so the last post i wrote was short and sweet. but i posted and forgot to mention my “close call” for the day…and it was kinda a big close call!

my day was going along okay with my sweet, kind, wonderful patients. but while they were caught up and resting comfortably i was helping my fellow nurses and doing things that needed to be done on their patients. like: starting an IV, drawing lab, helping them to the bathroom, giving meds, etc…

so i go and start an IV on a gentleman in curtain 12. i set everything up as usual…gloves, IV start kit, needle, IV fluids, yada yada. as i usually do i take off the top part of the glove on my left index finger in order to allow me to palpate the patient’s vein so as to get it on the first try. luckily this guy had huge veins so it shouldn’t be too hard. i start IV and get it on the first stick, then i do what comes next by connecting all that is necessary to complete my task, and what happens…blood goes everywhere, free flowing right out of his vein all over the place, right down his arm. so i try to connect everything very quickly to keep from making a bigger mess. all the while my left index finger is still uncovered. i see some blood on my finger and wipe it off on the sheet. usually no big deal because i have no opened sores or cuts on my fingers, EXCEPT FOR TODAY! i remember i had earlier sliced my left index finger with and wonderful paper cut. i didn’t panic but washed my hands…thoroughly, and then asked the charge nurse what she would do…do i report it or forget it. she says since i had a fresh paper cut from earlier that wasn’t closed up yet that i should report it. so i do and this consisted of drawing more blood from the patient (not me), obtaining blood from me, a urine drug screen from me (to make sure i wasn’t under the influence..ha!), a bunch of paper work, and then “the wait” to see if the patient’s whose blood got all over me has Hep C or HIV. lovely! did i mention he had cirrhosis of the liver (which is either alcohol induced or a result of Hep C) wonderful!

well i am glad to say that he did come back negative of both Hep C and HIV. phew! but i now have to get tested in 6 weeks, 3 months, and 6 months to still make sure I am okay! i’m not worried because of course God is in control and i don’t feel in my gut that i am in danger.

so it was a close call and needless to say i will not be exposing my left index finger to that possibility again! i will just have to stick my patients more! ha!

i am SO glad when i get assigned sweet sweet patients. it really does make my job easier and more enjoyable. i worked in the ER again today and took care of the “hold” patients…(which means they are waiting down in the ER to be admitted up to the floor and there are no available beds in the hospital) i had a total of 6 total throughout the day. each and everyone of them were so nice, polite, friendly, kind and sweet. men and women. nothing too terribly exciting–chest pain and abdominal pain. but aghhhh such a nice wonderful day.  if only every day was like it my job would be PERFECT!

so i was getting morning report from the night nurse…and when she starts off “the patient is an inmate” you worry a little and jump to crazy ideas and assumptions. then she continues “the patient is in shakles and is secured to the bed, with 2 guards present” now you really get all ‘nervous-like’ wondering what the heck has this patient done? and finally she says “he is really nice though” hmmmm….

so i go and meet this patient wondering what kind of person i am about to encounter and he was in fact very pleasant and friendly. he didn’t look like a bad guy. he had several tattoos and scars to his upper body (which i found out later were bullet entrance/exit wounds and stab wounds) but looked very clean cut with a smile on his face. the guards didn’t seem to be bothered by me nearing his bed for my daily assessment so i relaxed a little…all the while acting like nothing was different in taking care of him vs my other ‘law-abiding’ patients.

he turned out to be my easiest patient but with the saddest story. he is sick with multiple myleoma and is about to undergo more chemo and radiation. i did find out via one of the guards that his unknown offense was not considered that serious/dangerous and that he should be getting out of jail soon. but unfortunately for him he has to contend with a different kind of jail after being released. the jail of being trapped in a body that is not getting any healthier, only sicker, and having to suffer the side affects of cancer treatments. i really did feel bad for the guy. it definetly made me realize we are all human. we all make mistakes. we all get sick. and it still SUCKS no matter where we come from!

well this story was not witnessed first hand but came from someone who was present at the scene…

code rush: is an overhead page for all available men to a patient’s room in order to calm or man-handle a patient who is out of control

today there was a “code rush” on the CVICU (cardiovascular intensive care unit), where a male patient was standing atop his hospital bed screaming, pulling out his IV’s, being obsene, cursing, etc…well no MEN hospital workers showed up, so therefore this irate patient had to be controlled and contained by 6 female nurses and 4 security officers (who showed up later). the code RUSH lasted for a good 30-40 minutes in order to put another IV line in the patient and sedate him with IV medications all the while holding him down. the patient was going through DT’s (alcohol detox) and these patients can become pretty dangerous and “out of their minds” during their detoxification. everything eventually became undercontrol and lets just say that that patient is now sleeping off his detox with the aide of wonderful medications.

i am so upset i missed all the action. i would have loved to be in the middle of all of it. maybe next time i will just have to report to a “code RUSH”

Well, Chris updated my wordpress and I finally got it up and running again…so here is my work updates.

