Happy New Year 2010!!! I'm still here...just taking a little break from writing. I have an orientee now...a new nurse & it has been enjoyable teaching someone new the ropes. It's also nice to have an extra set of hands to take care of my patients. Luckily she's a lot like me, so we get along well.
I'll write more later next week when I have some time off. Just wanted to say Happy New Year & word of advice...go see Avatar in 3-D......it is well worth it!!!!!
p.s. Can you believe they are predicting snow in Orlando in the morning??? Brrr...it's so cold!
Friday, January 8, 2010
Friday, December 18, 2009
The Week of Grumpsters!
Ahhh...so refreshing to be back to work after having nearly 2 weeks off...NOT! Monday night was ok....busy, but doable & ok. Then Tuesday night came....sit back, it's gonna be a long one...
I came into work taking back the 5 patients I had the night before. Ordinarily, this would be a good thing & report would be quick & I could be on my way to taking care of my patients. NOT! Two of my patients were ok for the most part. The third was to be discharged...but for some reason, case management thought it was necessary to go discuss with the patient & his wife their hospital bill. This patient was in the hospital for less than 18 hours...diagnosis chest pain. He had an echocardiogram done and a stress test as well as a couple of sets of cardiac enzymes. Case management tells him his bill is $50,000 of which his insurance company will pay 90% and could he please pay them $5,000 before he leaves. What?????? Seriously....what??? This isn't something you say to someone that just 18 hours ago came into the hospital with CHEST PAIN. Were they trying to cause it again? So I get there & the patient asks if I think that amount is excessive. Such a fine line....as nurses we are supposed to be our patient's advocate....they are the top priority of nursing care. At the same time...I get paid by the hospital. So what am I to do or say? I do only what I know how...be honest & say yes...I think it is excessive for not even being in the hospital for 24 hrs. No way can a stress test cost that much. I advise them to go to financial services & ask for a printout of the charges & take it from there. They should not have to go home worrying about this stuff.
Ok, that was not even my top concern as far as patients go. I had another patient who had a son that was one of those that...I swear if he could jump on my back, he would do it. The type that thinks you are the personal nurse of their family member & you have nothing better to do than meet whatever needs they may have or just to listen to them talk. Sometimes I have the time, sometimes I don't. This was one of those times that I didn't have the time. Of course you can't come out & say that...nor can you tell them what is a higher priority at the moment. All you can do is try to slip away without being too obvious & hope it doesn't piss them off.
My top priority was a patient that came back during the day after having a heart cath & she developed a hematoma at the insertion site (femoral artery). By the time my shift started...this hematoma was from her groin all the way over to her hip. It was the largest hematoma I've ever seen. Luckily, the cardiologist had rounded earlier & seen it himself & ordered an ultrasound to rule out a pseudoaneurysm. The patient went down to ultrasound & I attempted to do some charting & start giving the other patients their medications.
Less than 30 min later I get a call from the ultrasound tech saying my patient is positive for a pseudoaneurysm. I was not really sure what that even was exactly as I've never dealt with it before...but I knew it had to be important if the tech was calling me to inform me. I then called the cardiologist...had to page him twice cause he wasn't calling back. He calls back & immediately orders for this patient to be transferred to our bigger hospital for a femostop protocol...again, not familiar with it, but it sounded pretty important. So I inform my charge nurse & we get the ball rolling to get this patient transferred as quickly as possible. I tell the patient & her family about what is going on. The cardiologist comes in & also discusses it at length with them. He tells them "I hope to get you over there within the next 8 hours." I get a call from the other hospital & I already have a bed assigned & transportation is on their way!!
I'm feeling really good about this because it hasn't even been an hour since I got these orders...way under the 8 hr window the cardiologist was hoping for. Transportation arrives...the patient is loaded up & sent on her way...I call report to the receiving nurse. I think "Wow, I did so well!!" I then place a courtesy call to the attending doctor to inform him of what is going on & that his patient has been transferred.
I get a call back & from the time I answered my phone...all he did was yell at me. For a second I was thinking "Are we even talking about the same patient?" Although it wasn't "we talking" it was him yelling....like a 3 yr old having a tantrum. He insists the transfer is not necessary & that he has cancelled it...he then starts giving me orders. I interrupt him & tell him "The patient has left this hospital." How am I going to take orders on a patient who isn't even there? Seriously! I didn't say that, but I sure did want to. He yells at me "No she hasn't, I cancelled the transfer" & then carries on again. Ummmm...I just saw the hot EMS guys that took her & she is not here. So he rants on & on....it wouldn't have surprised me if he had a heart attack with how he was behaving. He then insists on talking to my charge nurse...where he continues his tantrum. She didn't really care....I guess it's typical of this doctor to always be yelling. That's so unprofessional!!!
