Monday, June 27, 2011


Things I hate about nursing:

*Patient's, not all of them. Just the annoying ones. The ones who think they know it all or think they are staying in the penthouse suite of some fancy hotel & that you're their personal servant. You know the type. 9 times out of 10, they are worse than the patient.....and funny how when they leave, the patient feels much better.

I'm not dissing family members as a whole. If my family member were in the hospital, I'd want to know what was going on. I would not, however, let the staff know I was a nurse nor would I try to boss them around. I have yet to spend the night in a hospital unless it was for myself & that was one night back in August of 1996 when I had my gallbladder removed. I'm just not a fan of sleeping at hospitals. I can see if your kid is hospitalized, but beyond that...I'm not sure why people spend the night with their family members. Regardless, no biggie. Just don't climb in the bed with them. This is a hospital, not a hotel! And don't get mad when we ask you to get out of the bed because you are in the way.

Also, do not get mad at the nurse when your family member dies. Case in patient...the other night. An eighty something year old, veryyyy sick. Organs failing. Pt two days earlier stating she knows she's going to die. Doctor discusses with family that they need to decide on you want her to go home & have hospice to the house or do you want her admitted to a hospice facility? Family couldn't make a decision. "We need to think about it." Ok, but that isn't going to delay the fact that your family member is actively dying. They leave at 8 pm that night. She had labored breathing since I got there at 7....well, she had it for the last week or so, this was no different. No worries. I get her hooked up to TPN (nutrition through a central line). Take her vitals...they were fine. Only thing I didn't like is that she wasn't waking up, but day shift had given her Ativan due to a panic attack a couple hours earlier. So I figure she's in a nice comfortable sleep.

Check on her again at 9:20 when respiratory is there giving her a breathing treatment. Heart rate was the same as when I took her vitals 40 min earlier. Still not really waking up, but breathing rate the same. I come back about 15 min later...don't really know why at the time, but it's obvious afterwards that God was sending me there. I look at my patient & see that she no longer has labored breathing. I think for a quick second "wow, that breathing treatment really helped." As quickly as I thought it, that thought went away only to be replaced with patient is not breathing AT ALL. Ummm, not good. I know she is a full DNR, so I'm not panicking. I calmly tell my charge nurse I can't get my patient to wake up.....I don't like drawing a crowd. No one but my charge is interested, so she follows me to the room & declares what I had been thinking....she's not waking up cause she's not breathing.

At this point I find it odd that the monitor tech hasn't called me...because surely if she's not breathing, she can't have much of a heart rate. So I call him & ask how her rhythm looks. He was like "Oh Sh*t, I'm sorry, I didn't notice...she's in the 20's." That's ok...luckily I was on top of it. There is nothing to do when it is a DNR...except wait. Oh & call the MD & the family. I dread calling families over the phone in situations like this. I hate being the one with the awful news, plus I worry that they'll get in an accident while driving to the hospital. I page the MD & then call the family. I don't want to tell them that she's pretty much gone, but I do want to stress that they need to get to the hospital. What do I say? What do I say??? I tell them that her breathing pattern has changed (it's the truth!) & that I don't expect her to make it through this change. They get my point & rush on over.

One of my co-workers met with them & was in the room with them when I walked in. I overhear one of them saying "the nurse should have known she was going to die earlier & then we would have stayed." Ummm...what? We're nurses, not psychics. While I may have had a feeling she wasn't doing well & made a comment an hour earlier to a co-worker that I hope she makes it through my shift...I had no idea that she would be gone in less than 5 minutes. I tried to explain that we did not see any changes in her, that it happened very quickly. Then I quieted down because I realized they don't want an answer...they just want someone to blame. This family member had skipped seeing their mother that day & had planned to see her the next day. I can only imagine the guilt she was I just stood there & listened to her complain about how disappointed she was with the hospital care because we should have known she was about to die. We left them to grieve & I never went back in again. My charge nurse handled it, because I couldn't. It's the one thing I don't like about nursing....dealing with heartache & grief. It would pull me too close to that emotional line I try to stay away from.

*Another thing I blue scrubs. Well, I don't hate the color...I hate the fact that we all have to wear the exact same uniform AND we have to pay for it ourselves. How is that legal? They require it, yet we have to pay for it. I miss having some variety & pretty colors.

Things I love about nursing:

*Those wonderful shifts that tend to follow miserable shifts...
I was dreading coming in the next night. I wasn't emotional, I just didn't want another sad night or exhausting night. Guess the universe understood, because I got 3 very easy patients the next night. Patients that liked to sleep & were not needy for anything. I had so much free time on my hands that I got to (you're gonna love this, Amanda!) watch 3 hours of Prison Break on my cell Netflix! And I got to read. Not continuously of course...still did my one hour rounding & gave one of my patients a bath...but that was about it. No drama, no one expecting me to be a psychic.

*Another thing I love about nursing....CPOE. It's where the doctor's put their orders in the computer instead of writing them out. We just started it a week or so ago & I love it! Veryyyy little redlining the charts. And very little responsibility on the nurse. If the doctor doesn't order something's on him/her. All the responsibility falls on the MD...where it belongs. It's the future at all hospitals & I fully support it. Change is hard, but this is a good change.

