Email excerpt

Just a little bit if the desert for ya. I can't decide which I like best the cactus or the palm trees...you can keep your fall leaf changes and the summer humidity, I'll keep the heat, the cactus and the palm trees.
This is a little excerpt from an email from my favorite nurse:

Long day today. I admitted an Indian woman yesterday from the ER. She had 32 home medications which were not written on the med reconciliation form and No allergy band on from ER. She went to the ICU at 0300 today for respiratory failure. I got her back not bathed, from ICU at 10AM. 25-30 relatives at her bedside. Well at 1820, after being in the room for the last 20 minutes of her life,the nursing supervisor tells the Organ donor bank that she is a white lady. Well,that fried me for some reason and I told him Hey she is no white lady she is Native American. I did not see her grandson standing nearby but, he stopped me in the hall and thanked me for correcting him. She would appreciate it. Long day.

Sometimes it's the little things...they can either make your day or just mess it up. The 32 meds not on the med rec form and the allergy band not on the patient from the ER will most certainly mess up your day. I find it happens a lot from the ER...all over the country. I know they are busy down there, I've worked there a couple of times but, they still need to be held to the same standards as the rest of us...just those little omissions can cause error.
Getting your patient back from the ICU without a bath or at least smelling like they got no bath seems all too common as well. Most ICU's bathe their patients at night but, I have run into some that don't get it at all...maybe it's too basic of a nursing chore for them...that's one of my peeves. I know you are trying to keep them alive and it's really busy but if they are well enough to come to the floor then you should give them the decency to be clean when they get there. Getting a dirty patient half into your shift can really make for a messed up afternoon, cuz then you have to stop and clean them up before the hoards of family members come to see them. Minimal visitors and lots of weird smells in the ICU can mask it for ya but, no so on the floor. Plus, I don't feel like I have cared for my patient if they appear dirty or unkempt.
Just that 2 seconds it took for the grandson to thank the nurse can make your whole day seem worthwhile. After all, it's what we need, just for someone to notice that we really do care. After a long day of family in your face, patients being crabby, poor staffing, nurses whining about their assignments, doctors yelling, and your boss not backing you up, it's nice to hear something positive.If we didn't care, we wouldn't do what we do. Just one sincere thank you for a little thing can make it a good day.
We can do it for our co-workers too...let them know if they helped you, tell them you appreciate it. It just might make them have a good day.
Thanks to my favorite nurse for sharing and for caring enough to be the very best....
Non noc nocere.

Heat is on

That's right, the heat is on...33 days over 100 degrees. But, the humidity has still been low, until this past week. The rain and clouds and the wind, it's monsoon season finally. All the native Arizonans are soooo happy, they actually go outside to be in the rain.

I have had a long week, the beginning of the week my patients were great and I went home feeling like I did a great job. Yesterday was a different story...just really had people that got on my nerves. It should be ok for me to not take care of someone if they refuse to help themselves. If you know what you are doing will kill you and you refuse to even try to stop...I should not have to help you or put my taxes toward helping you. I have 2 examples:

A 40ish year old male with chronic back pain and a HUGE family history of heart disease. He has already had stents placed in the not so distant past. He comes to our unit for chest pain and continually leaves the floor to go and get his Pepsi (since we can only give him Shasta colas from our floor stock and that's not good enough)...yeah he comes back with a Pepsi but also smelling of smoke. I repeatedly explain to him why it is unsafe to leave the unit, especially when he complains of sob and chest pain when he returns. He has not stopped smoking since he got his stents. So, he goes to the cath lab and comes back needing a CABG. He has had a cath before, his bedrest is only 4 hours and he is doing everything he can to try to get out of it. Then, he's up smoking in the bathroom. He says it's driving him crazy that he can't be the one who decides when he quits smoking, he wants to go home and set a date for 3 weeks from now or so and then he will be able to quit...wow, can you believe that logic? Not even the reality that he could have a massive MI and die is enough for him to want to stop doing what is killing him. Amazing, he doesn't think enough of his life...I know all you smokers out there are saying..you don't know how it is, it's hard...well, yes I do and yes it is hard but you have to want life more than cigarettes. I don't think the residents of Arizona or the US should have to foot the bill for this guy to have a CABG when he doesn't even want to try to quit smoking.

