Friday, December 18, 2009

The Week of Grumpsters! refreshing to be back to work after having nearly 2 weeks off...NOT! Monday night was ok....busy, but doable & ok. Then Tuesday night came....sit back, it's gonna be a long one...

I came into work taking back the 5 patients I had the night before. Ordinarily, this would be a good thing & report would be quick & I could be on my way to taking care of my patients. NOT! Two of my patients were ok for the most part. The third was to be discharged...but for some reason, case management thought it was necessary to go discuss with the patient & his wife their hospital bill. This patient was in the hospital for less than 18 hours...diagnosis chest pain. He had an echocardiogram done and a stress test as well as a couple of sets of cardiac enzymes. Case management tells him his bill is $50,000 of which his insurance company will pay 90% and could he please pay them $5,000 before he leaves. What?????? Seriously....what??? This isn't something you say to someone that just 18 hours ago came into the hospital with CHEST PAIN. Were they trying to cause it again? So I get there & the patient asks if I think that amount is excessive. Such a fine nurses we are supposed to be our patient's advocate....they are the top priority of nursing care. At the same time...I get paid by the hospital. So what am I to do or say? I do only what I know honest & say yes...I think it is excessive for not even being in the hospital for 24 hrs. No way can a stress test cost that much. I advise them to go to financial services & ask for a printout of the charges & take it from there. They should not have to go home worrying about this stuff.

Ok, that was not even my top concern as far as patients go. I had another patient who had a son that was one of those that...I swear if he could jump on my back, he would do it. The type that thinks you are the personal nurse of their family member & you have nothing better to do than meet whatever needs they may have or just to listen to them talk. Sometimes I have the time, sometimes I don't. This was one of those times that I didn't have the time. Of course you can't come out & say that...nor can you tell them what is a higher priority at the moment. All you can do is try to slip away without being too obvious & hope it doesn't piss them off.

My top priority was a patient that came back during the day after having a heart cath & she developed a hematoma at the insertion site (femoral artery). By the time my shift started...this hematoma was from her groin all the way over to her hip. It was the largest hematoma I've ever seen. Luckily, the cardiologist had rounded earlier & seen it himself & ordered an ultrasound to rule out a pseudoaneurysm. The patient went down to ultrasound & I attempted to do some charting & start giving the other patients their medications.

Less than 30 min later I get a call from the ultrasound tech saying my patient is positive for a pseudoaneurysm. I was not really sure what that even was exactly as I've never dealt with it before...but I knew it had to be important if the tech was calling me to inform me. I then called the cardiologist...had to page him twice cause he wasn't calling back. He calls back & immediately orders for this patient to be transferred to our bigger hospital for a femostop protocol...again, not familiar with it, but it sounded pretty important. So I inform my charge nurse & we get the ball rolling to get this patient transferred as quickly as possible. I tell the patient & her family about what is going on. The cardiologist comes in & also discusses it at length with them. He tells them "I hope to get you over there within the next 8 hours." I get a call from the other hospital & I already have a bed assigned & transportation is on their way!!

I'm feeling really good about this because it hasn't even been an hour since I got these orders...way under the 8 hr window the cardiologist was hoping for. Transportation arrives...the patient is loaded up & sent on her way...I call report to the receiving nurse. I think "Wow, I did so well!!" I then place a courtesy call to the attending doctor to inform him of what is going on & that his patient has been transferred.

I get a call back & from the time I answered my phone...all he did was yell at me. For a second I was thinking "Are we even talking about the same patient?" Although it wasn't "we talking" it was him a 3 yr old having a tantrum. He insists the transfer is not necessary & that he has cancelled it...he then starts giving me orders. I interrupt him & tell him "The patient has left this hospital." How am I going to take orders on a patient who isn't even there? Seriously! I didn't say that, but I sure did want to. He yells at me "No she hasn't, I cancelled the transfer" & then carries on again. Ummmm...I just saw the hot EMS guys that took her & she is not here. So he rants on & wouldn't have surprised me if he had a heart attack with how he was behaving. He then insists on talking to my charge nurse...where he continues his tantrum. She didn't really care....I guess it's typical of this doctor to always be yelling. That's so unprofessional!!!

He has gone as far as reporting it to my manager, who now wants to have a meeting to see how we could have handled this better. I'm hoping she's just doing this because it will please admin & the jerky doctor....not because she seriously thinks we didn't handle this correctly. Because I do not believe anything we did was wrong. It was a complication caused by a cardiac procedure that the cardiologist did that day. Everything was run by the cardiologist...the one doctor that was actively seeing that patient after the complication began. If she was post-surgical & developed a complication...I'd be calling the surgeon, if it was a renal complication...I'd call the nephrologist, if it was a GI complication, I'd call the GI doctor, etc. I would not be calling the primary to handle a secondary complication....unless I could not get in touch with the specialist. Sorry, primary doctors are just not at the top of my list as the "go to" doctors when a serious complication arises.

Wednesday night was another busy night. The son I spoke of earlier was even more of a pest. I try to be understanding & put myself in his shoes. His mother is very sick, but even still...lose the thought process that we are to bow down to your every need. He tells me she didn't eat much that day. I acknowledge what he says & he stands there looking at me like I should do something about that. Ummm, if she doesn't want to eat...what makes you think I can force her? If it were my mom...I wouldn't be relying on the nurse to talk my mom into eating.....I would be doing it myself - because if she isn't going to listen to her own children, it's highly doubtful she'll listen to anyone else. I can let the doctor know in the morning, but I'm not calling him now...because really...what is he going to do at 10:00 at night anyways?

I don't know...maybe people have a different illusion about what we can do as nurses. I wish they'd remember we are human too & most of us are doing the best that we can....even when getting yelled at for no reason.

I had another doctor who promised one of my other patients that he would order her cough medicine so she could not cough so much & hopefully get some rest that night. So I go in to talk to her & assess her & she asks "Where's my cough medicine?" Umm, let me look at what is ordered for you. Nope, no cough medicine. She then shows me the piece of paper where she made the doctor give him her name because he made that promise. Gotta love

So I call this doctor & luckily he's on call. I remind him of what he promised this patient & his reply was "So." So you never ordered it. He then rambles off Hycodan & the rest I could not understand a word of he wanted me to be thrown off & it's not because of a language barrier. He was American. I ask him to repeat it....which brings up another thing. We are told that when we get orders over the phone, we are to repeat it back to the doctor. Only it seems like 99.99999% of them don't want to do this. Usually it's something like "Tylenol 650 mg PO every 6 hours as needed......GOODBYE." And they hang up. It's just so rude. Anyways...I ask him to repeat himself because he mumbled his way through the order. He repeats it & I just add (to clarify) you want this PRN (as needed)? Because that is what I'm used to when it comes to cough medicine....take as needed, right? He replies in what I can only describe as a very rude manner..."DID I SAY PRN???????????" I wanted to laugh out loud....seriously. It's like dealing with 4 yr olds...or worse. At least 4 yr olds are fun. Instead I said "Nope, no you didn't, ok thanks!!!!" Which I think pissed him off even more as he was probably hoping to make me feel bad. Sorry, not gonna happen. Maybe as a new nurse all these grumpy docs would get under my skin....but not now. Not when I'm only doing my job & putting my patients first.

I'm off for a few nights & then back to work on Sunday for 4 in a row. I signed up for overtime...hopefully they won't call me off. I need to finish up the Christmas shopping on Fri & Sat as I won't have any more time to do it before Christmas. I can't believe it's only a week away.

