Early Sunday - How to Save A Life

Okay, I'm going to try something different. I'm going to post both here my blogspot journal, "Life is the Interruption of Everything". Read and comment whereever you want. ;)

This is Your Brain on Drugs...

 

 

Well, to get started, let me say that work last night was just a thinly disguised chaos (I am an RN and have worked in the ER for 11 years in case you don't know anything about me). I get there and see my assignment, which included the "code room". We don't keep this room occupied all the time and try to save it for critical patients only. And that's exactly what I happened to inherit last night. Mr 43 found down by his roommate, who initiates CPR after calling 911. EMS arrives, intubates, and begins ACLS (advanced cardiac life support - drugs & shocking). Mr 43, it seems, had been indulging in a massive amount of drugs. Positive for marijuana, benzodiazapenes (valium, ativan, etc), and opiates (heroin, pain pills, etc). Most probable scenario would include respiratory suppression followed quickly by cardiac arrest. No pulse or respirations when EMS arrived. Was a PEA (pulseless electrical activity - means electrical activity put out by the heart w/o contractability, otherwise no heartbeat) on the monitor at the scene, same when he arrived at the hospital. Pupils fixed and dialated. No neuro response at all to deep painful stimuli.

Okay, here is where the story gets a little more interesting. Mr. 43 was found by his roommate after seeing him "just fine" before getting in the shower, and not breathing 10 minutes later when he got out and started CPR immediately. Okay. How many of you have seen anyone walk by someone, get in the shower, bath, get out and dressed, check on someone, and initiate CPR in 10 minutes, male or not? I found that hard to believe. It was probably more like 20 minutes. Add another 10 minutes or so for EMS to arrive, intubate and begin ACLS. Then add transport time to the hospital and another 30 minutes of code activity to obtain a sustainable rhythm. Are you keeping score? Looks like at the least 1 hour of minimal-moderate cardiac perfusion activity. Ending result? Massive cerebral edema (brain swelling caused by drug overdose and hypoxia - no oxygen), no spontanous breaths (so total ventilator assisted), cardiac output by drugs only. Basically...dead.  This man was transferred to the ICU and three days later removed from life support.  Dead, dead, dead.  Common people, stop doing drugs!  They will kill you, really they will!  All it takes is once (remember that is what our parents and teachers used to say about unprotected sex?). 

When I arrived at 7pm last night, Mr 43 was just returning from CT Scan. I hurried into the room and helped get him re-situated, i.e., placed back on the monitor, vent reconnected, etc. I come back out and go to the day nurse "Okay...tell me about the other rooms" because I not only had the code room, but another three additional rooms. Here is where my night went bad right away because I can't handle a 1:1 patient and be expected to have any free time to take care of 3 other patients! I said as much to the charge nurse, too, but what could she do? Every other nurse there had 4 patients. Could I expect them to have 5 apiece? Neither situation was safe. So what happened? My patients waited anywhere from 1 hour to 2 hours to receive much needed medication. Thank the good Lord they were all stable because if not...never mind, I don't want to think about it. Oh sure, if something bad had happened I could argue in Court that the charge nurse should have made sure my other patients were being taken care of while I had my critical 1:1 patient, and I'm pretty positive that I would be exhaunerated, but I really don't ever want to face that situation.

Okay, this is what I'm going to do. I got name stickers from each of the patients I had at the beginning of the shift and wrote down what was wrong with them and how long it took me to get to them from the time the orders were written until I completed the task. Now I'm going to write a very long letter to our Nursing Director and Medical Director and explain the situation and the hospitals legal liability, along with making suggestions on how to fix the problem. I can only hope this catches someone's attention and changes be made accordingly.

So, because I had to start my shift drowning, I was so far behind on my charting by the end of my shift that I didn't clock out until 8:54am, a full two hours after my shift ended. That sucked! I didn't get home until after 9:30am and I was so worked up I couldn't go to sleep until 11:30am. Add that to the fact that I couldn't sleep past 1:00pm yesterday, and I wasn't 100% at my game because of getting over my tummy virus, and I was pooped! Up side? I slept like a log!