He has gone as far as reporting it to my manager, who now wants to have a meeting to see how we could have handled this better. I'm hoping she's just doing this because it will please admin & the jerky doctor....not because she seriously thinks we didn't handle this correctly. Because I do not believe anything we did was wrong. It was a complication caused by a cardiac procedure that the cardiologist did that day. Everything was run by the cardiologist...the one doctor that was actively seeing that patient after the complication began. If she was post-surgical & developed a complication...I'd be calling the surgeon, if it was a renal complication...I'd call the nephrologist, if it was a GI complication, I'd call the GI doctor, etc. I would not be calling the primary to handle a secondary complication....unless I could not get in touch with the specialist. Sorry, primary doctors are just not at the top of my list as the "go to" doctors when a serious complication arises.
Wednesday night was another busy night. The son I spoke of earlier was even more of a pest. I try to be understanding & put myself in his shoes. His mother is very sick, but even still...lose the thought process that we are to bow down to your every need. He tells me she didn't eat much that day. I acknowledge what he says & he stands there looking at me like I should do something about that. Ummm, if she doesn't want to eat...what makes you think I can force her? If it were my mom...I wouldn't be relying on the nurse to talk my mom into eating.....I would be doing it myself - because if she isn't going to listen to her own children, it's highly doubtful she'll listen to anyone else. I can let the doctor know in the morning, but I'm not calling him now...because really...what is he going to do at 10:00 at night anyways?
I don't know...maybe people have a different illusion about what we can do as nurses. I wish they'd remember we are human too & most of us are doing the best that we can....even when getting yelled at for no reason.
I had another doctor who promised one of my other patients that he would order her cough medicine so she could not cough so much & hopefully get some rest that night. So I go in to talk to her & assess her & she asks "Where's my cough medicine?" Umm, let me look at what is ordered for you. Nope, no cough medicine. She then shows me the piece of paper where she made the doctor give him her name because he made that promise. Gotta love it...lol.
So I call this doctor & luckily he's on call. I remind him of what he promised this patient & his reply was "So." Uhhhh...so??? So you never ordered it. He then rambles off Hycodan & the rest I could not understand a word of it...like he wanted me to be thrown off & it's not because of a language barrier. He was American. I ask him to repeat it....which brings up another thing. We are told that when we get orders over the phone, we are to repeat it back to the doctor. Only it seems like 99.99999% of them don't want to do this. Usually it's something like "Tylenol 650 mg PO every 6 hours as needed......GOODBYE." And they hang up. It's just so rude. Anyways...I ask him to repeat himself because he mumbled his way through the order. He repeats it & I just add (to clarify)...do you want this PRN (as needed)? Because that is what I'm used to when it comes to cough medicine....take as needed, right? He replies in what I can only describe as a very rude manner..."DID I SAY PRN???????????" I wanted to laugh out loud....seriously. It's like dealing with 4 yr olds...or worse. At least 4 yr olds are fun. Instead I said "Nope, no you didn't, ok thanks!!!!" Which I think pissed him off even more as he was probably hoping to make me feel bad. Sorry, not gonna happen. Maybe as a new nurse all these grumpy docs would get under my skin....but not now. Not when I'm only doing my job & putting my patients first.
I'm off for a few nights & then back to work on Sunday for 4 in a row. I signed up for overtime...hopefully they won't call me off. I need to finish up the Christmas shopping on Fri & Sat as I won't have any more time to do it before Christmas. I can't believe it's only a week away.
Have a great weekend everyone!
I came into work taking back the 5 patients I had the night before. Ordinarily, this would be a good thing & report would be quick & I could be on my way to taking care of my patients. NOT! Two of my patients were ok for the most part. The third was to be discharged...but for some reason, case management thought it was necessary to go discuss with the patient & his wife their hospital bill. This patient was in the hospital for less than 18 hours...diagnosis chest pain. He had an echocardiogram done and a stress test as well as a couple of sets of cardiac enzymes. Case management tells him his bill is $50,000 of which his insurance company will pay 90% and could he please pay them $5,000 before he leaves. What?????? Seriously....what??? This isn't something you say to someone that just 18 hours ago came into the hospital with CHEST PAIN. Were they trying to cause it again? So I get there & the patient asks if I think that amount is excessive. Such a fine line....as nurses we are supposed to be our patient's advocate....they are the top priority of nursing care. At the same time...I get paid by the hospital. So what am I to do or say? I do only what I know how...be honest & say yes...I think it is excessive for not even being in the hospital for 24 hrs. No way can a stress test cost that much. I advise them to go to financial services & ask for a printout of the charges & take it from there. They should not have to go home worrying about this stuff.
