Friday, December 11, 2015

Getting the swing of things and failing

So I finished my first week at the new place. I'm still recuperating from the IIH (Idiopathic Intracranial Hypertension) saga that I've been dealing with. Mon, Tues & Wed went pretty good - I slept pretty crappy on Sun, Mon, & Tues but boy did I crash on Wed! So on Thurs when hubby, little tyke and I went shopping at this toy factory, then to IKEA, then grocery shopping so when we got home I had a pretty nasty headache brewing. I thought that I could wait it out. Ya, I was wrong! I kept getting grumpier and grumpier til finally hubby snapped at me and told me to go to bed! Ha!

I went and laid down to "rest" and took some lovely lovely meds so that when I got up I would feel more like myself. Sure enough, hubby was right (OMG, I admitted it for all to hear!) and I felt better. The headache was WAAAAY less (dare I say even manageable!).

I had orientation today as well. It was good. I FINALLY got my ID so that I can get in/out of the parking lot and get into the kitchen - plus it'll tell my pt's that I actually work there and who I am. I also finally got my ability to get into the computer and work on my documentation. This new place is ridiculous tho - it's still expected for nurses to do PAPER charting!!! Geeze I haven't done that since 2002!!!! Their computer documentation program is also behind at LEAST 5 yrs and their order entry system is VERY different than I am used to. During days this is alright because the clerk enters in the majority of the orders and all you have to do is verify the order.... but on nights you have to do all the ordering and checking. It causes me some anxiety I must admit. So much so that I asked for another night shift for orientation because I really don't think that 2 night shifts would be enough to guarantee that I would have been privy to an admission. It was agreed upon so before I start on my own and after I get back from going to see the family for the holidays, I will have another night orientation shift. Also, it will help to bring everything back in case it slips my mind while I am gone.

On another note - I couldn't imagine being sick in the hospital and missing the funeral of my spouse. This happened to my pt, I almost cried on their behalf... it breaks my heart for them. I hope that this person finds peace somehow.

Tuesday, December 8, 2015

Physician assisted suicide - could you do it?

I live in Canada and there's a new law that's soon to be passed that will make it legal for physicians to provide assisted suicide/euthanasia.

Physician assisted death - this article talks about the repercussions that physicians would have when they participate in these.

I think that those who participate in this should spend time in areas where they will see the suffering that occurs when people are dying. We give our pets the decency of a fair death without suffering, I think the same is only fair and right to have occur with the people we love and cherish.

I've seen the suffering of a terrible death - of families desperate for options that can provide a death with dignity - to have their family member just "drift off" and pass away. Everyone says that palliative care and hospice provides this. I don't necessarily agree.

In the article it notes "you come at a moment where you say there really is no alternative and applying euthanasia actually is an act of empathy, of compassion. It's the only thing you can do to take the suffering away." - this sums up how I feel..... and I think MANY physicians who would be privy to this option should see it as well. 

I've seen it where the patient hangs around for years after they are afflicted - be it a traumatic brain injury, stroke, cancer, alzheimers/dementia, Lou gerigs disease, etc.... and they are a burden - something that they would NEVER have wanted to be.

Also - who would readily put up their hand and volunteer to suffer?! I know I wouldn't. Give me a good death. ~6 1/2 yrs ago my gramma died in her sleep - THAT is the kind of death I would give anything for. No burden, no suffering. I think that if people can CHOOSE this route for themselves, then they should be able to find someone who can help them attain that.

Honestly, I think that were I to ever become a doctor or a NP (if they'll allow them) - I absolutely would be one of the health care providers (HCP) who would help another attain a death that a human being deserves. I'm sure that others will question whether they are depressed and that's why they're making such a decision. I think that after any terminal diagnosis that any patient would experience depression. I think that a HCP can see through this and get to the root of it all if they spend enough time with that person. 

I think that if the Supreme Court actually does their job, they'll be able to provide regulations associated with this new law so that it doesn't get misused and abused. I think it's possible - it'll just take time and lots of work and dedication.

Friday, December 4, 2015

Reading to the youngin's

Just finished reading a bedtime story to little tyke - something I would do ALL the time with big boy while he was growing up and learning how to read and such. Our favorites were Robert Munsch books - I would use such emphasism and would go as far to yell (when indicated in the book) and sing (when it was done in the book).... and little boy would LOVE it.... little tyke on the other hand prefers LESS - much less emphasis. Anytime I would yell or "carry on", she would cover her ears - even though she's smiling ear to ear!

About 10 years ago I got the chance to hear him read several of his books and he would do so with just as much emphasis as I was doing. I enjoyed it thoroughly and even got him to sign a couple of books and a high school assignment I had used him for. I contacted him last year, only to find out that he has had several strokes and no longer does this anymore. Such a disappointment!

I only wish that my reading to her was as successful at getting her to read as it was for big boy. Regardless, I will continue to do so.

Some excellent, albeit unexpected news

Spoke with my nurse educator who spoke to my (soon to be) charge nurse who indicated that I get to have Christmas off this year!!! Yaaaaay.... that means I get to go home this year and actually celebrate the day with everyone else. With us it's about family and sharing the times together, so I'm really looking forward to it.

I tried to tell my  mom about the good fortune and when I tried (oh ya, she just invested in a cell phone - so no longer should she be able to say she didn't know that I called) and I missed her several times yesterday and so I figured I would give it a go today and try to reach her - several times again actually. No response either time. Hell I even left a message yesterday and when I called during "dinner time" - a time I would expect her to be around. I did get a hold of her today - after several attempts but she didn't even appear to even care that I was trying to get a hold of her. I broke down after trying so hard to maintain a stiff upper lip. Goodness she could be so callous. When I explained why I was quite upset, she seemed to understand but who knows until next time.

I'm looking forward to beginning at the new place. The new unit is 52 beds and the sister unit is 28 beds. I wonder which I would enjoy more. I think the buzzer system of the new unit would drive me crazy because there would be so many patients that could be on the buzzer at any given time. However, you have a better chance at diversity with patient acuity and such. I'm sure in the near future I'll let you know which I prefer. Monday is corporate orientation - it's going to be a long and boring day for sure then Tuesday morning for 4 hours I have computer training (pretty sure they're using the same charting program that I was using - just possibly a newer version? We shall see) then another 4 hours shadowing the unit cleark to get order entry down pat. Wednesday & Friday (12 hr days) I'm shadowing a nurse for orientation then the following week I'm Monday & Tuesday 12 hr days then Thurs & Friday I'm 12 hr night shift orientations and that completes my orientation. Then I'm off until Jan 1st when I work 12 hr days. It's a very short orientation if I do say so myself, hopefully things aren't too different!

Wednesday, December 2, 2015

School, work and ouch

So for the school update: I hadn't heard from my prof which option she wanted me to do. It's already Tuesday, I needed to know what to do - assignments or tests/exam prep - so I bit the bullet and called her.... it was actually quite useful. I'm getting an incomplete ("I" on the transcript) for an ATI exam and the final exam and she wants me to focus on getting my assignments competed. I can do that - at least I've been working that end so I don't feel like I've been wasting my time. Then I have another 4 wks to schedule the things I'm getting the "I" for. However, my  medical documentation indicates that I can't do any school work until Dec. 7th so I indicated that I would keep working on my school work and submit what I've finished after that date. We also talked about my clinical assignment b/c I didn't agree with my educational clinical teacher who is responsible for marking my clinical assignments - I am expected to do a problem list and concept map on NANDA diagnoses and yet she gave me one that wasn't even one. I mentioned that to the prof and talked about priorities and such. She said that she would take over my marking my assignment from here on out since we talked it all out. Works for me!

Work update: I tried to call yesterday to speak with my new manager - she's on vacation until the day that I'm expected to start working. So I talked to the person designated and then transfered to the nurse educator for the unit who worked out a schedule for orientation => 72 hours worth! I'm not too concerned considering I'm not going to be working in a specialty area where there's a ton to learn and I'm not a new nurse fresh out of the gate. On Monday I have corporate orientation for 8 hrs and then Tuesday morning (for 4 hours) they're giving us computer training (honestly I think it should be more - especially if it's going to be a new system that I have to learn) and after that completes then I'm buddied up with the unit clerk for the rest of the day to get a handle on the order entry part (normally the confusing part anyways) - so that will be a full 12 hrs. Then I am "buddied" up with another nurse for the orientation part for Dec. 9,11, 14, 15, 17, & 18 - the last two will be night shifts - shifts that I really am looking forward to because that's the shift I really want to work anyways - and when I mentioned that to the educator he perked up and said that he would talk to the unit scheduler about trying to find me a predominantly night shift line. I also talked about getting Christmas off and working New Years due to a wedding in the hometown and was told that he could look into it. Then after that we're off to the races!

And for the ouch bit - I was looking to cook hamburger helper and heated up some oil on the stove and when I put in the minced meat it splatered oil all over my one arm and burnt it pretty bad - 2nd degree partial thickness I'd say. Geeze it hurt (and still does!!!) like a bitch!!!! I hope it heals quickly.

Sunday, November 29, 2015

Oh the yummiest cookies

I wanted to get this down because goodness they are yummy - they're like a cross between a cookie and a cake - especially when done correctly. My SILs mom makes THE best ones - they're sooooo soft and have such a high anise flavor (yummy! IMO).

