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I worked Sat/Sun on 3East.  Saturday I had 3 patients, one was the same from Thursday so I only had 2 "new" ones.  Two of them were pretty self-sufficient.  The third had undergone abdominal surgery, had a PICC line with IV fluid, TPN (nutrients) and an NG tube.  Never got an admit, which was fine with me.  Sunday was the busy night!  It was after 0200 before I could sit down and begin to do charting.  Thank goodness I had the same 3 pts from the night before and I'd been over their charts with a fine-tooth comb so I knew they were okay and could spend a little more time on the 4th pt's chart.

I got an admit around 2130, TIA but no residuals except for a slight right facial droop.  She was spanish speaking only, the daughter had come up with her but gave the instructions I needed to before she left.  When she first came up her BP was 204/110 so I immediately called the doctor; she was already in for TIA and I didn't want her having a full stroke on me!  He was coming in to see the pt anyway, but gave me an order right away; by the time he got there (1 hour later) her BP was down to 133/65.  He smiled & said "we fixed her!"

She pushed the call bell about 0130 and when I went in there I found blood all over the bed rail, across the floor and in the sink.  She had pulled out her IV, then after bleeding all over the place she got up & wrapped it with a paper towel.  She was complaining about a headache too.  I could tell by her gesturing at the IV pump (she'd had 1 liter of fluid which was discontinued when it was done) she thought since she wasn't hooked up to a line she didn't need her IV access.  As I was setting up to start a new IV I called out that I needed someone to call the charge nurse and ask her to get me an interpreter, then to call environmental services and get someone up here to mop up the floor. 

Because of the headache the first thing to do was take her BP again, which thankfully was okay.  The doctor had been there until midnight, had been up since 0530 and I wasn't looking forward to calling him again at almost 2 in the morning!

I apologized later, I was working with Sally and Andrea.  I don't think I said please when I was throwing around orders!  They both laughed and said it was no problem, there was no doubt as to what needed to be done.  I was right, she told the interpreter "we left all this tape on her" when the fluid was finished.  He explained what a Saline lock was and why she still needed it and not to pull on it.  Luckily her roommate was very deaf and all the commotion didn't bother her.

By the time Day shift got out of report it was about 0745 and I had a class to go to at 0800.  I figured it was easier to do it right after work, when I had 3 days off as the class is mandatory.  There's a new law going into effect about pt privacy and according to some of the rules, I don't know how they're going to comply.  The one part I thought of, and privacy was an issue before this new law, but we have 1 double room on each side.  When you're obtaining info from one pt, the other can hear.  Before it was a privacy issue, but now we'll be breaking the law.  And according to the info, there's a big fine involved with this.

I know we'll irritate family members but now we have to go to all sorts of lengths to verify who we're talking to.  As before, no info to anyone without the pt's consent, even spouses; however, if we have the pt's consent and the person calls, we have to verify that person's identity.  Such as telling that person we'll call them back at the number listed in the chart, or something to that effect.  There are all sorts of other rules invovled in this new law.  Day shift will bear the brunt of it, but we will have some issues of this at night.

Andrea finally got to Seaport Village, she went with her roommate, so I'm glad.  Now we've got Disneyland on the list!  I haven't been since they re-did Fantsyland (darn, I
liked the people mover!) or added all that new stuff.  It would be fun to go.

DREAM ALERT
:   I had another dream about being barefoot at work.  I'd taken a pt down to the second floor and when I got there I realized I didn't have my shoes on.  I tried to stay out of everyone's way so they wouldn't notice and I could get back up to the 4th floor and get my shoes back on!  Have no idea what no shoes represents.
3/13/03  Thurs  (0022):   Today is National Open An Umbrella Indoors Day, go ahead & do it, it's not really bad luck :)  It's also Uranus Day, and that's because in 1781 the planet Uranus was discovered by William Herschel.  This planet's name has been the "butt" of many a joke, heeheeheheee!

My horoscope:  'Remember today: two wrongs don't make a right. But three do.'

