if you ever remember anything...

this wise words came from my preceptor at work... about blood transfusions. You have to understand first and foremost, she is quite an anal person. But anal is good in nursing, after all, we do have some responsibility and accountability for our actions and misactions. So anyhow, she is telling me, "if you ever remember anything about blood transfusions and blood warmers, always remember that the tube coming from the warmer goes directly into the iv site." Now I am not sure if the previous nurse that had set it up did it wrong, but by the look on her face and the disgust in her tone as she said this to me, but I assumed that it was indeed, set up wrong. I can already tell from my other experiences with blood, that it is not a fun task, not at all. I mean so many things can go wrong, and you have to continously monitor the pt's condition along with all of the other patients on the floor as well. Anyhow, keep those words in mind, tuck them away into a memory to be used later. I really would like to talk about the person who was receiving that blood, but first, I have to give another word of warning about blood transfusions. When running them as secondary piggyback, always make sure that the secondary is running and not the primary. This could cause big problems (like air in the filter!), especially since blood can only hang for a predetermined amount of time (4 hours). Tuck that information away for future use as well, I promise it will most likely come in handy.

Now about Mr. Transfusion... such a lovely fellow with a GI bleed who was absolutely zonked on pain meds the first part of the shift and all through the transfusions. Never even knew what was going on I believe. Working the floor like this, I don't usually get to go through the entire charts and learn everything about everything, but mostly just observe and assist when needed. So anyhow, halfway into the shift he springs to life. As I am entering the room for the second set of vitals, this man has his jeans on, and he is bound and determined that he is going to make a phone call, at 4:30 in the morning. No idea who he wanted to call, he just had to make a call. In fact, he demanded that someone wheel him downtown to make his call. As I tried to calm him down and assure him that he would be able to call from his room, he got a bit more agitated and things weren't looking so hot from my angle. So I went to the charge nurse and let her know about this patient and his demands and his agitation. From further assessment, it was pain driving his agitation (as well as an extensive etoh abuse history), so he received his pain meds which sent him back into the lovely pt he had been at the beginning of the shift. Sometimes I do find it intriguing when a pt throws you for a loop, this time however, I was just happy to have him sent to his own personal la-la land where I know he was much happier.