More good news

Well,this proves the determination of my husband. He looked at this hole, and the ones in each of the other 2 bedrooms, figured out the tools he needed to fix them, and just did it. I really wonder how our renter made this hole in the hard wood flooring? Any ideas? There were boxes for air mattresses left in the house amongst all the rubble, so, it wasn't a bed, what else could it have been? It is still very disheartening to me. Is it really true that people just don't care any more? The have no pride in ownership or being self-sufficient anymore? That is really sad.

Work is ,unfortunately, just as depressing. I really dislike working in the downtown inner city hospital. People are different than they are in suburbia. They demand things instead of ask for them, they act as though they are entitled to demand them...like some how I owe them something. I am not saying everyone, but a larger majority than I see out in the suburbs. I took care of a guy who refused to leave the hospital, he was discharged and refused to leave...he stayed there an extra 3 days...at whose expense? ...he refused to call medicaid to appeal his discharge, he just refused to leave, he had demands before he left...everyday they were the same, he wanted to see each one of his doctors, though he had seen them or one of their partners the day before. He wanted his dialysis time changed, he wanted new medications, he wanted a different diet. But, he knows his patient rights....whatever dude. Why can't we demand he take care of himself, eat right and exercise, not do drugs or drink alcohol, take his medication and follow up with his doctors like he's supposed to? We ask him to ,but we still take care of him when he doesn't, we still allow him to come in to the hospital and get care even though he can't pay the bill. What has happened to taking care of yourself? Guess we've shown that you don't have to do that either, America will take care of you. And you don't have to be nice or ask politely or anything, we just have to do it...patient satisfaction you know.

Ok, I'm off my soap box...on a good note I might be able to make the move back to the hospital that is closer to me...they have a job available. I just have to convince my new boss that she should let me leave. That one's gonna take some thinking....

My orientee is close to being out on her own, I think she needs a little more time...they only get to be with us 2 days a week, the other day they spend in class. I thought they just got done with all that learning stuff...guess not. I will ask for another week for her but I'm sure the budget will rule the answer.

Until next time...non noc nocere.

When life gives you lemons

This is my fixer upper in Columbus, Ohio. My husband and my brother, with a little help from me and my nephew, turned this 1930's 3 bedroom 2 bath into a nice home. Granted it's not in the best neighborhood, but, it's not in the worst either. November of 2007 we finished it and put it up for sale, the market sucked of course, but we got a renter/buyer March of 2008. We thought we were helping out a single Mom who was moving to a new city, couldn't afford to buy a home yet but we gave her the opportunity to rent our house and build up her credit enough to buy it and become a home owner. I guess it was a fairytale for both of us. She has not paid rent in 4 months. We were nice enough to give her 30 days to move (Ohio has a 3 day eviction process) again shooting ourselves in the foot. The house is full of trash, they changed all the locks, holes in the hard wood floors, completely turned off the heat so the pipes could freeze in the 30 degree weather, and took the alarm remote. I am so disheartened. Please someone explain the rationale. Why would you trash something nice someone is trying to help you own? I watch Extreme Makeover Home Edition and see people who fall on tough times get help and they are so grateful...do they end up trashing their home as well? I'm very disheartened...but that doesn't mean I quit. I know what I did, by trying to help this person out, was the right thing to do. I know it can work. I still believe that real estate is the way to go..it's something tangible, something real, not worth as much as it was a few years ago but, still worth money. It is just a game of numbers. Thomas Edison tried over 10,000 times until he finally got the light bulb to work...where would we be if he had stopped trying? In the dark, like my poor husband because the renters broke ,stole or unscrewed all the light bulbs in the house...lol. Ya gotta laugh..pick yourself up, dust yourself off and try again.
Work has been steady...4 or 5 days a week. Anything I can do to help pay 2 mortgages. I thought about a job in education. Monday - Friday 8-4:30 no weekends no holidays, a nurse's dream...but, also not a sure thing. Budget cuts are looming in the shadows and I see educators on the top of the list. I have an orientee with me...she is a really bright girl, very sweet and kind. I think she is there, at that big downtown hospital, for the experience. I think she would fair much better up in Scottsdale once she gets her experience. But, again, jobs are pretty scarce these days, you don't get the luxury of coming in and naming your price and hours and which days you'll work. You are glad to have a job that pays your bills.
Well, wish me luck and, if you can, please help me to understand people. Non noc nocere.

