Saturday, March 26, 2005

"Use your nursing judgment"

I don't know how many times I was told that in school - "you have to advocate for your patient & use your nursing judgment."  Well, I encountered a situation like that the other night at work & I'm still thinking about it today. 

I worked on Wed & Thurs night.  Not too much going on Wednesday night - one patient dying from multiple conditions, she only weighed about 60 lbs.  So very frail & delicate - only 51 years old.  I felt for her, she was in pain & there was no relieving it.  She was already taking multiple pain relievers around the clock.  It was another one of those situations that there truly wasn't anything I could do to make her feel better.  Repositioning & talking to her only did so much.  I don't like when my patients are in pain, but I am seeing more clearly that there will be times when all the pharmacological & non-pharmacological methods will not relieve a patient's pain.  She was discharged the next day to hospice. 

My second patient was an older woman with small cell carcinoma that eventually spread to her bones & other organs.  She had a lot of edema in her legs & ascites in her abdomen.  She had a paracentesis done during the day & drained 5,000 cc's - which is 5 liters.  That is a lot of fluid.  By the second day though, it was all back.  She said her legs felt like weights, she could barely even move them.  3+ pitting edema.  She wasn't in any pain though, which I thought was odd.  Perhaps she is simply used to the pain, I don't know, but never once did she complain of pain or discomfort.  We restarted her heparin drip a few hours after she returned from her paracentesis - only to discover from the am labs that her PT & PTT/INR were way out of wack.  A call to the doctor & the Heparin was dc'd.  Came back Thursday night to discover that she was bleeding internally somewhere & they were giving her Vit K (to counteract the coumadin she had been taking).  This is the patient that I had to use my best nursing judgment on - I'm not going to go into too much detail regarding it, but it's the first time that I realized a decision that I had to make was ultimately "my" decision.  I had no instructor to fall back on, my preceptor was saying you have to make the decision - you can't do it because I'm telling you to do it - you have to make the choice.  It could have been a simple call to the doctor at 3am, but I was told doctors would get pissed off if you call them at that time for something so simple - yet it was something that required a doctor's order.  I went ahead & did it, while anticipating that we'd get a doctor's order for it later.  The evidence behind my decision was there, fully supporting that my choice was a good one & definitely called for.  I talked to my clinical leader about how to document what took place & she also used the words "best nursing judgment" & that there will be times when you truly have to use it.  I went ahead & documented my decision. 

My third patient on Wednesday evening was basically a grumpy man.  There was no real pleasing him.  His family was complaining about how it seems like he never has the same nurse 2 days in a row - they wanted to know why.  He was discharged on Thursday, so I had a new admit Thursday night.  An older gentleman complaining of chest pain.  His cardiac enzymes were negative, he had no further c/o chest pain & slept most of the night. 

Now it's Saturday morning & I am off until Wednesday night - yay!  Not much to really do though, it rained all day/night yesterday & it's supposed to be like that again today & tomorrow.  I could go shopping, but there really isn't anything I need.  Guess I'll just chill out here at my house for awhile. 

Wednesday, March 23, 2005

Love those thunder storms

It is thundering & raining out right now - I love the storms, especially when I don't have to be out driving in them. I am getting ready to go to bed shortly since I'm working tonight.

I've been reading other journals & they are so amazing. It's pretty cool to be able to see a day in another person's life.

I've been craving junk food for the last 24 hours, I have no idea why. Trying to resist, but it's so hard. I need to go food shopping - there isn't a lot of variety of food to choose from in my house. But I want to wait until after this junk food craving is gone - otherwise I'll fill my house with junk.

It's been a relatively quiet night, I've gotten nothing accomplished, but oh well - we all have nights like that, don't we? I think my dreams are calling me...nite nite!

