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2/11/03  Tues  0633:   Today is Eid Al Adha (the Festival of Sacrifice) and it's celebrated throughout the Muslim world as a commemoration of Abraham's willingness to sacrifice his son for God.  Eid-ul-Adha is celebrated on the tenth day of the month of Zul-Hijja.  It's also Clean Out Your Computer Day, so get to it - I know you've been thinking about getting rid of all that junk crammed into your computer!  Surprisingly it's Satisfied Staying Single Day since February is also National Single And Searching Month.

My horoscope:  'While channel-surfing by remote control, you will accidentally happen upon a secret US government channel and will overhear people in the Pentagon talking about their success with several operatives code-named after various amphibious creatures. A sudden horrible realization will strike you. Either that, or you'll get jam on your shirt.'

I worked Sat & Sun on 2West, which wasn't so bad as there were no vent pts, just one with a trach and T-piece, which I ended up taking care of.  It's a sad story, and should be a wake-up call to people to learn CPR. 
Young man, collapsed and the person with him didn't know CPR.  By the time the paramedics got there he'd been in V-fib (heart just sort of quivering, not pumping blood around) 10-12 minutes with no CPR, basically dead.  They revived him but after 4-5 minutes of no oxygen to the brain, brain cells start to die and the brain does not regenerate itself.  So, he's basically a vegetable now.  I took care of him both nights and there's not much to do for him but keep him comfortable, turned, and clean. 

I do talk to my patients that are like this; you never know what may happen, what they're hearing, etc.  I told him everything I was doing, discussed stuff happening on TV.  As I was doing his trach care (have to clean around the stoma, change the inner cannula, etc) the sitcom person was singing "Me and My Shadow" so I was too.  He looked at me.  I know what anoxia does to the brain, but you can't help the little flip your heart does when this happens.  He did it again when I was in the room with the doctor bringing him up to date on my findings, the doctor said, "look at that."  But he doesn't keep looking and doesn't track.

He was the most invovled of the 3 patients I had, had the same three both nights.  Sat morning I was giving him his meds thru his Keofeed (small bore tube thru the nose into the stomach) and the last one was potassium.  I'd smushed it up, let it dissolve completely, did the swirling motion as it went down, but it somehow managed to clog up the tube.  I tried everything, smaller syringes (have more pressure behind them), drawing back, coke, force!  I got two showers from the water spurting out backwards, I got Sharon once and Myra got me once as she tried also.  I finally put in a new one but you can't use it until placement is verified by Xray.

When I came back that night Priscilla had had quite a time with that!  Xray confirmed proper placement but the tube wouldn't flush, nothing she tried would work; so she puts in a new one.  Xray says the end is kinked, pull it back 5 cm then advance it again.  She does that but it won't flush either.  So he gets
another one put in, luckily this one works.  I guess it was sort of good he was as he was; getting 3 tubes put thru your nose & down your throat is not pleasant.

Also, as this is going on he is moving some, he's a little diaphoretic and as he's moving his arm he scrubs off the tape on his IV and flips it over, pulling it out somewhat.  Now he needs a new IV.  Mornings are always hectic with things to do and now there's even more to do - new Keofeed, new IV, new trach dressings (which I changed multiple times on him).  Andrea was soooooooo nice, she knew what was going on and stepped right in and did the new IV!  The next night she needed one placed on a patient, she couldn't get it; I looked but didn't see anything so Kathie ended up doing it.  I wanted to help her out after she was so nice to me.

Sunday night was not bad, I had the same 3 patients, Andrea had the same 4 and Kathie had the other 4.  No emergencies, just a couple of pts who were needy, but they weren't mine!  Monday morning Marcy came thru asking if I'd stay 'til 11am, I said sure!  I'm off the next 3 days so it's no problem; besides, it's for double-time!  It was quite pleasant, I didn't have very many meds to give; I did a quick re-assessment of my 3 pts, which was very easy as I'd had them for 2 days.  Then one was taken downstais so I was left with 2 pts.  All in all it was quite nice.  My 2nd pt was a confused little lady and the 3rd was a very pleasant gentleman.