Have a great weekend everyone!

Sunday, December 6, 2009

Vacation Time

I'm officially on vacation. Well, I have been technically since last Tuesday at 11:30 pm. I was sick Wednesday night & now I'm off until Dec. 14th. Niceeee! I'm going to attempt to get all Christmas shopping completed AND wrapped before the end of the week. I don't want to even think dealing with crowds or what to get people after my vacation is over. Actually I guess it's called a staycation as I'm not going anywhere. Just gonna enjoy some family time, friend time & time to myself until Dec 14th. Then it's back to work.

I've been needing this time off. The patients are so very complicated and physically exhausting as well as mentally as it seems like we have 3948023 things to think about on a nightly basis.

On a very sad Florida Gators were defeated earlier tonight. It wasn't pretty...there were tears....mine & Tim Tebow's. :) I'm gonna miss seeing that guy lead the Gators. He'll go to the NFL, but I don't think he'll have quite the influence he does right now. He's an amazing man for only being 22.

On a good note...I saw an amazingggggg movie yesterday. It is The Blind Side with Sandra Bullock and Tim McGraw. It's one of those feel good movies that makes you feel even better because it's a true story. Bring'll be crying happy tears & for once, it's nice to hear something positive in this world.

Sorry, gotta mention it just so it's documented in my blog when I look back one day...but Tiger Woods.....HOW IN THE WORLD DID YOU JUGGLE 4 AFFAIRS (possibly more) AND A MARRIAGE, CHILDREN AND A SUCCESSFUL CAREER??? Never in a million years did any of us see this coming. I understand it's a private matter....but come on...4 affairs (or more)? He's only been married for 5 years! I don't blame his wife for attacking his car with a golf club. Ok, enough said.

I had lunch this past Friday with some of my current co-workers & some of my past co-workers from the hospital I quit. NOTHING has changed over there. has gotten worse, if that's possible. And by the sounds of's going to get even worse in the next few months. It's that administration. A majority of the clinical leaders have left and a majority of their experienced nurses have left. They are hiring more grad nurses to make up for it. glad I left at the beginning.

Speaking of has been nearly 6 months since I left. Time has flown by! Kind of like this night has. Time for me to get some sleep. Stay warm everyone...have a GREAT week!!!!!!!

Thursday, November 26, 2009

Happy Thanksgiving 2009!

I am hoping everyone that reads my blog had a wonderful day today. I worked the first 8 hours of it, then slept & now I'm patiently awaiting 7:15 to arrive...because I just might get the night off. I'm on call & have to remain available until 7:15. If I don't hear anything, then I'm heading over to my parents house to surprise them. I still have to remain available until 11:15, but chances are it won't be a busy night at the hospital...unless some family feuds break out, but hopefully that isn't happening.

I'm kind of relieved to not have to go back. I had a patient last night...a man who I am told has basically given up on life. He's refusing to eat, refusing medications, refusing to be moved. He just wants to be left alone. So I go in the room & his daughter is there. She's very concerned, which I don't blame her...I would be too. I dread the day of having to watch my family or friends take a turn for the worse. His vital signs were stable, but he was I do an accucheck. It's 49. I give him some D50 IV since I knew he would refuse to eat or drink. That gets him up to 77 & it wouldn't be long before it started dropping again. I started his TPN & hoped that would kick in & sustain his blood sugar. During the day, the bag had run out the dayshift nurse gave him insulin to cover his high blood sugar...but since he wasn't eating or drinking & the TPN wasn't running for was no wonder he was dropping. I don't blame the day nurse as I know they are very busy during the day & it probably slipped her mind when it came to giving insulin & nothing to eat or drink to follow behind it. I've done it myself when giving insulin at night & the patient just wants to go to sleep instead of having a snack. It happens.

So for a few hours, I was checking his blood sugar often. I didn't want it getting any lower. By 1 am, he was sustaining in the low 100's, which is perfect. All while this is going on, the daughter is saying he's had a change in status. He isn't responding. I told her it was probably a combination of having low blood sugar & being tired. I mean it was nearly 11 pm when she brought this up. She didn't like my answer, but I didn't know what she wanted me to do. I can't call a rapid response...the man was simply sleepy. I did talk to my charge nurse, who in turn went in & spoke to the daughter. It was agreed that we would monitor his vital signs every 2 hours. Luckily I wasn't so busy that this couldn't be achieved. He remained stable through the night & around 4 am, he was awake & talking to me & drinking grape juice.

I think to a degree, he simply didn't want to talk to his daughter. This happens quite a bit...the patient just wants the family to go home. I think it worries them watching their family worry about them. They rather just be alone or communicate only with their nurse. It's hard to watch this because it is very much appreciated & comforting to know there is a family very concerned about their loved one. So often we see the opposite...not a single visitor or phone call. Sometimes the only communication & touch they receive is from their nurse.

Last night I also got to meet my new orientee. She makes me feel old.....we both graduated from the same high school. Small But I graduated the year after she was born!!!! OMG! She seems pretty cool, we hit it off & I think she'll be a good nurse. She was a tech on an oncology floor while in nursing school. I am hearing it's rather difficult out there now for new nurses to get hired. My hospital just hired 25 of them, but supposedly we're the only hospital hiring new grads at this time of the year. We won't be working together for another month, but I am looking forward to it. I'm glad I said yes to being a preceptor.

Ok, it's 7 pm...I don't want to jinx myself by packing to go to my parents house, but I want to leave as quickly as I can. So have a Happy Thanksgiving everyone & a great weekend!!!!

Monday, November 23, 2009

Moved Back...Yay!

I had another 5 days in a row off. It has been nice...relaxing...enjoyable. Goes by way too quickly though.

We got to finally move back to our regular floor last Tuesday. It is being home again. I had a patient that I had the previous week. Turns out she has Guillian-Barre disease & NO, she has not had any recent flu shots. She's a woman in her mid-80's that exercises every day & now she can barely move her legs. I feel so bad for her. No matter what we did, she could not get comfortable & she couldn't move herself. The disease is moving progressively fast for her. It makes me sad. To be of sound mind, but your body is failing your control. Not fair.

Not much really stands out from last week. Guess that's a good thing. I did find the time to go see New Moon on Saturday. I was expecting crazy crowds. My niece & I got there at 1:15...they had a show at 1:30, it wasn't crowded, no line to get in...perfect. The movie is decent, but I still say the whole storyline is kinda cheesy. At least my niece has come to her senses & is on Team Jacob. :)

Now my niece & I are reading Lovely Bones - since we saw the preview for the movie. Well, my niece is reading it anyways. I'm still muddling my way through True Blood.

Not much else really going on. Gosh, I seem so boring lately. Maybe something exciting will happen at work. I have to work Tues, Wed and Thurs nights this week...which means it will be the first year ever that I've had to work on Thanksgiving. I'm bummed I can't be with my family, but grateful I have all of Christmas off.

Sunday, November 15, 2009

Ho Hum

Not too much going on at the moment. I've been off for 5 days and after I work the next 3 nights in a row, I'll be off for 5 days in a row again. Not a bad lifestyle, eh?

I'm going to be precepting a new grad next month. I have never precepted a new grad before...hopefully it will go well. Work wasn't too bad last week. I had a sad case...a drug addict...again. I don't know why it still surprises me when that happens. I guess I am more optimistic than pessimistic...even with all the unfortunate things going on in the world. This patient was in her late 20's...totally hooked on anything that would make her sleep. I don't get it. If you want to sleep...take Tylenol PM or Melatonin. Why get hooked on the narcotics? Probably a tolerance thing.