Genetti cookies:

1/2 teaspoon salt
3 large eggs
1/2 cup canola oil
1/2 cup whole milk
1/2 cup white sugar
5 teaspoons baking powder
3 teaspoons anise extract or anise flavouring
3 cups all purpose flour


Beat eggs with oil and sugar 5 minutes
Combine the milk and anise flavour
Combine the flour and salt and baking powder
Add dry ingredients into wet ingredients
Make a soft, very soft dough - soft but not sticky. If you add too much flour they will be dry
Roll pieces of dough into finger lengths and widths and shape into a figure 8
Bake on a parchment lined cookie sheet
Bake 350 for 8-10 minutes, just until bottoms are slightly golden. Tops should have no colour
Frost with a glaze of icing powder, anise flavour and a drop of milk.

Will be doing these with little tyke soon and hopefully they turn out like my SILs mom's! Mmmmm my mouth is watering just thinking about them.

Getting prescriptions filled

I went to get my prescription filled today - I went to the store and was told it would take 20 min....

So I went to the grocery department and grabbed some green beans (yummy for dinner!) and some mushrooms (good for breakfast and to go in pasta tomorrow) then went over to the meat counter area and found the hot dogs (chicken.... yes I know that some ppl find them gross but my daughter LOVES them and they're certainly healthier than the pork ones!) and travelled across to see what the discount section had (peasly selection - I found sangria that was alcohol-less to try) & bought a carton of OJ (good with breakfast!) then went up to the cashes to buy my things, paid for it and then went out to the car to drop them off - came back in and went back to the pharmacy and when I stopped to stay in line I felt EXHAUSTED (just like before)..... geeze all I did was a bit of walking and I feel terrible! Go figure that a simple walk wear me out.

Unfortunately, I'm told that the prescription isn't ready (it was being held up by the narcotic on the prescription) so I went up and down their isles looking for Nix (b/c little tyke caught head lice while I was hospitalized b/c my MIL wasn't taking care of little tyke and doing her hair - making sure her hair wouldn't be penetrated by those little nasty bastards) and went down at least 7 isles before I realized it may just be behind the counter (it was btw) but grabbed some Vicks vapo rub and some hair elastics (on clearance! - yay - LOVE clearance) and went over to the counter to check out the Nix products - buying a couple things cuz I want to be thorough and get rid of them ASAP!!! Then waited til it was my turn - and directly in front of me was toothbrushes on clearance (again - yay for clearance!) so I grabbed that cuz I know hubby and I need to swap out the ones we have in our bathroom. Waited another 5 min and they finally had it (thank goodness - I think it actually took me 45 min to get the damn prescription filled) and was able to leave after going and grabbing a bag of ice and making my way back out to the care and coming home. I was pooched!

In regards to school - I sent off emails to the profs to give extensions on the work - hopefully I hear tomorrow. In the meantime, I'll be putting my nose to the grind and trying to get some of the assignments completed. Oh, did I tell you - one of my profs actually "advised" me that I should take a "medical withdrawl" from the course - as in..... withdraw from the course (due to medical reasons so you don't get penalized grade-wise) and do EVERYTHING all over again...... dude - I'm like 80% done these courses - actually, I think in my elective I'm actually 90% done! Hells no I'm withdrawing from ANY courses.... according to the school policy (according the the school), I should be granted MINIMUM 4 weeks extension on my stuff so at least I can provide some push back if it's required.

Saturday, November 28, 2015

Finally home, now what do I do?

My doc swings by today super late in the afternoon (as I'm biting at the bit) and asks how I'm feeling.

All I wanted was for him to send me home. He seemed apprehensive to do so because Thurs I got another severe headache that didn't want to go away... I think I had it for like 18 hrs - yep it sucked.

I can absolutely see why he didn't want me to leave considering the day I was supposed to be discharged I get another severe headache that causes me to postpone things.

Being a nurse in a hospital - especially the one that you work in - and being a patient there means that anytime that you spend there causes it to feel exponentially longer. I was there 17 days and honestly, it felt like it was 5 weeks long.

So now what do I do now that I'm not in the hospital...

I start the new job Dec. 7th and that means 12 hr shifts. Dude, I could barely make it from my room, to the elevator, then another approx. 5 min med paced walk to the cafeteria to buy soup and then repeat this again. Once I got back to my room I felt so incredibly ill - just absolutely over-run. I felt like I weighed a ton and it felt like my heart was racing and that I was just panting away. Rested for about 10 min and when the nurse took my VS they were normal (except for some mild tachycardia). After about an hour of resting I felt like myself again. So if I can't even cope walking to the cafeteria, how the HELL will I handle a 12 NURSING shift?!

I suppose I have to try to rest but also try to recondition myself to be able to handle being a nurse again - in just over a week's time! Wish me luck!!!!

Wednesday, November 25, 2015

Developing metabolic acidosis

So I've been admitted for almost 2 weeks and it's getting a bit old. I guess that means that I'm getting better with the fact that I'm sick and tired about being in the hospital. I even asked the Dr if I could have a pass to go on a dinner & movie date and then come back.... I was put in my place and told no.

Thing being is that blood work this am showed me developing metabolic acidosis due to the new med - so Doc lowered my med..... the one thats supposed to be lowering my production of CSF and thus decrease my severe headaches/migraines. So ya - decrease dose = increased headache.... at least that's what I figure.

SO although I realize that I need to be here because of the adverse effects that I keep experiencing, I miss home - I miss little tyke. She colored me a couple of pictures and sent them in with hubby today.

On the school front - I was told by my teacher that she thinks it would be prudent to take a medical withdrawl from the course.... dude I'm already 80% done my courses - I'm not friggin doing this work all over again! PLUS that will put my graduation behind ANOTHER 5-6 months. Now if you've been reading this blog you will know that this has happened before where I've lost my course and been put back - I was SUPPOSED to graduate more than a year ago! Plus, when I had the head stuff go on the last time, they wanted me to do the same thing then - I was able to pull my shit together and make it work, so I don't see why I wouldn't be able to do it again.

Wonder what the blood work will show this morning?!

Sunday, November 22, 2015

Idiopathic cerebral hypertension/benign intracranial hypertension

So that's my diagnosis. Reason for it...... because I'm fat! Ha, as if I didn't already know that! It's something that I want to deal with and haven't been able to because exercising is a feat in and of itself because of the rectal fistula. When I try to exercise = sweating = increased infection rate.

So when I saw my surgeon the last time I asked about gastric bypass and was told that I wasn't fat ENOUGH! Geeze. I was told that I would be if I had secondary conditions such as diabetes, hypertension, cardiac or renal disease.... so I was excluded. So I wonder if having hypertension in your head counts?!

I had the LP done yesterday and it showed that my opening pressure was 28 => less than the 36 it was before but more than it certainly should be (normal = 10-20). It was weird having it done under fluroscopy because they do it in the supine position and then once close to/in position then they turn you to the lateral position to obtain the opening pressure and take the samples. They also took off some CSF (I was told between 35 & 40).

I instantly felt some relief from the fluid being removed which I was thankful for. Unfortunately it didn't help the hazy vision issues.

Because we now know the diagnosis, I was restarted on the med that caused my sodium to drop the last time I was on it so I'm in the hospital still to ensure that we monitor it. Well I had my blood work done today and while my sodium was fine my CO2 (I think that's the one that the Dr said was abnormal) wasn't and had dropped from 25 to 21 (normal 23-29) so while it's not in the danger range it''s stil something that we have to watch. I was told that the reason for the drop is that my kidneys coould be having difficulty coping with the medication and that if  it dropped any more then I may have to stop the medication. Don't quite know the repercussions of that one. Also, I dont know if ppl feel any different when they first start this medication but I certainly haven't.

This morning I woke up because of a nasty headache. Ugh. Then the dilaudid didn't even help and required toradol above that. Together they seemed to take away the brunt of it and I was able to go back to sleep. Today has been rough when it comes to headaches.

I also went to the opthamology appointment and had them check my eyes and then they dilated them. Oh boy was that interesting. Geeze were things blurry! But I was told that my eyes look healthy so we still have no real reason for the continueed bluriness. The Dr wants me to have a follow up appointment with an opthamologist but don't know with whom. Also - he said that if I lose just 5% of my weight that things will be drastically different - ya we'll see!

So ya, I feel so great about myself. Yes I know I'm fat. Thank you for throwing that fact in my face time and time again.

Thursday, November 19, 2015

7 days in and still no real answers

SO if you've actually been reading this blog (thank you!) you'll notice that there's been a drop in my posts even though there's things been going on in the life of Nurse Dee.

Well it all started last week (we'll say monday for shits and giggles) and I had a headache, decreased appetite and nausea (no vomitting) and been monday and wednesday I had a fever off and on - it seemed that when I had the nausea really bad that I also had the fever. The highest it got was 38.4 C/101.2 F. The other temps were <38.0 so I didn't go to the hospital. Figured I could just get over "whatever" this was.

So thursday rolls around and my husband gets fed up with me saying that I'm not feeing well and tellls me that I either need to put up or shut up.... in other words - go see a Dr or stop complaining!

So I grabbed some stuff and off we went to the hospital - no temp at the hospital but because I had had a high one the night before I was considered a SIRS alert and was seeen a bit quicker.