Ok, that was not even my top concern as far as patients go. I had another patient who had a son that was one of those that...I swear if he could jump on my back, he would do it. The type that thinks you are the personal nurse of their family member & you have nothing better to do than meet whatever needs they may have or just to listen to them talk. Sometimes I have the time, sometimes I don't. This was one of those times that I didn't have the time. Of course you can't come out & say that...nor can you tell them what is a higher priority at the moment. All you can do is try to slip away without being too obvious & hope it doesn't piss them off.
My top priority was a patient that came back during the day after having a heart cath & she developed a hematoma at the insertion site (femoral artery). By the time my shift started...this hematoma was from her groin all the way over to her hip. It was the largest hematoma I've ever seen. Luckily, the cardiologist had rounded earlier & seen it himself & ordered an ultrasound to rule out a pseudoaneurysm. The patient went down to ultrasound & I attempted to do some charting & start giving the other patients their medications.
Less than 30 min later I get a call from the ultrasound tech saying my patient is positive for a pseudoaneurysm. I was not really sure what that even was exactly as I've never dealt with it before...but I knew it had to be important if the tech was calling me to inform me. I then called the cardiologist...had to page him twice cause he wasn't calling back. He calls back & immediately orders for this patient to be transferred to our bigger hospital for a femostop protocol...again, not familiar with it, but it sounded pretty important. So I inform my charge nurse & we get the ball rolling to get this patient transferred as quickly as possible. I tell the patient & her family about what is going on. The cardiologist comes in & also discusses it at length with them. He tells them "I hope to get you over there within the next 8 hours." I get a call from the other hospital & I already have a bed assigned & transportation is on their way!!
I'm feeling really good about this because it hasn't even been an hour since I got these orders...way under the 8 hr window the cardiologist was hoping for. Transportation arrives...the patient is loaded up & sent on her way...I call report to the receiving nurse. I think "Wow, I did so well!!" I then place a courtesy call to the attending doctor to inform him of what is going on & that his patient has been transferred.
I get a call back & from the time I answered my phone...all he did was yell at me. For a second I was thinking "Are we even talking about the same patient?" Although it wasn't "we talking" it was him yelling....like a 3 yr old having a tantrum. He insists the transfer is not necessary & that he has cancelled it...he then starts giving me orders. I interrupt him & tell him "The patient has left this hospital." How am I going to take orders on a patient who isn't even there? Seriously! I didn't say that, but I sure did want to. He yells at me "No she hasn't, I cancelled the transfer" & then carries on again. Ummmm...I just saw the hot EMS guys that took her & she is not here. So he rants on & on....it wouldn't have surprised me if he had a heart attack with how he was behaving. He then insists on talking to my charge nurse...where he continues his tantrum. She didn't really care....I guess it's typical of this doctor to always be yelling. That's so unprofessional!!!
He has gone as far as reporting it to my manager, who now wants to have a meeting to see how we could have handled this better. I'm hoping she's just doing this because it will please admin & the jerky doctor....not because she seriously thinks we didn't handle this correctly. Because I do not believe anything we did was wrong. It was a complication caused by a cardiac procedure that the cardiologist did that day. Everything was run by the cardiologist...the one doctor that was actively seeing that patient after the complication began. If she was post-surgical & developed a complication...I'd be calling the surgeon, if it was a renal complication...I'd call the nephrologist, if it was a GI complication, I'd call the GI doctor, etc. I would not be calling the primary to handle a secondary complication....unless I could not get in touch with the specialist. Sorry, primary doctors are just not at the top of my list as the "go to" doctors when a serious complication arises.
Wednesday night was another busy night. The son I spoke of earlier was even more of a pest. I try to be understanding & put myself in his shoes. His mother is very sick, but even still...lose the thought process that we are to bow down to your every need. He tells me she didn't eat much that day. I acknowledge what he says & he stands there looking at me like I should do something about that. Ummm, if she doesn't want to eat...what makes you think I can force her? If it were my mom...I wouldn't be relying on the nurse to talk my mom into eating.....I would be doing it myself - because if she isn't going to listen to her own children, it's highly doubtful she'll listen to anyone else. I can let the doctor know in the morning, but I'm not calling him now...because really...what is he going to do at 10:00 at night anyways?
