Saturday, June 6, 2009

Meeting with the CNO

I had the meeting with the CNO = Chief Nursing Officer. It lasted about 45 minutes. It was ok. She's easy to talk to & she must have asked 25 times for me to stay at the hospital. She kept asking "what will it take?" Sorry, a little too late. She took notes & it seems as though they are addressing a few lack of decent equipment & pharmacy straightening up their act (somewhat). They are not changing their minds on uniforms. I told her it's not that we dislike uniforms (yeah, we do)...we dislike the way it's being "wear this & the patients will be happier." What? Not only that...these "uniforms".....the nurses have to buy them (is that require us to pay for company uniforms?) from the manufacturer the hospital picks out. They say it will be about $20 for shirt/pants. That's sounding like some awfully cheap material.

Anyways, not my worry. I have 2 shifts left. It will be sad to go, but it really hasn't been that difficult. Not for a second have I seriously thought "maybe I should stay." It sure does make it easier when 5 others are going with. I heard last night that 2 ICU nurses quit. Apparently, there are more to come in the future. They created this though...if only they'd own up to it & lose the "it's my way or the high way" type attitude.

I worked Thurs & Friday nights. I won't go into all the details. It's been busy...our hospital is at max June. This is unbelievable. I don't remember ever being this busy in the summer.

The patient that stands out the most to me was someone that was taking Clindamycin at home. I'm not really sure what he was taking it for....I think some type of foot infection. He started to have blisters on his legs, so his doctor prescribed Gentamycin cream. After a few days of putting that on...he had blisters/sores all over his body. By the time he got to the hospital, he was in bad shape. They believe it's Stevens-Johnson syndrome. (If you're going to google it for aware, they are quite graphic.) Basically from what I've read....Stevens-Johnson (in this case) is a reaction to antibiotics. It basically makes the skin start falling off. Who knew this could be caused by a reaction to antibiotics? I surely didn't & I've been a nurse for nearly 5 years.

And wouldn't you know it....the patient is the sweetest man ever. Why do things like this happen to the really nice people? He's in his mid-80's & it's unlikely he's going to recover from this. It can be deadly because when your first line of defense (skin) is sloughing leaves you wide open for infection. He's already been confirmed to have MRSA in his wounds. There is a standing order to transfer him to a burn unit for skin grafting if his condition worsens. He's in his mid-80's....he's not going to survive that. And all because of an allergic reaction to antibiotics!!!

It's could have a mild illness requiring antibiotics & end up like that. I had to do dressing changes on his legs & feet. Amazingly he wasn't in any pain, just complaining of a little bit of itching. I'm not sure how those open sores couldn't be painful. I think he is just one tough guy that won't admit to pain so as not to bother anyone. Plus he takes care of his sick, blind wife at home. Sad, sad situation. So not fair. It's one of the few times where I come home & think about a patient & their possible outcome...over & over. Sooo sad.

I had another patient with Dandy-Williams syndrome. What's that? I didn't know either. Some type of fluid build-up in the cerebellum (I believe). I'm going off of what I read this morning & I'm a bit I may be a bit off & I'm so tired I don't feel like googling it at the moment. Anyways...her diagnosis was uncontrolled a result of this fluid build-up. She was young too...early 40's. By the time I got her, the blood pressure was controlled. I think the highest was like 117/70. I fixed her! Just kidding.

I work Sunday & Monday last shift being Monday night. Wow! It's here. It's really here. Wednesday we have a private ACLS class...meaning it's just for 7 of us......7 of us that work together. Should be entertaining & I like the idea of no strangers...other than the instructor. Not sure how he's going to survive dealing with us, but it's gonna be a long day. 9 am to 6 pm. 4 out of the 7 are working the night before...meaning by the time we get to's usually the time they'd be going to sleep after working 12 hours. Maybe I should bring a case of Red Bull....or pillows & blankets. :)

Thursday morning I get my routine check-up with my doctor. I've been putting it off for 6 months, but my thyroid medication refills have run I'm forced to see him. I don't know what it is...he's a nice guy, I just so don't want to go see a doctor. Plus I've hit 40....which means mammogram time. Joy joy! Lucky me!

I'm looking forward to Thursday night...girls night with my best friends. Chili' we come!

Have a great weekend & week everyone!


Carlene Noggle said...

That poor guy! I know you hate having to see himm like that...and you are right seems like it is always the good ones.
Hope all goes well with your meeting!

LivingDeadNurse said...

wow sounds like you had a full day.enjoy your nite out with the gals!

Grumpy, M.D. said...

Stevens-Johnson is nasty. It keeps up at night worrying when an epilepsy patient on a new med calls with a rash... I've only seen it once, with Dilantin. But you can see it with several.

It's Dandy-Walker Malformation. It's a congenital malformation of the cerebellum.

Sounds like your hospital needs a major league attitude adjustment. I've seen this to many times, and I'm not much older than you. Some non-medical bozo comes in with stupid ideas about employee morale and such shit.

They don't realize that happy employees have the tools they need to get the job done. Instead, they cut staff and spend the money on an employee picnic or their own damn bonuses.

My wife used to work oncology floor. One November the floor's nursing director told them they would have to work short-staffed through the end of the year, because she wanted a big bonus that year, and it would be reduced if she brought in registry.