Sunday, October 5, 2008

READY, SET, GO!!!






The black and white flag is down, and the race is on!




Report is over, time to check each patients labs, blood pressures............my phone is going off ALREADY!




This is Tami, can I help you? You're IV is beeping? I'll be right there! Didn't get to check tele yet.



Oh, no, this IV is leaking. Looks like we need to change it. Dang phone... This is Tami can I help you? Ok, I'll get my aide to help you to the toilet. Go get supplies for IV restart.





Success! This IV should last a couple days. What, you need pain meds now? O.k. Let me get them with the rest of your morning meds.



Phone rings.... You need help to the bathroom? (didn't they just call 4 minutes ago... I called my aide, did she not help my patient to the potty?). I'll be right with you.



I still need to help the other patient to the bathroom. That's two that need toileting. I still need to check my tele strips. I still need to get all my a.m. meds! It's nearly 8:30.



Phone rings.... Can you... please...into....room......



What? I couldn't even understand what they just said, but it didn't sound like the patient in that room. I better go see what he needs, he's the heart surgery patient and may need my help. Oh, hi Dr Kim....yes, I can stop the amiodarone drip and pull out his IV, then restart it! (RIGHT! He has absolutely NO veins and needs another stick. I still haven't seen my strips! Still need to go get everyones meds and it's almost 9:00 o'clock and I STILL NEED COFFEE!!!).







Man, I gotta go before my bladder bursts, but I've GOT to get meds and start another I.V. Better check orders! Oh, it looks like 104's going home. That means I get to take out the IV I just PUT IN! Wonderful. Get my drugs out for four patients and go give 104 pain meds. Stop at tele quickly to check rhythms! Ok, my heart patient is in normal sinus rhythm, it will be ok to take him off the amiodarone.



Deliver meds to each patient, get the discharge ready to go home and take both IV's out (one of which I JUST started)! He's a cute kid, hope he doesn't have a lot of pain when he goes home.



Time to walk my patient. I'm getting hungry myself! Wonder if I'll get a chance to eat some toast? I've got to get some coffee!



..............And on and on and on the day goes. No stopping, always moving.



There have been a couple twelve hour days in my 13 year career that I've only gone to the bathroom ONCE or not at all because I'm so busy. I come home exhausted most of the time or so keyed up I can't sleep.



It's really hard to see people with so many physical ailments. I remember wondering in nursing school how it would be possible to avoid getting attached or all caught up in the heart ache of illness with my patients and I've since learned that there is absolutely no way to avoid it. And I'm not sure I'd consider myself human or humane if I did!



What the patients and their family members go through with some of the devastating and life threatening issues I see every day makes me very grateful for my health and the health of my own family.



My 86 year old patient recently had lung surgery to remove a mass. She originally went to the doctor for a hydrocortisone shot for pain in her left shoulder. The doctor got an x-ray and found a nodule in her lung. Later a CT scan showed a mass and this patient ended up having a thoracotomy with a partial lobectomy and mass removal at 86 years old. It was cancer. She was a darling woman with a thick German accent. Never cried out in pain, only winced and asked if she could have some pain meds. She needed help up to the bathroom, not only because it hurt to move,, but for crying out loud, SHE'S EIGHTY SIX YEARS OLD!!!! Her daughter was a nervous nelly (more difficult to deal with than my patient). This cute little patient went home today. I hope she is able to heal..... I hope the cancer doesn't return..... I hope her family is grateful she is still here on this earth.



Another of my patients today was a 19 year old boy with Crohn's disease. Crohn's is one mean and painful disease! I saw a few cases when I worked in endoscopy and their colons look like a bomb went off inside or they ate WAY TOO MANY JALAPENOS, all raw, ulcerated and bloody (not table talk but what do you expect, I'm a nurse!) Many patients face the possibility of partial or complete colon removal. I can't imagine how painful this disease is and it's an autoimmune thing so it has nothing to do with anything the patient has done to themselves like eating poorly or using drugs or something like that. This kid wasn't the average 19 year old. He was up on current events, had watched the presidential and VP debates, and was watching CNN! Yeah, he played video games and watched movies but I don't think my 19 year old would spend the time to watching the debates (do we still call them video games even if they are DVD's?). He said he was attending college to become... what else.... a doctor... of all things. I told him he could specialize in GI, he already has plenty of personal experience.!!