Coming home

As most of my readers know my nephew is in Iraq right now, and has been since early last year...I am happy to say he will be joining us back here stateside within the next 2 months. I am happy and relieved that he has been safe and admire his dedication and all the sacrifices he has made for our country. Wonder what he thinks of is new boss?
The cardiac cath I went to Oklahoma for went well, no complications. The new diagnosis and changes in lifestyle were a little difficult to get across at first but, I think they will do just fine. The number of Americans with coronary artery disease is rising everyday. I take care of these people everyday, and everyone says the same thing. I don't eat that bad and I just need to exercise more. Ok, there are other risk factors, some you can control, some you can't. Yes, you will most likely have to take medication for the rest of your life...many studies have been done to prove the efficacy of this routine. But, you are ultimately right, diet changes (low fat, low cholesterol, low sodium) and the addition of exercise will only have a positive impact on your life. Sorry, guess I'm just tired of taking care of people who drink excessively, and smoke and don't exercise. I don't like exercise either, but...I know what will happen if I don't.
Work has been ok. The day of the Superbowl was less quiet than I thought. I figured I would get all my work done before it started and people would just watch the game..no really so, they still wanted their beverages and ice and pain meds. The downtown hospital was actually a little slow, they closed one pod (15 beds), guess nobody felt sick that weekend. The worst part were all the people wanting to go home to watch the superbowl. I actually had a patient who was in with severe vertigo, like she couldn't even walk to the bathroom without help and she bugged me all morning about going home for the superbowl. The doctor came in and tried to walk her and said no way...it ended up she couldn't even watch the superbowl on the tv because she was so dizzy it was making her sick. People.
The weather is getting warmer...78 degrees today...and sunny. Sorry all you Northeasterners...non noc nocere.

Barrett-Jackson or Cardinals?

This is a car made for Pope John Paul II but he never rode in it, it was deemed unsafe for him. You'll only see stuff like this at a museum or Barrett Jackson.

If you know me , you know my answer. I love Barrett-Jackson and all the fantastic cars. I watched it on television for years, God bless the Speed channel, and finally 2 years ago I was here during the blessed event. If anyone says there's no money being spent in America all they have to do is turn on the speed channel, $200,000 for one car...and it's not even Saturday. These cars are amazing, the restorations are superb. Just the sound of the engines sends chills up my spine. I thank my brother for introducing me to muscle cars and helping me learn to appreciate a great sounding engine, and my husband for keeping the thrill alive. He has patiently taken me to the auction for the last 3 years, and answered all my questions with out making me feel stupid.

As for the Cardinals, I am not a fan. Only a fan of whoever beats the Steelers...I am a true blooded die-hard Browns fan...sad as it is, year after year I keep hoping. Most people think it will be the Cardinals vs. the Steelers for the Superbowl...guess we will find out tomorrow.

Work is crazy as usual, I now have a tail for the next 12 weeks. I hope I can help to mold her into a useful, well adjusted, thinking nurse. (Without making her quit or driving her crazy first.) Non Noc Nocere

Close to home

Like the title says, I have some family issues, and they are hitting close to home. One of my family members is headed to the cath lab for a cardiac cath. Now I can really put myself on that side of the bed. I am used to being the one coming in and reviewing what the doctor told them, answering any questions and sending them off to the cath lab. I am also used to getting people back from the cath lab and doing the normal stuff, checking their vitals, checking their pulses, checking their groin site...I guess I will see what it feels like to not be in control of anything. Nurses really are, or become control freaks, I think. Ok.Maybe it's just me, but if I am in control of a situation I can 99% control the outcome. That makes me calm and confident...and a control freak. If I am not in control (i.e. things don't go the way I planned them) then I'm irritable and I snap at everyone around me. Yeah, I got issues. I just hope I can be a calming force when I am with my family member during this procedure, because I won't be in control of anything.
On a lighter, happier note my nephew should be headed back from Iraq early this spring and I am so happy about that! I hope he gets the chance to stay stateside for a long time!

HAPPY NEW YEAR!!

