He had enough. He somehow conveyed to the pulmonologist to take him off the vent. It's been a rough few months for the old guy and he was cognitively with it for just long enough to say, "No more." God Bless him.
His wife couldn't make the decision. She waxed and waned. DNR'ing him one day and revoking it the next. It was hard to keep up with. I found it quite peculiar that the wife, nephew and neighbors didn't want to be at the hospital when we took him off the vent. No, I found it downright sad.
The caring nurse part of me wanted to run in there as his sat's dropped and sit next to him, holding his hand. I had a tear in my eye for a moment as I thought about the reality of this. I wiped away the tear took a deep breath, blocked what was going on in that room from my mind and went to work on the other sick people that needed me. He wasn't my patient that day and I'm glad, it would have been too hard to see him dying.....alone. I had grown fond of him and liked to take care of him. Plus, I had others to worry about.
If I allowed myself to emotionally go down that road on every patient I wouldn't have any room left for joy in my own life. It can get heavy. And I don't want to get to where I am having to decipher the grief and sadness....theirs, mine, theirs, mine??? So, when you see a nurse in a critical area behaving somewhat aloof and non emotive, this is why. It takes a special person to do this kind of thing, I am finding out.
So, with all that said, I guess it brings me back to my usual rant of keeping dead people alive. Maybe God has some purpose for all of this. I pretty much knew from seeing this particular guy from day one that he wouldn't leave the hospital. We coded him several times (all the time his wife couldn't decide on what to do). And, for what? Isn't it interesting that He wakes up and is lucid just long enough to say, "STOP."
Sunday, January 27, 2008
Wednesday, January 23, 2008
Lab Rats
Keeping dead people alive and lab rats. That's what I think. That's what it's all about at the end of the road. Occasionally one slips through the cracks and actually makes it, but not often.
I'm getting used to dead people and codes! Yeah! I'm excited because this has been one of my biggest nemesis.....getting through the fear of 'IT'
I guess I have worked through it. I don't feel responsibility anymore. I don't feel like I (little ole me) could have done anything to change it. I mean come on, how can I make an already dead person live? These people are dead, we just don't let them die. Sometimes they up and say, "F&^%K you, I'm dying for good now." And then there's nothing we can do about it. They beat us at our own game.
However, I am taking this opportunity and using it as my learning experience.
We had a code the other day and I just stood there all relaxed (I was the recorder). No excitement pulsating through my veins, no stress, no nothing. It was like a routine thing. The old geez came through it alright, we cranked him back up and running in no time. But, this go around we can add a cracked sternum to his endless list of medical, train wreck, readings. How cool is that?
Oh, and then the Physical Therapist wants to know if he can go ahead and do therapy on the poor guy. LOL. Damn, who are we kidding here? This guy just dies, we crank him back up, now he is barely hanging, and he has a cracked sternum. I highly doubt phys. therapy is in order at this point. Or, who the heck knows. Maybe aggressive physical therapy is what the guy needs.... let's torture the poor bastard some more.
Yesterday I worked 1/2 day even though it was my day off. My director sweetened the deal where I just couldn't refuse.
I got to work and had the one patient I didn't want to have. He is another Big Fat Bastard (BFB), but unfortunately this one knows what's going on. That's sad. His case is sad. He is yet another dead person we are keeping alive. I also had the other BFB and his note taking wife. So, my day was spent taking care of BFB dead people.
This new guy is on all sorts of drips and that's why I didn't want him, however, I kept reminding myself, 'lab rats, dead already, learning opportunity'. It was a good learning experience for the drugs I was titrating. Of course, I would prefer one titration/drug experience at a time....he is on dopamine, dobutamine, natracor and a lasix drip, Not to mention the intermittent solumedrol, diamox, mannitol, and the IV abx. But,because I was so busy with this guy and the drips, I had no time to contemplate, read about, or absorb any information about the drugs. My only saving grace was that I didn't have to actually titrate the stuff because his blood pressure remained hovering around 90 systolic until I was giving report. (Whew.) That's when he decided to take the dreaded nose dive into the 70's. Oh, yeah, we titrate 'up' around here! lol.