About 6hrs later I finally see someone - the nurse practitioner - now I'm ok with them - I know that often they will know just as much or more than regular docs but this one seemed real unsure about what to do with my symptomolgy. She calls in the MD and he makes the decision to do blood work and a CT - those come back clear and I wait some more.

When I see the Dr again he decides he wants to do a LP (lumbar puncture) which I thought would be valid given my symptoms - my neck was stiff and my vision turned hazy that day which is actually why I agreed to go in.

Anyways - he also has a call in to the neurologist (one I actually know and converse with on my unit) and he comes in JUST as he's (the ER doc) creating his sterile field and said he wants to ask some questions and proceeds to. I think he got 3 questions in when I told him I needed an emesis basin in case and I think he asked another question and a wave of nausea hit me and of course I reacted - trying to keep the stuff down - and he thought I was just being emotional about the question! Hahahaha. So I think he asked about 2 more questions and I answered by vomiting.... he was so astonished! Oh to just picture his face! He said "yep, I think that's about enough, we may want to reconsider doing the LP in her condition" Hahahahaha

They gave me some Zofran and 20 min later we did the LP - not simple and certainly painful! But we got the fluid.

Before doing it though I made sure to have him check my opening pressure (see I am learning things from school!) and that that's really important! So when he opened the first kit and it didn't have it he ensured that he found one that did.

Well good thing I pushed for that because my opening pressure was 36!!!!!!!!!!!! High normal is 20 so it's no wonder I was in soo much pain. And let me tell u pain.... after the hour of being supine/lateral, I got up to go pee - OMG the pain..... it was searing from the LP injection to my neck like someone was stabbing me or something. I could no longer look left/right or put my chin to my chest without excruciating pain - I couldn't lay flat with my legs down - when they had me do that I was in tears!

So they admitted me. They said the fluid looked clear and the results of the LP came back clear so we didn't know what was going on. Then we did a MRI/MVA where we look at the veins and artieries and such of the brain to see if there's somthing going on there. Nope - that pretty much came back clear - the neurologist said that I had a slight compression of some area that is often associated with a condition called iopathic cerebral HTN.... but he didn't see me til the Saturday and in his notes indicated that he wanted a therapeutic LP done on me to drain 40cc of fluid!!! That seems like an awful lot! The MRP refused, indicating that he wasn't confortable taking that much, neither was the anesthesia consult MD because if u take off too much,u could cause herniation and thus death unless dealt with immediately.

Now, my hospital might be huge but we do no have neurosurgery on stand-by! So if I did herniate then I would die or have severe deficits - just what I always wanted!!!

So today finally came when the same neurologist was back in house and he came to see about doing the LP - said the risk of herniation is about 1% and risk of low CSF is 5%, so I consented.

The fellow that he has on service with him is also an anasthesiologist by trade and said that she would do the tap.... and didn't bother numbing me at all!!!! Said that it can "screw up/shift the anatomy" and make it more difficult to get into the space. I think it was utter bullshit but who am I to say?!

So now they want this tap done under x-ray/fluroscopy/CT/MRI - whatever the hell it is! And who knows when that will be!

I just told my MRP (because we've known each other for 4+ yrs now) that I think it would be better to just go to the hospital that specializes in this sort of thing.... tomorrow we will see. I didn't see him tonight before he went off.

Tuesday, November 10, 2015

Here I sit waiting

I thought perhaps that I would have had an email when I got up in the morning.

Alas, nothing.

So I don't know how to decide between one position or the other if I don't have all the answers.

So I put out an email to the recruiter to find out about information that I require.

Hopefully I'll know more tomorrow.

Saturday, November 7, 2015

I thought my previous problem was a problem, now it's a real conundrum

Today I had an interview for the position that was offered to me when I applied to another position - at a different hospital.

So I showed up at the wrong hospital and when I realized it I ended up at the place late. I covered it well because the location was locked up tight and when they called me to ask if I was actually showing up I played it off that I had been circling the building trying to get in and that's why I was late. Thankfully another interviewee was also waiting along side me so it seemed like I was just simply locked out.

The interview went awesomely. As in my best yet.

The new place is as follows:

52 bed medical unit with 8 beds reserved for surgical patients
The other unit that I would be hired for is an ER overflow unit
The shift is 12 hours (what I really, really want to work!!)
The new place is closer to my house and would be easier to get dropped off/picked up from if needed
The new place is actually going to be a new unit so there's something to be said about being the one to be there for that


I would be missing out on surgical post-op patients all the time - I feel like I need that experience
I would lose my senority
I may not be making as much money (but I wouldn't have to work as many days in order to get the same amount of money)
The new place would mean that I wouldn't have to work more frequently which means I can use that time to study

Lastly - I don't know about the paeds position yet and I would technically have to start the new position on Nov. 23rd which means giving my place less than 2 wks notice (not that I work that day so I suppose it could be >2wks notice - but that's not really what I'm concerned about).... if I were to leave I don't think I would be eligible for the paeds position - which is what I would really want if I could choose.

So HELP - I don't know what to do! Each is good in their own right. So I have no idea what to do now.

Thursday, November 5, 2015

A real problem

Ok so I accepted the surgical position - supposed to start at the beginning of December...

But today a paediatric position showed up on the posting board today... and so I applied because it's really where I want to be. Like REALLY REALLY want to be.

But how do I go back on my word if I actually get hired?

I want to work in ICU - but I want to work in a NICU/PICU so having the peds experience would be really really important.


I really want an interview. I really want that position.

I guess time will tell - for now I study for my crazy hard exam I have due this week. Wish me luck!

Wednesday, November 4, 2015

What nurses should realize is this...

On my current unit we have 37 beds with 3 potential hallways for a total of 40 pts to be divided between nurses.

There is a combination of 8 & 12 hr shifts - and even 4 hr shifts for when there's a gap.

I find it surprising when people get so upset that their assignment from yesterday or the day before changes - primarily this occurs with nights and sometimes for evenings. 

Yet it's often the experienced nurses (those who have been on this unit for 5+ years) who are the ones who are complaining. As though they don't know that sometimes things change according to how many 8 and how many 12 hr shift nurses there are. Plus at 2330hrs you have to put up 2-3 more pts to have over night.

Now, often the charge nurse will "try" to give the same assignment but that's not always feasibly possible. You would think that nurses would understand this. But alas you still hear the complaints that they have to take on new patients.

OR, the charge nurse will change things up entirely and do it depending on the area that the pts are because our unit has pods (sorta) and will give you patients depending on where they're located - with no regard to how heavy a pod may be pt wise - you could feasibly have 4-5 (of your 6-7 pts) that are total care with which they are incontinent and you have to change them at least twice on your shift - it can make your back and feet hurt a lot. And these same ppl will still complain about their assignment. 

It's a lose-lose situation IMO - you can't win with these ppl. Such a shame that they clearly don't learn.

REALIZE THIS: Your assignment will ALWAYS change - expect this and just roll with it. If you don't like it, go to days, their assignment won't change for the slew of shifts that they're working.

Saturday, October 31, 2015

Start slow means crazy at the end

Why does it seem that when the shift starts off slow that the shit hits the fan at the end and you're stuck late on the unit completing charting.

But guess what... T-38 days til I get to start on the surgical/ortho unit!!!

I was talking to a nurse who floats to lots of different units and she said that she enjoys working there and it's MUCH better than my unit.

Can't wait to start!!!

Thursday, October 29, 2015

From neuro to surgical nurse in T - 39 days

I received my transfer letter yesterday, signed it and sent it off today. I suppose that finalized it all.

I begin orientatino on Dec. 7th and I'm absolutely excited!

I'm sure the learning curve will be quite steep, I'm sure there will be times that I will be overwhelmed. Transferring to the surgical unit will put me back to square one (almost) where, although I'll have the basics, I don't know how to handle the adverse events that occur when someone's on the unit after having had surgery. At least not firsthand. I'm sure it's quite different to experience it than to read about it in a book.

I'll be having 4 wks of orientation then reassess whether I'm ready to take on the pt load myself. I think in terms of prioritization and juggling many different balls will be easier because of my experience on the in-pt neuro/gen-med unit.

I doubt that my unit will do anything to commemorate my transfer to the new unit. It bothers me how some are given things but others are not. I suppose I shouldn't be surprised. I'm ready to leave, that's for sure.

On a side note - little tyke comes home from Pakistan in FOUR days!!!! I miss her so much. We haven't talked as much as I would have liked. My BILs & SIL came home last week so I was able to see a video and some pics of her, bringing the longing for her out to the open. On the flip side, I'm oh so excited that she was able to experience her heritage through this trip. It's important that she knows that side of her history.

Tuesday, October 27, 2015

Oh the times they are a changin

So a little back story...

Last week hubby's uncle died and under Islam laws you must bury the dead "as soon as possible" unless there are factors that will delay this (autopsy, dying overseas, etc...). Well I was supposed to work the next day (the day when they were to bury him) so I called in and told the acting charge nurse about the death. I was told that I didn't have to work the shift - so I focused on the family as I should have. Then they call me back not 2 hrs later to tell me that I have to find someone to cover my shift - giving me less than 24hrs notice to do so! I went home after a couple of hours to begin the phone calls.