I do work again Sunday and Monday night, so here's hoping for calmer nights. Oh shucks! I probably just jinxed myself, lol.

Hope your Friday and Saturday were spent with family and friends.  Catch up with you later!

De ;)

Extra Food For Thought:

Tags: Overdose, How to Save a Life

Early Friday

Well color me a bad Mom!  Last night I was trying to get Caleb to finish up his homework and Caleb kept telling me to "feel his fever".  I said "you don't have a fever now finish your homework before you get in trouble".  So he kept working on it and complaining.  Finally he got to a point where I said, okay, you can finish the last two sentences tomorrow (all homework is due on Friday, but they have assignments for each day).  Then I started getting him ready for bed and then he was like "Mom will you feel my fever now?"  So I'm like "whatever" and then I'm like, "oh!"  I get the thermometer and he has 102 temp.  Boy am I a mean Mom or what?  He's still sick today but now on antibiotics for Strep Throat for the 3rd time this year.  Man does his school needs a deep clean or what?

Oh my gosh, I have to tell you this...my friend J emails me the other night at 3:30am.  I'm usually up at that time but she isn't because she is a day person.  So instantly I'm clicking on the email because it concerned me.  So anyways J tells me she just back from Mexico (I knew she was going out of town) and tells me she had a couple of procedures while there (which I didn't know about) and would David be able to take out her stitches today (Thursday) cause "I know my doctor will be mad at me for going to Mexico".  Instantly I'm laughing to myself because I've been saying I should do the same thing (although different procedures) and David is arguing with me that we will not cut corners on any type of surgery.  Well, cut to today and David gets back from J's and tells me "I know I hurt her because some of her stitches are infected and I lanced a couple of abscesses".  Yikes!  Now J is a very meticulous person about keeping clean and sterile.  J is such an extreme stickler for doing things as clean as possible that instantly I know she doesn't have an infection because she hasn't taken care of herself, so it must be where she had the procedure done.  So David was talking to her while he was taking out the stitches w/o trying to scare her and expressed very clearly she needed some antibiotics (which he prescribed) and to wash her incinsion with some anti-microbal soap (different from otc stuff).  No wonder she is hurting so bad, poor thing (another prescription for stronger stuff).  The other really bad thing is that J's husband's brother died suddenly Wednesday night and now they have to fly out this morning at 7:55am for the funeral. 

So I guess I'm telling you this because I am asking for some prayers for J and her husband M. Poor M has been dealing with his mother's declining health and has been to Wisconsin twice this month already and was literally walking across the threshold to their house after getting home the other night when a family member called and told him about his brother.  They've had a rough year with dealing with M's accident, his resulting physical therapy, his mother's declining health (alzheimers and a recent hip replacement), and now his brother's death.  These are dear friends of mine and my heart just goes out to them.

 

On to a lighter subject...I have to tell you something funny.  I was talking to Hannah the other night and was saying how I've already been scoping out the costs of plane tickets for her to return to Oklahoma at the end of April.  So I go, "I'm going to ask Granny (my Mom) if she wants to come out for a couple of weeks and then fly back with you."  Long pause, then Hannah says "What?  You don't want to fly back with me this time?"  OMGosh!  I just bust out laughing and said "No...I've think I've had my quota of flying for this century, thank you very much.  But I love you bunches!"  So Hannah, of course, had to laugh, too.  What?  I think my Mom flying instead of me is a fantastic idea, lol.

 

I work tonight so I hope you all have a great day!

 

De ;)

 

Tags: Strep Throat, Dear Friends, Funerals, Flying

Tuesday/Wednesday...wait what day is it?

Wow!  Did today just breeze by.  But then again, they all seem to do that lately. 

