Wednesday, May 11, 2005

All in all

It's mid-morning Wednesday & my work week is complete.  I like working Sun, Mon & Tues - gives me the rest of the week to do as I please. 

I had a very good week - no real problems.  In fact, I think I was the only one on my floor not running around all crazed the first couple of hours at shift change.  I had 5 patients my first night, then 4 the next two nights.  That's another thing I like working 3 days in a row - often times your patients will be there for awhile & getting report is short & sweet.  As soon as report is finished, I do my assessments & then come back & start charting.  Next I get my meds that need to be passed between 8 & 10 pm.  By 11 pm, I'm all caught up on my charting & paperwork - ready to give report to the clinical leader & then spend the rest of the evening checking on my patients, looking up results in the computer or simply relaxing.  I realize that it's not always going to be an easy week like this, that's what makes me appreciate it.  Last night I spent a couple of hours making up a new report sheet.    How exciting!

My first patient was a 72 yr old male that had gone to his doctor's office first because of chest pain.  The doctor told him he needed to go to the hospital for a carotid study.  Turns out his carotid arteries are 50 to 70% blocked & he'll probably be having surgery either today or tomorrow.  He had an arteriogram done last night & I'm sure he was so very tired of me continuously assessing the puncture site & his pulses as well as his vital signs. 

My next patient was an older woman admitted with left DVT.  A greenfield filter was put in place & I'm not really sure why she was still in the hospital.  Her H&H were low so she was given 2 units of packed RBC's.  Nothing was ordered for today.  Turns out she goes to the same doctor I do which is probably the doctor most feared by the nurses because I hear she can be rather rude both in person & on the phone.  I have not had to deal with her personally from a nurse's perspective, but she's always been a good doctor to me.  Should be interesting when/if I ever have to call her in the middle of the night.

My third pt was an older man that had come from the ICU.  I can't remember exactly why he was admitted, but he was a grumpy fellow.  Luckily he was discharged before I went in last night.

My fourth pt was a 40 yr old male that came in because he had tripped & fallen while fishing & hurt his leg.  When he was in the ER, he also told them that the day before he had chest pain.  He had a heart attack in the past (drug related) & has a family history of death via cardiac disease.  This guy loved to talk!  I think I know his entire life story by now.  He was inspiring though, he went from being a drug addicted criminal to "being saved" & now spreads the word of hope to others. 

I had another patient on Sunday night - a 64-yr old woman that came in with chest pain.  Turns out her husband died a month ago & she has not been able to sleep much at all.  She is very anxious & emotional.  She was having difficulty breathing, so I called her Dr. to get an order for a breathing treatment.  He was giving me medication orders & as he was ordering Xopenox, my clinical leader was whispering to me that only pulmonologists can order that medication.  So I inform the Dr. of this & tell him that the pharmacy will automatically change it to Albuterol & Atrovent.  He starts ranting & raving about how no one is allowed to change his order, asks me who made up this stupid rule & proceeds to say that if anyone changes his order - he'll come down there & make them change it back.  I wanted to laugh.  He sounded like a 2 yr old having a tantrum.  I played it off well though, basically telling him I understood but just wanted to let him know that pharmacy would change it.  He ended up ordering the Albuterol & Atrovent after all.  I got respiratory up there right away to give her a treatment & she kept thanking me over & over.  I didn't have her as a patient the next night, but the nurse that did have her started telling me a story about the husband that passed away.  It turns out that I watched him during a code blue back in April.  I'm sure I probably wrote about it on here - he came in fora simple cholecystectomy (gallbladder surgery) & he passed away later that evening.  :(

And my newest pt that I got last night (I sound like I'm talking about something I bought at a store!)...another older male in with chest pain & difficulty breathing.  His cardiac enzymes were negative & he has an echocardiogram scheduled for today - so not really sure what is going on with him. 

All in all, it was an easy-going week.  The big picture is starting to make a little more sense day by day.  I have the opportunity to work overtime this week as well as the rest of the month, but I haven't decided yet.  I am looking forward to enjoying a day off & relaxing.  As my one patients kept saying to me for the past 3 nights - "God bless you!"  Bye!

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