finally a format...

i can't believe that i have not formatted this computer since early 2005. what a shame, really. i never usually wait that long. ever. but boy oh boy is my computer running smmmmooooooth!! it just feels good to have it feel like new again. too much stuff accumulates after so much time, you just have to format to get it good and clean again. now, the microsoft updates must be for dummies because it took me forever and a million years to update everything. and had to validate windows 100 times over to make sure it was genuine.... isn't once enough???

well not much else to report other than xmas coming soon, we all know this! that's all!

Long Night, Indeed

Got called in to work last night around 11:15. Just told that they really needed my help in the unit, which is okay but that was all I was told. Little did I know that I would be walking into a full code situation, several times over. Seems we spent a good amount of the first 4 hours strictly in that room, only getting about 30 minutes before we had to code the woman again. She was 40 years old and brought in unresponsive. Pupils fixed and dilated. Epi would bring her up, but once it wore off, she would brady down and no perfusion. Finally, the family said, just one more time and then we don't want you to do the chest compressions anymore, but leave her on the ventilator. They got to spend some time with her for about 45 minutes before she brady'd down and went asystole.

At least when dealing with a patient, we are able to compartmentalize our emotions and do what is necessary. It is when dealing with the families that we aren't as able to do that, and emotions can just erupt. Not one of us in there had a dry eye. For me, it was their singing of Amazing Grace that really got to me, and then her 15 y/o son having to experience the death of his mother just a few days before Christmas. We do what we can to be strong for the families, but the truth is, this affects us, as nurses, just the same as it may them because we invest emotionally into our patients.

I wish this night had a different turn out than it did, but we did all that we could do. The only thing really keeping her alive was the epi, and once we stopped that, it didn't take long for her to follow on nature's course. Once we got her cleaned and the family taken care of, we got another new patient. A 24 y/o man with sats in the 80's and LOC of obtunded. Reasoning was unknown other than a possible od on perhaps methadone or benzos. Another sad situation really, and quite a complex situation. Not sure how he will turn out, I suppose that is all in what happens over the next 24 hours. Luckily for me, I am going to Christmas party this evening and am NOT going to work at all. Even told them, don't bother calling because I am not coming in. I hope the night goes well for them, even though I wasn't upset to have to go in last night. Being able to help your colleagues once in awhile makes a person feel good, even if you work your ass off all night for it :)

Christmas Shopping

I didn't realize how difficult it could be to buy items for a 13 y/o boy. Suddenly the shirts he wants are $50 and pants are $70 a pop. I understand though because I wanted name brand items when I was a teenager, but that certainly didn't start until I was well into high school, more like my sophomore year and beyond mostly. Now everything just seems to start much sooner. I told him that he has to understand if he wants the more expensive stuff that he will have to settle for less presents because even though he might have less to open, the money spent will be the same. Of course he doesn't understand that! (all kids think that money grows on trees, right??)

Actually, the biggest problem that I have found while shopping for christmas stuff is that most kids seems to wear the same size clothes that mine do because those are the sizes of all the cute stuff that is completely sold out! Go figure? Lots of all the other sizes but the ones I need. Anyhow, I need to go out and finish some of this shopping.

Asystole?

Typically, when you think of asystole, you would think of a flat line on the cardiac monitor right? Well, our monitors out on the tele floor are just very sensitive to movement and such, and sometimes, the asystole alarm will ring with a rhythm full of artifact. Unfortunately, the nurses on the floor have become a little complacent because these alarms ring off all of the time for nonserious things. But the other night, it so happened that it rang off for asystole, and this time the rhythm was not full of artifact, but instead looked like there was a slight ventricular beat but that was about it. Being the astute student nurse that I am, I said to the charge nurse.. "hey, this one is for real." I took off immediately for the pt's room to check the pt.

He was arousable, and I immediately checked all of his leads. Got him to sit up on the side of the bed, and finally the charge nurse decides to come down to the room. She asks the other nurse at the monitor was it said now, and they told her that his hr was in the 70's, so she left. (not exactly the best thing to do, but it was her last night at the hospital as she was moving away, so i dunno if she cared?) i got a BP on the man, and it was about where he had been running. I told him that his rhythm had changed and we had to make sure he was ok. I told him to lie on his back or on the other side for a bit and we would be back soon to check on him.

I went up to the desk and got the print out of this rhythm and took it over to the unit for the nurses there to look at. They said that his pacemaker wasn't firing, and that is why his rhythm looked like it did. They asked if he was okay, and I said he seemed fine. I went back in to check on the patient, and he was still sitting at the side of the bed. I checked his leads once again, and when he had moved, his red lead had come off, so I fixed that and let him go back to sleep. There were no further incidents the rest of the night.

Now the man was admitted with vertigo and dizziness. When his pacemaker failed for those 3 minutes, the reasoning behind his symptomology became clear the next day for the doctor who evaluated this occurrence and all of the symptoms he had been having. Luckily, we were able to capture it on the monitor for evaluation. His pacemaker was failing and would need to be replaced. He may not have been a true asystole, but it was a serious incident that will hopefully get these nurses at the tele station to realize that they need to pay much more attention to those monitors. (in my opinion, anyhow).

Yeah!

Finally, this semester is really, really over! Passed my final exam with flying colors and am now ready to finish the last 15 weeks of the program. I cannot begin to tell you just exactly how excited I am to be that much closer to my degree :)) Graduation day is May 15 and coming up soon! *pats self on back for a job well done!*

last class!!

