Tis Friday night and naturally i am stylin! I am sporting a fabulous dark blue jeans, yellow t-shirt, brown cardigan combo. The clincher is the cardigan. After wearing it for over 8 hours i noticed that i had somehow managed to put it on and button it while it was inside out!
List of Things to Do Tomorrow:
- learn to dress myself, properly
- learn to make chocolate chip cookies, recognizable as such
Friday, January 06, 2006
Thursday, January 05, 2006
JV vs. the ER - Round 3, sock it to 'em!
Holy toledo, what a night!
I was first tipped off that it was going to be a memorable evening when one of the local doctors (who's wife is also a Dr) called to say they were bringing in their 5 year-old son. If two doctors are going to bring in their son to see another doctor, something's up. There was vomiting. There was pain. There was an ambulance trip to another hospital for air ambulance to another province for surgery.
Meanwhile, in my corner, elderly man with severe pain to neck, right shoulder, right arm, back, and right abdomen with shortness of breath and a history of cardiac problems. I got to see what a pacemaker looks like on a chest xray! I wrestled with the EKG machine. (Tis a good thing i learned how to use it last night because i had to do one on every one of my patients tonight and my mentor was busy with the child to be air-lifted out for surgery.) Oh, and the IV. This is how it went:
me: i am going to start an IV (there's no one else available. i need this. i have to do this. )
patient: ok. but i have no veins left. I had vasculitis and an embolism and deep vein thrombosis and surgery and now i have no veins left. They're all gone. Kaput. blah blah blah NO VEINS.
me: i am going to start an IV.
result: KAPOW! That's me NAILING it on the first try! The patient was stunned! I was stunned as i realized he was bleeding all over the place and i had no tape (damn!). The nurse who came to my rescue with the tape said it wouldnt hold because i hadnt done something and i said, oh it will hold. And it held! HUZZAH! The patient looks down at me crouched on the floor, nursing his new IV and says: high five to the nurse! And so i got a high five from my disbelieving 80 yearold patient. What a high! The doctor was totally impressed too. He had seen the patient and didnt think i would get it! I got another high five! Later my mentor, the doctor and i were talking about it and i was explaining what i hadnt done (that's different than standard nursing procedure) and why and they both agreed i was right to have done so! Woohoo! See my head, its getting bigger.
Next scene. I'm in the middle of admitting the guy with the lovely new IV to the ward for overnight observation when the ambulance calls to say they're bringing in a new guy with shortness of breath. Déjà vu! My mentor took over the old patient and i got to follow through with the ambulance transfer. He was having moderate respiratory distress but had no history of cardiac problems. What was ordered? An EKG! What else? An IV. I got the EKG ok. It had a lot of artefact (background noise) but it was clear enough for the doctor to see that the guy was experiencing some ischemia (precursor to an MI. recall MI = heart attack). I think it would be scary to be a patient, laying in wait for an impending heart attack. What happened with his IV? At first it seemed i had some time to play with it. But then the doctor realized it was becoming urgent. I had a bad feeling about it. I tried once. Twice. On the third time, the doctor set it up for me and guided me through it and was stunned when it failed. I was rather crushed. It brought me down hard after my winning IV high.Fitting result for letting Pride get the best of me? And of course the doctor got it on his first try. But then again, he's been doing this for awhile. I've really only been trying since yesterday. I dont think its an excuse. I think its a valid point. My mom says its ok that i keep missing. Arent moms always right?
It was busy. There was winning. There was failing (though we didnt lose anyone. A friend told me before me shift to tell my patients they were not allowed to code on me. I guess they heard because none of them did). But it was exciting to take charge and do things while waiting for the doctor to be able to exam the patient and give orders. And it was good for me (says my mentor) to have seen and tried so many things. Sure she's right, but i'm beat. When we made it down to the unit around 4am to hang out with the other nurses, i was so tired i was nauseated and giddy. And when one of the nurses asked my mentor what she was reading and she said The Beaver, i couldnt stop laughing. And it made another nurse laugh. And there we were, laughing like nuts until we couldnt hold up our heads and our eyes were tearing.
I thought it would be a nice way to end the night. Giddy, drinking overly-sweetened energy tea, reading my book. Then the phone rang. 5:55am. Aw, peas. All the nurses were guessing it was someone calling in sick. No way. They can call in sick all they like as long as its not the ambulance calling.
It was the ambulance.