By the time I got her, they had discontinued the Dilaudid & was only giving her Percocet and Phenergan. They should have dc'd the Phenergan as she was totally using it for sleep only. I had no problem giving it to her because when it's nighttime & you have 4 other want your patients to remain calm & a sleeping patient is a good thing for us nightshift nurses. Still though, it's sad to see someone throwing their life away because of a drug addiction.

I also had this her late 60's...screaming her head off. As soon as I arrived on the floor, I thought "That's probably going to be my patient"...cause I'm lucky like that. :) Sure enough, it was. And if that wasn't lucky enough, she was also on bedrest & drinking Golytely. Yes....the one drug in medicine meant to make us smile when we say the name. Cause it does everything BUT make you "go lightly." It's a prep for a colonoscopy & it produces some strong results. So having a confused bedbound patient drinking Golytely is a nightmare.

Sometime during the night though, I got to make the deal of a lifetime. There was another patient that was having trouble with his nurse. So much so that he did not want her in his room anymore. He thought she was rude & he did not need a nurse like that. So they asked another nurse to trade a patient for that one. Ummm, that nurse couldn't do it...seems she already had a falling out with the patient. The next nurse said "No way!!!!!" So they came to me...begging. I first started to ask "What is wrong with that patient?" And then I suddenly stopped & asked "Can I trade my confused patient?" The reply was YES. Ok, done deal.

This irate patient was someone getting Oxycodone every 6 hours for back pain. He was an older man & I did believe he had genuine pain....not that it matters as I go with the belief that if it's ordered & the patient isn't showing any signs of drug toxicity or unstable vital signs...they get their medicine. This isn't the show "Intervention." We aren't here to cure someone with chronic pain or even drug addiction. It's supposed to be short-term nursing if it's ordered...then give them their medicine. I went in & spoke to him, got him some food, got him his medicine & that was it.

The other nurse....the one that got the trade....well, let's just say she was not a happy camper. Oh well...don't be rude to your patients next time!

Speaking of rude, this same nurse can be quite vocal & not in a good way. I often overhear her say rude things to the point that I feel the need to report her. I don't usually do things like this as I know nursing can be stressful & it's probably just her way of releasing stress....but it's wrong. It's rude, insensitive & wrong. Problem is...I'm not sure how to go about it. Talking to her is out of the question as she is so self-centered she would never accept the idea that she is doing something wrong. It's always someone else's fault. So the next step is do I verbally say something to the charge nurse? the manager? write an anonymous letter? I don't know...but we work hard to achieve patient satisfaction & here she is ruining it all...repeatedly.

My youngest niece turned 13 this past week. Sigh. I miss the days of when she was 3 yrs old. It doesn't seem possible that she is just 5 yrs away from being an adult. Where does the time go?

Friday, November 6, 2009

Refreshed & Excited

We had a staff meeting today. It was good. I like the meetings there....very casual, interactive, funny. It was also refreshing. I guess maybe it's because we don't see our manager very often since we work nights, but she is a breath of fresh air. She seems to understand the hard work we put in & the common sense it takes to be a manager. She fights for us...gets us the equipment we need, listens to us gripe, tries to make things better.

She explained the one hour rounding to us in a way that totally made sense. Rather than it being yet another burden to put on nurses, we could see how it would be beneficial for both the patient and the nurse. Even waking the patient up for labs seemed understandable when she gave an explanation as to why this has been put into effect. We all want our patients to be happy, don't we?

We get to go back to our remodeled floor on Tuesday. Cannot wait!!!

Sunday, November 1, 2009

How in the world is this legal???

I'm not sure if you all are aware of what our govt is up to when it comes to healthcare. I'm not talking about the $1 trillion dollar cost to cover 6 million people with a low cost health plan, I'm talking about patient satisfaction.

There used to be a time that we could say to our very demanding patients..."look, this isn't the Hilton, it's a hospital." Somehow, it's all changing though. Not that patient satisfaction wasn't important back then, but now...if the patient is on Medicare & isn't satisfied with their hospital stay.....the govt doesn't have to pay the hospital for that patient. How in the world is this legal???

And we wonder why hospitals are struggling to keep their doors open & shortstaff us on a daily basis...all over the country. Probably due to non-payment. Don't get me wrong...I'm all for patients being satisfied & I try my best to meet their needs...but there are usually 4 types of patients:

1) confused/dementia/out of their mind & probably wouldn't even remember being at the hospital or even recognizing that they were in a hospital

2) demanding patients who have something to complain about no matter what you do

3) patients that seem genuine & happy, don't ask for anything or if they's immediately taken care of....only to complain a day or two later that none of their needs are being met

4) drug seekers who are never happy with what you do unless they are getting their latest fix

So, as you see, it's nearly impossible to achieve high patient satisfaction scores. This doesn't stop hospitals from trying though. Instead of hiring extra staff...such as patient care techs or more nurses so we have a better nurse to patient ration...they have decided that nurses can also do customer satisfaction type work.

Just when I think "what else can they possibly come up with to add to our workload"...they come up with more non-nursing things. The hour rounding. Sounds nice in theory, doesn't it? We are supposed to stop in at each patient room every hour & ask "Are you having any pain? Do you need to go potty? Do you want to change your position in bed? Do you have any other needs that I can help you with?" Again, sounds nice in theory. But every freaking hour? Just when do they expect patients to get some rest?

Ok, fair enough, I can handle it. What else can they throw at us? Hahahaha...why do I even ask? Now they want us to go in a 1/2 hour before the lab techs come around....they want us to wake up our patients to alert them that the lab will be drawing blood in approx 30 min. This is to be done any time between 2 am & 4 am. The lab will give us a 30 min notice. Somehow this will make the patients less frightened when the lab tech actually enters the room. As if it is the lab tech they are frightened, it's the needles!

And if this isn't order to keep them awake for that 30 min period before lab gets there, we should bring them fresh water, empty the garbage & volunteer to help them to the bathroom. Are you kidding me? Seriously. Is there anyone that wants to be woken up at 2 am with a 30 min notice that lab is on their way? Do you want me bringing you fresh water at 2 am? Emptying the garbage can? I know if I were the patient I would be saying something like "GET OUT OF MY ROOM NOW!!!!!!!!" or "LET ME SLEEP!!!!!!!"

Ok, so seriously....what more can they add? Ha......more. We also have to ask when we do our initial assessment..."What is the most important thing we can accomplish for you tonight?" They look at me like I am insane or a bit off the wall.

And if that wasn't enough....the superuser post I had a week or so ago. I'm a superuser to show doctors how to put in their orders. Is this really part of nursing? Can't they hire ancillary staff to be available to the doctors rather than pull nurses away from the patients? Or how about the unit know...the ones that usually put in the orders. Wouldn't that make more sense since now they won't have as many orders to put in?

Sigh...I am afraid to ask "What else can they add?" Cause I'm sure there is a whole list of non-nursing ideas that they have.

I'm all for patients being satisfied with their hospital stay. I'm also realistic enough to know that by opening this door & allowing the patient to dictate what they consider "satisfaction" will be nearly impossible to achieve. We're not a high class hotel or a shopping mall, we're a healthcare facility. Let us get back to focusing on health.

It's wishful thinking though...sigh.