Other things I hate:

*Casey Anthony & Jose Baez. This trial is making me crazy. Just when I think the prosecution has proved their case....the family members get on the witness stand & lie & cry & screw with everyone's head. I'm sorry, I love my family members...but if one of them kills a child......I'm not lying for them. Makes me sick. And then court on Saturday gets dismissed for a reason they won't disclose. Talk about patience being tested!!!!! I am counting the minutes to 8:30 this morning so I can see if court resumes or if there is a mistrial or if one of her lawyer's are quitting. Drives me crazy I tell you.

Other things I love:

*Jeff of the prosecutors. He's just awesome. Nuff said.

*89 days to my cruise in September...yeahhhh!

*My family & friends.

*Luke Bryan (y'all should know this by now!)

Hope everyone has a fantastic week!

Sunday, June 12, 2011


Katy Perry concert was ahhhh-mazzzzingggg. She is really good. I guess I'm comparing her a lot to the Gaga concert & well....Katy kicks butt. Only because she doesn't seem to be a freak (except when it comes to marrying one) & it was a concert, not a performance like Gaga. I'm done with concerts now until October....Sugarland. And of course whenever Luke Bryan publishes his concert lineup....ahhhh...patiently waiting... ahhhhh.

Can't really say much about work. I haven't been there since last Tuesday morning. Having 8 days off is sweeeeeeet. I feel least as far as work goes. I know I was close to feeling burnt out & angry with things I don't need to be concerned about. So to be able to take a step back &'s been nice. I'm glad my unit gives me that flexibility. I'm going to continue to do this light schedule at least until October. Cause I have a cruise in September & nothing's getting in my way of that!

We celebrated my parent's 51st wedding anniversary last night at the best steak & lobster restaurant in Orlando. A good time was had by all. I ordered a margarita & I swear they showed up with a fish bowl size glass. Whoa! As my facebook status reads....3 giant margaritas later...mmmm hmmm. I was feeling no pain. And I had lobster tail...from Australia. It is the best. They are gigantic. Yummm! I've been recuperating today. Hoping for some good weather tomorrow & Tuesday so I can work on this tan...but it's supposed to rain. So who knows what I'll be doing. I'm sure I'll find something. :)

Thursday, June 9, 2011

What Makes Me Happy

This is how I get thru tough times at work...replaying his face & music in my head. :)

He's the next big star of country music! He's an awesome performer. He just rocked the CMT Music Awards...check him out...

p.s. his name is Luke Bryan....future country music entertainer of the year...mark my words

Tuesday, June 7, 2011

Silly ER nurse!

Sunday Night at work was wonderful. I started with 3 walkie talkie patients....which NEVER happens. So I was in my glory. I knew I was open to get a 4th patient since I had such easy patients. No problem. I've got plenty of time to admit someone and my new admit was also an easy patient. So I just knew Monday night would not go as well. Never is it possible to have 2 great nights in a row.

Monday night I got 3 of my patients back. Great, I think. The charge nurse gives me an admission while at the same time one of my patients is getting discharge orders. Wonderful! @@. I take report from the ER nurse. It had to be one of the worst reports ever given. I'm hoping he's a new nurse, otherwise....he doesn't belong in nursing. The patient's name sounded very familiar to me, yet I couldn't place her face. I'm told she overdosed on morphine tablets....but didn't mean to. She took 10 times the dose she was supposed to. Ummm, that doesn't sound like an accident to me. Apparently she was just trying to get rid of the pain. At least that's what she told them when she was still conscious. Fastforward approx 2 hours later and I'm told they gave her 2 doses of Narcan & she's still unresponsive, but has lots of secretions that they are suctioning. Ummm, ok??? He goes on to tell me she has normal saline running at 100 ml/hr through a #24 IV in her thumb. And that they bolused her with 1,000 ml's. I asked how was her urine output. He sounded surprised & answered honestly....he didn't know. I asked does she have a foley cath or a diaper on...since she's unresponsive & obviously not getting up to pee. The ER nurse doesn't know. He's reading through the orders when I ask if she has any oxygen on. He replies 2 to 4 liters. Ummmm, which is it? He isn't sure. And he proceeds to tell me he cannot get an O2 sat on her. Then how do you know this drug overdosed unresponsive patient is getting enough oxygen? He doesn't know.

Now I'm starting to wonder if our ER has any doctors...because this is making no sense. I ask what her rhythm is. He says sinus tachy at about 120 or so. No one is concerned about that rate. Guess they're just happy she has a heartbeat. He proceeds to tell me she is a Baker Act & requires a sitter. I thought this was a little silly as she was unresponsive, but she obviously was a threat to herself, but ok. Only there is no sitter available. WTF? This is a joke, right? I hang up with ER cause now anything I ask, I get the generic response of "I just got this patient.". I go to my charge nurse & tell her I do not think this obviously unstable, critical patient belongs on PCU. Since no sitter is available, she calls the supervisor & refuses to accept the patient. Later I hear that she is in ICU, still unresponsive, on a Narcan drip with a blood pressure in the 80's and a temp of 103 and on the verge of being intubated. I want to know who the heck made the decision that she belonged on a PCU unit. Ridiculous!!

I did end up getting an admission. Luckily, it was after I discharged my other patient...who by the way was so happy to go home, that she surprised me by giving me a hug and a kiss on the cheek. I don't usually like strangers getting that close to me....unless we're talking about someome like say Tim McGraw or Luke Bryan. :). It was sweet though, so I didn't flip out.

I'm off now for 8 days...yay! Celebrating my mom's birthday tomorrow, then the Katy Perry concert on Thursday & a nice lobster dinner on Saturday night! Yum!