I don't know...maybe people have a different illusion about what we can do as nurses. I wish they'd remember we are human too & most of us are doing the best that we can....even when getting yelled at for no reason.
I had another doctor who promised one of my other patients that he would order her cough medicine so she could not cough so much & hopefully get some rest that night. So I go in to talk to her & assess her & she asks "Where's my cough medicine?" Umm, let me look at what is ordered for you. Nope, no cough medicine. She then shows me the piece of paper where she made the doctor give him her name because he made that promise. Gotta love it...lol.
So I call this doctor & luckily he's on call. I remind him of what he promised this patient & his reply was "So." Uhhhh...so??? So you never ordered it. He then rambles off Hycodan & the rest I could not understand a word of it...like he wanted me to be thrown off & it's not because of a language barrier. He was American. I ask him to repeat it....which brings up another thing. We are told that when we get orders over the phone, we are to repeat it back to the doctor. Only it seems like 99.99999% of them don't want to do this. Usually it's something like "Tylenol 650 mg PO every 6 hours as needed......GOODBYE." And they hang up. It's just so rude. Anyways...I ask him to repeat himself because he mumbled his way through the order. He repeats it & I just add (to clarify)...do you want this PRN (as needed)? Because that is what I'm used to when it comes to cough medicine....take as needed, right? He replies in what I can only describe as a very rude manner..."DID I SAY PRN???????????" I wanted to laugh out loud....seriously. It's like dealing with 4 yr olds...or worse. At least 4 yr olds are fun. Instead I said "Nope, no you didn't, ok thanks!!!!" Which I think pissed him off even more as he was probably hoping to make me feel bad. Sorry, not gonna happen. Maybe as a new nurse all these grumpy docs would get under my skin....but not now. Not when I'm only doing my job & putting my patients first.
I'm off for a few nights & then back to work on Sunday for 4 in a row. I signed up for overtime...hopefully they won't call me off. I need to finish up the Christmas shopping on Fri & Sat as I won't have any more time to do it before Christmas. I can't believe it's only a week away.
Have a great weekend everyone!
Sunday, December 6, 2009
Vacation Time
I'm officially on vacation. Well, I have been technically since last Tuesday at 11:30 pm. I was sick Wednesday night & now I'm off until Dec. 14th. Niceeee! I'm going to attempt to get all Christmas shopping completed AND wrapped before the end of the week. I don't want to even think dealing with crowds or what to get people after my vacation is over. Actually I guess it's called a staycation as I'm not going anywhere. Just gonna enjoy some family time, friend time & time to myself until Dec 14th. Then it's back to work.
I've been needing this time off. The patients are so very complicated and physically exhausting as well as mentally as it seems like we have 3948023 things to think about on a nightly basis.
On a very sad note....my Florida Gators were defeated earlier tonight. It wasn't pretty...there were tears....mine & Tim Tebow's. :) I'm gonna miss seeing that guy lead the Gators. He'll go to the NFL, but I don't think he'll have quite the influence he does right now. He's an amazing man for only being 22.
On a good note...I saw an amazingggggg movie yesterday. It is The Blind Side with Sandra Bullock and Tim McGraw. It's one of those feel good movies that makes you feel even better because it's a true story. Bring tissues....you'll be crying happy tears & for once, it's nice to hear something positive in this world.
Sorry, gotta mention it just so it's documented in my blog when I look back one day...but Tiger Woods.....HOW IN THE WORLD DID YOU JUGGLE 4 AFFAIRS (possibly more) AND A MARRIAGE, CHILDREN AND A SUCCESSFUL CAREER??? Never in a million years did any of us see this coming. I understand it's a private matter....but come on...4 affairs (or more)? He's only been married for 5 years! I don't blame his wife for attacking his car with a golf club. Ok, enough said.
I had lunch this past Friday with some of my current co-workers & some of my past co-workers from the hospital I quit. NOTHING has changed over there. Wait...it has gotten worse, if that's possible. And by the sounds of it...it's going to get even worse in the next few months. It's that administration. A majority of the clinical leaders have left and a majority of their experienced nurses have left. They are hiring more grad nurses to make up for it. Sigh...so glad I left at the beginning.
Speaking of leaving....it has been nearly 6 months since I left. Time has flown by! Kind of like this night has. Time for me to get some sleep. Stay warm everyone...have a GREAT week!!!!!!!
I've been needing this time off. The patients are so very complicated and physically exhausting as well as mentally as it seems like we have 3948023 things to think about on a nightly basis.
