|Chandrani came up to help with the paperwork as it's going on 2100 now and I still have to take care of my other 2 patients. I did get an admit but luckily it was around 0100 and by that time I had pretty much caught up.
After the family left I still had the PM aide to help me get her ready to take downstairs. You can't send them with anything still attached, so had to take out the catheter, the central IV line, and she had two chest tubes. I had to cut the sutures then place my padding & pull. Didn't have to worry about sterile technique, just snip & pull! It's the only time I would be allowed to remove chest tubes.
Sat night I worked with Ron and a registry LVN, who was ok to work with - at least he knew what he was doing. Ron and I were having a running "argument" about who was the resource nurse. I think I mentioned it before, one nurse is the "resource nurse" usually it's someone who has been there a while, it's someone the other nurses can turn to if there are questions. She/he gets 3 patients, the LVN gets 5, and the 2nd RN gets 4 patients. At night, though, we always divide the patients equally (and I've heard a rumble of complaint from Days about this). Anyway, Ron says he's the resource nurse. I turn around and say "heeeeyyyy, wait a minute, I'm the resource nurse as I'm core staff and you're 'just' a traveller." Of course this starts off a round of discussion and laughter.
So, it's the end of the shift and one of the LVN's patient's is asking to see the "senior nurse." Ron turns around and tells me to go in "since you're the resource nurse!" We're thinking it's a complaint, so now all of a sudden I'm the senior nurse :) I went in - he had nothing but compliments. Wanted to let us know that he thought we "ran a very nice place, the staff was very professional, kind, helpful, and he was very happy with the care he had received."
Sunday night Ron and I were back, and the LVN was Rebecca; I've worked with her before and I like her. I started out with my same three patients, all of us had 3 patients to start. I was the only one to get an admit and I think it's about the most frustrated I've been in a long time! He had a DVT in his right leg (blood clot) and had alzheimer's, at least he was pleasantly confused. He needed to wear a continuous pulse ox on his finger to monitor his oxygen saturation in case he threw a clot into his lungs. He kept pulling it off! Over, & over, & over, & over................. aarrgghh!! I'd go in and say, "Mr. X, you need to leave this alone," and he'd say, "oh, okay," and reach for it again. The only positive thing about it was that it was keeping his attention away from his IV site; however, he eventually started pulling on that so I wrapped it up to hide it.
I was in the room so much and repeating the same stuff over & over - at one point we almost had a "who's on first" routine going on. He said something about being in Fontana, I said, "you're in Oceanside." He says, "well who are they then?" I ask, "who?" and he replies, "Oceanside." I say, "yes, you're in Oceanside." "well who are they?" "who?" "Oceanside." I gave up at this point and said "I don't know who they are."
After about the 15th time in the first hour of replacing the finger probe I told him I didn't know what I was going to do, I'd explained several times why he had it but he just couldn't remember. I finally told him if he kept it up I might have to tie his hands down to keep him safe. (I just knew if I took it off he'd throw a clot and there's no way I'd know anything was wrong as he wasn't on a monitor) He looked very affronted and said "now why would you go and do that to someone like me?"
One time he asked me "what are you going to do with those birds over there?" I looked at him, as I was yet again re-taping the pulse-ox, and said "shoot 'em!" He just said "oh." Then I decided if someone else had been walking by and heard that, not knowing all that had been going on, they might get the wrong idea. So when he next said something about the birds in the room, I dredged up my "therapeutic nursing skills." I asked him if he saw birds, when he said yes I told him "there are no birds in this room. You are in the hospital." His reply, "oh, well, what about those birds?"
I finally gave him a sleeping pill, it was my last resort as he was squirming around, legs out of bed, inching his way out of bed, pulling at the pulse ox, IV, etc. I kept waiting for it to work and he was just as active as he was when he came in. Then one of the times I went in to re-tape the pulse ox I noticed something strange in the bed, flipped on the light and there were his two pills, lying neatly on the sheet, # %&$ @# %^*#^# aarrrrggghhh!!!! ^#$^@#&&*(
I have no idea how he managed it as I had sat him up, gave him the pills, held the glass while he drank, and watched him swallow! So I gave them again, told him to say ahhh, then go "la la la la la" and then lift up his tongue. I checked the cheek pockets and had him go thru the ahhh & la la la's again. Finally after about 45 minutes he slowed down and actually slept for a couple of hours - just enough time for me to get some charting done. I told Ron if he was still there when we came back and Rebecca didn't come back, I was not taking him again! They just laughed at me again.
