Tuesday, April 29, 2014

I'm a hurting gal!

Hubby and I could stand to lose a few pounds... In Aug we want to take a road trip through to Texas (hey gotta scope out where I want to practice right!) and we BOTH want to be in shape and comfortable wearing summer clothing - including beach wear.

So my BFF had a baby 6 months ago and she found this exercise program and has been working it for the last 90 days - that's how long the program is.... it's called bikini body mommy....

and MAN is a doozer. We did it for two days and spent the next two barely able to walk. We're not on day four and I'm scared to go and look to see what we have to do! But I promised him that if HE stuck with it, so would I. So we've been exercising together mainly and when we aren't we've been doing it seperately then calling the other once we do it so that we are accountable to each other. I promised him I wouldn't lie about not doing it (curious as to why he thinks I would because I don't lie to him). So I'm hoping that by Aug we drop a bunch of weight.... I would be happy even with inches lost so long as it's a lot of them!

I'm definately not ready to post any sort of pics, maybe when we're done with it perhaps? We'll see.

On a different note....

Yesterday we celebrated little tykes birthday - let me tell you, she was one excited girl!!!!!!!!

The evening before, I put little tyke to bed and waited to make sure that she was asleep and then we decorated the house in her honor. Let me tell you, when she woke up in the morning she was BEAMING!!!!!!!!!! She ran into the bedroom, into my arms and exclaimed "Mommy, I'm 5, I'm 5!!!!" It was incredibly precious. Then she proceeded to tell me about all the decorations and how some of the balloons had her name on them. Ya she was stoked to say the least! Totally made all the effort worth it! I'll have to post some pics though, she was so happy and so was everyone else. She is a VERY loved child!

Tuesday, April 22, 2014

Incident my ass

I admitted a pt on my last shift who was ?CVA - for which the orders indicated that the pt was to be screened for dysphagia. I had never done one before but I've heard others talk about it and figured that I could do it just as well. But to be sure I ran the steps by one of my teammates - and I was correct....

so off I went to do the assessment - and the pt passed - so I went back to the computer to document it in meditech.

Somehow it didn't register it. I KNOW I did it - I know that I added the intervention myself and that I documented it. Not entirely sure that I put the intervention on the correct person but I know for sure that I did it.

Well now I'm getting in trouble saying that the documentation wasn't done and an incident report needs to be filled out - it's such BULLSHIT!!!!!!!

I'm seriously starting to hate this unit. Is it a huge deal whether it was done? The important bit was that it WAS done and was communicated to on-coming nurse who then communicated it to the next nurse.... hell if anyone was to actually ASK this pt if someone did this, they're cognitively in tact enough to say so I bet! But of course not, who would ever do anything so easy!


Sunday, April 20, 2014

Hypertensive kind of day

My shift was filled with 3/5 pts requiring interventions for SBP > 150

Go figure their BP's were ok ALL DAY LONG! Now I get onto shift and these BPs are incredibly out of whack.

Several phone calls later and ppl's BPs are semi back to where I wouldn't shit my pants because they're sooooo high.

It was amusing when I took my one guy's BP and found it to be 170/100ish and so I went looking for the on-call doc - turns out he was on the next door unit so I took my  MAR and went to him....

What had happened was that my pt's IV went interstitial last night and family decided they didn't want access anymore and the discussion was to make the pt DNR - but not palliative.... well the IV access was because my pt couldn't control his own BP due to pontine myelinolysis and so required IV hydralazine - but without that access it was changed to G-tube.... well the doc's in all their wisdom decided to leave the dosage the same even though the route was now different..... now it was catching up with my pt! On-call doc was familiar with the guy and said he didn't much care that it was elevated and to just give him his next scheduled dose of hydralazine - which wasn't actually due for another 3 hrs. Ya not happening without an actual order. So since the guy was moaning (he was also nonverbal and non responsive except to pain) off I went to grab him some morphine - hey it's going to lower the BP so it's helpful in two ways! Then I also gave himt he hydralazine when I was supposed to and an hour later it was 149/90 - well at least it was moving in the right direction!

At least it's no longer my problem! Tomorrow is another day though!

Thursday, April 17, 2014

I'm no longer a virgin

I'm shell shocked speechless

I had my virginity taken away from me....