The last two weeks I have been orienting in the ER, and let me tell you what a trip. I worked in the ER at BIG Baylor in Dallas several times in the resource pool and I had forgotten what a crazy place the ER can be. To start off, my first day orienting there was an older gentleman that came in complaining of stomach pain, 8/10 (pain scale). “OH it hurts so bad, I am so constipated, I can feel it all right there, I can’t sit up it feels like I am sitting on a big log of poop…” No lie these were his words to me. Gross right. Well the ER doc ordered him Lactulose (MAJOR stool softener) and a soap suds enema. Yep I had to give it. I assisted the patient to the beside commode and you know what happened next. Hmmmm….His stomach pain was gone and we sent him back home! Go tax dollars! Way to pay for someone to poop!

Then there was the constant influx of people complaining of pain somewhere here or there and were sent back home with a prescription for pain meds. Glad to hand them a new Rx to help out their drug habit. But what can you do right. The pain is what the patient says it is. Sometimes however the docs don’t give them their pain medication prescription and then you have to deal with a pretty upset customer who was relying on their free handout.

Last Thursday was quite a day. This was my last day in orientation and I had one of the ER nurses following me. It was all going fine until we had a patient in cardiac arrest arrive. They were doing chest compressions on him as they were rolling him through the ambulance bay doors. Well every nurse, tech, and respiratory therapist was in the room. I started writing down/charting everything that was being given and being done to the patient.  There were people alternating giving him CPR, and I made the comment I hadn’t ever done chest compressions before on a “REAL” person and then of course everyone was like, good it’s your turn. So I jumped up on the stool and started pushing down on this guy’s chest to beat his heart for him. You think when you are going through the CPR classes that it can’t be that hard. HA! I guessed wrong. I lasted for a whole minute before I was breathing hard myself, my face turned red, and my back started hurting. That is freakin’ hard work. We as a team worked to save him for a complete hour before the doctor called it quits and hopefully that patient went to see Jesus. By the time we were down in that room the entire ER had filled up and the waiting room was running over with patients waiting to be seen. So it was pure craziness. But it was FUN! I definitely like working in the ER. It is a nice change of pace from floor nursing. Can’t wait to go back!

well i haven’t ignored my blog i’ve just been sick with something. we don’t know what yet. waiting on the doctor’s return call. some weird epigastric/abdominal pain. so needless to say i haven’t been at work and i don’t have any interesting stories for you, but hopefully soon.

Last week, I had two very different patients at work. The first patient was very sweet and “cute.” And also very very confused. He had alzheimer’s and was stuck back in the 1940′s. He was quite the gentleman. At the beginning of the shift he was very worried about his dog, dottie, and wanted me to call Jeanie, his caregiver. I asked if he knew her number. His response was…”awhhh…now your gonna embarass me!” I didn’t understand. He said, I can’t remember. This “mind thing” is really hard to get used too.

Later that day, Jeanie, the caregiver came up to the floor to visit. She shared with me a story. She says she has had to trick him a couple times to get him out of the house. He needed his hair cut but stated that he wasn’t leaving the house and that his hair was just fine. So she used her cell phone and called his house phone. After answering the house phone and talking to an imaginary barber. She got off and said Bill (patient) that was your barber and he said you had an appointment to get your hair cut today. Bill covered his mouth and said, Oh my gosh! I forgot all about it. Then rushed to put on his coat and shoes. And he got his hair cut.

Alzheimer patients are one of a kind. Even though they can get agitated and hostile at times, all they need is love, kindness, and a compassionate heart from the ones around them. 

As for my second patient, I have never been more shocked to hear a woman curse so much. She was seriously a sailor. Every other word out of her mouth was a curse word. Not just the common most frequently slip up curse words, we are talking hurt your ears and make you cringe curse words. Let’s just say that every time I had to check on her to see how she was feeling I tried to exit quickly to avoid a long-drawn out story of how this and this happened and bleep, bleep, bleep this. Agh! I tried to laugh it off and wouldn’t dare ask her not to curse for fear of getting a royal a** chew!

It’s amazing to me how you can have two completely opposite patients who are both equally sick and still have to care for them the same. I just pray that I am a kind, gentle, friendly patient when I get older versus the mean, cruel, and sometimes vile patient.

What a day!

This last week working three days in a row comepletely exhausted me. As I wrote in my last post, I had needy patients.  I had the same two needy ladies again on my second day of work as well. Even though I had learned their manerisisms the previous day I was still tired of running all their errands and doing everything “just right” for them. So no exciting story there to tell you.

On my third day however, I worked on the transplant unit. Everyone on that floor is really sick and their stories are so sad. I was still very busy but a different kind. The kind of busy that consists of continually getting them medications because you don’t want them to hurt or you want them to relax because their anxieties are through the roof.