Well, Happy 2009 everyone! We brought in the new year in the same old fashion, watching Dick Clark and Times Square. Pretty sad to see him get old though. He looks and speaks pretty darn well for a stroke victim.
So, I worked 5 days (12 hour days) last week and had one day off and worked 3 days already this week. The company I am working for is doing away with their double time for overtime so, I had to get as many hours in there as I could. Smart business move, they have filled most of their nursing positions with the new grads and they are all willing to pick up overtime since they are fresh out of school and money from being in school.No one is really happy about losing the double ovetime but, we can understand. Of course there are the people who just live to complain, I try to stay as far away from them as possible. Some people would complain if you gave them the world.Sad.
What can I say about work this last week. Wasn't too bad, but the new nurses, I think they are so overwhelmed. They don't seem to even know which questions to ask or when. Our unit is post open heart/thoracic surgery. The daily tasks for each patient is a huge laundry list. You have to monitor their weight, vitals, electrolytes,their exercise, their fluid balance, their rhythm,their blood sugars,plus all their tubes and lines. It's really difficult when you have more than one cabg patient.I started out in Medsurg, back then units weren't so specialized, it was med surg or step down or icu. I think it really helped me get my organizational skills together.75% of nursing is organizing your work, the other 25% is common sense.
Case in point: I had a new nurse ask me at about 8:30 in the morning if I thought she should change an IV on a patient that was 7 days old, this was a post open heart patient. I said definitely. I heard her later ask another nurse the same question she agreed with me and said yes as well. At 5:30 pm she again asked me if I thought the iv really needed to be changed, I said I really do, do you want me to change it. She said no, I want to try, but he had a really bad experience and doesn't want it done. I explained to her she has to be comfortable and make him comfortable, if she wanted, she could have someone else do it. She ended up asking the charge nurse to do it, and it got done at 6:30. I just don't get it. The longer that IV stays in the bigger the risk of infection, we have to be able to tell patients what we know is best for them and just get it done, not sit around and wait all day to build up the anxiety of the nurse or the patient. But, how do you teach that?
Can you guess what my picture is of?
Non noc nocere.

Merry Christmas

Yeah,yeah,yeah so, the title isn't very politically correct...cuz, it's my blog, that's why. Sorry, had to say it. So, how was every one's Christmas? Was the Christmas spirit alive and well in your world? Maybe it was if you weren't working. Boy, people are just plain crabby sometimes. So, you can complain about having to take Mom home on Christmas day and have to look for an open pharmacy or you can be happy that you get to take Mom home on Christmas. Maybe people don't realize they have a choice. So, that was my Christmas, most people were happy to be alive and realized they might not have made it to Christmas if they hadn't had their open heart surgery. But, there were the few who just complained anyway...what can you do?
I am working with a gaggle of brand new nurses. Some have only been off of orientation for a month...it's kinda scary. They seem reluctant to ask pertinent questions, or any questions. I had a nurse talk about having to re start an iv for about 6 hours of our 12 hour shift...I finally asked her if she wanted me to do it. She said no, I want to try, but he has so much hair on his arms. She seemed in awe when I told her she could shave his arm...she finally got the iv but, procrastinated about it all shift.I think she might be a little too nervous to be on PCU, med surg might be better for her. It's still busy but, her patients wouldn't be of such high acuity. Guess we'll just pray and keep our fingers crossed. I'm there to help and guide as much as I can, please remember to ask if you have a question...it could save someone's life not to mention your career.
I heard people complaining about some of the cost saving measures that the company I work for is making. Why are people always complaining? This company had a difficult time filling it's empty shifts a couple of years ago and started paying it's RN's and LPN's double time for overtime, they have decided that this is no longer a cost effective measure, yeah it's sad to see it go, but, now they are just paying us like every other nurse in Arizona. Times are tough all over, it's your attitude that will make or break ya.
Non noc nocere.

