Saturday, May 30, 2009

Now we know who kept Sears & Craftsman in business

I remember when I was in nursing school and it was my patient I was assigned to who was scheduled for surgery. I was LESS THAN excited about this. . . actually I tried to get out of going with her. I volunteered to take someone else's patients and let someone else go to the OR and observe. But with everything I tried, my instructor didn't buy it. I had to go. I HATED IT!!!

My patient was an 83 yr old lady who had fallen and broken her hip the day before. She was confused due to dementia and had to lay in the bed for over 8 hours before she could have surgery to fix her hip.

I had not been through the OR part of our classes yet. I knew NOTHING about what I was getting into. I was actually "scheduled" a few weeks later to do an "observation" in the OR and a day before that scheduled time I would learn all the ins and outs about the OR so I would actually know what to expect or what I should/could do and should/could not do.

So I get to the OR with this patient who had broken her hip and the OR staff ask me to help position her on the table. So I do. I noticed all the tables full of equipment and all the blue sheets. I was so "green", I had no idea there was a section of the room that was sterile and other sections of the room that was not necessarily sterile. One of the nurses asked me to help her with her sterile gown. She walked me through how to properly grab the velcro and ties without breaking the sterile field. Then . . .in walks the surgeon. He also asked me to help him with his sterile gown. I was so nervous!!! They had told him I was a student and was observing so he was well aware I was there. I did as he asked and helped him, then moved out of his way. That is when I decided I didn't like him very much. He pretty much yelled at me for walking toward the "sterile" tables. There were so many people in the room at that time, I was having a hard time finding a place. So I was just moving out of the way. I was several feet away from the table and there was NO chance of me even touching it.

The circulator was nice enough to tell me where to stand so I could see and still be out of the way. This surgery totally grossed me out!!! It looked like the surgeon had gone into his garage and brought all his "Craftsman" tools to the OR.
They sedated this lady and laid her on her side, then put her leg up on foam type positioning devises that held it in place. They draped it and cleaned it . . then the noise started. All I really remember after that is the drilling and hammering. I can't believe anyone recovers so well from a hip replacement. The pain has to be absolutely terrible, especially after seeing the drilling and hammering.

The video below is an advertisement for a live webcast of a surgery. It is the video that I found that shows the equipment the best. I wanted you to have the visual that I had during this surgery. Pay close attention to the drilling and hammering. . . . if you have a weak stomach you might want to bypass the video and just take my word for it!

Now remember the purpose of the video is to show the hammering and drilling. This is not exactly the method I observed that day. They actually had a drill with a really long drill bit on it, kinda like what you see in horror movies. They totally removed the head of the femur and drilled down into the middle of the femur. Then hammered in the joint hardware. Once completed it looks something like this picture to the left.

The picture to the right is very similar to the hardware that was placed in this ladies hip.

The entire surgery lasted maybe 2 hours. I was amazed at how the body can hold up for a surgery such as this and how well the good bones can hold up with all the trauma they go through during this surgery.

I admire anyone who goes through this and makes it out on the other side and still has the ability to go about everyday life virtually uneffected.

I also learned that I DO NOT want to be a surgical nurse!!!


Friday, May 29, 2009

To Seize or not to Seize. . .

Do you ever wonder what some people are thinking when they come to the hospital? I know most people come because they are sick and need "special" attention, but there are those few who come for routine tests that require inpatient stays.

Those are the ones who have the best stories. The ones I will never forget but at times wish I could. (Some of those will have to be for another post)
One of the hospitals I have worked in had a special video EEG unit. This is where people who had seizures would come spend up to 5 days hooked up to an EEG monitor. They were allowed to move about their rooms (only in the presence of the nurse, they are considered a "fall risk" because they have seizures), but they cannot leave their rooms. They have electrodes attached to their head 24/7 for the entire hospital stay. They have to wear button up shirts because they can't have anything that goes over their head, it would mess up the electrodes. Actually because of all the wires they wouldn't be able to get the shirt off. The wires from their head attach to a portable box that has a cable that is attached to the wall. So they are literally attached to that room.

These patients actually sign a waiver stating they are aware that EVERYTHING in the room is audio and video recorded. The only time they are not on video is when they are in the bathroom and at that time there is a nurse standing right outside the bathroom door.
So you can only imagine how wonderful it is to be the nurse of these patients. Sitting in a control room watching computer screens and being able to see your patients and their visitors at all times. Now, these are normally "healthy" patients. They don't really need alot of typical "nursing" care, like other hospital patients. So the nurse is not in and out of the room as much.

The funny part comes when there are patients who for whatever reason feel they need to fake a seizure. I remember Joe, who was a post-op patient. He frequently came to this unit after any surgery. On the particular shift that I was working Joe was comfy in his bed and asleep. I was sitting watching the monitors. The next thing I saw made me and the EEG techs just simply laugh. . .