On a very sad note....my Florida Gators were defeated earlier tonight. It wasn't pretty...there were tears....mine & Tim Tebow's. :) I'm gonna miss seeing that guy lead the Gators. He'll go to the NFL, but I don't think he'll have quite the influence he does right now. He's an amazing man for only being 22.
On a good note...I saw an amazingggggg movie yesterday. It is The Blind Side with Sandra Bullock and Tim McGraw. It's one of those feel good movies that makes you feel even better because it's a true story. Bring tissues....you'll be crying happy tears & for once, it's nice to hear something positive in this world.
Sorry, gotta mention it just so it's documented in my blog when I look back one day...but Tiger Woods.....HOW IN THE WORLD DID YOU JUGGLE 4 AFFAIRS (possibly more) AND A MARRIAGE, CHILDREN AND A SUCCESSFUL CAREER??? Never in a million years did any of us see this coming. I understand it's a private matter....but come on...4 affairs (or more)? He's only been married for 5 years! I don't blame his wife for attacking his car with a golf club. Ok, enough said.
I had lunch this past Friday with some of my current co-workers & some of my past co-workers from the hospital I quit. NOTHING has changed over there. Wait...it has gotten worse, if that's possible. And by the sounds of it...it's going to get even worse in the next few months. It's that administration. A majority of the clinical leaders have left and a majority of their experienced nurses have left. They are hiring more grad nurses to make up for it. Sigh...so glad I left at the beginning.
Speaking of leaving....it has been nearly 6 months since I left. Time has flown by! Kind of like this night has. Time for me to get some sleep. Stay warm everyone...have a GREAT week!!!!!!!
Thursday, November 26, 2009
Happy Thanksgiving 2009!
I am hoping everyone that reads my blog had a wonderful day today. I worked the first 8 hours of it, then slept & now I'm patiently awaiting 7:15 to arrive...because I just might get the night off. I'm on call & have to remain available until 7:15. If I don't hear anything, then I'm heading over to my parents house to surprise them. I still have to remain available until 11:15, but chances are it won't be a busy night at the hospital...unless some family feuds break out, but hopefully that isn't happening.
I'm kind of relieved to not have to go back. I had a patient last night...a man who I am told has basically given up on life. He's refusing to eat, refusing medications, refusing to be moved. He just wants to be left alone. So I go in the room & his daughter is there. She's very concerned, which I don't blame her...I would be too. I dread the day of having to watch my family or friends take a turn for the worse. His vital signs were stable, but he was sweaty...so I do an accucheck. It's 49. I give him some D50 IV since I knew he would refuse to eat or drink. That gets him up to 77 & it wouldn't be long before it started dropping again. I started his TPN & hoped that would kick in & sustain his blood sugar. During the day, the bag had run out early...so the dayshift nurse gave him insulin to cover his high blood sugar...but since he wasn't eating or drinking & the TPN wasn't running for hours...it was no wonder he was dropping. I don't blame the day nurse as I know they are very busy during the day & it probably slipped her mind when it came to giving insulin & nothing to eat or drink to follow behind it. I've done it myself when giving insulin at night & the patient just wants to go to sleep instead of having a snack. It happens.
So for a few hours, I was checking his blood sugar often. I didn't want it getting any lower. By 1 am, he was sustaining in the low 100's, which is perfect. All while this is going on, the daughter is saying he's had a change in status. He isn't responding. I told her it was probably a combination of having low blood sugar & being tired. I mean it was nearly 11 pm when she brought this up. She didn't like my answer, but I didn't know what she wanted me to do. I can't call a rapid response...the man was simply sleepy. I did talk to my charge nurse, who in turn went in & spoke to the daughter. It was agreed that we would monitor his vital signs every 2 hours. Luckily I wasn't so busy that this couldn't be achieved. He remained stable through the night & around 4 am, he was awake & talking to me & drinking grape juice.
I think to a degree, he simply didn't want to talk to his daughter. This happens quite a bit...the patient just wants the family to go home. I think it worries them watching their family worry about them. They rather just be alone or communicate only with their nurse. It's hard to watch this because it is very much appreciated & comforting to know there is a family very concerned about their loved one. So often we see the opposite...not a single visitor or phone call. Sometimes the only communication & touch they receive is from their nurse.
Last night I also got to meet my new orientee. She makes me feel old.....we both graduated from the same high school. Small world....lol. But I graduated the year after she was born!!!! OMG! She seems pretty cool, we hit it off & I think she'll be a good nurse. She was a tech on an oncology floor while in nursing school. I am hearing it's rather difficult out there now for new nurses to get hired. My hospital just hired 25 of them, but supposedly we're the only hospital hiring new grads at this time of the year. We won't be working together for another month, but I am looking forward to it. I'm glad I said yes to being a preceptor.