Downtown

Well, I had forgotten just how sick some of the folks can be when they come into the hospital. Especially the big level 1 trauma centers, they get it all. Here in Phoenix there are a few, 3 I think, level 1 trauma centers. Since the population of Arizona is largely in 2 main cities (Phoenix and Tucson) and then there are lots of little communities throughout the state, when someone is really sick they send them to Phoenix. This is my first week in my new position, I have had one patient with a chest tube, pca and epidural both of which were set up as pca's...yes, she could control the bupivicaine in her epidural, which was in for the sole purpose of controlling the pain at her chest tube site. Never seen that before. I also had a patient with 2 chest tubes, one was attached to a little accordian looking collection bag (never seen that before) an ng tube, a g tube, a foley and a picc line. The ng was to wall suction plus he was using a yankaur suction for his saliva so, we had to get the old fashioned portable suction. Yeah, more tubes than I have seen in a year, I got them all in a week. They call that initiation by fire. The nurses I worked with, although inexperienced, were very helpful and friendly.
I am getting used to the drive, still not liking it, but, getting used to it. Wish me luck. Non noc nocere.

New position

Ahh, Christmas in Arizona. Ya gotta love the decorated palm trees and cactus. Oh, and the weather it's getting a little cooler 40 at night but still up well into the 70's during the day.
I had my 2 days of orientation fro the hospital this past week and I actually learned some things. I had 2 days of orientation on the floor this weekend and next week I'm on my own. The unit I am now assigned to has had a huge turn over in the last few months. There are a bunch of newbies...like less than a year under their belts. It's kinda scary because these folks are some of the really sick. They need people to be on top of their game and to be able to spot a problem in the earliest stages, which can only come with experience. Things like an transvenous pacemaker, gun shot wounds and lots of chest tubes are being sent to this unit. So, wish me luck. As always Non noc nocere.

Stayin in Arizona

Yeah, how bad can it be to live here year round? Well, I've been here over a year already, survived my first summer, and I still love the weather. How can you not? If it's too hot, drive an hour or so and you are in the mountains. If it's too cold or wet up there, come down to the valley. More sunshine than grey, more heat than cool, what more could you ask for. Ok, maybe a beach, but that's it.
I am a victim of the crappy economy. All the hospitals are tightening their belts, they may not need to but, it's a good excuse. I am now officially a Banner staff member. I got a pretty good rate, plus the insurance is incredibly cheaper, and PTO when they call me off like this week. I tried everything this week to work...the only day I wasn't signed up was Monday...I only worked 32 hours...that sucks. But, Monday I get to go to orientation, again. Yeah, free money, maybe I'll get some orientation on the floor or maybe they will send me to computer class again,lol.
It's been a good ride. If I wanted to work nights in Oregon or days in Rhode Island I could have gotten a travel position. But, I'm beyond all that. I've been nursing way too long to put myself in an uncomfortable position again. Not that a staff position is all that, it's just something different for a while.
Non noc nocere

What's next?

Aahhh, Phoenix in the winter. Dang, you just can't beat this weather, how did I live for so many years in the frozen north? It was 73 degrees at 7:30 last night on my way home from work...amazing. And sunny everyday...the days it is gray are so rare, what a switch from Cleveland.
Well, traveling is getting a little more difficult and not paying as well. I got offered $28/hr blended in California...yuck. As a matter of fact, I cannot find a contract in the state of Arizona at all...so, I think I will be making the plunge into staff nursing. Wow, never thought I'd say that. I just really like my life the way it is right now, and I don't want it to change. I don't want to leave my husband for a job somewhere else again...so, I guess Arizona is my home for awhile. My new boss to be seems very accommodating. She has let a majority of her staff take off weeks at a time for personal reasons or for the holidays. No, I don't love everything about the job or the idea of a pay cut, but, it's better than no job. And it's better than night shift somewhere or ending up in a situation like I had a the other hospital I transferred to. I have already been here 11 months...at this hospital, and been here in Phoenix just over a year. It'll be hard to get used to getting paid every 2 weeks but having PTO will be a nice switch. Yeah, everyone is still complaining about not getting any over time but I think they are just complaining to be complaining... I see them at the hospital everytime I am there...and I'm getting my 4-5 days a week. Gotta let it go, let them keep complaining and see where it gets them, huh?
Well, say a prayer for our troops, take care of yourselves...non noc nocere.