 

I was up early this morning getting Caleb to school, in case you couldn't tell from my emails.  I actually responded to things before midnight, lol.  Then I slept and got Caleb from Art at 3:30.  It is a city skyline with the mountains off to the side.  Is my 6 year old talented or what?

"silhouette and shading to create depth and volume"

 

Here is a picture Hannah drew.  Don't ask me why, but she is into whales lately:

Whale & Squid 1/07

I don't know where they get all their talent, it certainly isn't from me!  David draws really well, too.

 

 

So after school, I think I literally spent 2 hours feeding Caleb.  I swear, sometimes I check to see if there is a whole in his stomach.  Where on earth does all the food go, somebody tell me?

 

I started dinner around 5:30pm.  I browned some pork chops in the skillet and seasoned them with salt, pepper and garlic powder before adding them to some apple cider seasoning in the crock pot. They were good, but a little sweet.  I think from now on if I make a recipe for meat that involves sugar I will only put in half of what is recommended.  Then I cooked rice and peas.  It was pretty good and really, really easy.  I think I'm wearing my crockpot out! ;)

 

After dinner I was talking to Hannah on the phone and Elizabeth online while I cleaned the kitchen.  I am so multi-talented, lol.  Oh here are a couple of pictures of Elizabeth & Alan:

 

I swear, I don't know what has gotten into me, but I've cleaned the kitchen, the fridge, doing laundry, and cleaning bathrooms.  Next is the den.  Lindsi is coming over tomorrow and I don't want to her think that I don't do anything the entire time she is gone.  Well, I don't want her thinking it every time, ha ha.  But whatever it is, somebody better bottle it because I never clean, well next to never anyway!  I go by the saying on this magnet that Hannah got me for Christmas: "Anything worth doing is worth hiring someone else to do."  Yep, I think that is my mantra!

 

Well, David is "napping" right now.  Yes, I know it's after midnight, but that is what he said, "I'm going to take a nap" when he laid down about 11:30pm.  Yes, I also know that we are really, really weird!  Ha!  David is going skiing tomorrow, or rather today "because if I don't go by myself I won't get to go again this year!"  David is going up to Flagstaff with his friend, David (24yrs old).  They ought to have fun with as much as it's snowed recently.  I do believe they are cross-country skiing, my fav.  Oh well.  Maybe spring break if I don't fly down to Kathryn's surgery.

 

Speaking of Kathryn...remember when her oncologist said "I want you to have surgery in the next two weeks"?  Well aparently he wants a bunch of different docs in on her surgery and it has taken a while to get it scheduled.  It is going to be March 13th, smack dab in the middle of spring break.  Hmmmm...skiing....Kathryn....beach...Kathryn....how to choose.  As if there was a choice.  Who knew it was going to be in the middle of spring break with all the airlines charging the max?  And of course you all know just how much I love to fly.  Another, yeah right.  I did talk to Kathryn last week and it looks like everything is a go, but she is supposed to meet with a urologist on the 27th, so I think I will wait to see if things get changed or not before buying a ticket.  Here is a picture of Kathryn & Scott, her boyfriend.  Scott is really being Kathryn's rock during all this, and what really is amazing is that they didn't start dating until I think either August or September.  Who knew?

Kathryn & Scott Christmas 2006

 

Well, I guess I had better get up and finish all that I've started.  I've kinda had ADD tonight.  I go from one project to the next w/o really finishing the other and back again.

 

Have a good sleep, or a good day, or whatever it brings you.

 

De ;)

 

Tags: Tuesday, Wednesday, Artist, Cleaning, Dinner, Sister, Surgery

Monday

Hello all.  It has been rainy and cool all day today.  We did get out and go to IKEA, despite the rain.  Had a good time.  Didn't buy much, not even the furniture I wanted.  But we got a lot of good ideas.

 

I told Hannah today about the concert (www.falloutboyrock.com) and she was like "YEA!  Oh...I need someone to share my madness with."  I just laughed.  I told her about my friend from work who has a 13 year old daughter that I invited.  She was like "oh that's good."  I guess it would've been better if one of her friends were here, but hopefully she and McKenzie will get along well.