I called FOURTEEN ppl - and EVERY one (except one - who said that she would trade me shifts) told me no - even though I explained WHY I needed the time off. If it hadn't been for the fact that the prayer part (sort of like the viewing in the caucasian world) of the burial started during the last part of the day shift but the burial part was during the first part of the evening shift - so in essence I needed both shifts off. So ya, I'm pretty damn pissed at the ppl on my unit.

It seems to me that the ppl I work with are becoming less helpful as the time goes on. As such, I have been applying for positions elsewhere.

So when we got back from being with family I came home to a voicemail offering me an interview for a position I hadn't even applied for at another hospital - I had applied for a different position but they were offering me an interview for a position (provided I was interested in it). I called them back and left a voicemail indicating that I was intersted. So the next day they returned said voicemail and asked if I could come for an interview on Saturday. Unfortunately, that was the day that I was to attend clinical. So alas, I had to decline the interview. They said that they would put my name in the pile for the next round of interviews and I was cool with that.

So I ended up having to work my shift afterall and when I got back from my shift I had another voicemail offering me an interview for a position I had applied for at my hospital. I called back and we set the date for this morning.

Hubby was nice enough to ensure that he called me a bunch this am to wake me up so that I could make it there on time. He told me that there was an accident on the highway and it was hugely backed up. So I made sure that I left an hour & 15 min before said interview. Even when I work and have to take local roads, it usually takes me ~45 min... so I figured I was good to go.

Ya, not so much! It took me almost an hour and a half!!!! Nearly double the amount of time that it normally takes me when I have to drive the local ways.

That meant that I was LATE for an INTERVIEW!!!!!  Holy shitballs I was so embarrassed. I apologized profusely and they were so easy going, tell me it was alright - that they were just worried.

Otherwise the interview went swimmingly, but I certainly thought that I lost my running in the race for the position because of being late.

When I got home I was talking to my BFF and as I stepped in the door she was telling me to call her when I heard one way or another about the position. My BIL was sitting in the living room overhearing my conversation and when I got off the phone with her, told me that I had a voicemail on the phone. When I played it, it was this...

"This is Alice (not her real name) in HR, we would like to offer you the position at Big Hospital on the in-pt surgical/ortho unit that you interviewed for today, if you're interested please call me back at such and such a number"

O M friggin G I got the position!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Against many odds, they offered ME the position.  WOOOOOOO HOOOOOOOO

Of course I returned that voicemail immediately! I was told that I had to wait to hear when my manager would "release me" (as though I'm a prisoner - HA) before I could start the orientation on the surgical unit. So until then, I'm kinda in a holding pattern.  

On a separate note, but equally awesome - clinical has wrapped and I have passed - exceedingly well! My preceptor gave me VERY high praise, which I will absolutely use in the future when it comes to positive references of me and my abilities as a nurse. Now to finish up the theory portion in just as exceedingly positive (if I can). Wish me luck - I need it with this course!

Friday, October 23, 2015

Watching a grown man cry

Last week when I worked I had a pt who had a sinal aneurysm that was leaking and was so large (8.5cm) that the family was told that surgery wasn't an option - but then a new doc came onto the case and told the family that decisions would be held until a MRI was done - but wouldn't be done for 2-3 more days.

Unfortunately the pt was in incredible amounts of pain with shooting pains down & up the left leg - which no nurse was really trying to get a handle on. I took pity and ensured that it was my mission for the day to get the pain under control. Which I managed to do.

The sad part was the conversation that I had with the daughter & son-in-law... about watching the parent die a slow and REALLY painful death... about how the pain wasn't being controlled/managed, and how they just wished she would be snowed into oblivion because it was painful to watch this parent suffer.

The talking was cathartic to them but it was difficult. The daughter started crying which made me choke up a bit but when the son-in-law started crying the tears welled up and I only JUST managed to control them. I was able to get through it just barely though.

I was surprised to see the daughter yesterday when I worked. I asked about her parent and whether the MRI showed anything.... she told me that the aneurysm had grown to twice the size and was definately inoperable. My paultry words "oh, I'm so sorry to hear that" and my follow up "are the nurses at least controlling her pain properly". I was saddened to hear her respond that no they weren't and saw the tears well up again. I apologized on behalf of the nurses of my unit because I know that more could have been done for this pt. Then the palliative care doc took her to a private room to discuss what would now occur from that point on.

When she came out she gave me a brief synopsis of the conversation - that the pt would be moved to the palliative unit later in the shift. When they were transferring her there the son-in-law was there as well and he was looking sooooo sad, on the verge of tears. I went over to the pt and said my good-byes and then gave a hug to the son-in-law, who gave me a solid hug back who let a tear roll down his cheek. Then I gave a hug to the daughter, with whom I connected with,

When we parted ways she thanked me for being so caring and that she would always remember me and when she sent in her letter about the care she & her parent received, that I would be mentioned as her #1 nurse.

It was perhaps the hardest interaction I've had in a long time - seeing grown men cry is hard for me. It causes me to well up every time.

Tuesday, October 20, 2015

You did NOT just say that!

At clinical we had this woman come in with chest pain - history of CHF & MI so hooked her up to tele as soon as she came.

Now the state that I'm doing my clinical in has a narcotics database that u can use to pull up which narcotic was prescribed, how many have been prescribed, which doctor prescribed, which pharmacy was used to fill the prescription and when each prescription was filled

Well this woman had like 250 pills in the last month filled so that set off some bells

The doc comes in and asks what's going on with her - she tells him and he walks out - it's not something that's unusual or out of the blue and her tele wasn't showing anything abnormal so off he went....

Like 2 min after this woman shows up a little boy is brought in by one of his parents because he developed a rash over the trunk, neck & arm that didn't seem to get any better with benedryl. So the doc comes in asking a billion questions - trying to figure out what's going on then he goes away.

Well about a 1/2 hour goes by and this woman asks for pain meds and the doc actually treturns to tell her that he wouldn't be prescribing anything until results were returned.

Well the woman gets all peeved off cuz she expects that to be dealt with... and she essentially pouts then when the doc returns to the little boy to ask more questions she goes BALISTIC

"why is the doctor spending more time with him than me, aren't I important?!"

Oh no, you did NOT just say that!!!

I flat out said "well we're used to ppl like you" - ya not my best moment cuz it set her off more...

her: "well what do you mean by THAT"

me: "just that with chest pain we're used to but little boys having reactions we aren't"

That seemed to placate her for a moment til the doc went back to the little boy and then she was complaining about her chest and asking for pain meds - the doc came over and said that results weren't back and that she wouldn't be getting any pain meds

So she went crazy and signed AMA

Sayonara then!

When the results came back after she was already gone.... turned out she had fractured ribs - oh well, she was gone already

Monday, October 19, 2015

I always miss the good things & seatbelts save lives!

Clinical rocked, but as the title says, I missed the good stuff (mostly)

There was a pt that came in with septic shock who fell down on the floor and was there for 12+ hrs til found and was in such bad shape that the paramedics just wrapped the pt in the rug that was under the pt and transported them into the hospital...

The pt was in such bad shape that it necessitated intubation and being life flighted out

The pt was in such bad shape that while in mid-flight the pt coded!

Don't know if the pt made it or not but WOW!

Onto seatbelts saving lives (as docbastard always says on his blog)......

There were two men who got into MVAs that were thankfully wearing seatbelts - one walked away with nothing more than a forehead abrasion and the other suffered a L1 compression fracture.

One of the vehicles rolled and another ditched (literally) the vehicle - so their injuries would have been WAAAAAAY worse had they not had their seat belts on.

Sunday, October 18, 2015

Another first for me

I worked yesterday...

20 of 24 hours! A day shift, stayed an extra 4 hrs then had 4 hrs off then worked another 8 hrs over nite

SOOOOoooo I was basically awake 26hrs cuz I woke up early to have breakfast and drive to work

Needless to say, it was a busy, busy day!!!

Wraked up some good OT in the midst of it tho

Nothing interesting to report for work - clinical was interesting tho - I'll write about that next time

Friday, October 16, 2015

1/2 way done.... what's I've learned is this....

Finished 1/2 my clinical hours and have gotten through 1/2 the semester

While clinical has been a breeze and a joy, school less so!

I don't think that it's right when a teacher puts 20 (or there abouts) questions on the exam (out of 50) that are "select all" type of questions.... you're just trying to fail your students! I think it's poor form and I would think that if you're trying to weed out students who are weak, senior year isn't the appropriate time to do so! You would think if that was your goal that you would have done it last year or the year before!

Come to learn that this particular teacher is also going to be the teacher for capstone/preceptorship course. UGH!!!

See, my program puts a restriction on who is allowed to do high-acuity nursing (like ER or ICU's) for that course - so only those who are honor roll and have done well in their clinical courses.... now that sounds simple enough except when they are rallying for you to fail exams, that becomes quite the challenge!!!

So I'm really trying to swim against the current and stay afloat.... I'm just hoping I can do so without kicking my GPA too badly!

Saturday, October 10, 2015

It hurts to burp

Monday I went under the knife again - this time to have ear tubes put in.

Last year the quack immunologist thought it was important to have a head CT done to see whether I had any anatomical abnormalities to account for my ear & sinus infections.

I already knew about the one thing that it turned up - that I have a narrowing in my eustacian tube on the left - which would account for why I have an increased number of ear infections in that ear.

So when I saw the new ENT she thought that it was a good idea to try a new med that I shoot up my nose. Unfortunately the med was super expensive (not covered by my insurance) and it wasn't guaranteed to work.