Tuesday, March 22, 2005

What a night, what a night

My night started out well - I had the same patients from the night before, so taking report was very quick & easy.  I am not one to sit around & gab about my life like a lot of the other nurses - I like to get my assessments done quickly & my meds pulled before it gets crowded around the Pyxis.  So by about 7:50, my assessments are done & I'm just waiting until 8:00 to pass meds to my patients.  My charge nurse said "There is a patient in the ICU that is getting ready to be intubated & may code - do you want to go down there?"  I said sure - because the more you observe, the more you learn & get used to how a code situation goes.  So we arrive there & the doctor is just getting ready to intubate.  Our top surgeon was there also & he was putting in a central line because this guy had a bad IV site & they had to get some meds into him.  He didn't actually code to the point of needing CPR, but they did have him on a ventilator & called in the heart cath team.  I would have loved to observe the heart cath, but since this guy was in such grave condition, the doctor wasn't allowing it...grrr.  So back to my floor I go.  Later we got a call saying the patient had a triple ventricular aneurysm = death is imminent, there isn't anything they could really do for him to repair it.  :(  I don't like hearing stuff like that.

Around midnight I went in to give one of my patients her meds.  I was only in there a couple of minutes when she started having an asthma attack - I didn't know what to do.  My usual "try to take a few deep breaths" wasn't going to help her because it was impossible for her to take deep breaths.  My preceptor was off the floor on a break - so I approach the first nurse I see - a much, much older nurse.  I thought surely she must have experience with situations like this.  I say "My patient can't breathe, I don't know what to do."  This older nurse slowly says "Maybe you should call respiratory."  So I reply "How exactly do I do that?  I've never had to call them before."  She slowlyyyyyy looks around & says "Oh, there's the number."  I'm like panicked now because this older nurse seems so unconcerned that my patient is not breathing well.  Luckily another nursewas overhearing it & went immediately to the patient's room & confirmed that she was having an asthma attack & we needed respiratory "STAT."  So she calls them - which let me fill you in on our respiratory department = they hate when nurses call them.  I have never seen people so resistant to wanting to do their job.  It's not like we were asking for a miracle, we needed a breathing treatment & they are the ones who have the medicine to do breathing treatments.  So anyways, this nurse calls respiratory & is getting an attitude from them saying "We were just there a few hours ago & she was fine."  Hellooooooo....that was a few hours ago, she is not fine now.  I'm in with the patient while all this is taking place & I am feeling so unhelpful because there is nothing I can do to make it easier for her to breathe.  She already had 2L of 02 on, she was already sitting up on the edge of the bed leaning on her bedside tray - I could see the panicked look in her eyes & there was nothing "I" could do to help.  The respiratory therapist finally shows up, gives her a breathing treatment & within 2 minutes - she is back to breathing normal.  Thank god!  Meanwhile, the nurse that was helping me says "We need to call the doctor, there is nothing ordered for her & she needs some orders."  So she pages the doctor & then writes out what I should say to the doctor & what orders to ask for.  Did I mention that I don't like calling doctors?  So I was a little nervous about the upcoming phone call, but grateful that she wrote out what I should say so that I don't look like a total idiot when he does call.  I went back in to check on my patient & she is joking & laughing - totally back to the way she was before the asthma attack.  She was thanking me for being there for her & getting her help - I don't think she was even aware of how scared I was.  While I was in with her, the doctor called & the other nurse handled the call.  She said afterwards that it's a good thing she did because the doctor was being a complete a**hole on the phone for waking him up.  Ughhhhhh....they annoy me.  They get all the glory, but if only people knew how annoyed these doctors get when nurses advocate for the patients & call the doctors to get what the patient needs - and they give us such an attitude.  If only the patients could see how their doctor acts, they would definitely lose respect for them. 

