End of Year Fiesta

Yesterday we had a big cookout for Stu… combo gradparty/bon voyage party. Because he technically doesn’t go home until the end of June but his time is rapidly drawing to a close with us and June is already packed full of his own social engagements with his friends. Stu’s father comes next week and will be staying with us through graduation and taking a few little roadtrips with Stu to see as much of the USA as possible before heading home.

Hubbin is really going to miss Stu, but we’re both looking forward to having our house back and for it to be just us again.

I feel like I spend most of my posts now apologizing for the lack of posts and offering up excuses, so I won’t bother.

School is stressing me out, I’m taking 7 credits this summer and even though online Sociology is a lot of “busy work” it’s still A LOT of busy work. I’ll be glad to finish up with the BSN program this fall so I can quit taking BS classes like sociology now and poly sci and global studies this fall. BLEH. I feel like it’s a serious waste of my time and money to take electives.

I’m also currently working on hammering out a plan for summer vacation the second week of August. I’m open to suggestions, got any? What are your summer vacation plans?

Congratulations Erica!

Enough antioxidants to kill a horse

So I stopped at costco today on my way home from studying and picked up some fruit. I’ve decided that this is going to be “the summer of smoothie” because who eats enough fruit anyway? Hubbin and I decided we’re going to have a whole month of nudity at our house after A: our exchange student leaves and B: it gets above 60 outside… Smoothies just seem like appropriate breakfast food if you are or intend to be nude. I’m still working out the kinks in my master plan because who has time to make real breakfast when you have to punch in by 7am? My master plan is to figure out some way to store breakfast smoothies in the freezer so they can ultimately be a “grab and go” breakfast for both of us.

Not pictured smoothie players: banana, soy milk and carnation chocolate instant breakfast. –I fully intended to mix in yogurt but it expired yesterday. I know I know, but it also had some mold, so well have to catch up with yogurt next time around.

Open to Suggestions

So I’m open to new good-reading blog suggestions. Anyone have any blogs they love reading and would like to recommend? I badly need to update my blog roll as I’m a bit disappointed in how many people I read nearly every day have switched to invited people only or password required.

Got any favorites?

Ashes to Ashes

I just found this in my little folder for potential posts from, ahem, my trip to visit my great aunt in January. -I tried to tell you, school is destroying my brain- She was telling us about after her husband died (probably almost 30 years ago now since she’s 96 this year) she’s blind and weighs about 90lbs but her mind is amazingly sharp. Her husband, Higgy, wanted to be cremated, so she did, but I guess he wasn’t real specific about where he wanted his ashes so she decided she would put a little of them everywhere he loved.

So she was telling us how she sprinkled them around their church in Florida, at their cabin in Pennsylvania, his childhood home in Ohio, San Francisco, and then at the beach and a little here and there on every vacation she took after he died.

Anyway then she started telling us how people thought she was just a liiittle bit crazy for taking the ashes everywhere. Then she told us my grandma (who died at 91 in 2005 and had a wicked sense of humor) said to her: “Well I guess when it comes time for the resurrection Higgy’s going to have a heck of a time finding himself!”

A Rare Follow up

Twice this week the man who had a cardiac arrest right under our noses a few weeks ago stopped by. He’s back to work now and looks amazing. I still couldn’t believe it. He said he wanted to come by to thank us, tell us that he thanks god for us every day as does his wife, daughter, and grandson. Then he stopped by a second time, later in the week to give my preceptor who had been his nurse a big hug.

I’m hoping to get back to blogging a bit more soon. My statistics final is this week and my pathophysiology final is next week. This summer I’m taking advanced assessment and then an online class: intro to sociology. Hopefully these summer classes won’t be quite so time intensive. I was looking at my schedule for the fall though and had one of those “what the fuck was I thinking? ….I thought I was doing this part time” oh well… I think this fall might be even worse than this semester. It will included advanced pharmacology

Yikes

Todays grass mowing ended very poorly for one young rabbit. Thank goodness we have at least one family member who is willing to put an end to the suffering of small furry animals.