Do I sound angry, or bitter? I also had a female patient come in with chest pain, she's about 40 years old, also a smoker and morbidly obese. She says she goes to see her primary care doctor every couple of months for her high blood pressure. Her glucose level was well over 300 in the ER as well as her urine being positive for amphetamines and opiates. Her cardiac enzymes are way out of range (her troponin which should be less than 0.01 is 57). So, off to the cath lab she goes, her vessels are so bad they had to go through her brachial and even then they couldn't see all they needed to see..but what they did see was not good. She ended up going home on meds because the chances of her being able to survive the CABG were so slim...this woman is also on disability and she's out there getting high and killing herself by smoking and over eating and generally not taking care of herself. I was really glad that she wanted to go home on the meds, I don't think she'll make it which is pretty dam sad to say for someone so young, but she isn't doing a whole lot to help herself either.
I think that's my message for today, and why we as nurses can get burnt out. If people are out there and they know what they are doing is hurting them, yet they keep doing it, why should I have to try to help them when they won't try to help themselves? Why do we spend millions of dollars on healthcare for people who turn around and continue doing what got them in bad shape to begin with? When does the responsibility get shifted to the patient?
Really glad I got the day off today. Kinda sounds like I needed it huh? Remember non noc nocere.

Computer Crash

So, I had a great day off yesterday, I slept in, I exercised, I got to swim in the pool and enjoy the sunshine. Oh yeah, it's monsoon season...still waiting on some rain. My dog is thrilled that it never rains...she always hated going out when it was wet. Luckily we bought a house with desert landscaping, so, not much water needed there either.
The last day I worked was Tuesday, we really thought it was April 1st not July 1st...I guess we'll call it July fool's day...what a mess. Some how our computer system at the hospital crashed. It started out running really slow when I passed my morning meds...thank goodness it was my second day with these people and they didn't have a ton of meds. I actually got done at about 8:45, and I took a break...yeah I do it when I can because the opportunity doesn't come along too often. By the time I got back there was an irritation in the air. The doctors had started doing their rounds...there was much grumbling and a lot of mouse punishment going on. You know how it is when the computer just isn't responding so you pick up the mouse and slam it on the table a few times to wake it up...yeah it doesn't work people. It's not a real mouse, it's not sleeping, you don't have to wake it up...the problem is in the computer. Maybe I shouldn't tell them that, they'll be slamming the tower against the desk next...lol. So, first it was just taking a really long time for the pages to load, then they are timing out, then you get kicked off, then you can't even sign on to the program so everybody starts rebooting their computers...because communication is sooooo wonderful in the health care field, there have been zero announcements about the computer problems. But, everybody is complaining. Some of the docs are really verbal, " How do they expect me to do my job? None of my patients are going to get discharged today with all this going on, I was going to discharge 10 people now only 4 get to go home." It was getting bad. The we found out it's not just our hospital, it's not just the hospitals that belong to this certain company in the Phoenix area either. They have hospitals in AZ,CO,WY,NV,CA,AK and they are all down...what a nightmare. Plus the hospital where I work has only been live on the computer system for nurses to chart for about a month...so, there are a lot of people not comfortable with it yet. Now they are being asked to go back to paper charting until the computer comes back up....what a headache!!! Thank goodness my patients were angels and didn't need much charting. The issue was completely resolved at about 6pm just before night shift came in. And they got an extra nurse to help them....WHAT????!!!! the problem is solved what do they need an extra body for? Maybe, the band aid might not stick huh? SOOOOOO glad I had a day off yesterday!!!Guess we'll see what happens when I go back tmorrow.
Remember our troops and have a Happy and safe 4th!!!
Non noc nocere.

IT'S HOT!!!!!

