last night was an nice example of how nightshifts should go:
- patients were all in bed by 2130
- no one puked
- no one coded
- no one was admitted overnight
- the doctor on call actually slept in the On Call room instead of trying to go home in between calls (maybe he was in a tiff with his wife. he's strange man. he was sleeping on the floor when i went to wake him up about a patient in the longterm care facility with chest pain)
- i went down to the LTC facility in the basement to assess a patient in the middle of the night. Isnt that a doctor's job? Med school?
- we spent several hours doing a math puzzle (it was fun and i did mine all by myself, unlike my one coworker who copied off the other RN) all the while holding the gassy baby. go us! multitasking in cool ways!
- i got to hold the gassy baby!
- he farted so loudly when i was holding him that apparently i blushed!
- lime sherbert!
Friday, March 17, 2006
Tuesday, March 14, 2006
Monday, March 13, 2006
scary things
this morning i was making breakfast. (that is not the scary part). i cracked the egg into the pan and turned to the sink to wash my hands. but i espied something as i was turning and it made me pause. i turned back around. and screamed.
dangling from the middle of the ceiling was a spider. he was either going for my head or he was suicidal and aiming for the hot frypan.
later i was sitting in the art room, minding my own business when suddenly i felt like going jogging. so i went. i put on some shorts. hey, if Dr. Chicken Legs can do it, so can i. Dont worry. I wore my blindingly white runners to detract attention from my legs so sexy.
i returned from my random exercise excursion and decided to satisfy my orange craving. i had one innoncent-looking orange. i sliced it into small, attractive wedges and sat down to enjoy them. the first one was tasty enough. as i was about to grab the second piece and eat it sight unseen, i stopped and looked at it. something was not right.
something was very wrong.
disgustingly wrong.
the inside of one end of the wedge looked like baby spit up (that chunky oatmeal-esque regurgitation). ewwwwww!
dangling from the middle of the ceiling was a spider. he was either going for my head or he was suicidal and aiming for the hot frypan.
later i was sitting in the art room, minding my own business when suddenly i felt like going jogging. so i went. i put on some shorts. hey, if Dr. Chicken Legs can do it, so can i. Dont worry. I wore my blindingly white runners to detract attention from my legs so sexy.
i returned from my random exercise excursion and decided to satisfy my orange craving. i had one innoncent-looking orange. i sliced it into small, attractive wedges and sat down to enjoy them. the first one was tasty enough. as i was about to grab the second piece and eat it sight unseen, i stopped and looked at it. something was not right.
something was very wrong.
disgustingly wrong.
the inside of one end of the wedge looked like baby spit up (that chunky oatmeal-esque regurgitation). ewwwwww!
Sunday, March 12, 2006
lions and tigers and bears, oh my?
the day proved sunny yet again today so i set off on a new adventure.
there is this road a few blocks away that winds up into one of the mountains. i was excited to follow it to the end today. i packed some provisions (a scarf, mittens, first aid kit - no bouillon cubes, water, powerbar, and gummiebears) and set out.
the walk was nice.
though everything is rather brown and grey/gray right now.
the paved road turned to dirt.
oooo things should get good now, i thought.
there was this huge white display of excessive wealth hidden up the side of the mountain. i wondered who lived there because the house was so different from the other types in town.
and then the road ended.
private drive.
no trespassers.
drats.
i turned around and headed back down the road to home.
a little disappointed that the road was so uneventful. it didnt even curve.
one straight prairie-like road.
but things got interesting on the way home.
no, there were no lions.
there were no tigers.
there were no bears.
but there was a band of WILD TURKEYS!
turkeys are odd to watch.
i continued walking down the hill, distracted by thoughts of wild turkeys (do they attack?!) and avoiding breathing in the dust of passing vehicles, when i spied a man walking up the hill on the other side of the street. i stared at him a little. I couldnt tell if he was youngish or not. Or tallish or not (tall, married, incomprehensible?). Suddenly the man spoke.
Hello JV.
uh... hello.
how could he tell who i was from across the street? creepy. maybe i need better glasses. maybe all caucasians look the same to me.
it was Dr. L. He was coming back from a run. He asked if i was taking a break. Uh... yes? I'm standing in the middle of a road that goes nowhere in the middle of the day. From what am i taking a break? Did he think i was on a coffeebreak from the hospital? I'm not wearing scrubs. I'm in civilian garb. Why didnt i say i was catching some vitamin D?
