So much going on!

It's been quite awhile since I wrote last - so much has been going on - I'll try not to make it tooooo long.

First off - I got to see Tim McGraw in concert! Woo hoo! It was great, but went by way too fast & I probably drank a little too much...but it was fun. On top of seeing Tim McGraw...I got to meet Linda - someone that has been reading my blog here for a long time. She has always been so friendly & supportive...it was a real pleasure to get to meet her in person. We still have to go out for some margaritas, Linda!

Work has been challenging. There are so many administrative changes and they don't seem to be stopping any time soon. I am getting more and more convinced that hospitals don't care about their patients or the nurses. I can't speak for all hospitals - just mine. They expect us as nurses to do so much, yet won't allow us the staffing that we need. So what it comes down to is basically hardly anytime to really spend with our patients or even speak to them...because we have soooooooooooo much charting and paperwork to do.

That's tough for me to accept. Especially this week as I was reminded that ultimately what most people want in life is someone to listen to what they have to say. That's it....time to listen. I think that is the key to gaining their trust and confidence....and yet we are very limited with the amount of time we can spend with our patients at the bedside. I don't totally blame my hospital because I'm sure it mostly goes back to the insurance companies and all the paperwork they require to be processed in order to pay the hospital for its services...but still. Something needs to change. We are nurses....we are trained to care for patients. Instead I predict in the next 20 years....the majority of nurses will be affected with carpal tunnel syndrome and bad backs because of all the charting we have to do on a daily basis.

The way I was reminded of how important the skill of listening is....I got a patient from the ER that was agitated due to the ER nurse's attitude. I shouldn't say that it amazes me how one person can affect another and change their total outlook on the entire hospital...but that's exactly what happened Sunday night. I'm not going to go into too much detail with why he was at the hospital, but the ER nurse basically accused him of trying to commit suicide and would not listen to why he came to the hospital. I could understand the patient's side of it and I also figured that the ER is busy and understaffed...perhaps the ER nurse didn't have time to listen either. Still though, it agitated this man and I felt bad for him. So I took the time to listen to what he had to say. It took 90 minutes to get through the admission, but he had calmed down and was able to sleep after I was finished. I left work 45 minutes later than usual in order to catch up on....you got it...the paperwork....but it felt good knowing that I diffused a situation simply by taking the time to listen and my patient was calm as a result.

It was a tough night that night though....I had 2 post-op patients......one that was nearly 500 lbs and could barely move, but was so uncomfortable in bed that we had to get him up to the recliner chair. It took about 30 minutes to complete that task, but as a result, he was feeling better...so it was worth it.

My other post-op patient was a type A personality - he wanted what he wanted when he wanted it and how he wanted it and that was that. I've dealt with people like that before and have learned it is better to just do what they want rather than upset them - because when you upset them, they become more demanding. Luckily he & I developed a good rapport and he really didn't call for me too often through the night....unlike what I heard from how he's been previously...very needy & always on the call light. When he did call, I was right there & did whatever he needed - to a degree. When he started asking for a back massage and to be iced down on his back....I declined. I'm not a massage therapist.

My third patient ended up being easier to deal with than when I had him the week before...thank goodness. He really didn't ask for anything, just was very unhappy with having to be in the hospital. I've never seen a patient with so many different consults...he had at least 9 different doctors following his case. He came in with septic shock.

My fourth patient had been a new admit at the beginning of the shift. She had been admitted with chest pain...but it wasn't actually chest pain. It was pain near the left side of the rib cage under the breast. She was calm and pleasant - went to bed around 11 pm. Then we got the call...that we had to move her into another room so we could put 2 male patients in the room. We woke her at 2:30 in the morning (ridiculous!!!!!!!!!!) and moved her into another room with another patient. Well, that set her off into crying for nearly 2 hours. When asked why she was crying, the reply was "Because you moved me to a different room." Does that really require crying non-stop for 2 hours? She complained of chest pain rating it a 10 out of 10.....yet was lying in bed reading a book. I don't know, I don't understand what goes through some people's minds.