Friday, October 30, 2009

It Happens in Threes

This past week was a strange one at work. And also a sad one. Tuesday night started out extremely rough. My orientee & I had 4 patients. 4 patients that were total cares. I was so thankful to have an experienced nurse as an orientee. I could not imagine how stressed I would have been had those 4 patients been all mine with no help. Wow...ok, don't want to imagine that scenario anymore.

The orientee took 3 of them as her own, I took 1 & would take the future admission. We worked as a team though...both helping each patient & each other. My patient was in some extreme pain in his lower extremities. He was all swollen. I thought for sure it was going to be DVT's (blood clots) in his legs...but the ultrasound ruled that out. He was getting 4 mg of Morphine every 4 hours. It's a decent dose...with Lortab inbetween. I felt bad that I couldn't take the pain away completely. I don't think anything we had could do that short of putting him into a coma.

We made it through that shift & for some odd orientee & I went to the day charge nurse & volunteered to be floated that night....if they needed someone to do that. She looked shocked that someone was volunteering, but we assured her it would be no problem. Partly because we didn't want that group of patients back & partly because it's easier to float to somewhere new when you have a partner to go with you.

Our wish was granted...we came back the next night & we were floated to another PCU floor. Before we left my usual floor, the day nurse of one of our patients informed us that he died that afternoon. We were shocked as he had been very alert & active all night long. She said physical therapy took him for a walk, then he came back, said he was tired, laid down & never woke up. He was a DNR, but still. Although ideally that is the way I want to go. No pain, no discomfort...just sleeping when your heart decides to stop.

So we leave my floor & go to the other floor. It was a piece of cake. We only had 4 patients the entire night & they were all pleasant people. With 2 of us being there, we could attend to their every need within seconds. This really should be how nursing should be done if the hospitals/Medicare really care about patient satisfaction. I'll save that topic for another day.

We're sitting there charting when we hear "Code Blue, room such & such." Gasp...that was my patient from the night before that was having the pain in his legs. O.M.G. He's coding. Part of me is wanting to know what happened & the other part is thanking God & the stars above for floating me tonight. I'm not a new nurse, but I still panic during stressful situations such as when my patients heart stops working. I didn't want to call up there as I knew they were all busy. I also didn't want to be an onlooker either. A little while later an oncology doctor we knew came to our floor & told us he was at the code & the patient did not make it. Wow....that makes 2 of our patients from the night before gone. This has never happened in my nursing career. Even though I wasn't present when either of them passed, I still felt weird inside.

My orientee then reminds me "You know this death stuff always happens in threes." Ugh, that's's usually true. So we waited & hoped none of our patients coded. At shift change, we hear a code blue called for my usual floor...again. My orientee turned & looked at me & said "see!!!!" However, that code was cancelled within a couple of minutes, so it wasn't a true code.

We came back Thursday night & did not get to float this time. We were a little on edge, but we did have an entirely new group of patients. My 2 were wonderful....walkie talkies....didn't need much. Her 2 were so so, but not bad. My orientee then got a call from her usual floor telling her that the patient that fell on our floor last week just passed away within the last hour. She had been my orientee's patient last week the night she fell. There was our third.

I am weirded out...if that makes any sense. I don't believe the fall caused her death or speeded up her death. She was in congestive heart failure and she had an aortic valve that needed to be replaced....for the second time since it wasn't working properly. Because of her poor health (prior to this hospitalization), there wasn't a cardiologist in the area that would agree to do this procedure. She was in respiratory failure when she was admitted & it steadily got worse. I feel bad for her husband. He is such a sweet man. I'm sad for all of these patients lose someone that you love....there are no proper words to describe the grief.

I'm sure there will be a lawsuit in regards to the fall even though she was alert & oriented. We've already been advised to write down what happened & keep it somewhere safe...because it could be 2 or 3 years before anyone asks us anything. This is the part of health care that I don't like. You give your all & you can still be sued even if it's not your fault.

Friday, October 23, 2009

How Awesome is This?

I am a superuser. What does that mean? I'm not exactly sure at this point, but I have been appointed superuser along with 3 charge nurses. I feel honored as I'm the only floor nurse chosen. Again though, I'm not sure exactly what my duties are. Hopefully one day they'll explain it to

What is awesome though....doctors putting in their own orders!!! No more written orders. Nope, if they want blood work done in the AM, they will be entering the orders on the computer themselves. And if they mess up, well...then it's all on them. No more blaming the secretaries or nurses for their mistakes. Is this not awesome?

The downside to that is no more guessing games as to what is written. That can be fun as some doctors can not write...they scribble. Even their name....half the time we can't figure out who the doctor is that even ordered stuff. So we pass the chart around from nurse to nurse with "Can you guess who this doctor is? Can you guess what they wrote?" It's like a medical version of Jeopardy. I will miss that.

It's starting in the ER right now. I guess they figure if the ER doctors can do it, then any doctor can do it. I absolutely cannot wait. The redlining of charts will be virtually nil, except for telephone orders. I am loving this! Whoever came up with this idea....I love them!!!!!!!!!!!!!!!!!!!!!!!!!!

Saturday, October 17, 2009

Worst Patient Ever

Ahhh, I am so glad this week of work is over. It was a true test of patience for me...I think I passed. Let me start by saying that I am soooooooo sick of drug addicts. I try to sympathize, I try to see their viewpoint, I try to be understanding......cause that's just me. They, however, don't give a damn about anyone other than themselves....which in return causes me to start to wonder why do I even bother trying to care for them?

It makes me wonder...does the drug addiction make them that selfish or are they naturally selfish & that leads them to be drug addicts? We'll never really know, but I am sick of them & soooo wish that the hospitals could turn these people away. Instead, the doctors cave into their drug addiction & prescribe Morphine and Dilaudid....which creates the path of as soon as they are discharged, they come right back with yet another fake ailment in order to get their drug fix. It's so irritating & then they have the nerve to complain that the hospital is what is making them sick...all the germs floating around. Then go home & stay home!

I had my worst patient ever....he was young, in his 30' with chest pain.....because of cocaine. Ugh. It should not be allowed. If you choose to do cocaine, then you should be taking it at your own risk & not wasting the taxpayer's dollars to get more drugs. By the time I got him as a patient, he had already been there a week. Ridiculous. Don't prescribe him pain meds & I'm sure he would have been out of there in a day. Regardless, the doctors did not give him his drug of choice (Dilaudid). But they did allow him Morphine...not what he wanted, but he was quickly gaining an addiction to that. Every 4 hours.

When I first met him, his room must have been 100 degrees. No lie. It was hot in there. He was so disrespectful & he had just met me. I tried to calm him.....asked him what he needed right then, tried to meet his expectations....but all I got was "this place is contaminated, you're the reason I'm sick, none of you know what you are doing." Yeah, buddy......I'm sure you live in a sterile environment & are the picture of health outside of here. It's like he really wanted to piss off anyone that he came into contact with. It wasn't at that point that he annoyed me though. I've dealt with plenty of jerks before and I'll deal with them in the future too. It's just part of nursing. Sometimes you run into selfish jerks that think you are there to cater to them & only them.

He was the type that no matter what you said, he had to argue & even though his argument was ridiculous...he insisted he was right. You could say the sky was blue & he'd disagree. Around midnight I found him complaining to my charge nurse. Not because of me...but because he couldn't stand the smell of sickness that he felt was coming in from the halls and that this place was making him more sick. Meanwhile, his room is still 100 degrees & he is naked at this point. Naked. Totally alert & oriented, but naked. Ugh, disgusting pervert. So the charge tells him that keeping his room that hot isn't going to help him get better, that a cooler room might allow him to breathe a little better. He has the nerve to say he doesn't want to get cold. She replied "Then put some clothes on!" I swear, he could have a starring role in Dumb & Dumber.

