Saturday, September 13, 2008
Is it a full moon?
The fountain at the new Palazzo in Las Vegas. Everytime a new casino opens it is more elaborate and more stunning than the last....ya gotta love Vegas.
Was it a full moon yesterday? Wow, my day started out ok. I went to a different floor at the new hospital I am working at , it was the surgical floor. Not a big deal, I can do surgical. It started off kinda crappy because I couldn't punch in, there was no paper to tell me the punch code for the unit, so, I had to walk over to their sister unit and punch in there, only a minute late not too bad. Then I came back and get report, doesn't sound too awful. They came from Interventional Radiology and swept my patient away while I was in another room...didn't get to see him. Then I have the guy who's wife is a nurse (great), someone else going to surgery, somebody with back pain and a copd pt. The morning was ok, trying to find my way around the floor and learning the flow...my other guy goes to surgery, and I get to eat lunch. When I come back, my first guy comes back from IR with a stent in his leg and has to lay flat for 5 hours, my other guy comes back from surgery in pain, my pca has to be changed, my copd pt thinks she has a blood clot in her leg and calls her family who calls me then....
My back pain guy calls me and says he's in a lot of pain in his face...I went to his room and he is squirming around in the bed, his jaw is all clenched he feels like he can hardly breathe, he is majorly freaking out...and secretly so am I ...no idea what is up with this guy. He says he feels like his head is all distorted and he can't close his eyes.or open or close his mouth all the way and he really sounds like he's having trouble breathing. So, I use my calm voice and hold his hand and tell him to breathe through his nose. The cool thing about this hospital is that the hospitalists are on the floor from like 8 in the morning to like 6 at night..literally they see everyone on the unit and they have a little office they sit and chart in. So, I go and get the doc...we give him Ativan and it helps a little...the doc asks what meds he is on and one of them is IV Reglan...you can see the light bulb go on above his head he says give him Benedryl and Cogentin..IV. I have never given cogentin IV before but, it worked! The guy was having an acute dystonic reaction to the Reglan. Never seen it before in my life...I have given Reglan hundreds or maybe even thousands of times...and this guy had been getting it for at least 24hrs...weird. He was very nice and grateful for us being there and helping him so quickly. I told him he taught me something and he thanked me again for being there and being calm.
It's weird how that happens...in that emergency kind of situation...I can keep cool and not look freaked out even though inside I'm going "Oh my God, Oh my God, Oh my God...somebody help me!!!!" I don't like the feeling and that's why I don't do ICU...stuff like that happens so fast and it happens all day long...my little heart couldn't take it.
So, after all that you'd think I'd get a break or something, like in football after a really big play the wide receiver gets to sit out a down or two to catch is breath..nope I'm right back in the game. Giving my pain meds, checking pulses, giving insulin, printing out education materials...constantly moving constantly checking my patients...you'd think I'd weigh about 100Lbs with all the walking I do,huh. Fate.
Non noc nocere.