Yep, it's summer in Arizona. I wasn't sure how bad it was going to be and I'm sure I haven't seen the worst of it yet...this past week the average temp was 112. I didn't mind much because I was at work...but we did have a couple of admissions from heat stroke. I had a guy who likes to keep his apartment at 85 degrees and actually called his maintenance guy because there was a draft coming from the fan in his bathroom(WHAT???). His rectal temp on admission was 104.8...nice...and he has 7 college degrees.Bright but not smart.
My boss is trying her hardest to get me to come on staff. I have a really hard time with that. I have been traveling for 7 years now and it would have to be a really exceptional place for me to decide to stay. I had a day last week where I got my cath patient back at 6pm. She had an ablation so she came to the floor with one arterial sheath and 5 venous sheaths in. She was oozing when she got to the floor, I was so thrilled. I called to get my CM (charge nurse) to come up and take a look at her. The CM's get report at about 6:30 so they are usually off the floor at that time. Well, they didn't come to help me. One of the internal med docs came to see the patient and was not happy about the amount of oozing so he called the cardiologist who said pull the sheaths. Ok, well, the patient has been on coumadin her INR was 2.6 and they had given her heparin during the procedure...not a good combo for pulling sheaths..plus it's the end of the shift and I don't pull sheaths.So, I call the CM again..it's now about 6:30. She finally gets there at about 7:20 and says oh it's not so bad...then she takes the dressing down....yeah, she realized then that she should have come up a long time ago to pull them...she pulled at 7:29. Yeah, I know what you are thinking "but, your shift ends at 7:30" yeah most days. I did end up getting out of there about 15 minutes later because the house sup came to help the CM hold pressure. I'm pretty sure they were there for a LONG time. So, that's just one example of why I would not jump at the chance to become staff.I don't feel I have the resources I need to provide the best care for my patients.
There are a couple of other hospitals close by that are in a different conglomerate...they are CHW hospitals. I have an orientation there through my agency the middle of July so, we will see what happens with that. The only time I have had a problem getting a contract here in Phoenix is in the summer and my contract ends the end of August so, I am not too worried.
As always, first do no harm.

Moved in and moved on

So, this is a picture that my husband took of our friends when we went on our boat trip. Jeannie has the hat on and Don is her husband (sitting behind her) and Shirley is sitting next to Jeannie. Jeannie and her husband went back to Napa to be with their daughter. It's been a little over a week and I still really miss them. It was nice having friends in town. We moved into our house officially one week ago, last night I got to sleep in my bed.. it was wonderful. When I came home from work I went out back and put my feet in the pool for a while. Then we sat on our double chaise lounge under the stars and talked. The temperature was about 75 or so it was very comfortable.
I had 8 days off (to move in)and then worked 4 in a row. I don't like working 4 in a row. I get really crabby on day 4...I had the same patients for almost the entire 4 days, which, in a perfect world would be great, but, I had the drug seeker who would follow me around in his wheelchair ( I still would like to know who gave him a wheelchair) and ask if it was time for his Dilaudid; I had the slightly confused old guy who cried and complained all day about how awful he felt, no matter what I did or what meds I gave him he felt awful, but he watched tv and ate ice cream at the same time; and the 300+ lb woman with a chest tube who had to be lifted from her air bed to the chair for all her meals. So, it was a very long 4 days.
Today I plan to catch up on some emails and to sit out by my pool. I am scheduled again tomorrow and the next day. Census dropped a little during Memorial day but, we have been full ever since. My boss is trying to get me to go core staff...she has had a traveler there for the last 3 years who is still there and there was another one that moved to a different floor this month who had been there for 2 years...so, I am not going to cave...there are plenty of travel jobs in this city...yes, I like this hospital but, not for a $10/hr pay cut.
Well, hope ya'll have a great day. Remember first do no harm.

