Rainbows & crying wolf...

On my way home from work this morning, I saw a beautiful rainbow in the sky. Rainbows amaze me - I love looking at them. They are a good reminder that in order to see the rainbows in life, you have to endure the storms that come your way .

I am sooooooooooooooo tired of newscasters. If I hear one more thing with the word Ernesto in the story, I will scream. They have blown this tropical storm out of proportion. News coverage began on Saturday. I'm not talking just a little update here & there, I'm talking that 99% of the newscast was all about this storm. This is the problem when it comes to hurricanes - newscasters blow it out of proportion so much that people don't believe a word they say. Even with 7 hurricanes in 4 years, I still don't believe them because they don't really know anything until about an hour before the storm is about to hit. However, just like most trainwrecks in life, it also gets to the point that you can't help but watch. Then the stress sets in because you begin imagining the worst....until reality strikes again to remind you that weather forecasters are only right like maybe 1% of the time.

It is raining here...but is that uncommon? Nope. Besides, Florida needs the rain. And it allows me to see the rainbow. :)

Ok, my tough 2 days at work...yep, that's all I'm working this week - well besides the computer class I have to take tonight for 8 hours. I can't complain, my patients were relatively easy to care for. I learned a little bit...way more about tapeworms than I ever really wanted to know. I've seen one of my patients get news that is devastating - her lung cancer has spread to her bones. Once it gets there, it's all pretty much downhill. She started out a little grumpy (who can blame her), but I charmed her & took time to talk with her. I still don't really know what to say when someone gets news like that. I find it's better to try to get them to express how they're feeling, because I know nothing I say will make a difference.

I had some interesting conversations with a couple of docs. The first one....my patient was on Heparin, her PTT (lab test) came back at 154 = extremely high. Protocol says to stop the Heparin immediately & call the doctor. So I did...at 5 am. I could tell I woke him up...but so what...this is a critical lab value. I tell him the PTT level & he says "Well, what does the protocol say to do?" As if I had never bothered to follow it or something. So I tell him "Stop the Heparin & call the doctor & here I am...talking to you now." It's like he didn't know what to do & was hoping the protocol would give him a clue. His wise answer..."repeat the PTT in an hour & follow whatever the protocol says to do." Ummm, ok.

My second doctor incident was regarding a patient I just got report on last night. He had been there for a week, had a surgical procedure when he came in & everything was going well - until 2 days ago when it seems he had a stroke as he has the facial droop & is unable to move the right side of his body. They ran some tests & it is looking like a stroke. Welllllllllll...no one has bothered to talk to the family about what is going on. All they know is that their once fully functioning family member is now unable to move the right side of his body. His speech is slurred & they want to know why. They were point blank asking me if he had a heart attack. I was able to tell them no, that his heart is ok. I can't tell them the real test results because the doctor has not talked to them regarding what's going on. So they ask me for the doctor's phone number. I give them his answering service number & tell them to call during the day because it's unlikely they would hear back from him at night (it was after 9:30 pm). About an hour later I get a call from the doctor. He says "This is Dr. so & so"...I said "hello Dr., let me find out who called you." Because 99.9999% of the time a primary doctor calls at night - it's because someone has paged him. He says "No, no one paged me." I say "Oh, ok." He says "You know, you really should take the time to find out why I'm calling." My response "Ummmm, ok." Have I mentioned that I really can't stand this doctor to begin with??? He goes on to tell me that a family member called & wants to know why. Well....wouldn't it make more sense to call the family member & ask them why??? It irritates me how some of them will avoid the family & their questions. I told him they basically want to know what is going on with the patient, that they don't understand what is going on because no one is telling them anything. He asked me how the patient was doing & that was that. Who knows if he ever called them back.

Ok, time for me to get a little sleep before computer class tonight. Peace all!

Uneventful shift

The hurricane party is cancelled - because the hurricane has already come & gone through the night Thursday night. It ended up making a quick turn & hit the very south end of Florida. I'm hearing 4 people died & 5 are missing - how terrible. Just goes to show that even though it's only a category 1, it's still deadly. My part of Florida didn't really get much of anything - a little bit of rain - nothing like they had been predicting. It's beautiful & sunny today but way too hot for me. I can't wait until the cool weather gets here, who knows when that will be though.

