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11/5/02  Tues  (0846): Darn!  I didn't have my new list so I didn't know yesterday was King Tut Day, I would have worn my egyptian top to work and told everyone I was celebrating King Tut Day!  Don't forget to vote today.  It's also Donut Day, mmmm.  Now we have a conundrum for Wednesday!  It is the beginning of Ramadan, but it's also Nacho Day!  You're not supposed to eat or drink from sunrise to sunset, guess it's a good thing for those who celebrate Ramadan that the days are shorter this time of year!!  Did you know it was Peanut Butter Lover's Month? 

Friday (11/8) begins Pursuit of Happiness Week.  Remember, the Declaration of Independence gives you the right to pursue happiness, it just doesn't guarantee you'll find it!   So get out there & pursue, pursue, pursue ! ! ! !  (you can read it right
here.)

I was kicking back thinking I had a couple of hours before my alarm went off (I always set it when I have to work just in case I doze off) when the phone rang.  Kate called wanting to know if I could come in earlier, I said sure.  So I got to work at 1615.  I worked on 4West and started with 3 patients and was waiting for a transfer from ICU.  The three patients were being taken care of by the student nurses (yay Palomar!) so I didn't have to worry about giving meds until after they left, which was 1900.

Got to give a couple of pointers to them.  Judy introduced me to one I'm going to be working with, next weekend I think.  I signed up to be back-up for the preceptorship program for the last 4 weeks of the nursing program, didn't think I wanted to be 100% responsible.  Turns out I get her for the first two nights.  Should be okay, she's an LVN who works in the ER elsewhere, so she'll know stuff & know how to manage when things happen fast.

At 1900 Ann & Jun came in, so we had a good team for the rest of the night.  And it worked out well, Jun was the only one who'd been there the night before and I didn't have any of his patients.  Poor Ann, had to deal with one lady who was up & down to the toilet all night long, and most of the time missed, or didn't make it out of bed.  Another of her pts was in isolation to rule out TB and she was adamant that she was going to go downstairs and get something to drink.  She was smoking in the bathroom, and who knows what else in there, the bathrooms are small and she was in there with one of her visitors.  We decided Jun had the best patients of the night!

My transfer from ICU was a lot of work.  He'd had part of his stomach & esophagus removed.  He had a chest tube and one down his nose into his stomach.  Chest tube was okay.  Had to replace what was removed from the NG tube.  He also needed a couple of antibiotics.  Had to have some albumin given, then 30 mins later lasix (makes you pee), plus I had to give him four K-riders (potassium) over 4 hours.  Thank goodness he had a central line (PICC) so I could use the smaller bags as he was having a problem with fluid overload.  Poor guy didn't get much sleep as I was in and out most of the night.

2nd patient has basically given up and I think he just wants to die, he's been there since Sept.  He stopped eating and they put him on TPN (total parenteral nutrition, thru the IV).  His lungs sound horrible, you don't even need a stethoscope to hear the junk rattling around.  He refuses to cough the stuff up, just letting it stay & clog things up.

3rd guy had had a small stroke, but he was doing ok.  Had to give him blood, that's always time-consuming.  He was up & down all night, which means I was up & down, in & out with him all night also.

4th guy was the easiest.  After getting some Tyelnol for a headach he slept thru the night.

Another example of how much I've grown.  I had no qualms about handling this guy from ICU who had dressings all over the place, had undergone major surgery, and had all this stuff to do to him.  Plus, there were orders in the charts that needed to be entered in the computer & written down and we didn't have a PM secretary.  I just plugged along, pts came first, balanced with what orders needed to be put in first (such as a lab draw at 2300 that night vs 0600 the next morning).  I managed to get everything done :)  (although I
did have to take some aspirin!)

DREAM ALERT
!   Marilyn Monroe came over to my apartment, yeah she was a friend of mine!  Anyway she shows up wanting to escape from the public & attention.  She was wearing a strapless evening dress with a billowing skirt & fitted bodice - beautiful scarlet dress.  She comes in, sits on the floor, and takes off her prosthesis.  Her left foot and ankle were amputated and she wore a prosthesis on that side.  I knew this of course.  I picked up my digital and asked if I could take 2 pictures of her for my website, I'd make sure her leg didn't show.  She said okay, and sat cross-legged on the floor, her skirt billowed up around her with most of her legs showing, but the position she was in didn't show her amputation.

