|Liz was the busy one! She had four patients and right off the bat one was going to surgery. He had a large clot in his leg, no pulses in the foot, lower leg was cold & mottled, kind of purply in the toes. So she had to deal with getting that ready. There was a new admit and the paperwork hadn't been finished, there was something else going on with him, but I already forget. Third pt was maybe going home that night, we don't do discharges often and she would need help with that. Family was wanting to know what was going on. As she was busy with the anesthesiologist on the floor, I went in and answered questions, they wanted him to stay and luckily the doctor wanted him one more night also.
Then her 4th pt wanted medication for her cough, I said I'd do it as she was still busy with another pt, I go in & the pt's throwing up. Can't give her anything, she'll just throw it right back up. She did have an order for an anti-emetic, I told Liz I'd give it. Well, her IV was hurting when you flushed, meaning it was time to change it, even though it wasn't out-dated. I went ahead & gave it super slow, and told Liz the IV needed changing, but it was working and was available in case of an emergency; it was not on the top of the list of things to do. She agreed.
I had a pt with whom I walked a fine line, he tended to get grouchy. I managed to keep him on an even keel and even had him lauging a few times. Only one was the same from Monday night, my CABG lady. The gentleman had undergone the same surgery and had just come off the external pacer that day. I also had dressing changes to do to both legs. Roxy was the LVN and she was busy also, but that meant Liz and I were responsible for another 2 pts.
So Liz's surgery pt comes back, they weren't able to fix his leg, don't know why they couldn't get all the clot. Dr. was hoping it would open up. There were a lot of post-op orders, the night secretary was busy so I sat down & entered them for Liz, called & got the equipment she needed for him. While she's dealing with him Roxy asks me about an IV order for one of her pts (Liz covering). Turns out she should have had IV potassium given; Liz was busy, I set it up and started the IV going.
Then, a little later, Liz's post-op pt's blood pressure is dropping, it's about 65/40 something. She tips the bed so his head is down (trendelenburg) and calls the doctor. He gets a fluid bolus (lots of fluid fast) but that doesn't help much. We check his groin, he'd had a cath in there as part of the surgery. We decide he's bleeding from the site into the surrounding tissue. Oh, by the way, he's on a heparin drip (keeps the blood from clotting). And he starts saying his lower abdomen is starting to hurt.
Liz and I look at each other, what if he's bleeding into his abdomen from the arterial site???? The hematoma in the groin is getting bigger and the blood on the dressing is getting bigger. We put a 10lb weight on him. Liz calls the doctor again, his pressure isn't all that better, Lee (charge nurse) is standing by in case we have to send him down to the unit (ICU). Dr. says he's coming in. Of course when he gets there he doesn't think it's that bad and the pt is okay. But we did a good job! By this time day shift is there and Dr. oders a Dopamine drip (to bring up the blood pressure). This poor guy had 3 separate IV sites in him!
We discussed all avenues and what we thought was going on, what to do, etc. What a great feeling to see how much we've learned and to know that we can take care of a pt that was critical there for a bit - we did it!!!!!!!! And did it calmy I might add :)
I stopped at Costco today for some prescriptions and to get plates for work (we like to keep them on hand for pot-lucks) and as I was walking back to the car I remembered a dream & had to call Kathi. Ultrasound says she's having a girl, but she's had dreams she's having a boy. I dreamed she had a boy so told her, she was happy. We'll see if either of us are fortune tellers!
|5/12/03 Mon (2227): Today is Limerick Day..."there once was a girl from Nantucket...." You know, I checked out a book full of hundreds of limericks from the library once and not one of them was about that girl! I made up a limerick one time in high school:
There once was a girl from Burk
Who had a slight little quirk.
She came in one night
Bombed out of sight
And never took another squirt!
My horoscope: 'You will be followed by people who look suspiciously like shoe salesmen. Try to remain calm -- they can sense fear.'
Worked on 2West Sat & Sun; Saturday was okay, but last night was another one of those nights! It was me, Sharon, and Sarah (registry and she'd been there Sat night). Poor Sharon, she only had 3 pts and one of them didn't require much, which was fortunate. First thing, we're in report and resp tech opens the door & says "pt in Rm XXX is on the floor!" Took about 6 of us to get her back in bed, including the one Lift Team guy that was on. Luckily she didn't pull out her PICC line, the foley was out, though. She kept schooching down to the foot of the bed Sat night and we kept pulilng her up. 2 of the day nurses were at the other end sending a pt to surgery and the 3rd was in the room giving us report (which was a waste of time, she wasn't very good at it; I believe she was registry). So the pt had wiggled down and managed to go over the foot of the bed.
