Ahhh, in the past week, I have worked over 80 hours (what's wrong with me??? lol). Now I have 7 days off to relax & recuperate. There was a staff meeting at work yesterday. They went over the new policy of being in the staff breakroom at 6:45 prior to shift change - no later. Which is fine with me. I get there around 6:05 anyways. Rather be early than late. They reviewed the unit's gallup scores again & showed us what type of remodeling they are doing on the second floor. All in all...it was boring. And there's always one person that asks an off the wall question that has nothing to do with the topic at hand. This time it was chest pain from cocaine & how he thinks we should send everyone to rehab. Yeah, ok.....discuss it on your own time.
My night went pretty well though. I had one patient whose blood sugars had been in the 300's & 400's all day...so the doctor ordered "no bedtime snack." Well, his blood sugar at 2200 was 60. So much for the "no bedtime snack." I gave him some graham crackers, peanut butter & low-fat milk. That got him up to 67. Gave him a turkey sandwich & more milk & he made it up to 138. Perfect as far as I'm concerned. By the time morning labs were drawn, he was up to 255 & counting.
I had 5 patients last night...all pretty much easy to care for. My new admit was this undernourished older woman. She came in with pneumonia, hip fx, diarrhea & dehydration R/O c-diff. She was confused when she got to the room, was saying mean things to the ER nurse that brought her up. I got her situated, assessed, talked to her for a little while, made her comfortable & she was praising me. :) I had another patient the night before that kept telling me that I was a good girl & she wished she could take me home with her. Awwwww! I think some of these patients just really need someone to sit down & give them a few minutes of their time & show them that they care.
Anyways, my pt above only weighed 85 lbs, was pretty much justskin & bones. She had multiple skin tears all over her body & all the nursing home was doing for her was covering them with tegaderm. Who knows how long those had been on. I informed my clinical leader that we needed to take pictures because she was in real bad shape. The x-rays also showed that her left hip was broken - but it's not a new fracture - it's old. So who knows when or even how she actually broke that hip. Sad!!! It's weird how some patients can be so confused, yet as I was walking by her room - I heard her reciting prayers & she knew them word for word. I ended up giving her some Ativan because she was rather anxious & kept pulling off her gown & the leads to the heart monitor. That calmed her down & allowed her to rest a little bit.
We had another patient on the floor that wasn't mine, but he was confused also. So confused that not only did he repeatedly try to get out of bed, but he began to be combative. They put him in wrist restraints & called his wife in to help reorient him. Instead of reorienting, he began to tell his wife how he was going to kill her & was yelling at her to leave. This poor little old lady was so shook up & saying "He's gone crazy!" I felt for her - I couldn't imagine what it's like to hear your husband of many, many years speaking like that. Hopefully they'll figure out what's going on with him because he was not like this 2 days ago.
It was a much calmer week compared to last week. I'm thankful. The administrative staff irritated me though. I requested to work on the second floor & they wouldn't let me. They gave me a b.s. excuse. I would have rather them just straight out say no than lie to me with a dumb excuse. It's like they simply don't care about their staff. The hospital morale is so low - I couldn't imagine why!
On a brighter note, I have an interview with the other hospital on Tuesday morning. Gina has one also. They are a better hospital - one of the best in the area as far as cardiac care & that's what I want - to learn more about the critical care of a patient as well as be able tocompare hospitals & the way things are run. Should be interesting!