 

How was your President's Day?

 

De ;)

Tags: Monday, Rain, IKEA, Fall Out Boy

Sunday

Boy did I just blink and the whole week went by.  Anybody else?  Seems all I did was work and sleep, or not sleep, ha ha.

 

I didn't do much today.  We were supposed to go to IKEA and look at some bedroom furniture for the extra bedroom, but David let me sleep too late and I guess I was too tired to wake up earlier than I did.  At any rate, I think we can go tomorrow.  I want to because they are having a sale and we need something other than a blowup mattress for Lindsi or whoever to sleep on.  I've just been doing dishes, laundry, etc.

 

Last night was fun.  We met some of my friends from work and had a tailgate party before we went to the Coyotes v Red Wing games.  We all knew the Red Wings were going to win, but neither team exhibited much action.  It was a non-exciting game.  At least the company was good. :)

 

So hey, check out "The New Sexy"...

 

Sexiest Jobs % of Votes Bartender 11.4% Nurse 10.1% Firefighter 9.6% Personal Trainer 9.3% Flight Attendant 8.0% Surgeon 4.5% Soldier 4.5% Teacher 4.5% Photographer 4.4% Police Officer 4.3%

Speaking of Nursing...My last two shifts this week were much better than Sunday night's.  We were still busy, but at least we things seemed to run a little smoother and the doctors weren't as anal about getting people right back.   They really didn't have a choice, but at least they were too busy to care much.  Thursday night I think we just headed off a disaster, though.  We had 3 registry people there, 2 nurses and 1 tech, and they had never been at our hospital before.  Thank goodness there were 3 of us there as well.  A bunch of East Valley hospitals were on divert and since we are not allowed to go on divert (per administration) we just got hammered.  And then wecouldn't seem to move the admits upstairs because the newbies couldn't figure out what the heck they were supposed to do.  So add me and the house supervisor, and we got them up and out opening more beds for those coming in.  One lady waited 5 hours in the lobby before getting back and being seen by a doctor due to all the ambulances.  I just kept checking on people in the lobby until we could get them back.  Fun.

 

There was one registry nurse who just seemed like he was doing okay and then I think he just stopped working about 2 or 3am.  I don't think he did anything else but catch up on charting after that time because even though I was in triage, I was in his rooms taking care of his patients.  When we got one of his admits up I noticed later when I was doing charges, that he had not documented anything on that patient all night.  All night!  That was 8 or 9 hours.  So I went up to him and told him he had to correct the chart.  He just goes "You do realize I've never been here before, right?"   I said "You do realize that you could end up in Court over this chart and not be able to defend yourself, right?  You've got to correct this.  You don't have a choice.  If you need help, just let me or anyone else know."  The nurse just jerked the chart from my hands and said "Leave me alone."  Ooookkkaaaay then.  So later I checked with him and said "I need that correction so we can make copies and send the original upstairs."  He said "I don't have it".  So I had to dig it out of the filed charts and makes copies and send it upstairs.  He did correct to a degree, but what the hey.  I did the best I could to help everyone, he was the only one with the attitude.  Oh well.  He won't be back.

 

Oh I have a surprise forHannah!  I bought tickets for the Fall Out Boys concert here in Phoenix on April 27th.  I haven't told her yet.  I know she will just freak.  They are one of her favorites.  Do any of your kiddos know this band?  They are labeled "alternative rock".  I like them.  Not too bad.  It ought to be a fun concert.

 

Well, gonna jump off and try to be productive again.  Is everyone off tomorrow since it's President's Day?  We are!

 

De ;)

 

Tags: Sunday, The New Sexy, Phoenix Coyotes, Detroit Red Wings, President's Day, Fall Out Boy

Manic Monday

Back to my discussion regarding my offer to my niece Rachel...the going rate in Phoenix is $12-$15 an hour for a Nanny.  Overnight at most of the agencies charge $15.  And yes, the cost of living is pretty high here.  Not as high as California, but it is up there.  Our house is only 200sq ft larger and cost double what it did in Oklahoma.  Gas is usually 30-50c higher here than Oklahoma.  And the Natural Gas is waaaaaay higher.

