Things

Things I hate about nursing:

*Patient's families....no, 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 point...my 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 hospice...do 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 reality...my 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 feeling...so 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 hate...navy 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 phone....love 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 correctly...it'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 Ashton...one 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!

Refreshed

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 refreshed...at 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 & regroup...it'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. :)

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...

http://blog.zap2it.com/frominsidethebox/2011/06/luke-brian-rocks-country-girl-shake-it-for-me-for-2011-cmt-music-awards.html

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

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!

Cold Blooded Murder

Never did I think something like this would happen. Not that it couldn't happen, because it can & has...at other places, but not here...not so close to home. I'm in shock.

Yesterday I got to work & was told there was just a shooting at our sister hospital...someone got shot in the parking garage. I didn't know what to think. Like why of all places...a hospital parking garage? I was able to get in touch with someone that was working there that night & she informed me that it was a surgeon that had been shot. The news was reporting that both the shooter and the victim were in critical condition.

It wasn't long before I found out the shooter died. Silently I thought...GOOD. What kind of person murders a surgeon in cold blood? Not just any type of surgeon, but a transplant surgeon. Those type of surgeons perform nothing short of miracles. Their glory isn't in the money they make, but in the lives they save.

Our hospital is well known for having a dream team of a transplant team. It's a small team, but a great one. Last year...the 4 surgeons & the rest of their team transplanted 3 livers and 5 kidneys. They also harvested 2 hearts, 4 livers, 4 sets of kidneys & a pancreas in ONE weekend. They are awesome people. Yeah, it's not much compared to the big hospitals in this country, but for Florida...it was recordsetting & it shows their commitment to doing what they love...helping people get a new chance at life.

Back to Thursday night...a disgruntled patient...hunted down one of the surgeons & shot him in the hospital parking lot. It happened with other people around. We know for certain the surgeon was the target, because thankfully, the shooter didn't shoot anyone else....besides himself a few minutes later.

They both died.

Things aren't supposed to happen like this. Anyone involved in health care knows we are in a vulnerable profession. We try our best to help people who are feeling their worst. Sometimes we end up having to care for people that are not mentally stable. We all know the risks...mostly in the form of abuse...physically &/or emotionally. It's a given. Not everyone is going to like you. We don't expect to be murdered because of our job.

We were talking about it last night at work....at any given time, anyone can walk into our hospital & just start shooting. I guess that can happen anywhere (and does). I can only hope that this does not become more common. I'm not going to say we should have better security because of what happened. I doubt any amount of security could have changed what happened Thursday evening. If someone really wants to hurt you, chances are more on their side of it happening than ours.

Still though, it's not right.

RIP Dr. N.

Yeee Hawww

The time has come that I give in to being a "country" girl. I was born just outside of Chicago, but raised here in Florida (most of my life). I never listened to country...like ever. For me, Florida, was in the south...but not a redneck, southern accent, beer drinking type place like all the other southern states...lol. No one has a "Florida" accent. Probably cause 95% of us are from somewhere else. Unlike Georgia, where you can barely understand anything they say or North Carolina or Tennessee...the ones who have the real southern accents.

Sure I like (ok, loveeeeeee) Tim McGraw & Garth Brooks. I enjoy Toby Keith, Kenny Chesney & Martina McBride. But it was not until May 1st of this year when I heard Luke Bryan sing for the first time, that I decided I am partly country.....if that's possible. Now I'm not gonna start wearing jeans & boots or start drinking whiskey...but I am going to enjoy listening to his music. I'll be honest...I'm not sure if it's the music or his looks....ok, yeah, right...it's his looks...who am I kidding. He's adorable. His music/accent takes a little getting used to...because to a degree he does have that Georgia Gomer Pyle type accent. More than his looks though, the man can work a crowd!!!!!!!!! Like from 0 to 60 in no time flat.

What I'm talking about (if you're still reading this)...is the Emotional Traffic/Tim McGraw concert. The Band Perry opened for him....ehhh, they have a long way to go. They have one really good hit song, but they are amateurs compared to the other opening act.....Luke Bryan. I had heard his name, but never his music or him in person. He livened that crowd right up. I don't even know why he's opening for people...he could definitely sell out concerts on his own. I guess it takes time, because last year it was Lady Antebellum who I saw opening for Tim & now look at them. :)

Dare I say it.......Luke was better than Tim. GASP! And you know how much I loveeeeeeee Tim McGraw. Don't get me wrong, the concert was great...something was lacking though. Seemed like Tim didn't have a lot of energy. He needs to do whatever Luke does, cause that guy has tons of energy.

Ok, enough of the concert review...back to work type stuff. Hmmm...this part-time status is great! My bank account isn't too happy, but mentally I like it. I feel like I hardly ever work. On top of that....my niece & nephew finally got to go home. So I have my house back...my privacy....my freedom! Oh, how I have missed it. I worked last Wed & Thurs...have been off since Friday morning & I have not left the house once....except to get the mail & newspapers. My sleep schedule is all messed up...I'm not sure I'll ever figure out how to successfully go from a night schedule to a day schedule. Regardless, it doesn't matter.......I can sleep when I want. I can be awake all night long & it doesn't matterrrrrr....cause I don't have anywhere to be & nothing to do but rest & relax. It's heaven on earth, I'm telling you!

Work is still crazy. I have never seen a hospital so full all the time. I don't know where these people come from. It's not like we're the only hospital in the vicinity. There has to be at least 7 or 8 hospitals within 30 miles of one another. Yet we are filled to the capacity night after night, day after day. I don't know if it's that we truly are busy or that they are just admitting people that normally wouldn't be admitted. If they are, they aren't on my floor...cause on my floor, the patients seem really sick.