And my fifth patient - the one that reminded me that listening is one of the best skills a person (not just a nurse) can have. He was admitted into the crying patient's previous room of all places. So while I was busy admitting him, she was still crying.

It was a busy night, but I think I handled it pretty well. Not much really gets to me anymore at work. I just tell myself to get through the night - it's just 12 hours - I can survive. It's not worth getting stressed out or upset.

I had a whole new set of patients last night as I was on my usual floor (the night before I had been transferred to 3rd floor). My group was pretty good. The first one was status post a heart cath. It had been abnormal, but the doctor was unsure of how to treat it and would discuss it with the patient in the morning. The patient was very easy to get along with - so much so I had him laughing at 5 am this morning. I like when I just click with a patient. Makes work much more enjoyable.

My second patient has been in the hospital for about 6 weeks - came in with abdominal pain and turns out it was stomach cancer. How scary is that? I swear...every time I have a headache or stomache...in the back of my mind I'm hoping it's not cancer. She had just finished up with her last round of chemo - so I imagine she'll be leaving the hospital soon.

My third patient was transferred to med/surg just after the change of shift - so I didn't know too much about him.

My fourth patient came in with chest pain, but it turns out it was back pain and more of an ortho problem than cardiac. He needed pain medication so I gave him 2 mg of Dilaudid. Within 30 minutes, he was itching everywhere! So I got him an order for Benadryl and Solumedrol - it knocked that itching right out...and the patient too...which would be a good thing later in the night. You'll understand in a few minutes....haha.

I got a new admit around 2 am - altered mental status and hyponatremia (low sodium level). What is strange is that in the last week...this is like my third or fourth patient to be admitted with hyponatremia....where it was at 122. Normal is 135 to 145. Usually when someone's sodium level is that low, confusion appears. My other patients weren't confused last week, but this gentleman definitely was. He kept repeating to me "I don't know what's going on." He must have said it 20 times in 10 minutes. Luckily he went to sleep. The only thing I did was hang a bag of normal saline. Well, 2 hours later he is awake...and totally alert and oriented. What the ???? He could answer all of my questions appropriately, he could stand & walk, he was cured....lol. Wow...I'm good! I don't know...I don't get it. I'm not totally believing that the first set of labs were even his. I mean he was confused....but listen to this (and those that know electrolyte levels will understand why I don't believe the first set of labs were accurate). His sodium went from 122 to 136 in 12 hours. Is that even possible just by hangingone bag of normal saline? No. On top of that...his potassium went from 3.1 to 4.4 with NO replacement. And his magnesium went from 1.5 to 1.8 with NO replacement. On top of that....his urine output in 12 hours was nearly 5,000 ml. If anything, his electrolytes should have been wayyyyyyy off after all that urine output. Like I said, I'm good....haha!

This poor gentleman though...he nearly broke my heart. He's 78 years old and his health is declining. He told me that he has been married for 50 years and that his wife recently told him that the marriage has not been what she expected, that she was unsatisfied with it and wants to put him in a nursing home so she can live out the rest of her years without him. OMG....sooooooo heartbreaking. He says she said this to him about 6 months ago...but for him to remember it now....sad. He says she is hateful towards him, but he doesn't want to go to a nursing home, that he still has a few good years left. I wanted to give him a hug! I mean what do you say to someone that is telling you this out of the blue? I didn't get to meet her and I'm sure there is way more to the story, but it still made me sad for him to have that on his mind at 4 am while he's in the hospital. I'm sure he fears that instead of going home on this admission, that they'll put him in a nursing home. So many of our patients have that fear. It's heartbreaking.