Finally! Our last class of the semester was today. Too bad I was too tired to enjoy it. Our final tests are on Monday with finals on Thursday :) I am soooo happy to finally be done. Now just one more semester before graduation and I cannot even begin to relate the load that is slowly coming off of my back. Woot! :))

Hoping to have more time to post some stories and stuff and get this blog completely updated over break. See you very soon. Gonna be a busy weekend with work and studying :)

goodness, time just flies by

well we finished our fall break without incident, for sure. just have one more test this semester, ati, and then our final exam. i am so excited to be just almost finished with just one more long semester to go. unfortunately it is going to be filled with nothing but med-surg, and i have already been forewarned of just how difficult it is. i just want to be done, but moving ahead slowly but surely. this semester has seemed to just simply fly by. i can remember our first clinical in the psych hospital, and now of course, we are finished with clinicals for this semester. having gone through all of the OB stuff has been really exciting. it will be difficult to go back to the other stuff and have to relearn and review it all over again in even more detail than before.

work has still been crazy with the census fluctuating from shift to shift it seems. we have been blessed with warmer than normal weather lately and people just aren't really sick yet. i have a feeling that when they finally do succumb, we will be getting slammed. i am ready for all the learning experience i can get in the icu over this winter and spring so that when i graduate, i am ready to work. i will probably have to work on the floor to begin with, but i still hold out the possibility of working in the unit when i graduate. that is why they are spending the time with me to work in there, because that is where they are planning for me to work if there is a spot open.

A break!

well finally we have reached our fall break (or thanksgiving break really). i am so excited not to have to look at anything for a whole week... well if that were exactly true it would be nice. we will have our second peds test when we come back, so i plan on reviewing so i don't have to cram it all in at the last minute. i hate cramming for a test. 3 more weeks before our final exam an then a glorious 15 weeks left of school before i graduate. i am getting so burned out on studying that the day cannot come soon enough for me. unfortunately, i am scheduled to work for most of my break, so no real vacation for me. it would be nice, but my kids want to play youth basketball, so have to earn the money for that! :)

Random Ramblings

I am so happy to be almost finished with OB. We have our last lecture on it today with our testing on Monday. Not that it wasn't a fun and interesting rotation. I actually loved it. But it is another milestone conquered in the happenings of nursing school. We are left with Peds for the rest of the semester, and I am so very thankful to have completed that clinical rotation. We all know that caring for sick children can be very demanding. In fact, it is probably the parents that can make the experience even more difficult. I just know that I am not cut out to be a Peds nurse at all, ever.

Census is still down at the hospital, so it seems on the weekends anyhow. Or at least there haven't been too darn many critical patients. In a good, perfect world, that is really is a GOOD thing, right? But man does it ever make my paycheck stink. I need people to be sick enough to be in the ICU so that I can work and learn, don't they know this? It is times like this when I wish that I would have just stayed out on the floor instead of being a little hot shot and transferring over to the unit. I know I made the right decision for myself, just perhaps not my paycheck. I love working in the unit though, and I wouldn't trade the experience for the world.

What do you say to a fellow student who thinks that she is the know all to everthing, talks over you in clinicals, interrupts when the instructor is asking questions to answer the question that was asked of you? Do you just let her go on and make a fool of herself because she doesn't know when to shut up? What do you tell her when you are going to do some patient education, and it is her wish to follow you, knowing when she gets in there, she will take over and mark it down as her accomplishment? Well I let her talk over me in front of the instructor so that the instructor could see what she was doing, but when it came to my patient, I politely told her, "I think I am going to do this one by myself, thanks." Yeah, it pissed her off pretty good. She won't talk to me, heck she won't even barely look at me. I don't see how this is my problem anymore :) I know she is sensitive to matters like that, and I am sure that she took it personally when I said I wanted to deal with my patient by myself, but that is what we are supposed to do! I certainly didn't follow her into her room and interrupt her whole educational session with her patient. I know she just wanted everyone around to know that she knows everything. Well, now she can go bother someone else because I am sure she won't bother me anymore.

have to run to class in a few to get our last OB lecture. ciao.

a mini vacation...

census is down and i did not have to work ALL weekend long. i cannot even begin to tell you just exactly how much i needed these days off to recover from lost sleep and whatnot. it was beautiful. really. so did i get to work on the project due at the end of the month? nope. did i review my study notes from the lectures? nope. haven't cracked a book or looked at anything to do with nursing in 3 whole days. i feel like a new person though! i feel like i might actually be able to concentrate in class tomorrow. i am refreshed. renewed. ready to finish out the rest of the semester. i try not to think of next semester when we have med-surg II. i have heard the horror stories. i have heard just exactly how hard it is. i don't want to go back to hard, but i don't have a choice, do i? although i am more comfortable with the knowledge that we get with med-surg. it is more focused upon the stuff we will really see in the hospital. i love ob and i love the newborns, but in my area, there is no hope for a job there. those people just never leave. they stay in that unit for years and years and years. i will have to move if i have ob aspirations. even in the icu, the same goes for in there as well. another unit where people aren't inclined to leave or even transfer out. i will have to move if i plan on having a job in that area. although there is one possibility of a person leaving, i just have to hope that they hold out til may or close to it. but i will probably have to chose the med-surg/tele mixed floor where the unit director wants me to start until they have an icu position open up. i want options! i want to make the decision for myself. i don't want to feel pushed into accepting a position that i might not want. sure i still have several months before this arrives, but they are already discussing it, without me, of course. and still, people ask my opinion, where do i want to work when i graduate? i always answer the same and tell them that i don't know. i don't know what will be open when i do. somewhere in there, they aren't getting the options message. i suppose i just need to lay it out for them and tell them that i don't want to commit yet. that this is a decision i need to make on my own. will they listen? nah. i doubt it. all they see is a potential person to fill that open slot on nights. sigh. i know new grads often have to work nights because days gets the more experienced nurses. i even don't mind working nights. but that is still them making the decision for me. i will figure it out. soon.