Spoiled

Yep, that's me. Everytime I have to take care of myself I realize it again, I'm so spoiled. My husband is such a great guy, he does everything...ok so, he doesn't have to go to work but, he does everything else. This week I've had to do it all myself. Take the dog out in the morning before I go to work, get ready for work, make my own coffee,drive myself to work, (park in the parking garage which I hate and walk to the hospital) drive myself home, walk the dog, feed the dog and myself..ugh it's like 2 full time jobs. When I was in Virginia at least I only had to take care of myself, ok I was lonely, but, I didn't have to get up so early. Ok, yeah I'm complaining...sorry, like I said I'm spoiled! I have been taken care of and catered to for the last 7 years that we have been on the road...I would not give it up for a second! I will continue to work and have him here to clean and do laundry and take out the trash and cook and take care of the dog...I got the easy part!
I'm sure there are others out there who are in my position, I know at least one and she loves it too...yeah nobody wants to work but, if you do have to work this is the way to do it...my normal life: I get up and shower after I start the coffee maker which is ready to go I just have to turn it on, then I get dressed, get my coffee, get driven to work and dropped off at the front door, get picked up at the front door , come home change my clothes have some food that has already been prepared for me and sit on the couch and watch tv or surf the Internet until it's time for bed. Sounds rough huh? I am very lucky to have the arrangement I have and luckily my husband feels the same way. No, not that I am so lucky , that he is so lucky maybe that's why it works for us. Here's to a loving, caring, give and take relationship!!! I wish it for all of you!
Non noc nocere.

Life...

This is part of the awesome metal display by the Bricktown walkway in Oklahoma City. All these pieces are forged in Norman and brought to the site...it is supposed to tell the story of taming the west...the pieces are bigger than life, just amazing.

Well, it has been a good couple of weeks at my old home. Of course I have been able to work a few days on my old unit. I feel really comfortable there. I feel like I know what to do and who to go to which makes it easier to care for my patients. I went to a different hospital about 2 weeks ago and it was a disaster. I couldn't get the hang of the computer system, I didn't know who to call for what...it really made me feel ineffective as a nurse. There is a huge difference between being a traveler and being an agency nurse. Agency/registry nurses go to different hospitals and different units daily, plus they get almost no orientation to the hospital or the unit until they get there. You have to have a lot of confidence in your skills to do it. As a traveler, you go to the same hospital but it could be a different unit and you get at least a day or two of orientation, so you have been to the hospital before you actually start working and you have some idea where to go and what to do. Maybe I'm just getting old.

On a sadder note, my husband lost his mother this past week. She lives in Ohio and she is an old world Spanish woman. She never worked outside the home, never drove a car, and spoke very little English. She mellowed with age and actually tried harder to communicate with us in English. It was quick and unexpected, but she didn't suffer, which is the only way to go. The down side is no one gets to say their good byes. Tell the people you love everyday how much you love them and don't leave the house angry...just a little advice. non noc nocere.

Workin it out

Just a couple of things you will only see in Oklahoma..ok, that's the only place I have ever seen them. The sign was above the water fountain in a Home Depot. The other picture is of the baseball field at Bricktown with a statue of Johnny Bench. We made the 14 hour trip to Oklahoma to visit with my family and see my nephew who was home on leave from Iraq. It was a nice trip...so good to see family.

I guess sometimes it does help to complain when things aren't going right. I got a call just before I left on my little vacation from my travel company..they said I could go back to the other hospital I was working at and be a tele med surg float over there...hell yeah I took it. I was doing my last 2 shifts at the new place when I saw one of my traveler buddies from the other hospital. I had forgotten that she had asked me like my first day there how it was because she was thinking about coming over there. I had told her it wasn't bad...cuz it was too early and I didn't know. But, when I did see her I let her in on what was happening, then Friday I was with her when she oriented.She somehow got stuck with someone I hadn't worked with before and she didn't have her stuff together. It was also the day they in formed their staff that due to some issues with the flooring ,they were going to close some beds and that they would be having patients in the hallway waiting for the beds of patients that were discharged. Can you believe that crap? You are expected to remove the iv and remove the tele box and give your patient their walking papers as soon as you get the order then, another patient will arrive and sit in the hallway with a little privacy screen around them until the other person leaves...or you could choose to put the discharged pt in the hall or the conference room and have them wait there until their ride comes to get them...hmmm, so much for patient satisfaction. Give me your thoughts...

Non noc nocere.

