Summer Flu???

I have been dealing with some type of illness the last 4 days. I had been off for nearly 2 weeks. Took a trip to Atlanta and another trip to Daytona. I was all ready to go back to work last Saturday. Then Friday I was exhausted. Slept a lot. Woke up in the evening with a fever. Ugh...I never get sick!

I started taking Advil. I knew I couldn't call in sick to work. I already called in on time in July and you aren't allowed to call in more than once in a 2 month period without getting in trouble. Stupid rule! So I went in to work Saturday night. Big mistake. As soon as I got there, I could feel my temp starting to rise. I was flushed & tired...and hadn't even done anything yet. Luckily they had enough nurses there so I was able to go right home. Didn't even have to take report or anything. I don't care if I get in trouble for calling in sick. I am sick & no way can I work nor should I be around other sick people.

So I came home...my temp is normally 97, but now it was 100. I figured it's low-grade...let my body fight whatever infection it is trying to fight without intervening. Another big mistake. Within a couple of hours it was up to 103. Way high for me. So I resumed the Advil, put some ice packs under my arms & in the groin area (since that's what I do for my patients at work) & it took awhile to come down, but eventually it was back to 97 by morning. Weird thing is...I really don't have any other symptoms than a cough. My nose, head & lungs are clear. Stomach is fine, no UTI. My throat is just a tad scratchy but nothing to complain about. Even with the high fever, I felt ok.

So now it's Sunday morning...I called in sick to work. No way was I going in after what I dealt with Saturday night. I retake my temp & it's 96.4. Even better! Till the evening. Back up to 101 with Contac cold medicine & fever reducer. So I start back with Advil & went to sleep. I woke up all sweaty, but too exhausted to do anything & slept some more. Monday morning, my temp is back to 97...yay. Jump in the shower & then back to bed. Took a nap from 1 to 4 & woke up with another temp. Started Advil again.

I don't know what this is & I wish it would just go away. Luckily I don't have to go back to work until Thursday, but I'd like to get back to normal before then. I'm debating about whether to see a doctor or allow them to start me on a broad spectrum antibiotic. I'm all for my body fighting its own battles...but not when I see no results. And did I mention...I never get sick. I don't know anyone that is sick or has heard of being sick. So I don't know what this is.

And on top of that...it has made me all weepy. Like I rented Soul Surfer Saturday night & could not stop crying. You would have thought that was my kid in the movie. Then Sunday night I watched this special on Amazing Animal videos...omg, a polar bear was attacking a woman & I got all emotional. And they showed that Christian the Lion clip at the very end. Forget about it....cry me a river. I've seen that video 93040932 times...but it gets me every time. And this morning...someone on FB posted a pic of one of the fallen Navy Seals funeral & his dog lying by his casket. Niagara falls for me...could not stop crying. It's just a picture!

Hope everyone is having a better week than I am!!

Third Degree Heart Block

I am still thoroughly enjoying my part time schedule. I'm there just long enough to get a decent paycheck, but short enough that when a night goes bad...I'm so glad I don't have to come back.

I had 3 patients last week. One with a mystery as to why he was so weak & suddenly anemic, one alcohol withdrawal and one who has chronic anemia, but again, they have no idea why. They sounded terrible on paper. I should know by now not to assume they will be as terrible as they sound...because usually the train wrecks on paper are awesome patients, while the ones that sound too good to be true...end up being a pain in the ass. So I should know by now not to think the worst. I just pictured having to give blood to two of them while dealing with an out of control alcoholic as the third patient. Luckily, NONE of that happened.

Pt #1...mystery man. I made an extra effort to connect with him. I could tell he was frustrated being in the hospital for a couple of weeks and not getting any real answers. We could tell him everything it wasn't, but unfortunately...no one had figured out what was causing his problems. So I really took my time to comfort him. He slept like 10 hours out of my 12 hour shift...so it wasn't bad.

Pt #2...the alcoholic. He looked a mess, but for some reason, he & I bonded. He didn't give me any trouble, I didn't give him any judgment. Whatever he needed, I got it for him...if it was ordered. One thing I wouldn't get was nausea medicine. I cannot allow myself to call an MD for nausea medicine when a patient says "I'm feeling nausous, I need medicine....oh, and can you get me a turkey sandwich, a pepsi & some ice cream too." Uhhhh, no...pick one or the other. Nausea medicine or food. Which is more important to you? He always chose food.

Pt #3...although his hemoglobin was enough to make you panic....in the 5 and 6 range, he actually never asked for a single thing and the only time he would call was if his IV machine was beeping. During his time at the hospital, they had already transfused something like 15 units of blood. His count would go up for a day & then drop back critically low. NO.IDEA.WHY.

I also got an admission around 4:30 in the morning, but one of my friends did nearly the entire admission. She rocks! The patient had an active GI bleed. Eeeekkkk...don't like those because the smell is horrible. And you never get used to it.

So my first night was good. You know what that means. My second night would have to be bad.