 

But despite all that, I still make more in one shift than I am offering to pay Rachel for a week, so it is a good deal for me.  Better than what I pay Lindsi, so I guess that is why it is a bargain for me.  I'm glad you guys feel it is more than fair.  I hope that Rachel does too.  Now I see she would be crazy not to take the offer, lol.

 

I had such a stressful night last night I purposely stayed in bed until almost 4:30 just trying to avoid getting up and getting ready.  So now I'm out of time and have to get in the shower.  I've told you the changes they are making at work.  Nobody likes them.  I had a "conversation" with the Medical Director (who was the all night doctor) last night expressing my concerns, and he pretty much just blew me off.  The doctor tonight is always irritable until we get the place cleared out.  So you can see why I'm having avoidant behavior today.

 

Iget my hair done tomorrow.  I can't wait.  It's been at least 7 weeks, which is a long time for me.

 

Hope your night is awesome!

 

De ;)

Tags: Nanny, Niece, Work, Stress

Early Sunday

Sorry I haven't been around much lately.  I really don't know what I've been doing except work and uh...I don't know, lol.  Seriously.  Oh I've done some cleaning, laundry, etc.  Mostly just being lazy.  Today I did get up and get a shower earlier than I normally do.  Then Caleb had some errands for me "Mom, remember you promised me to go to McDonald's today?  And I want to go to Toys R Us too because they have Pokemon toys.  Can we, please Mom?"  Oh how could I refuse, after all, every little boy needs some Pokemon toys.  Don't they?  We also ended up buying "Open Season" so we could watch when we went to bed tonight.  I didn't see much of it because Caleb got started without me, but what I saw was cute.

 

Tell me your opinion on this one.  My 20year old niece is getting married this December (despite me telling her she is too young, ha ha).  Rachel wants to earn some extra money.  I could use a live-in nanny.  So I proposed for her to come out for the summer.  Now Rachel can only come out for about 7 or 8 weeks, but every little bit would help.  I proposed to pay for her round trip airfare, room and board, and whatever family entertainment (movies, dinner out) we do.  I then proposed to pay her $450 (for 40 hours, which equals $11.25 an hour).  That would be a huge savings for me because I pay Lindsi $15 per hour, so in one week I could end up paying her $675, plus $75 paid to the agency ($750 a week).  Do you think that is fair, more than fair, or I should offer more?  I don't want to offend family, and I want it to be financially beneficial to both of us.  I think it would be fair because Lindsi doesn't live with us and Rachel would be.  Tell me what you think.

 

This week at work has been interesting.  It seems that the CNO (Chief Nursing Officer) has decided that we are not busy enough at night to warrant 5 nurses and a tech after 3am.  So we have really been pushed to the limit (taking 4 patients all night plus whatever else ends up in the hallway which could mean 5 patients).  Although the JACHO (Joint Commission on Accreditation of Healthcare Organization) has determined that a safe emergency department nursing ratio is 1:4 (nurse:patient), anything over that ratio increases mortality and morbidity ratios by 7% per patient.  So here we are lately having 1:4 all night, and at times 1:5 ratio.  That is really, really scary.  And the fact that at times we do not have not even had a tech is stretching us even further.

 

Of course, you have to look further than a standard 1:4 emergency department ratio, because JACHO also advises a 1:2 ratio for critical care patients, and a 1:1 ratio for every trauma patient.  There are plenty of times when 1 or 2 of your 4 is a critical patient, and sometimes (if you have the "code" room) a trauma patient.  What then occurs, what happens to your remaining "non-critical" patients?  They are put by the wayside and hopefully will not end up with a bad outcome.