I almost forgot - the reason why it was good my 4th patient was knocked out for the night. We got the patient I had transferred to med/surg back around 2 am. A different nurse got him this time since I had just gotten an admission. None of us really knew what the med/surg nurse said to the doctor to get him upgraded to PCU...because he wasn't in any distress, his vital signs were fine, he was asymptomatic. She claimed that when she was suctioning his mouth, that fecal matter was coming out. I know...gross! Still though....no tests were ordered...just a transfer to PCU and some Reglan. It made no sense. When they brought him up....he stunk.....like really bad. So bad that I didn't even want to go into the room and he was put in the room where my fourth patient was. The nurse that got him said she thinks it's his breath that stinks. What? How can anyone's mouth stink so badly that the room and hallway were unbearable to stand in? I didn't send him down to med/surg like that! She suctioned him...nothing was there but clear fluid...no fecal matter. Then she pulled down the bed sheet & it was very apparent this patient had a GI bleed. Anyone familiar with what a GI bleed smells like? Picture that only a million times worse!

I've had my share of GI bleed patients and although the scent is unmistakable......this was the worst I had ever encountered. The nurse and care tech caring for him had to put on a mask & put toothpaste on the inside of it so they could smell the minty scent in order to clean this patient up. I, on the other hand, was tearing open alcohol pads & holding them up to my nose in order to survive because I had been sitting & charting near the room. I had to move...and even with the move, the smell was making it's way down the hallway. I sprayed the spray they have at the hospital - but that isn't much of a better smell and I gave another nurse a headache because of all that I was spraying.

I was praying my patient was ok, but I couldn't venture in there quite yet. I'm telling you - this was a bad smell. I figured if he needed me, he would call for me. I did check on him a little later and somehow he was sleeping through it all. Maybe the smell knocked him out...I have no idea. Our hospital is full, so I couldn't even offer to move him anywhere else. It seems like that is always the case. Anyways, the GI bleeding patient ended up being transferred to ICU....not so much because he needed to...but because at least he'd be in a private room. He probably could use the closer monitoring too - since he was actively bleeding. Ahhh, what a night.

I'm sure I have plenty more stories I could tell you regarding the patients I've had since I last posted...but I'm getting old & my memory is fading (lol)...plus this is a long post already. I am off now until next Wednesday. Not really sure what I have planned - but I do want to go to the beach. The weather is already unbearable - summer is here. Hopefully the hurricanes will stay away, but we do need the rain.

I got called off of work tonight...yay...actually I volunteered to be called off. My hospital has hired wayyyyyyyyyyyyy too many people and as a result, we're all being called off. They tell us that they hired all these people to prepare for when we are busy in the winter. Ummmm....that's a long way off! I'm sure it will be here though before I know it. I am getting closer & closer to venturing out of the comfort zone. In fact, I'm going to check out some travel nurse web sites online. Any recruiters reading my blog - send me an email! Jennerizer@aol.com

Have a good week everyone!

Happy!

Yay! I'm in a happy mood because I got to leave work at 11 pm this evening. They were downsizing and asking for volunteers to leave. This hardly ever happens and it's my last night working this week...so I quickly volunteered. This way I'll be able to get some sleep tonight rather than sleeping all day tomorrow.

This week the shifts were easy. The patients were pretty good. Today was the beginning of Nurses Week. One of my patient's families brought in a huge shopping bag full of chocolate candy and a card thanking us for all that we do. It's nice to be appreciated. In fact...they did more just by doing that than what our hospital is doing.

My hospital is having a breakfast for nightshift and a luncheon for dayshift......food courtesy of the CAFETERIA! That's it. I remember the times when they would do something unique each day/night and make a big deal about celebrating nurses week. This year....practically nothing. I don't get it. I mean our yearly bonuses went towards redecorating the doctor's lounge and buying them a big flat screen tv. It's obvious who the hospital caters to, but I didn't think it would get so bad that they'd blow off nurses week. Just more signs to move on I guess.