Lame

So essentially I’m very lame and have no very good excuses as to where I’ve been for the past few weeks. School has been totally kicking by butt time commitment wise (and therefore emotion wise) Today I spent no less than 10 straight hours on this beautiful sunny day hunkered down in Panera typing up THIRTEEN pages of notes for my midterm in Pathophysiology which is on Tuesday. Pathophysiology is a little overwhelming as I expected and I’d like to meet whoever had the bright idea to make this class into an “accelerated format” class and make the students responsible for 14 weeks worth of lessons, including 14 separate online tests, the mid-term, final, class presentation, and online discussion board questions in an 8 week time period. Our mid-term on Tuesday, 4 weeks into the class, covers the first 600 pages in our text book. Nice. And the final… 4 weeks from then our final will be covering the next 8 online tests and 800some pages in the book.

Make my statistics class accelerated — we’ve learned nothing in that class!

I’ve also been working nights because they’ve decided we should work 6 offshifts each month now. Out of a total of 12. I also had a traumatic shift one of those nights where I made my first major med-error as a nurse. Hopefully last, although a few people have assured me that’s just wishful thinking. I had a patient who was being boarded in the ER for the night because there were no beds. She was a sick cancer patient who was in for pain control. Very sweet, I tried to take good care of her and everytime I walked in asking her how her pain was an reinforcing that I had her narcotics in my pocket and could give them whenever she needed them (probably better for her than being admitted to a floor room because she was my only patient for most of the night). Anyway. The floor doc came down and wrote orders for her sometime around 3/330am. I looked them over, morning labs, regular diet, PRN (as needed) med, Daily med, Daily med, patch to get changed each sunday. She was assigned a bed about 630am so she left before change of shift.

I was driving home about 8am and I got a call from the daylight charge nurse asking if I had given her metformin in the middle of the night because the floor was “all fired up” about this med not having been given. I said “nooo, I only saw daily meds” – anyway long story short, apparently one of the meds was ordered “daily with a dose now” and I totally missed it. And to make matters worse I found out the next week that it wasn’t metformin (oral diabetes medication) but atenolol (blood pressure medication). I felt like the worst person alive. Her pressure had been up through the night but the ER doc had finally written for some nitropaste which brought it down, plus she was in pain which can elevate pressure too. I mean nothing bad happened, when she went to the floor her pressure was about 130/80… but I still felt just AWEFUL. It’s totally inexcusable regardless… but it’s not even like I was busy or doing something else. I just didn’t see it? I looked through the list and just never saw it. Oh god, I was in tears for days. Plus I was convinced I was going to be fired.

I had a long talk about it with my preceptor, which I think was good for her too because she was having a lot of guilt about that cardiac arrest patient from the other week, but the summary of her advice was “You have to look at how your patient was, what was her pressure when she went to the floor?” I said 130/80, and she said “well then it doesn’t matter, shit happens and no one died” and my mother kept telling me “it’s bad, but it’s a learning experience, it would have been worse if you had given her the WRONG med, or too much of something… nothing bad happened to the patient”. Ugh, I hope to never go through that again! The guilt was terrible… for weeks! Everyone has assured me I won’t be fired. The charge nurse that day said she was pretty sure our boss was most upset that the floor called him at home, on his day off, at 730am. It’s been a few weeks, and I haven’t got a pink slip yet, so hopefully I’m okay.

I also totally fell off the shrinking-jeans wagon for ahem, all of March… which is now spilling over into April. I’ve just been too busy to go to the gym, and have been induldging my food wants just a LITTLE too much. A little because I want to, but I’m sure a little has to do with stress… I need to get back on that. Of course, then there’s this mid-term.

Nothing Left to Give

So here I sit, the end of night shift, the sun is rising and the sky turning from black to navy blue and so begins: The Hour of No Compassion.

The ongoing joke of the steady night shift nurses is the last hour of their shift is “the hour of no compassion”, where they may take care of patients, but they are no longer required to care about them.

I really think we need to implement this on day shift AND somehow need to integrate that with our one nurse’s idea of having one day a month where you’re allowed to tell everyone exactly how you feel about them -no consequences attached- patients included.

