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!