Moving's now around 2 & his pain medicine is due. I push it in the IV, then flush, then start an antibiotic running. Everything is problems. About a half hour later he is complaining that something is wrong with the IV. I go (and bring another nurse with me to witness cause I knew he was a liar) and check the IV. We kink the IV line to see if we can get blood return in his IV & it's there....which means the IV is in the vein & in the right spot. He is so clueless that he doesn't realize what we are doing, so we explain it. He then starts tugging on the IV & says it's all messed up & infiltrated. Yeah, ok.

My witness asks him "does he want a new IV?" I had already warned her in advance of this guy. He replies "Yes." She puts in a new IV & it's at that moment that he claims the other IV was no good & he needs more pain medicine because it didn't go in the right place. As if I'm going to fall for that!!!! I'm blonde, but not that blonde. I tell him there is no way that I am giving him anymore pain medicine before 6. He's saying some very disrespectful things, myself & the other nurse choose to ignore him rather than put him in his much as we would have liked. He then insists on talking to the charge nurse again. As if her answer would have been any different than mine. I'm sooooooo glad I brought the other nurse in as a witness. The charge already knows him well & is as equally annoyed as we are. She lets him know that there will be no pain med given before 6.

He continues to ask for one at a time. I need some juice. Brought him juice. I need some ice. Brought him ice. I need a new gown. Brought him a new gown. I need something to eat. That's it......I'm done. I'll see you at 6.

I go in at 6 to bring him the pain medication & he's moving his hand all around so I cannot get to his IV. So I stop & look at him cause at this point...he pretty stupid to be playing this game since he is the one that wants the pain med. I would have no problem throwing it away & calling it a day. He then starts yelling "Why are you so nervous? Why can't you get the medicine in my IV?" Ugh, this is not nursing. And for any of you in nursing school that think "I never want to go into psych nursing" me, the psych patients will come to you!

I tell my charge nurse that I do not want this patient back the next night or ever. I make sure the day charge is aware also. What happens.....I come back that night & have him again. I was sooo irritated. I don't get mad often, but I was mad. No one was around for me to complain or get it switched, so I figured I'd just deal with it. For some reason, God must want me to spend another 12 hours taking care of this drug addict.

I go in to assess him & find that he is acting totally different. He is actually being nice & talking normal & his room isn't 100 degrees. I am ready to go into shock. He's still a little off the wall, but being friendly. I actually say to him "I like seeing this side of you." And I listen to him talk for like 15 minutes. I wanted him to see that I want him to feel better. I'm not there to make things worse. For a few more hours, things go very smoothly. I think to, a caring heart really can do wonders.

Well, about 4 hours later he's back to his selfish ways & now he's calling random numbers in the hospital asking for pain medication stronger than what we have prescribed for him. The charge nurse (a different one than the night before) goes into his room & tells him if he doesn't stop calling random numbers, she will take his phone away & he has 3 options at this point.....comply with his current plan of treatment, sign out against medical advice or fire his doctor - but he has to find another doctor to take his case. The doctors will not allow you Dilaudid, so stop asking for it. She said it like it was & then walked out.

I never heard another word out of him. I went in & gave him his other scheduled IV medications & I believe he thought one of those was his pain meds as he never called for pain meds again that morning & when I left...he was sleeping. I was very thankful not to be going back that night.

Frustrating, annoying, exhausting, disappointing. Luckily, my other patients were very thankful for all that I did for them & they were nice to me. I wasn't going to let one lousy person bring me down. I even had a patient that tested positive for H1N1. While I didn't want to go into his room & be exposed to it...the times that I did, he was super nice. And he was getting better. Now I definitely know I have been exposed to H1N1. I'm hoping I don't get it.

Florida finally is getting some cool weather this weekend. Yay! I go back to work Monday soon. But after I get off work on Thursday morning...I have 5 days off. I think I'm just going to hang out at, relax, maybe attempt to get organized. It's a never-ending process.

Have a good weekend everyone. Stay warm, northerners!

Monday, October 12, 2009

Go Big or Go Home!

We had another townhall meeting this week. I decided to go yesterday since I am working Tues, Wed & Thurs this week & didn't want to go after working 12 hours. It's hard enough adjusting to losing an hour of sleep (due to the drive), but add in a loss of another hour = Jen not a happy camper. So I went yesterday & loved it. I'm not just pretending either.

As with any work meetings...I dread going. I'm used to them being boring and the administration not really caring what we felt/thought & usually we'd be told of what we're not doing right & what we need to improve on. Basically they were doom & gloom. This hospital is different. It is more like a pep rally. It is simply amazing. Seriously. Amazing. A work meeting. Who would have ever thought they could be fun?

I was looking forward to this meeting because we just went through the employee satisfaction survey & although I was unable to give my input (you have to be there for at least 3 months to take the survey), I was interested in seeing the results. This meeting was a Hollywood Academy Award carpet, pictures, food, administration dressed up in tux & long gowns, paparazzi. It was pretty impressive! Not only were they taking pics, they printed them during the meeting & were handing them to us after the meeting was over. Who knew administration could be this quick & efficient?

The results were amazing too....we are a hospital within a large chain of hospitals. I think one of the largest chains in the United States. That being said...we rank #1 in employee satisfaction within our chain. Number one!!! On top of that, our hospital is in the 83rd percentile in the entire U.S. And my department ranks in the top 25% in the country. Say what?????

We have not had a patient fall in 58 days...and we don't even use bed alarms! This is a hospital with more than 350 beds. At my old hospital...we were lucky to go a week without a fall & the hospital is less than half the size. And we had bed alarms - not that they always worked.

Anyways, it feels really good to be working somewhere that I can be proud of. Somewhere that the departments can work together rather than against one another. Somewhere that the administration pays tribute to all that we do. It's the little things that mean so much....yeah, the candy, chocolate & cheesecake help....but just having our administrators recognizing & acknowledging our hardwork is the best. Especially after leaving a hospital that views nurses at the bottom of the barrel.

I am so glad I made the decision to change hospitals. Nursing is still a very tough, demanding & tiring job...and always will be. However, it's nice to be free of the chaos & drama from the higher ups. It's nice to be able to call pharmacy & not get the run around or have to wait hours for a medication. It's nice to get report from ER & things be in order. It's nice to call lab & not get excuses. It's nice to call doctors & not get an attitude or hung up on. It's nice to have a new unit that we all have pretty much blended right into. It's been a nice adjustment.

It's nice to work at a hospital you can be proud of.

Thursday, October 8, 2009

What Do You Mean???

Told you I would survive. My cold is nearly gone. I have a cough, but it's not bad. I had no problem working 3 nights in a row. To think back to a week, what a difference! I'm not 100%, but getting there. I even went ahead & got the regular flu shot this year. I am refusing the swine flu shot though. There just isn't enough testing for me to feel confident that 1) it will even work and 2) that it won't cause more problems because no one has a clue because it hasn't been tested enough. As far as my illness last week...I don't think it was the swine flu. I never had a fever & it felt more like the usual congestion of a cold. Oh well, I'll never know.

Work has been pretty simple this week. The patients weren't bad. I mean they are very sick and half the ones we discharge don't seem to be any better than when they came in. I think it's the general population of where this hospital is. So many are nursing home patients that they give a few IV antibiotics & send them back until the nursing home wants a break & sends them back to us. And others....they are there for weeks. I have no real idea what we are doing for them other than wasting money on keeping them in the hospital day after day. For those that think one will be turned away simply because they have no insurance...that is so not true. At least not in Florida.