Ron and I were back Monday night and there was a nurse there until 2300, but after that it was just Ron and I, and a CNA. I told him it was a good thing my confused pt was gone as we would have probably come to blows over who was going to take care of him :)
I had 5 patients on Monday and Ron had four, but he was busy enough with two of them. One rang the bell a lot, he had a hard time getting comfortable so he'd ring to get up in the chair and a few minutes later he'd want back in bed; up down, up down. Then one had been a little nauseous so he'd given phenergan - sent her for a loop! She was trying to get out of bed, but she'd had a cardiac cath and we were wanting to keep her in bed (they go thru the femoral artery and you don't want that one popping open & bleeding!)
I have to admit, even though it was 3 in a row, they were pretty good nights (overall) and I had good co-workers.
Oh, I guess it was wishful thinking, but my rent is actually going up $75 as of January 1st. Must have had a mental block when I said previously it was $65. Ron has been looking at apt prices and I really can't complain too much, most of the rents are $900+ One of the aides said she was paying $1100, I don't know how some people manage such high rents, kids, food, utilities, etc.
|11/14/02 Thur (0104): Okay, who knows who Nell Gwyn is? Mom, put your hand down, give someone else a chance! Anyway, she died on this date in 1687 and to read about her you can go here. She died at age 37, wonder why so young? I've looked at several different places & so far haven't found out why.
Where is winter! It was 80 degrees yesterday and today, and looks to be as warm for the next few days. Hey, it's the middle of November! I wish it would get cold & stay cold, and it could start raining a lot too. Oh, the new roof works quite well! After the last rain no leaks, there were none in the old one either. Years ago when I lived in the studio apt I had no problem with rain, then they replaced the roof. The first rain after that I had Niagara Falls in the bathroom. It continued to leak everytime it rained, even running down the corner of one wall and I found a mushroom in the carpet once! I heard after I moved out that during the rain that winter the roof collapsed!
Went to lunch today with Kathi, Rachael, Jordan, and Jackie....guess where? Yeah, Mi Fiesta! After that I picked up the rest of my scrapbooking stuff I'd ordered from Brooke in August. She'd given it to Deanine (her sister) as she works at Dr. Ansari's just down the street and she lives pretty close too. Since Brooke lives in Ramona she figured Deanine would see me sooner. Now I have no excuse not to get started scrapbooking on the Road Trip pictures. I have all the stuff I ordered before I went, and I stopped at Everafter in Carlsbad after the trip to look things over & pick up stuff once I looked at the pictures & knew what I had to work with.
I think Friday I'll splurge & go see the new Harry Potter movie. Since it's a Friday maybe most of the kids will be in school and it won't be as crowded as a Saturday would be.
|11/16/02 Sat (0113): Today is International Day for Tolerance and I guess that ties in with tomorrow's World Peace Day. Sunday is also Take Hike Day, so you have an excuse to tell someone, "oh, go take a hike!"
It's amazing where I end up when I start surfing around on the web; sometimes I can't remember what took me to a particular page, what thought was in my head. I ended up on a page about Eleanor of Aquitaine, you can read it here. (btw, one of Mom's favorite people)
Once again I say - IT'S NOVEMBER, STOP ALREADY WITH THE HOT WEATHER! It was 86 degree Friday, and the weekend doesn't look to be any cooler. Makes it hard to sleep during the day.
Work called, offered me double-time to work 3-11:30 but I had other plans, darn! Would have liked the extra money. However, I was invited to dinner at Fariba's. She was having a lot of family over and wanted me to come. I've met them all before, except Nasser's parents, I believe. She must have been cooking all day, there was tons of food. It had also been Nasser's birthday a few days before, so that was part of the celebration. I will have some pictures up later, one will point out the fact that Fariba is doing all the clean-up work & no one is helping her, they're all sitting around! I helped until she chased me out of the kitchen.