On an upnote...I got to see Michael W. Smith in concert last Friday. He was amazing. Words alone can go right to the heart and he knows exactly what to say. PLUS I get to see Tim McGraw in concert this coming Sunday. Woo hoo!!! I'm excited!

Have a good week everyone!

Venting - for a few minutes

Sorry all - but I have to vent a little bit.  I'm getting closer & closer to really thinking about travel nursing because:

 

My hospital is getting sooooooooooo very nit picky with all these insane things they want us to do.  It's at the point that they truly must be off in fantasyland thinking we can achieve everything they want. 

 

The latest is that they want us to bring our rolling (noisy) laptop computers into the patient's room.....chart in front of the patients- so that we can be "visible" & thus prevent falls (say what???).  Sounds good in fantasy...but the reality is...I have 5 patients.  Charting takes at least 20-30 minutes (I figure it's likely that if we are in the patient's room, there will be at least a few interruptions) and we have to chart at least 3 times a night on each patient.  So....let's see....30 min x 3 = 90 min x 5 patients = 450 min or 7 1/2 hours.....that's just charting.  Granted the first assessment should take the longest, but now they are saying the want full assessments charted at least twice a shift and one assessment where we just focus on why the patient is there.  Again, more unnecessary work.  See....what I don't understand...there is this one choice where we can say "No changes" if nothing has changed.  You would think that would suffice so that EVERYONE understands there has been no changes, right?  Nope, even when we get to choose "No changes"...we still have to chart the same exact things as the initial assessment.  Does that make sense to you?  It's like they are looking for ways to eat up our time - when really, that extra time could be spent actually with our patients minus the computer between us.  Patient care...that should be the priority here, shouldn't it?

 

Now let's move on and add in the medications we need to give & the time to actually assess our patients....probably another 30 min per patient (by the time we check the charts to make sure the medications are accurate - and the repeated faxes & calls to the pharmacy to get the medications we need and also do a full assessment) = 2 1/2 hours.  So now we're at 10 hours of our work day and all we've done is assess our patients, give medications and chart the basics.  10 hours! 

 

We get two 15 min breaks and a 30 min lunch break.  So it's 11 hours.  And that's not including any time for the needy type patients, the family members, the patients that are unstable or crashing, the patients that are incontinent, in pain, nausea/vomiting, admissions, discharges, calls to the doctors, ambulating the patient, dressing changes, and most importantly...keeping an eye on the heart monitor screens, etc.

 

Oh AND now they want us...every hour to assess how much our patients have urinated (seriously, does this really matter every single hour?  Who goes to the bathroom every hour anyways???  Especially at night?) 

 

Plus make sure they reposition themselves in bed on an hourly basis - regardless of whether they are alert and oriented and able to move on their own.  I see it going like this...ummm, excuse me Mrs. Smith, can you wake up (as if we don't wake them up enough at night to begin with), you were on your left side an hour ago when I last checked, can you please flip over to your right side so the hospital administration doesn't think I'm not doing my job???  How well will that go over?  It's ridiculous. 

 

Haha....oh AND they want us to always chart in the patients rooms.  It's impossible.  Our first assessment is at 8, but meds are usually due at 9 and 10.  How can I complete all my charting and get the meds to my patients on time?  Oh, and can you see me midnight and 4 am (our next scheduled times to chart)...rolling in my noisy computer & sitting next to my patient in the dark (cause they should be sleeping at those times) trying to type and chart without disturbing them or turning on a light?  Most importantly, do our patients really want us next to them while they are sleeping?  Doesn't that sound a little creepy?   