I took a last look as he walked past and then i giggled all the way home. I know i shouldnt laugh at people, particularly their physical selves. But i just couldnt help it. It was a classic case of CHICKEN LEGS!
oh man oh man oh man!
Skinny, gangly, hairy, male chicken legs. In 80's style striped cut-off shorts! With bluish man socks. Why do socks look so funny on men when they wear shorts?
I know, i'm mean. Really, you dont need to tell me. But CHICKEN LEGS!!!!!!! Come on! Its so strange to see the chicken legs of a dresspant-wearing health care professional. I'm sure i'll get over it eventually.
Speaking of doctors, this is my beef with them. Well, its not really a beef but more of an awkward ambiguousness. What do i call them? If i'm approaching them at work with a question about a patient or calling them at home or the office, i'll call them Dr. So-and-So. But what about the in between times? If we're joking around or just passing in the hall or on the street, they all say "hello JV" but i never know what to do. Can i call them by their first name? They've never introduced themself by their first name. Or any other name. WHY DONT THEY TEACH US THESE THINGS IN SCHOOL?
there is this road a few blocks away that winds up into one of the mountains. i was excited to follow it to the end today. i packed some provisions (a scarf, mittens, first aid kit - no bouillon cubes, water, powerbar, and gummiebears) and set out.
the walk was nice.
though everything is rather brown and grey/gray right now.
the paved road turned to dirt.
oooo things should get good now, i thought.
there was this huge white display of excessive wealth hidden up the side of the mountain. i wondered who lived there because the house was so different from the other types in town.
and then the road ended.
private drive.
no trespassers.
drats.
i turned around and headed back down the road to home.
a little disappointed that the road was so uneventful. it didnt even curve.
one straight prairie-like road.
but things got interesting on the way home.
no, there were no lions.
there were no tigers.
there were no bears.
but there was a band of WILD TURKEYS!
turkeys are odd to watch.
i continued walking down the hill, distracted by thoughts of wild turkeys (do they attack?!) and avoiding breathing in the dust of passing vehicles, when i spied a man walking up the hill on the other side of the street. i stared at him a little. I couldnt tell if he was youngish or not. Or tallish or not (tall, married, incomprehensible?). Suddenly the man spoke.
Hello JV.
uh... hello.
how could he tell who i was from across the street? creepy. maybe i need better glasses. maybe all caucasians look the same to me.
it was Dr. L. He was coming back from a run. He asked if i was taking a break. Uh... yes? I'm standing in the middle of a road that goes nowhere in the middle of the day. From what am i taking a break? Did he think i was on a coffeebreak from the hospital? I'm not wearing scrubs. I'm in civilian garb. Why didnt i say i was catching some vitamin D?
I took a last look as he walked past and then i giggled all the way home. I know i shouldnt laugh at people, particularly their physical selves. But i just couldnt help it. It was a classic case of CHICKEN LEGS!
oh man oh man oh man!
Skinny, gangly, hairy, male chicken legs. In 80's style striped cut-off shorts! With bluish man socks. Why do socks look so funny on men when they wear shorts?
I know, i'm mean. Really, you dont need to tell me. But CHICKEN LEGS!!!!!!! Come on! Its so strange to see the chicken legs of a dresspant-wearing health care professional. I'm sure i'll get over it eventually.
Speaking of doctors, this is my beef with them. Well, its not really a beef but more of an awkward ambiguousness. What do i call them? If i'm approaching them at work with a question about a patient or calling them at home or the office, i'll call them Dr. So-and-So. But what about the in between times? If we're joking around or just passing in the hall or on the street, they all say "hello JV" but i never know what to do. Can i call them by their first name? They've never introduced themself by their first name. Or any other name. WHY DONT THEY TEACH US THESE THINGS IN SCHOOL?
Saturday, March 11, 2006
the joys of saturday mornings free from obligation
in the early afternoon i went for a walk
down the hill,
across the highway,
past the grain bins,
and across the tracks
to the public library.
Usually i go back across the tracks,
past the grain bins,
and across the highway
and walk along it to the store.
today i decided to take a new way.
the long way.
and i was rewarded for my effort
i found the TRAILER PARK!!
down the hill,
across the highway,
past the grain bins,
and across the tracks
to the public library.
Usually i go back across the tracks,
past the grain bins,
and across the highway
and walk along it to the store.
today i decided to take a new way.
the long way.
and i was rewarded for my effort
i found the TRAILER PARK!!