Anyways, as I was looking at the med sheet, I see that she has respiratory treatments ordered for every 4 hours.  Turns out our lovely respiratory therapist "forgot" to come give it to her around 11 pm.  I pointed it out & he says "I was on my way to give her one."  Uh huh, sure buddy.  I tell him to please not be late the next time she needs one since it is so obvious that she definitely needs these treatments.  Sure enough, he showed up "early" for her next treatment - glad to see he paid attention.  Ok, back to the other nurse being on the phone with the rude doctor - she gets the necessary orders that we needed, doctor is not happy that we are telling him what we need.  They seem to be such control freaks.  As this is all going on, my preceptor makes it back from her break & says to me "Did something happen while I was gone?"  Ummm, yes, my patient nearly stopped breathing.  She says to me "Why didn't you page me?"  How????  No one has ever shown me how to page anyone in the hospital & not that it would have mattered, she was on a smoke break & was outside anyways.  Then she says to me "I wouldn't have handled it this way.  There was no reason for the doctor to be called."  Huh??  I was very grateful that I had an experienced nurse there that took control & helped me out.  The doctor had ordered 1 mg of Bumex (diuretic) & my preceptor was saying she didn't think the patient needed it, but since the dr. ordered it, go ahead & give it.  We put a foley in & sure enough....within 6 hours, she had a urine output of 1250 ml - that was a lot of fluid she was retaining. Later my preceptor said to me "You did the right thing, you needed help & you brought someone with experience in to help you. You made the right call." 

It was scary & I did feel helpless, but the outcome was good.  I probably overreacted, but I don't like seeing my patients in distress.  I still can't get over how slow that other nurse was..."Well, maybe you should call respiratory."  Maybe???  Ya think??? & learn.  I definitely won't go to her next time there is a crisis. 

My second patient was pretty quiet the entire night - he just rested in bed.  My third patient has me convinced she's a hypochondriac.  She was complaining about her roommate coughing all the time & now she has pneumonia.  Well, the roommate has COPD & therefore has a chronic non-contagious cough.  My patient was constantly calling me into the room saying now she has a sore throat & she has chest pain from coughing so much & she's worried she's going to break a rib from coughing.  I talked to my charge nurse & we offered her a move to a different room.  Her reply "I already caught whatever this other woman has, why spread it to someone else?"  So I offer her some hot tea & she refuses it saying "What good will that do, I'm already sick."  Ok, I listen to her lungs.....all lobes were clear.  She's sitting there sucking away on cough drops convinced she has the flu or pneumonia.  Needless to say, I'm glad I was off tonight.

Although we had the championship game at volleyball & lost.  Oh well, we lost to a good team, so I'm not feeling bad about it.  We win most of the championships so I guess we can let another team win now & then.  

I'm working Wednesday night & Thursday night, then I'll be off for almost a week.  Time to get this house straightened up a little.  And also spend a little time with my niece & nephew - I haven't seen them since the beginning of the month.  I need to decide if I want to take them to Sea World or not...hmmm.  I guess I'll see what the weather forecast is next week & make a decision.   

Sunday, March 20, 2005

Another day, another dollar

I had another good night at work although I did encounter something I wasn't expecting.  I went in to see my first pt - a 70 yr old man admitted with pneumonia.  I walked in & he was sitting up, trying to dial the phone.  I make the usual chit chat & suddenly he starts crying...sobbing, head down on the table, tears flowing type crying.  I had no idea what was wrong nor have I ever seen a man cry this way.  (I've done it plenty of times, but that's a different story!)  So I rubbed his back, encouraged him to tell me what was wrong, got him tissues for his tears.  Turns out he had a stroke awhile back & since then he has trouble remembering things...he couldn't figure out how to call his wife at home on the phone.  Poor guy!  He made me a little nervous the entire night...just because he seemed so anxious & uncomfortable.  He didn't want to watch tv, didn't want to listen to music, just wanted to lay in bed & stare at the ceiling.  Eventually he fell asleep & had no complaints throughout the night.  I felt bad for him...I can't imagine what it's like to know mentally what you want to do or say but unable to actually express it. 

My second patient was a 90 yr old woman (who looked not a day over 70) with a TIA.  She was pretty quiet & easy-going - didn't hear much from her the entire night. 

My last patient was a 77 yr old spanish woman in for a COPD exacerbation.  She was adorable - great sense of humor.  Her husband was up in the ICU after suffering a heart attack a few days ago.  He had no idea that she was also admitted into the hospital.  I hope they both get well.