 

According to the ENA (Emergency Nurses Association), inadequate nurse staffing has already resulted in more overcrowding of hospital emergency rooms, diversion of emergency patients to other facilities and fewer staffed hospital beds to move the patients admitted through the ER out to their rooms to be taken care of by other nurses.  If you don't have enough nurses you can't effectively and safely take care of the patients, nor can you move whatever comes in by ambulance or the front door due to beds being taken up by admit holds.

 

The problem with all this is that we (nurses) are responsible for maintaining patient safety no matter how overcrowded or under staffed we are.  So basically what this boils down to is that if the work environment is not safe for the nurses, then the nurses cannot safely care for the patient.  It can make for a very stressful night trying to balance everything out.

 

So why do I do what I do?  It really is simple.  I truly love what I do.  I only hope that I don't become so burned out by working short that I end up quitting, like so many nurses today.

 

Okay...was that more than you wanted to know about my job?

 

De ;)

 

PS:  I just have to put in a plug for one of my favorite sites.   Pop on over to Patrick's Place for a daily dose of interesting tidbits, current events, and day to day thought provoking topics.  Patrick also has a couple of weekly memes that you can find over on his other site, Patrick's Weekender.

 

Tags: lazy, Toys R Us, Pokemon, McDonalds, Open Season, Nursing Shortage, Patrick's Place, Patrick's Weekender

Is It Really Thursday?

Man, time just flies when you are having fun, ha ha.  Two shifts down this week and tonight to go.  Just had so much fun both nights, and I can't wait to see what tonight holds, ha ha.  And, I always try not to work to hard, but whoever comes in has other ideas.

 

Too many drunks last night.  I'm like "this is Wednesday, isn't it?"  You couldn't tell.  Then this 24yr old girl was brought in by her co-worker after taking a bunch of pills and drinking.  "I'm not happy" she says.  Well, because she wasn't happy now she is going to have liver damage because she took a bunch of tylenol.  Dumb, dumb, dumb.  Seems as though her boyfriend just broke up with her.  Silly girl!  Boys are dumb and not ever worth pills and booze.

 

I did go to 1 hour and 20 minutes of our mandatory staff meeting this morning then I bugged out.  I'm crossed eyed right now I think, ha ha.  Oh I'll be okay as soon as I get my Starbucks! :)  Oh and thanks, Hannah, for the words to the Starbucks song!

 

Okay...back to the ole grindstone.  Gotta jump in the shower.  Catch up tomorrow!

 

De ;)

 

Tags: starbucks, dumb boys, drunks, work

Monday

Good afternoon!  I've gotta get ready and go to work.  Hope you have a good night.  Catch up with you tomorrow.

 

De ;)

 

PS:  Whoo Hoo COLTS! 

 

Tags: Colts, Monday

Early Sunday

How has everyone's weekend gone so far?  Pretty good here.  I got home Saturday morning from work right at 8:00am.  I stayed up until 10:15am cause little Mr Caleb got up right after I got home.  David was sleeping and so I stayed up for a while so David could sleep in some, although he didn't have to work last night after all.  David was supposed to work at a different hospital but for one of the same groups, but his credentials hadn't completely been approved.  It's crazy what these doctors have to go through just to get a job.  It usually takes a minimum of a month to get approved to work under temporary privileges (2 weeks if you are lucky).  You would think since David already worked for this company at two other hospitals that this wouldn't be an issue, but doctors have to be credentialed at each facility.  Of course there are always little fees associated with all this.  Usually a few hundred dollars.  Nice.

 

I've got it easy.  I just obtain whatever state license I need by endorsement (usually a few hundred dollars, but then your license only has to be renewed every few years, 4years here in AZ), apply for a job, interview, and hopefully start work rather quickly once your license checks out.  Usually you can start to work w/in a week.  What is really nice about Arizona is that it is part of a multi-state license agreement which, right now, includes 19 other states.  New ones are coming on board.  Oklahoma is not part of this pact so far, so I've kept that one current.  Never say never that you aren't going back somewhere, right Betty?  LOL.  I let my South Carolina license lapse (not that I ever worked a day there or ever want to), but now it is part of the pact.  Hilarious.  What is funny about SC is that we've had this nurse named Charity working as a traveler in the ER who is from Florence, SC.  She just kids me all the time of my hell time in Sumter.  Sweet girl, sorry her contract is up, hope she comes back soon.

