Saturday, October 28, 2006

Taking a Breath

I only have a I'm on my way to bed this morning. I've worked 5 nights this week...tonight will be my 6th. I'm tired, but it really hasn't been bad at all. My patients have been relatively stable. I'll go into more detail when I have the time...just wanted to say hi & have a great weekend!

Monday, October 23, 2006

Not So Bad charting is not so bad.  The night started out a little rocky for the agency nurses as they were having a hard time signing on (I was the only staff nurse on that part of the floor out of 7 nurses), but I was in like flynn.  Much, much better than handwriting.  I'm not sure I'm documenting everything correctly, but I did my best. 

It seems like our hospital is back to having very few staff nurses & 75% travelers or agency nurses.  So many new faces & names, I can't keep track.

I managed to stay at 3 patients for the night.  We were told it would remain like that for 2 weeks...but not even 6 hours into the shift, some nurses were getting a 4th patient.  Supposedly next year, our new budget shows that we will only have 4 patients maximum.  I'll believe that when I see it.  Watch, we'll end up with 6.

Anyways...I had one patient that I really can't say much about.  It's a very sad case...a simple procedure that went very wrong.  The reason I'm not comfortable writing all that much about it on here is because I feel that a lawsuit will be brought forward & I wouldn't blame the family one bit if they make that choice.  Therefore, I'm not writing anything regarding specifics....just in case.

My second patient was an elderly man with a history of dementia.  He was a handful.  He was wonderful when he was sleeping, but so off the wall when he'd wake up.  He'd start yelling & telling very odd stories.  Like the first time, he kept trying to wake up the person he was sharing a room with - so much so - he'd throw his pillow at the guy.  He was demanding that they make a movie together.  It was like dealing with a 2 yr old.  Eventually he went back to sleep for a few hours - I went on break, only to have another nurse call me & say I need to get back, my patient is attempting to jump out of bed.  I get back & he's at the end of the bed saying he is an inspector & he needs to inspect the building immediately.  He was convinced it was about to fall apart at any moment.  There was no talking sense in to him. It wasn't too long before he fell asleep again.  Dementia is a sad disease - he truly believed everything he was saying. He was in with a UTI and sepsis, but seemed to be improving medically.

My third patient was an older lady with pulmonary embolisms.  She was very independent, didn't want to be bothered & would call me when she needed me.  I love those kind of patients. 

So yet another pretty easy night.  I have volleyball tonight & more than likely back to work tomorrow night.  I need to get some overtime in to rebuild my savings account so I can take some time off at Thanksgiving & Christmas.  Hope everyone has a happy Monday!

Sunday, October 22, 2006

Today's the Day!

October 22nd = the day my hospital switched over to computer charting...ahhhhhhhh. The day I've been waiting for. I hope it's a smooth transition & that it beats handwriting hours & hours of charting. Maybe now, my writing hand won't look so deformed with the

Supposedly we are only supposed to have 3 patients each during this transition period. I'll believe it when I see it. Rumor is...there will be chocolate Such healthy rewards! We always know something not so great is up when there is chocolate around.

I'll let ya know how it goes!

Friday, October 20, 2006

Off Topic - Sheriff Daniels

It wasn't supposed to end this way. It was supposed to be a great evening....a fun way to raise money for charity. It was the 5th year this fundraiser was held. "The Battle of the Badges" was the name & it entailed the local Sheriffs gathering at a race track - all in fun. They raced old school buses - mostly for raising money, partly for bragging rights.

Something went terribly wrong that night. Sheriff Chris Daniels bus was hit from behind. Somehow he was ejected from the bus & was run over by his own bus as well as the bus that originally hit his bus. By the time anyone could get to his side, he was already gone. Just like that.

His funeral was held today - it was televised - it was touching. I didn't know the Sheriff, but I've seen him enough times on tv to know who he was & how good of a Sheriff he was. I still can't believe he died this way.

October 14th = the day he was born & the day he died...on his 47th birthday.

R.I.P. Sheriff Chris Daniels

Thursday, October 19, 2006

The Last Name Sounded Familiar

I worked one day this week...whew, I'm exhausted.  Ahhh, not  I'm resting up for all of the overtime I'll be putting in the next 2 months.  We go "live" with our new computer system on Sunday.  I went ahead & asked to be added on that night - partly because I want to be there when everyone is "new" at it & trying to figure it out and partly because there is a rumor we will be given pizza & chocolate all night  Is there a nurse that doesn't like chocolate???  Heck, is there a woman that doesn't like chocolate????? 

I had another good, easy night.  I had 4 patients and was due to get a 5th, but luckily we never got the call from ER for anymore admits.  Two of my patients were women & every time they had to use the bathroom, they'd call me for assistance.  That was fine with me, I'd rather help them than risk a fall - especially since they both had to drag their IV poles with them.  We had 4 male nurses on the floor last night & by the end of the night, they were saying "Why do your patients always call you when they need to go to the bathroom?"  I jokingly replied with "It's a girl thing, we like to go to the bathroom together."  They laughed.  I like my co-workers, they are so easy to get along with. 