At the end of the night, Gina & I got to go over to the ICU & see an IABP - intra aortic balloon pump - in action.  It is amazing what technology has come out with.  This pump was placed in the femoral artery & it blows up with every heartbeat or every other heartbeat to help the heart completely fill with blood so the output can be full force.  It does this by closing off circulation of the blood to the lower extremities.  We were talking to the ICU nurse & she was so helpful & informative.  The ICU is still an intimidating place to be, I'm definitely not ready for that yet. Maybe one day in the future.

I've got to get some sleep....another night of work ahead for me.  I'm hoping I have the same patients & my night goes just as well as last night did. 

Tuesday, March 15, 2005

Grad class is over & out!

Yessssss!  Class is over!  The class was very helpful, but after 8 weeks of it, I think all of us were ready for it to be over.  Today we had a lecture from respiratory regarding chest tubes & also suctioning.  We also did somewhat of a mock we would know what our responsibility when we have a patient that codes.  That helped although I'm sure it's still gonna be a scary experience when I encounter it. 

I only got about an hour of sleep last night because I slept too much after work during the day.  That is one reason I wanted class to be over I wouldn't have to switch back & forth from nights to days in less than 24 hours. 

Volleyball was fun last night....Julie nailed me with the ball, but somehow it hit my shoulder & went over the net.  Julie fell down  I love my volleyball nights.

Time for me to go enjoy my week off...yay!

Monday, March 14, 2005

Some time off

Last night at work was a pretty good night.  I'm getting used to handling 3 patients now.  I had an 80 yr old man diagnosed with TIA.  He was for the most part alert & oriented...kept complaining that he couldn't move his legs, even though he was moving them.  Someone in the ER put in his foley catheter wrong & caused some trauma in his urethra which resulted in a lot of blood which is still bleeding.  They inflated the balloon before reaching the bladder!  The strongest pain med we had for this guy was Tylenol.  I felt bad that I couldn't make him feel better, but with a TIA it's unlikely they would prescribe him anything strong anyways.  My other gentleman is a 45 yr old man that had complete occlusions in his iliac arteries - so young to have that.  He is scheduled today to have some stents put in.  He was very anxious/nervous all night about what to expect today.  I tried to comfort him as best I could considering the circumstances.  I had a new admit last night also...a 21 yr old girl that had a seizure while swimming.  Someone was there to catch her before she went underwater.  In the ER she had another seizure, but she didn't have any of the residual effects so it was tough to determine what was going on with her.  She showed up on my floor wearing a bikini.  Why they didn't have her change into a gown, I'll never understand.  Or maybe she didn't want one, who knows?  They were all stable throughout the night.  I finally felt like I had some idea of what I was doing.  I'm sure that will be short-lived.  I am off the floor until next Saturday night - it will be a nice (nearly) week off.  I have a 1/2 day of class tomorrow & then some freedom to do whatever I want for a few days.  I'm happy!!!!!!

Sunday, March 13, 2005

Back to work

I need to start getting ready for work. I have slept so much in the last 48 hours...guess I really needed it. I wish I had one more night to just relax, but I gotta work. I'm sitting here wondering what kind of patients will I have tonight...will it be a difficult night or a good night? I guess that is part of the thrill - not knowing what to expect. I am hoping for a not too difficult night as I'm feeling pretty mellow at the moment. Maybe that will change as I start drinking some caffeine. Gina won't be there tonight cause she worked Friday night. I like it better when she is around, someone to talk to & joke around with.

Dale Jr. already crashed out of the race in Vegas today, so no need to continue watching. :) Oh well, that's about all that is happening right now. I need to jump in the shower & get my night going. Ciao!

Saturday, March 12, 2005

A Day to Myself

It is so nice to have a day to myself. I have absolutely nothing planned, nowhere to go & no one to refreshing. I have spent my morning putting my nclex books for sale on Ebay. I don't need them anymore! Woo hooooooo! May as well make some money, right?