So we waited to see what would happen with my hearing...

Well it didn't improve and the hearing tests showed that my eardrum wasn't working particularly well because I had an accumulation of something behind it - but it didn't look like fluid but she had no idea what else it could be.

So we made the decision to put in ear tubes again - but longer lasting ones this time. Because clearly I've had ear issues most of my life.

When I came out of the anesthetic (general) holy moly was I in pain - particularly the Rt ear that I thought had an infection in it. Well it turns out that my eustacian tube isn't working very well on that side either. When she came and saw me after I was in recovery she explained that the pain was from the release of pressure. She said I didn't have an infection though - so I guess that's a plus.

But holy does it hurt to burp or hiccup! I've also found that when I'm awake for a while it sort of accumulates throoughout the day and I eventually have to have a nap in order to essentially reset things. Bummers about this is that I'm supposed to be able to hang out with hubby while everyone is gone but I'm lucky if I can stay awake for very long. At least I can say he's being patient and understanding. That's a bonus! Now if only I could get him to clean!

Friday, October 9, 2015

Cleaning while in nursing school

My house looks something like this this week...

Now my house isn't toys, cuz little tyke is still in Pakistan (it would look like this if she were here tho!) but the mess and clutter evident in this photo is evident in my place - on the table, on the counter, along the edges of the room, on the side table, etc...

This week is insanely busy - it's like my prof enjoys piling on work during certain weeks. This means cleaning and tidying goes onto the back burner.

Next week I head out to do clinical then upon my return I'm working - so after all that, this is what my future holds....

Unless I can convince the hubby to undertake some of this... but as those who have husbands know, they just don't clean the same as us!

Saturday, October 3, 2015

Question for surgeons

So this is twice now that I've been taking care of pt's awaiting surgery

Both were "on call" to get said surgery

BOTH got pushed to another day (one actually got pushed back two days)

One has a nasty hip (femur head) fracture and the other had a previous G-tube insertion go wrong and they created a nicked bowel and a fistula + abcess.

The fracture was identified two days post admission and then this pt waited another day after that..

So I would think that these would be urgent enough to actually ensure that they're done on the days that they're supposed to.

Additionally, said surgeon (for the most recent one) left before 2130hrs - which makes me wonder why they couldn't have done the surgery they said that they were going to do!

Also - if the surgeon is too tired (as I'm sure that some would indicate as a reason that the surgeon stopped) - at least have the decency to call my unit and tell me this because you ordered fluids that would be appropriate for a diabetic pt who is NPO for said surgery so now I am going to have to deal with on-call to get a hold of an order to have this changed.... because you couldn't just call me and tell me that you pushed your patient to another day!

Lastly - said pt is in major pain - especially when moved (such as when their incontinence brief needs to be changed) - and I'm sure that when you put the pt out for the surgery you will put in a foley catheter - so why didn't you just order it when you did the orders so that at least I don't have to manipulate this pt more than absolutely necessary.

I put myself in these pt's positions - I hate to see them hurting and wish that others thought about these things as well!

Monday, September 28, 2015

What 40 degrees Celcius looks like in picture form

Little tyke is LOVING Pakistan - still affirms that she's not returning (at least not anytime soon!) cuz she's having too much fun!

We're getting snippits of updates for little tyke's activities - I'm hoping that when my other two BIL's and the one SIL is heading over there that I will get more pictures of what's going on and such.

Little tyke said it's hot there - according to MIL it's 40+ degrees and so it's quite warm. So as a way to cool off they headed to the local watering hole to cool off - this is what they found...

She was LOVING every second of it! Just hope she doesn't get Giardia or something from it!

It's kinda hard to make the time difference work for us to talk on a regular basis - it's expensive for them to call here and we never know whose house they're going to be at visiting and depending on the city that they're in determines whether there's internet that would be good enough to support skype and it be clear and smooth.

Today I got to talk to her - she just got to my MIL's older brother's house after having a 10+hr bus ride. She said that she slept the entire ride except for anough time to eat some chips! HA - what a girl!

Saturday, September 26, 2015

She doesn't want to come home - goats are fun - Eid mubarak

Here's a pic of little tyke the second day after she arrived

Little tyke is on the left and my youngest BIL is on the right

Can little tyke look ANY happier?! Also, could BIL look ANY taller in this pic?!

Friday is/was Eid - the goat in this pic is one that will be slaughtered for the celebration - I wonder how little tyke will take that.

Hubby asked me if there was one thing I didn't want little tyke to see when she was there - my response was seeing animals slaughtered.

Let me state this openly and directly - it's GOOD to know where your meat comes from. It's important.

BUT and this is a big one - she's still little and is not raised on a farm - this is not usual practice for her. I think that she would be quite upset if she were to see an animal slaughtered in front of her - especially considering in Islam it's important for the blood to be drained and so when slaughtering the animal the throat must be cut and this appears quite traumatic to see even though it's actually quite humane for the animal.

I hope I get to talk to her tomorrow - I miss her. When asked yesterday (thursday) whether she wanted to come home she emphatically responded "no, never!!!" and ran away!

Oh wait another week or two - we'll see if that changes!

Thursday, September 24, 2015

I got it and you didn't - naner naner naner

We had a pt come in with vomiting and diarrhea - supposedly not unusual for this pt - she's well known to the ED staff

Seemed like she was legit vomiting but also coughing excessively to try to vomit - who knows for reals

Either way, lady was dehydrated and Doc ordered an IV

Now I will preface this that I am quite good at FINDING veins but not always the best and actually getting them in.

So I gathered the necessary supplies and off preceptor and I went

I was able to find a vein but preceptor wasn't able to give it a go in time so I took the tourniquet and when she was ready and I put the tourniquet back on I couldn't get the vein to do its thing again and try to put the IV in

So off she went to put the IV in and poked her about 3 times-ish while I was trying to find another vein on another arm

And while she was poke pokin away at that other arm I actually found a good vein and get it to stick up nicely

I excitedly made that announcement but preceptor wasn't too keen on trying it and I didn't want it to go to waste so I figured that I would try

And holy kamole I actually got it - now the problem - I have NO idea what to do next - I got blood but I am SOOOOOOOO not good with their equipment so preceptor walked me through what should be done in what order to get it to work and I was able to make the IV stick

Success never felt so good!

Wednesday, September 23, 2015

Almost killed my patient (as a student!) and wished I had seen it!

I've been in the healthcare field for like 14 years - I've been a practical nurse for 5 years and I've been working in my hospital on my unit for 4+ years and I can say that I have not actually lost a patient on my watch (technically).

I've had a patient die BEFORE I come on, and AFTER I leave - and where the technicality lies is where once I had a pt died after my shift technically ended but before I was able to give report - so technically the pt died on my colleagues shift.

And pt''s who have actively tried to die on me I've managed to keep living long enough to be transfered to ICU.

Now as a student I had a pt during my last clinical time who had had a knee replacement surgery done - on a replacement that had become infected secondary to a tooth infection and therefore needed to be replaced (so the replaced knee was a replacement).

Well the pt lost quite a bit of blood during the surgery and then when they got to us had put out a bunch (say 700ish cc) in the last 8 hrs and when their Hgb was checked it was found to 8.1 = transfusion certainly needed! So it was our responsibility to set them up.

Here's a foreshadow - pt has a history of A-fib - but it's managed with meds now and pt's on Lovenox

So we put pt on telemetry and start the transfusion slowly - pt's never had a transfusion previously o we explained what reaction sort of symptoms we're anxious about - itchiness, difficulty breathing, hives, flank pain, fever, chest pain, etc...

We wait 15 min - pt says they're feeling the same way so we increase the transfusion slighly for another 15 min and still no change - so we increase it slightly again and my preceptor likes to stay with the pt throughout the transfusion (if and when possible of course!)  so 15 min later pt says that everything is peachy keen (A-ok) so it gets increased a bit more to be about 110cc/hr and we maintain it there until it's time for us to leave - when we left pt was perfect - napping in fact - feeling perfectly normal - including normal sinus rhythm with clear breath sounds and appropriate RR of 16!

So when we got back in the AM and find out that pt is no longer in the building I was shocked to say the least. I ask what happened and am told that nearing the end of the transfusion (say 45 min after we leave) the nurse informs us that pt went into A-fib then v-tach and they tried to cardiovert him by DEFIBRILATING him....

And it fails and they immediately send him to another hospital so that they could deal with this!

Man I wish I could have seen it - just last week (and the week previously) we were going through heart rhythms and that would have been PERFECT to use as a case study for school! Plus to see it up close and actually experience it myself as well as the cardioversion would have been quite the experience.

So ya, loving my site - wish we get more cool stuff happen. Time will tell - but at least I'm still on record for no deaths!

Monday, September 21, 2015

Another round of surgery to be

Life has been rather crazy and forgot to post about the fact that I get to go under the knife again.

Oct. 5th I get to have tubes put in my ears AGAIN!

I'm 33 (not ashamed or embarrased by that fact!) and can't believe that I still need these!

I had my first set when I was 13yrs old - I never realized how hard of hearing I was!

