Updates and musings from one momma nurse

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Monday, November 28, 2011

No Wonder I'm Tired

The beginning of my shift went something like this.

0715- Get report from offgoing RN. Find out Patient A will need two units of blood. Blood isn't ready yet.

0720- Start to look at charts. Make it through one.

0730- Call light goes off. Patient B needs to use the bedpan, and is very particular (read: slow) about it.

0740- Go back to charts. Make it halfway through a second one.

0745- Another call light goes off. Patient C needs to get up to the commode, and though she moves steadily, she certainly does not earn any prizes for speed.

0755- Back to the charts.

0800- Another call light. Confused Patient D engages me in conversation for a while before I can politely excuse myself.

0820- Finally finish with charts and make it to the med room to start pulling up morning meds.

0840- Lab calls and lets me know about a critical hemoglobin on one of my patients.

0842- Discharge planning.

0845- Spy doctor at a nearby computer. Notify him of aforementioned hemoglobin. Receive orders to transfuse two units.

...You get the idea, no?

The rest of the day went something like this:
Start a unit of blood, put someone on a commode, take a set of vitals, take someone off a commode, receive a call from somebody's family member, pass some pain medicine, page a doctor to clarify an order, start another unit of blood, receive call back from doctor, remind confused patient how to use call light, call report to ECF, check on blood again, discharge patient, grab some saltines to tide me over, sit down for approximately 7 minutes to chart a couple things, finish a unit of blood, head to lab to get another, start another unit, give a suppository..

Lather.
Rinse.
Repeat.

Tuesday, November 15, 2011

Thanks, I think.

One of my more demanding patients recently told me that I was "one of the better ones."

I think it was meant as a compliment.

During my initial assessment of a new (elderly) patient, I asked her why she was here. Her response: "I just had a baby downstairs. Have you seen my baby?"

Monday, October 3, 2011

Our Family Has Grown!

I realize it has been a while since the blog has been updated, but I promise there is a legitimate reason for that.



I'm on leave, so I don't have new work stories.



And this is the reason for leave:


Brighteyes made her grand entrance last month, and we are thrilled to be a family of four!



Sweet Pea (who recently turned four) has had some moments of jealousy, and demands snuggles more often than usual, but she is doing really well in her new role as a big sister. In fact, we often need to rein in her enthusiasm a bit.



I look forward to seeing these girls interact as Brighteyes gets a little older.



I'm so blessed to be a momma to these two girls!

Friday, August 12, 2011

Nurses = Detectives

Please, for the sake of your healthcare providers, keep a current list of your medications with you. Otherwise something like the following may happen.

Nurse: So what medications are you taking?
Patient: I don't know what they're called. I'm taking about 28 of them, I think. I don't know what they are for.
Nurse: ...Ok, let's figure this out. Where do you get your prescriptions filled?

(Later)
Nurse: Hello, Goldman's Pharmacy? I'm trying to figure out John Smith's home medications. Would you be able to fax over a list of his active prescriptions?
Goldman's: No, we can't do that, but we can read them to you over the phone.

(Later)
Nurse: Hello, Dr. Jones? You are listed as John Smith's primary physician. Can you fax over a list of his active prescriptions?
Dr. Jones: This patient has never been seen here.

(Later)
Nurse: Hi, Goldman's, it's the nurse again. Can you tell me who prescribed each of those medications you read to me earlier?
Goldman's: Sure, it was Dr. Seuss, Dr. Who, Dr. Carter, and Dr. Strangelove.

(Later, after some googling to find phone numbers)
Nurse: Hello, Dr. Seuss' office? Please tell me John Smith is an active patient with you.
Dr. Seuss' office: Oh, Dr. Seuss retired earlier this year.

Nurse: Please, for the love of all that is holy, let Dr. Who be John Smith's doctor..
Dr. Who's office: Oh yes, but that patient has not been in for about 6 months.
Nurse: So you have a list of active medications to fax me?
Dr. Who's office: I can't do that, but I can fax you the list that the patient provided to us on a crumpled, faded piece of notebook paper.
Nurse: And those are current medications?
Dr. Who's office: I have no idea. I'll just fax it and you can sort that out yourself.

(Later)
Nurse: This is the nurse, leaving a message for the specialist, Dr. Strangelove. Pretty please call me back.

(An hour later)
Dr. Strangelove's office: Yes, we saw that patient less than a month ago. We can't fax you a list either, but here, I'll read it to you.

(Later)
John Smith's family: Hey nurse, we are here to visit John, and we brought a current list of medications on a crumpled, faded piece of notebook paper. Want it?
Nurse: AHHH WHERE WERE YOU EIGHT HOURS AGO?

Thursday, June 30, 2011

Double Check That

Sweet Pea and I came back home from running errands, only to find a couple cars parked behind our garage.

As I started to unbuckle Sweet Pea, a 20-something young woman got out of one of the cars and cheerily said, "Hi! I'm here to buy your couch!"

"Excuse me?"

"We talked on the phone, and I'm here to buy the couch you're selling."

"..Yeah we don't have a couch for sale. You talked to someone here?"

"Yep! This is 123 Main St., right?"

"It is, but I don't think you want our couch."

20-something young woman makes a phone call, then hangs up and looks sheepishly at me. "I guess the couch is at 1234 Main St. Whoops."

Monday, June 27, 2011

Honesty

At the end of my shift, I walked by the room of one of my (older, confused) patients and saw she had her legs scooted to the edge of the bed.

I walked in and asked what she was doing.

She looked up at me and replied, "Oh, trying to escape again."