It's overkill with the testing here. I had one older gentleman that came in with a fever of 100.0. They did nothing to treat the temperature & it went away within a couple of hours & stayed away. However, they admitted him with the diagnosis of "Fever rule out Meningitis." What? Because of a one time fever of 100.0??? They attempted to do a lumbar puncture THREE times & could not get it. So then they decide to order an MRI of his spine. This patient is unable to answer the questions on the MRI form because he has dementia & we have no next of kin to call. Sooooo they do a series of x-rays to try to determine whether he has any metal in his body that would prevent him from having an MRI. All this for a guy that showed up with no other symptom than a fever 100.0 one time. Needless to say, he had no meningitis...but it took thousands of dollars just to be sure. Ridiculous!

I get this call last night from a doctor I have never spoken to (nor would like to speak to again). He runs through a list of orders...blah, blah, repeat it back to me. I like that...he's efficient even though you can tell he's being cocky at the same time. Like he's waiting for me to mess up. He orders an MRI of the thoracic spine & lumbar spine for a patient of mine that has to be done asap. I call the patient's daughter to make her aware since she is the power of attorney as her mother has alzheimer's. She tells me her mother will need something to sedate her in order to get the MRI done.

So I call the doctor's service....only to find out he's not on call. Ummm, I just talked to him 5 minutes ago. "Sorry, he's not on call." Ok, then who is on call & have him call me back. They give me a one word answer as to who's on call & they page him. This P.A. (physician's assistant) calls me back. I don't generally like talking to them, because it doesn't seem that they know what they are doing. Anyways...I explain to him what is going on...that Dr. so & so ordered for an MRI & the patient needs sedation. He replies with something like "My partner ordered that?" Ummmm...since when are MD's partners with PA's? Anyways, I say yes & the patient's daughter requests she get some type of medication for sedation in order to have this MRI done.

I think I'm speaking clear english that makes sense. It's not uncommon for a patient to be claustrophobic or uncomfortable having to lie still during an MRI that takes over an hour. His reply..."Is she medical?" What????? Medical?????? What are you talking about? He says "Is she medical services?" Huh??? What do you mean medical services & what does this have to do with sedation? I mean he did just call my floor at the he really asking if she's a patient that's been admitted? I don't understand! He finally gives up or I finally give him the answer he's looking for...I'm not sure which, but he moves on to ask "What kind of sedation do you want?" WTF? MRI sedation! What do you mean what do I want? I want my patient sedated so that she can get this MRI done. Am I not speaking clearly? He replies "Conscious sedation or regular sedation?" Say what????

My co-worker/friend is sitting next to me & is amused at my conversation as she is only hearing one side of it & I'm giving her a look like I'm talking to a nutcase & that I need her to step in & interpret even though both the P.A. & I speak very clear english. So he asks again if I want conscious sedation. In my mind, the only times I think of conscious sedation are during certain ICU procedures and to be cardioverted during SVT. It requires anesthesia administered by a professional........I have never heard of that type of sedation done for an MRI. I was looking for an Ativan, maybe Xanax, Valium.....something to make the patient sleepy/relaxed but not unconscious.

Now the P.A. is getting really annoyed with me as we simply don't understand one another & he is trying to talk me into calling the primary doctor for this. I couldn't understand why he wanted me to call the primary who didn't order this test nor had any clue it was even happening. I just wanted to speak to the doctor that ordered this MRI & get some sedation. Is that too much to ask?

Long story short...he orders Valium which I also imagine he was hurrying off the phone so he could take some himself since he seemed so rattled at my questions. The patient went down for the MRI, but complained one time she felt a little short of the MRI tech stopped the exam, called me....I went down to assess her, but couldn't find the MRI tech anywhere. So my charge nurse calls the nursing supervisor who basically handles it like a rapid response & brings the patient back = incomplete test.

I go to assess my patient upon her arrival back to the floor & ask her "How was the test?" Her reply...."What test?" I asked her if she was short of breath. She had no clue what I was talking about. Sigh. My charge nurse wanted me to call the doctor to let him know the test wasn't completed. 2 am I'm supposed to call?????? I knew I'd end up getting that P.A. again. No way. What are they going to do? Attempt to medicate her more when she complained she was short of breath? I don't think so. I called him at 6:30 this morning & guess no call back. The answering service kept paging only guess was that he was waiting until shift change was complete as I'm sure he had no desire to speak to me again. :)

I'm sleepy. Heading to bed. I have 5 days off...yay!!!

Friday, October 2, 2009

I Will Survive

I could kick myself right now because 2 weeks ago I said to my friend/co-worker..."I never get sick." Then I go on vacation for a week & have been sick ever since. Ahhhhhhhhhhh....why can't karma work this fast in other situations?

I was feeling achy on Sunday...thinking it was my sunburn. Tuesday I had a sore throat, head congestion, was hot...but no fever. I called in sick to work. I didn't want to as I haven't been there very long, but there is no way I could have taken care of anyone besides myself that night & even that was rough. I sucked it up & went in Wed. night & lucked out that we were overstaffed & I could leave at 11 without any penalty against me. I thought I was better last night...went into work & before I knew it...I was in the middle of a non-stop coughing fit which led to my eyes getting all watery & my body was sweaty yet clammy & the headache began. It just goes on & on. We weren't overstaffed, so if I wanted to leave - it was basically like calling in sick - even though I was at work.

I hope I don't get in trouble for it. I mean I'm really sick. Oh well, whatever is meant to be will happen.

I just want to get rid of this sickness. I don't even have any reason to go to the doctor.....I have a cough, but no temp & anything coming out of my nose is a clear color. So I doubt antibiotics are necessary. I'm off until Monday night & praying this is all gone by then. Meanwhile I'm contemplating buying stock in Nyquil.

My patients this week were pretty simple...which made me regret going home. I think a couple of them wanted to take care of me. And last night was like one of my most embarrassing moments ever....a family member called me on the phone to ask about his mom. During our conversation, my throat got very dry & I was coughing & barely breathing. He's saying "It sounds like you need to be in the hospital." Yet, he keeps asking questions. And not normal questions like "how is my mom doing?" No...he asks me how long does it take for someone that retains long does it take for the extra CO2 to get out of her bloodstream? Huh??? I was nearly ready to pass out with his endless questions & my lack of oxygen. I couldn't even say throat was that dry. It was so awkward.

Meanwhile I'm coughing so hard that I expect blood or one of my lungs to appear at any moment & one of my co-workers says "It sounds like you need some water." And she just keeps going about her business. This same co-worker asks me later "Why are you going home?" Are you serious? As if non-stop coughing & an inability to breathe is my norm. Another co-worker says "I think you have a pre-existing condition." What????? Who are these people? I'm sick!

And I don't get it....I'm sick, my nose is stuffed up, I'm coughing non-stop & yet when they need a witness for their insulin - they hand me their toughbooks to put in my information. I am touching their computers with the hands that I have been coughing into & they don't care. If it had been the opposite, I would have been sanitizing my computer immediately or finding someone that wasn't so ill that they had to go home. But that's just me.

Another thing...I may be 40 yrs old, but I am half-tempted to drive out to my parents house so that they can take care of me. Yeah, I'm that sick. However, they are 45 min away & I am more comfortable in my own home & I don't want them catching instead they drove to me & went to the grocery store to get me some survival items. I love you, Mom & Dad!!! They are the best.