My mentor was so annoyed. Cant they keep the person until 8am? What do they think we can do with them? And its true. It was almost shift change. The doctor had only been gone home to bed less than 3 hours ago. There was no way we were going to call and wake him up for a patient who had fallen in the bathroom at the senior's lodge. I sat around for 40mins waiting for the ambulance to arrive. I took my blood pressure. I think it was a little high. At least the systolic was. And my heartrate was on the high side of normal, but lower than when i was a nursing student! I took my mentor's BP. I started offering to take the blood pressure of the cleaning staff and someone who was randomly walking through the ER. When the ambulance finally arrived, they asked if i wanted the patient left on the clamshell. Uh...?! I dont know, what do you guys think? Hey, they said, you're in charge. What? I'M NEW. Too bad, you're Hospital, you're a higher rank, you decide. Dang! Can we just send her home and go back to eating timbits (brought by the ambulance guys, bless them, upon their return from taking the boy to the big city hospital) and trying to get back to the high from the successful IV?
The ER tried to get the better of me and it looked for awhile like it might win. But even though it tripped me up in the IV department, i'm still alive, my patients are all still alive. I think the title belt goes to ME!
Now its time for bed. Oh how sweet it is (oh Women's choir!) to crawl into my bed at the end of a 12hr night, knowing that i dont have to get up tomorrow until i want to because i have five days off! And yesterday was payday! And i rocked the casbah on the first IV! And i was useful! And there are chocolate chip cookie-wanna-bes awaiting consumption. It's a new day!
I was first tipped off that it was going to be a memorable evening when one of the local doctors (who's wife is also a Dr) called to say they were bringing in their 5 year-old son. If two doctors are going to bring in their son to see another doctor, something's up. There was vomiting. There was pain. There was an ambulance trip to another hospital for air ambulance to another province for surgery.
Meanwhile, in my corner, elderly man with severe pain to neck, right shoulder, right arm, back, and right abdomen with shortness of breath and a history of cardiac problems. I got to see what a pacemaker looks like on a chest xray! I wrestled with the EKG machine. (Tis a good thing i learned how to use it last night because i had to do one on every one of my patients tonight and my mentor was busy with the child to be air-lifted out for surgery.) Oh, and the IV. This is how it went:
me: i am going to start an IV (there's no one else available. i need this. i have to do this. )
patient: ok. but i have no veins left. I had vasculitis and an embolism and deep vein thrombosis and surgery and now i have no veins left. They're all gone. Kaput. blah blah blah NO VEINS.
me: i am going to start an IV.
result: KAPOW! That's me NAILING it on the first try! The patient was stunned! I was stunned as i realized he was bleeding all over the place and i had no tape (damn!). The nurse who came to my rescue with the tape said it wouldnt hold because i hadnt done something and i said, oh it will hold. And it held! HUZZAH! The patient looks down at me crouched on the floor, nursing his new IV and says: high five to the nurse! And so i got a high five from my disbelieving 80 yearold patient. What a high! The doctor was totally impressed too. He had seen the patient and didnt think i would get it! I got another high five! Later my mentor, the doctor and i were talking about it and i was explaining what i hadnt done (that's different than standard nursing procedure) and why and they both agreed i was right to have done so! Woohoo! See my head, its getting bigger.
Next scene. I'm in the middle of admitting the guy with the lovely new IV to the ward for overnight observation when the ambulance calls to say they're bringing in a new guy with shortness of breath. Déjà vu! My mentor took over the old patient and i got to follow through with the ambulance transfer. He was having moderate respiratory distress but had no history of cardiac problems. What was ordered? An EKG! What else? An IV. I got the EKG ok. It had a lot of artefact (background noise) but it was clear enough for the doctor to see that the guy was experiencing some ischemia (precursor to an MI. recall MI = heart attack). I think it would be scary to be a patient, laying in wait for an impending heart attack. What happened with his IV? At first it seemed i had some time to play with it. But then the doctor realized it was becoming urgent. I had a bad feeling about it. I tried once. Twice. On the third time, the doctor set it up for me and guided me through it and was stunned when it failed. I was rather crushed. It brought me down hard after my winning IV high.Fitting result for letting Pride get the best of me? And of course the doctor got it on his first try. But then again, he's been doing this for awhile. I've really only been trying since yesterday. I dont think its an excuse. I think its a valid point. My mom says its ok that i keep missing. Arent moms always right?