Sunday, June 5, 2011

Letters

We enjoy watching Wheel of Fortune together as a family, and I suppose I may get a little animated once I've figured out the puzzle.

The other day, a new puzzle came up on the screen, and Sweet Pea leaned forward and hollered, "Cheese and butter! Cheese and butter! CHEESE AND BUTTER!"

We went out to dinner with friends, and in the middle of our conversation, Sweet Pea piped up with, "Hey! Do you like cheese sticks?"

Wednesday, June 1, 2011

Pain Scale

Me: So how are those pain pills treating you? Helping with the pain at all?

Patient: Oh yes, they are definitely helping.

Me: You rated your pain at a 10 out of 10 earlier. How would you rate your pain now, after the pills?

Patient: Oh, still at a 10. My pain will be a 10 as long as I'm here.

Me: ?

Tuesday, April 26, 2011

Recognition

Checked in a patient who had been on our unit several months ago, and before I could introduce myself, he called me by name and asked how I was!

Wednesday, March 30, 2011

Delegating

"Mama, mama! Oh, my baby is calling for me. I'm the mommy." (walks over to baby doll and picks it up, then hands it to me) "She says she's sick. You're the daddy. You take care of it." (walks back over to rocking chair, grabs a book, and puts her feet up) "I'm busy right now!"

Tuesday, March 29, 2011

Cooties

What did you play with your friends this morning? "We played Cooties." Oh that sounds like fun. How do you play? "Well, first you pick the winner, who picks all the cards. And then they SMASH the bug. And then you give the player a high-five. And then the player goes to a different center. And everybody gets a turn."

Wednesday, March 23, 2011

Fun with Delirium

You know it's going to be a fun day at work when you assess your patients and realize that only one out the five can tell you where he/she is.

Some of my favorite exchanges:
Me: Do you know where you are right now?
Patient 1: I have no idea.

Patient 2: Did you work on the highway last summer, too?
Me: No, last summer I worked here as a nurse, just like I am right now.

Me: Your dressing is off again. That needs to stay on so your wound can heal.
Patient 3: Are you saying I'm doing that?

I come in to find Patient 4 out of bed, standing sans-gown in the corner of the room.
Me: Why are you out of bed? No weight on that leg, remember?
Pt 4: You need to call my parole officer.

Pt 2 again: How long have you worked at (local grocery store)?

Thursday, March 17, 2011

Her First To-Do List

We had a limited amount of time this morning before a scheduled activity, and numerous things to do to get ready.

I reminded Sweet Pea of all the steps, but she was just not in the right mindset and we weren't clicking.

I decided to try something new for us: A pictoral to-do list.

It's not a brand-new concept; many people use it in various settings, but this was the first time we had tried it.

So she and I brainstormed the steps to getting ready, and I drew a picture to represent each step.

Then she could see what her options were, pick one off the list, and then check it off when she was done and see what was left.

Still needed a little redirection at times, but she took more ownership over getting ready.

Here's our list, midway through completion.


In case it is not abundantly clear (I am not the greatest artist), the pictures are of a book (gather library books to return), a toilet (go potty), cup/bowl/spoon/placemat (eat breakfast), clothes (get dressed), and then a car and the library.
Fairly successful! We will likely repeat this strategy in the near future.

Saturday, March 5, 2011

Pewshing

This afternoon, Sweet Pea decided to play dressup. With her Cinderella dress, flip flops, and long white gloves on, she picked up a parasol, leveled it, and jerked it back and forth a couple times.

What are you doing, Sweet Pea?
"It's a gum."
That's not a good game to play. What do you know about gums?
"All my friends at daycare pewsh the gums at all the girls, and we run away."
Pewsh? What is that?
"Yeah, the pewshing game. When you pewsh."
..How do you do that?
Sweet Pea makes two fists in front of her, sticks her thumbs up, and makes a sound effect like "psh".

Crud. Time to sit down and have a chat! Amazing how much a kid can learn from peers, eh?

Monday, January 31, 2011

Watch out for those wild animals.

(I have several pictures to upload, but that will have to wait for another day.)

Little old lady, confused as all get out, has recently had surgery and persists in climbing out of bed and attempting to leave the room/floor/building. Because wild animals are about to come in, and she is going to bleed to death, and everyone is trying to kill her.

We discuss safety. We discuss a need to heal. Reorienting only helps for about 20 seconds at a time, and then she is hollering my name again.

I redirect little old lady back to bed. Again.

She looks up at me and says, "What happened? I thought you were my friend!"

"I'm not your friend. I am your nurse. Those two don't always overlap."

Wednesday, January 12, 2011

11/365


Our little leftie?

7/365


A glimpse into the future? Hopefully she'll have better vision than I do.

4/365


Sweet Pea's "cheese" face

(After this is where I skip a few days in the 365 project. Surprised?)

Monday, January 3, 2011

Sunday, January 2, 2011

Thanks, Dr. Google.

"You know that pain medicine button? Is it true that there isn't really pain medicine in there? That it's all in the patient's head? My friend told me it's actually an antibiotic. That's not very nice to trick the patient like that."

*facepalm*

1/365, 2/365

I make no promises that I will update daily, nor that I will get all 365 in by the end of the year.

However, I am going to attempt to record daily some aspect of our life through 2011. I'm sure the majority will be of Sweet Pea, but there may be other subjects thrown in there from time to time. I suppose it depends on what is going on.

Here is January 1. Sweet Pea, reading a new book and eating peanut butter off a spoon to get rid of hiccups.



January 2 saw Sweet Pea using her workbook (a Christmas gift to familiarize her more with letters). We're nowhere near proficiency, but she seems to enjoy it. Here's a sample page from the day.