Now is that a weird dream or what!  I haven't even seen a Marilyn Monroe movie in a l-o-n-g time!  One of my favorites of hers is Gentlemen Prefer Blondes, I think I like that one best.

I really need to think about travel nursing & checking into the assignments that give completion bonuses. Ron, a traveler who has come back, got $8000+ for an assignment in New Jersey, 4-5k for another state.  I could put up with just about anything for 13 weeks if I knew I'd get 8 grand at the end.  And this still included a good salary & a place to live.  Wow!

Oh well, time to see what I can accomplish for today.  This week is a lousy schedule.  Worked Sat, off Sun; worked Mon, off Tues; work Wed, off Thur/Fri; work Sat/Sun/Mon :
(
11/7/02  Thurs  (0901):   Happy Birthday Richard, where in the world are you right now??? 

80 years ago yesterday Howard Carter discovered King Tut's tomb (Tutankhamen, although when he first became pharaoh he was called Tutankhaten; although he started & ended life as Tutankhamen)  Confusing, ain't it  :)  If you really want to know why all the name changing, e-mail me or write a note in the guestbook. 

I worked on 3East last night, didn't have any spooky happenings (3East and 3North/South are haunted, there have been reliable witnesses to strange occurrances!)  For example, a patient asked the nurse why "that man" kept going in and out of the bathroom, the nurse told her it was the aide, pt says "no he has a gown on just like me."  There were no male patients around, but one had died in that room just a few days prior to her being there.  Charts have been known to fly off the desk when no one was standing near them.  I got on the elevator one time on 3East.  I was standing well away from the doors, just before they closed they popped back open, as they would if someone punched the button or stuck a hand in.  I looked, no one around.  I just stepped back, swept my hand back and said "come on in, I'm going down to the lower level."

Anyway, it was Gail, Jun, and me.  It was nice working with Gail; Jun too, but I had just worked with him Monday night.  Gail had a patient whose heart rate kept dropping, like to the 30's, one time 29, then back to the 40's.  The pacer pads were there and the Zoll was in the room, but he never had to be hooked up.  Jun had a patient who would occasionally had a funky rhythm.  I was lucky, my pt's were okay, except for the one with high blood pressure that just wouldn't come down!  She received a total of 80 mg of Labetolol over a 10 hour period and her BP was still in the 190's - you or I would have been on the floor long before that!

Had a patient who'd had a CABG, he slept all night; 2nd pt slept all night and except for one short period of confusion, was okay, I managed to catch her & reorient her before she could yank out her IV.  3rd pt was having problems with too much fluid & the heart not being able to pump things around (congestive heart failure) and he had sleep apnea so he got to wear the bipap thingy on his nose (forces air into him).  I always think they look like they have a little piggy snout.  4th pt was the one with the high blood pressure, occasional confusion, lots of tubes, and a doctor's mother!

The three of us managed to get thru the night without any mishaps; the worst thing to happen was right at the end; one of Jun's pt pulled our her IV and he had to restart it right at the end of shift.  Not a bad night, which is good as I had a headache!

I have two days off, then the dreaded 3 in a row working.  I guess I'll survive it, we'll see.  At least I get 4 days off after that.  Doesn't always happen; take Jun for example, he worked Sat/Sun/Mon, had Tues off and was back last night.  That would be hard - after 3 in a row I'm usually not good for much the first day off.  I don't see how Gail does 5-6 nights a week!

DREAM ALERT! Montie was wearing a long-arm splint and kept pulling at it and moving it around until it was loose and he was going to take it off, said it was bothering him.  (don't know why he had one on)  I checked it out and there was practially no padding around the elbow & lower arm area.  I just happened to have a 6" roll of cast padding so I folded some up and re-padded his splint, re-wrapped it and he said it was now "great."  Maybe this is a warning Montie - be careful! 