The last couple of years I knew that my hearing was decreasing but was kinda in denial

But with all the other issues I have going on I figured I might as well get that dealt with (plus the whack a doodle immunologist suggested I see one again) with all my sinus and ear infections (plus when I moved to where I am now I never got a new one and the one in my hometown died when I was like 16 (I think)

So when I went to this new ENT (whom I really like) she suggested that I try this new med that I spray up my nose - but turns out that that med is like $100+ and it's not guaranteed to work - so when I saw her again (b/c she only returned my calls once and we missed each other) I explained this and so we've decided that surgery is our next best bet

So now I get to go under the knife - but hopefully it will deal with my issues and help improve my hearing

On the other side....

I saw her after seeing the good immunologist (who didn't do anything but suggest that my ENT do something) and when I relayed that the immunologist wanted HER to do testing on me things went a little weird..... she had NO idea what I was telling her about!

She ended up having to call one of the specialty hospitals to speak to another ENT to inquire about this VERY specific/rare test that the immunologist suggested that I have done => ciliary movement disorder/testing

Knowing my issues I doubt that it will come back positive but at least we can check off one that I DON'T have!

Sunday, September 20, 2015

7 1/2 yrs together but maybe 3 mos in total really

Little tyke goes to Pakistan tomorrow - for SIX weeks! Minus me and hubby. She's going with the in-laws, and the youngest BIL and then in 10 days the other two BIL and the SIL are leaving together and meeting up with them.

I'm anxious for her to go - I think that she will thoroughly enjoy the trip. I'm rather jealous that she can go to Pakistan before I can. I'm not nervous that she'll be kidnapped or hurt in any way because she resembles that side of the family a lot and she speaks the language fluently. I'm not worried that hubby's family will keep her in Pakistan because hubby and I are good - it's not like we're on the verge of divorce or are fighting. And if they keep her there it would terribly shocking and very surprising.

If it wasn't for the fact that I have school and work I would totally be going - I would love to see where hubby was born and raised.

According to hubby where he was raised was just like any other big city - that you have high rises, appartment buildings and subburbs - just like on this side of the world.  So it would certainly be quite the experience to see it myself.

They're going to several of the major cities and she gets to meet all the extended family - good thing she speaks and understands the language - it's neat to see her fluently speak to all the family here. I can just imagine how she'll be when she comes back.

She's all excited about going on the plane - she'll be even more excited when she finds out that the backpack I prepared for her has a few surprises. She's really into these "blind bags" that you know the kind of toy inside (my little pony, my littlest pet shop and shopkins) but u can't see which toy it is - hence the blind part. I know she'll be super uber excited about this stuff. But I told her she's not allowed to play with the backpack stuff til she's on the plane - tho I know that the in-laws will let her have at the back pack as soon as they are away from us - little tyke has them wrapped around her finger and they have difficulty saying no to her - they hate when she has her melt down when they do.

So when it comes to the title - hubby and I have been married for nearly 7 1/2 years but have spent maybe 3 months in total together ALONE - when we were first married we had big boy around most times - he spent some time with his biological father so we had that time but then when I was pregnant with little tyke we  had decided we didn't want to live in my hometown forever and that I would continue with my nursing degree further so we would need to leave - then when I had complications in my pregnancy we decided to leave even earlier because where we live now is close to the hospitals that little tyke would be in if we did deliver early. So we moved when I was 7 months pregnant and moved in with the in-laws and so that meant that for the next 6+years we were NEVER alone - I think we've gone on weekends away maybe once without little tyke - and when we go on vacation we take her with us so ya, we've spent little to no time together alone.

So although I know that I will miss little tyke, it will be nice to spend some alone time with my husband with (mostly) no one around!!! Hubby and I pretty much get 3 weeks solidly alone without ANYONE else in the house - then the other 3 weeks the one BIL will be here but he's solitary in nature and he also works so we'll have little to no interaction with him - so it means that we're mostly alone. Boy I can't wait!

Plus while little tyke is away, there's always skype! We'll talk frequently so it will make things easier ( I think!)

Time to party!!!!

Friday, September 11, 2015

Flooding wards

Because we're a neuro unit we get a lot of things - like ETOH withdrawl - to take care of.

These can be easy, but then there are times where it's not.....

Like the other evening when I was taking care of someone who was just transferred to the unit and was in the early stages

I told my pt to stay in bed and the spouse to not allow the pt out of bed because they hadn't been assessed and indicated that if the pt got up that they were at increased risk of falling and so it was better to stay put.

Well NEITHER listened! What a shock huh?!

Next thing I know I'm walking past the room and the spouse is flagging me down saying that water is coming out from under the bathroom door - YAAAAAAAAAAAAA - like a god damn flood gate opened up or the sky opened up and rained a deluge on the floor of my ward room.

Of course the pt locked the damn door so it's not like i could turn off the water....

Once the pt did the bathroom was flooded as well - reason for the water???

The pt wanted a SHOWER and used the hose at the back of the toilet to have one in a bathroom without a drain or an actual shower head!!!

Sunday, August 30, 2015

Disciplining friend's children

Hubby's BFF his wife & kids came over for a visit...

Little tyke and their son (their son is 6 mos younger than little tyke) were playing - acting like power rangers or something.... little tyke is play kicking & punching but their son goes out and punches little tyke full force into the chest - it hurt so much she almost started crying.

I spoke calmly to both and told them that how they were playing was too rough and that it needed to stop.

Then not 10 minutes later he goes and hits little tyke again.

UGH - so calmly I look at him with my mommy look and say "didn't I say that you couldn't play like that?!" He goes mute, not responding - so I repeat myself and he shakes his head yes

So I tell him that he needs to go sit down and be in time out

He actually listened to that but then immediately starts crying in this whiny pathetic voice.

So his mother races over and picks him up - shushing him and telling him that it's "ok" and tells him that he doesn't have to be in time out and he just needs to be calmer when playing with little tyke!

So just like that their child goes off without any sort of recourse

This kid - he's whiny and NEVER gets disciplined - UGH!!!!!

Pisses me off that hubby did NOTHING.... yet, he's also caught between a rock and a hard place because what could he do without setting them off

Thursday, August 27, 2015

We're off to the races & ICU's stupidity

School started - WOW - and boy are we under the grinder already - it's only the second week! It's crazy! Good thing I picked up my shifts before this semester started because I don't think I'll be able to pick up shifts cuz this course is crazy... oh ya, and I also have an english course that I have to deal with!

We'll see what my stress level is like throughout but I doubt that it will be going down anytime soon!

The other day there was a code blue on our unit - probably because the pt was experiencing septic shock so the Dr wanted a certain antibiotic NOW - as in get your ass moving and into the pt like yesterday.... so off went one of our nurses to contact ICU to have them tube it to us for the pt in the code blue and was told "no, find it from someone else because it comes out of our budget"!!!! You can bet your bottom dollar that didn't go over well! So I just took one of the sheets and RAN to ICU to pull from their machine myself and ran back to the unit.... anything for the pt right?!

I'm sure someone will be getting in major doggie doo-doo for that comment! I mean, seriously - they were told who it was for, one should NEVER hear that in response! Brutal

Sunday, August 16, 2015

My immunologist appt & butt issues oh ya and school's beginning

I saw the immunologist the other day - or rather the resident - who inquired about everything I've been dealing with from childhood til the most recent.... everything the other immunologist had already asked (I get it, I'm in health care!)

In the end tho, I find out that my blood work looks fantastic except for my IgG1 which they say is "mildly" low..... but when I got a copy of the blood work, it's not all unremarkable. There's  a section that's all high & low but they're in letters & numbers that I don't understand (it's the complement's being checked) and when I google them it doesn't really make sense.

The Dr came in and said that although my IgG subclass is low, he won't do anything about it but more testing in 6 mos! I asked about my vaccinations being non existant and req FOUR rounds of MMR to still have issues with mumps - told that I could be someone who doesn't hold them and no idea how long that the coverage will last for but that I just have to check them every once in a while.

So we recheck my subclasses and check oxidative burst assay to see if my phagocytes are working the way they're supposed to. Plus the suggestion is to see my ENT and determine whether I have a ciliary movement disorder which would explain the sinus/throat & ear issues.

Then when I was going to the bathroom the other night, I was ensuring that I was clean and all and after wiping, my seton came out - just like that. Hopefully I can see the surgeon soon, I don't know if the seton has done what it's supposed to (cut through all the way to the rectum) and I'm worried that the abcess & fistula will just recur just like last time.

On a better note - school's right around the corner (tomorrow actually) - it would mean the count down is on to getting this program completed. The second last of my electives and #5 of the nursing courses. Goodness I hope this time next year I'm entering my last two courses of this program!

Wednesday, August 12, 2015

Cancellations are a wonderful thing!

I called the immunoligist's office and asked to be put on the cancellation list - to find out that one had JUST been received.... so now I have an appointment for FRIDAY!!!!

My family doc is possibly sitting tomorrow for walk-in so i have to call in the afternoon and find out if he is... I want to get little tyke checked to see if she has immunity to MMR & dTAP as she's heading to Pakistan and so if she's not immune, this will put her at risk! A risk I don't want to take if I don't have to.

Unfortunately, I see the immunologist before I have results to which I could ask the one person who would have the answers any questions I may have.

Hubby still isn't on-board so I'm a bit leary about taking him with me to the appt - but I'm hoping that when he hears the information from the doctor, things might sink in and he might be more supportive. At least that's what I'm hoping!

So ya - busy couple of days to come!