Ok, it's 7 pm...I don't want to jinx myself by packing to go to my parents house, but I want to leave as quickly as I can. So have a Happy Thanksgiving everyone & a great weekend!!!!
I'm kind of relieved to not have to go back. I had a patient last night...a man who I am told has basically given up on life. He's refusing to eat, refusing medications, refusing to be moved. He just wants to be left alone. So I go in the room & his daughter is there. She's very concerned, which I don't blame her...I would be too. I dread the day of having to watch my family or friends take a turn for the worse. His vital signs were stable, but he was sweaty...so I do an accucheck. It's 49. I give him some D50 IV since I knew he would refuse to eat or drink. That gets him up to 77 & it wouldn't be long before it started dropping again. I started his TPN & hoped that would kick in & sustain his blood sugar. During the day, the bag had run out early...so the dayshift nurse gave him insulin to cover his high blood sugar...but since he wasn't eating or drinking & the TPN wasn't running for hours...it was no wonder he was dropping. I don't blame the day nurse as I know they are very busy during the day & it probably slipped her mind when it came to giving insulin & nothing to eat or drink to follow behind it. I've done it myself when giving insulin at night & the patient just wants to go to sleep instead of having a snack. It happens.
So for a few hours, I was checking his blood sugar often. I didn't want it getting any lower. By 1 am, he was sustaining in the low 100's, which is perfect. All while this is going on, the daughter is saying he's had a change in status. He isn't responding. I told her it was probably a combination of having low blood sugar & being tired. I mean it was nearly 11 pm when she brought this up. She didn't like my answer, but I didn't know what she wanted me to do. I can't call a rapid response...the man was simply sleepy. I did talk to my charge nurse, who in turn went in & spoke to the daughter. It was agreed that we would monitor his vital signs every 2 hours. Luckily I wasn't so busy that this couldn't be achieved. He remained stable through the night & around 4 am, he was awake & talking to me & drinking grape juice.
I think to a degree, he simply didn't want to talk to his daughter. This happens quite a bit...the patient just wants the family to go home. I think it worries them watching their family worry about them. They rather just be alone or communicate only with their nurse. It's hard to watch this because it is very much appreciated & comforting to know there is a family very concerned about their loved one. So often we see the opposite...not a single visitor or phone call. Sometimes the only communication & touch they receive is from their nurse.
Last night I also got to meet my new orientee. She makes me feel old.....we both graduated from the same high school. Small world....lol. But I graduated the year after she was born!!!! OMG! She seems pretty cool, we hit it off & I think she'll be a good nurse. She was a tech on an oncology floor while in nursing school. I am hearing it's rather difficult out there now for new nurses to get hired. My hospital just hired 25 of them, but supposedly we're the only hospital hiring new grads at this time of the year. We won't be working together for another month, but I am looking forward to it. I'm glad I said yes to being a preceptor.
Ok, it's 7 pm...I don't want to jinx myself by packing to go to my parents house, but I want to leave as quickly as I can. So have a Happy Thanksgiving everyone & a great weekend!!!!
Monday, November 23, 2009
Moved Back...Yay!
I had another 5 days in a row off. It has been nice...relaxing...enjoyable. Goes by way too quickly though.
We got to finally move back to our regular floor last Tuesday. It is wonderful...like being home again. I had a patient that I had the previous week. Turns out she has Guillian-Barre disease & NO, she has not had any recent flu shots. She's a woman in her mid-80's that exercises every day & now she can barely move her legs. I feel so bad for her. No matter what we did, she could not get comfortable & she couldn't move herself. The disease is moving progressively fast for her. It makes me sad. To be of sound mind, but your body is failing your control. Not fair.
Not much really stands out from last week. Guess that's a good thing. I did find the time to go see New Moon on Saturday. I was expecting crazy crowds. My niece & I got there at 1:15...they had a show at 1:30, it wasn't crowded, no line to get in...perfect. The movie is decent, but I still say the whole storyline is kinda cheesy. At least my niece has come to her senses & is on Team Jacob. :)
Now my niece & I are reading Lovely Bones - since we saw the preview for the movie. Well, my niece is reading it anyways. I'm still muddling my way through True Blood.
Not much else really going on. Gosh, I seem so boring lately. Maybe something exciting will happen at work. I have to work Tues, Wed and Thurs nights this week...which means it will be the first year ever that I've had to work on Thanksgiving. I'm bummed I can't be with my family, but grateful I have all of Christmas off.