I had to call the pharmacist 100 times to ask questions about certain things I was doing so that I wouldn't actually kill the guy on my shift. Good God, I only have two ports to work with here! He is going to check out soon on his own anyway, but for the record, I would rather it be on someone else's shift :-) This guy has a really sick heart. His Ejection Fraction is 30%, down from 45% when he first arrived. He is blowing up like a balloon and hanging onto fluid. Oh yeah, he has no sternum! He had a CABG and then had an AID placed somewhere along this journey to the other side. He developed a raging infection in the sternum and now he has a wound vac placed, and.....how would we actually do CPR? He's a full code, of course,.....I meant to inquire, but was too busy.
His sister comes in and request I put a note in the chart for us to notify her if the patient passes out again. Dah, what? Yeah, okay, I'll get right on that...... I wanted to say, "We will be calling you shortly when he dies, so I don't think any call regarding passing out is gonna be necessary, dumb ass.....But, of course, if you would like me to stop working on him in the midst of an emergency and call you, I can do that.......will that work for ya, dumb ass?"
My other (original BFB) patient was holding steady. I probably spent 20 minutes with him for the sake of the other guy. His note taking wife sat at his side like usual. She must have removed the frog picture from the ceiling. If I remember correctly I think it's now a pic of a cat.
At one point during the day I look down the hall to see the Physical Therapist waving at me, trying to get my attention. He stopped short of coming into the unit and kept pointing at BFB's room.
I walked over and found out what the deal was. It's too funny. The wife of BFB apparently tells the physical therapist to bring dumb bells into the room and start having the patient squeeze them. The patient is already gone to the other side lady! But, okay..... So, the therapist knowing the futility in this doesn't want to stand there asking the patient to squeeze when he knows he can't. He wasn't wanting to come to the unit if she was still there because he didn't want to get roped into this ridiculous request!
I'm getting used to dead people and codes! Yeah! I'm excited because this has been one of my biggest nemesis.....getting through the fear of 'IT'
I guess I have worked through it. I don't feel responsibility anymore. I don't feel like I (little ole me) could have done anything to change it. I mean come on, how can I make an already dead person live? These people are dead, we just don't let them die. Sometimes they up and say, "F&^%K you, I'm dying for good now." And then there's nothing we can do about it. They beat us at our own game.
However, I am taking this opportunity and using it as my learning experience.
We had a code the other day and I just stood there all relaxed (I was the recorder). No excitement pulsating through my veins, no stress, no nothing. It was like a routine thing. The old geez came through it alright, we cranked him back up and running in no time. But, this go around we can add a cracked sternum to his endless list of medical, train wreck, readings. How cool is that?
Oh, and then the Physical Therapist wants to know if he can go ahead and do therapy on the poor guy. LOL. Damn, who are we kidding here? This guy just dies, we crank him back up, now he is barely hanging, and he has a cracked sternum. I highly doubt phys. therapy is in order at this point. Or, who the heck knows. Maybe aggressive physical therapy is what the guy needs.... let's torture the poor bastard some more.
Yesterday I worked 1/2 day even though it was my day off. My director sweetened the deal where I just couldn't refuse.
I got to work and had the one patient I didn't want to have. He is another Big Fat Bastard (BFB), but unfortunately this one knows what's going on. That's sad. His case is sad. He is yet another dead person we are keeping alive. I also had the other BFB and his note taking wife. So, my day was spent taking care of BFB dead people.
This new guy is on all sorts of drips and that's why I didn't want him, however, I kept reminding myself, 'lab rats, dead already, learning opportunity'. It was a good learning experience for the drugs I was titrating. Of course, I would prefer one titration/drug experience at a time....he is on dopamine, dobutamine, natracor and a lasix drip, Not to mention the intermittent solumedrol, diamox, mannitol, and the IV abx. But,because I was so busy with this guy and the drips, I had no time to contemplate, read about, or absorb any information about the drugs. My only saving grace was that I didn't have to actually titrate the stuff because his blood pressure remained hovering around 90 systolic until I was giving report. (Whew.) That's when he decided to take the dreaded nose dive into the 70's. Oh, yeah, we titrate 'up' around here! lol.
