A Martian

Yeha, It's been a few days since I've posted. I worked Christmas weekend, and I'm just starting to catch up with things (including sleep!)

I've been helping out with one particular patient who has been in the ICU for a few days. As a tech, I usually know what the diagnosis is, but rarely will get much background information on someone unless I have the time to look it up myself.

This patient, "Tommy", was about 60-65 years old. He had suffered a hypertensive crisis/stroke and was on the respirator. He often stared into space, though if you tried harder to get his attention he might answer a question by nodding yes or no. His family checked in on him frequently, with his wife staying at the hospital many nights.

Once, as I went in to do a blood glucose check, his teary-eyed son (early 40's)ducked out of the room. Tommy's wife asked me "Doesn't it seem to be harder on the guys? My son, he doesn't know what to do." I told her I found some truth in the book "Men are From Mars / Women are from Venus". In the book the author makes a case for men and women dealing with problems differently - men really want to FIX something to make the problem go away, where women will talk about it. When a man's father is sick there's nothing at all for him to fix. I suggested she make a list of things for her son to do to help out during that time - to help him feel he's contributing (I didn't offer suggestions, but I was thinking "Mow the lawn because your father can't get to it right now" might be appropriate).

Previously, I tried to use this theory to help another man who's wife was also on a ventilator. She wasn't very responsive, and the look on his face told me of his fear and desperation. I had only gone in to wash her up, but upon seeing him, asked him to help me out. He jumped out of his chair at the chance to wash her hands, arms and face - he even asked me questions about methods to use. I made a tub of suds and left him with her, delicately washing each finger. I think that being able to do something for her really meant a lot to him. I know it felt like the right thing for me to do.

Anyway, back to Tommy. He breathing stabilized and he was able to come off the ventilator, although his LOC was still greatly diminished. He was transferred to the medical floor. As we walked back to the unit, his nurse told me that it was such a great shame he would probably have to live out his life in a nursing home, because the whole thing could have been prevented. Evidently Tommy had come into the ED for a laceration sometime within the last 2 years. His blood pressure at that time was well into the 200's and the ED doctor gave him a referral to another doc for hypertension. Tommy never went. His wife said she told him several times to make an appointment, but he refused. His stroke had been preventable.

"Lubricant to bedside"

If you like a good laugh, especially if it's medically-related, check this out.

Assault with a deadly...

"Yahoo News has a story of a Benihana chef who tossed a shrimp tail at a man, which caused the man to reflexively jerk his head away from the incoming projectile, resulting in a neck injury. The subsequent surgery for said neck injury failed, requiring a second surgery that ultimately lead to a fatal infection. So, in this litigious modern era, the man's family is naturally suing the Benihana chef for the untimely death."

(From boingboing)

Gettin' warmed up for the holidays.

Holiday Hospital ?

For some reason, the ICU is completely devoid of any Christmas cheer.

Decorations are hung in all of the other units I've worked on in my orientations these past two weeks. Tinsel and lights. Post-partum has one of those Santas made of lights in a tube. The Hospital itself decorated and there are a few beautiful trees in the lobby and lights all around the building's rooftop. The three gift shops are practically bursting with Christmas gifts, decorations, and floral arrangements. Why does critical care have nothing? There are DNAR patients on other floors, so it isn't that we're not trying to remind the family that one of those major family holidays has come up. I don't get it.

I signed up to work Christmas Eve. I think I'll put some of my orientation time to work and actually go to one of these other units. The overtime will pretty much pay for the presents I've bought for my hubby and daughter. Christmas Day is a normal scheduled day for me. I'll work until 3:30 in the afternoon, rush home and shower and change, and try to make it out to my brother's house for dinner. I don't know how we'll do our little family Christmas. Maybe we'll open presents on Christmas Eve while we have time. Then Santa can fill stockings and there will be a little something on Christmas morning (that they can't mess with until I get home at 4pm!).

Santa's traveling light this year. I expect he'll have one small present for each of us, a book for my daughter and one for my husband, and maybe a can of Almond Roca for me. Santa's not giving expensive presents this year - I want the credit. :)

I'm going to get myself a new digital camera. My other one's not working properly and I can't trust it to always save the photo I take. I'd like a small one. I'm looking through the last minute ads today.

To You, Dear Reader :

Wishing to extend appropriate seasonal or holiday greetings, but desiring not to violate any existing laws, ordinances, or implied societal policies regarding diversity and/or sensitivity, I wish to offer everyone, equally and without prejudice, the following:

Please accept with no obligation, implied or implicit, my best wishes for an environmentally conscious, socially responsible, low stress, non-addictive, gender neutral celebration of the winter solstice holiday, practiced within the most enjoyable traditions of the religious persuasion of your choice, or secular practices of your choice, with respect for the religious/secular persuasions and/or traditions of others, or their choice not to practice religious or secular traditions at all ... and a fiscally successful, personally fulfilling, and medically uncomplicated recognition of the onset of the generally accepted Gregorian calendar year 2005, but not without due respect for the calendars of choice of other cultures (Incan, Mayan, Hindu, and more) whose contributions to society have helped make America great (not to imply that America is necessarily greater than any other country or area of choice or any other such distinction that is mutually agreeable to be discussed), and without regard to the race, creed, color, age, physical ability, religious faith, or sexual orientation of the wisher or wishee.