When I went back in his room Monday morning he was surprised to see me; I said to him "ohhh, you thought you were getting rid of me huh?  I decided to stay around and torture you for a little bit longer."  He laughed.  I got him settled for breakfast, changed his bed since I had time and the aide was busy.  We were joking around and as I left the room he said "Barbara, you're something else!"  I popped my head back in & said, "as in good or bad?"  He laughed and said, "definitely good!"

It's kid of damp outside, I'm hoping it will rain really good today, then hold off tomorrow.  Andrea (the new traveler from Iowa) was wanting to know what there was to do around here.  We listed the zoo, wild animal park, etc.  She was looking for things not as touristy, asking us what
we do.  Sharon mentioned Seaport Village and as I've only been there once, and ages ago, I asked if she'd like to go.  So, we're going tomorrow.  Hopefully it won't be pouring down rain.  I'd like to check out the shop that has nothing but windchimes.  I adore the big tubular ones, the ones that sound so melodic and beautiful.  I may get a couple!

Also mentioned Old Town and Juilan.  Told her if she went to Julian she
had to stop at Dudley's and check out the yummy bread they bake there.  I said if she decided after Wednesday she could put up with me I'd be glad to go with her!

I'm glad it got a little cooler.  When I left the hospital yesterday, at 1130, the sun was warm and I was griping to myself about no winter and being hot all the time.  I know what you're thinking Mom, but let me bitch while I can :)   In fact, as I'm sitting here I'm thinking of actually putting on my house shoes; you know, the ones I've only been able to wear a couple of times as they're so warm!

Help, I'm being abused by my cat!  He keeps smacking me in the face!  He's sitting up here to my right, wanting attention and kisses on the head.  So when I'm not doing it, he's taking his right paw & smacking me on the side of the face until I look at him and let him head-butt me so I'll kiss his little head.
2/11/03  Tues  (0846):   Okay, I finally got the pics to upload; two under "people at work" and a page of pics for "Jake's Place," you can go here to look at them.

It was raining a little bit ago; now it's not as dark & gloomy outside.  I was hoping it would rain most of the day and night, take a break tomorrow, then start again in the evening.  We need the rain and I like the rain.

Today in 1542 the English parliament passed bill - treason for unchaste woman to marry the king; Catherine Howard to die.  Henry the VIII wanted an excuse to get rid of her to marry someone else.
2/12/03  Wed  (0343):   Today is Lincoln's birthday.  It's also Freedom To Marry Day; aren't you free every day to marry?  But it's also Chocolate Day; I think we've had one of these before, but I'm not complaining!  Any day is a good day for chocolate; my rationalization - it has potassium in it and that's good for you!

I was looking ahead and one "holiday" caught my attention.  On Saturday we can celebrate Lupercalia.  Not knowing what that was I looked it up; you can check it out
here.  Also shows how the month of February got its name.

My horoscope:  'You will discover that you can see people's auras today, if you squint. That should be done in moderation, however, as many people object to being squinted at.'

Andrea called last night and we decided since Seaport Village is such an outdoors-type of expedition we'd put it off until next week.  That means it won't rain tomorrow!  Oh well, maybe I'll see if Rachael has the day off and wants to go see the movie Chicago; she says none of her other friends want to see it.  We'll see.

DREAM ALERT   Don't ask me where this came from!  There was an alligator in the house!  It wasn't my apt, but I was living in a house and there was an alligator crawling around.  I was afraid it would get my cats so I had a large stick which it chomped onto and I was trying to push it backwards.  I couldn't get rid of it, thought it might go away if it had something to eat so I grabbed the chicken that was in the house (don't ask me why I had a chicken in the house) and threw it around the corner at the alligator.  It ran back into the room so I picked it up again and tossed it at the alligator, but as I threw it I realized it was a cat, not one of mine.  I didn't want to hear the screeching of the cat so I turned my back and plugged my ears.  And that was the end of that dream! 