Saturday, August 8, 2015

The invisible disability

I have suffered for many years with being sick. Knowing that my immune system was screwed up but had NO idea how to get answers.

Remember, I've been in the medical "field" for almost 15 years and have had to be my own advocate. It's not like the doctors that I've had find many answers.... or go looking for them - it's usually dealing with the symptoms at hand and managing what I'm dealing with at that time. It's hard to look at the whole when you're looking at the incident.

I received confirmation today about the IgG1 deficiency and now I want some answers.... to see what symptoms fit with what or what further examinations need to be requested and advocated for.

I had a "tiff" with the hubby tonight on the phone - how my disability is completely invisible and is difficult to understand. When you're disability is physical, one can understand when you're in pain or you can't do something. If you have cancer or something like that it's understandable that you're tired or can't do something. But when you can't see what's wrong it's harder to grasp or understand.

My husband says to me - well if you lost weight then you would have more energy...

he's ABSOLUTELY correct! HOWEVER, that's easier said than done when every time I go to exercise it increases my bumm infections and pain.... so I can't exercise.

He complains that I sleep all the time.... well I AM tired!!! Somedays it's just everything to sit on the couch and do NOTHING!

My hubby can't believe that I've been on the computer all evening doing my "research" and can't I just wait for my appointment in OCTOBER for answers from the specialist?! .... to which my retort was..... "have doctors provided me answers or given me all the information or what sort of things are we going to do next???? NOT VERY OFTEN!!!! It's usually I who is inquiring about things, asking for referrals to certain ppl, asking for certain tests..... while I'm lucky that I have a family physician who listens to me and certainly is willing to give what I ask, it's me who is initiating everything.

I hate that I have to wait almost 2 months til I see a person who specializes in this, and I doubt that treatment will be commenced when I see the physician. I'm sure that I'll have more questions, very little answers. UGH!!!!

Friday, August 7, 2015

My IgG number

So I had my follow up with my family doc - last week I had bloodwork to see if I was anemic and to see if he could get the results of my bloodwork from the immunologist.

So it seems I'm not anemic - my Hgb is 140 - perfectly in the normal range - which is suprising to me because every time I have a bowel movement I am bleeding. Seems that my bleeding is encouraging my body to create more.

The bloodwork from the immunologist confirms an IgG deficiency - subclass #1 deficiency with a value of 2.68 - normal range is 4.5 - 9.0 g/L.

The bloodwork also shows I'm still NOT immune to mumps, even though I've been vaccinated against it 4 times in the last year!

At least I'm immune (ATM) to measles, rubella, diptheria and tetnus!

So now I can go into my appointment armed with questions and possibly a few answers - I don't like going through things completely unaware.

Now, where to go from here.... that's the question!

Tuesday, August 4, 2015

Going to the capital of my country

Tomorrow bright and early we're leaving home and heading to Ottawa, Canada.

We're going to the largest waterpark in all of Canada; Calypso

I still have yet to figure out how tall little tyke is, I'm hoping that she's tall enough to go on the majority of the rides.

Another day we're going to take in a few things in and around the city....

A restaurant/lounge/cafe where we get to hang out as a family, have a snack/treat and play a couple of board games.... AWESOMENESS!!!! There's this one game that hubby and I really enjoyed playing before little tyke came along and I've wanted to buy it several times but it's like $80 and so we never have.... I'm putting my foot down that if it's available to purchase when we go (the one place sells some of the games as well) then I'm buying it (and maby more!).

Another part of the day we're going to hit up a farm where you can get up close and personal with the animals. And to go along with this we're going to hit up the agriculture and food museum where I'm hoping we have fun and have a bit of learning as well.

I asked hubby if he wanted to hit up the parliament building and go on a tour or do stuff more appropriate for little tyke, he chose stuff for little tyke.

There's also Hog Back Falls that we're going to go to - perhaps grab some take out and have a picnic at the falls, that would be nice.

There's the Byward market that I want to go check out, it's right around the corner from the boardgame place I'll probably kill two birds with one stone.

And perhaps if we have enough time we may go to a trampoline place to expend some energy that little tyke has pent up. Not sure if we'll get to this or not but at least I have it if that's how we decide to go.

And if we're bored enough and have some times on our hands then we may go to a cinema where the movies are only $5!!! Hopefully they don't try to make up for this by charging an arm and a leg for popcorn and pop!

I've found some really yummy places to go to eat - some BBQ, a mexican joint and a place that if we are in the mood for brunch then we have it!

Oh boy I can't wait! hopefully this will recharge my batteries and get me ready to undertake another heavy loaded course. I'm sure I'll have fun, hopefully  hubby can be patient for this trip - he tends to get very anxious and tends to cope very poorly when we're on trips and he lashes out. He said that he would "work on it", I hope he does!

Sunday, August 2, 2015


I've been thinking lately about graduation. Ever since I got through the one course (not this last one) that has been the bane of my existence I have had trouble not thinking about the end - graduation

I have been taking this program for 3 years - getting my readings done, assignments completed and group projects accomplished.

I have 15 months left until I (hopefully) finish this program.

IF I finish next year (which I sure hope I do!) it will have taken me 15 years to obtain my BSN

I have 6 courses in my way to get my degree

I have 4 nursing courses to get through

I have 2 english courses that must be completed by the end of  next semester

By the end of April I will have gotten through 4 courses - both english courses and 2 of the nursing courses.

By that point I will have gotten through 2 clinicals - I hope! I will certainly try my hardest to make all these numbers a reality! But they really are doing my head in to think about. I want so badly to be at the finish line - to see my course's final mark and knowing that the only thing that stands in my way of being a registered nurse is the NCLEX!

Thursday, July 30, 2015

Another down, one more closer to the goal

This week was my final week for my summer semester. I completed my leadership course - with a 99.3%!!!!

What a relief - this will give me a A+ in the course which will help bring my GPA up - because I know with the course I'm taking next will be a doozie!

My next course will be critical care and while I'm excited for it, the teacher isn't very helpful and she makes her tests/exams really difficult. So I'm certainily not looking forward to that aspect!

What I AM looking forward to is the critical care aspect - it's an area I want to focus in for my career so I'm looking forward to what this entails.

It's hard not to think that at this point next year (God willing [inshallah]) I will be taking my final course. It makes me very excited to get this done and the next chapter of my life underway. It's been such a long time coming. This time next year will mark my 15th year of trying to get my BSN - and while I've certainly not taken the direct path, at least I'm getting to my end mark.

I can't wait to prove those who thought I couldn't do it wrong - to prove that I'm resilient and can be a competent RN.

I can't wait til I'm walking across the stage to get my degree - boy will that be a day!

Tuesday, July 28, 2015

Helicopter parenting & friendship

Today was the big day - the cast is off!!!  I point blank asked the doc how long I needed to be a helicopter parent for - I think I threw him off a bit!

"I mean, how long do I need to obsess about her risk for refracturing - to monitor every little thing she does so that she doesn't do summersaults or cartwheels or pick up stuff she shouldn't be"

"oh.... two weeks"

face palm!!!

How in the WORLD am I going to parent this child ensuring that she doesn't cause damage and continues to heal for two more weeks?! It seems hopeless.

She's a daring child, often silly and ALWAYS active. Hell, that's how we're in this mess in the first place!

Oh and if THIS isn't prophetic - we were sitting in the line waiting to register for the fracture clinic to see the Doc and the woman behind us was commenting about her grandchild and how when they removed his cast that the child refractured it and had to undergo surgery to repair! Geeze! I hope like hell this doesn't happen to us!

On a completely different note....

I was talking to my fellow nursing student (4 hrs total - I killed the phone so we had to let each other go! HAHAHA) and the topics varied (as 4 hr conversations go!) and one of them happened to be about friends.... I mentioned that hubby had little to no friends and that it was difficult for me because he doesn't have anyone really that he hangs out with.

Well dont' you know, hubby announces today that we're now going out for dinner with a new "friend" of his through work and his wife. It's weird how when you put it out into the world that it answers back! So now we're going out for dinner with this new friend and his wife and their 3 children as well as taking little  tyke along for the adventure. Wish us luck!

Sunday, July 26, 2015

Another round of testing

On friday I got a message on my voicemail indicating that I was being transferred care from one specialist to a special specialist?

I guess the results have come back on the tests that the immunologist ran has returned and so he's transferring me to someone else to have "more tests run" - but I wasn't given the results.

Now I'm in the blue as to what to think.

Obviously SOMETHING has come back positive, I just have no idea what. ERG!!! I wish I could find out the results, try to look into things so that at least I'm prepared when I go and see this new physician.

When I looked at what he specializes in I have SOME sort of idea as to what I would be seeing the guy about but no definite.

Now I have to wait 2 months before I know what the results of the tests were and what the next steps are. So bloody frustrating!!!

Tuesday, July 21, 2015

All about little tyke

Today we met with her orthopedic Dr......

T - 1 wk til the cast comes off!!!

At least tentatively because it all comes down to what the next x-ray shows.

The current one shows minimal alignment - the Dr isn't concerned by this because he said that because she's young she'll set new bone to make the current bone straight and where there's a blip, her body will eventually shave it off to make that side straight.