I come back & get my first 3 patients, but didn't have to deal with GI bleed. Well, other than continuously spraying the hall every hour because that odor was creeping its way into the nurse's station. My patients were all doing well. You know you've bonded with a patient when they say "Heyyyyyy girlfriendddddddddddd" as you enter the room. That would be pt #2.

Everything was going great until about 4 am when I'm told I'll be getting an admission. Ok, fine. I start getting report from ED and the nurse tells me the patient's blood pressure is labile. Ummmm, can you explain a little more in depth...as I'm clicking on the vital signs tab on the computer. She says "It goes up & down." I look...he came in it was 130/65, now two hours later it's 75/22. Uhhhhhhhhhhhh....................hold up. I call the nursing supervisor & she says she'll check it out. I tell the ED nurse what's going on & she says "I understand what you're saying, but you do know that blood pressure & stability are NOT related. Really? What nursing school did you go to?

The nursing supervisor checks him out, says he's fine...talking, joking, bp currently 110/60. Ok, fine, whatever. Bring him here...fully expecting I'd have to do a rapid response should his bp drop. I take my other patients vitals. Everyone is great...stable. My new patient arrives, no less than 2 min later I get a call from the monitor tech...."uhhh, your patient is sustaining a heart rate of 30." So I rush over to that room. It's pt #1. Thirty min earlier he had been normal sinus rhythm with a heart rate of 80. Now he was 30. Luckily he's talking to me & his blood pressure hasn't changed. Whew..did not want a code blue.

I tell my charge nurse what is going on....5 of us go back in his room & are staring at him...lol. This is the tricky part....you have to tell your patient why you are there, but you don't want to scare him either. I leave to call the cardiologist. Someone else reminded me to call rapid response. I call the rapid response nurse & get the reply "He sounds fine." Uhhh, you can tell all that over the phone??? So he comes up, looks at the rhythm strip & runs to the room. He tells us the patient is in 3rd degree complete heart block. Eeekkk...this can be fatal. In my 7 years as a nurse, I have never seen someone go from normal sinus rhythm right into complete heart block.

I'm still waiting for the cardiologist to call back, so we order an EKG and I call the primary to get an order for ICU. She calls me back quickly, I get the order....easy peasy. Finally the cardiologist calls back & after I read him the EKG strip. He thanks me for telling him & hangs up. WTF? I wasn't telling him the morning weather report.

Anyways, we quickly got my patient to ICU. The nurse down there asked him what was going on as a gauge to see how much he knew. His reply..."one minute I was sleeping and the next thing I knew...5 beautiful nurses were standing over me asking if I was alright." Awwwwww....sweet! I really hope he's ok.

Needless to say, I got back to my floor at 6:30 am...I checked on my admission who was now sound asleep & I passed him onto the day nurse. I had a staff meeting at 7:30, so no way would I have been able to do the admission. And he was sleeping, it could wait. Wow, what a morning. So glad I then had like 9 days off. :)

Weird thing is....within 48 hours...two more patients on my floor went into complete heart block. This never happens!!!!!!!!!!

Some good things...

*We got a cost of living raise....yesssssssssss

*I pretty much spent that raise staying at a resort for 2 days & drinking frozen drinks by the pool....yessssssssss

*I went from having no guys lately to two asking me out....yessssssssss

*I got a new dishwasher....yessssssssss

*Found out my friend that just went thru a double mastectomy for breast cancer is now cancer free....yesssssssssssss!!!!

Hope everyone is having a good week!!! :)))

What The F???

Not guilty??? Seriously??? What kind of people are those jurors? Never mind, don't answer. Believe me, I already know & I can sum it up in one word = MORONS!!!!!! The more they talk, the more they annoy me. They did not even take her behavior after the death or her numerous lies to everyone into consideration. They were more focused on trying to figure out if her father was involved & how she died. Helloooo, McFlyyyyyy....if someone is acting very suspicious, never reports her child missing for 31 days & everything she says is a lie...even to law enforcement & the child's remains are found in a garbage bag in a swamp a block or two from the house...and the face has duct tape all over it, then you should consider that that liar is hiding something. I give up. Just reinforces that common sense isn't so common. And if another one states "Not guilty doesn't mean Innocent"...I am going to throw something at my tv.

I've spent the last 7 weeks watching this drama on tv & the last nearly 3 years hearing about this case day after day because it's local. She gets out this Sunday & I can only hope that she disappears forever. She has what's coming in due time & by a higher power. At least I got the pleasure of learning who Jeff Ashton & Yuri Melich were. :)))

Work...it is exhausting me lately. It truly feels like I work in a psychiatric hospital. We have patients screaming, patients yelling, patients detoxing, patients acting bizarre...and it's not even a full moon. I called in sick tonight. I was feeling nauseous & feverish, but I'm doing better now. I need to get some sleep. I was puppysitting the last few days & not getting nearly the amount of sleep I need.

Hope everyone has a good week!

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!