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 sweaty...so 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 early...so 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 hours...it 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 world....lol. 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!!!!