 

AND THE MOST OBVIOUS QUESTION OF ALL ----- UMMMM, WHO IS GOING TO BE WATCHING OUT FOR MY OTHER 4 PATIENTS WHILE I'M IN A ROOM FOR 30 MIN OR SO?  The same goes for the other nurses....who is going to be watching out for their patients if we're all in patient's rooms for extended times like that?  It's like they never thought of that.  So the quick answer was...utilize and negotiate with your patient care tech to watch your patients.  As if the PCT's are standing around waiting for something to do.  They are busy too at those times with vital signs and patient care.  And yet another good question was asked - what do we do when we don't have a patient care tech?  Not only that - at night we are lucky if we have a unit secretary, but they usually leave at 11 pm.  So who is going to be answering the phones, putting in orders, answering call lights, etc.

 

If I didn't enjoy being around my co-workers so much, I would be out of there.  Ahhh, the new ideas that "administration" comes up with.  I'd like to see them spend twelve hours on the floor doing what they propose we do.  It's obvious they haven't a clue what the real world of nursing is like. 

 

If they want to prevent patient falls and increase our visibility to the patients and their families - why not work on getting adequate staffing ratios and more patient care techs?  At times there is one patient care tech for 26 patients.  How realistic is it for that person to truly take care of 26 patients?  And many times there is no patient care tech at all - the nurse is expected to be both a nurse and the patient care tech.  I don't think they realize (or care) how tough that can be.  And why not get up to date beds in which the bed alarms actually work?  I think that would be the one feature that would work best towards preventing patient falls.  Combine that with adequate staffing and I would bet money patient falls would decrease.

 

Plus they have thrown in this paperwork that insurance companies are demanding or they won't pay the hospital for certain conditions...it's called quality measures.  In reality, it sounds fantastic....if you do this, this & that for a patient - the outcome is usually better than if you don't.  But it all needs to be documented and the doctors aren't doing it....so it's left for the nurse to do it.  Just more work that really doesn't fall under our job role, yet they expect us to do it. 

 

Sigh......ok, I'm done.  I can only hope it's not like this all over the country.  I have faith that there are some hospitals out there that actually value nursing care and allow their nurses to focus mainly on hands-on nursing care.  I know charting is a must, but it shouldn't take up the majority of our time.  Nor should we be expected to work past our 12 hour shift to "finish up charting" that we weren't able to do during our shift.  12 hours is a long day/night and most of us just want to go home and get some sleep after working.  Sighhhhhhhhhh!

 

On a better note, I saw Lifehouse in concert Wednesday night.  They are awesome.  I could listen to them all night.  It went by so quickly though.  I'll be seeing Michael W. Smith in concert in 2 weeks.  He's very spiritual and I definitely could use some of that right now in my life.

 

Work has been ok.  I've been floating around to different floors.  Nothing major has really happened with any of my patients.  I've had a few that were a challenge.  Like this one gentleman - he came in with congestive heart failure.  For some reason, his blood sugar would not stay in a normal range.  It was running low repeatedly and I could not figure it out.  He started out at 70 one night, so I encouraged him to eat, gave him apple juice, peanut butter and graham crackers, whole milk, a sandwich...figuring that would keep him ok through the night.  I got a call from the lab around 5 am with a critical glucose level of 44.  I wake him up, luckily he's non-symptomatic, but I give him more to eat and drink - recheck it 30 min later and it's barely changed.  So I gave him D50 through his IV.  He was rechecked at 7 am and I think he was like 50 something.  We want it at least 70 or higher, but after all that he had consumed and the D50....it should be well over 100.  Throughout the day, he dropped as low as 31.  The day nurse had given him more D50 and then Glucagon.

 

So when I got him...his blood sugar had reached 100. Yay!  We rechecked it 2 hours later and it was 67.  Grrr!  I finally called the doctor to inform him of all that we've tried and he ordered D5NS.  We don't usually like to give patients with congestive heart failure extra fluids like that, but he definitely needed it to keep his blood sugar up.  Even with the fluids, he still floated around 75-98 blood sugar, but that was good enough for me to relax. 