Last night was pretty much what I wanted - uneventful. I had 4 patients - 4 very wonderful patients. All of them were pleasant & friendly & just a pleasure to work with. It is a rare night when you get all wonderful patients.

My first one was in with a-fib. When I went into this patient's room, you would have thought he was on vacation in paradise. He had a smile on his face, the sun was setting in the background, he was joking around, said he loved our hospital. We were waiting for the cardiologist to show up to possibly discharge him. Time went by, no cardiologist. So I put a call out to the doctor - very pleasant doctor & he called back saying "I thought that patient already went home." Ummm, nope, he's still here. "Well then, send him home." As much as I didn't want to give up my happy patient, I gave him the news & he was dressed & ready to go in 15 minutes.

My second patient came into the ER complaining of chest pain - come to find out he had a collapsed lung for the last 3 days & didn't even know it. He thought it was just the Florida heat that was wearing him out. So he had a chest tube to heal his pneumothorax. He was sharing a room with the patient I described above & he was a lot like that other patient - very happy to be there, loved the hospital, says everyone is friendly, they all explain what is going on, even the doctor putting in the chest tube was explaining exactly what he was doing - sweet. All I really needed to do for this patient was give him his meds & he went to sleep for the night. Didn't hear a peep out of him until morning when he requested giving himself a bed bath at 5 am. I love these self-sufficient patients!

My third patient was this elderly woman...all 86 pounds of her. Just a sweet little woman that didn't want to bother me for anything. When I went to assess her, I pulled up a chair & chatted with her first. I wanted her to feel comfortable & to feel like more than just a patient that we assess & leave. I think that's one of my strengths - comforting the patient & making them feel like more than just a patient in a hospital bed - if that makes sense. We chatted for a little while & I got her some hot chocolate - she was thrilled. She came in with a hemoglobin of something like 6.2. She received blood, of course, which raised up her H&H, but then it would start to decline again. All GI tests were negative, no blood in her stool, they didn't know how or why she was losing blood. Today she has a bone marrow biopsy scheduled. Hopefully they'll be able to figure out what is going on. She had no PM meds, so once I got her covered up with plenty of blankets, she also went to sleep for the night. Sometimes I feel like a babysitter. :)

My fourth patient was a new admit that the day nurse for some reason didn't assess. He's a new nurse, so I cut him some slack, but he did have this patient for well over an hour & didn't do a physical assessment nor a admission assessment - not good, especially with a patient in for chest pain. He hadn't even read over her orders. I guess he just wanted to get out of there. Luckily, I wasn't busy so I was able to get it all done pretty quickly. She came in with chest pain rule out MI (heart attack). Her cardiac enzymes were negative & she has a stress test scheduled today. After talking to her, it seems that she has a lot of anxiety but can't figure out why. She was thinking maybe it was connected to menopause - I don't really know cause I don't know a whole lot about the signs/symptoms of menopause - other than hot flashes & mood swings. All she really needed from me last night was Percocet & Phenergan. She also went to sleep around 10 & I didn't hear anything out of her through the night. No further complaints of headaches or nausea - gotta love that.

So I went most of the night with just 3 patients - which was nice, but the time dragged. I volunteered to help the other nurses with some of their patients, but even with that the night seemed never-ending. I'm not complaining though...with as tired as I was, I am glad I had an uneventful shift.

Around 5 am I got report on an ICU transfer. This patient came in the day before with abdominal pain & no appetite. Some tests had been run & it looks like he has liver cancer. He has no idea yet. For me those are very tough situations - the patient not yet knowing his poor diagnosis. They still had to run a couple more tests to confirm their suspicions, but it is definitely looking like liver cancer. :( He got to my floor around 5:45 am & just wanted to go back to sleep. Easy enough...sweet dreams.

That was my night pretty much. Time to go jump in the shower & wake up so I can get ready to go out tonight. I have no idea what we're doing now that the hurricane is already gone. Kinda hard to have a hurricane party when there is no hurricane. :) It's Aaron's birthday so we'll have a birthday party instead. Have a good weekend everyone!