I am heading back to bed & hoping/praying/dreaming that I am back to normal health by the am.

Sunday, September 27, 2009

I'm back!

Why is it that I always feel like I need a vacation when I get back from being on vacation? I am exhausted! Luckily I don't go back to work until Tuesday night.

I went to Orlando & Tampa with my brother, niece & nephew. I don't think I'll be doing that again until next summer. They drain me. Physically, mentally, emotionally......drain meeeeeee. There were some good times, fun times, relaxing times...those I cherish. What aggravates me is having to pay for everything & then have them complaining in the process. That's the reason this won't be happening again until next year. I would go insane.

We started out at my favorite hotel in Orlando. It's so casual, relaxing, nice pools, great outdoor restaurant and an ice cream shop that is soooooo yummy. Plus the discount I got was like 60% off the rooms. I'm already thinking of taking myself back there next month just to relax by the pool for a couple of days.

Thursday we went to Tampa & Busch Gardens. It was pretty empty there, which was nice...but the 101 degree weather was not. Hotttttttttttttttt!!! We checked into Embassy Suites after that & just relaxed for the next day. Friday night I took them all to Howl-O-Scream at Busch Gardens. Soooo many haunted houses. That was the fun part. It was so crowded with younger people though. I'm officially old...I know this because looking around & seeing all the younger people drinking alcohol & acting like morons was annoying rather than entertaining.

Saturday we went to Adventure Island...Busch Garden's water park. It was really nice. Not too crowded. Loved the wave pool. It's got me thinking about buying passes to one of the water parks in Orlando. I'll reconsider next year.

I'm back now...sunburnt on my back (ouch). I wish I had more time off. I'm actually thinking about going back to part-time status....just because this 40 hours a week is so repetitive (lol). I'll wait until next year to decide. If I can get my credit card bills paid off, then I'll probably definitely do it.

I need to get refocused.....back on me. I do so much for work, at home.....that I put myself last. It's starting to take a toll. I need to change that. I want to be balanced, relaxed & happy...and that all begins with focusing on me.

I never did make it to Atlanta due to the flooding they were having. I saw pictures of the rollercoasters underwater & was amazed they were able to open this weekend. Maybe one day I'll get up there...but not anytime soon.

I hope everyone is having a good weekend!

Monday, September 21, 2009

I'm taking credit

As nurses, we mostly do our jobs without taking any real credit. We deal with ups & downs, chaos & calmness, outrageous & bizarre...and we do it all without blinking. This time though...I'm taking credit for saving a life.

Thursday night I had a diabetic patient whose blood sugar at bedtime was 85. That's normal, but I gave her a it women's intution or just knowledgeable nursing...but I didn't want it dropping below 85.

Fastforward to about 1 am & I'm walking down the hallway...checking on my patients when I hear some loud type snoring. Hmmm...that's odd. I don't remember my patients snoring loudly the night before. So I notice it's my diabetic patient's room that the sound is coming from. I peek in & notice her shaking.....her arms, her legs....shaking. For a moment I wonder if she is having a seizure. I go in to talk to her...notice that she's very sweaty & of course isn't waking up.

Some might panic at this situation...but I instantly knew it had to be low blood sugar. I calmly left the room & asked my tech to do an accucheck. I then went to the med room & got an amp of D50. Went back to my patient's room & waited.

Waited why........cause the darn accucheck meter needed controls run. Ugh, stupid! So I wait. When the meter is finally working, I get a reading of "low." Ugh, not good. No time to wait for lab to draw a stat lab confirming this. My eyes could confirm it with the symptoms I was noting. I push 1/2 amp of D50 & wait again. Gotta give it time to circulate. After about a minute, I shake my patient & her eyes open. Yay...success!

I explained to her what was going on & how I needed her to eat some food & drink some milk so her blood sugar wouldn't drop again. She kept apologizing for passing if it were her fault. My charge nurse says she'll go get her some milk, peanut butter & crackers. She comes back with peanut butter & graham crackers & low-fat milk and leaves the room.

I go out to get regular milk & run into the charge & ask "low-fat milk? Why not sugar free crackers also?" She looked mad at me for even talking about it. She replies with "Well, we rechecked her blood sugar after the D50 & it was 165, I didn't want it to go any higher." Seriously? She had no clue that the D50 was just a temporary fix & would come crashing back down if we didn't get some carbs into her.

Anyways, I left work that morning feeling good & also thinking of the alternatives. What if I hadn't chosen that moment to do my rounds? Would she have survived much longer? I don't even want to really think about it now. For whatever reason, I was meant to find her & bring her back. I'm patting myself on the back for this one....job well done, Jen.

Vacation has officially begun. I still don't know what I'm doing or where I'm going. I've been told it's raining a lot in Atlanta...that was my plan. We'll see what happens. Have a good week everyone!

Wednesday, September 16, 2009

90 day eval

90 days gone already. Wow. That time went by so quickly. Not sure that's a good thing or a bad thing. It just is what it is. The amazing thing eval was done. I'm impressed. Not just because they had good things to say about me, but because it was done on time.

Of course this 90 day mark means I can now be floated all over the hospital to wherever they need me. That started last night. I saw where I was being floated & I was happy....because it's a newer floor. The rooms are huge and they have 50" flat screen tv's which means the patients are spoiled & happy.

I started out the night with 3 patients. Then got an ER admit. Then was given the option to go home. I took it. Hence, the reason I am posting now at 4 am. I could have stayed, probably should have, but didn't. I was out of my comfort zone and my patients problems weren't the greatest. On top of that, I'm tired. I don't know why - I slept ALL day.

Oh well. No biggie. I'm home now & ready to watch a little tv & then sleep ALL day. Two more nights and I am on vacation for about 10 days or so. I think I'm going to go check out Atlanta.

I feel like this post is so I apologize. Not much is going on. The most exciting news I have had all week is the reminder that Dairy Queen will have their pumpkin pie blizzard soon. Lol...sad, huh?

Have a good week everyone!

p.s. RIP Patrick Swayze - you will be missed

Tuesday, September 8, 2009

Thanks, Dr. Grumpy!!!

I haven't written much because I have had a few uneventful (love that word) nights at work. Last week couldn't have been any easier. It's times like those that remind me that being a nurse isn't so bad. Last night changed all of that.

I started out with 5 patients, but somehow the planets aligned themselves & we got an extra nurse so I was able to give up one of my total cares. That left me with 3 walkie talkies and one lunatic. I mean lunatic in the best sense of the word. She was out of her mind & what's could happen to any of us at any time. She had been in a car accident a few years ago & it left her with permanent brain damage.

I am not kidding when I say she yelled all night long. No matter what I gave her, it did not work. I was actually afraid I might kill her with all that I gave I stopped giving her anything by early morning. She had received before I got there....1 mg of Ativan IV. I added in a sleeping pill that was ordered, not PRN. By midnight she was still irate & driving the entire staff up the wall. So I gave her Benadryl IV. That slowed her down a little, but within a couple of hours, the yelling was getting louder & louder. I was shocked. I take Benadryl PO sometimes & am out for like 6 hours. I couldn't imagine it IV. She's a dialysis patient too, so I was a little worried all of these meds were staying in her system...that's why I stopped giving any more meds. They were having zero effect on her.

