70 Things

I'm not sure everyone wants to know this much about me, but here goes...

70 THINGS YOU PROBABLY DON’T KNOW ABOUT ME

1. DO YOU SNORE? - I hope not!

2. ARE YOU A LOVER OR A FIGHTER? - Lover

3. WHAT’S YOUR WORST FEAR? - Losing someone close to me

4. AS A KID, WERE YOU A LEGO MANIAC? - I wouldn't quite classify myself as a maniac, but I did like my legos - I used to build a hospital all the time, no joke...lol

5. WHAT DO YOU THINK OF “REALITY” TV?- I like it, well most of it

6. DO YOU CHEW ON YOUR STRAWS? - Nope

7. WERE YOU A CUTE BABY? - Oh yes...lol

8. IS THE SINGLE LIFE FOR YOU? Since I'm still single, I'd have to say yes...but it would be nice to meet someone wonderful

9. WHAT COLOR IS YOUR KEYBOARD? grey

10. DO YOU SING IN THE SHOWER? - Nope

11. HAVE YOU EVER BUNGEE JUMPED? - No way

12. ANY SECRET TALENTS? - Uh huh...shhh, it's a secret

13. WHAT’S YOUR IDEAL VACATION SPOT? - a nice beach

14. IS JAY LENO FUNNY? - He can be

15. CAN YOU SWIM? - Yes, since the age of 4 I believe

16. HAVE YOU SEEN THE MOVIE “DONNIE DARKO”? - Yes, long time ago & don't ever plan on watching it again

17. DO YOU GIVE A DAMN ABOUT THE OZONE? - Yes

18. HOW MANY LICKS DOES IT TAKE TO GET TO THE CENTER OF A TOOTSIE POP? - Too many

19. CAN YOU SING THE ALPHABET BACKWARDS? - Definitely not

20. HAVE YOU EVER BEEN ON AN AIRPLANE? - Yes

21. ARE YOU AN ONLY CHILD? - I have two older brothers

22. DO YOU PREFER ELECTRIC OR MANUAL PENCIL SHARPENER?Either

23. WHAT’S YOUR STAND ON HUNTING? - I don't like it

24. IS MARRIAGE IN YOUR FUTURE? - Only God knows

25. DO YOU LIKE YOUR HANDWRITING? - I wish it was better

26. WHAT ARE YOU ALLERGIC TO? - No known allergies

27. WHEN WAS THE LAST TIME YOU SAID, “I LOVE YOU?" – Earlier in the week to my niece

28. IS ELVIS STILL ALIVE? - No way

29. DO YOU CRY AT WEDDINGS? - I haven't so far, am I supposed to?

30. HOW DO YOU LIKE YOUR EGGS? - Scrambled

31. ARE BLONDES DUMB? NOOOOOOOO!!!!!!!

32. WHERE DOES THE OTHER SOCK END UP? - Good question

33. WHAT TIME IS IT? - 10:02 am

34. DO YOU HAVE A NICKNAME? - Jen, Jenny, Jennerizer, Jenny the Great...lol...it's true!

35. IS MCDONALD’S DISGUSTING? - Noooo, love McDonald's fries

36. WHEN WAS THE LAST TIME YOU WERE IN A CAR? – last night

37.DO YOU PREFER BATHS OR SHOWERS? - Showers

38. IS SANTA CLAUS REAL? - If you don’t believe, you don’t receive.

39. DO YOU LIKE TO HAVE YOUR NECK KISSED? Mmmmm

40. ARE YOU AFRAID OF THE DARK? No, love the dark

41. WHAT ARE YOU ADDICTED TO? Caffeine at the moment...and junk food

42. CRUNCHY OR CREAMY PEANUT BUTTER? - Crunchy

43. CAN YOU CRACK YOUR NECK? - Not on purpose

44. HAVE YOU EVER RIDDEN IN AN AMBULANCE? Yes, once, back in 1996, it was a dark & stormy night.....just kidding! I had a gallstone attack - only I didn't know I had gallstones at the time & thought I was dying, plus I figured it would get the ER staff to help me faster, I can't remember if that theory worked or not