I had to call the pharmacist 100 times to ask questions about certain things I was doing so that I wouldn't actually kill the guy on my shift. Good God, I only have two ports to work with here! He is going to check out soon on his own anyway, but for the record, I would rather it be on someone else's shift :-) This guy has a really sick heart. His Ejection Fraction is 30%, down from 45% when he first arrived. He is blowing up like a balloon and hanging onto fluid. Oh yeah, he has no sternum! He had a CABG and then had an AID placed somewhere along this journey to the other side. He developed a raging infection in the sternum and now he has a wound vac placed, and.....how would we actually do CPR? He's a full code, of course,.....I meant to inquire, but was too busy.
His sister comes in and request I put a note in the chart for us to notify her if the patient passes out again. Dah, what? Yeah, okay, I'll get right on that...... I wanted to say, "We will be calling you shortly when he dies, so I don't think any call regarding passing out is gonna be necessary, dumb ass.....But, of course, if you would like me to stop working on him in the midst of an emergency and call you, I can do that.......will that work for ya, dumb ass?"
My other (original BFB) patient was holding steady. I probably spent 20 minutes with him for the sake of the other guy. His note taking wife sat at his side like usual. She must have removed the frog picture from the ceiling. If I remember correctly I think it's now a pic of a cat.
At one point during the day I look down the hall to see the Physical Therapist waving at me, trying to get my attention. He stopped short of coming into the unit and kept pointing at BFB's room.
I walked over and found out what the deal was. It's too funny. The wife of BFB apparently tells the physical therapist to bring dumb bells into the room and start having the patient squeeze them. The patient is already gone to the other side lady! But, okay..... So, the therapist knowing the futility in this doesn't want to stand there asking the patient to squeeze when he knows he can't. He wasn't wanting to come to the unit if she was still there because he didn't want to get roped into this ridiculous request!
Saturday, January 12, 2008
This one really is dead.
I got to work this morning and had two patients assigned to me, one of which Is Dead! Great. The poor guy was another one we kept alive for as long as we possibly could....for naught. He was a mess. The funeral home finally came to pick him up. The family chose not to call us back for almost 6 hours. The man lay in the room rotting. When he was transferred to the stretcher there was a trail of blood on the floor. I'm not sure where it came from, don't really care. It's sad, that's all. His wife allegedly died a few weeks ago in ICU. And, that's sad. At least they are together now. The only reason he's resting in peace is because his family had the mindfulness to make him a chemical code. Otherwise we would have cranked him back up and running for another few weeks of pain and misery.
One little old guy, a patient of mine, is on his last breath. His wife is a sad case too. I am picking her up Monday to bring her to the hospital. Another nurse is giving her a ride Tuesday.
This little old lady has no one! It's heartbreaking. They lost their only son to a cardiac condition when he was 40 years old. He had two sons, but they have nothing to do with the grandparents due to a divorce situation.
Geez, life is sooo hard sometimes. This stuff is all around us and most days we go about our business oblivious that our neighbors, strangers in the grocery store or in the car next to us, etc. are going through such a horrible time. I just wish it were different and that there weren't so many hurting people out there.
It's hard as a nurse to separate. You have to though or it will kill you. I'm a sensory-intuitive type person and can already pick up thoughts and feelings from others without even trying. So, to not take on other's pain and heartache while having compassion and sympathy is a real juggling act. Many times I have to totally disassociate in order to save myself. That's the only way I can function at work sometimes. That feels and sounds brutally cold, but it's the only way to survive at times. Ah, I don't know what I'm saying. I'm tired, it's been a long day and I need to sleep.
OMG. I almost forgot. Wife of BFB is going to be piiiissssseeeed when she finds out an EEG was ordered for him. Damn, I can still smell him.....he is rotting from the inside out....The whole fricking HOU smells like it. The charged asked me where I wanted to work tomorrow. I swear to God, because of that smell, I told her I wanted to work on the floor and not back in the unit. This am I wore a mask with coffee grounds in it to hide the stench. We even changed rooms with this guy because wife was convinced it was the plumbing. Yeah, His plumbing! The stench followed him....hmmmm. I feel sorry for him. If he only knew. I know I would be horrified if someone was keeping me alive for naught. This EEG will prove he isn't with us, but she is likely to freak when she finds out, so really the EEG is for naught. Just our satisfaction. The wife doesn't give a S&^t what the picture looks like.
One little old guy, a patient of mine, is on his last breath. His wife is a sad case too. I am picking her up Monday to bring her to the hospital. Another nurse is giving her a ride Tuesday.
