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 damn...it 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 her...in 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 though...so 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!