It smelled like rain when I left for work last night, but there weren't a bunch of clouds in the sky.  I wish we'd have a nice rainy winter!  Since we don't have snow, it's the next best thing.  I like to cozy up with my blankie and a good book!
11/8/02  Fri  (1342):   Today is X-ray Discovery Day, after working all those years in Orthopaedics I can tell you x-rays are a great invention.  It's also Young Readers Day, there are worlds waiting to be discovered between the pages of books.  I was eight or nine when I discovered the wonders of books.  It was a Saturday morning, Mom was reading a book and of course I wanted to be just like Mom.  I picked up Mystery of the Black Stallion by Walter Farley (great series by the way!) and started reading it, I finished it that day.  When I told Mom she was appropriately congratulatory and that made me want to keep reading.  Then I got hooked on it!  So encourge your kids, your kid's kids, the neighborhood kids, any kids to read!

Sunday is the birthday of the U.S. Marine Corps, big thing in my neck of the woods due to all the Marines around, Oooh-rah!  You can read a little bit about the USMC
here

Monday is Veteran's Day, but more importantly, it's
HELEN'S BIRTHDAY! She always razzes me about me being older (since my birthday is 2 months sooner) but at last she's old, just like me hahaha heeehahe heeehaha hahehehe haaa!  Happy birthday Helen!

I'm still finding codes & stuff to use, if you haven't noticed, look at the bottom of your screen.  There's a note on the first page too.  Also, on some of the pages I've disabled the "right click."  Try it now.  With right click you can see the "source code" it's the entire webpage in code and allows people to use whatever you have, along with pictures, backgrounds, etc.  Of course I guess I shouldn't be so stingy, where do you think I got a lot of my stuff ;)  In fact, the "mystery button" on the first page was lifted off another site (it was called something else, I retitled it), I right-clicked, searched thru all the stuff and found the code to make it work.  That one was a little difficult, there were two separate codes on different parts of the page and I had to figure out where they were and then where to place them on mine to make them work.

It's raining outside, and has been since sometime last evening.  I like it when it rains.  We'll see if the new roof was done correctly :)
11/9/02  Sat  (1200):   It rained all day yesterday and I think into the night, was nice.  It could rain & rain & rain and I'd like it.  And it was the best kind of rain for around here, not a deluge, just a nice, steady rain.  When it comes too fast it can't absorb & that's when things start to flood & fall down.  Of course, Mission Valley always floods when it rains a lot, whether it's a slow rain or not.  What do you expect when you build in the river bottom! 

I'm glad I didn't have to drive to work, people around here act like it's snow & ice when it rains!  Accidents all over the place, traffic snarled beyond belief.

The new neighbors downstairs tortured me last night!  I think they were cooking ribs - the molecules wafting up and thru my slider were making my mouth water!  mmmmmm, smelled delicious, and they must be having left-overs right now as I smell that delectable smell again!  Oh well, time to take a nap.
11/13/02  Wed  (0010):   Today is World Kindness Day; try something different, smile at everyone you see today.

I worked three nights in a row, which you know by now I don't like!  Sat night just about 1900 they brought a transfer up from ICU.  We listened to report and this transfer was one of my patients.  I started with 3 which meant I had an open bed for an admit/transfer sooner or later.

Went into the first room to assess the patient.  I don't remember her history exactly, but she'd had previous lung problems, and had been admitted to the hospital recently.  They were in Utah when she collapsed and they airlifted her home.  She was on a continuous morphine drip, continuous ativan drip (for seizure control).  She was basically comatose, agonal breathing.  Anyway, about 2015 the pt's daughter came out of the room and said "my Dad thinks she's not breathing any more."  This was not cause for panic as she was what we call a DNR (do not resuscitate) and was there for comfort care.  I went in & listened, no heart or lung sounds.  Told them I would call the doctor (have to let him know, plus get an order allowing the RN supervisor to pronounce the pt to verify death), but I would wait to call the supervisor to allow them some private time.  She was only 65.
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