|Unfortunately she was stuck with 7 patients! That's another reason I didn't want to work on the Pavilion when I graduated from nursing school; when I worked there as an aide the night nurses would get 7,8,9 pts - that's waaaay too many. Of course they're not as sick as the patients I take care of, but that's still too many to watch over.
I worked with Kathy, she used to be a Tele nurse and I'd worked with her as an aide; Ava was the 3rd nurse and we've worked together over at my end of the hospital. I started with 5 pts, but lost one at 2300; in fact, I heard her last heartbeat. She was expected to die, we just didn't know when. We always hope it's not on our shift, but I didn't think she'd make it through the night. The CNA came to tell me she was breathing "really fast" when before her resp was around 10. When I went in she was hardly breathing, so I listened with my stethoscope. Very slow heart rate, could barely hear it, then there were no more.
We didn't get any more admits so I was left with 4 pts. Two had had abdominal surgery, one had her ovaries removed, the other her uterus. Another pt was being evaluated for cancer and the 4th had radiation burns which were being treated. All were alert and oriented and after about 0030 they were all sleeping and no one needed anything for a while. We also had an aide, which we don't get over on IMC/Tele. It was amazing, I come on at 1900 and there are 14 pts on the floor, 3 RN's, 2 CNA's and one secretary until 2330. They went home, we had 13 pts, 3 RN's and one aide. Over in "my world" we can have 12 pts on the floor, each nurse has 4, no aide and one secretary for the entire tower (60 pts) from 1500-2330. And we have a heavier pt load, ours are more intense. Oh well.
I can't complain, it was a very nice, quiet night and I was back over on IMC to clock out at 0730. Sandy gave me a ride home, it had rained and Jess got sent home early. We thought it was going to rain, it didn't but it was nice to get a ride home.
Came home, grabbed my purse & went to the grocery store. Then took a nap for a couple of hours as I couldn't sleep all day. Tomorrow I'll be at a seminar all day, Managing Cardiac Emergencies, and I'm to meet the others at 0615 at the hospital. If I'd slept all day I would have been up all night, then wouldn't make it thru the day tomorrow. Wendy (unit manager), Priscilla, Lorna, Charlene, and I are going. I got the info in the mail a couple of months ago and asked around, wanting other people to go as I was going to go, no matter what. I'm the only one from night shift going.
Anyway, that means I just worked 3 in a row, have today off, will spend all day tomorrow at a seminar, then work 3 in a row again :( That's because I switched Thurs/Sat so I could go to a baby shower on Sat. I'll have Fri/Sat/Sun off, then on Monday morning I have to be at the courthouse at 0800 for Jury Duty. Hopefully they won't pick me for a jury. People were giving me all kinds of "advice" on what to do to avoid that. "When you're asked how you feel about X crime, just ask 'what color is he?', that'll get you off right then & there!" If I don't get picked for a jury then I'm done and will be free from having to do it for a year.
I've always gotten out of doing it as my previous employer didn't pay for jury duty so I could say it was a financial harship as I am my sole support; Tri-City pays for Jury Duty, darn it!
Okay, I've managed to play around and waste some time, I can go take a shower, wash my hair and then kick back watch TV and not worry if I fall asleep. I have my alarm set for 0500, aarrrggghh! I can stay up all night until 0500, but to get up at that time, yuck!
|4/20/03 Sun (2134): Happy birthday to my Grampa :) It's also Dr. O's birthday today, I saw him at the hospital last week and wished him a happy birthday then. We don't often get the Orthos at our end of the hospital, it was nice to see him :) Another person born today, one infamous one I should say, was Adolf Hitler.
How many Easter eggs did you find today???? The last bit of fun I had at Easter was when my Auntie Judy and I were living together. I got up and when I opened my bedroom door there was a string attached to the doorknob. I followed it all over the house, outside, back inside, and around to the Easter goodies at the end. That was great fun, thanks Judy!
My horoscope: 'Good day to stand on the sidewalk near a tall building and stare up at the roof. You'll meet some interesting people that way.'