Didn't do anything Wed.  Rachael called in in the early evening to see if I wanted to go to the movies, but I was too grungy and it would have taken too long to get ready.  She was going to see Bringing Down the House with Steve Martin (who is great) and Queen Latifa (I've decided I like her, she did a great job in Chicago).  It looks funny in the previews and I would like to see it.  Probably should have gone with her, she probably got in free again as her Cousin is the manager over at Edward's in San Marcos.  Oh well, next time.
3/16/03  Sun  (0238):   Today is Lips Appreciation Day, so find a pair and appreciate them!  Today in 1966 Gemini VIII was launched with Neil Armstrong becoming the first civilian to orbit the earth.  Also, in 1917 Czar Nicholas II abdicated throne and the former royal family had a choice - face revolutionists or flee country.  They should have chosen the latter!

My horoscope:  'Time to throw down the gauntlet. Or, if you can't find a gauntlet, a ski mitten will do. Just make sure you throw it down. (That's one heck of a lot more fun than throwing it up.)'

NOW I understand!  Yesterday was March 15th, the Ides of March - Beware the Ides of March!  I went out to the car, clicked off the alarm and got in.  Noticed I'd left the window open 2-3 inches, should have rolled it up immediately as I can't now!  I put the key in the ignition, turned it, got one engine sound, seatbelt started to move, then everything died.  I have no power whatsoever.  Nada.  Zip.  Zilch!  Hopefully it's just something to do with the battery or its connection.  It rained most of the day; car sits under a carport, but maybe things got damp - can you short out a fuse in wet weather?  I don't think you should, wouldn't be able to drive around when it's raining if that was the case!  So, in the morning I need to call Econo Lube-N-Tune and see if I should have it towed to them; see if it sounds like something they can fix.  It's Sunday, may have a problem if it has to go elsewhere.  May have to have the car towed back here, then to wherever it needs to go on Monday.  Wonder if I'm going to have to rent a car? 

I may not go many places, but not to have a car is the pits!  It was about 1800 when this happened.  I was on my way to pick up something to eat as I didn't have anything here.  Ended up calling Terry and she came & got me.  I like her new car, it's a Huyndai (however you spell it) Tiburon.  They got that and her daughter got an Elantra and they got great deals on them.  Didn't know you could get a nice car these days under $11,000!

I'm going to try & think positive, it's just something with the battery & easily fixed:  "We always attract into our lives whatever we think about most, believe in most strongly, expect on the deepest level, and imagine most vividly." Shakti Gawain

I worked on 4West Thursday night, ran alllllll night long with barely enough time to finish charting.  I had 4 patients, plus covered 2 of Matt's pts (LVN) and Darell covered his other 2 pts.  It seemed as if that side was Confused Central!  Friday got a call around 1300 asking if I could come in at 1500 to work on 4East, I said yes - escape from 4West!  I started with 2 pts, but one was off the floor for a test.  Then he came back from the test with chest pain, just as my transfer from ICU was showing up!  Got him settled, got the transfer settled, then the first one had chest pain again!  I was hoping that was not an omen for the rest of the night!  Well, it wasn't.  The pt's doctor had called and added some meds, which seemed to help as there were no further episodes of chest pain.

Jess & Helene came in at 1900 and were nice enough to let me stay with 3 pts (one room was still "hot" so the pt division was 4/4/3) as I'd only had about 3 to 3.5 hours of sleep!  There was enough to keep me busy with the 3 pts and even with starting early I wasn't finished with my charting until 0330.  And in that, they're not completely finished until I&O's are done and any additional, last-minute info is entered.  But, I was finished & ready to go by 0645 so I can't complain!
3/17/03  Mon  (0005):   Obviously it's St. Patrick's Day today, don't forget to wear green.  Do they still dye the river green in Chicago, or did that go by the wayside??  I don't know of any other "holidays" yet as my new list hasn't arrived.

My horoscope:  'To your vast embarrassment you will be unable to describe the differences between halibut, sole, and flounder. It's easy to remember, though -- they are (in order) "big", "small", and "clumsy".'

