Friday, December 8, 2006

Setting a record

Yawn!!!!!!  I'm sleepy.  I've worked the last 7 nights straight & am scheduled for tonight & tomorrow night also.  It's a new personal record for me for the amount of nights worked in a row.  I'll probably continue to work through next week...makes me feel less guilty about taking 2 weeks off at Christmas...not to mention the money.

Luckily my patients have been very stable for the most part & I've had it easy.  I only had one critical incident in which the morning labs revealed a 6.9 potassium level.  Normal is 3.5 to 5.  Anything above 5 is definitely not good.  6.9 is very, very bad.  The doctor prescribed an amp of calcium gluconate, an amp of D5,10 units of regular insulin IV as well as a nebulizer treatment.  I had never heard of that "cocktail" before, but works quick.  I pushed the meds at 6:45 am & they rechecked the blood at 7:05 am & her potassium had gone from 6.9 to 5.3.  So I learned something new about how to get the potassium out of the bloodstream & back into the cells very quickly.  I'm hoping this patient goes home today.  She is a drug seeker & the doctor wrote no narcotics allowed for this patient.  Then he also wrote for a strict diet since her potassium had been so high.  Needless to say, she was not a happy camper. 

The rest of my patients have been wonderful to care for.  I've had one for the last 7 nights.  Poor lady...she has pancreatitis as a result of her gallbladder not working properly.  The gallbladder needs to come out, but they can't do that until her amylase & lipase (pancreatic enzymes) return to normal....only they aren't returning to normal.  They started to come down, but all of a sudden they are going back up.  She went 7 days/nights without eating (doctor's orders).  They finally started her on PPN.  She just wants to go home...she's young, in her early 40's.  She has a good attitude about it though.  I'm kinda getting attached to the sense that I want to see her get back on the road to recovery & be at home with her family.  Maybe there will be some good news when I get back to work tonight.

I also had one of the sweetest patients ever & he wasn't even trying to be sweet....I think that's why I think he's so sweet.  He's 90 yrs old, totally self-sufficient!!!  He said to me the first night I admitted him with chest pain..."I hope I don't bother you too much."  Gotta love a patient that doesn't think you are their personal slave.  He'll probably go home today I'll most likely have a whole new group of patients.  Hopefully my nights will continue to go well. 

Ok, I'm off to get some sleep.  Hope everyone is doing great!


1 comment:

steveb2221 said...

hi... glad to hear things are going well for you... you deserve to take 2 weeks off after this marathon... the d50/insulin cocktail works because they open the transport sites in the cells, and let the circulating pottassium transfer into the cells, where it doesn't hurt anything...I also gave kayexalate with it the last time i used this... thankfully I was leaving 20 minutes later and didn't have to deal with the "aftermath"  happy holidays... Merry Christmas and all that jazzy stuff.