45. HOW MANY TIMES HAVE YOU BRUSHED YOUR TEETH TODAY? - Once

46. IS DRUG FREE THE WAY TO BE? - Yes

47. ARE YOU A HEAVY SLEEPER? - Not really

48. WHAT COLOR ARE YOUR EYES? - Blue

50. DO YOU LIKE YOUR LIFE? - It could be tweaked a little, but as of right now...things are pretty good - I hope my sister-in-law & her sister are ok...say a prayer

51. WHOSE IS BETTER? - I don't compare myself that way to others

52. ARE YOU PSYCHIC? – Sometimes = womanly intuition

53. HAVE YOU READ “CATCHER IN THE RYE”? - I don't think so

54. DO YOU PLAY ANY INSTRUMENTS? - No, but I wish I could play the piano

55. HAVE U EVER STOLEN MONEY? - No

56. CAN YOU SNOWBOARD? - No

57. DO YOU LIKE CAMPING? - Nooooo

58. DO U SNORT WHEN U LAUGH? - No

59. DO YOU BELIEVE IN MAGIC? - It's all an illusion, not that that's a bad thing either

60. ARE DOGS A MAN’S BEST FRIEND? - To a degree

61. YOU BELIEVE IN DIVORCE? - It's nice to have options I guess, some marriages are mistakes, sometimes people grow in different directions...to each their own

62. CAN YOU DO THE MOONWALK? - No

63. DO YOU MAKE A LOT OF MISTAKES? - No, I'm perfect! Yeah, right!!!! Is it a mistake if you learn from it?

64. IS IT COLD OUTSIDE TODAY? - It's beautiful outside

65. WHAT WAS THE LAST THING YOU ATE? - Coldstone Ice Cream

66. DO YOU WEAR NAIL POLISH? - Sometimes

67. HAVE YOU EVER BEEN KISSED? - Yessssss

68. WHAT’S THE MOST ANNOYING TV COMMERCIAL? - anything political lately - living in Florida, every other commercial seems like it's either Obama or McCain.....grrrrr = annoying

69. DO YOU SHOP AT AMERICAN EAGLE? - No

70. FAVORITE BAND AT THE MOMENT? - Maroon 5, Lifehouse and Tim McGraw & his band

Ok, now you know me a little better...if you made it this far! I've been off of work all week - trying to get my house organized. I got one big project done, but my house is a mess - wish me luck!

I'm not going to comment very much about work last week - mostly because I've blocked it out of my mind (and partly cause of short-term memory loss = hey, I'm almost 40, it's allowed!). I do remember one of my patients had an order for Cardizem because his heart rate was in the 150's...but the nurse never bothered to start the Cardizem drip. She didn't even know it was ordered. When asked how long the patient's heart rate was in the 150's, she said "about 3 hours now." Ughhhhh! I stopped report right then & insisted she go hang it right now. Scary stuff.

Anyways, I saw "Nights in Rodanthe" last night. It wasn't bad. Half the movie I spent staring at Richard Gere & Diane Lane while thinking "They are getting old!" Which then reminded me that if they are getting old, I must be getting old too. Sigh!

Today, my brother & I are taking his kids to the county fair. The weather is beautiful & I just know there is a funnel cake waiting for me!

Happy Halloween everyone!!!!!

Frazzled??? lol

I had a patient last week that reminded me of that story in one of my posts..."The Patient I Failed." My patient had come in with respiratory failure. She also was end-stage renal disease and on the verge of going on dialysis. When I got report, they had her on a bipap because she was having difficulty breathing. I was told that it was crazy during the day because the patient wanted to die and her husband was fighting her wishes to be a DNR. Three of her doctors were at bedside as well as her family. The patient was in her 70's, she was totally alert & oriented.....she was tired of having breathing problems. The slightest of movements tired her out. Her husband was not ready to say goodbye. The doctors took him into another room and tried to make him understand how his wife was feeling, but it didn't matter - he was not going to be a willing participant in her wishes to die. The grown children were on board - they understood their mother's last wish & agreed to do as she pleased. It sounded like a heartbreaking day. I never met the husband, but I felt for him.