It was busy. There was winning. There was failing (though we didnt lose anyone. A friend told me before me shift to tell my patients they were not allowed to code on me. I guess they heard because none of them did). But it was exciting to take charge and do things while waiting for the doctor to be able to exam the patient and give orders. And it was good for me (says my mentor) to have seen and tried so many things. Sure she's right, but i'm beat. When we made it down to the unit around 4am to hang out with the other nurses, i was so tired i was nauseated and giddy. And when one of the nurses asked my mentor what she was reading and she said The Beaver, i couldnt stop laughing. And it made another nurse laugh. And there we were, laughing like nuts until we couldnt hold up our heads and our eyes were tearing.
I thought it would be a nice way to end the night. Giddy, drinking overly-sweetened energy tea, reading my book. Then the phone rang. 5:55am. Aw, peas. All the nurses were guessing it was someone calling in sick. No way. They can call in sick all they like as long as its not the ambulance calling.
It was the ambulance.
My mentor was so annoyed. Cant they keep the person until 8am? What do they think we can do with them? And its true. It was almost shift change. The doctor had only been gone home to bed less than 3 hours ago. There was no way we were going to call and wake him up for a patient who had fallen in the bathroom at the senior's lodge. I sat around for 40mins waiting for the ambulance to arrive. I took my blood pressure. I think it was a little high. At least the systolic was. And my heartrate was on the high side of normal, but lower than when i was a nursing student! I took my mentor's BP. I started offering to take the blood pressure of the cleaning staff and someone who was randomly walking through the ER. When the ambulance finally arrived, they asked if i wanted the patient left on the clamshell. Uh...?! I dont know, what do you guys think? Hey, they said, you're in charge. What? I'M NEW. Too bad, you're Hospital, you're a higher rank, you decide. Dang! Can we just send her home and go back to eating timbits (brought by the ambulance guys, bless them, upon their return from taking the boy to the big city hospital) and trying to get back to the high from the successful IV?
The ER tried to get the better of me and it looked for awhile like it might win. But even though it tripped me up in the IV department, i'm still alive, my patients are all still alive. I think the title belt goes to ME!
Now its time for bed. Oh how sweet it is (oh Women's choir!) to crawl into my bed at the end of a 12hr night, knowing that i dont have to get up tomorrow until i want to because i have five days off! And yesterday was payday! And i rocked the casbah on the first IV! And i was useful! And there are chocolate chip cookie-wanna-bes awaiting consumption. It's a new day!
Wednesday, January 04, 2006
JV vs. the ER - Round 2, night duty
I survived!
And i meant BUSINESS!
At one point, i went to do a treatment on a patient and when i came back my mentor was all impressed and said that i was rather quick. I told her that i dont mess around. She thought that was funny. I'm a no-nonsense sort of nurse. Really now!
Except with IV starts. Dang! I think i am actually getting worse at it. Everyone had the memo to call me to do their work for them. I missed another handful of IVs and my mentor MADE me try starting them on her, at 530 in the morning! That wasnt a highlight.
I think my favourite part was running the EKG machine. Doing an EKG on a patient has always seemed like a rather challenging procedure. There are so many wires to hook up in specific places. Now i know it isnt. The hard part is reading the results (i just give it to the doctor. Let them earn their keep).
In the downtime last night, my mentor told me to go play around with things so i'd become familiar with them. ok! I played with the crash cart and with all the defibrillators! Fun!
One of the perks on no longer being a student is that now, when a doctor asks you to do something, you can actually do it. You dont need to have him/her repeat it to a "real nurse" and then relay the order to you. Unless of course, you dont know how to do it (which happened to me last night and i had to tell the doctor i didnt know how to do it and that's why i was standing around like a nob. good times).
Sometimes i dont like being a nurse (and not a student) because i find talking to doctors intimidating. And calling them at home! And calling them at home in the middle of the night! Unless you dont like the doctor, in which case calling them and waking them up is a sick pleasure! Ha ha! Sick, hospital, doctor! HA HA! (i think i need more sleep)
Time to get ready for Night 2. Watch out IVs, JV's coming back and she means business!
And i meant BUSINESS!
At one point, i went to do a treatment on a patient and when i came back my mentor was all impressed and said that i was rather quick. I told her that i dont mess around. She thought that was funny. I'm a no-nonsense sort of nurse. Really now!
Except with IV starts. Dang! I think i am actually getting worse at it. Everyone had the memo to call me to do their work for them. I missed another handful of IVs and my mentor MADE me try starting them on her, at 530 in the morning! That wasnt a highlight.
I think my favourite part was running the EKG machine. Doing an EKG on a patient has always seemed like a rather challenging procedure. There are so many wires to hook up in specific places. Now i know it isnt. The hard part is reading the results (i just give it to the doctor. Let them earn their keep).