This little old lady has no one! It's heartbreaking. They lost their only son to a cardiac condition when he was 40 years old. He had two sons, but they have nothing to do with the grandparents due to a divorce situation.
Geez, life is sooo hard sometimes. This stuff is all around us and most days we go about our business oblivious that our neighbors, strangers in the grocery store or in the car next to us, etc. are going through such a horrible time. I just wish it were different and that there weren't so many hurting people out there.
It's hard as a nurse to separate. You have to though or it will kill you. I'm a sensory-intuitive type person and can already pick up thoughts and feelings from others without even trying. So, to not take on other's pain and heartache while having compassion and sympathy is a real juggling act. Many times I have to totally disassociate in order to save myself. That's the only way I can function at work sometimes. That feels and sounds brutally cold, but it's the only way to survive at times. Ah, I don't know what I'm saying. I'm tired, it's been a long day and I need to sleep.
OMG. I almost forgot. Wife of BFB is going to be piiiissssseeeed when she finds out an EEG was ordered for him. Damn, I can still smell him.....he is rotting from the inside out....The whole fricking HOU smells like it. The charged asked me where I wanted to work tomorrow. I swear to God, because of that smell, I told her I wanted to work on the floor and not back in the unit. This am I wore a mask with coffee grounds in it to hide the stench. We even changed rooms with this guy because wife was convinced it was the plumbing. Yeah, His plumbing! The stench followed him....hmmmm. I feel sorry for him. If he only knew. I know I would be horrified if someone was keeping me alive for naught. This EEG will prove he isn't with us, but she is likely to freak when she finds out, so really the EEG is for naught. Just our satisfaction. The wife doesn't give a S&^t what the picture looks like.
Tuesday, January 8, 2008
Can't You See I'm Dead?
BFB is still with us......amazingly.
I had the opportunity to have him as my patient yesterday. His wife is headfirst in total denial and has since added a frog picture to the ceiling......along with the duck. The cow pic on the left bed rail is now accompanied by another cow pic on the right rail.
I had two patients. The other nurse had two patients. Both of us kept extremely busy. No unit secretary, and no tech. That's nice.
The first part of my day was working on Mr. W. His platelets were seriously low, he is an old CABG, bp steady, but heart rate up. His cardiac doc ordered regular release verapamil and not to substitute with sustained release. We don't have reg. release on board...and won't have it until the next day.
It's going down a peg, so I'm not sure why crushing up the sustained release wouldn't be okay. Wouldn't it act just like a reg release in this case? dunno.
Anyway, I change out the guys Foley, give him some coreg, draw some labs and send off some urine.
A surgeon comes into the unit to check on a patient that has a penrose drain in her rectum and other drains he has jabbed into her sides. She isn't my patient, but I had already helped the other nurse clean her up from the constant leaking diarrhea.
The other patient this nurse has is a mess too. He is on levophed and getting HD. A doctor calls to the unit and because other nurse is busy, I take the order....."Put him on an insulin drip...." I tell the other nurse and she is okay with it, but because she isn't an RN she can't titrate. Go figure.....so, I get to do that
BFB, my patient, has a midline that won't draw. He is getting septic (again) and obviously we need to draw labs. Because his veins are toast and he is bloated and fat we can't ever get him peripherally. I stuck him three times, had another nurse from the floor stick him three times. She can usually hit anything with her eyes closed....but not him.
BFB's wife is there.....writing her fricking notes....!!!
An order is written to get another picc line placed. The picc line nurse goes to start the picc, but the wife of this patient says she can only use the right arm, the left arm is being saved for HD. The guy has a permacath in his right chest. This is why we couldn't place a picc last time and had to settle for the midline. The picc kept going up into the jugular and not down towards the aorta after being dislocated by the permacath. It gets confusing, but it's not, it's just nursing at it's best.
The guys cultures come back with Gram neg- Rods. I'm no infectious disease nurse, but apparently this is bad. I start him on cefepime. His temp continues to rise. He starts to do this funky breathing using his abdominal muscle. Because he is so big it's almost scary to watch. However, his Sat's are fine, his AFib is fine, but his wife is not fine. She wants me to do something 'now' to stop him from breathing this way. I give him morphine. Worked! Well, temporarily.