I called Econo Lube-N-Tune Sunday morning, described what happened & was told "I can't help you."  Turns out even though they're open on Sunday they have no mechanics working.  I was wanting to get an idea of what
might be wrong and if they could take care of it as I will have to have the car towed.  He said I'd have to have the car towed over and they would look at it.  I asked him why were they open if there were no mechanics working, he said "I'm not going to answer that, that's a stupid question."  I didn't think so! 

I had things to do and couldn't be without wheels and not knowing what's going to happen to the car, how long it will take (although I keep telling myself it's just the battery or a connection & easily fixed and since the battery is less than 2 months old it will be replaced free), I rented a car.  Well, a truck actually.  It's a 2003 Ford Ranger, still has the new car smell.  I checked around on the internet Sat night and found a Budget Rental just down the street which had an okay price.  Hopefully I will be returning it tomorrow, well, today actually.  It's an automatic and I keep reaching for the clutch or gearshift. Have to keep telling myself just 2 pedals & steer!  Paige was nice enough to come get me and take me down the street to pick it up.  It has a CD player too, so I grabbed the Chicago soundtrack out of the car.

Ooommmmm, ooommmm, I'm thinking good thoughts.  The vibes are positive.  All that is wrong is the battery, it will be replaced and the car will be fine.  Life is positive.  Everything can be fixed.  Everything will be fine.  It's St. Patrick's Day, I'm 1/4 Irish so the luck of the Irish will be with me :)
3/18/03  Tues  (0001):   Today is Awkward Moments Day, for some of us that can be just about every day!  Wednesday is Swallows Return to San Juan Capistrano Day and Chocolate Caramel Day.  Thursday is the Vernal Equinox and my Mom's birthday!

My horoscope:  'Your children will return, but they'll be unnaturally quiet and good-natured. Eventually, you'll discover how the switch was made.'  I guess it's a good thing I don't have kids then!

Tried to get an early start this morning (well, Mon morning) in an attempt to get the car over to be checked out by 0800.  I called the towing serice that patrols our parking area looking for cars without the proper ID and discovered I'd have to wait until 0800 as they were out on CHP duty.  Finally got someone here around 0830 or so.  He decided to see if he could jump-start the car.  That was the ticket.  And he didn't charge me!  So I drive over to Econo Lube-N-Tune and parked on the side.  I've seen people pull up in front of a bay & be told to move the car, so I decided to park on the side.  As soon as the car was turned off it was dead again.

I walked over and knew the older man was the one I spoke with the day before.  When he said to pull the car up, I told him it was dead, "why'd you turn it off?"  Then the nice guy with whom I usually deal came up and took over.  Turns out the older guy is the owner, or I would have said something.  He asked me, after I explained about the car, "are you the one who called with the stupid question yesterday?"  I told him I was "not going to go there," and that's when I got the other guy.  As he was working on the battery connections (turns out that's what it was) I quietly asked him if he was the owner or was the older gentleman the owner.  He said the other guy and I said "okay, then I'll keep my mouth shut."  He smiled and said, "understood."  I so desperately wanted to respond to his "stupid question" remark.  It's an automotive repair place, you're open, you have no mechanics so you can't do any automotive repair -
why are you open?? And....he was a sarcastic asshole!

Now the car's fixed.  The guy working on it said when he put in the battery in Jan it's usually best to leave the connections as they were and not trim them, "but in your case it wasn't."  He fixed it in about 10 mins and once again, no charge.  So my positive thinking worked on this matter!

Now I needed to get the rental back and then back home.  I called Terry and she met me down there.  We went to Sizzler and I bought her lunch.  We ate and chatted, then she dropped me off, I'd say it was a little after 1300 at this time.  I'd only had an hour or two of sleep but still couldn't sleep, lots of things on the mind these days. 

DREAM ALERT:   I was on an episode of Friends, and it was filming at the hospital.  I had a line or two to say at the Nurse's station, then was to walk down the hall.  I did this okay and went to the one double room we have as it was being used as the "holding" area.  They had TVs there and you could watch what was going on with the filming.  I had some friends with me, but they weren't there and I was wondering first where did they go, and second, did they see me do my thing :)
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