Monday I went to the seminar down in San Diego with "the girls" and it was great! In fact everyone has mentioned since then that it was great and I picked a good one, keep my eyes open for more. I'd forgotten to wash the particular pair of pants I wanted to wear so I ended up wearing a pair of scrub pants, the kind with the drawstring. You can't tell when you have a shirt hanging over them, they look just like cotton pants. Except when the drawstring breaks! Which it did right after lunch. Everytime I stood up I had to hold onto my pants. Then when we were leaving it was pouring down rain so there I was holding the umbrella for the others in one hand, my papers and pants in the other.
I worked Tues/Wed/Thurs and they were some of the worst nights I've ever worked! Tuesday it was me, an LVN, and a med-surg nurse floated from the other end. Remember, I can go their direction with no problem, but they can't do as well coming our direction as they are not tele nurses, ACLS certified, etc. So I had to keep watch over everything. On top of this, I had a patient that took up a lot of my time. He was admitted at 1930 and I was basically in that room most of the night until 0230! He had early Alzheimers and kept asking the same questions over, and over, and over, and over........ I answered them each time. Then about 0130 he felt he couldn't breathe. Called respiratory up for a treatment, his oxygen sats were fine, he was feeling panicked, feeling he couldn't breathe. I finally called the doctor to get him some morphine, to help relax him and help him breathe better. It didn't work as well as I would have liked as he wouldn't relax. Finaly, at 0230, I just couldn't stay in there any more. He was fine, he was stable. He kept repeating over & over (continuously) "hold me up," "put your arms around me," "hold me."
There were two other pts on the floor that were also time-consuming and it happened to work out that we each had one of those. I said on the tape for report that no one person should have two or more of those pts! Wednesday it was me and a float RN and once again I chose wrong. Knowing what I'd been thru the night before, I didn't take that one pt back. We started with 4 pts each, the pt I'd had Tuesday night and didn't take back Wed was transferred off and she ended up having 3 pts the rest of the night :(
Thursday night I chose to start with 4 pts, as I'd had admits the previous two nights. It was Jess, me, and darn it, I forgot the 3rd nurse's name! Anyway, it was busy that night also. As I said, three of the most horrible nights I've done. I told Kathi "only for a friend would I basically go 8 days with only 1 off!"
Friday I recovered, farted around and in the evening went over to Target to get baby shower gifts for Kathi, her shower was yesterday at Rachael's club house. I will have pictures up with a link from the main page eventually. Don't know if I'll get them all up tonight, I have to go report for Jury Duty tomorrow and I have to be there at 0800. Means I can't stay up all night long!
I came home from the shower last night and couldn't find Vladimir. He'd been acting squirrelly during the morning and was trying to sleep in weird places, such as behind the TV. Anyway, I searched for half an hour, looking everywhere. Mom calls and before she can say anything I say "I can't find Vladimir." I kept looking around as we were talking, just before she'd called I'd even opened a can of cat food, which he absolutel loves, banged on the side of the dish & still no BooBoo! As I was talking to her I heard a meow, from outside! Opened the door and there he was! Mom and I decided he'd snuck out when I came home from the shower as I had a box in my arms and my field of vision was blocked. I'd even been outside twice looking over the railing, but I didn't call him. I think he heard the spoon banging on the metal cat dish and he knew what that meant. I told Mom I was surprised he was smart enough to know where he lived! I'm glad he came back, though, he's never been out and he wouldn't make it in the big bad world out there!
So today, I'm dozing off and on and decide it's time to get things updated here, get some pictures up, generally just spruce up the webpage. Vladimir likes to sit up next to me and as I was looking at him I thought the left side of his face looked swollen, his left eye kept closing too. After more inspection I decided he might have an abscess so I called the vet, of course they're closed, but they had a number to call for emergencies. The vet there didn't think he had an abscess, he said I had a good eye, yes there was a minimal amount of difference in the sides of his face, but he'd been stroking both sides, and the left one firmly, with no reaction. Looked in his mouth and didn't see anything bad. He did notice some areas of redness over his eyes on his forehead, where he'd been scratching, he'd also been picking out tufts of hair from his legs, and yesterday was walking like something was on his back feet; taking a step, shaking, taking another step, shaking a back foot.