Loss

Above is pictured my favorite Uncle. He had a battle with cancer and copd for the last year.He was put in hospice on Thursday of this week and passed on Friday. It makes it all too clear that you must live your life not just be alive. He had a surgery last year which made it possible for him to travel and visit friends and family. The other lesson this has brought home to me is take care of your body and it will take care of you. You cannot over indulge (in anything) and expect not to have any consequences. Ok, I'm off my soap box. He was a great guy, always had a big smile and a kind word. He had a fantastic voice, bass baritone, I loved to hear him sing. I took a travel assignment last year in Columbus Ohio to be near him and my brother and to buy our house there. I am so glad I got to spend that time with him. I hated the job and the weather but it was worth it to spend that time there.
Thanks for listening.
Remember our troops and all those who fought before them...it's Memorial Day. Be a proud American!!!
Non noc nocere.

Marathon for computer charting

Well, I made it. We are the last of the Banner hospitals in Arizona to go live with their computer charting. I worked the whole first week. Since I used the system before I got to be a "super user" and spent the last 3 days of last week helping the nurses find their way. I have a new appreciation for those of you who know how to type, even just a little. The hardest part was helping to teach those who don't use a computer at home on a regular basis. If you have to study the key board to find the letters, you should have practiced. If you cannot click and drag, you should have practiced. If you cannot scroll without clicking your mouse a bazilion times, you should have practiced.
The biggest thing I learned, a new tool doesn't change old bad habits. If you want to pull all your meds for all your patients for the whole day, you'll still find a way to do it, even with a newer better system. If you didn't check the meds against the mar and check the name band before you gave them before we got computer charting...you won't now.
All I can do is never let my family members go to the hospital or stay in the hospital alone.
Non noc nocere.

Happy Nurses Week

Well, it's that time again. Nurses week, it used to be a day...now it's a week. The hospitals usually give you some free food and some free stuff and say they appreciate us. I think about god old Florence, she did it because she cared about people and wanted to make them feel better when they were sick and hurting. I'll bet her patients were mighty grateful for every little thing she did for them. Her nursing was about fluffing the pillows and keeping them clean, dry and warm. Have we lost sight of that somewhere along the way? Some days it seems like nurses just come to work to see their friends and check their email or surf the Internet. Some days it's like we are there just to pass out pills and food. This May 6th (Florence's birthday) I am going to honor her by wearing all white. I try everyday to be the best nurse I can be to my patients. Looking back, yeah there was a time in my career that I cared more about seeing my friends than taking care of my patients. Traveling has helped to cure a lot of that, when I start somewhere I don't have any friends to worry about. I focus a lot more on my patients needs than what the other nurses did over the weekend. I think that's what it's about. Being the best nurse you can be, every day, like Florence did. Have a great nurses week!
Non Noc Nocere

The Code

Hey all...yeah it happens to all of us. I was transport nurse for 8 hours then took over for a nurse that went home. Things were great at 4pm...all of my patients were happy and healthy just waiting to go home in the next day or so. My best patient had finished her walk around the unit with her chest tube and was sitting in her chair visiting with her friend... when her friend came out and said that her friend (my patient) felt dizzy. I went immediately to her room after checking the monitor and she said she felt dizzy, we immediately got her back to bed and by then she couldn't complete a sentence and her pupils were fully dilated. We coded her for about a half an hour. Thank goodness her friend was there because she was in PEA for a while. It was devastating to me. I hate to code patients,especially my patients, but this one I knew there was nothing I could do. As we laid her down in the bed, she couldn't form a complete sentence, and she looked into my eyes and started to cry. It is really a strange predicament to be in. But, it really makes you think of your life and how quickly it can change. (She didn't make it)
Ok, on to better subjects...today is my birthday. It has been a great day..ok so all of my siblings didn't call or email me happy birthday..but my friend Jeanett called from Ohio to say she missed me at the Louie Run today ( a motorcycle ride named for a guy in North East Ohio that benefits lots of different charities) and my friend Frank called from Kentucky. Frank has the same birthday as me and is married to one of my best friends Frankie. We took a boat ride on Saguaro Lake with our friends Don, Jeannie, and Shirley. We had a great day and went to the marina diner for lunch and it was a great day.
I am still waiting for the bank to decide if I am going to get this house or not but I am finally stabilized here for another 3 months...at least till the end of August. So, another year and none the worse for wear. Non noc nocere.