 

I had another patient that wanted me to help her fill out her living will paperwork because she was having a cardiac cath the next morning and was worried.  It was 2:30 in the morning and I didn't think that was the best time to be making deicisions - but she insisted.  So I sat down with her and helped her fill it out.  After that she was able to go to sleep.  Turns out she did have something major wrong and was transferred over to a bigger hospital that could handle her cardiac problems.  I guess she just knew something was wrong and wanted to get her paperwork in order.  Kinda eery sometimes.

 

It's 4 am, time for me to go get some more sleep.  I must have been really tired yesterday as I slept for about 12 hours altogether (I would wake up for a little while, then fall back asleep repeatedly).  I should work tonight for the overtime - I probably will...but I'll decide later.

 

Hope everyone is having a great weekend!

"Being a Nurse..."

"Being a nurse isn't about grades. It's about being who we are. NO book can teach you how to cry with a patient. NO class can tell you how to tell a family that their parents have died, or are dying. NO professor can teach how to find dignity in giving someone a bed bath. A nurse is NOT about the pills, the IVs and the charting.

It's about being able to LOVE people when they are at their WEAKEST moments and being able to forgive them for ALL their wrongs and make a difference in their lives TODAY.

Nobody can make you a nurse...YOU JUST ARE."

~Author Unknown~

You just never know...so scary

I got a call on Thursday telling me some more sad news. One of my nursing school classmates that I graduated with had passed away at my hospital's ER last weekend. I was shocked! She was 36 years old and I was told that she died from a pulmonary embolism (blood clot in the lungs). It's another reminder that life isn't fair and your entire world can change in a second. You just never know when that will be....soooo scary.

Carlene - I don't know why I thought about that patient from earlier in the week the way I did. I didn't connect it to myself or my family at all though. Maybe I was overly tired & things got to me more than usual. I'm not really sure. It can be a tough job sometimes - having to deal with critical situations, death and grieving families. I can usually separate what needs to be done at work from what I take home at the end of a difficult shift. For some reason...that day I wasn't able to. Sometimes it doesn't always make sense and I'm ok with that. Like anytime in life...there will be some good days and some not so good days.

I'm doing better now. I've been off since Monday and have been doing a variety of things including getting some rest & relaxation, getting back into working out & balancing between staying busy socially and having time to myself. I work tonight and tomorrow night and then will be off until Friday and work 4 in a row...eeekkk...lol. It's spring break for my youngest niece and nephew so I plan on making sure they have some fun. Being around kids is always refreshing....as long as I can send them home after a few days. :)

Enjoy the weekend everyone!

Weird coincidence???

It's nearly the end of March. I cannot believe it. I swear each year flies by faster than the last. The hospital continues to be at max capacity. I don't recall it ever being like this before & that is even with all the people complaining of chest pain via ambulance are diverted to the bigger cardiac type hospitals. I have heard a rumor though that our hospital is going to start focusing on increasing their cardiac procedures - as obviously the need for it is great. I wish we would open up a cardiac only floor. I would love to work in that specific area. Maybe my wish will come true one day.

Speaking of cardiology, I had a patient last week who had multiple things wrong with him - the main one being that his cancer had spread all throughout his body. His blood pressure sat in the 150-160 range systolically and the doctors seemed comfortable with those results. The last morning I had him, his blood pressure rose to the 180's systolically. It was nearly 4 am & I questioned whether this result could be delayed by say an hour - before calling the doctor. I mean it wasn't like his blood pressure was normally 110 or 120 & jumped up to 180. It was 160 to 180...not a huge increase. So as I sat there & debated with myself whether to call & wake up the cardiologist...the phone rang. I answered the phone & guess who....the cardiologist...calling me out of the blue...lol. He was asking me what the first name of this patient was - the same one that had the higher blood pressure. I laughed to myself & thought "how weird is this right now???" I gave him the answer & said "By the way - while I have you on the phone, his blood pressure is this..." He said that was fine, leave it alone. I hung up the phone wondering...seriously...what are the chances of this ever happening at 4 am?

