big day back

Yesterday was my first day leaving Moose to go to work. He was under the excellent care of his nurses and doctors, but still. It was stressful. Also, I had a long night rocking him and sleeping in the chair.

At 0800, my admission rolled through the doors with no warning or report. A code from the floor, so the whole code team rolled in, with the other 50 med students/gawkers hot on their tails. Oh, and the patient was head to toe covered in blood. As were the members of the code team, and her bed, and her equipment. It was really a sight. After getting her into the room, she lost a pulse again. At least, I couldn't palpate one. I'm not a great femoral pulse palpator though. But anyway, we did more compressions and 1 of epi, we got a good pulse and sinus tachy. It took several of us to organize and clean her up, but we finally got her stabilized and presentable.

Then let the family fun begin! Everyone, especially husband, seemed to agree that with her advanced stage IV cancer, she had already been nearing the end and would not want to spend it on "life support". Ok, that's great, we would withdraw. But no, wait, oh my god, there is a new DPOA form from last night in her file, where she (very strangely) had switched her DPOA from her husband to her best friend, and detailed out that she wanted to stay on a vent until 12 months had passed. What?! Totally different from what her family and friends had discussed with her.

Hours of detective work later, it was determined that she had had altered mental status at the time, some nurse or someone had helped her fill it out, but it was not complete and therefore not legal, and everyone was able to agree that she would not want to live out what remained of her life on life support.

So we withdrew.

Whew. What a day.

the day before Moose

The day before my life changed forever was this last Tuesday. I had a Down Syndrome patient who has a very bleak prognosis. Not that we couldn't get him through the acute phase, but it was difficult to imagine he would have much quality of life anymore. It was so hard on his family, and I really connected with them. I felt like I did some real good in the world when they told me that I explained things so well, and wanted me to talk to everyone else in the family. It seems like a lifetime ago, but it was a great couple of days taking care of them, and made me realize again why I do what I do.

I was also told that some of the "gossipers" had been saying I was lazy. I was so annoyed. Mostly because I don't like to not be liked. I feel like I am SO nice to everyone, and go out of my way to offer my help. If I have downtime, and someone asks me to help them, I'm there in a second. I'm happy to do it. These particular co-workers do not even talk to me. They don't ask me for help or include me in any conversation at all. Nevertheless, should they ask me anything, I would happily help out.

Grrrr. I really don't like that feeling. Such snobishness. It's way less than on my last unit, but it's still there. I just don't have thick skin, no matter how I try.

So on Tuesday I was glued to my phone (even though I try never to carry my phone around with me while I'm working) because I was waiting to hear if I would receive my very first foster placement since I was licensed in April. And it happened. I am now the proud (tired) foster mom of an adorable 3 month old little boy I call "Moose". He was a premie at 29 weeks, so his adjusted age is 3 weeks old. I love him to pieces!

The nursing part of all of this is that he's still on O2, and I'm managing his sats and tracking how much O2 he needs until his next steroid injection. I've got a little O2 and HR monitor, concentrator, and humidifier all set up. It's the little mini one baby ICU in my living room. It has made becoming a mother overnight a little easier, because I can feel so in my element as half nurse as well as mother.

If you want to follow the my foster care story, head over to All My Pretty Ones.

exhaustion

Am I getting old or something??? I'm only in my late 20s! But whenever I work 3 12s in a row, I just am plain exhausted the next day. I can't fight the sleepiness. I sleep for around 24-36 hours afterwards! I do struggle with Excessive Daytime Sleepiness but the 3 in a rows really exacerbate it. I guess I can't do it anymore.

On the other hand, it's not like my job is THAT strenuous! I had one day with a floor status patient, who generally just slept, and two days with a filter patient who was out of it. So what did I really do besides just hang out, change the filter bags, chart things, and do one bath? I mean, that's not exactly hauling bricks for 12 hours!

I have to get my sleepiness under control. I will be going to the sleep clinic. In the meantime, working on going to bed earlier and trying to stay more active and busy during the day. Bah.

In other work-related news, I am running another clothing sale. When I first joined the ICU I immediately wanted clothing with our unit logo. They said sure, go for it. Apparently if I wanted to do that, I'd have to set it up myself. I did and it went pretty well. This time I've gone with a different company, and offered some different clothing items as well as taking away the scrub options. We're allowed to wear t-shirts/sweatshirts and by and large that's what everyone wants.

I enjoy doing these sales because it gives me a chance to interact with my co-workers and do something for them and the unit.

Ah just remembered a dream I had where I found out some of my co-workers didn't think I was good at my job and resented me taking filter patients. Ouch, insecure much?

I dare you

I did tube feed shots with an intern. Osmolite 1.5. I thought it would have a vanilla-y taste.

It didn't.

Liquid cardboard, concentrated, soaked in whole milk.

Bottoms up!

overheard a resident saying...

"What?! Wikipedia was WRONG???"