 

Speaking of work, last night was pretty busy, and we were two nurses short.  Boy did that ever make the charge nurse cranky and irritable.  That meant that she actually took an assignment and charged, something she absolutely hates to do.  The particular charge nurse would rather not assign herself any patients and pick up what is in the hall or extra rooms, and then take the 3pm-3am nurses patients when they leave, meaning that she usually only has patients for short periods of time and after 3am.  I would rather take an assignment (preferably triage so I won't be tied up in patient rooms freeing me up to pick up charts, clean rooms, take ambulance reports, etc) so the other nurses don't have a heavy burden all night while we are being killed.  I was in triage last night.  That meant that we had only 3 nurses in the back  when we usually have 4, plus a nurse in fast track...anyway, you get the idea.  And, I had to work the medical director again, but he wasn't as irritable as the other night, but the all night doc was.  So it was just a trade off, lol.  We stayed busy until the day shift came in with their eyes wide and their mouths dropped open.  Day shift absolutely hates to walk into a busy ER because that means they don't get their coffee and breakfast time, and that usually means they are totally freakin out by the time we come in at 7pm.  We are used to hitting the ground running and hopefully getting a few breaks later on, usually after 3am.  It's just so funny, and the difference is literally "day and night".  Ha ha.  I just crack myself up, ROTFLMHO!

 

Any plans to watch the Superbowl today?  David has to work, but I will have the TV on.  Who are you rooting for?  Me?    I'm rooting for the Colts since the Patriots aren't going.  I'm really hoping Peyton Manning gets a win.  He is really good.  Did you see where Joe Namath said that Manning was the best quarterback?  I can't remember if he said of right now or of all.  But at any rate, that is pretty high praise.  The Superbowl comes on at 4:00 here.

 

I finally spoke to Hannah tonight.  First time since her "United" weekend started on Friday.  She sounded like she was having fun.  I'm glad.  ALMOST makes the horrible flight worth while, ha ha.  No really, it does.  Hannah and her friends sang me the "Starbucks" song.  It was cute.  I'll have to see if she will write it down.  I'm sure I'll hear a full report since she will be home tomorrow afternoon on all they were doing.  Spent the day up at the church, then spending the night at a church member's home.

 

That got me to thinking about things I've noticed since Hannah has been gone:

(10) I have much less black and brown clothes to wash;

(9) I can take a hot shower most anytime I want;

(8) I don't have to say "You two get along before I have to kill you";

(7) I don't have to say "Can you turn your music down so you can hear me when I'm talking to you?";

(6) My coffee creamer isn't sitting out all day spoiling because someone forgot to put it back into the refrigerator;

(5) I have to stumble out of bed, into the car, and walk up to the school sidewalk myself to pick up Caleb after working all night and having my bed-head hiding under a hat;

(4) I have to do the dishes now;

(3) I don't have to hear the countdown to the next Harry Potter book or movie release;

(2) No one is hogging my computer 15 hours a day;

...and the number one thing I've noticed since Hannah has been gone?

(1) None of that really matters when you are missing your daughter.

 

Ya'll have a great day and I'll catch up with you on the flipside. De ;)

Tags: credentials, compact nursing license, er, superbowl, harry potter, daughters

Early Friday

Hey all.  How are you?  Not a lot going on here at the moment.  Had a lazy day.  I was worn out from working last night.  Very, very busy. Didn't stop all night.  I was in charge and in triage.  I worked my butt off.  I got upset with the doctor who was on last night because he jumped my case about one mistake I made all night.  I thought I ran a darn good shift and kept things moving and for him to come down on me in the way that he did was not right. I just felt he could have addressed his grievance in a more productive and less rude and judgmental way.