One of my patients died. While I was working. Anytime I've taken care of a dying person, they've always died after I've had them. Or before I come onto shift then I have to do the death rites. But this time it was different.

Sort of anyways.....

Between my first shift and me coming on for the next shift my patient's O2 needs increased ALOT.... as in 2L to requiring 50% O2.

He lasted on 50% for 2 hrs then went up to 60% for an hour then needed 100% via a non rebreather mask in order to simply maintain him at 90% - and I had the vitals machine hooked up to his toe so that if I or any of my colleagues went past his room we would know what his sat was (BTW ALL his other vitals were awesome)

I did my last rounds at 0645hrs - I get off at 0730hrs so that left me enough time in order to complete my documentation.

At 0730 hrs I gave report on 4 of my patients - then was about to go into THAT pt's room when my colleague decided she wanted report on the other patient first - I said alright and we went to the room next door (door ways are not next to each other tho) and gave report.... took about another 5 minutes total.

When we went into Mr. X's room, he was gone. You could tell just by looking at him. Clearly he had just passed because he was still warm. My colleague and I just looked at each other completely shocked. He was NOT expected to pass! At least he was a DNR so we didn't have to do anything to him but man was I shocked. I couldn't believe he had died.

Stats state that people die most often at change of shift - go figure!

I feeel a bit of guilt - maybe had I gone in there another time he wouldn't have died. You coudl tell that he knew he was dying because he took off his oxygen mask. It was sitting in his hand. So maybe if I had gone in there again it would have stayed on his face, helping to keep him breathing.

When I informed his doctor that he had died he was shocked as well. No one expected this guy to die. I mean, 2 days previously he was on the rehab unit!!!! He was on his way to getting better (he was a previous patient on our unit and I had taken care of him when he was with us before - so it was kinda surreal). So because he wasn't expected to die there was no order on his chart that indicated that the nurse could pronounce so we had to wait to pronounce til the doctor made it to us.

I felt bad for his family as well because they didn't get a chance to say their goodbyes. When I called his family I was only able to say that he was doing poorly and that they needed to come now (charge nurse told me not to tell them that he had died). Sucks. His family was shattered that they didn't make it in time to say goodbye. So of course they're going to feel guilty that they didn't get to the hospital faster. UGH. I would seriously be pissed or feel guilty if that sort of thing happened to me let me tell you!

I left my patient's death rites to my colleague but I did all the documentation associated with his death. May he rest in peace!

Monday, April 7, 2014

I passed at least

Unfortunately I missed the top level by 3% - ugh!

Feeling less overwhelmed but at least I have a bit of stuff off my plate. I'm plugging my way through it.

I feel like the little train that could - "I think I can, I think I can, I think I can" - therefore I know I can.

On other news... I've been in talks with the teacher of my next course (clinical that is) about trying to set up placement cause I've had SUCH a hard time getting it arranged myself. I have inquired whether I would be able to do placement in the ER because I work already in a medical unit and if I can't get into a surgical unit then I would love to try out a placement in the ER. We'll see how that goes though, it's doubtful.

Friday, April 4, 2014


A feeling I can certainly say I feel at the moment.

Here's what's on my plate...

Sunday previous - MAJOR test - only got 73% on it (boo!)
Tuesday this past - 3 quizzes - not too bad but a TON of reading for it
Tomorrow - MAJOR paper due - still reading resources, got my quotes picked out (mainly) but still have to get it put together

Saturday - working days then coming home and studying immediately BECAUSE....
Sunday - another MAJOR test - can't say I feel prepared for it! Oh and I have to also work days! Plus I have a discussion board post due and my final draft of my paper for my one course (finished that one already at least)

Then Tuesday I have 2 more quizzes - TON of reading for them.
Friday - MAJOR paper due - mostly done - still have to complete the editing though.
Sunday another discussion board - and I work saturday and sunday evenings.

And it just keeps going like that with a few more tests and quizzes thrown in for good measure!

Seriously, I'm only JUST keeping my head above water - it doesn't help that this paper that's due tomorrow is NOT a subject that interests me (so as to try my ADHD!) and the psych course is the bane of my existance (I hate the subject - and hate is a strong word but it so aptly fits!). I just keep telling myself to take one day at a time, it's the only way I'm surviving.