Friday, December 9, 2011

Not that great of a week

I worked three in a row this week & it wasn't too bad....except for early Monday morning. I had a pt in her early 90's with gallstones. Her daughter was staying in the room with her. Pesky daughter, but she meant well & I think she saw that her mother & I sorta bonded. Daughter comes out at 2:45 am to say she is leaving & her brother will be here soon for the rest of the shift. Says her mother sounds like she has some liquid in her throat, but otherwise no changes. Around 3 am, I decide to take vital signs. I like to get vital signs out of the way as soon as possible...I am so NOT a procrastinator at work (unlike the rest of my life).

I start with her first. I put the blood pressure cuff on & start it. Then I put the 02 sat on. I see her heart rate is 91. Pretty normal. The blood pressure comes back at 75/35. I think "uhhhh, that can't be right." The 02 sat reads 80%. Hmmm, no, that can't be right either. Heart rate is still saying 90. So I retake the blood pressure & attempt to wake this little lady up. I get nothing. By now I realize this isn't going to have a happy ending. I call my charge...she's on break. So I drag two other nurses in to confirm what I'm witnessing. They agree...she's actively dying. I call the daughter to tell her to turn around. That her mother isn't responding to me. I call the monitor tech to let him know to watch. As I'm on the phone with less than 10 seconds her heart rate went from 90 to 44 to asystole. She was a DNR...thankfully. I would not want to have cracked her ribs trying to save her. The three of us (nurses) are at the end of the bed just watching her. I started the vitals at 3 am. Time of death is 3:06 am.

Just as I turn to walk out of the room, the son walks up. Ugh, this is the part I hate. Breaking devastating news to family members. He's all smiles as he hasn't realized what just happened. I tell him she just passed away. Ugh, heartbreak. He, of course, is in shock. This is the part of nursing that I hate. Well, that & trachs. The daughter arrived...shocked, but at the same time it makes me wonder as the patient was in hospice care before coming to the hospital for a check on the abdominal pain. So it shouldn't have been totally unexpected....still though, losing a matter what age is devastating I'm sure. They didn't stay long.

I go on to take my other patients vital signs because this is nursing & you don't get breaks....even when your patient dies. You are expected to just keep going. Not more than 10 minutes later do I have the charge handing me a paper on a new admission. Seriously??? She replies "you're down to 2 patients." Now this I totally disagree on. It isn't like my 3rd patient just disappears because she died. I still have to do charting on her. I still have to get her ready for the morgue. Can I at least get this stuff done before you bring me someone new? So annoying sometimes. Luckily, my new admission was a wonderful woman who was not in any distress & just wanted to go to sleep.

My other patients this week were pretty good. One had this forceful cough that scared the heck out of me. I thought he'd be the one coding as he looked like he was about to die every time he had a coughing fit. I got some cough medicine ordered & gave it to him. It was no help. Did I mention he was on a 50% venti mask at the time & he would rip it off every time he started to cough. And his 02 sat would drop to 75%. Ugh. I called the doctor after a few hours of this coughing cycle & she tells me "there is no miracle cure for coughs." Really????? There is nothing out there that can help someone stop coughing? Fine, whatever. I bring respiratory in on this & we decide that since he rips the venti mask off anyways, let's switch him to a high flow nasal canula at 10 liters. Wouldn't you know it...that solved the coughing problem. It isn't to say he stopped coughing completely, but I can definitely say it was the venti mask irritating his throat into these coughing spells. I'd never seen that happen before.

I'm off until Tuesday now & it has been a rough week outside of work. The "guy".....well, it's not going so well. Not going to go into details, but I don't see it lasting. I'm beginning to think there is no Mr. Right out there for me. Oh well. Things could be worse.

And I learned this week that someone I went to high school with was strangled to death in her home. She is a recently divorced mother of 5. They have yet to name the ex-husband a suspect....but I would bet everything I have that he did it. It's not cause she had a restraining order on him that makes me think that. Or the fact that she had a security camera installed in her house because she felt he was coming in when she wasn't there. It's not the fact that in October, she got a judgment against him....he owes something like $65,000 to her. It's not the fact that he has been telling the police she has been using online dating web sites to meet men & how "dangerous" it is to meet online people. You know what seals it for me...the ex states he got a text message from her on the day she was killed asking him to pick up the kids from school. The police state they aren't sure if she texted that or the killer did. Now come on!!! What random person who is in the midst of killing someone is going to stop, text the ex to get the kids & continue to kill? Or why would she text that? She wasn't even in communication with him. I have no doubt he is the one that killed her & texted that after the fact as he picked up all 5 kids and kept them at his house while her body lay in her house for over 48 hours before being found. Disgusting. I can only hope they have enough evidence to prosecute him.

I am trying so hard to get into the Christmas spirit. Seems like December is flying by. Oh well, I am ready for a new year. Hoping 2012 isn't as crazy as 2011 has been.

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