After the picc line nurse gets the picc in the brachial-cephalic successfully we have to get an xray to check for placement. Which means we have repositioned the guy and he starts in on the weird labored breathing again.
It was about 3:30 pm and I hadn't had lunch and no one to relieve me. This is where I start to throw temper tantrums and act like a crazed hungry person on crack. My director shows up on the unit and she tells me to go to lunch and that she would continue to work on the endless pages of orders for this guy.
I come back from lunch and nothing was done.....director was no where in site and Mrs.BFB is pi...isss...ed. I give BFB some ativan to see if that would help him. It didn't.
This hogwash of keeping dead people alive is mysterious to me. Would I be any different if it were my folks? I hope so. I hope I wont be so delusional and so selfish to let them lay there, stinking, rotting away.
It's sad, so sad. And such a laborious task for naught. The guy basically shows us everyday that he is dead. We just don't let him go.
I had the opportunity to have him as my patient yesterday. His wife is headfirst in total denial and has since added a frog picture to the ceiling......along with the duck. The cow pic on the left bed rail is now accompanied by another cow pic on the right rail.
I had two patients. The other nurse had two patients. Both of us kept extremely busy. No unit secretary, and no tech. That's nice.
The first part of my day was working on Mr. W. His platelets were seriously low, he is an old CABG, bp steady, but heart rate up. His cardiac doc ordered regular release verapamil and not to substitute with sustained release. We don't have reg. release on board...and won't have it until the next day.
It's going down a peg, so I'm not sure why crushing up the sustained release wouldn't be okay. Wouldn't it act just like a reg release in this case? dunno.
Anyway, I change out the guys Foley, give him some coreg, draw some labs and send off some urine.
A surgeon comes into the unit to check on a patient that has a penrose drain in her rectum and other drains he has jabbed into her sides. She isn't my patient, but I had already helped the other nurse clean her up from the constant leaking diarrhea.
The other patient this nurse has is a mess too. He is on levophed and getting HD. A doctor calls to the unit and because other nurse is busy, I take the order....."Put him on an insulin drip...." I tell the other nurse and she is okay with it, but because she isn't an RN she can't titrate. Go figure.....so, I get to do that
BFB, my patient, has a midline that won't draw. He is getting septic (again) and obviously we need to draw labs. Because his veins are toast and he is bloated and fat we can't ever get him peripherally. I stuck him three times, had another nurse from the floor stick him three times. She can usually hit anything with her eyes closed....but not him.
BFB's wife is there.....writing her fricking notes....!!!
An order is written to get another picc line placed. The picc line nurse goes to start the picc, but the wife of this patient says she can only use the right arm, the left arm is being saved for HD. The guy has a permacath in his right chest. This is why we couldn't place a picc last time and had to settle for the midline. The picc kept going up into the jugular and not down towards the aorta after being dislocated by the permacath. It gets confusing, but it's not, it's just nursing at it's best.
The guys cultures come back with Gram neg- Rods. I'm no infectious disease nurse, but apparently this is bad. I start him on cefepime. His temp continues to rise. He starts to do this funky breathing using his abdominal muscle. Because he is so big it's almost scary to watch. However, his Sat's are fine, his AFib is fine, but his wife is not fine. She wants me to do something 'now' to stop him from breathing this way. I give him morphine. Worked! Well, temporarily.
After the picc line nurse gets the picc in the brachial-cephalic successfully we have to get an xray to check for placement. Which means we have repositioned the guy and he starts in on the weird labored breathing again.
It was about 3:30 pm and I hadn't had lunch and no one to relieve me. This is where I start to throw temper tantrums and act like a crazed hungry person on crack. My director shows up on the unit and she tells me to go to lunch and that she would continue to work on the endless pages of orders for this guy.
I come back from lunch and nothing was done.....director was no where in site and Mrs.BFB is pi...isss...ed. I give BFB some ativan to see if that would help him. It didn't.
This hogwash of keeping dead people alive is mysterious to me. Would I be any different if it were my folks? I hope so. I hope I wont be so delusional and so selfish to let them lay there, stinking, rotting away.
It's sad, so sad. And such a laborious task for naught. The guy basically shows us everyday that he is dead. We just don't let him go.
