructor, I found the adjustment a little difficult, but I think once I hit my stride with my own pt load I will be okay.

I wasn't sure what to expect with this unit, since my last surgery rotation was orthopedics. I think there will be a lot of similarities. Older patient population, multiple comorbidities, people who are more or less paying the price for a lifetime of unhealthy choices. Sure makes me re-evaluate my own healthy habits. There are amputations, bypasses, carotid endarterectomies, a whole plethora of vascular surgeries I don't yet know about, and general surgery.

My precepting nurse today was a new grad herself, class of 2010. I shadowed her and rounded with her on her 4 patients, getting a feel for the unit's flow and routine. I was pleased to see the teamwork dynamic on the unit - an AWESOME change from my maternity rotation, where the floor had some serious politics that they made no attempt to hide. Like the day I had to request a new nurse because mine spent the entire morning griping to me about other nurses and work environment instead of letting me care for my assigned patients - wow, awkward.

It was nice having a newer nurse to shadow today. It helps to give me a visual on where I would like to be when I graduate. Usually, when I shadow really experienced nurses, I get blown away by how much they know and what they know to expect. It can be intimidating when they are connecting dots long before the questions have even formed in my brain!

Today's patients included a middle-aged woman with a brand new ileostomy, a senior who'd had her gangrenous leg amputated, a patient with a gianormous gallstone and pancreatic issues, and a man in his 60s who was about a week post-op from a fem-pop bypass.

The unit is pretty old-school in terms of layout; it is a horseshoe with rooms around the perimeter and the nursing station at the opening. Being oldschool, there isn't really anywhere to chart comfortably or congregate with other students to do research. I got pretty used to that on my last rotation - couldn't go 10 feet without running into a charting station complete with computer and task chair :)

I am feeling good about this rotation EXCEPT my instructor will be leaving in a few weeks and will be replaced by someone, but we don't know who. So my current instructor will be doing my midterm evaluation and then a new instructor will be doing my final. This could play in my favor, as I have time to find my feet and then the new instructor will come in and see me being awesome, or it could go the other way.

I am looking forward to my leave of absence from my job; I will be off March-April so I can focus exclusively on clinical. This will be a first for me and I intend to take full advantage of it in terms of home study and knowing my stuff - I should get another 20-25 hours per week to myself! Unfortunately I will be completely broke for 2 months. :(

In other news, I attended my STTI chapter's executive meeting to offer my assistance with maintaining a web presence via The Circle. This kind of evolved into them asking me to give a presentation at the next meeting to show them how to use it. Ironically, the next item on the meeting agenda was succession planning. IMO, the single best way to recruit my digital generation into any role is to create accessible information and make it easy to become involved. Honestly, the first thing I did when I got invited to STTI was go to the website. Same with CNSA. Same with Alberta Health Services. I am probably a little more gung-ho than the average student in terms of finding information, and a little ballsy when it comes to getting involved, and I think more people would love to get involved if the process of becoming involved was straightforward and clear.

I believe we are at an awkward stage in terms of information accessibility; a lot of the areas in senior management that are responsible for coordinating information grew up in the era of newsletters and paper applications. Information was accessed days or weeks from the initial request in terms of fax or mail or answering machine. What you knew was directly related to who you knew, and "in person" was often a requirement. However, these outdated methods of Finding Out no longer meet our expectations. We want to find information in seconds. This dichotomy is causing tension between old methodology and what we've come to expect from online resources. It's no one's fault, of course, that we are taking our time getting information more freely accessible - healthcare is a little unique in terms of extremely important confidentiality issues. I definitely see a huge potential for information distributed almost exclusively through digital media. There really is no reason to have paper anything (unless you live in Canada and have paid attention to recent events involving Usage-Based Billing). It is my hope that I can do my part through CNSA and STTI Mu Sigma to encourage freely accessible information and improve involvement in these organizations.

By the way - I don't know if I mentioned it, but I was elected into an informatics position on the Board of Directors of CNSA! It is currently an Officer position which reports to Director of Communications, but informatics is a massive role in its own right and I see potential for the position could be expanded to Director of Informatics at the next National Assembly. Obviously it will take a whole lot of work on my part to make that happen. I am really excited about this opportunity. The website is going to improve a lot over the next year. It needs improved navigability, richer content, frequent updates, CNSA projects and involvement, and clear role descriptions for the BoD. There are some lacklustre forums on there which need better organization and spam filtering. There are opportunities for greater integration with CNA's NurseONE (I met the project lead at the conference) and hopefully nursingideas.ca. I have a lot of ideas and am hoping to get together soon with the webmaster to discuss the back end process for the website. My term doesn't officially begin until April 1 so no rush.

Wow, I had a lot more to say than I thought. I am so, so, so excited about all these possibilities. Going to bed with visions of awesome, engaging, easy-to-navigate websites dancing in my head. Second RN-shadowing shift tomorrow!