Updates and musings from one momma nurse


Wednesday, August 26, 2009

Two stories

Story One:
I come on shift and find that Susie Q Patient is one of my assignments for the evening. Susie has a history of some mental health issues. Susie is a little impulsive and sporadic in conversation, so I set her bed alarm before I leave the room after taking her initial vital signs. I'm afraid she will try to get out of bed on her own and end up falling.

Within a few minutes I hear the bed alarm go off. I come in to find Susie on her way out of bed, and there is a strange smell. "Are you smoking?" I ask. "You can't smoke in here, this is a hospital."

"Oh, I didn't know that, just help me out and show me where I can go to smoke."

"No, it is a hospital wide policy, you cannot smoke anywhere on the grounds of the hospital." At this point I am still trying to locate the dang cigarette. Finally I find it, IN BETWEEN THE BED AND THE RAIL. Yes, please do what you can to burn down the hospital.

I dispose of the cigarette, then as I am pulling her pack out of her bag (charge nurse told me to confiscate them), she offers me her lighter, too. Well alright, I will take that too!

Story two: (Less funny, more warm-and-fuzzy)
Mildred P. Oldlady has just had surgery that day. She is anxious about recovery, and Mr. Oldlady is not doing much to relieve her anxiety.

I do what I can to be reassuring, anticipate needs, etc. Standard plan of care on my part.

Toward the end of my shift, it's clear that Mildred will be needing a catheter inserted. I go to let her know, and she starts freaking out. Completely unexpected response. Come to find out, she's never personally had a catheter, and the only bystander experience she's had was extremely negative. Just the mention of catheters brings up all sorts of emotional memories for her.

Holy smokes, looks like I'm going to need to do a little bit of holistic care here.

When I come in to do the actual procedure, I do a whole lot of explanation. I tell her just about everything I'm doing and why. I tell her what she can expect in the following few days related to the catheter. I have her tell me a little more about her fears. I teach her a simple breathing exercise (4x4 breathing) to help focus her energy.

When I have finished, she says she hardly even felt the catheter go in. She is visibly more relaxed than she was when I had first given her the news about needing a catheter.

I come in a little later to check on her, and she says she has been doing the 4x4 breathing ever since I had left the room, and she loves it. I make sure to come say goodnight before I clock out, and she says she will not forget me, and that I have made a difference for her.

Ah, patients like Mildred and situations like this are why I am becoming a nurse!

Attention span?

Wait a minute, when did MY child get the beginnings of an attention span?

The other day I decided to check on her, since she had been playing in another room and I hadn't heard anything from her in a while. I walk in to find her lying on her belly looking at one of her books. When she saw me, she jumped up, grabbed a stack, and asked me to read ("Mook?").

Wouldn't you know it, she sat on my lap and we read three whole books and the first half of another before she got bored and wanted to do something else!

This is the kid who flips to her favorite pages and will spend a few minutes on those, but rarely does an entire book start to finish.

She also had her 2 year well child appointment this week, and it almost went more smoothly than usual. :)

She hates being at the doctor's office, no matter who the patient is, and screams and hollers till we leave.

This time I tried to prepare her a bit, talking about what they were going to do. We even practiced stepping up on our scale at home so she could see the numbers and see how big she was getting.

That part worked beautifully! She stepped up and stood still long enough for the nurse to get a reading. (Usually we have to weigh me with and without her and subtract, cause she throws such a fit.)

But then it kinda went downhill from there. Even though we talked about how the doctor would listen to her tummy with the stethoscope, she wanted no part of it. She was ok with the doctor listening to ME, but not to her.

And the shot? Oh goodness.

And here's one: Doctor wanted her to get blood drawn to do an H/H and lead test. They did not stick her foot like I expected. Nope, they busted out a tourniquet and actually drew blood from a vein in her arm! Holy smokes, she was not a fan. We had to hold her down hardcore to keep her still enough to get poked in the right spot. Technician commented on how strong she was, lol.

Anyway, she's doing well. She's back up to the 75th percentile for height and weight, and her head is off the charts again.

I have a few work stories, but I'll save them for a separate post.

Monday, August 17, 2009


I am officially on break now (for about a week and a half), and I have every intention of fulling enjoying it.

Last night after work, instead of staying up insanely late working on homework, I went to bed at a reasonable hour. This morning, I slept in past 8! Heavenly.

On the docket for today:
-make a couple doctor's appointments (DONE)
-freecycle our couch (DONE)
-vaccuum where couch used to be (DONE)
-get new-to-us couch from R's aunt (Call made, will be here later today)
-put away clean laundry
-wash and dry at least one load of dirty laundry
-take a walk if the weather clears
-turn in papers for Sweet Pea's new daycare
-spend quality time with Sweet Pea (IN PROCESS)

This is so doable.

The Staff Assist button is NOT a toy!

Three times this weekend, someone visiting a patient on my floor has hit the Staff Assist button, when all they wanted was a glass of water or some pain meds.

Hey, Einsteins.. that is what the call button on the remote is for. Can you see it? The button is red and has a picture of a nurse on it. The patient knows how to use it; he's been using it all day.

The Staff Assist button (which is located completely out of the way, behind the bed, next to the CODE BLUE button) is intended for use when a Staff member needs immediate assistance from other staff, like if a patient has fallen or has become violent.

We don't mess around with the Staff Assist button. If you push the button, you will get several nurses and aides in the room within 10 seconds.

Don't waste our time by hitting it unnecessarily.

Thursday, August 13, 2009

23 months

First clinical is over, and hurray, I passed! It got better and better as the weeks went on, and though I have a long way to go, I feel that I learned a lot and grew in confidence.

Sweet Pea (23 months) is undeniably no longer a baby. I am amazed at all she can do, how quickly she picks up on concepts, how much she knows! She knows most of the basic colors (green sometimes gives her trouble) including gray and brown and black, counts to 4 on her own and to 10 with help, recognizes some letters and shapes, and has been talking more and more. It's hard to believe three short months ago is when she really started saying words!

She likes to sing (I catch her singing to herself in her crib in the mornings), taking walks and pointing out evvvverything she sees. ("Car. Red!" "You see a red car?" "Yeah! Bike. Helmet, no!" "Yeah, he isn't wearing a helmet, is he?" "No! Inside?" "Sure, maybe he left his helmet inside today." "Ball! Boy! Green car! Kitty, eow!"), scooting around on her ride-on toy, toting her baby doll around (changing her diaper, taking her to the door and pointing out all the colors of cars to HER), and coloring. Oh how we love coloring!

She is a sweet girl, sleeps well, can sometimes entertain herself, and even picks up and puts away toys when she is done with them!

She starts daycare this fall, which I'm sure will be a tougher adjustment for Momma than for her!