Workin in the desert

Well, it's been another week ...that means 10 more to go before I get to get outta this hospital. How to survive a travel assignment you hate: grin and bear it, make the most of it, just do your job to the best of your ability. It all sounds like good advise doesn't it? Some people would just up and quit..find a different assignment in a different hospital, I've done that as well. Burning your bridges is never a good idea...hospitals can change when the staff changes or they start losing enough nurses they figure out what's wrong. Plus if you like your travel company, you don't want to piss them off either. Yeah, it's a tough spot. If you really feel like your license is in danger I say by all means call your recruiter and tell them and don't put yourself back in that situation. I have done that, when I was in San Pablo CA..it was absolutely awful..I called my recruiter and I got another assignment...never went back. This hospital, it's just irritating stuff.I will refuse to take ER patients when I get sent back to the ER...that's because it is not in my scope of practice...hopefully they will refuse to have me back. Other than that I will continue to communicate my dislike for the units and staff and the assignments I am given in a constructive manner to my agency. Not that it will get me anywhere but it will have it documented. Wish me luck.
Non noc nocere.

Calling all ER Nurses

Hey there all you adrenaline junkies...my hat's off to you! I don't know how you do it but I am glad you do! My question is how do you feel about your ER being invaded by floor nurses, who are clueless as to how your area works (such as myself), when you all are running short?
I got floated to ER "holding" yesterday and it was a friggen nightmare. My first time down there, no here's where your area is and here's who you can ask for help, no here's how we do things in a nutshell...just here's your rooms. I got stuck with a Registry ER nurse who was willing to help when she could, thank God, otherwise I'd have really lost it. The gave me not their floor or PCU holds...but the BHS (behavioral health) holds...all one to ones and a PCU hold..Then they started moving patients on me and not giving me report (apparently I was just supposed to research the pt myself or go find the nurse who sent them over). But, how was I supposed to know any of that? I get a transferred pt from another room, no report, I thought it was someone else's pt since I got no report...guess it was mine..she had a blown iv an was diabetic who hadn't had a blood sugar check since breakfast and hadn't eaten...VERY NICE. Then they kept tossing the BHS pt to me...then they wanted my to take an ER patient...I said, probably for the hundredth time, I am NOT and ER nurse...but they put her in there anyway..bp 75/50...VERY VERY nice. They said "Shawn will help you" well, I never saw "Shawn", the nurse who was doing discharges took one look at this lady and got to work...she ended up being moved out of my room to somewhere else and we looked at her blood work later...let's just say I don't think she made it.
Then they put another patient in that room and the chic who handled the last one says this one is yours, I just gave her that look...it was a 23yr old who took an overdose of somebody elses meds...also not my area of expertise.
I must tell you that at about 12:30 after the incident with the no-report-patient I called staffing and said that they needed to get me outta there...they said we really can't and sent the supervisor to talk to me...I told her I was very uncomfortable and was being given ER type patients not waiting to go to the floor type patients which I was told I would get...and that I wanted to leave. She listened to me blubber for about 10 minutes and said she would try to get someone to come in early...yeah, OK...meanwhile the Registry chic that was helping me had completely disappeared and I was left with Miss Attitude ER nurse who eventually just took all my patients and I got to go home. I guess they realized what I had been telling them all day...I was just in the way.
So, as ER Nurses, how do you feel when we non-ER nurses come to your area? I understand it would be different if you had a bunch of floor holds and I was there to take care of them...I'm just glad I got out without hurting anybody. Absolutely the worst day of my nursing career so far.
First do no harm.

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.