One time I walked in there & she was insisting on calling my mother. I tried to picture that scenario in my head. Don't think my mom would be too pleased. :)

So I did the next best thing...let her yell at herself & left the room. It seemed I agitated her more by trying to carry on a conversation with her. Instead I spent some time catching up on Dr. Grumpy's blog (he would be It was a quick reminder that I am not the only one that ends up with some bizarre situations. Thanks, Dr. Grumpy!

I work this week and next week...then I get a week off. I am not sure what my plans are for that week off. Part of me just wants time to relax, do nothing...that's paradise to me. The other part says get out & see the is short.

So maybe I should actually leave my town & go somewhere. There's plenty of options.....starting with Orlando & all the theme parks. It's too hot, so that makes me weary of that. Then again, there are a lot of water parks. But being around a bunch of screaming kids/tourists reminds me too much of being at work. I could go to the beach....that image is looking good, but the thought of getting sunburnt & dealing with the Florida heat...once again, changes my mind. So I don't know. We'll see how I feel next week. Good thing about living in Florida...can plan things at a moment's notice as there are 9032490309340923490 hotels in this state.

Hope everyone is having a wonderful week!

Sunday, August 23, 2009

What Do You Do When...

Picture this...

You are working at a hospital and there is a huge thunderstorm with a lot of lightning & as you are standing in a patient's look out the window & see lightning strike & start a fire. What do you do?

Nothing. I was pretty amazed that I got to see something like that. I mean the entire sky lit up & stayed lit up for a few a baseball stadium. I still didn't think much of it. Must be the blonde in me. Although I did wonder why the sky remained lit up for a few seconds more. Still though, I put it out of my mind & kept working.

And then it happened...a couple of hours later...our entire floor went pitch black. About 5 seconds later the back-up generators kicked in. This was all new to me. I've seen our generators get tested...but never been in a situation where they were put into use. So I go & check on my patients & I notice that while the hallways are lit...the air conditioning is no longer working. Not a big deal for most...but for those with respiratory issues, they usually prefer a cool environment as opposed to a warm one.

I went back into the patient's room in which I saw the lightning strike & I looked out the window again. Whatever it was...was still on fire & you could tell it had been that way for awhile.

Anyone wondering what it was that got hit by lightning?? Any guesses??? Hmmmm?????

Well...what do you do when your electric company gets struck by lightning & it results in a huge fire thus knocking out the electricity completely??? That's what happened.

Not only did we lose electricity, but we also lost our connection with the internet. Luckily, someone had been watching tv earlier & had heard the power company was on fire. So we sat around for a couple of hours. It was getting very warm. The aromas floating around were not pleasant. I had a new found thankfulness for air conditioning if it keeps those awful smells away. And I prayed. It was only midnight...I couldn't last another 7 hours this way.

I don't know how...but we got electricity back around 2 am. I thought for sure we'd lose it again, but we didn't. Considering the circumstances, my night was decent. Add in we had 2 mock fire drills and we had a patient being very disrespectful to the staff and I was thankful I would not be back that night.

My patients were all great...well, that might be inflating it a bit, but they were good. I bonded with one over Big Brother (lol).

And my only real problem patients was this woman that came in with abdominal ascites....liver problems/cirrhosis/etc. She had been in a month earlier & knew that they'd be doing a pericentesis to get rid of the extra fluid. Now, you would think somone with fluid overload would be cautious as to how much fluid they consumed...but not this one. I have never in my life seen anyone eat so much ice, drink so many liquids & eat so much pudding & apple sauce ever. If I didn't put my own restrictions on it...I have no doubt she would have taken in at least 5 to 6 liters on my shift alone. I tried to educate her, tried to make her understand, tried to reason with her....but every half hour it was "Can I have more ice? Can I have more milk? Can I have more juice? Can I have more pudding?" I finally had to say "No, you cannot."

On top of that the doctor ordered Dilaudid for her abdominal pain from having all this extra fluid. Ugh, come on...Dilaudid? There is one thing I have noticed....drug seekers are the world's best timekeepers. Seriously. To the very minute that it can be given again, they are on that call light asking for more. It's ridiculous.

Time for me to get some more rest. I am fighting some type of something. My throat is feeling weird...scratchy...not sore, but like something could be developing. I've had it since I woke up. I hope when I wake up tomorrow it is gone. I don't want to be sick!

Have a good week everyone!

Saturday, August 15, 2009

What's Up With the Flowers?

I don't know how many of us out there are familiar with the price of flowers.....but I certainly wasn't. I'm not talking about flowers at a flower shop or on Valentine's Day....I'm talking about the cost of flowers at the hospital gift shop.

I have never had the need to buy flowers while at the hospital (thank goodness) fact, I don't think I've ever visited anyone in the hospital outside of my close friends having babies - which did not require flowers, but baby gifts.

Anyways, as me & my friend/co-worker strolled down to the cafeteria to scrounge around & see if there was anything that looked half-way decent to eat before they closed at 11 pm, we walked by where the flowers are on display. Now at my last hospital, I walked by the flower display often as it was right there when you walked into the entrance of the hospital. I never once saw the prices as they were not anywhere to be seen. I guess I imagined they'd be somewhat reasonably priced as they were gifts for someone that was sick enough to be hospitalized.

Boy...was I wrong.

One rose.....ONE ROSE is $15. What??? They did have a deal though....two roses for $25. Huh? In what country is that a deal? Six roses = $50. And we're not talking like the most beautiful roses you've ever seen...just plain, generic roses that I probably would have a hard time paying $5 for.

I then checked out the multi-flower displays...which started at $45 & up. It's absolutely ridiculous. It makes me want to go to our administration & ask "What's up with the flowers?" Seriously...I realize that there is something about flowers that for a lot of people...makes them happy. I see often when walking into a patient's room & there is a gift of makes the room more light, more cheerful. And they scream out "Someone loves me." Why do they have to be so expensive? I feel like starting a "flowers for the sick" campaign.

My week at work was ok. I got the opportunity to go home early on Wed night. I said "Yesssssss" because my shift started out crazyyyyyyyyyy & any chance to get out of that mess was one I would take. I had a new admit at shift change, I had 2 that needed to go to ct scan, I had another whose family had 9308403 questions...even though they were there all day & had plenty of chances to chat with the doctors...they wait until 8 pm to start making requests. I was overwhelmed from being pulled in so many different directions.

I'm normally easy going & not much really bothers me....outside of work. I am great at procrastinating, being unorganized, wasting away of day simply relaxing...doesn't bother me one bit. At's a different story. I want everything done ahead of time, no procrastinating, no disorganization, no relaxing until all of the work is done. I can't stand that I am like that, although it probably is a good thing because I am never there past the time I am supposed to be in order for myself to catch up. If I'm there past can guarantee it's one of two reasons....there is a patient on the unit not doing well & I'm helping our or the day staff is taking their time to get report.

So when I have nights that start off a big mess...I am scrambling to get it all get the patients needs met so they can get to sleep, to get my charting done so the rest of the night can go smoothly. It overwhelms me & at times I feel like I'm in over my head. Not to mention the spectralink phones they make us carry & they call us 90348023042 times throughout the shift interrupting anything we are doing.

I was running around, passing meds, charting....and finally got done at 11:37 pm...I was ready to go. I was elated. As I was walking to the time clock, I heard "Jennifer, we need you to stay." Ughhhhh....nooooooooo. The only good thing about that is that at least all of my work was done & I could have it easy the rest of the shift as long as the patients cooperated. I have learned though...when they say you can leave at better get out of there before they change their mind.

Have a good weekend everyone!