Wednesday, March 08, 2006
PNS
Post Nightshift Syndrome.
That restless nauseated low tolerance high irritabilty state of being that occurs after working a nightshift and then only sleeping for 5 hours so that you can try to get back on a more traditional sleep schedule and not screw up your natural circadian rhythms too badly.
Last night was my first shift as a Real Nurse. It was also my first nightshift after an unusual stretch of nine day shifts.
My old mentor was working and decided to try to make it as interesting (read: challenging) as possible for me.
Thanks a lot.
The third nurse says it was my fault because i had declared at the begining that we were not going to have any deliveries.
I also said NO ADMISSIONS, NO BARFING, NO CODES.
At the start of the shift i was talking to Dr. T, the doctor on call for the night.
Me: Dr. T, are you stressed?
Dr.T: Yes. Are you stressed, JV?
Me: No.
Dr.T: Are you married?
Me: No.
Dr.T: Ah, well. I am married.
Me: Well Dr.T, that was your choice. You are going to have to learn to cope with the decisions you make.
Dr.T: Yes.
Me: And i shall die a Happy Spinster!
Dr.T: ha ha ha!
This is what happened.
Agatha the frustrating aggravating bell-ringing patient with dementia had been tranferred to the long-term care unit in the basement before the start of my shift. We were all relieved.
I didnt have the 5 cardiac patients i had had on sunday. Well, 2 of them were still with me but they were my sweet old ladies so its ok. I also had two extremely hard of hearing men with dementia who kept coming out into the hall and insisting that it was time to eat. (It is 4 o'clock in the morning. GO BACK TO BED.) So far not too bad. But there was still one more patient. He wasnt being Specialed. But he was still in the ICU room. We dont put people in there without really good reasons. Damn.
My mentor had a very nice woman come into the ER about to have her third child. We called in the Obstetrician On-Call who tried to convince Cranbrook to take her but they wouldnt so then we got to call in the OR staff and the back-up doctors for an emergency c-section.
The Third Nurse took care of the maternity patient and baby so while she was down in the OR and my Old Mentor was in Emerg, i was in charge of the whole ward. Great. It wasnt bad because we only had 11 patients instead of 20. But my patient in ICU was keeping me busy and i had to pee the whole time. Surgery never felt so long.
The mom and baby came out of surgery just fine and the Third Nurse took back her patients and i was left with my 2 cardiacs, my 2 patients with dementia, and a man in ICU.
I was so tired. That "its painful to be awake. its painful to not be horizontal" sort of tired. I spent the whole night praying that i wouldnt have to call a code. I would put my head down on the desk to rest and then jump up every time the cardiac monitor made the bad beeping sound. And that happened rather frequently. One of my ladies had a very low heartrate (in the 30's). My gentleman in ICU also was having a very low heartrate. And he was also having a low blood pressure. As part of the cardiac protocol, if the heartrate is below 50 (which it was) and the systolic BP is below 90 (which it was), atropine has to be given as a cardiac stimulant and a code has to be called.
Every time the bad beeping happened, i would look at the monitor to see if it was ICU man or Cardiac Lady and run into their room to see what they were doing. I was in and out of ICU all night. And every time my ICU man would open his eyes and say he felt fine and wasn't having any chest pain.
I called Dr.T at 3am (boy did he sound out of it) to tell him what was going on with ICU man. I really thought we should have been doing something. Like shipping him out someplace. The Dr wasn't that worried. My Old Mentor wasn't impressed. She made sure i charted everything the Dr said to cover my arse because she said he hadn't really been on the ball so far that night.
A short while later i put my head back down on the desk.
And jumped up when the bad beeping went off and the monitor said my ICU man was in ASYSTOLE! (flat lining).
Beat heart! Beat!
I ran into his room and stood over him.
Suddenly
He grabbed my hand, opened his eyes, and said "good morning".
Freaky.
The other problem with ICU man, besides his slow heart and low BP, was something called sinus pauses. He would have these pauses where heart beats normally would be but weren't. When the computer said that he was in asystole, it was because, technically, he had been. For 4.2 seconds. My ICU guy had a 4.2 second pause. The guy totally needs a pacemaker.
CAN WE PLEASE SHIP HIM OUT?!
In the morning, at the end of my long long shift, i went in to see how ICU man was doing. I was curious to see how he was feeling after being woken up randomly all night and having funny heart things happen.