This wish is limited to the customary and usual good tidings for a period of one year, or until the issuance of a subsequent holiday greetings, whichever comes first. "Holiday" is not intended to, nor shall it be considered, limited to the usual Judeo-Christian celebrations or observances, or to such activities of any organized or ad hoc religious community, group, individual, or belief (or lack thereof).

Note: By accepting this greeting, you are accepting these terms: This greeting is subject to clarification or withdrawal, and is revocable at the sole discretion of the wisher at any time, for any reason or for no reason at all. This greeting is freely transferable with no alteration to the original greeting. This greeting implies no promise by the wisher to actually implement any of the wishes for the wisher her/himself or others, or responsibility for the consequences which may arise from the implementation or non-implementation of same. This greeting is void where prohibited by law or by age limitations. Not responsible for any overconsumption of beverages or food substances.

A Student Nurse throws up when the patient does.
An experienced nurse calls housekeeping when a patient throws up

A Student Nurse wears so many pins on their name badge you can't read it.
An experienced nurse doesn't wear a name badge for liability reasons

A Student Nurse charts too much.
An experienced nurse doesn't chart enough.

A Student Nurse loves to run to codes.
An experienced nurse makes graduate nurses run to codes.

A Student Nurse wants everyone to know they are a nurse.
An experienced nurse doesn't want anyone to know they are a nurse.

A Student Nurse keeps detailed notes on a pad.
An experienced nurse writes on the back of their hand, paper scraps, napkins, etc.

A Student Nurse will spend all day trying to reorient a patient.
An experienced nurse will chart the patient is disoriented and restrain them.

A Student Nurse can hear a beeping I-med at 50 yards.
An experienced nurse can't hear any alarms at any distance.

A Student Nurse loves to hear abnormal heart and breath sounds.
An experienced nurse doesn't want to know about them unless the patient is symptomatic.

A Student Nurse spends 2 hours giving a patient a bath.
An experienced nurse lets the CNA give the patient a bath.

A Student Nurse thinks people respect Nurses.
An experienced nurse knows everybody blames everything on the nurse.

A Student Nurse looks for blood on a bandage hoping they will get to change it.
An experienced nurse knows a little blood never hurt anybody.

A Student Nurse looks for a chance "to work with the family."
An experienced nurse avoids the family.

A Student Nurse expects meds and supplies to be delivered on time.
An experienced nurse expects them to never be delivered at all.

A Student Nurse will spend days bladder training an incontinent patient.
An experienced nurse will insert a Foley catheter.

A Student Nurse always answers their phone.
An experienced nurse checks their caller ID before answering the phone.

A Student Nurse thinks psych patients are interesting.
An experienced nurse thinks psych patients are crazy.

A Student Nurse carries reference books in their bag.
An experienced nurse carries magazines, lunch, and some "cough syrup" in their bag.

A Student Nurse doesn't find this funny.
An experienced nurse does

Stolen from here

Orienting around the hospital

I'm getting some orientation in other units so that I can float during my break from school. I went to ATU and med-surg and bariatrics so far.

Med-surg was so boring, and I had to keep asking for things to do. I felt like an albatross around the neck of the poor lady I had to shadow becuase she really didn't have much to do. By the time the shift was over we had gone from 5 patients to 2 patients because they were discharging to home left and right. One of the remaining patients was in surgery, so there was really nothing to do. I helped out everyone else. They probably think I'm awesome but I just hated doing nothing at all.

ATU and Baritric were much more interesting. I like the idea of getting to try out different areas in the hospital. It might help me settle on where I'd like to be when I graduate. I will go to the joint center tomorrow, then my regular shift in the CCU on Friday.

No really interesting stories from today, unfortunately. The patients I met were nice - three of them were recovering from laminectomies (sp?). I took a lot of vital signs. I met an 87 year-old man who had been married to his wife for 67 years. They were both in very good shape, although he was recovering from pneumonia.

At least I kept busy.

Busy fooling around

OK, so I haven't posted in a few days. If you've been here, you'll see that I made some little images for my links area. I'm having fun. HTML is not a really difficult thing to do if you have the right puzzle pieces. I've probably spent as much time looking around the internet for cut-n-paste code to make the images work as I have making them. But it's getting easier.

I have to give credit and appreciation to whoever made the HTML help guide online, because it's been a valuable resource. They've got some fun stuff there too.

Well, I'm pooped after a long day at work. I'm ready to go relax in the recliner and get my feet up. School and work are so different in that respect.

An eye grabber

So what do you think? I made this banner myself in Photoshop. I like it, although I wonder if it's too bright. Well, I guess it's not too bright for me, so It'll do since I'm looking at this page more than anyone else at this point!

I have just a smidge of homework to do. Already finished finals, and I did ok. I have to finish a paper on chlamydia. Just a few more words, but I've got to take a break.