This week was going well...I worked Sat & Sun nights. It was pretty uneventful. Well - until Monday morning. A co-worker & I were waiting to get our yearly PPD shots. The reason we were waiting was because a code blue had been called about 10 minutes earlier & whoever was doing the PPD shots - ran to the code. So we waited & eventually I could tell by the looks on other co-workers leaving the floor that the code was not a success. Another co-worker quickly updated us on who had coded & although she wasn't my patient at the time - I did have her as a patient back in December. I didn't write about it at the time as it was right before Christmas & very sad. She was in her early 30's who came to the hospital because she had trouble swallowing. They initially thought it was pneumonia...only to find out it was 3 or 4 large tumors on her esophagus. Basically she had stage 4 cancer...that is the worst stage there is. She was married and had 3 children at home. Her room was decorated with a Christmas tree & presents back then since she would be spending Christmas in the hospital.

Fast forward approx 3 months & she is the one that they called a code on. As I was processing all of this information, her sister was being led by the ICU nurse to the waiting room and I heard her crying on the cell phone to her mother while saying "She's gone, Mom, she's gone." I keep hearing those words over & over. I came home & couldn't stop replaying those words in my head. I felt miserable. I tried to sleep...took 1 Tylenol PM. I had a sore throat, headache, still not sleepy. So I took 1 Sominex and layed down again. I could not sleep. I ended up calling off from work - because I can't go in with no sleep in over 24 hours & then work another 12 hours. I was tired, but couldn't sleep. Eventually I did fall asleep around 5 pm until 11 pm. I ate, watched tv & went back to sleep & woke up at 7 am.

I feel better today. I'm getting some things accomplished, but still think about that family who lost someone at such a young age. I don't know why it's affecting me - I usually am so good at keeping everything at work. Maybe I'm just more sensitive at the moment. I don't know.

It's just a major reminder that life isn't fair and you have to make the best of it while you still can.

On a good note - I have tickets to see Tim McGraw on May 11th. I cannot wait! I'm also seeing Lifehouse on April 16th. Soooo looking forward to getting out & hearing some good music.

I hope everyone is having a good week!

Another year goes by

I turned another year older on Friday.  I'm 39...eeekkk.  Even I can't believe it.  It also marks one year since I had to put Jagger to sleep...sad, sad memories.  This year was much better. 

Work has been ok.  I've been working the usual 3 days per week.  Lately it's been every Sat, Sun & Monday nights.  Not sure if I like that schedule or not.  I do but I don't.  I guess there are pros & cons to everything.  The patients that I've seen in the hospital for the last month or two have been very, very sick.  They came up with this new thing that anyone with chest pain that is picked up by an ambulance - has to go to a different hospital - even if ours is the closest hospital in the area.  We don't specialize in cardiac procedures.  As a result, we are seeing less & less of the easy to care for chest painers and more of the respiratory & gastrointestinal issues.  I have had patients that have been at our hospital for weeks & months...and they aren't improving.  I'm not used to that.  Usually after 2 or 3 days in the hospital, the patients would be discharged.  Now they seem to stay a long time. 

There was one night that I came in and we had 23 patients waiting in the ER for a hospital bed.  They had been admitted, but we had no rooms/beds available.  That's the busiest I've ever seen it & it was only a Monday night.  It doesn't seem to be slowing down anytime soon.  I imagine it's like that all over the country.

I'm tired - heading to bed.  Hope everyone is having an enjoyable weekend.  Oh...congratulations to Amanda who had twins last week!!!  A boy & a girl.

Oh...one more thing...for Carlene.  PCT's are patient care techs...it is pretty equivalent to what one would call a CNA.  I'm sure they have their slight differences, although I don't know what they are.  They cannot give shots or medications.  They are mostly responsible for vital signs, helping patients, cleaning patients up, feeding patients, transportingpatients, etc.  It's a tough job!