Naps 1, Blog 0

Yesterday was the perfect day to catch up on all of your blogs and my posting but instead the wiles of a rainy day, warmth of my bed and 20 hours of wake time tricked me into doing, well, nothing. Napping and nothing. So, I am posting yesterday's entry today since I never got around to it and since nothing much is going on right this very second.

Monday, December 07, 2008

Rainy Day Essentials

I actually made it through a three night stretch without being floated to another unit or having my shift canceled. It's been over a month since I have worked full week and have been out of payed time off for about half of it. The time off itself is great but starting the new year off just as broke as the last one ended is not how I envisioned a new beginning. Just before the holidays shifts have become harder and harder to come by. I'm not talking extra shifts but scheduled ones. Somehow the hospital is able to close down whole 15-bed pods on each floor due to a decrease in patient admissions. It is difficult for me to believe that less people are ill or injured during months of November and December. More likely I think that house staff is at a minimum, people who would normally be admitted for 'observation' don't make it past the ER and that others would rather put off a hospital visit and remain at home with 104 degree neutropenic fevers, festering wounds caused by wine corker mishaps or wait until the trickle of blood from their rectum becomes a gushing torrent.
To this third group of people, I have this to say: On any normal day, during any other time of the year, you would rush over to be looked at, checked over and treated. Why are the holidays any different? Being with your family is important, yes, but this is your life we are talking about (all except wino but not to say your digit is any less important). We want you (and your extremities) to be around for many holidays to come. Exercise good judgment and take care of yourselves people. That is why we are here.

Anyway, it was somewhat refreshing to work a full week and this morning when I walked out of the building the sky was dark and stormy, the air was chilly and the rain was coming down. There is nothing better than leaving work at eight a.m., after your last shift, knowing you can either rush right home to go to sleep or laze around and enjoy a cold, rainy, winter's day.
So here I am. Showered and wearing my flannel jammies, cozied up with my coffee and book, in clean sheets next to a puppy that smells like Pantene*.
One of the many things on my mental to-do list for 2008 (not resolutions per say) is to actually finish one book at a time instead of starting a new one a third of the way through the previous one. Currently, I have four in process. The first book on my list is Bright Lights, Big Ass, which I started before Thanksgiving and have been itching to get back into. If you are looking for a light, easy read that will have you in stitches I totally recommend Jen Lancaster. Seriously funny stuff. Do not try to read this book at 3 a.m. when patients have just gone to sleep (or similar situations requiring complete or near silence, say a golf tournament or Wimbledon).

My coffee is getting cold and my book is waiting. Happy Monday Tuesday to you all. Good day and good night.






*This story and possibly pictures for another day when I am less annoyed and can laugh about it.

Sometimes, More Is More

Cupcake, originally uploaded by scoobers

Cupcake season has officially arrived! The air outside is cool(er). Ovens are fired up. Bloggers are baking. Each time I log on I see cupcakes galore and the places where I don't see cupcakes I find people seeking them out. Lori, this is yet another tortuous post for you to endure during your prenatal cravings. Apologies!

Today, my friend, KB turned thirty-six years old and so I thought I would officially ring in cupcake season by whipping up a batch of my own special*, sprinkled, delights for her. I planned to make enough so that her 'herd' would be able to enjoy them as well. I filled the cups half way with batter so I could stretch it out and make more of them. I ended up with cakes not mushrooming over the tops of their tinfoil incubators but resembling golden brown hockey pucks. In order to compensate for the missing tops I layered the sweet, delicious vanilla cream frosting on pretty thick.

On her way over to my house tonight, KB received a phone call from the family of one of our patients who told her that he had lost his year long battle with cancer. It was pretty tough to hear because I know they made every effort, tried every option and that he fought with everything he had. The family is super tight, as is the bond between my patient and his brother. I pray that he finds the means to make it though such a difficult time.

Now, I can't sleep because my mind is running in circles, again, over the reactions of others towards choices I have made and continue to make. Earlier tonight, KB and I drove out to the hospital together to visit another patient of ours. On the way there I told her that a couple of the other nurses shook their heads in a disapproving manner when they found out that we visit our patients after they are moved to ICU or keep in touch with them or their families after they are discharged. We talked about the line that should not be crossed and how to know when you've reached it.