I was so busy at work on Thursday night. I think it's because I told my preceptor "I'll take 3 patients from now on." What a difference it is from 2 patients...especially when one was a total care patient. I couldn't help but feel bad for him. He was a 72 yr old gentleman that is in end-stage renal failure & his AV shunt was clotted & infected. He came into the hospital a few weeks ago & has declined since then. It's sad to see that happen. In his room was his walker from home. After seeing him laying in bed, very confused & lethargic, it was hard to believe that he walked himself into the hospital just weeks ago. I don't believe he has been out of the bed since he arrived because his health deteriorated so much. He had an NG tube for feedings and because he was confused, we had to restrain his hands so he wouldn't pull the NG tube out. I don't like restraining people, even when it is in their best interest. It just seems so...I don't know the right words...I just don't like seeing them restrained to a bed against their will. The nurse I got report from was just awful. It made me question if he had even spent anytime reading the chart or even in the patient's room. He told me that the gentleman came in because of an infected shunt in his RIGHT arm, so they put a new one in his LEFT arm. That wasn't true, the infected shunt was in his LEFT arm & they put a new one in his LEFT arm because his right arm was ecchymotic & weeping a yellowish type fluid - I'm not sure what was going on with that. As we read through the doctors orders, we saw an order from TWO days ago to d/c his central line (because it was clotting) & put in a peripheral line. Where in the world did this doctor think we could put in a peripheral line? Definitely not in his left arm with the new shunt there & the right arm was totally off-limits with all that yellow fluid weeping out. Did the doctor even observe this patient??? Doesn't seem like it. Anyways, the real concern was why was this order not addressed on the day the order came in? We asked the day nurse & his reply "I never saw the order." What? Do you not read the chart? So what does my preceptor tell me - call the doctor & tell him it can't be done. Ummm....I'm supposed to just outright tell the doctor that? Is he going to be ok with that? It just sounded like I was setting myself up to be yelled at or at the very least, thoroughly questioned about a patient that I had just received a poor report from the day nurse. We paged the doctor, but (thankfully) he never called back. We did attempt to put an IV in, but it just wasn't happening. Looking back now, I should have documented all of that, but it slipped my mind totally. Now I know better. Charting is my weakness right now....when it comes time to chart, suddenly I can't think of the words to say & I'm usually good at putting my thoughts into writing. I'm working on it. Something else I forgot to chart on was respiratory. This poor man was practically drowning in his own fluids...he couldn't cough it up. We suctioned him, but couldn't get it all out. So I called the doctor at five am to tell him I needed an order for respiratory to suction & provide respiratory treatments. I'll talk about the dr's call a little later, but I did get the order. Respiratory came up, did what they could, but the man still had a terrible unproductive cough. I don't think I could ever be a respiratory therapist - it looks like torture when they do suctioning, not to mention the lovely looking fluids they pull out of people's throats...ugh. On top of all that, the day nurse tells me in report....look, his potassium level is 3.3 & that was at 5 am that morning. Why in the world did he not contact the doctor during the day?? The gentleman was on the potassium protocol, but that is only good for people with kidneys that function properly. So I had to contact a different doctor to get an order to help raise his potassium level. It amazes me that the day nurse had no clue what a low potassium level can do to a person - it can kill them! It was definitely an eye opener seeing that there are some nurses out there that just don't have a clue. They probably mean well, but that isn't going to make a person's health improve. This gentleman's temp had been as high as 104 during the day. There is a doctor's order that read "If temp is >101, get a blood culture & contact me for Ancef orders." We show it to the day nurse & his reply "I didn't see that order." I wanted to ask "Are you blind??" Since the patient's temp was down to 99 when I got report, we didn't contact the doctor. I definitely passed that important message to the nurse that took over after my shift in case his temperature did rise. It was 100.4 when I left. Did the day nurse not realize that a temp of 104 is not a good thing? I swear, he was the worst that I have encountered so far.