Friday, January 4, 2008
January
Just worked 3-12's. Trying to recall any crazy stuff that occurred.
I had a gomer who was kinda my Guinea pig. Since he was my only patient (miracle) I had a lot of time on my hands. I used him to re-evaluate and practice some of my assessment skills. He was out of it and didn't know I was percussing, pinching, palpating, etc. And, how come so many geezers have herpes! That's what I'd like to know...... Also, men and their genitals. No matter what age, they are hanging onto those puppies even on their death bed. If I'm ever out of it and my hands are stuck down my pants, please do me a favor and remove them.......then restrain me. However, I think I'm safe, seeing that most women don't have this problem.
This guy's gomerish wife came hobbling in using a walker. Apparently my patient, who is like 90 years old, wrecked their car. So, she had another gomerish woman drive her to the hospital. I thought about pulling up a bed next to his and having her crawl into it. It's only a matter of time....
It breaks my heart seeing this. The poor woman doesn't know how to manage their finances. They have no children. The one they had, died. The phone in their house was turned off so she can't even call the hospital to see how her husband is doing. I've had this man 3 days and have only seen her once. What do you do? The good part of me wanted to extend help in some way, but how? I don't know, geez, and there are so many sad cases just like that one.
I see it everyday. It's depressing. This guy is so close to kicking the bucket and she is pretty clueless. I tried to talk with her about his condition. She asked me if he will have to be on all this stuff (the monitors/ventilator) when she takes him home. How do you say, "He won't be going home?" I don't know that for sure and it's not my call, nor my position to say anything like that. However, he won't be going home.
My PCCN course starts tomorrow. I read some stuff online and this doesn't look easy. It will probably take me about 3 months to be comfortable enough to take the test. There is a pay increase of .50cents or $1./hour if I pass....?
Next week I take, yet, another EKG course. Everyone has their own internal 'yuck' factor. This is mine. I don't know why that is, but, unfortunately, having it here makes this stuff much more difficult to digest and assimilate. One minute I think I'm getting it and the next I have forgotten everything. Afib, Vfib, VTach, Old Infarct, New injury, duh, duh, duh,,,,,,,
I'm still in contact with the NNOC person. I asked a few more questions regarding the legislation for 2009. I don't have the answers I want or need yet to pursue further action for or against unionizing. All I care about right now is that there are safety ratios passed....for the nurse, and the patient. It is kind of interesting to note that California had 70,000 nurses come out of the woodwork as soon as the Ratios were in place. Shortage? I think not. Doesn't that speak volumes about the conditions on the floor?
It seems funny to me that the National Board of Nurses isn't involved. Maybe it's a legality/ethical issue and they can't be? Anyway, I would like to do more than pay my $30/year to get this thing passed. Another thing I wonder about...Is the NNOC bent on pushing through the legislation first and then working on unionizing Texas or are there ulterior motives, like almost pushing this thing through, hoodwinking nurses to unionize and then do the work to push it through?
There has to be some catch...right? And, why can't nurses organize without the union? Cuz, we're stupid, that's why. I don't know how to organize nurses. If I did, I would have done it already. Plus, many nurses are wimpy, afraid of losing their jobs, standing up for what they believe in or making waves. Or, what's always done me in is I get one good day and think, 'Oh, things aren't that bad'. But, really I think it's more of a lack of knowledge of the process of legislation and how to change things politically. I don't really care to have political knowledge in my head, but with the Ratio Issue being so unsafe, I am forced to learn. I've always had this knack of interpreting stuff that's hard to learn and understand and then explaining it to people so it makes sense. Maybe that's why I'm doing this?
Actually, I'm shocked I'm doing this at all. As a new Grad I could see many, many things that needed to be changed....and for a short time, thought maybe I could do something about it....and wanted to.
I was green. I left out of college thinking the work environment at the renowned teaching hospital I took a job with would be one wreaking of academia, one that the learning environment would be stimulating, engaging, supportive. hahahahah! It wasn't, it's still not....
I turned my nose up at learning anything more about nursing and copped a huge resentment with the system. I really believed I would ultimately find another career, another avenue of nursing maybe that would work for me. But, here I am. I love gomers. What can I say. Stinky, old, crusty gomers.