We got to finally move back to our regular floor last Tuesday. It is wonderful...like being home again. I had a patient that I had the previous week. Turns out she has Guillian-Barre disease & NO, she has not had any recent flu shots. She's a woman in her mid-80's that exercises every day & now she can barely move her legs. I feel so bad for her. No matter what we did, she could not get comfortable & she couldn't move herself. The disease is moving progressively fast for her. It makes me sad. To be of sound mind, but your body is failing your control. Not fair.
Not much really stands out from last week. Guess that's a good thing. I did find the time to go see New Moon on Saturday. I was expecting crazy crowds. My niece & I got there at 1:15...they had a show at 1:30, it wasn't crowded, no line to get in...perfect. The movie is decent, but I still say the whole storyline is kinda cheesy. At least my niece has come to her senses & is on Team Jacob. :)
Now my niece & I are reading Lovely Bones - since we saw the preview for the movie. Well, my niece is reading it anyways. I'm still muddling my way through True Blood.
Not much else really going on. Gosh, I seem so boring lately. Maybe something exciting will happen at work. I have to work Tues, Wed and Thurs nights this week...which means it will be the first year ever that I've had to work on Thanksgiving. I'm bummed I can't be with my family, but grateful I have all of Christmas off.
Sunday, November 15, 2009
Ho Hum
Not too much going on at the moment. I've been off for 5 days and after I work the next 3 nights in a row, I'll be off for 5 days in a row again. Not a bad lifestyle, eh?
I'm going to be precepting a new grad next month. I have never precepted a new grad before...hopefully it will go well. Work wasn't too bad last week. I had a sad case...a drug addict...again. I don't know why it still surprises me when that happens. I guess I am more optimistic than pessimistic...even with all the unfortunate things going on in the world. This patient was in her late 20's...totally hooked on anything that would make her sleep. I don't get it. If you want to sleep...take Tylenol PM or Melatonin. Why get hooked on the narcotics? Probably a tolerance thing.
By the time I got her, they had discontinued the Dilaudid & was only giving her Percocet and Phenergan. They should have dc'd the Phenergan as she was totally using it for sleep only. I had no problem giving it to her because when it's nighttime & you have 4 other patients...you want your patients to remain calm & a sleeping patient is a good thing for us nightshift nurses. Still though, it's sad to see someone throwing their life away because of a drug addiction.
I also had this patient...in her late 60's...screaming her head off. As soon as I arrived on the floor, I thought "That's probably going to be my patient"...cause I'm lucky like that. :) Sure enough, it was. And if that wasn't lucky enough, she was also on bedrest & drinking Golytely. Yes....the one drug in medicine meant to make us smile when we say the name. Cause it does everything BUT make you "go lightly." It's a prep for a colonoscopy & it produces some strong results. So having a confused bedbound patient drinking Golytely is a nightmare.
Sometime during the night though, I got to make the deal of a lifetime. There was another patient that was having trouble with his nurse. So much so that he did not want her in his room anymore. He thought she was rude & he did not need a nurse like that. So they asked another nurse to trade a patient for that one. Ummm, that nurse couldn't do it...seems she already had a falling out with the patient. The next nurse said "No way!!!!!" So they came to me...begging. I first started to ask "What is wrong with that patient?" And then I suddenly stopped & asked "Can I trade my confused patient?" The reply was YES. Ok, done deal.
This irate patient was someone getting Oxycodone every 6 hours for back pain. He was an older man & I did believe he had genuine pain....not that it matters as I go with the belief that if it's ordered & the patient isn't showing any signs of drug toxicity or unstable vital signs...they get their medicine. This isn't the show "Intervention." We aren't here to cure someone with chronic pain or even drug addiction. It's supposed to be short-term nursing care...so if it's ordered...then give them their medicine. I went in & spoke to him, got him some food, got him his medicine & that was it.
The other nurse....the one that got the trade....well, let's just say she was not a happy camper. Oh well...don't be rude to your patients next time!
Speaking of rude, this same nurse can be quite vocal & not in a good way. I often overhear her say rude things to patients...to the point that I feel the need to report her. I don't usually do things like this as I know nursing can be stressful & it's probably just her way of releasing stress....but it's wrong. It's rude, insensitive & wrong. Problem is...I'm not sure how to go about it. Talking to her is out of the question as she is so self-centered she would never accept the idea that she is doing something wrong. It's always someone else's fault. So the next step is do I verbally say something to the charge nurse? the manager? write an anonymous letter? I don't know...but we work hard to achieve patient satisfaction & here she is ruining it all...repeatedly.