When I took over, the patient's heart rate jumped up to the 150's. She had agreed to wear the bipap for the night, but wanted it off first thing in the morning. I didn't even think to ask her what she wanted to do about the heart rate....I just immediately called the cardiologist figuring he'd order Cardizem or Digoxin. I've never had to stop & think..."hmmm, does this patient even want us to treat the increased heart rate?" I got an order for a Cardizem bolus and drip. It was then that I realized she may very well refuse the medication since she had chosen to be a DNR. It's against my nature to just do nothing, so I went in there & started setting up the IV medication. I explained to her what her heart rate was & what this medication would do. Thankfully she was fine with it. She actually got quite a lot of sleep - most people don't with the bipap. It's a big gawky mask type thing that is tight on the face & it basically forces you to breathe.

About 5:00 in the morning I answered the phone. It was a man saying he was trying to call my patient & wasn't getting a response. My patient had already told me she was refusing all phone calls because it's pretty much impossible to have a conversation while wearing the bipap. I told him it was too early in the morning for phone calls to patient's rooms. He says to me in a desperate voice..."Is she still alive?" OMG...it was heartbreaking. I knew instantly who he was - the husband of my DNR patient. I told him that she was. He replied "Are you sure?" I guess he figured she wouldn't be & was so elated to hear that she was. I told him yes & reassured him that if anything were to happen to her - he would definitely get a phone call. He went on to ask me more information, but I couldn't release it to him as he didn't remember what her password was. Darn HIPPA! Due to the privacy laws, we can't release information over the phone unless the person knows the password the patient set up. This man was elderly, he couldn't remember the password. I reassured him that she was stable and definitely alive. I don't think I'll ever forget his voice.

I never had that patient again, but I was told that the following day she was feeling better respiratory wise and didn't have to be on the bipap any longer. I believe she went home a few days later. At least her husband gets more time with her. I can't imagine what it's like to feel like you are about to lose the love of your life.

I worked last night & go back again the next 2 nights. When I got to work last night, it was chaos as usual. The day nurses refused to allow voicecare to come back...grrrr. They are the reason we need it. Change of shift report takes on average 60 to 90 minutes at night. That is ridiculous!!!! Anyways...I get there & see that I have 4 patients. I am waiting around 20 min just for the nurses to start report. One nurse has 3 of my patients & she's running around frantically. I see that one of my patients has her heart monitor off - so I go in to investigate. She's dressed & ready to leave. Tells me she's been waiting over a 1/2 hour for the discharge papers. I tell her I will work on it so we can get her home quickly. I find the nurse & she had no intention of discharging this patient herself. She wanted to give me report & let me take care of it. That alone will take at least another hour. So no...not gonna happen that way. I tell her to work on the discharge paperwork & I will get report from the other nurse. She wasn't happy...but seriously...the patient was ready to go. There was no reason to hold it up any longer. In the time it takes her to give me report, she could have the discharge finished.

So I get report on one of my patients...no problem. I come back to the other nurse & she has the discharge paperwork printed out. Yay! She then announces to me that another patient of mine has orders to be transferred to ICU. What??? And he's still here on PCU? Again - she wanted to give me report on him, then I could handle the transfer. Nope, not happening. I call the clinical leader & let her know we have a patient that needs to be transferred to ICU now....so that she could arrange bed placement. I then tell the nurse to discharge the patient, I'll take her downstairs and she can call report to the ICU nurse while I'm downstairs. That makes sense, doesn't it? Again, she's not happy....but there's no sense in both of us being unhappy...lol.

I come back & report has been called, the clinical leader is transferring the patient and I am ready to get report on the only patient she has left. This patient should have been discharged. All she needed done was PFT's (pulmonary function test) that was ordered at 1:30 pm. It was never done & they don't do them at night. So this patient had to spend another entire night at the hospital as well as be billed an additional day waiting for this test. Ridiculous! The day nurse was frazzled (is that a word?).

Luckily, I had a great night. I had one admit - a gentleman with chest pain that was already telling me he was going home tomorrow. I've learned not to argue with them when they talk like this. I simply say "Ok, let your doctor know when he comes in to see you tomorrow."

