Friday, August 15, 2008

Did I Do the Right Thing?

I haven't done a good job at keeping up with my blog. Sorry! It seems like the older I get, the faster time goes by. Let's do some updates...

I started my new job at the other hospital. It's ok. It makes me appreciate my hospital. I'm not sure it's so much that my hospital is better, just different and what I'm used to. Not to mention the other hospital just started the team nursing concept and the staff there is not very enthusiastic about it. So I have only been there 2 days for orientation - which really isn't much of an orientation since they are not even sure what they are doing yet with this team nursing concept. I think I actually would prefer not being on orientation so that I can do my own thing without having someone checking up on me every hour. This is what I like about nursing - the independence. I don't want someone looking over my shoulder or secondguessing my choices. I am not shy about getting opinions if my patients needs require more than my own opinion...but I don't want someone telling me what I should or shouldn't be doing. Example...I had a patient at the other hospital that wanted an 1 am. Sorry, I'm not calling and waking a doctor for an antacid - it just isn't happening. My "preceptor" wanted me to call. I'm not calling...nope, never. So she discussed this with our medication nurse (another person on the team) and they decided to give the 9 am dose of Prilosec. Fine - it's your decision, I'm not having any part of it. Not more than 30 seconds after they gave her Prilosec - she was asking for food. FOOD! Now did she really have indigestion? Did she really need medication at that point? I would have offered her ginger ale and crackers or something of that sort. I think they ended up giving her coffee and who knows what else. And to think they wanted me to wake a doctor over this. @@

I have to call tomorrow and let them know when I can work again. My main focus is my hospital, this other hospital will just be to fill in. It works - and it shows me that I do have the confidence it takes to make it somewhere else. It also helps that they use the same computer charting that we do.

I appreciate my co-workers even more now that I have spent a couple of nights with virtual strangers. I spend more time with my co-workers than anyone else (isn't that a sad fact?), although I doubt I'm the only one that does this. Seems like anyone with a 40 hr or more work week can say the same.

We had a code last week that was just plain sad. I'm still thinking about this gentleman and it's over a week later. I had him as a patient on a Sunday. I had been warned he loved the call light and used it non-stop. I was hoping he would get some sleep that night, but as it turns out, he felt miserable. Nauseous, constipated, dry mouth, uncomfortable, etc. He wasn't a big guy, but he did have a big belly and no matter how we situated him in bed, he didn't look comfortable - his belly just seemed to make it difficult for him to breathe. I believe he was in with congestive heart failure and respiratory failure. I offered to get him some nausea medicine and he turned me down. All night long he was calling and reporting how miserable he was feeling, but no matter what I offered - he didn't want it. After 12 hours of that, I informed my clinical leader that I did not want him back as a patient the next night. We are allowed to do that - to request not having the patient again. Monday night he did much of the same with the other nurse he got. By Tuesday night, he was in worse shape than ever. The pulmonologist came in around shift change and ordered for him to be transferred to ICU.

Right as the nurse was getting ready to move him in his bed to ICU...his heart rate dropped from 115 to 52. A code was called and although they managed to save him, it was only temporary - he passed away about 2 hours later. His family was able to get there before he passed, but there are no words to really comfort them. It stopped me in my tracks and made me reevaluate my decision to not want to be his nurse after the first night I had him. Does that make me a bad nurse? Or a bad person? I know I'm human and one can only take so much...but was it fair of me? Was I fair to him? I reflect back on the things he talked about to me that Sunday night - about how he was the one that usually took care of his wife and that he was afraid he wouldn't be able to do that anymore - that he would end up in a nursing home and who would care for her? I tried to be encouraging and tell him that he would get better and be able to return to her, but was that the right thing to say? Should I have said anything? Should I have simply encouraged him to talk more about it? I don't know that there is a right answer. I guess, like life, nursing has it's learning and learn. Try to do better next time. This is the hard part of nursing - the emotional side - the stuff you can't learn from a book.

I've been off of work since last Wednesday - it's been a nice break. I've enjoyed the Olympics - go USA! If there's one thing I've learned about the's that the Chinese women sure do like to put a lot of hair clips in their Am I the only one noticing this? Michael Phelps is amazing - he makes it look so easy. I love the Olympics!

Have a good weekend everyone!

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