In the downtime last night, my mentor told me to go play around with things so i'd become familiar with them. ok! I played with the crash cart and with all the defibrillators! Fun!
One of the perks on no longer being a student is that now, when a doctor asks you to do something, you can actually do it. You dont need to have him/her repeat it to a "real nurse" and then relay the order to you. Unless of course, you dont know how to do it (which happened to me last night and i had to tell the doctor i didnt know how to do it and that's why i was standing around like a nob. good times).
Sometimes i dont like being a nurse (and not a student) because i find talking to doctors intimidating. And calling them at home! And calling them at home in the middle of the night! Unless you dont like the doctor, in which case calling them and waking them up is a sick pleasure! Ha ha! Sick, hospital, doctor! HA HA! (i think i need more sleep)
Time to get ready for Night 2. Watch out IVs, JV's coming back and she means business!
Monday, January 02, 2006
Time for an Experiment
Its nearly 1am. I've been up since 530am. The randomness, the giddiness is setting in.
I decided to do a little experiment. I LOVE experiments.
I wondered what would happen if i replied, via email, to the automatically-generated email notices informing me of new comments posted on my blog. Where would it go?
I replied to a comment.
And the message was SENT.
La de dah de dah.
Where did it go?
Not here on my blog.
Not in my email account.
To the Dead Letter Office?
Maybe i should write a song about it.
I wonder what would come to pass first: the reappearance of my reply or the composition of a song speculating on the location of my reply?
Hey! Yo! Whoa there, buddy!
IT'S BACK!
oh.
disappointment.
the answer is: PERMANENT FAILURE
(it disappears for awhile and comes back stamped permanent failure. Unable to deliver. Ever. what a bummer)
Inspite of the disappointing outcome, i do not consider this experiment a failure because it has provided us with knowledge. And i've done you all a favour. You no longer have to worry about where the replies go. Find something else to worry about. Worries needing investigation can be submitted to RE (Random Experiments).
I decided to do a little experiment. I LOVE experiments.
I wondered what would happen if i replied, via email, to the automatically-generated email notices informing me of new comments posted on my blog. Where would it go?
I replied to a comment.
And the message was SENT.
La de dah de dah.
Where did it go?
Not here on my blog.
Not in my email account.
To the Dead Letter Office?
Maybe i should write a song about it.
I wonder what would come to pass first: the reappearance of my reply or the composition of a song speculating on the location of my reply?
Hey! Yo! Whoa there, buddy!
IT'S BACK!
oh.
disappointment.
the answer is: PERMANENT FAILURE
(it disappears for awhile and comes back stamped permanent failure. Unable to deliver. Ever. what a bummer)
Inspite of the disappointing outcome, i do not consider this experiment a failure because it has provided us with knowledge. And i've done you all a favour. You no longer have to worry about where the replies go. Find something else to worry about. Worries needing investigation can be submitted to RE (Random Experiments).
it's a good thing...
It's a good thing my life does not depend on being able to make chocolate chip cookies because apparently i can't, Who knew?
Now you ask: what do you mean you cant make chocolate chip cookies?
I reply: I CANT. Dont get me wrong, they are rather tasty, but they look about as far from a cookie as you can get without calling it a muffin or a pancake or a crepe or a hash. In fact, if you looked at my table tonight, you would see the Evolution of the Chocolate Chip Cookie. Minus the final evolutionary stage in which the Cookie actually becomes the Cookie.
Now you say: perhaps you haven't tried enough. One attempt is not an acceptable sample for reaching any generalizations or definitive conclusions. It is one isolated incident.
I reply: i tried 4 times tonight.
Now you inquire: how does one make chocolate chip cookies wrong?
I reply: Yea, i'm wondering about that one too.
Possible reasons for my baking fiasco: uh... the altitude? Yea that's it. That's totally it. The recipe was made by someone living in the South Swampland, USA. Which would make it all wrong for someone at my elevation. And.. uh.. the oven! Yea, it's the oven's fault! Stupid gas oven! And maybe the sifter i used didnt sift down to the same diameter as the sifter used in the original recipe.
I had planned to lounge in the bath, savouring some warm chocolate chip cookies. I'm scared to take a bath now. What if i take it wrong too? I mean, i was pretty confident regarding my ability to make cookies and that didnt exactly turn out...
Now you ask: what do you mean you cant make chocolate chip cookies?
I reply: I CANT. Dont get me wrong, they are rather tasty, but they look about as far from a cookie as you can get without calling it a muffin or a pancake or a crepe or a hash. In fact, if you looked at my table tonight, you would see the Evolution of the Chocolate Chip Cookie. Minus the final evolutionary stage in which the Cookie actually becomes the Cookie.