I had a gomer who was kinda my Guinea pig. Since he was my only patient (miracle) I had a lot of time on my hands. I used him to re-evaluate and practice some of my assessment skills. He was out of it and didn't know I was percussing, pinching, palpating, etc. And, how come so many geezers have herpes! That's what I'd like to know...... Also, men and their genitals. No matter what age, they are hanging onto those puppies even on their death bed. If I'm ever out of it and my hands are stuck down my pants, please do me a favor and remove them.......then restrain me. However, I think I'm safe, seeing that most women don't have this problem.
This guy's gomerish wife came hobbling in using a walker. Apparently my patient, who is like 90 years old, wrecked their car. So, she had another gomerish woman drive her to the hospital. I thought about pulling up a bed next to his and having her crawl into it. It's only a matter of time....
It breaks my heart seeing this. The poor woman doesn't know how to manage their finances. They have no children. The one they had, died. The phone in their house was turned off so she can't even call the hospital to see how her husband is doing. I've had this man 3 days and have only seen her once. What do you do? The good part of me wanted to extend help in some way, but how? I don't know, geez, and there are so many sad cases just like that one.
I see it everyday. It's depressing. This guy is so close to kicking the bucket and she is pretty clueless. I tried to talk with her about his condition. She asked me if he will have to be on all this stuff (the monitors/ventilator) when she takes him home. How do you say, "He won't be going home?" I don't know that for sure and it's not my call, nor my position to say anything like that. However, he won't be going home.
My PCCN course starts tomorrow. I read some stuff online and this doesn't look easy. It will probably take me about 3 months to be comfortable enough to take the test. There is a pay increase of .50cents or $1./hour if I pass....?
Next week I take, yet, another EKG course. Everyone has their own internal 'yuck' factor. This is mine. I don't know why that is, but, unfortunately, having it here makes this stuff much more difficult to digest and assimilate. One minute I think I'm getting it and the next I have forgotten everything. Afib, Vfib, VTach, Old Infarct, New injury, duh, duh, duh,,,,,,,
I'm still in contact with the NNOC person. I asked a few more questions regarding the legislation for 2009. I don't have the answers I want or need yet to pursue further action for or against unionizing. All I care about right now is that there are safety ratios passed....for the nurse, and the patient. It is kind of interesting to note that California had 70,000 nurses come out of the woodwork as soon as the Ratios were in place. Shortage? I think not. Doesn't that speak volumes about the conditions on the floor?
It seems funny to me that the National Board of Nurses isn't involved. Maybe it's a legality/ethical issue and they can't be? Anyway, I would like to do more than pay my $30/year to get this thing passed. Another thing I wonder about...Is the NNOC bent on pushing through the legislation first and then working on unionizing Texas or are there ulterior motives, like almost pushing this thing through, hoodwinking nurses to unionize and then do the work to push it through?
There has to be some catch...right? And, why can't nurses organize without the union? Cuz, we're stupid, that's why. I don't know how to organize nurses. If I did, I would have done it already. Plus, many nurses are wimpy, afraid of losing their jobs, standing up for what they believe in or making waves. Or, what's always done me in is I get one good day and think, 'Oh, things aren't that bad'. But, really I think it's more of a lack of knowledge of the process of legislation and how to change things politically. I don't really care to have political knowledge in my head, but with the Ratio Issue being so unsafe, I am forced to learn. I've always had this knack of interpreting stuff that's hard to learn and understand and then explaining it to people so it makes sense. Maybe that's why I'm doing this?
Actually, I'm shocked I'm doing this at all. As a new Grad I could see many, many things that needed to be changed....and for a short time, thought maybe I could do something about it....and wanted to.
I was green. I left out of college thinking the work environment at the renowned teaching hospital I took a job with would be one wreaking of academia, one that the learning environment would be stimulating, engaging, supportive. hahahahah! It wasn't, it's still not....
I turned my nose up at learning anything more about nursing and copped a huge resentment with the system. I really believed I would ultimately find another career, another avenue of nursing maybe that would work for me. But, here I am. I love gomers. What can I say. Stinky, old, crusty gomers.
Tuesday, January 1, 2008
My First Death
I've heard it said that what you spend New Years Day doing is what you have to look forward to the rest of the year. How I hope that's not true.