He said he had an excellent sleep.
That restless nauseated low tolerance high irritabilty state of being that occurs after working a nightshift and then only sleeping for 5 hours so that you can try to get back on a more traditional sleep schedule and not screw up your natural circadian rhythms too badly.
Last night was my first shift as a Real Nurse. It was also my first nightshift after an unusual stretch of nine day shifts.
My old mentor was working and decided to try to make it as interesting (read: challenging) as possible for me.
Thanks a lot.
The third nurse says it was my fault because i had declared at the begining that we were not going to have any deliveries.
I also said NO ADMISSIONS, NO BARFING, NO CODES.
At the start of the shift i was talking to Dr. T, the doctor on call for the night.
Me: Dr. T, are you stressed?
Dr.T: Yes. Are you stressed, JV?
Me: No.
Dr.T: Are you married?
Me: No.
Dr.T: Ah, well. I am married.
Me: Well Dr.T, that was your choice. You are going to have to learn to cope with the decisions you make.
Dr.T: Yes.
Me: And i shall die a Happy Spinster!
Dr.T: ha ha ha!
This is what happened.
Agatha the frustrating aggravating bell-ringing patient with dementia had been tranferred to the long-term care unit in the basement before the start of my shift. We were all relieved.
I didnt have the 5 cardiac patients i had had on sunday. Well, 2 of them were still with me but they were my sweet old ladies so its ok. I also had two extremely hard of hearing men with dementia who kept coming out into the hall and insisting that it was time to eat. (It is 4 o'clock in the morning. GO BACK TO BED.) So far not too bad. But there was still one more patient. He wasnt being Specialed. But he was still in the ICU room. We dont put people in there without really good reasons. Damn.
My mentor had a very nice woman come into the ER about to have her third child. We called in the Obstetrician On-Call who tried to convince Cranbrook to take her but they wouldnt so then we got to call in the OR staff and the back-up doctors for an emergency c-section.
The Third Nurse took care of the maternity patient and baby so while she was down in the OR and my Old Mentor was in Emerg, i was in charge of the whole ward. Great. It wasnt bad because we only had 11 patients instead of 20. But my patient in ICU was keeping me busy and i had to pee the whole time. Surgery never felt so long.
The mom and baby came out of surgery just fine and the Third Nurse took back her patients and i was left with my 2 cardiacs, my 2 patients with dementia, and a man in ICU.
I was so tired. That "its painful to be awake. its painful to not be horizontal" sort of tired. I spent the whole night praying that i wouldnt have to call a code. I would put my head down on the desk to rest and then jump up every time the cardiac monitor made the bad beeping sound. And that happened rather frequently. One of my ladies had a very low heartrate (in the 30's). My gentleman in ICU also was having a very low heartrate. And he was also having a low blood pressure. As part of the cardiac protocol, if the heartrate is below 50 (which it was) and the systolic BP is below 90 (which it was), atropine has to be given as a cardiac stimulant and a code has to be called.
Every time the bad beeping happened, i would look at the monitor to see if it was ICU man or Cardiac Lady and run into their room to see what they were doing. I was in and out of ICU all night. And every time my ICU man would open his eyes and say he felt fine and wasn't having any chest pain.
I called Dr.T at 3am (boy did he sound out of it) to tell him what was going on with ICU man. I really thought we should have been doing something. Like shipping him out someplace. The Dr wasn't that worried. My Old Mentor wasn't impressed. She made sure i charted everything the Dr said to cover my arse because she said he hadn't really been on the ball so far that night.
A short while later i put my head back down on the desk.
And jumped up when the bad beeping went off and the monitor said my ICU man was in ASYSTOLE! (flat lining).
Beat heart! Beat!
I ran into his room and stood over him.
Suddenly
He grabbed my hand, opened his eyes, and said "good morning".
Freaky.
The other problem with ICU man, besides his slow heart and low BP, was something called sinus pauses. He would have these pauses where heart beats normally would be but weren't. When the computer said that he was in asystole, it was because, technically, he had been. For 4.2 seconds. My ICU guy had a 4.2 second pause. The guy totally needs a pacemaker.
CAN WE PLEASE SHIP HIM OUT?!
In the morning, at the end of my long long shift, i went in to see how ICU man was doing. I was curious to see how he was feeling after being woken up randomly all night and having funny heart things happen.
He said he had an excellent sleep.
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