Vegas

Hi all,took a few days off for my wedding vow renewal. Here we are after the ceremony in the conservatory at Bellagio. Behind us is a miniature of the Bellagio and a miniature Bellagio fountain...only in America. We did a drive up wedding, it was as expected. I would probably pick a different place next time we went to A Special Memory Wedding Chapel on a Sunday afternoon. It looked pretty deserted, we picked from the "drive up menu" but we were told some of the items they no longer offered like the commemorative photo. I was not really happy about that one...our only option for pictures was a package of 6 which would cost $70...no thanks. We did our vow renewal ($25) and had to pay the "minister" her gratuity (no less than $40) for our 5 minute ceremony. It's was an experience. I found that people are really nice to you if you are wearing a veil..they'll even take your picture and not steal your camera!!
This week I started at my new assignment, 8 miles in the opposite direction of the other hospital. I find that a new building and "healing" surroundings doesn't actually change how it operates. It's the same stuff in a prettier package. Same amount of patients going and coming and no team work. The charge nurses are still just a voice on the vocera or a piece of paper on your desk with another patient's name on it. No thought to how many patients you have already admitted or even ask if you've had a break, she was nice enough to take report for me so that I had absolutely no warning that my patient was coming and then poof she was just there in the room. Yeah, it's like that.
I do miss my friends at the other assignment.. I was hoping to go back there prn but, I don't know if that will be possible either. Computer glitches might prevent it.
Sometimes I do wonder why I continue in this field, then I get the paycheck and the reasons are a little clearer...sometimes I even get a thank you and then I know why. Non noc nocere my friends.

Summertime

So, my nephew was here for a week and we went to see the D'Backs play. It was a good time. My sister was here for 3 days and we just shopped and relaxed. I wish she would have stayed longer...but, that's the sign of a good visit huh? That they leave and you wish they would stay longer, not the other way around.

Plus, I get 4 days off in a row (woohoo)then it's off to Vegas for 3 days. Work has been good, not too busy not too slow. The patients have been much of the usual. Too young to be as sick as they are,but, since they didn't take care of themselves ...they are in the hospital. Most of them smokers, who think they are ok cuz they can still talk and walk, they think they can keep smoking...never mind the fact that they couldn't breathe when they came in or that they just had a triple bypass...they are fine now and all they need is a smoke. Or the alcoholic who was back 2 hours after they were discharged so drunk that they ended up in the ICU....pretty sad.

6 more shifts then I'm off on a new venture. I have a computer class next week for the new hospital...the doctors over there have to enter all theire notes and orders into the computer...yeah! No more bad penmanship!!!!We'll see how well it works. Wish me luck!

Remember..first do no harm.

What do you thnk

I just read an email from my nurses e news and I am not sure how I feel. It seems the US government has a proposed bill..HR 5924 to get rid of the cap of 20,000 work visas per fiscal year for nurses and physical therapists from other countries to come here and work. It is proposed as the Emergency Nursing Supply Relief Act. It also allows for more grant money for nursing schools which I wholly agree with. I am just on the fence with the influx of foreign trained nurses.
The floor I work on now is very culturally diverse. The problem I have is not with the nurses themselves it's with the communication barrier. We do walking rounds at our facility when we change shift. I introduce the next nurse and sometimes the patient will make a comment or try to make a joke and the nurse doesn't get it, the patient looks at me with a nervous look like "she can't understand me" I have to say it's gonna be a good night and leave. I feel awful for the poor person in the bed. They have to be thinking, what the heck am I gonna do, I can't understand her and she can't understand me, what country is this? That's what I would think. Most people don't have to deal with the diverse dialects and accents that we do on a daily basis, it's just not as easy for them to understand the accents. It's got to be scary for them.
I also had a patient who complained of a little chest pressure but denied pain so the nurse did nothing about it. When she told me in report that he complained of a little chest pressure since 6 am and it's now 7am. I got right up, didn't let her finish her sentence, and went to check the patient. I think it was a combination of a lack of experience and a weak grasp on the language that caused her not to act. He was complaining of chest pressure, but had not gotten any nitro and didn't even have any oxygen on, very basic stuff. The patient ended up in the cath lab by 8:15 and had 2 stents to his RCA. For the non-cardiac nurses out there...that's a BIG DEAL. It's scary to think what could have happened if the nurse following her also had a weak grasp on the language or was as inexperienced.
I am not sure that allowing more foreign trained nurse to come and work here is the answer to our shortage. How about making it so nurses want to stay in nursing? How about cutting out some of the paperwork stuff so we can spend more time with our patients and give them the care they need? A lot has to do with work ethic as well, which is lacking in the USA in general. Nursing is a career not just a job. It's bettering people's lives, or trying to at least positively impact them, not spending half the day on the Internet and the other half on your cell phone.
There are lots of great people out there who would love to be nurses and they are getting put on a waiting list for nursing school...then they find something else to do because it just takes too long to get in. There has been a nursing shortage since I started back in 1991...I wish I knew the answers...any ideas?
Non noc nocere.