Waitin on a contract

So, I'm waiting on 2 contracts right now. Number one is for the house pictured above. It is in the neighborhood right next to our apartment. It is a foreclosure and has been vacant for a year. Yeah, the pool is a little low and green... the weeds are a little high in this picture...luckily the HOA has since cut them down for us. The inspection is done but we are still waiting for the OK from the lender...so that's one contract. We are hoping to buy this house at a discount, live in it for a year or two and then sell it for a profit.
The second contract I am waiting for is from Banner for an extension to stay working at the hospital I am in now. About a month ago I asked my boss if she needed me for the summer and she said she wouldn't know for a few weeks. So, now that it is getting close to being a month away from the end of my contract, and with everyone elses contracts ending the end of May too, we are all getting a little nervous. I would just like to be able to stay at this facility for a little longer. I like the people I work with for the most part and the work is not very annoying. Let's just say I can tolerate it for a few months longer. At a increased rate of pay, because I will get a housing stipend instead of an apartment...that stipend should pay my mortgage, plus I will still get my same hourly rate. Of course at the other end I will not get a bunch of write offs for my next years taxes but, I'm ok with that.
All that aside I had a very phlegm filled week this week. Our cardiac unit has turned respiratory on me. I had 2 COPDer's , one CP and a suicide. Yesterday my suicide was discharged to inpatient psych and I got an ESLD. My least favorite was the 49 year old Cerebral Palsy patient...he was nice enough but barely functional and just coughing and coughing and I was so afraid he was going to choke when I fed him. Speech therapy said he was ok, just a delayed swallow, just not in my comfort zone. But, I have 2 days off and next week is another week.
Remember non noc nocere.

Poem Crabby Old Man

This is a great story whether true or not...

When an old man died in the geriatric ward of a nursing home in North Platte, Nebraska,
it was believed that he had nothing left of any value.
Later, when the nurses were going through his meager possessions,
They found this poem.
Its quality and content so impressed the staff that copies were made and distributed to every nurse in the hospital.
One nurse took her copy to Missouri.
The old man's sole bequest to posterity has since appeared in the Christmas edition of the News Magazine of the St. Louis Association for Mental Health.
A slide presentation has also been made based on his simple, but eloquent, poem.
And this little old man, with nothing left to give to the world, is now the author of this ' anonymous' poem winging across the Internet.
Crabby Old Man
What do you see nurses? .What do you see?
What are you thinking.....when you're looking at me?
A crabby old man, ...not very wise,Uncertain of habit ........with faraway eyes?
Who dribbles his food.......and makes no reply.
When you say in a loud voice.....'I do wish you'd try!'
Who seems not to notice ..the things that you do.
And forever is losing .......... A sock or shoe?
Who, resisting or not...........lets you do as you will,
With bathing and feeding The long day to fill?
Is that what you're thinking?
Is that what you see?
Then open your eyes, nurse......you're not looking at me.
I'll tell you who I am . As I sit here so still,
As I do at your bidding, .....as I eat at your will.
I'm a small child of Ten.......with a father and mother,
Brothers and sisters .........who love one another
A young boy of Sixteen .with wings on his feet
Dreaming that soon now. ......a lover he'll meet.
A groom soon at Twenty ..my heart gives a leap.
Remembering, the vows......that I promised to keep.
At Twenty-Five, now ........ I have young of my own.
Who need me to guide .... And a secure happy home.
A man of Thirty ......... My young now grown fast,
Bound to each other ...... With ties that should last.
At Forty, my young sons ..have grown and are gone,
But my woman's beside me.......to see I don't mourn.
At Fifty, once more, . Babies play ' round my knee,
Again, we know children ....... My loved one and me.
Dark days are upon me .. My wife is now dead.
I look at the future ..............I shudder with dread.
For my young are all rearing......young of their own.
And I think of the years....... And the love that I've known.
I'm now an old man.........and nature is cruel.
Tis jest to make old age look like a fool.
The body, it crumbles..........grace and vigor, depart.
There is now a stone........where I once had a heart.
But inside this old carcass .. A young guy still dwells,
And now and again .......my battered heart swells
I remember the joys........... I remember the pain.
And I'm loving and living.............life over again.
I think of the years .all too few......gone too fast.
And accept the stark fact........that nothing can last.
So open your eyes, people .......open and see..
Not a crabby old man.
Look closer....see........ME!!
Remember this poem when you next meet an older person who you might brush aside without looking at the young soul within.....
we will all, one day, be there, too!

