|long as she calls 60 days in advance. If she decides to rent out her two weeks there, she has a choice of numerous other places around the world. Hope it works out, maybe next time I can tag along with her. I wouldn't mind going snorkeling around Cancun :)|
|10/13/02 (0122): Hmmm, today is 'Train Your Brain Day' something I try to do every day! And I guess in preparation for Halloween it's 'Scream Day'. Tomorrow starts Wolf Awareness Week, very maligned in movies - wolves do not seek out humans to kill & eat!
Thurs & Friday I was on 2West (yech) with Jess & MaryAnn. When I saw where I was working I almost asked to be changed, then I saw who I was working with and decided to stay. It was 0100 the first night before I could stop to take a breath. One was basically okay, no pleural effusion so they didn't do a thoracentesis (draw fluid off the lungs), he was stable. The 2nd guy had had his parotid gland removed, that's a salivary gland that swells up when you have mumps. I just had to monitor him for bleeding, temp, and pain. He did okay.
3rd patient was on a ventilator. Lots of stuff to do, bolus feedings thru a G-tube (tube into the stomach), dressing changes, trach care, suctioning, turning every 2 hours and he was a big guy so it takes 2 people. All vent patients are bathed by the night shift, so that took 2 people also.
4th patient came up from ER at 2000, stroke patient, but the only thing that seemed affected was his speech, he couldn't talk. It's called expressive aphasia, he knew what he wanted to say, but the connections between the thought and uttering them was broken. Nice gentleman, 6 daughters. After they left I ended up calling one of them back and asking for family to come stay with him. He was impulsive & wasn't connecting consequences with actions. He would get up, start walking away from the bed, but he was attached to an IV occasionally & was a little unsteady. There was no hesitation on their part.
So Thursday night was busy, but the three of us managed to get thru the night! I had a moment, though, that made me sick to my stomach. I was reading the new admit's chart more thoroughly and thought I'd made a med error - horror! The Dr. ordered a medication to control seizures to be given every 12 hours, when the doses came up from the pharmacy I gave him one. While reading the ER nurse's notes I discovered he'd been given Dilantin at 1630, and I'd given him a dose at 2230. By this time lab was up to draw morning labs, they come between 0400 and 0500, I asked her to please draw his right away and send it down for a Dilantin level as I was going to have to call the doctor. I was also writing up the incident. I went back to his chart and finally got to the doctor's notes. My exhalation of relief was so loud Jess & Mary Ann looked over at me, "I didn't make a med error" I exclaimed! The one given in the ER was a loading dose the Dr. wanted given right away. Alhandullelah! I got to throw away the incident report, and told lab she didn't have to do a STAT draw. addendum - his level was pefect!
Friday night was much better, in most ways. I had the same four patients. The first two were very stable, no extra interventions. Vent pt still required lots of time and care, but 2nd nights are always a little easier as you know what needs to be done and when. My problem child on Friday night was the gentleman who'd had a stroke.
He definitely was not connecting actions to consequences! When he'd come in he had 2 IV sites, the one in the left hand was infusing fluid. I left the one in the right hand as it was a good one. When I checked him Friday night, the cap was missing so I had to remove it. You can't replace the cap as germs have had a chance to collect around the inside edge. We had to move the IV in the left arm to the right arm as his arm looked a little red, no tenderness, swelling, pain, warmth, but it was better to change to prevent any problems.
Well, about 0030 he pulled it out. So I put another one in the right arm. That one lasted to about 0400, he pulled that one out also! The daughter that was staying kept saying she was sorry, she fell asleep. I assured her that was okay, it wasn't her "fault." After the 3rd IV was put in she asked what was next if he kept doing it, I told her unfortunately the next step would be to tie down his hands, which is something we didn't want to do. I taped & wrapped the site, and she held his hand for the rest of the night.
Thank goodness Friday night wasn't as hectic or hard as I had to go to a mandatory class Sat morning! I'd gotten to work about 1840 on Friday and got home at 1330 the next day. I was tired! I was supposed to go over to Fariba's for chatting & dinner, but I called her about 1230, left a message and said I was sorry I'd have to cancel as I thought I'd be dead in about 2 hours! I think we're getting together tonight.
|10/14/02 (0213): Today is when the US observes Columbus Day, although he did not discover America. If he did, why isn't this Country called Columbia, or Cristobol, etc. Actually, not counting the indigenous peoples, North America was first seen by the Vikings. North & South America was actually named after Amerigo Vespucci, you can read about him here. For those of you experiencing desertion by your follicles, today is 'Be Bald and Be Free Day' so have fun! It's also 'Dessert Day', a holiday I can celebrate with gusto!