I didn't go see the 2nd Harry Potter movie, decided the first day might be too busy. I'll go Tues or Wed, early and hopefully will miss the crowd. I work tonight & Sunday night and I'll have a student with me. I'm the backup but becuase of her schedule she needs weekends and Ron is her primary but he's off this weekend. He was telling me last weekend to "break her in for me." I'm gonna be the teacher, don't know if that's good or bad!
|11/18/02 Mon (1013): Today is Teddy Bear Day and that's because in 1902 there were the first cartoons of Teddy Roosevelt as a hunter sparing a bear and that's how teddy bears came to be. It's also New Buffalo on the Block Day, which I don't understand at all! And it's Mickey Mouse's Birthday; in 1928 the first talking cartoon premiered at the Colony Theater in New York - it was Walt Disney's "Steamboat Willie."
I worked the last two nights on 3East, Leslie (a traveler) was there both nights; we had an LVN on Sat and last night Katie was with us. It's not as funny as it was Sat night, but we nearly cracked up when we got report. The LVN said she didn't tape report as she had "performance anxiety" so she gave us a verbal. She gets to one patient and says "she did a Rip Van Winkle all day and there's this big ass bag of white stuff hanging up." We couldn't look at each other or we would have lost it. She actually didn't know what it was (it was TPN). She didn't give the info we needed during report and when she was asked about certain things, there were vague answers. I gave up, figured I could look things up for myself to make sure they were right.
It was a pleasant night, that should have warned me about Sunday night! This is the perfect example as to why I prefer only 2 nights in a row. I don't have to worry about going back tonight and dealing with one particular patient. Pt I had Sat night was still there last night, he'd been moved to a room opposite the nurse's station as he was starting to go thru DT's. Half the time he didn't know where he was, he kept getting up & wandering about, he was a safety risk to himself. I spent most of my time in there. There were no sitters available, the medication I had I could only give once every 4 hours and it calmed him down for about 10 minutes.
It's about 0015 and I'm in the room, yet again. I've done no charting, there are things I need to do to my patient I got from ICU, another patient has an elevated BP so I need to give her meds. Leslie was in his room with me and I think she saw it in my eyes, not to mention hearing it in my voice - I'd just about had it and was fixin' to hunt for a bat! Not the kind with wings, the nice hard kind you can swing! She headed for the chart, called the doctor and got an order for some Valium. Now I'd given him 0.5 mg & 1 mg of Ativan, the 1 mg slowed him down for about 10 mins. She gave him 10 mg of valium, he was dozing for about 45 minutes.
Just before he got antsy again the charge nurse called & asked if I needed a sitter. Right after I said "not right now" pt was up prowling about, pulling off his O2, etc. So I called Lee and told him I really needed a sitter. Somehow, he'd found a sitter for me! What a relief! Gave him more Ativan in between giving him more Valium - I'd say he was quiet, relaxed, and dozing for a total of about 1 hour all night.
They were short a nurse this morning, Lee asked if I could stay over an hour, I said "sure." Ended up staying until 0915. My ETOH pt dozed for about 20 mins, I hooked him up to his IV antibiotic and asked if he'd take some pills for me (it was time for morning meds). He nodded & said ok. I opened them into the little paper cup, handed it to him and he threw them on the floor, and swung his hand at me. Ok, I wasn't gonna force them on him and that's when I decided I'd stayed long enough, I didn't want to deal with it any more. I'd helped transfer one patient, gave meds to two others and a 4th was now off the floor for a PICC insertion. They were expecting an LVN about 1000 and I told Kathy & Rebecca I was going. Luckily the other nurse was getting off the elevator as I was getting on.
I can tell you, if I'd had to go back tonight, I would not have taken that patient again! His own wife refused to come in the previous day, saying she'd dealt with his alcoholism for 20 years and she'd had enough.
History lesson time. Antarctica was discovered by Capt. Nathaniel Brown Palmer in the sloop 'Hero' on this date in 1820. If you'd like to read about him, go here.
I think tomorrow or Wednesday I'll go see the new Harry Potter movie. It'll probably make me want to read the books again! I highly recommend reading them. I liked the first one so much that when I finished it I turned right back to the beginning and read it all over again :)