So now the bad news with this news..... how in the WORLD am I going to ensure that this little girl does NOT put any pressure on this newly knitting bone? Because when I asked him about whether she can put pressure on it once the cast is off he said that she shouldn't for another THREE weeks..... so what do we do to ensure that she doesn't?! When I posited this question to him, he suggested a sling.... WTH is with all these physicians suggesting slings?! He KNOWS that her broken bone is due to her having the treadmill FALL on her..... so CLEARLY she's not any ordinary little girl!!!

UGH I'm so frustrated with physicians. Can they not think outside of their little box? Strategize a way that you can save me a LOT of grief and her potentially breaking this bone again!

On a separate note - the family is heading to Pakistan. Except hubby and I!

Little tyke with go along with my MIL, FIL, and two BILs - I would love to be going but I have work and school. I don't want to be delaying getting my courses done than I absolutely have to. My MIL doesn't really understand that but at least she's accepted it. At first hubby said no about little tyke going. I think he's afraid that something's going to happen to him when we aren't there. THAT I get. But she's very Pakistani (with a good mix of white girl) and she has their appearance so she'll fit in. Plus she speaks their language fluently. I think it's vital that she understands this part of her heritage and I think she's old enough (I hope) that she will remember this trip for the rest of her life.

I wish I were going but, as I told my MIL, I want to go when I can spend a good quantity of time there - like 3+ wks..... hubby and I agreed that when I'm done school that we will make our way there. Or if my BIL gets married and we go back there to do it (they'll probably find someone to pair him up with this time around) then I'll go over. But right now is just the wrong timing. At least I can send little tyke in my place who can enjoy this trip.

This has excited little tyke like crazy. Or at least my MIL is hyping up little tyke. A couple of years ago little tyke went to England and she LOVED it! I think I'm going to have a little adventurer on my hands. I hope so. I hope she learns to love adventuring the globe and going to new places. Learns to cope with the anxiety of entering new places and doing new things. Maybe she's a globe trotter in the making! Perhaps she'll learn to see the world as a whole and not just her little part of the world. I hope that by letting her experience this at such a young age she will grow a little bit each time.

So to this I say bonvoyage little tyke, bring me back a token of your travels!

Tuesday, July 14, 2015

Creutzfeldt-Jakob Disease (CJD)

We had someone who was suspected of having this disease - my knowledge isn't the best but I knew that it could be transmitted to others.... here's what the NIH says....

There are three major categories of CJD:
  • In sporadic CJD, the disease appears even though the person has no known risk factors for the disease. This is by far the most common type of CJD and accounts for at least 85 percent of cases.
  • In hereditary CJD, the person has a family history of the disease and/or tests positive for a genetic mutation associated with CJD. About 5 to 10 percent of cases of CJD in the United States are hereditary.
  • In acquired CJD, the disease is transmitted by exposure to brain or nervous system tissue, usually through certain medical procedures. There is no evidence that CJD is contagious through casual contact with a CJD patient. Since CJD was first described in 1920, fewer than 1 percent of cases have been acquired CJD.
No idea which category this patient had but still.... it's a prion disease that can be transmitted to others and that's what's important! Infection control wanted us to isolate the patient and maintain precautions - whatever that meant! No one told us a thing, just simply wrote an order and left!

Forward 3 hours later and the nurse was checking charts and found this order. Not knowing what to do she contacted infection control who took over an hour to call back and being told that it would be important to isolate and that for any invasive procedures that items had to be incinerated and not simply put into the garbage can OR the sharps container (even though it's a biohazard container).

Now that last bit became REAL important when at the end of shift the code button goes off on the unit and you wait a minute to see if it's real or not - and you make your way to the room to find out that the code is real - then you learn it's the patient with CJD!!!

So then when ppl come running with the code cart and you get all the personnel that need to be there for a code, you have to attempt to tell them all that they need serious PPD - so out everyone runs to get covered up and I go running to get N95 masks because who knows what you're going to be exposed to!

The code is finished and patient is determined to be deceased after several rounds of CPR and epi - so then we contact infection control to find out what to do with all this "stuff" left over and what is required for the body - and we all ask each other - is this a coroner's case - is it a mandatory autopsy?

NOPE! Not a mandatory autopsy - coroner says it's up to family to decide!

HOWEVER - dealing with the body is done differently - I get told by infection control that we need to use an EBOLA body bag!!! WOW! Wasn't expecting that. Didn't even know how to go about getting that! Thankfully infection control says that the ER has it and they can provide it. Whew, what a relief!

Then we work frantically to try to clean up the mess that's left after a code because ALL PPE was piled atop the patient and that simply would NOT be good when the family came and would see this person with "trash" (essentially) piled on top.... but we couldn't just put it in the corner or in the regular garbage. So we called housekeeping and STATed the "special" bags - which thankfully they did.

Sunday, July 12, 2015

What a coming-back shift

Dealing with patient's is one thing, dealing with family members is another!

Today was my first day back from having 2+ wks off - having vacation and dealing with a nasty head cold to finally feeling well enough to take care of patients and boy was it a shift.

TWO hours in and my pt was crazily delerious and thinking that birds were in the hospital and we just HAD to "deal with the birds", "the birds, the birds, they're everywhere" - which if I were him, I would be QUITE agitated. So I get it - BUT, when the daughter gets involved and become agitated that I am not doing something to "make him better" - Lady, I've only been with him for TWO hours - I know VERY little about him - just what I got from report and from his history.

So there I am trying to calm both pt AND daughter down - bloody hell, how did this happen to me?!

So off I go to call the MRP to ask for resperidone to manage the hallucinations - nope - he says that he gave orders earlier in the day to the nurse for seroquel and haldol and for me to give this.... ok so off I go to find these "orders" that I knew little about because the day nurse hadn't updated me on these - instead leaving me in the dark!

K so I pull the meds from my pyxis - and fail miserably attempt to give these oral meds - but by this point the pt is so agitated that he is suspicious of what I'm offering.... I attempt several times with different ways to get him to take with no results - dinner comes - and he won't touch it.

That was the last straw for the daughter - she starts cussing at me saying that no one is doing anything to help her father and that he just keeps going down hill. I try to calm her down but that does nothing and starts raising her voice - that's it - straw breaks the camel's back and I inform her that if she doesn't calm the f*ck down that I would notify security (whom is already in the room with another pt) to have her excorted out of the hospital if she can't be respectful. This doesn't deter her and she continues on about how she wants an umbudsman - I inform her that I can get the number if that's what she wants - she confirms this so off I go. I also give the go ahead to the security in the room to notify main security to send someone for back up - and I go get the # as well as notify the MRP about this situation. So by the time I go back to the room the security shows up and informs her that she's a visitor and that if she can't be respectful then she can be escorted out of the hospital. She becomes quite upset and is incredulous about the fact that I gave the go-ahead for security to come.

MRP was irritated that he needed to come speak to this daughter (he said he already spent an hour earlier in the day speaking to her about everything so couldn't understand why she was freaking out now) - and once he showed up she was COMPLETELY calm - and for some reason the pt completly relaxed with him around - enough so that I could get the haldol on board and he talked to the daughter while we were waiting for the haldol to kick in - once that starts to take hold, he allows the doctor to give him the seroquel and clonazepam but won't let me do anything. ERG!!! Well at least he took them! Two hours later he's FINALLY asleep in his bed - may he remain that way the rest of my shift!

Then while all this is happening I have another pt who had IV fluids and IV antibiotics ordered and hasn't had an IV access since nights and the day shift nurse is a tard and ALWAYS leaves stuff (especially the more difficult and time intensive things) for the next nurse - not ONCE did she inform the MRP that there was no IV access!!! Instead she tried to get it, then had a NEW nurse attempt (who is notorious for sucking at IV initiation!) but not ONCE did she contact ICU who have support nurses who attempt difficult IV starts or ICU stepdown to see if they could start it. ARGGGG. So now this responsibility is mine - so I attempt - I could find it but once you start it blows or won't thread.... ARG!!!! So off I go and call ICU (like you should!) as the one senior nurse on our unit who is good at IV initiation said she was "too busy" to try.... so I had to wait for ICU to come.... which they did about an hour after calling - and they get it in the AC but kink the catheter so it's difficult to use.... soooooo I was only able to get the IV antibiotic in and then it went interstitial. So by this point it's after 1930 - which means new nurses!!! So I called ICU and asked that once report is given could they send someone for this guy..... so about another hour goes by and someone comes and attempts 3 times with them blowing each time.... ARGGGG!!!! OK, I'm done..... so by this point this poor pt has been poked NINE times!!! I assessed his feet and they actually look like they're possible - but it requires a physician's order to do. BUT of course SOMETHING gets in the way.... a code blue on the unit next door so off goes the doc to deal with that!

By the time he gets back to our unit it's 2245hrs!!!! I tell him the situation - either a foot IV initiation so that he could get IV fluids, antibiotics and hydrocortisone (steroids) - OR give me an order for these things to be oral.... thankfully this pt was drinking and eating well so while the IV fluids would be helpful it's not URGENT or emergent for IV fluids to be required. Also, the pt wasn't septic so oral antibiotics should be alright til they figure out the IV situation - this pt TOTALLY needs a PICC line!!!! Perhaps I'll tell the MRP to order one for this pt!

Then you have 3 other pt's with required needs, as well as another pt who had diarrhea who required bedpanning four times in my shift as well as a blood product and several nebulizers. Ugh it's just too much for one person and there's no one that I could delegate to :(  Hopefully my next shifts are better!!!