Well, next to the doctor phone calls. I don't know what it is, but it seems like 90% of the doctors on staff are from another country...which is fine, but I can't understand anything they say - especially over the phone. They talk so fast & with their foreign accents, I can only interpret like every 3rd word out of their mouth. When a doctor gives an order, we're supposed to write it down & repeat it back to him. That sounds nice in theory, but the doctor's usually don't want to take the time to have us read it back which I don't understand because it's in their best interest that the order is correct. This is what I hear "tkadjfaoireakfsaopokra, ok?" Huh??? Maybe it's cause I'm new, but I can't imagine ever being able to understand what these doctors are saying without the need to say "Can you repeat that?" Not to mention sometimes it's the middle of the night when I call & they are half asleep & mumbling their words. Hopefully in time I won't mind calling the doctor, but right now it's not on my favorites list.

My other patients were pretty easy to care for. One lady was in for chest pains R/O MI. She didn't have a MI, her labs were normal. I don't even see why she was still there after 3 days. She was asymptomatic, labs were normal & nothing was ordered for the following day. I had a new admit around 9 pm. He had been to his doctor that day & his pulse was 35. So his doctor sent him over for a direct admit. By the time he got to my floor, his pulse was 60 & he was asymptomatic. So he was pretty much an easy 23-hour observation. He was a very nice gentleman. I like doing admits...I like asking them 1,000 questions (on the admit form) & getting to know who they are & trying to make them feel comfortable with their hospital stay. I guess it's the customer service side of me from jobs in the past. He was in the same room as a long-time friend of my family. I don't think I told that story earlier...

I was at work a week earlier & the nurse's call bell rang. I looked at the screen & immediately recognized the name. He is a gentleman that was a really good friend of my dad's in the past growing up. He's known me since I was born! So I pick up the phone to see what he needed & he went on & on about something he bought in Chicago. That is not the norm...usually people call to say they have to go to the bathroom or need pain meds, etc. So I go into his room to see if he recognized me as I probably haven't seen him in about 10 years. He didn't recognize me, he was confused & just kept going on about this story from Chicago. That was so weird to see - someone I had known for a long time to be so disoriented. Anyways, when I came into work on Thursday, he was so much more with it & he immediately knew who I was. It was nice to see that he wasn't confused although at one time during the night he had gotten up & I thought he was trying to climb into bed with my patient! That wouldn't be the first time a patient has done that...that is one reason I don't like the semi-private rooms. You never know who your roommate is or what condition they may have. At my old hospital, every single room was a private room so I got used to it. Never had to worry about someone invading someone else's space. Most hospitals are not like that though, so I will get used to the semi-private rooms.

Anyways, the night flew by. I don't know how I'm going to be able to care for 5 patients. So much paperwork!!!! I guess it takes time to learn how to be organized. Tuesday is my last day of class...yay! Freedom at last! Now it's just work, work, work & I'm looking forward to it! I have a light week next week...I work on Sunday & Saturday, have class on Tuesday & many days off inbetween. I'm looking forward to have a few days off in a row.

Suddenly I am craving a peanut butter cookie - a nice, warm cookie. Hmmm...where can I get one of those? I'm really trying to eat better because I got on the scale earlier in the week & did not like what it said. So I've been eating pretty well since Wednesday & managed to lose the extra pounds I had gained this month. Now I just need to continue eating well & add in exercise so I can get rid of the rest that I need to get rid of. Easier said than done, right?

Tuesday, March 8, 2005

Another year older

I turned 36 yesterday!  I spent my birthday playing volleyball & then going to Chili's for dinner & drinks.  I'm going out tonight with my best friends to dinner & to see "Be Cool."  It's nice to finally have a full day & night off.  I feel like I've been working, working, working.

I had 2 patients this weekend for both nights.  One was a very sweet older lady that adored me.  She told me many times how wonderful I was & how I was taking such good care of her.  She was in the hospital because of pneumonia & at that time they also detected that she was low in potassium.  She was really easy to care for.  When I was leaving yesterday morning she was asking when I was working again.  I told her not until Thursday & hopefully she will be home by then.  So she asked for my name & address on a piece of paper.  I wasn't sure what to do or what the hospital policy was on stuff like that.  I ended up writing it down & giving it to her.  I didn't see anything wrong with that.  I figure she just wants to send me a thank-you card.  After I did that, she asked if she could give me a hug.  So I gave her a little hug & she says "I love you."  It was sweet.  It was nice to be appreciated.  If only all patients could be like that! 