More days off

This tomb is in Papago park next to the Phoenix zoo...it is a great place to look out over the city...especially at sunset. It was one of our stops with my niece because it's right next to the hole in the rock.
I had another 3 days off this week for my husband's birthday. We didn't do anything spectacular but we did go house hunting. Hey, what can I say ,it's what he wanted to do. We found a cute little house right down the street from our apartment that has been vacant for almost a year...sounds about right for us. It is a 3 bedroom 2 bath with a pool...we'll see what happens.
Work has been frustrating because we still have our doctor's father. I feel badly for the doc...trying so hard to keep dad comfortable. We have been having some staffing issues...people not showing up for their shift and late call offs. Sometimes it can't be avoided...and I prefer if you call instead of not showing up at all or coming in and then leaving because you don't feel well. You know you don't feel well when you get up so, just take the points or the attitude from the staffing people and call. Don't, don't, don't think you will feel better once you get to work because you will just end up going home and leaving everyone in a worse position.
I have to ask...how many people will go into work if the staffing office calls you and asks you to come in? Does it depend on how you feel? How much they beg? Do you even answer the phone? Would you be more likely to say yes if they called you the night before if you are a dayshift person? When is a good time to call a nightshift person to come in? How likely are you to stay a couple of extra hours if you are already at work and the next shift is short?
Here's my position. I will pick up extra days when it is convenient for me...not 4 in a row or more ...don't even ask me if I have been there for more than 2 days in a row. Call me the night before if you have an idea...I will most likely not come in if you call and wake my butt up at 5:30 am and ask me to come in. Now, when I was working agency, that was the norm, I had to wait for them to call and tell me where I was going to work that day so I was up anyway. It also depends on my wallet...and how much cash I need. What's your take on it? Just wondering.
Remember first do no harm.

Desert in bloom

What a great week! We went for a little nature hike one day and got to see the desert in bloom...some really vibrant colors. Not a lot of color, which makes it even bettre just splashes here and there. I had so much fun sitting by the pool and shopping with my niece. We took her to a little restaurant that we had gone to with our friends. They serve a lot of senior citizens...lots of cheap food...it was fun. We went to the workout room at the apartment complex and played racket ball as well. It was fun playing the cool Aunt.
Went back to work on Saturday and Sunday, nothing too exciting. The boss actually came in on Saturday. She told me one of my crazy patients had called administration and told them how nice I was. Yeah, how much weight does that statement hold when they know he's crazy? Does it just show my attraction for the bizarre? This is a guy who has been admitted to the hospital 15 times since the beginning of the year...not to mention all the times he was in the ED and was not admitted...for chest pain. When I had him he got a Psych eval and the Psychiatrist even said he was and odd bird...she couldn't tell if he was schizophrenic, drug seeking or just plain odd.At least he didn't tell them I was crazy,huh?
Headed to class today...at least I got to sleep in. It's a refresher so, hopefully I'll retain something. Then tomorrow, it's back out to the pool. Yeah, traveling sucks.
Remember first do no harm.

a week off

Yep, a whole week off...one extra day cuz I was sick. Beware of food brought in for "pot luck". I usually have a pretty strong stomach, but it really got me. Easter dinner...better with family. So, my neice is here for a week. I get to play the cool Aunt..as close to being a Mom as I ever wanted. Seems weird what with everyone else in my family having one or more off spring. I'm lucky I just get to enjoy them all. So, we will be spending a lot of time at the above scene...the pool, so she can got back home to the frozen north with a little tan and make her friends jealous. My oldest sister is in the happiest place on earth...Disneyland...don't envy her. She is there with her 4 kids and 5 grandkids...sounds like fun to some...can't wait to see the pics. Be safe and find some time to enjoy a day off.
Remember non noc nocere.