 

What happened was I triaged this lady who came in complaining of chest pain.  Basically she was a train wreck, but because of her significant medical history felt like I had to treat her complaint as legitimate.  So I got her back into a room and got her changed.  I alerted the PA who was the only "provider" at the desk and went back into the room to finish connecting her to the monitor.  The PA then walked into the room and I went back out.

 

An ambulance came in right as I walked out of the room with a lady who was also complaining of chest pain with a cardiac history.  I didn't have any other monitor beds available so I had to move people around.  After doing so I took report from the EMTs and went to the room.  Not one single nurse had been in there to get the lady changed or connected to the monitor, even though I had alerted that nurse that I was putting the ambulance in her room and she was at the desk when the ambulance came in.  So I proceeded to get her changed and connected to the monitor.  The nurse then walked in and I went backout to triage.

 

Normally, when I put a chest pain in a room, I walk back up to the desk and request the secretary to call for an EKG.  I didn't in either one of these circumstances because another person walked into the room while I was still there and felt the situation was taken care of.  What happened to the first patient was that the PA ordered all the appropriate tests right away.  What happened in the second instance was the patient wasn't seen for over 30 minutes and there was a huge delay in her getting an EKG (according to the doc, 55minutes, but part of that time was not being able to contact the cardio for the EKG).  I really didn't think anything about it until the doctor called me over said "What excuse do you have for the patient in 5A not getting an EKG for 55 minutes?"  I tried to explain that I felt the situation was under control as her nurse walked into the room while I was still connecting the patient and felt I had turned the patient over to her and subsequently everything was taken care of.  But he just kept interrupting me by saying "what reason do you have?"  He was obviously not going to be satisfied until I took complete blame and so I said, "You know, I doing the best I can to have control over every patient that comes into this ER tonight and felt I had that situation under control.  I overlooked the fact that I could not rely on someone else to do what was needed.  I'm sorry that detail was overlooked."  He then said "Thank you."  Doctors!  Egos!  He just wanted someone to blame in case the situation was bad, and it wasn't.  Her EKG and enzymes were completely normal.  Of course it could have turned out differently, but didn't thank goodness.

 

Tell me what is the point of assigning a nurse a room/patient if you have to ultimately have to take responsibility for everyone and everything?  I'm still mad because that is the one oversight I had all night.  I was pre-ordering tests on people, medicating fevered babies, ordering breathing treatments, xrays, EKGs, etc.  But this one time when I felt the nurse took over the patient was where I went wrong.  Geez.  Makes you feel really appreciated when you do good all night and someone zeros in on one thing that where they feel you failed completely.  Sure makes you feel unappreciated.

 

Also, my sister Kathryn went and saw the oncologist yesterday in Shreveport.  Complicated  news right now.  I had her boyfriend, scan her reports and send them to me email.  I read everything.   Basically this is being considered an endometrial tumor that has invaded her cervix, vaginal wall, and possibly her colon.  It is pressing on her urethra and there are cysts on her kidneys.  The doctor said it needs to come out "now".  Initial pathology suggests that it is benign, but because of how invasive the tumor is the oncologist feels there is a certain urgency in getting it taken care of.  Needless to say, Kathryn is feeling a bit overwhelmed.  The doctor did assure her that he had seen endometriosis do this exact thing, although not very often.  He hopes by going ahead quickly with the surgery he would be able to preserve her fertility.  I urged Kathryn to go ahead and schedule the surgery as quickly as possible so as to encounter the least possible complications.  She is going to call the surgeon back tomorrow and let me know what is going on.  Poor thing.  So needless to say, Kathryn is greatly in need of your prayers.

 

Well, I have to work today so I hope you all have a great day if I don't touch base.

 

De ;)

 

Tags: nurse, doctor, chest pain, ekg, endometriosis, tumor, sister