During the conversation between KB and our patient's brother he told her that 'D' told him to let, specifically, the two of us know that he felt truly cared for by us. Going beyond our 'work' in the hospital made a difference in his life and the appreciation for that was voiced by his family. This only solidifies my thinking that our patients are still our patients whether or not we see them when we clock in to work and that taking the time, our own time, to make sure they are taken care of makes a difference in how they perceive the 'care' they get. I plan to continue giving more of myself to my patients and their families. If this means that I become attached to some of them and end up hurting because of an unfortunate outcome then so be it. The sorrow I feel is nothing compared to what they must go through and if spending time with them, crying with them and following up with their families after they've gone is what it takes for them to know that their caregivers truly care, then that is what I need to do.

Right now, I am going to go to the kitchen to soothe myself with cupcakes, extra extra frosting and a big glass of ice cold milk.

*By 'my own' I mean my own box of Betty Crocker vanilla cake mix and white vanilla frosting.

*Heard from the Nurses Station

Multiple IV infusion pumps are alarming.

Bed 2 puts his call light on.

Bed 4, "Nuuuuuuuuuuuurse! I need water!"

Bed 3, "God DAMMIT!"

Bed 4, "Waaaater! Nuuuuuuuuuuurse! I need waaaaaaaaaaaaaaater!"

Bed 7, "Somebody help me, pleeeeeeeeeeeease!"

Bed 5 wretches.

Bed 4, "Nuuuuuuuuuuuuuuuuuuuuurse!"

Something crashes to the floor in Bed 1. Thankfully, not the patient.

Bed 4, "I want to see the monkeys!"

Laughter from Bed 8 (and the nurses station).

Bed 4, "Nuuuuuuuurse! Nuuuuuuuuurse! Nuuuuuuuuuurse!"

Bed 3, "Oh, Damn."

A dying infusion pump from the dirty utility room continues to beep.
'C' smothers it with pillows.

Bed 3, "Oh boy, oh boy, oh boy, oh boy."


*I am on auditory overload.

Sound of Sedation

" Sound of Sedation"

Hello patient, my old friend

You're on the call bell once again

You're still calling, nothing to say

I could be surfing on eBay

But now you're snoring

and no one's turning blue

Woo, woo, woo

This is the sound... of sedation

* * *

I gave them all some benadryl

Some get IV, some get a pill

Patients sleeping without puking

Held the Colace, no one's pooping

Now they're all snoring

So, no one's turning blue

Woo, woo, woo

This is the sound... of sedation

* * *

~Written by O.M. RN

***ahh... what we do when patients are sleeping.

All In a Night's Work: II

'Neutrophil' courtesy of Onc0link.org

• 4 the number of shifts out of seven I have worked so far
• 14.5 the number of hours worked in a 12 hours shift (damn good over-time)
  
• 3 the number of patients I took care of last night (thanks, Sue for blocking beds)
  
• 3 the number of patients who are severely neutropenic
• 1 the number of patients who have an antibiotic resistant bacteria in their blood
• 1 the number of patients who crashed to the floor when no one was looking (about 5 minutes into start of shift)
  
• 3 the number of STAT procedures ordered to rule out bleeds and/or fractures
• 10 the number of times I had to call the doctor regarding patient status
• 2 the number of patients who were bleeding from their nether-regions
• 2 the number of blood products given
  
• 60* the number of liquidy, bloody stools/urine that were dumped
• 6000* the number of cc's of bodily waste measured, dumped and flushed
  
• 1 the number of times I, myself, was able to pee during my shift (finally at 0500)
  
• 15 the number of vital signs that were taken
• 0 the number of CNAs (nursing assistants) that were staffed to help us
• 1 the number of foley catheters placed
• 1 the number of IVs started
• 7 the number of blood draws performed
• 50* the number of IV narcotics, antibiotics and other meds administered
• 5 the number of minutes I got to scarf down my cafeteria salad
• ? the number of miles walked (or ran) in the nurses station
• 1 the number of toilets that burst a pipe and flooded a room
• 2 the number of times that I laughed so hard I almost peed myself

Thank you, J, for all of your help! You have no idea how much time you saved me. Everyone else... thanks for the laughs! Good times! See you tonight and nitey-nite!



*approximate number only as I truly could not keep track

7 More Things

Good Sam, originally uploaded by scoobers1.

Jenni started this off by 'tagging' me with seven random facts about me. Here are 7 more things that just came to my mind.
I am at work at 4:10 am. All my tasks are done. Everyone is sleeping (thank you, Ambien). Here are 7 things I do to occupy my time:

1. Write in my blog.
2. Play Text Twist.
3. Read my book or various catalogs/magazines.
4. Surf the net and answer email.
5. Eat.
6. Walk the stairs (12 floors!)
7. Plant my face in the desk