A patient of mine died today. It was my first day of having this guy. The night nursing giving me report said, "He probably won't make it through the day." She was right. At 1130 he died. Family in tow. This was my first. I've been around 3 dead people and have gotten over the he-be-jibes of that, but actually having my patient die was a trip. Surreal.
This guy had a pacemaker so I couldn't really tell if I was getting a pulse or not. Talk about feeling stupid! He's also on Mech. Vent. so I couldn't really hear any heart beat. I mean, what do ya say, "I think he's dead, but I'm not really sure.....here lets take him off the vent and he'll be dead in a minute or so."
I had two other, seasoned, death angel, nurses with me. They walked right on through it like they were doing laundry. I wanted to cry seeing the family cry. I wanted to say something comforting, but I didn't know what to say. I didn't even know these people but for a few hours.
The other nurses were able to chit-chat, laugh and plan their lunch all while our faces are glued to the monitor waiting for that last little sign that he's gone.
I was somewhat emotionally immobilized. I mean geez, a husband, father, friend, brother is dying here. I wasn't thinking about lunch with this going on. This is huge, isn't it? Isn't this the part I'm supposed to do something? He's a DNR, but still shouldn't I be doing something other then planning my lunch?
I suppose one day I will become used to this and maybe even a little miffed when a patient up and dies around my lunch time.
By the way, BFB is still kicking. He actually looks better and is producing urine. The wife is still out of touch. She thinks he is hearing us and registering, but I highly doubt this is the case. He doesn't track, squeeze, wiggle, notta, nothing. The left eye is inverted so his vision, even if he has any, is jacked up. Oh, the wife put a picture of a duck on his ceiling and a cow on his bed rail for him to look at. Okay, okay, this is pretty funny. But, hey, people do what they have to do.
Dr. Stephens was on the unit today during the death of my patient. He hung out for awhile making small talk with me. This is the Dr. I know. The other one who bitch-slapped my ass a few weeks back was someone else, I guess. It was funny watching him approach me, I swear to God, he hung his head a little low and move forward cautiously. I think he was a little apprehensive about how I was going to respond to him. I was kind and did the chit-chat thing, but not overly kind. He's too cute not to talk to!
A patient of mine died today. It was my first day of having this guy. The night nursing giving me report said, "He probably won't make it through the day." She was right. At 1130 he died. Family in tow. This was my first. I've been around 3 dead people and have gotten over the he-be-jibes of that, but actually having my patient die was a trip. Surreal.
This guy had a pacemaker so I couldn't really tell if I was getting a pulse or not. Talk about feeling stupid! He's also on Mech. Vent. so I couldn't really hear any heart beat. I mean, what do ya say, "I think he's dead, but I'm not really sure.....here lets take him off the vent and he'll be dead in a minute or so."
I had two other, seasoned, death angel, nurses with me. They walked right on through it like they were doing laundry. I wanted to cry seeing the family cry. I wanted to say something comforting, but I didn't know what to say. I didn't even know these people but for a few hours.
The other nurses were able to chit-chat, laugh and plan their lunch all while our faces are glued to the monitor waiting for that last little sign that he's gone.
I was somewhat emotionally immobilized. I mean geez, a husband, father, friend, brother is dying here. I wasn't thinking about lunch with this going on. This is huge, isn't it? Isn't this the part I'm supposed to do something? He's a DNR, but still shouldn't I be doing something other then planning my lunch?
I suppose one day I will become used to this and maybe even a little miffed when a patient up and dies around my lunch time.
By the way, BFB is still kicking. He actually looks better and is producing urine. The wife is still out of touch. She thinks he is hearing us and registering, but I highly doubt this is the case. He doesn't track, squeeze, wiggle, notta, nothing. The left eye is inverted so his vision, even if he has any, is jacked up. Oh, the wife put a picture of a duck on his ceiling and a cow on his bed rail for him to look at. Okay, okay, this is pretty funny. But, hey, people do what they have to do.
Dr. Stephens was on the unit today during the death of my patient. He hung out for awhile making small talk with me. This is the Dr. I know. The other one who bitch-slapped my ass a few weeks back was someone else, I guess. It was funny watching him approach me, I swear to God, he hung his head a little low and move forward cautiously. I think he was a little apprehensive about how I was going to respond to him. I was kind and did the chit-chat thing, but not overly kind. He's too cute not to talk to!
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