Now you say: perhaps you haven't tried enough. One attempt is not an acceptable sample for reaching any generalizations or definitive conclusions. It is one isolated incident.
I reply: i tried 4 times tonight.
Now you inquire: how does one make chocolate chip cookies wrong?
I reply: Yea, i'm wondering about that one too.
Possible reasons for my baking fiasco: uh... the altitude? Yea that's it. That's totally it. The recipe was made by someone living in the South Swampland, USA. Which would make it all wrong for someone at my elevation. And.. uh.. the oven! Yea, it's the oven's fault! Stupid gas oven! And maybe the sifter i used didnt sift down to the same diameter as the sifter used in the original recipe.
I had planned to lounge in the bath, savouring some warm chocolate chip cookies. I'm scared to take a bath now. What if i take it wrong too? I mean, i was pretty confident regarding my ability to make cookies and that didnt exactly turn out...
JV vs. the ER
Today was my first shift in the ER.
Dang.
I'm so tired i cant think.
Nausea, headache, dizziness, swollen ankles... and that's just me. Maybe i should go admit myself!
I'm glad i was still with my mentor because that gave us extra staff. Usually its 1 doctor + 1 nurse. We need more staff. We need more money. Aw damn! I'm gonna turn into one of those crazies ranting about the decline of healthcare.
Attention staff: could all procedures odd, stinky, or mean please be directed to JV
Dang.
I'm so tired i cant think.
Nausea, headache, dizziness, swollen ankles... and that's just me. Maybe i should go admit myself!
I'm glad i was still with my mentor because that gave us extra staff. Usually its 1 doctor + 1 nurse. We need more staff. We need more money. Aw damn! I'm gonna turn into one of those crazies ranting about the decline of healthcare.
Attention staff: could all procedures odd, stinky, or mean please be directed to JV
That's pretty much the message my mentor gave out to the other staff. I got called about IV starts (yes, i missed everyone of them. Stupid rolling, dehydrated, valve-y veins!). I got called about PICC line dressing changes (PICCs are very rare at this hospital. They are sort of like fancy longer-term IVs. I saw them alot when i did my practicum in oncology). I got called to do the dressing changes for the feet of a patient with diabetic ulcers on them (the smell! oh goodness, the smell! It thickly permeated the air).
I got called by the doctor to do a enema on a patient in the cast room. There wasn't any patient. The doctor decided to play a joke on me. Ha ha ha. Really, not funny.
At least the doctor on call today let me do other cool things. I assisted with the application of a back-slab (a half of a cast) to a fractured fibula. I followed the doctor to the Extended Care Unit and got to consult on a patient! And the x-ray technician taught me all about chest x-rays.
I hate answering the phone at work. Its scary. I never know who's going to be on the other end. Is it my co-worker's son? Is it a doctor? Is it someone trying to bring in their intoxicated spouse? Is it the ambulance announcing their arrival with some wacky patient? Today i had to answer the phone. All day. Once i answered it and the person said "oh hey JV, its your neighbour!". That was strange. I also learned today that the ambulance has its own special phone. Like the red phone on Batman. Now i just have to hope it never rings while i'm on...
I also hate the smell of work. I have this unfortunate condition whereby i will be exposed to a most disgusting stench early in my shift and for the remainder of my shift, i will continue to smell grossness. And then it follows me home. I'll be at home and i will still be able to smell something foul and will become paranoid that the smell is coming from me and maybe i should go to the hospital. It sucks.
What i do like about work: the people. Even though the malodor of the diabetic ulcers was enough to bowl me over, i had such a pleasant conversation with the patient. Even though we forgot about him for over an hour and stuck him 4 times before his IV went in, the patient kept smiling and never yelled at us and was just the sweetest man. I had to convince a young girl to stop giggling so i could prick her with a needle. There was the 3 yearold who was skeptical of me and my thermometer-gun and my blood-pressure arm squeezer but who i won over in the end. And of course, the woman who thought i was a doctor! A co-worker managed to work a Harry Potter reference into our conversation about nursing supplies. It was awesome!
It's been a wild 12 hours without coffee breaks or dinnerbreak. I think i stink (literally and figuratively). I'm tired. Slightly ornery. My legs are throbbing. My head aches. My ankles are swollen. And i'm going to go make chocolate chip cookies! And read the Sears catalogue that was just delivered to my door. In the bath! Yea!
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