Hubby was out putting up Christmas lights on the house tonight, and it looks so cute. Maybe when they're all done I can figure out how to post a picture. I've been having fun here decorating my little blogspace. :)

Hope it looks good

I spent quite a bit of time trying to figure out this HTML thing last night. I put up links to some blogs I really like and some other great sites. "This Land" is a hilarious little animated movie about Bush/Kerry that was (according to CNN) "the most popular political website" during the elections. I think supporters of either party will enjoy it.

CodeBlog is a site devoted to submitted medical stories, and has a following of both nurses and people who are just interested in what goes on in a hospital. The stories are great, and if you havent got a good idea about what nursing is all about, go check out her site. Head Nurse tells personal stories from her day, and her no-nonsense style is sure to make you laugh. Trans-Formations is a male psych nurse from the UK who uses hypnotherapy in his practice. I'm definately going to read all of his archives when I get my winter break.

Veshland and Dr. Charles have humorous medical stories that get you thinking. I've been to other doctor's blogs and some have such a wide range of topics, it's hard for me to find the stories I love. These guys got 'em. Of special note is Iraq:The Model, which is written by two Iraqi brothers (I think one is a dentist, and one a doctor). There are not many medical stories there, but the stories of Iraq and what it's like to live there (and fully support the American troops and the idea of a democratic Iraq) give hope for the future. What these people go through just to drive to work, and how much joy they have at the changes going on is an inspiration to Americans with loved ones over there (IMHO).

The Proxiderm Wound Closure System I came across while researching for a Client Care Sheet for my clinical class. I think my patient (abd c-section incision infection w/mrsa) would have healed a lot sooner if this device had been used. Maybe it's just a biased sales pitch on their part, but it really sems to make a lot of sense for open wounds, particularly pressure ulcers and abd. wounds.

The Nursing Student section has a lot of quizzes. If you're in a med-surg quarter and you've got a test coming up on (for instance) COPD, CHF, ARF I can just about guarantee you that in those links there is a quiz on it. I love to take quizzes because many of them are set up in a multiple choice format (like the NCLEX-RN) and you can get your answers instantly - some even have rationales. I bought 2 NCLEX books so far, but they're not organized into specific disease processes, just systems, so sometimes the online quizzes are a good way to find extra quesitons.

Well, I hope you like my format. If you've got a blog you'd like me to link to, send me a comment and I'll be sure to go check it out. The link for 'blog templates' is where I got the basic template for this one, although I've altered it somewhat.

Our hospital's Christmas Ball is tonight, so I'm going to go get all fancy now. Then I have to decide what 'the man' should wear. His idea of dressing up is a shirt with buttons...

An Interesting Day

I'm getting more used to working up in CCU - "the unit". Today I felt like I was able to help out and I hope I was useful.

A woman had a sudden onset of bleeding into her stomach. From what I understand she had episodes of bleeding before, but this time it got really bad really fast. I felt really bad for her, it must have been terrifying watching yourself throw up just tons of blood. The nurses just went into action like a commando team and got everything going - IV fluids and blood and plasma, got the doc up there, got respiratory care, etc. I brought towels and washcloths and tried to keep her suctioned. I cleaned up as much blood as I could and measured the amount - there was about 1400ml from the bins and unknown more being soaked up by towels and suction (in about 15 min). A doc came up from the cath lab and they decided to take her down there, so I went along struggling to keep 3 IV poles rolling along at the same speed as the bed (of course, each pole has 5 wheels, and only 3/5 roll worth a crap so I looked like one of those guys at a circus who spins plates on sticks). After she was on the cath table I went to get more blood and plasma from the lab. It was very interesting, and like I said, I felt good about being able to help out at least a bit. In the end, they did stop her bleeding and she was back up in the unit before I went home. I really do admire the nurses I work with.

THEN I went to get a loose filling replaced. The dentist I use doesn't charge for 'laughing gas' and I get it every time. Why not? It's a pretty weird feeling, but certianly calms me down. I wonder why they don't use it in the hospital? It seems like it would be much easier to put in sutures or do a lumbar puncture if a patient could have some. I asked a few nurses when I worked in the ER over the summer, and they didn't know. My tooth looks good and my lip has finally gotten feeling back into it. Finally.

After that I picked up my daughter and headed to the mall to pick up a wedding band for my husband of 3 months. We had a civil ceremony and didn't have rings at the time, but since then I bought one for myself. He told me just to get him a plain gold band, not anything expensive. I ended up with a moderately-priced comfort band from Weisfield's. I'm pretty happy with it. It was reasonable and serves the purpose and doesn't make me feel like a cheapskate.

Yes, I paid for it. Why? Because for the last 3 years he has been working while I was unemployed and spending all of my time in nursing school. He has paid the bills, rent, insurance, you-name-it, and supported my daughter and myself. Over the summer break I started working and he still pays the bills from his account but I buy food/clothing/gas/toilet paper etc. from mine. I figure this is one of those incidental items like... fabric softner.

:) :)

OK enough for now. I've got school in the morning, so I've got to get some rest!