My other patient was someone that I had first encountered in the ICU when I was a student last fall.  She's a 41 yr old woman that had a heart attack & a stroke while she was sleeping.  Needless to say, she is no longer herself.  She is pretty much unresponsive.  She has a trach & can breathe on her own, but her mind is disconnected from her body - the body is just doing what it's programmed to do - make the heart & lungs work.  It is no longer getting signals from the brain.  She has a peg (feeding) tube & her hands & feet are starting to have contractures.  She has been taken home only to return to the hospital because of infections.  The day nurse said to me "The husband is in the room & he won't leave until he meets you & trusts you can take good care of her."  I was thinking "Uh oh, I've never cared for a patient in this type of condition, how am I going to get him to trust me?"  My preceptor told me to go in there on my own & do an assessment - she didn't want to go in with me & let on that I was a new nurse because he might not allow me to care for her.  So I went in & he says "Are you here to care for my angel?"  I told him yes.  He asked if there was anything I wanted him to tell me about her.  I replied "Anything that you would want me to know."  So he went over some things & about 15 min later he said he was going home - so I guess I passed his test.  I took good care of her. It's sad to see someone in that condition - especially as such a young age.  That's why people should have living wills - take the responsibility & guilt out of your family's hands.  I don't think anyone would want to live that way.  I had my parents & one of my brothers & myself fill out a living will so that the decision has already been made should we ever encounter something like that cause you just never know.  It reminded me of the Terry Schiavo situation.  15 years on a feeding tube & no real sign of brain activity.  My patient's family still believes that one day she will wake up & everything will be back to normal.  The husband was showing me pictures of her before this happened.  Just so unreal that you could go to bed & never really wake up. 


Wednesday, March 2, 2005


Woo hoo!!!!! I did it - I passed the state nursing board exam - I'm an RN!!!!!

It still hasn't really hit me, but I am happy. Gina passed also. We found out around 11 am. I already picked up my work badge that says RN on it. It's been a long 2 1/2 years, but I finally feel like I've accomplished something very worthwhile. No more studying, no more practice nclex questions....freedom!!!!!! In fact, I'm going to start selling my nursing books & nclex study guides on Ebay - I'm tired of having them around the house.

We had grad class today - so boring. A respiratory therapist came in to talk to us about ABG's - the thing is, we already knew everything he was attempting to teach. It seems like this entire "grad class" has just been focused on information that we already know. Do they not realize that they do teach us stuff in nursing school? I wish they would teach more real world things - like how properly call a doctor: what kind of info is he/she going to want, what should we be anticipating, etc. Also, how to handle a difficult patient or family member or how to handle a patient and family who has just been told the patient has a terminal illness. Those kind of situations would be a lot more helpful than what they are currently doing.

I took Kelly to the airport a little while ago. Ivan is coming back from Germany & they are spending the next couple of days in Cocoa. She was all dressed up....dress & heels even. I'm happy for her - hope things work out. I can't believe they are engaged!

I should be out celebrating, but I am tired plus I have a busy week ahead. I work tomorrow night, have my birthday "party" Friday night, work Saturday & Sunday night, my birthday & volleyball on Monday night.....soooo I am staying in tonight & relaxing - and breathing a sigh of relief. :)

Tuesday, March 1, 2005

La da di, la da da - patiently awaiting

Is it Wednesday yet??? I want to know the results of my nclex exam. I've been keeping busy...playing volleyball, running errands, watching tv...patiently awaiting the results to see if I'm an official RN or not. I have grad class tomorrow & I know my classmates will be asking the results. Ohhhhhh, I hope it's good news.

My 36th birthday is on Monday. Where has the time gone??? Ok, time for me to go find something to do so it keeps my mind off this waiting game. Hopefully the next time I post on here, it will be happy news!