Another dream last night:  for some reason I was barefoot at work and someone in the elevator saw this and said this one time she wouldn't report me, but I'd better wear shoes next time!
Didn't know if you'd seen this on the first page; isn't it cute :)
2/15/03  Sat  (0923):   Of course everyone knows yesterday was Valentine's Day; I'd forgotten and could have worn a scrub top with hearts on it, darn.  Don't forget to celebrate Lupercalia today (check out 2/12 for a link to read about it if you don't know).  It's also National Sea Monkey Day; did you ever order those out of the back of a comic book????

February is American Heart Month, so do something about it; change your diet, start exercising, stop smoking, get a check-up, etc.

My horoscope:  'You will get the peculiar urge to go outside and roll around in something yicky.  Also, you'll notice your ears are getting hairy.'

Chandrani called me yesterday, I think somewhere around 1230 or 1300, and asked if I'd come in early.  I said "sure!"  She knows who to call when she needs someone early.  And it was a great time to do it.  I was over on 2East, my patients were great, I had four to start.  One was there for comfort care, she was not expected to last.  I was going in every 1/2 hour as I don't think anyone should die alone.  It was pretty hectic, I'd checked her at 1745 and didn't get back in there until 1830, she was gone, and had been; we decided she must have died right after I checked her.

I had to call the doctor, family, hospice, house supervisor, and donor bank.  It was the first time I did it all; before I've lucked out and someone else did all the paperwork stuff.  It took the daughter a while to get in, I assured her that her Mom would be there, we wouldn't take her away.  When they got there I explained I tried to be there but "she just snuck out on me."  The daughter gave me a watery laugh and said, "that's how she is."

I saw on the schedule that it was to be Jess, me, and MaryAnn with an orientee.  Unfortunately MaryAnn called in sick, so guess who got the orientee.  His name is Dale and he's from Scottsdale; he did pretty good.  So as I said, it was a good time to go in early as I only had patients for 4 hours, then Dale took over and he knew what he was doing.  It was a busy night, but not as busy as it would have been if I'd had the patients all to myself.

This afternoon I'm going over to Deanine's (Brooke's sister and Brooke will be there, haven't seen her in ages) for scrapbooking, chatter, and eats!  Hopefully I'll have some new scrapbooking pics to put up.  I forgot to take some of the one I did for Mom but will get some when I'm out visiting the end of March.

Therefore, it's time to go take a nap so I can go play this afternoon!
2/18/03  Tues  (0234):   Today is Cow Milked While Flying Day.....what!  I don't even want to think how this came about.  I haven't received my list of "holidays" so don't really know what else is going on.

My horoscope:  'You will begin a spiritual journey. The karmic chaos which has surrounded you begins to settle into a new pattern. Also, you will become strangely fascinated by electric juicers.'

Worked Sunday night, on 2West and it was horrible!  Not the pts, Anne and I only had 3, Marge (LVN) had 4 and as usual Anne and I covered 2 of the LVN's pts.  That was okay.  What was time-consuming was that
every chart Anne and I put our hands on had orders not signed off, things not done, meds missed, etc. 

For example, I was reviewing the chart of the pt I was covering for Marge, keep in mind it is now the 17th, about 0100.  There are some orders not signed off; I verify that they've been done & sign them off.  Then I discover one for a medication, which I assume was written on the 13th as the order before and after it is dated the 13th.  This order was taken over the phone from a doctor, it's not dated, it's not timed.  There's a line drawn thru one doctor's name (without error & the person's initials) and another name written.  This med had never been transcribed over to the MAR, it had never been signed off, it wasn't in the computer.  It is 3 days (going on 4) later and the pt had not been receiving the (continued on next page)
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