I've got to go get ready for work. Maybe one day I'll win the lottery...ahhh....

D50 Recordsetting shift

I finally managed to get myself on a day schedule (sleepwise) - yay! Somehow I believed that this would make me more productive on my days off. Nope, not true. I was supposed to go thru my closets this weekend and get rid of clothes and things I no longer need. What do I have to show for this effort = some clothing I managed to iron and hang up but has not yet reached my closet, some clothing I ironed but still in need of hangers and plenty of clothing that still needs to be ironed and oh.....one shirt to give away. ONE SHIRT! Something is better than nothing, right?

Work has kept me busy. I had decided to move to the 3rd floor PCU permanently - but about 2 or 3 shifts into that decision, I was feeling like it was the wrong decision. I'm just out of my comfort zone up there. They say PCU is PCU...but not true. Our 60 or so PCU beds are split between the 2nd and 3rd floors. I have worked 95% of the last 3 1/2 years on the 2nd floor. There are things I like and dislike about both floors. I did email the manager or director - whatever she is and requested to go back to my comfort zone on the 2nd floor. I never got a response. Hmmm. So now the last 2 weeks I have been floating back and forth between the two floors. I'm feeling like I have no home...lol. I did find out that we are probably going to be opening up an observation unit in January and I did tell them I was "somewhat" interested in "possibly" working there. (am I a commitment phobe or what??) We'll see what happens.

I did set a new record for myself and probably or should I say hopefully no one else can match it. I had a patient that came in with renal failure. When my shift started, his blood sugar was 64......and he had already had D10 running at 50 ml/hr and already had dinner. I wasn't messing around. I gave him a 1/2 amp of D50...fully anticipating that this would keep his blood sugar in a decent range for the rest of the night. Nope, not happening. I recheck it about 30 min later and he is in the 80's, but it should be much higher after what I gave him as well as having D50 running. About 30 min later, the patient tells me he feels like his sugar is low & this is after watching him eat a candy bar within that 30 min period. So I recheck and sure enough he's something like 54. Gasp! So I give him the other 1/2 amp & recheck 30 min later...he's back in the 80's. I'm not so confident that this is going to keep him ok overnight. So I call the doctor to report what I am dealing with. He says that's fine - just keep following the protocol.

30 min goes by, the patient again says he's not feeling right - recheck = 56. Grrrrrrr....this isn't good. Another 1/2 amp as well as a turkey sandwich, milk, juice...whatever he could possibly bear to eat or drink. Inbetween all of this, he's asking me why his blood sugar is so low. I asked him what medications he had taken prior to coming into the hospital & he says "I don't know." I told him I tend to think that low blood sugar for diabetics is usually medication related & that it could be awhile before his blood sugars stabilize. We go through another round of rechecks and it's still not over 70. He is sick of eating & drinking....so I give yet another 1/2 amp of D50. Recheck shows his blood sugar is even lower than before I gave the 1/2 amp. It's midnight now and I decide to call the doctor again - mostly because I have never in my life given more than 1 amp of D50 to a patient with low blood sugar & I am not confident this is what we should keep doing as it's obviously not working.

So I call the doctor - luckily he is one of the nice doctors who doesn't get upset with phone calls. I explain to him the situation. He tells me to give a full amp of D50 and also 1 mg of Glucagon IM and increase the D10 IV to 75 ml/hr. Ummm....ok....since he says so. Then he follows it up with "You don't need to keep calling me, just follow the protocol." Uhhhh....ok, just wanted to be sure you were informed as I have never had to repeatedly keep giving D50. His blood sugar should have been over 500 with as much as I had already given him.

So I give the full amp, give the Glucagon, turn up the IV...recheck 30 min later and it's 108. That's a little better, but seriously...it should have been in the 600's at least with all that medication. Tick tock....30 min later and he's complaining about not feeling well again. He's back in the 50's. How is this possible??? It was a cycle of that the entire shift. Luckily I only had 3 patients that night and the other 2 were sleeping with no problems. Looking back, I should have asked the doctor to upgrade this patient to ICU status as we don't tend to have the time because of our usual patient load (4 to 5 patients) to be doing accuchecks every 1/2 hour. However, I found it intriguing....so I kept at it!