I keep learning how to tweak things around on my website almost every day. What did I learn today? Well.....did you notice something when you opened this page??? The printing covers more of the page side to side and it's longer than ones before it. I don't know how many times I've looked at other sites that had long pages and I wondered how they did it. I'd run out of room too fast on these pages. Now I can go back to the first page & make it longer, so it doesn't look so crowded. I won't change the side margin, though, I like my blue genie too much and want to give him room!
|10/16/02 (1125): Hmmmmm, today is both 'National Boss Day' and 'World Food Day', coincidence?
I worked the past two nights on 4East with Diane. Monday we weren't going to get a nurse at 2300, I was not looking forward to it as it was a hard group of patients. Diane tried to get us a 3rd license, but we ended up with 2 aides instead. Which was great, but not. I had 6 patients, but I didn't have to answer any of the call lights, change beds, get ice, do vital signs at midnight and in the morning, etc.
Last night it was Diane and me again, along with Marge, an LVN. I still had to cover two of her patients but it wasn't as hectic as the previous night, although I was busy all night long.
I have skills tests tomorrow, written & hands-on, I hate them only because I'm afraid of not doing something right, or not passing the written tests. They have a lot of rhythms on the tests and cardiac rhythms are my weak point. The good thing is that we can use books and there's always discussion between others, which is allowed.
Didn't hook up with Fariba on Sunday, but we're both off Friday so we'll be doing something that day. Four days off in a row, then one on, one off, two on and another four in a row off. Have I said lately that I LOVE MY JOB! After that mandatory meeting I had to go to last Saturday I spoke with Joy, I guess you'd say she's the CEO of the nursing staff, after all the complaints she'd received, I told her, "I just wanted to say I am happy where I am, I love my job, and I enjoy working with the people I do." Should have seen her face, her eyes snapped to my ID badge and she quickly asked, "where do you work?" I just thought she'd like hearing from someone who was happy with TCMC and with their job.
And speaking of nursing, tell me, what other job can you have where you get e-mails every week and printed material in your mail from hospitals from here to Florida trying to get you to go to work for them! Teeheeheeheee :)
I don't work until Sunday, but can't tell you what my plans are for Saturday - just in cast a friend is reading this :) though I doubt it, but don't want to let the cat out of the bag!
Judy E. told me about the funniest web site, I was reading some of the submissions and was laughing my ass off! You can check it out here . Once it opens, click on the skull to enter, of course the first ones I read were under "weird nursing sex." Some are hysterical, other make you scratch your head. And the "Student Tales" oh my God! Makes you fear for your life!
|10/17/02 (1840): Today is 'Pasta Day', one of my favorite foods! Tomorrow is 'Boost Your Brain Day' and 'Chocolate Cupcake Day', eating chocolate cupcakes certainly boosts my brain!
Hey! I still have a job! Yaaayyyyy! I passed the skills tests and the two written tests. I was amazed at how much easier they were this year, I really am learning. I actually got up early so I could go to the Staff meeting before the skills lab. Since I knew I had to be up I managed not to stay up all night, like I usually do. And this year I passed all the skills the first time, last year I got a checkmark next to "needs review" on the code blue. I just couldn't keep stuff straight in my head that time. I took a couple of pictures of the gaggle of girls, but left the camera in the car so will get them downloaded later.
They were looking for people to work, Wendy (2nd unit manager) asked if I'd like to work that day, remember, I DO NOT like days. I said no and she said, "what about double time?" I felt really bad saying no since she'd just been so nice to me about letting me take Sat off, but I was tired and I really don't like days. Even just 1500-1900 is hectic!
So after that I decide I need to get an oil change and a smog check so I can get my new stickers for my car. Turns out you have to have the actual notice from DMV to get a smog check. Hmmmm, are soooooo many people walking in and requesting smog checks that they're in short supply? Since I couldn't find it I had to go to DMV to get a copy of the notice.