Like I said, I know this isn't dinner conversation, but I'm a nurse so much of my life entails something that has an element of being gross, disgusting or depressing. I've even turned Heather totally white before, telling her about my patients ulcerated and necrotic foot. I seriously thought she was going to pass out as she went all pale and pasty. I had to walk her to the sink and put a cool cloth on her the back of her neck to keep her from falling to the floor. Poor girl. I guess I'm just used to that kind of stuff.



My time in endoscopy gave me so many funny stories, I don't think if I'd heard them from someone else I would have believed them. People do the stupidest things sometimes, it amazes me what excuses they give actually expecting we health professionals to believe them. Like the kid who came into the hospital with a shampoo bottle up his butt and said he fell down on it in the shower and couldn't get it out. Yeah we heard a few bar of soap stories too. That bar of soap just got sucked up in there. :) It was an ass-ident!(ha ha)



One girl came in with exacto knife blades in her colon! How did they get in there? Her story suggested someone at the bar the night before, "spiked her drink". We saw the blades on x-ray. There were two of them. I was really in awe as I watched the skill of our doctor, as he painstakingly and carefully removed each blade from her colon. He had to attach to the blade and then manipulate the scope, while keeping a hold of the blade and holding onto the buttons on the scope to allow air to inflate the colon so he could see the that she was not cut as he slowly backed the scope out. The blade never nicked or touched the sides of her colon at all. (He must have played the game Operation a lot as a kid!). He was able to remove both blades without so much as a scratch to her colon. I think back on this story and really miss the relationships I developed with the docs in endo-land. Doctor Mike was one of my favorites. He is a brilliant and fun loving man and I miss him and his German accent. His skill amazes me still.



Once we had this guy who came to the hospital fully dressed in a suit and tie and had already sat through an entire hour long meeting at work. His wife came with him to drive him home after his "scope" because he would have been drugged for the procedure. He was having a colonoscopy. Prior to his procedure he specifically instructed us to keep the details of his "scope" from his wife as the truth of why he was having it would be totally humiliating to him and he would rather she not know.



This man had an entire zucchini up his butt!



Can you believe that? He couldn't get it out himself so he had to come to the endo lab to have it removed! He had been unable to remove it the night before, so he went all night AND sat through his entire meeting at work before coming to have the noxious vegetable taken out of his rectum!! An entire zucchini! Oh, I could have died! The embarrassment of it all. His wife was just under the impression her spouse was there for a routine, age based colonoscopy!

What a world, what a world!



                                                         (Daikon Radish)


Our nurse manager made a comment that if the guy was going to put something up his butt, he "oughta at least put a string on it so he can pull it back out"!



My white elephant gift that year for the Endo Christmas party included: a banana, a zucchini, a daikon radish, and a carrot, all neatly wrapped in Christmas paper, each one included a handy- dandy loop of oxygen tubing tied in the end it for "easy removal". Guess who got the gift? The nurse manager! What a fluke of luck! No kidding, we put all put our gifts in the middle of the room and played a game, can't recall the name of the game, but you get a gift, unwrap it and then other people get a chance to take your gift! My boss, the one who said it would be smart to have the ties on the end of the zucchini, just happened to pick my gift out of all the gifts in the middle of the pile! You should have heard the roar of laughter that came as each present was unwrapped! I made her save the daikon radish for last (it is way longer than zucchini and carrots.....HUGE).  Everyone was in stitches, tears rolling down our cheeks. And my boss was the one laughing the loudest! Hysterical!



My husband gets so tired of me coming home and talking about work. Maybe it would be good to just blog about it instead of sharing it with him. He can't figure out why, if work was so hard, that I come home and re-live it by talking about it. But, I think it's like venting, or spilling poison from a wound by letting it out so it doesn't accumulate under my skin or in my head or vital organs or something (yeah, he should share some of the fun I have at work don't you think?) I could work myself into an ulcer with all the stuff I see. Hell, I don't know if I don't have one already. Just adds to my ever growing physical complaints. And it's not just GETTING OLD that does this stuff!



I did manage to get that cup of coffee, which isn't smart in the "can't take a break to pee" department. The day hardly ever drags on as a nurse. My poor family tries to call me at work and are always rushed off the phone.



I guess I'll put the flag down now and call it a done deal. Until the next race!











1 comment:

Kateka said...

Your day sounds like something right out of GREY'S ANATOMY except for all the lying, cheating, and back biting.