I felt bad for the patient. He never really got any sleep because I was constantly in there assessing him. Finally it's about 6 am & I feel the doctor really needs to be updated as the protocol wasn't working and I was worried. I had given in 12 hours.....4 full amps of D50 IV as well as the one time dose of Glucagon and the patient had D10 running at 75 ml/hr....and his blood sugar at 6 am = 53. I hadn't called the doctor in 6 hours, he should be happy I left him alone for that long. So I update the doctor and inform him that I have never ever given this much D50. He can hear the worry in my voice and says to me "What's the alternative?" True...no D50 = the patient dies. Still though - he was in for renal failure and I know D50 is rough on the kidneys. The doctor assures me that we have no other alternative. I ask if he wants to increase the D10. His reply..."I don't want to put the patient into renal failure." Ummmm....doc....that's what he came in with.

So he agrees to up the rate as well as continue to follow the protocol. He tells me there is a slight chance the patient could have an insulin producing tumor in his body. I was doubtful...I mean what are the chances that he would be in the hospital on the very night this tumor decided to start producing insulin? Not likely.

I gave report to the dayshift nurse only to come back that night and find they transferred him to ICU. He needed closer monitoring. I found out he was discharged a few days later - so chances are it was medication related and not a tumor.

Sooooooooo....on another note.....I haven't been back to the other hospital in over a month, I think. I don't like the team nursing concept at all. The last time I was there, I felt like my fellow team nurse (let's call her "nosy") interferred in my patient care & I didn't like it one bit. Nosy knew nothing about my patient, yet felt it necessary to make a scene in the nurses station, proceeded to call the doctor (even though the primary doctor had just been there & assessed the patient) and when he began asking her questions, she panicked & handed the phone to me & ran out of the nurses station. I didn't think the doctor even needed to be called in the first place & I told him that. Nosy was ready to call a rapid response. My patient was a DNR....do we call rapid responses on DNR's? I had never been faced with that dilemma before - not that I felt my patient even needed a rapid response. He ended up being discharged the next day with hospice. He was a 94 yr old with congestive heart failure, aspiration pneumonia and c-diff....he wasn't going to get better. His body was tired out and filled with fluid. We can't save them all.

I don't like being forced to work with nosy....ooops, I mean that closely with someone that is virtually a stranger to me. She ended up leaving at 11 pm and the next nurse that came on...my "new partner"....I walked up to her and tried to be cordial & said "I guess we're partners." She basically thru her hands up in the air & said "Whatever" & walked off. Ok, just the way I prefer it - you do your thing, I'll do mine. If I need help...I'll seek out another nurse or the charge nurse...not a "partner."

I'll go back there sometime this next month, but the majority of my shifts will be at my usual hospital. I am still contemplating travel nursing, but my youngest niece begs me to not leave her - so I'm sticking around for now.

On a not so great note...I got a speeding ticket today. Actually I should say...again. It was the same darn cop as last time! I opted for driving school with the last one, so this time I'm gonna have to take the points...grrrr. $181 out the door. Oh well, my bad. So much for having a RN magnet on the back of my car.

I figured I'd end this post with a few things that not many...heck...absolutely no one knows about me....

1) I love half-frozen bottles of coke. It's messy when I first open the bottle, but that icy cold coca-cola can't be beat.

2) I'd say 90% of my scrub tops have hearts on them. I'm not even a heart-type of a person....if that makes sense! Why in the world do I have so many scrub tops with hearts????????

3) I could watch Travis Barker play the drums for hours. Don't ask me why...I don't know....I go into a trance watching him play the drums. It's not even that I like him...not that I dislike him either.....but there's something stress relieving and soothing about him playing drums. I have a video of him on my myspace page...check it out so you can see what I'm talking about.

Ok, that's enough for now! Have a good week everyone!!!!!!

As you all know

As you all know...or at least most of you know...AOL is getting rid of their journals. I will be looking for a new place to blog and hopefully be able to transfer all of my old entries over. If anyone has any suggestions, let me know. I'll be in touch.