Busy,busy,busy

Well, this is one of my favorite places...it's called the hole in the rock. It's in Papago Park in Phoenix. It doesn't look like it from this picture but you can stand in the hole and look out over the city. We stopped there on our way home from a baseball game last week. Yep, baseball is alive and well in the Cactus league..we saw the D-backs and the A's. It was actually a pretty hot day...about 85 and sunny.
My nephew has made the trip to Iraq...he is currently about 11km southeast of Baghdad. Still doesn't seem real to me. Please keep him in your prayers.
Got some bad news from a traveler friend, her husband's sister's body was found Tuesday near a lake in York PA. She was a high school teacher and had gone out for a hike Sunday and went missing. They suspect foul play but are awaiting the autopsy results.It just makes me shake my head, what is happening to this country when you can't even go for a hike in rural PA and return safely? Please also keep them in your thoughts.
I've been working my 4 to 5 twelve hour shifts a week. It's been really heavy at work...one of my patients was on the floor the other morning when I went in to see him...ya gotta love to start your day that way. We had to use the Get-a-lift to get him off the floor...he's a big guy and really sick too. I was really impressed, even the nurse manager came in to help. I've had a couple of nice old guys the last couple of days as well, they love to talk about the state of the country. I love to get the time to talk to them, some of them have such great stories.
Well, headed out to the game again...Cubs vs. Rockies...be back with pics.
Remember first do no harm.

One of those patients

We've all had them...the patient that just won't leave...every time you go into work you just hope they have gone home or to another floor or anywhere that you won't have to take care of them. It's not that they are a difficult patient or even really sick...maybe that's what irritates me. I like my patients to come in sick and go home better not linger in annoyanceville forever. Mine most recent one is still on the unit and I have had him everyday that I have worked now for 2 weeks straight. He has TGV(transposition of the great vessels of the heart) and he needs a transplant...the doc is trying to prove it by bringing him in and putting him on dobutamine, now he's dobutamine dependant. It's a fight with the insurance where to send him for the transplant...but he's not even on the list yet. Makes going to work just a little more annoying.

Had a great trip to Las Vegas...saw the new Palazzo and a great little place just off the strip called Tuscany.It's always changing, they are building a lot of new stuff. We followed our friends advice and took the southern route from Phoenix into Las Vegas. We got to go through little towns like Searchlight Nevada...plus we hit Arizona, California and Nevada...always a plus to hit as many states as possible in your travels. The ever present question...did we win...well, yeah we won some we lost some but, it didn't affect our financial standing so, it was a good trip. Still waiting to hit the big one...as always first do no harm.

CPR

Nothing wakes you up faster in the morning than a code.It was not my patient but I found myself there in the room...the monitor looked like V-Tach and the alarms were going off.I went quickly to the room asking who's patient she was. I looked at her and knew she was not breathing. My second responder (her nurse) entered the room and I told her to call the code...I flattened her bed and suddenly the room was full of people...the ambu bag was being tossed to the head of the bed, as I was putting it together the resp. therapist appeared and started bagging. I started the compressions, then came the AED pads and finally the backboard. I asked for a switch and the next person stepped in after the first shock...still no viable rhythm. More drugs ,more CPR, the ET tube was finally in and another shock and she was back...now, the entire room is completely full of people,student nurses are in the door way looking in with a look of shock,terror, and awe on their faces. You know they are thinking I hope that never happens to me. Well, me too but, it will. The patient was sent off to the ICU. Our patient population is getting older and sicker and the people who are in the ICU's are ones who would have been dead 10 years ago. So, the ones on the PCU's and Tele and SDU's are the ones who would have been in the ICU 10 years ago. And the patients on your med-surg floors would have been in the SDU or Tele floors and the ones who would have been on med surg are now in skilled nursing facilities or rehab centers and so on. It's scary to me, but it's reality. This is the second code I've been in since January when I got to this hospital. 2 codes in 2 months, those aren't good odds. I hope that pattern changes.
I have decided to stay here in Arizona until June, well, actually, the hospital asked if I'd stay and I accepted. Yeah, it'll be pretty hot by then,but, the money is good and the overtime is avaliable. This hospital is changing over to computer charting just like Good Sam did, so, luckily I already have had the classes and worked with the system...am easy transition for me.
Our little house in Columbus is still on the market,but we have started the search here for another one. It's a buyers market so, we hope to profit from that.
Remember first, do no harm.