I had a pretty good group of patients this past week. One man is a sad story though.....in his 60's, broke his hip, had surgery, discharged to rehab only to end up with a septic infection. Now he's been in the hospital for over a month I think...just laying there. Can't pass the swallow eval, family is hesitant to agree to a feeding tube. Sad. One minute everything is fine, the next you fall & your life changes forever.

Speaking of falls...lately we've had a bunch of them. They keep asking us what we can do to decrease it. I have no idea. We do now more than ever....round every hour, bed alarms, clearly communicating to every patient to call us for assistance. Short of sitting next to their bed all night or restraining them to the bed...I don't know what else we can do.

I had another patient who came in with a hemoglobin in the low 6's. That is really bad. We gave him 4 units of blood, but have yet to determine where he is bleeding. His stool was negative. He had no signs or symptoms. What the heck? Where does the blood go? The lovely doctor on his case wanted us...the nurses...to do a digital disimpaction. Ummmmm...yes, it's as gross as it sounds. United, the nursing staff refused & put it back on the doctor that if he wants that done, he can do it himself. My fingers are not going there. There are some lines I must draw. Luckily, the patient was able to go on his own.

I had a few other patients, but nothing really stands out. It's nice to be working on weekdays & seeing some of my other nursing friends who I hadn't worked with in awhile. Hope everyone has a great week!!!

Updates updates updates

Ahhh, such a wonderful way to start a morning...watching a fairytale come true. Yep, that's right...I've been up since 5:30 am watching the Royal Wedding. Nooooo, I didn't set my alarm. I just happened to wake up & figured I'd turn it on. I'm glad I did. It was beautiful. The groom looked handsome, the bride looked stunning & there's no doubt they love one another. Ahhh, William & Kate. Of course now I feel old because I can still remember watching Charles & Diana get married & seeing them introduce William as a newborn. Enough of that!!!

Updates!

*There are still some GRUMPY older people that will never be pleased. Luckily, I haven't had to deal with any of them lately. I worked 3 in a row last weekend & I had the same patients all 3 nights. This rarely ever happens. And they were great patients for the most part. One didn't want anything from me ever. The second one ate nearly everything we had to eat on the nightshift...all three nights. And the third one...couldn't eat anything. Poor thing was only like 60 lbs and even unable to absorb the tube feeding we were trying to give her. I really think social services should be called to investigate. It is not normal to be that weight & the family denies any problems. You could see every bone in her body. It was not pretty. I felt like she could break a bone with any movement. She didn't even have the strength to lift her head. It was like taking care of a baby. :(

*The HCAPHS (govt) surveys are still a pain in the butt & probably always will be. Grrrr!

*My eval rocked! And we get a 2% raise. It's not much, but it's something. Of course my eval only lasted maybe 10 min, the other 50 min was a discussion about HCAPHS surveys. Ugh!

*I no longer love my 2 day work weekends, so I switched to part-time status with the requirement only being 2 days a week, but I can pick up additional shifts. My reasoning being...I need a break & I'm not going to get that with full-time status right now. I think at the beginning of next year, I will switch back to full-time (I'll reevaluate that later in the year), but summer is nearly here & I want to be able to take some vacation time without anyone being able to say no. Weekend status wouldn't allow me that freedom & sometimes I want weekends off....so that's the reason I got rid of that status. What I don't want is to become burnt out on bedside nursing & that is easy to do if you feel like you don't have enough time off. I don't want to be one of those nurses that hates my job, but can't do anything else because the pay is decent in nursing. So although I'll be making less $$$, mentally I'll be better off.....for now. :)

*I'm still waiting on the doctors to put in their own orders. June is when they say it will start happening. I can't wait to see it!!!

*The jury is still out on how I feel about my new manager. Talking to her during the eval was helpful & I see her approach, but at the same time...it's still odd that she won't come out of her office to talk to us. I would never want her job in a million years & in my 7 years of nursing, I have yet to see a manager last more than 2 years in that position. It's not easy. So I'll try not to judge & hope that she has our best interest at heart.

*We just had a nursing survey & I'm sure the hospital won't be happy with our results. Maybe it will wake administration up. Still looking forward to the employee satisfaction survey in August.

*I still have my niece & nephew. Supposedly the boyfriend will be moving out this weekend & the kids can go home on Monday. I'm not holding my breath nor getting my hopes up. I do want my freedom & privacy back...but still in doubt this will actually happen. The kids don't even want to go back. Soon it will be summer & I'm sure they'll be over here again. One day I will get my place back to myself. (fingers crossed)

*The Lady Gaga concert......amazingggggggg....yet weirdddddddd. It will be shown on HBO in May from Madison Square Garden...so if you have HBO, check it out. You'll see what I mean. I used to think she just did this bizarre stuff to get attention.....but now I think she truly is bizarre & this is totally normal stuff for her. I'm not sure what her message was during the concert. There was some type of message, because she talked A LOT, but I have no idea what her point was. It was a great performance though...over 2 hours of HER. That being said, I don't think I'll ever go to another concert of hers again. Once was enough.

Ok, those were my updates from the last post. Now on to current stuff...

*Prayers for all of those affected by the tornadoes these last few days. So heartbreaking.

*I'm feeling sad that today will be the final space shuttle launch. I grew up in Florida & launches are a normal way of life. The thought of never watching another one or never hearing any more sonic booms...makes me sad. I can only hope the next President brings it back. Way too much is invested to just slash space shuttles from existence.

*I'm heading out to my parents house in a little while. They are right on the east coast & I've never been there to watch a shuttle launch. It's also a nice little get away for me.

*Tim McGraw concert is on Sunday....and it's his birthday! Can't wait!!!!!

Have a great weekend everyone!