It wasn't too bad there, they give you a number and a voice calls the number being served as it's also being shown on TV screens and tells you what window to go to. So I pay my fees, get my paper and head back for the oil change & smog check. The lady at DMV was nice, she said just bring the paper back to her window & she'd finish it up. I'm legal for another year.
I went up to the floor to give Lee back his ACLS book and I got a present! A patient's wife had made a beanbag frog, the material on the back was medical "stuff." I think she made them for the nurses that took care of her husband. She'd attached a note thanking me for "talking to him and giving him comfort through the night." That was very nice of her.
I can make this page as long as I like, but I think the size it is now is okay. Not too long so that a person feels they're scrolling forever, but longer than the previous pages with more room.
|10/19/02 (2204): I went over to Fariba's last night, she cooked spaghetti. We were both starved & almost couldn't wait for Nasser to get out of the shower! Afterwards, though, I was a very rude guest - I couldn't keep my eyes open. Fariba told me to go into the guest room & take a nap, I kept saying no, then fell asleep on the couch. I was so tired I finally agreed to stay & spent the night there. I've heard driving when you're sleepy is just as bad as driving drunk and I honestly didn't think I could stay awake long enough to get home.
I was awake by 0400, if I'd been home I would have gotten up & turned on the computer but I managed to go back to sleep. I would have left a little before 0800 as I needed to go by WalMart to get something for Sonya, but wouldn't be able to lock the front door behind me, so waited for people to wake up. My cell phone did that job very nicely about 0900 when it rang.
It was a slow & lazy morning there, then went to WalMart, got the cutest purple sparkly sweater & jeans for Sonya's new daughter, then decided everything else should be purple. Even the gift bag was purple. I told her that way she'd think of me every time she dressed Brielle in her purple stuff!
We were supposed to go to Brooke's for scrapbooking & a baby shower for Sonya, but Brooke couldn't do it so we met at Rachael's. Sonya graduated with us and left a few months ago for Pennsylvania and in the meantime delivered a beautiful baby girl. Unfortunately she's in town as her Dad had an operation for lung cancer, which they discovered to be worse than expected & couldn't do anything. I've put some of the pics from tonight up on the Friends section, but decided there were too many to all go on Friends so I've made a separate button for them on the main page.
|10/22/02 (0620): Today is 'Library Day' and nothing is better than curling up with a good book and spending the afternoon reading! It's also 'Gaudy Day', remember that pair of earrings you bought on a whim, or that outfit you thought would look great (in the 60's)? Go get 'em!
I worked Sunday night, 4 West. I always get there early. I like to get my stuff ready, say hi to people, etc. Well it's 1900 and I'm the only nurse waiting to hear report. At 1910 I called downstairs to the charge office and asked if anyone was coming. Turns out the registry nurse scheduled wasn't coming and they'd called someone else. So I got report alone, there was an RN there until 2300 and we would just have to cover until the other RN showed up.
Since I am core staff, I had to take the 3 patients who had had open heart surgery. Both the day charge nurse and night charge nurse told me to take only those three and no more. We started with 3 patients each and Ava got the only admit. I'm glad we didn't fill up, I would have felt bad not taking the last admit. But it worked out. I'm glad as my three kept me busy enough!
One thought she was getting better, but then was concerned that she threw up (right at change of shift). She said she was "fine until I ate dinner. I think I should have the food tested before I eat any more." Another had been having exertional chest pain, and chest pain when her husband of two months yelled at her and that's what brought her in to the hospital. The third spoke English when he felt like it. A drop of water landed on his wrist when I was flushing his IV and he starts pointing & saying, "wet, wet!"
You just smile & take care of things you can and find a way to soothe & calm when you can't.
I get a new pair of scrub pants, courtesy of the hospital. There are metal edges on the drawers that hold the keyboards, luckily it was the end of shift but I ripped my pant leg on a corner, ripped my leg too! Not enough to bleed a lot but there's a nice scrape pattern the width of the metal corner and it's looking pretty colorful! Wendy happend to be walking by, told me to buy a new pair and give her the receipt. Ran into Del downstairs and she said that was supposed to have been fixed on all the floors, she was going to submit an incident report. As I said, I'm glad it happend at the end of shift, of course if it had happend earlier I would have just gone down to surgery and "borrowed" a pair of scrub pants. I say "borrowed" as they're purple and I doubt I'd have remembered to bring them back :)