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6/26/03  Thurs  (2251):   Today is Beautician's Day, do they still call themselves that??  On this day in 1483 Richard III began his rule of England.  You can read a little bit here.  And for some more English history on this day - George IV died in 1830, read it here

Word of the Day:  olla podrida \ah-luh-puh-DREE-duh\ noun.  1: a rich highly seasoned stew of meat and vegetables usually including sausage and chickpeas that is slowly simmered and is a traditional Spanish and Latin-American dish.  2: hodgepodge.  The French translated "olla podrida" as "pot pourri," an expression we have adapted to "potpourri."

My horoscope:  'Try to think of life as a game today. For fun, make up new rules.'

I worked on 4West last night.  I don't know what's going on these days, but for about the past month at work it has been sooo busy, crazy, lots to do, heavy patients, etc.  I actually took something to eat with me Monday night but it was so busy I never go to eat it; I left it for dinner last night, but once again I was too busy to stop & eat, so I brought it home & had it for breakfast. 

Kelly was assigned to the floor initially, but then had to go to 2West and Kathy came up.  There were still 4 vent pts and that's the one thing she didn't have experience with.  We also had a registry LVN, who was practially useless.  We knew an admit was coming at report so we gave it to him.  The pt got there just before 2100 and I told him the pt was there, he didn't do anything, didn't come see him, didn't help him into bed. 

I know this because I went around the corner to help.  He was going into the only double room we have and housekeeping had cleaned A-bed area and I came rushing in with the admit papers and the next thing I knew I was on the floor!  She had mopped the floor and before she had time to put up the 'wet floor' sign I flew around the corner.  Landed on my left knee and twisted my back a little, but nothing broken and everything worked. (by the end of the shift my back was a little tired but after resting today it seems okay).  Once again I have proven I have strong bones!

I made sure the pt got settled and while we were doing this I pushed the call bell to again tell the LVN his admit was there, he
still didn't come see the pt.  As Kathy was covering this pt for the LVN I let her know what was going on.  There were several incidents which concerned me about this LVN; asking questions a first year nursing student should know, I can't remember them all now, but it made for extra work on my part to follow up on everything he did and I tried to be with him whenever he was in a room with the pts of his I was covering.  He'd been told twice by Kathy that he was not allowed to take IV orders over the phone, what was he doing, sitting there talking to the doctor getting orders, some of which were IV orders.

Cher was still there and she told him to give the phone to me before hanging up with the doctor about this one pt.  When I got on the phone the doctor asked who he had been speaking with; I told him it was the LVN, I was the RN covering the pt.  The Dr. asked if he could give me the orders, I said definitely, I'd prefer that.  We went over them, discussed the pt a little and at the end the doctor said he was glad he had spoken with me. 

Luckily the 2nd pt of his I was covering was stable & slept all night, it was just this one that was a handful.  I should have given up one of my pts & taken this one as she now needed 2 units of blood, 8 K-riders (potassium), lasix, magnesium piggybacks, PCA pump (morphine), etc.  And she needed to be monitored closely as the Dr was afraid she might turn septic.  But I was afraid to.  I had one that kept trying to get out of bed, he was confused; I knew he'd end up on the floor as the LVN wouldn't watch him enough.  Another was a post-op CABG and the LVN couldn't take him anyway (it was the one I'd started with on Monday on 2West who got transferred upstairs, when I went in the room I laughed & told him there was no escaping me!)  My 3rd one was also confused and had occasional problems breathing so I didn't want to give up my responsibility.  I got an admit around 2130 who'd had a TURP (prostate surgery) and was on CBI (continuous bladder irrigation) and required monitoring and regulation of the  flow of saline, otherwise it would get clotted off.  I'd warned this pt that he wouldn't get much sleep as I'd be in there about every 1/2 hour.  He'd already had problems with the flow in recovery & they'd had to replace the catheter, I didn't want him to have any more problems.  The doctor came in early and he was pleased with the pt's status and how the CBI was doing.

Kathy helped as much as she could, she had her own pts to deal with, plus the 2 of the LVN's she was covering and one of hers had a lot of IV's to deal with.  He also had an NG tube that the day nurse had put in and then connected to suction.  You're always supposed to check position and when she couldn't hear the air in the stomach she called me in to check also.  You attach a large syringe to the tube, place your stethoscope over the stomach & push in some air.  You're supposed to hear the gurgling in the stomach - I didn't.  So she had to replace that.

The nursing supervisor (over the whole hospital) came by and asked how things were going.  I looked at her & told her "now I see how mistakes can be made and pts die!"  She looked a little taken aback, but I assured her things were ok now and after a little discussion she said I seemed to have things under control.

I told Kathy towards the end of the night that it would have been better not to have had that LVN there and both of us just take 6 pts and she agreed - it worked basically that way anyway!  Another reason I watched him so closely, when I was standing by him at the Pyxis (med computer) I thought I smelled alcohol on his breath.  Charge nurse was aware of this (Lee) as he asked me about it.  I'm pretty sure that particular nurse will not be back!  Things may get hectic but the hospital is very good about not having unsafe nurses return.
6/27/03  Fri  (2155):   Today is Decide To Be Married Day, that's all well & good, but it takes two!  On this day in 1929 scientists at Bell Laboratories in NY demonstrated a system of color television with 3 separate tubes.  Wonder why it took so long to get to the public?