For instance today I would have liked to say: “you mean to tell me you’re 3.5 months pregnant and you’re taking not one, not two, but three medications for constipation and you don’t know the name of a SINGLE one of these chemicals you’re putting into your body? Are you eating ANY fiber at all? Ever? Or are you subsisting entirely off McDonalds and KFC? …because with a BMI of 57, it’s awefully hard for me to believe you’re really eating ‘a variety of foods’ like you claim”

-just sayin’-

Still in Awe

Awe:
1: An emotion variously combining dread, veneration, and wonder that is inspired by authority or by the sacred or sublime “stood in awe of the king”, “regard nature’s wonders with awe“

Yesterday was one of those days when everything falls magically into place and someone lives because of it all. I really don’t work in a major emergency room, we only have 14 beds and like I’ve said before there is a level 1 trauma facility mere blocks away. If something really bad was happening, where would you go? Yeah, me too. Yesterday we had a body in each bed when a man on the cleaning staff of the hospital came in the back door of the ER to the nurses station diaphoretic, clutching his chest, and looking a bit grey (and he’s a black man, so that’s saying something). Our charge nurse was in the process of kicking a patient out of her bed (I’m not even joking, she walked in and said “I need your bed NOW” lol) when one of our cleaning staff grabbed her and said “wait, I just cleaned room 4! It’s open” They started the chest pain protocol, performing his EKG, putting him on the monitor, oxygen… and really, his EKG didn’t look too bad. Some t-wave elevations, which not knowing anything about him could be an electrolyte imbalance, and some PVCs which aren’t the worst thing ever and aren’t totally abnormal in a 57 year old man anyway – at least not nearly as bad as the dreaded S-T elevation.

So everyone proceeded as normal our charge nurse took him as a patient (and at this point I had two patients, one who was with us for NINE HOURS and totally crazy -not even kidding: munchausen- Who was ringing the call bell every 10 minutes. No exaggeration. -I was so exhausted by the time I got home, she sucked all the caring right out of me) Our guy had been in the ER for maybe an hour or so when our secretary went in to talk with him, because she knows him from around the hospital. He told her he felt so terrible earlier he just left his cleaning cart in the middle of the hall and didn’t even tell his supervisor he was coming. So she offered to move his cart.

When she came back into his room and was talking to him, telling him she’d moved his cart, he pulled his arms into his chest and went totally unresponsive. She came tearing out of the room shouting our charge nurse’s name and the doctor’s name. I happened to be standing in the ambulance bay -I don’t even remember what I was doing now- but I immediately turned to my left and grabbed the crashcart pushing it into the room.

He was in Ventricular Fibrillation on the monitor, more commonly referred to in the medical world as Vfib. And when you click on that link you can read “Ventricular fibrillation is a medical emergency. If the arrhythmia continues for more than a few seconds, blood circulation will cease, and death may occur in a matter of minutes.”

We did a full code, called our equivalent of “code blue”, it was the first real-honest-to-god-cardiac-arrest I’ve ever participated in. (There was that one heroine overdose that arrived blue, but we got him up and alert real quick with some narcan) The charge nurse was doing chest compressions and I personally defibrillated him 3 times. Let me repeat that: I shocked someone. He got a couple doses of lidocaine we started a drip, and after the third shock his heart started beating on it’s own again. He was combative and disoriented for a few minutes after coming around, but then was alert and oriented. We repeated his EKG which showed he had just suffered a massive heart attack right under our noses. That S-T elevation showed up like a big waving red flag with blinking lights around it.

Our hospital doesn’t have a cardiac cath lab so we had him transported a few blocks away to the bigger hospital so he could have the blockage cleaned out emergently. Our medical director came by later to tell us that the cath lab said his coronary artery was 100% occluded.

So really if he had been anywhere else yesterday (home, in bed, in the car, at a store) he probably would have died. He was lucky enough to be scheduled to work, working mere feet from an ER, friendly enough with the people at his work place that our secretary went in to say hi to him… I’m just totally in awe over the whole thing. I had a long chat with my mom last night about the whole thing on the drive home as she’s a nurse anesthetist in the same hospital and she’s a firm believer in the philosophy of “when it’s your time, it’s your time regardless of all else”.

Yesterday just wasn’t his time.

:-/

I’m working 4 12s his week so I haven’t made it to the gym for a weighin this week, I don’t really want to either tho… I’ve definitely gained this week.

I tried to stick to my diet this week but hubbin suggested dairy queen on night (and I have no willpower) and I’ve just been so hungry this week, that even if I do okay during the day I get home and just can’t take it!