I also had two male patients who were sharing a room.  One was as silent as could be, the other - he more than made up for the other one being silent.  He talked & talked & talked.  One time when I was walking by, I saw our respiratory therapist in there talking to him.  Well, he was talking to her, she was just listening.  I could tell she wasn't able to get out of there so I said "Hey, can I talk to you for a minute?"  She walked out of the room & kept thanking me the rest of the night.  It's not that we don't like talking to patients, but we need time to do our job also.  I went back in later & he had on "Dancing With the Stars."  We bonded over  I told him to let me know who got kicked off.  About a half hour later, the PCT says "Your patient wants to talk to you about Dancing With the Stars."  He couldn't wait to give me theresults which ended up no one being kicked off last night. 

It was a simple night for all of us.  As I was giving my 6 am meds to one of my female patients...I stood back & watched her take them.  She's a woman in her 60's who has lung cancer.  Her blood pressure was extremely low when she was seeing her doctor that day so he sent her over to the hospital.  The last name sounded very familiar to me.  She's been to the hospital numerous times because of the cancer.  I still couldn't place her - she didn't physically look familiar to me.  Then she turned on her tv & watched the shopping all came back to me.  Months ago she had been sharing a room with a patient I was assigned to.  I remember the tv always being on the shopping network.  I also remembered that her husband was always at her bedside - catering to her - such devotion.  I found out last night during report that her husband passed away not too long ago.  How heartbreaking.  So as I stood back & watched her take her pills, I thought about how much I take for granted.  Here she was struggling just to pick up a pill & swallow very slowly, I had to split the pills in half for her.  It took her about 5 minutes to take 2 pills.  I don't want to say I felt sorry for her, because sorry isn't the right word.  I sort of wished I could make everything better for her, but I can''s not possible.  That's the part of nursing I don't like - with some patients, you'll never be able to improve the quality of their life.  You'll never be able to have them smiling or feeling happy - no matter what you do.  So I did what I was able to do - treat her the best way possible, make sure her every need was tended to & that if she needed anything, I would be there to help during the shift. 

It's another weekend with my niece...her birthday is getting close, not that I need that as excuse to spoil  Have a good weekend everyone!

Monday, October 16, 2006

Called off

I worked Wed, Thurs & Fri last week. I was supposed to work Sat night also, but they called me off. I was happy, mostly cause I was tired & could use the extra sleep. I'm probably the only person that is thrilled when they get called off. :)

I had another easy week - it's sort of scaring me because it has been so easy. I didn't have to call a doctor at all the entire week. My patients were stable and alert & oriented...except for one on my last night. I'll get to her later. Another patient came in with dehydration, admitted to med/surg...well they ended up overhydrating much that she went into pulmonary edema & transferred to my floor. We ended up giving her Bumex (diuretic) round the clock - the poor lady - I don't think she slept for more than an hour at a time with as much as she had to void. She maintained a great attitude through it all. She kept calling me her angel. She couldn't wait to introduce me to her family. She was being discharged on my last night & as much as I was happy to see her leaving because that meant she was better, I sort of wanted her to stay another night. It's rare to get a patient with such a great attitude.

We had another female patient on the floor that was the total opposite. She thought we were there to cater to her every need & normally I don't mind helping, but when they overdo it - it makes me want to do less & it wasn't even my patient. I don't like drama & I especially don't like when a person that is perfectly capable of taking care of themselves, sit back & ask for you to do what they are able to do. That's one of my pet peeves - people that take advantage of the system & would rather remain or pretend to be sick just so that others will take care of them. I see it at the hospital, I see it in patients that go home. I guess they like the attention &/or they are just too dang lazy to do things for themselves. They milk the system, but it ends up that they are mostly hurting themselves because the people helping will tire of it eventually & they'll be left to fend for themselves & not be able to do it. I couldgo on...but I won't. I'm sure anyone reading this knows exactly what I mean.

On my third night I got report on a woman in her 90's that was pretty much in a coma & the end was near. Her family had been contacted & told of this change in her condition...their response = call us when she dies. I try to understand what kind of family can do that to their family member, but I'm unable to understand it. I don't know how they can live with themselves knowing they had an opportunity to be with her, but choose to let her die alone or die with only the hospital staff around. Perhaps they can't handle being there or they think it will be much worse than it is...I don't know. It seems cold-hearted to me, but that's probably because I am not afraid of death....not a peaceful death anyways. Her heart rate was in the mid-30's, low 40's when I took over care & it remained there through the shift. Her breathing was getting more labored & for some reason they were filling her with fluids & she had practically no urine output. I turned off the IV fluids - she didn't need them. Her skin looked like it would pop like a balloon if you stuck it with a needle - she was third spacing. The family wanted us to give her morphine, but I didn't - she wasn't showing any signs of being in pain & her blood pressure was like 65/30. Morphine would have just pushed her over the edge & I wasn't going to be the one to do that. Her K+ (potassium) level was 6.4......I was surprised she made it through the night. I have a feeling she probably passed away sometime during the day shift. I'll find out when I go back.