Word of the Day:  Gretna Green \gret-nuh-GREEN\ noun.  1: a place where many eloping couples are married.  If you are a reader of historical romances, especially those set in England, you're familiar with this!  Mirriam-Webster explains it further:  "In the England of the 1700s, a person could not marry without parental consent until age 21. The Scottish were more lenient, allowing young people to marry without parental permission at 16. England also had rules that made it difficult to marry quickly, but Scottish law required only that couples declare their desire to be married in front of witnesses before tying the knot. So it isn't surprising that many English couples ran to Gretna Green, a small village on the English-Scottish border, when they decided to elope. In Gretna Green, the wedding ceremony was typically performed by the blacksmith at a roadside tollhouse, but it was all perfectly legal."

My horoscope:  'You will need two torches, a sword, leather armor, and a significant amount of courage today. And for heaven's sake, don't forget the twine.'

I think I caught up on my sleep, again (slept a lot in Phoenix).  Was up late playing on the computer, surfing, games, etc; reading; watching TV.  Fell asleep sometime in the early morning, woke up a couple of times but eyes still felt grainy & heavy so went back to sleep.  Fully awakened at noon today.  So you can imagine I got a lot done today - not!  I was lazy again.  Read some more, watched TV, made a run to the grocery store, and that was it.

I was watching Stargate and Teal'c was hooked up to a heart monitor.  My thought....not the story line - the leads were hooked up wrong!  They had them all across the upper anterior part of his chest.  With the 5 leads they had should have been one on each side, just under the collarbones, one slightly right of midline on the chest, one on the lower, lateral chest wall (side) and one on the other side.  Oh well, it's just TV!

And speaking of TV, saw an ad for the Wild Animal Park which reminded me I still want to do the photo safari.  They load you up in the back of a truck & drive around inside the enclosure, bringing you up close & personal to the animals.  Should have done it while it was still cool, but guess I'll do it late one afternoon this summer; or maybe I'll check out & see how early they do it.  If they go out around 0900 that would be great; otherwise, afternoon it is.

Also want to go up in a hot air balloon.  Now that the June Gloom is gone it should be fun to do, they go up so you can enjoy the sunset.  I just have to find someone to go with me - not everyone wants to do it!  Rachael said she'd drive me to the balloon, then to the landing point, but there was no way she was going up in one!
7/1/03  Tues  (0201):   I don't have my new list yet so I don't know what "Day" today is.  On this day in 1858 Charles Darwin's natural selection and evolution theories were first revealed in a meeting at the Linnean Society in London.  We (Lee, Ann, and I) were discussing evolution last night; I now realize the phrase I was searching for was natural selection in my description of the evolution of certain species.  And I brought up Charles Darwin.  Was discussing his observations in the Gallapagos Islands which lead to his writingThe Origin of Species.  You can read it on-line here.

Word of the Day:  moil \MOYL\ verb.  1: to work hard : drudge;  2: to be in continuous agitation : churn, swirl. 

My Horoscope:  'Your plans for a do-it-yourself replica medieval catapult will arrive today! Soon, your neighbors will become nervous (but you can explain that their fears are groundless -- you couldn't possibly hit anything that close with it).'

Worked on 2West Sat and Sun, you know....my
favorite place to be!   Anne, Jess, and I were there Saturday, this time Jess had the two vent pts.  I started with 3 pts, one was a vent pt, one was an older gentleman on a Dobutamine drip, and the third was there for respiratory problems.  I got an admit around 2230 who was also having respiratory problems and I started him on a Bumex drip.  This was to get rid of excess fluid.  Unfortunately a side-effect of this is a loss of potassium, which is what I suspected when he woke around 0500 with severe leg cramps.  Lab just happened to be there so I asked her to draw his first and to please send them down right away.  Didn't work as fast as I wanted, by the time I got the results it was close to 0700, luckily the cramps had quieted down after a little massage from me.

His potassium had dropped to 3.1 (should be at least 3.5), I had the phonebook in my hand to call the doctor & he came around the corner.  "What timing!" I said to him.  He agreed he needed IV potassium and days took care of that.  I had the same pts when I went back Sunday night.  I was hoping to be flexed off (cancelled) as 3East & 4West were closed and we were 2 nurses over.  I was trying to think good thoughts but Ann was thinking bad thoughts!  She didn't want me flexed off, wanted me to come back & work with her.  When I saw her Sunday night she said "oh it worked!"  I guess I should be flattered!

Kerry was the 3rd nurse Sunday night and we were busy again, I had my same pts, Ann had her same pts and Kerry got the 2 vents, but she only had 3 pts.  As I said, I was busy both nights, but not crazily so as it has been.  Maybe the curse has been broken!
7/2/03  Wed  (0143):   Well, I am certainly lost without my list of daily "holidays."  For some reason I haven't received the new one yet.  On this day in 1937 Amelia Earhart's plane disappeared near Howland Island in the South Pacific.

Word of the Day:  Antaean \an-TEE-un\ adjective.  1: mammoth; 2: having superhuman strength.  Merriam-Webster says "In Greek mythology, Antaeus was the gigantic and powerful son of Gaea the Earth goddess and Poseidon the sea god. Antaeus was a wrestler and whenever he touched his mother (the Earth), his strength was renewed, so he always won his battles even if his opponents threw him to the ground. He proved invincible until he challenged Hercules to wrestle. Hercules discovered the source of the giant's strength, lifted him off the ground, and crushed him to death."
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