My youngest niece turned 13 this past week. Sigh. I miss the days of when she was 3 yrs old. It doesn't seem possible that she is just 5 yrs away from being an adult. Where does the time go?
I'm going to be precepting a new grad next month. I have never precepted a new grad before...hopefully it will go well. Work wasn't too bad last week. I had a sad case...a drug addict...again. I don't know why it still surprises me when that happens. I guess I am more optimistic than pessimistic...even with all the unfortunate things going on in the world. This patient was in her late 20's...totally hooked on anything that would make her sleep. I don't get it. If you want to sleep...take Tylenol PM or Melatonin. Why get hooked on the narcotics? Probably a tolerance thing.
By the time I got her, they had discontinued the Dilaudid & was only giving her Percocet and Phenergan. They should have dc'd the Phenergan as she was totally using it for sleep only. I had no problem giving it to her because when it's nighttime & you have 4 other patients...you want your patients to remain calm & a sleeping patient is a good thing for us nightshift nurses. Still though, it's sad to see someone throwing their life away because of a drug addiction.
I also had this patient...in her late 60's...screaming her head off. As soon as I arrived on the floor, I thought "That's probably going to be my patient"...cause I'm lucky like that. :) Sure enough, it was. And if that wasn't lucky enough, she was also on bedrest & drinking Golytely. Yes....the one drug in medicine meant to make us smile when we say the name. Cause it does everything BUT make you "go lightly." It's a prep for a colonoscopy & it produces some strong results. So having a confused bedbound patient drinking Golytely is a nightmare.
Sometime during the night though, I got to make the deal of a lifetime. There was another patient that was having trouble with his nurse. So much so that he did not want her in his room anymore. He thought she was rude & he did not need a nurse like that. So they asked another nurse to trade a patient for that one. Ummm, that nurse couldn't do it...seems she already had a falling out with the patient. The next nurse said "No way!!!!!" So they came to me...begging. I first started to ask "What is wrong with that patient?" And then I suddenly stopped & asked "Can I trade my confused patient?" The reply was YES. Ok, done deal.
This irate patient was someone getting Oxycodone every 6 hours for back pain. He was an older man & I did believe he had genuine pain....not that it matters as I go with the belief that if it's ordered & the patient isn't showing any signs of drug toxicity or unstable vital signs...they get their medicine. This isn't the show "Intervention." We aren't here to cure someone with chronic pain or even drug addiction. It's supposed to be short-term nursing care...so if it's ordered...then give them their medicine. I went in & spoke to him, got him some food, got him his medicine & that was it.
The other nurse....the one that got the trade....well, let's just say she was not a happy camper. Oh well...don't be rude to your patients next time!
Speaking of rude, this same nurse can be quite vocal & not in a good way. I often overhear her say rude things to patients...to the point that I feel the need to report her. I don't usually do things like this as I know nursing can be stressful & it's probably just her way of releasing stress....but it's wrong. It's rude, insensitive & wrong. Problem is...I'm not sure how to go about it. Talking to her is out of the question as she is so self-centered she would never accept the idea that she is doing something wrong. It's always someone else's fault. So the next step is do I verbally say something to the charge nurse? the manager? write an anonymous letter? I don't know...but we work hard to achieve patient satisfaction & here she is ruining it all...repeatedly.
My youngest niece turned 13 this past week. Sigh. I miss the days of when she was 3 yrs old. It doesn't seem possible that she is just 5 yrs away from being an adult. Where does the time go?
Friday, November 6, 2009
Refreshed & Excited
We had a staff meeting today. It was good. I like the meetings there....very casual, interactive, funny. It was also refreshing. I guess maybe it's because we don't see our manager very often since we work nights, but she is a breath of fresh air. She seems to understand the hard work we put in & the common sense it takes to be a manager. She fights for us...gets us the equipment we need, listens to us gripe, tries to make things better.
She explained the one hour rounding to us in a way that totally made sense. Rather than it being yet another burden to put on nurses, we could see how it would be beneficial for both the patient and the nurse. Even waking the patient up for labs seemed understandable when she gave an explanation as to why this has been put into effect. We all want our patients to be happy, don't we?
We get to go back to our remodeled floor on Tuesday. Cannot wait!!!
She explained the one hour rounding to us in a way that totally made sense. Rather than it being yet another burden to put on nurses, we could see how it would be beneficial for both the patient and the nurse. Even waking the patient up for labs seemed understandable when she gave an explanation as to why this has been put into effect. We all want our patients to be happy, don't we?
We get to go back to our remodeled floor on Tuesday. Cannot wait!!!
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