Vet thought it looked more like an allergic reaction, such as to a spider bite. It told him that was entirely possible as I find plenty of spiders around here. He checked his kidney function just to be safe, it's fine. Took a sample to send for thyroid check and he'll fax this info over to Vladimir's regular vet. He also got a shot with Benadryl and cortisone in it to help with itching, I haven't seen him scratching or picking at himself since we got home. Now, on top of the 1/2 pill twice a day, I get to give him Children's Benadryl 3 times a day. I'm sure he'll appreciate the cherry flavor! So, 1 hour 45 minutes and $230 later we were home. Kids! I'm supposed to give him 6 mg, vet says that's about 2.5 cc. Being the nurse, I did the doseage calculation to be exact and it will be 2.4 cc :) desired amount / amount you have x cc (of the amount you have). So that would be 6 / 12.5 = .48 x 5 (cc) = 2.4cc. That's the only way I can do doseage calculations, never could get down the ratio method.
|4/27/03 Sun (1000): Today is Babe Ruth Day, although I admit I could never get interested in baseball. One time there was going to be a concert after a baseball game, took a friend who liked baseball. She watched the game and I read, killing time until the concert. It's also No Excuse Sunday, so you'd better be there, do it, whatever!
My horoscope: 'You will take a wrong turn today and become hopelessly lost. Eventually you will start a new life in Minnesota, along with all the other people who have little sense of direction. It'll be ok, providing you like tuna casserole.'
I reported for jury duty on Monday, at least they've fixed it so you don't have to report each day of the 2 weeks, or call in. But.....it was the most boring 3 1/2 hours of my life! They showed a little film about doing jury duty, of course everyone had a great time doing jury duty. Then you sat around waiting to see if there were going to be any cases. When there were, names were called and if you are called you go up to a courtroom and that's were the attorneys question you to see if they want you. I had a really good book to read, but I was so bored, and so resentful that I had to be there, that I couldn't read it for very long. I didn't get called so I'm free of it for a year!
Worked Tuesday on 2 West and had 4 pts. Three of them were stable, no problems. The 4th was okay, just a lot of work involved. T-piece/vent, G-tube, open abdominal incision that needed dressing change, trach dressing change, etc. Thurs/Fri I was on 4 East and had a student, Andrea, with me. She took care of the same 2 pts both nights. Thurs was pretty smooth, just extra for me to try not to hover over her, but make sure things are going okay.
Friday was the busy night. One pt (CABG surgery) she was taking care of had been hooked up to an external pacer, that's why I told her to take him, thought it would be good experience. He didn't need it so they disconnected it Friday. His catheter was removed and he was having difficulty going, just drips & dribbles, he was straining to empty his bladder, plus he was constipated and had been given something for that. He was sitting up on the toilet and suddenly had a 31 beat run of Vtach,. thankfully he stopped. I go running in there, Andrea was in the process of changing the sheets, I'm trying to get him off the toilet & back into bed and he's not wanting to. I'm trying to tell him (he's spanish speaking) that he needs to get back in bed, we'll get him a bed pan if he's not done.
Vital signs are okay and we were going to do a bladder scan to see how full his bladder was, but we decided to go ahead & put a catheter back in. While I called the doctor, Myra (charge RN) helped Andrea with that. He was full! We got about 775cc out right away. His bladder was full, he was uncomfortable, he'd been straining to have a BM and his heart said "heeyyyyy, this is just way too much and I'm gonna complain!"
The other two pts I had were also CABG pts, but they were doing great. It was busy Friday night and a lot was going on, but Andrea did pretty good; once again, practice and time will make things much smoother for her.
Let me check my PalmPilot, had a few things noted down to comment on. Saw a cute license plate the other day, ETIKKIT. You may not be old enough to understand the phrase, "E-ticket ride." No, it has nothing to do with the internet!
OH! Something that really irks me and I'm getting more and more infuriated with it as time going on - I RESENT being expected to know a foreign language. This is America - speak American!!!!!!!! One night one of my spanish-speaking pts had his wife staying in the room (doing everything for him, even holding the kleenex to his mouth so he could cough into it, I told her "don't do that, he is able to wipe his own mouth and he needs to do things for himself.") Anyway, before this, Jess had done some interpreting for me. After she left the wife said, in Spanish, "I would prefer the nurse that speaks Spanish." I wanted to say "Well, I would prefer a patient that speaks English!"