Barrett Jackson '08

If you watched any of the Barrett Jackson car auction last week on Speed..you saw this boat. No, that's not me in the pic but I was there. I love being in Scottsdale in January. I cannot get enough of the cars. I remember watching it years ago before I started traveling... and just thinking how great would it be if I could go and see all those cars. And, now I've done it three times...I could walk around there for days. You could tell people are holding on to their money this year because not many cars got over $500,000. Still, it's a fun thing to do.

Work is going well, I am getting in all the extra hours I want. The floor is laid out well and they are all private rooms. No more taking care of the patient in the bed by the window and the one by the door, who is someone else's patient, asks you for something every time you go in the room. The patients are mostly cardiac, there's a little med-surg thrown in there for fun. I can't tell you how nice it is to take care of an uncomplicated cath pt or even better and AICD or a pacemaker. Yeah, the patient turn over is pretty quick but, I love it. The charge nurses are very helpful and my coworkers are friendly. I had to float the other day and they were even friendly. There are quite a few travelers and most of them are Arizona residents. It's interesting, some of them have been there over a year..pretty unheard of in other parts of the country.

The apartment is very nice and quite. It's great having our friends in walking distance. We are headed to Vegas the end of next month...lots of working till then.

First do no harm.

New assignment

This is just one of the great pics sent to my by my nephew from his training in the desert in California. I know he worked his butt off and I hope all the training will keep him safe when he has to go to war.
I had my first day of orientation yesterday at Desert Hospital in Mesa. I so got off the hook. Since I just left Good Sam I didn't have to take any tests or stay for the computer class. Yeah! I didn't even have to get a new badge..I'm most happy about that. Lets face it, I have to get a new badge just about every 3 months. I do not photograph well most of the time so, when I get a picture I like I want to keep it. So, even though it was raining it was a good day. I was there about an hour and a half, got to see the unit where I will be working and met the manager. Then I was pretty much done. The rest of the week looks to be measuring up pretty much the same. I work about 8 hours tomorrow and 4 hours on Thursday. I get to orient of Friday and Saturday then on my own on Sunday...pretty easy week...then only 12 more to go.
Love, love, love the new apartment. It's so quiet and it's nice to have friends so close by. This place has a great workout room...lots of weight machines and 3 treadmills, 1 bike, 1 elliptical and 2 racket balls courts. I talked my husband into buying rackets and he actually went with me yesterday. We had a blast..next time we are going to look up the rules before we go. We just had a great time trying to hit the ball...neither one of us got hurt too badly. I got him in the nose with the ball once and we each got ourselves a couple of times. But, we stayed there for an hour!
I can only hope that trend continues!
Remember first do no harm!

Happy New Year

Happy New Year all. We had an awesome New Years Eve. I worked until 7:30 but it was an easy day. We drove to our traveler friends apartment..we were a little worried because or the Insight bowl ending in Tempe (yeah Pokes!) and road closures for the block party afterward. Luckily the freeway was not too busy and we got to our destination without a problem. It was a nice quiet evening, some tv and some poker with a splash of Napa Valley Sparkling wine. I hope it was a great night for all of you as well and I hope you all made some good resolutions. May the year of the Rat prove to be prosperous for all of us!! Non noc nocere.