This is the final week of handwritten charting. We switch over to the computer system on Sunday. I'm debating about whether to work that night or not - I have a feeling it's gonna be a mess. They did listen to Gina & I and came up with a report sheet so that change of shift won't be so difficult.

I got a flu shot last week also - I haven't been sick in a few years now...which is amazing, but just in case...I don't want the flu either. That's the nice thing about being in healthcare...all of your immunizations are

I've been relaxing today - it's overcast, the temperature is getting cooler...finally feeling like fall. I have volleyball tonight & after that I may see "The Guardian." I'll see how I feel after volleyball. Hope everyone had a great weekend & also hope you have a good week.

Tuesday, October 3, 2006

"You're An Angel"

I heard those words repeated often this past week & you know never gets old & I never get tired of hearing it.  If anything, it reminds me of just how much you can impact another person's life.  I think I was actually getting spoiled with all the compliments!  I also got plenty of hugs - probably the most ever since I got into nursing. 

It was a relatively simple week & you know what...I'm actually enjoying working the  Who would've thought?  Of course I can't tell administration that because they don't want their staff happy.  They would probably ban me from working weekends if they knew I liked it...seriously!!!  What I enjoy most about the weekend nights.....absolutely no doctors & no administration around.  It's fantastic. 

Wednesday & Thursday nights were hectic - I don't think I actually sat down until after midnight to start my charting.  Friday & Saturday made up for it - I had everything done, charted & completed by 10 pm.  The only drawback to having everything done so early is that the time ticks by so slowly.  But the good thing about it - I actually got to spend some time with my patients taking care of them & not just zooming in & out of their rooms to catch up with everything. 

The patient that stands out the most for me was an older gentleman that came in with a hip fracture.  He had fallen out of bed at home & broke his hip.  Hopefully he'll fully recover & go on to live out the rest of his life...but the odds are against that at his age.  I read somewhere that something like 50% of the elderly pass away within 6 months of having hip or knee surgery.  I'm not quite sure why that is...blood clots maybe, I don't know.  He was pretty much out of it when I took over his care as he had received a strong dose of morphine right before shift change.  His wife stayed the night & I actually learned a pretty darn good tip from her...she had a muscle cramp in her calf in the middle of the night so she asked me for a packet of sugar.  She swallowed the sugar and within 60 seconds, her muscle cramp was gone.  She also told me about her doctor telling her that if she or her husband get a low blood pressure reading, to put some salt in their hand & a glass of water in the other hand...lick the salt (like doing a tequila shot) & then drink the water - it raises the blood pressure according to her.  Trust me - I'm not giving out medical advice here whatsoever, just sharing what she told me.  I don't know if this actually works or not.

The next morning the surgeon came in, scheduled surgery and by the time I came back Thursday night, he was just getting back from surgery.  He was pretty much out of it.  I reassured his wife I would keep a close eye on him, told her to call me anytime - even if it's 3 in the morning.  Which she did & I'd give her an update on how he was doing.  Little by little he was improving.  I think he must have thought I was a crazy nurse - practically everytime I interacted with him, it was to get him to take his pills that I had crushed & mixed with apple sauce.  I always had a spoonful of apple sauce to feed him...the poor guy had to wonder what was wrong with me.  I was either making him eat apple sauce or talk to me.  I don't think he minded though - I got a smile out of him every now & then.  Hopefully he's recovering well & maybe even out of the hospital by now - I hope. 

I think out of the 4 days, I only had to call a doctor one time & that was just for some Benadryl.  I almost had to call for my fractured hip patient.  His heart rate was constantly jumping up to the 140's - even on a Cardizem drip.  I'd wait it out because it would also drop right back down to 80 for no reason.  Every time I was about to give up waiting for it to drop & had my hands on the phone ready to dial - I'd look at the heart monitor screen one last time & his heart rate would be back in the 80's.  Every single time!  They ended up starting him on Digoxin & that did the trick. 

It's been a good weekend...Tony Stewart won the race on Sunday even though he had run out of gas.  He just coasted to the finish line to take 1st place...woo hoo.  That means I owe my niece a trip to Libby Lu's.  I told her at the beginning of the season that anytime Tony Stewart wins - she gets rewarded.  Lucky girl.  I played volleyball last night & we won again.  We're undefeated.  I am so glad I got back into playing.  It feels good.

My sleep schedule is still really screwed up - so I will go finish watching some movies I got from Netflix.  They have really good rates & the movies get to my house quick.  A lot better than Blockbuster. 

Hope everyone is having a good week.  I can't believe it's Tuesday - it feels like a Friday to me. :)