She's back in bed, the daughter comes back; this is the same pt I had previously and the daughter is very "involved" in everything. Then the daughter was going from one side of the bed to the other and tripped over the pulse ox sensor, sending the machine crashing to the floor and she banged her knee against the bed. I wrote that one up; so there were now two incident reports on the same pt in the space of about 2-3 hours!
Sharon's other pt was a mess and was very involved, she was in that room off and on throughout the night. I helped as much as possible, 3 of my pts were the same from the night before and my one admit (which came at 2000) was fast as he was unable to answer any questions so I couldn't do any of that paperwork. It was a busy two nights, at least my one pt didn't have chest pain again, as he did Sat night. Except for having to start an IV right at the end of shift on the admit, it was okay; at least after a whole day of not doing anything the night doesn't seem that bad.
But, to give you an idea: at one point I looked over to Sharon and said "too bad I'm not a druggy-type person; I'd go home and do all sorts of drugs in order to erase this night from my mind." She agreed. Don't have to go back to work until Friday, but.....I have to go to a mandatory 8 hour class at the hospital tomorrow. And it's not even nursing skills, or stuff like that - it's so the hospital can get a good score on the next JHACO evaluation. 8 friggin' hours of policies & procedures (insert finger down throat at this point!)!
Came home and basically collapsed; Melodee gave me a ride home which was nice. I'm glad I decided to run an errand in the evening. Some point during the day UPS delivered a box and they didn't knock; wish they had! It was my DSL connect stuff....weeeeeeeeeeeeeeeee! Boy is it fast! I'm just whizzing all over the internet. Updated the virus checker and it took about 2 minutes, instead of 10-20 mins like before. Connection to my webpage used to take about 3-5 minutes, it was up & open in about 10 seconds! Heheheheeeheee.
I'm back, had to go look at stuff I'd saved for when I had the fast connection. Awesome is all I can say. I need to go away now, want to watch the news, then Katie Couric is taking Jay Leno's place, then have to try not to stay up all night as I have to be at the hospital at 0800. Night!
|5/13/03 Tues (1823): Not much happening today, it's Stevie Wonder's Birthday. Gary Cooper died this date in 1961.
My horoscope: 'Your relatives may try to have you committed today. Luckily, through a series of amusing misadventures, they will fail. You and your large invisible friend will simply shrug it off, of course, since it's not in your disposition to hold a grudge.'
Had to go to "Pursuit of Excellence" today at the hospital - 8 hours. They did provide lunch....pizza, salad, and breadsticks. It was a lot of information, all of it geared towards TCMC passing the next JCAHO evaluation. At the end we played "Jeopardy" and my team finally gave up. I was the captain but there were 4 distinct times I hit the bell before anyone else, but the next group to hit it were called upon! One I couldn't believe, I had come back from the bathroom, the question was on the screen, I knew the answer, sat down & hit the bell, then someone else hit theirs, and they were called on - so we all just sat back & didn't do any more!
Lee called last night wanting to know if I wanted to come in, double-time I believe, but told him "I have to go to that stupid 8 hour class tomorrow." I should have gone to work. Didn't sleep, well, maybe a couple of hours; but, I could have gone from work (8 hrs) to the class (8 hrs) and since it would have been 16 consecutive hours I would have gotten paid for 32 hours - darn!
I need to finish Tina's little scrapbook tomorrow as I'm invited to some program at her school on Thursday. It would be nice to take it to her at that time. I thought I had more pictures, I could remember definite pics, then realized they were digital ones, which are here in the archives section. So I will work on that tomorrow.
DSL is amazing, I got whiplash last night after zooming around the web. Now I can really update this site; I didn't feel like working on it for the past couple of months as I had to wait for pages to load before I could move things around. And if there were pictures on them, it took even longer. Now I can work on it, add things, change things, and not wait forever. I think I'm already spoiled! Opened email and they download so fast the little envelope indicating the virus checker is checking them almost doesn't have time to appear on the screen. And, it doesn't tie up the phone line any more!
|5/16/03 Fri (0001): It's National Bike To Work Day, so leave those car keys at home and get with it!
My horoscope: 'Excellent day to fill some pantyhose with popcorn and do the reindeer dance.'
If you didn't come in thru the "front door" I've updated some pages and added 3 new ones. The only problem with that is now I have to go around to every page that has a navigation bar on the bottom & add the link :(
Did you catch the lunar eclipse last night??? I had just come back from the store, it was shortly after 2000 and there was just a sliver left, low in the East sky.
Oh well, I'm tired so I think I'll turn this thing off! Oh, by the way, Mom confirms the ducks were a Mallard and his mate; they mate for life.