I had one woman patient that confessed with tears in her eyes that in five days she would have been in the hospital for an entire year. She went home for a few days here and there but the majority of her year was spent there in that hospital room. My heart broke for her. I asked her if she was a woman of faith and her reply was “I don’t know how I could still be doing this day after day without the Lord on my side.” I felt God telling me to pray over this woman as she was lying there crying. As I prayed for her, I was thankful at the same  that God brought me into this profession. She was so thankful after the prayer and appreciative, stating it brought her focus back to where it should be. We all need that sometimes don’t we…

So even though my week was exhausting and I was extremely tired and worn out from all the craziness God too brought ME back to the right focus as to why I wake up and go to work even when I don’t want to. To serve HIM. To be His hands of comfort touching the sick, and to be His voice to speak to those who feel all alone.

oh my gosh… today was a trip at work. i had 2 different lady patients today, and my oh my were they needy. it was like they were completely inept to do anything and wanted me to do everything.

 the first patient was 91 years old, so i give her some credit to being needy but still. she really just made me laugh. i would come into her room and she would start bossing me around. “oh ma’am could you get me something else besides eggs,” “ma’am could you raise me up higher in bed, oh ma’am that is hurtin’ me something fierce, ma’am lay me back down, ma’am i have a hitch in my back and can you make it better, ma’am i know you must be busy you don’t have time to mess with me, you can come back later and i’ll tell you some more of my worries ma’am”…this was constant all day long. it was comical at times because she was occasionally funny about how demanding she knew she was, but overall it was just mindlessly exhausting.

 then i got a new patient to the floor that nothing in the world was right about her care. she seriously refused every medication i tried to give her saying she wanted to call her primary doctor (who did not practice at the hospital mind you) and ask if it was okay to take those meds. then she said she wanted to take each pill spread out with bites of food in between. come on! are you kidding me! i try to spoil my patients but no! i told her that was fine for her to do that at home but at the hospital the nurses don’t have that kind of time to come back every 10-20min with her next pill. i seriously had to get her hospital doctor to tell her to take all her meds when the nurse gave them to her. she did end up taking all of them but of course there was a lecture later how they made her drowsy and slightly sick to her stomach (which neither of these were a side effect). oh and then at dinner she called me into her room, trapped me, and spent 15min telling me how bad her food was, and she couldn’t eat, and what could i do about it. i told her to call nutrition 7 different times in that conversation to try to get out of the room and pass it off onto someone else. it just DIDN’T WORK with this lady. aghhhh…what a day! my patience was definetly stretched to the max today. hope i float somewhere else tomorrow for sure! ha!

i am now going to write a new post with each interstesting day or patient i have at work. a true nurse blog…

this last saturday, march 8th i had a patient that wasn’t doing to well. he was very confused and would not keep his oxygen mask on. after trying to be patient and going into his room every 5-10min to put his mask back on so his blood oxygen would stay within normal limits, we finally had to put him in bilateral wrist restraints. this defintely helped me actually see my other 4 patients and see how they were doing that day. no one likes for their patients to be in restraints. one it feels cruel and in-humane, and two it is extra paperwork, but at the same time it does keep the patient safer and healthier in most cases. and us as nurses safer if they are violent when confused. i knew this patient was not doing well. and just the day before their POA (power of attorney) made the hard decision to make him DNR (do not resusitate). my patient’s blood pressure was really elevated, 200/100′s, and he was breathing about 32-36 breaths per minute when the normal is 16-20, his heart rate was really fast at 120, normal 60-90. he was struggling and did not appear comfortable at all. well his POA, a woman not related to him by blood but kind of like an adopted daughter came to visit i told her his condition did not look good and that his body was working really hard. she said that she needed to go pick up his wife because she would feel terrible if something happened today and his wife didn’t get to see him. so she went and picked up his wife and brought her to the hospital. i soon found out that they had celebrated their 65th wedding anniversary this last decemeber. i also found out that they never had any kids and did not have any family members but some nieces and nephews. my patient seemed more relaxed when she said she was there beside him, even if he was completely confused. in addition to his wife being there, there were probably 5-6 church members present. they had worked out shifts to stay with  my patient throughout the day and night, so that there wouldn’t be a need for a hospital sitter. (wow! what a church). well the day went on and my patient continued to look uncomfortable and in distress. after calling and calling and calling the doctor to get what i thought the patient needed for comfort measures i was able to give the patient some ativan to help him relax and morphine to make him more comfortable. the patient’s doctor did not think he needed to go to hospice even i thought that would be the best thing for him. it would provide him with the comfort measures that i couldn’t provide for him on the floor he was currently on. well after the medications helped him relax and be more comfortable, he took a turn for the worse. his heart rate slowed way down, as well as, his breathing and oxygen level. i knew what was coming next. he passed. i first i thought i just killed him but after thinking about it and talking with my peers and doctors i realized with the meds the patient received it allowed his body to relax, not struggle, and pass peacefully vs struggling for his last breath. the family/friends were amazing. they thanked me so much for being kind, comforting, sympathetic, and for explaining everything to them in detail. i was there when my patient took his last breath and it was after the entire room of people grabbed hands around his bed and said a prayer for peace for him. that is truly an amazing thing and one that i cherish very much. so even though my day started out rough and very busy, it ended with peace in knowing that i was an advocate for my patient’s comfort, and a support system for his wife and beloved friends…