He reached for his "seizure button" (the button the patient pushes when they "feel" a seizure coming on). This button sets off alarms, marks the event on in the monitoring equipment, turns on lights in the room and turns of the TV in the room.
Joe then used one arm to cover his head and then started to shake in a seizure like fashion. We could tell by the monitoring equipment this was NOT a seizure. So no one really ran to the room. About 20 seconds later, we see Joe peaking out from under the covers to see if anyone is coming, then he covers his head back up and continues the seizure like shaking. We go into the room and Joe won't stop shaking, won't respond to us, proceeds to urinate in his bed, then slowly stops shaking, rolls his eyes around and then lays there still and virtually unresponsive. Joe has just "faked" a seizure. He didn't "wake up" for about 30 minutes afterwards and stated that he didn't remember any of the event.

He did this same seizure like activity 4 times in 2 days that he was hooked up to the equipment. None of the seizures were real. Joe eventually ended up with a psychiatric consult and was moved to a regular post-op room.

I will never found out why Joe faked the seizures. I do find it interesting that they are aware they are on video and do such a poor job of acting.

I have many stories about these patients and would love to tell you more, however it would make for a long long post. So I will save them for another time.

Moral of the story. . . if you are going to fake an illness, make sure you read up on it first and maybe even practice so it doesn't look so fake. If you are willing to pay or have insurance pay for a hospital stay for a fake illness, make it a good show!


Thursday, May 28, 2009


I know . . It has been over a week since my last post! Ha! This sounds like a confession. I am not Catholic, but I feel like I am waiting to hear how many "Hale Mary's" to do.

I don't have anything exciting to write about right now. I am kinda having a little "writer's block" or something. Maybe someone could make a suggestion. . . .?

I do have some pretty good stuff stirring in the background but I am waiting on all the information to get here. I am working with a Mother of a small child to write some of her story here. It is amazing! So you will definatley want to stay tuned for that to come around.

I am starting to feel the sting of this horrible economy! And it is not making me very happy! I work at a pretty large hospital in my town. There are actually several large hospitals to choose from and I like this one pretty well. I have worked here for a long time. I am currently in the "float pool". This means that I am not benefited, I get paid more, I pick my own schedule as long as I get at least 36 hours scheduled a week, and I have to work 2 weekend shifts a schedule. So, I usually work every other Friday night and still have my weekend to play. In the "float pool" I call in to the hospital 1 1/2 hours before my shift starts and they tell me what unit I am working that night. I can work just about any unit in the hospital with the exception of: Pediatics (YUCK!), ICU (don't want to anyway!), Maternity (NOT FOR ME!), ER (too many crazies), and OR (don't want to stand in one spot for that long!). So pretty much it is basic med/surg, neurology, cardiology, cardiovascular/pulmonary vascular, respiratory, infectious disease, oncology, hospice, womens surgery, general surgical, and med pysch. Pretty basic really.

Here is the catch. . . .
If the census in the hospital is down, the "float pool" are the first people to be cancelled. So for the past few weeks, I have been cancelled at least one shift a week and sometimes two. This is not good on the paycheck as these days are unpaid.

What I am learning is that the floors are keeping their overtime people and telling the staffing office they are on numbers and don't need us "float pool" people. So we get cancelled while someone else is getting overtime and sometimes bonus pay for those shifts!!!

I also just learned that there are some people who take a lesser pay and are benefited in the "float pool". These people get the shifts before us non-benefited people do. So tonight I got canceled because there was a benefited "float" person who took my spot.

Now, I keep hearing about this nursing shortage and I have even posted about it previously. But I have to tell you, I am not sure that the shortage is as bad as it seems. I have been looking, for at least the last month, for some supplemental income. Thought about doing "float pool" at another hospital on a part time basis or doing some PRN at another hospital. I have at least 4-5 hospitals to choose from in my area. I get online and ALL they are hiring for is FULL TIME in the ER, PEDS, NICU or ICU!! All four of which I HATE! I could easily go work at a nursing home for around $22/hr, however I would have to do med passes and medicare charting on up to 35 people. I was in administration for a nursing home for about 9 months and it was scary how the state regs were so lenient when it came to ratio. That is not even safe!!!

So, I guess I would ask all you other nurses out there, what is is like in your area? How do you earn that supplemental income? Are places hiring in your area? What about agency or travel nursing? I don't think I would want to travel for weeks on end but a day or two here and there wouldn't be bad. . . maybe?

Leave me a comment and give me your input, suggestions, or what you see happening in the nursing world.

This getting cancelled and not paid is for the birds!!!


Thursday, May 14, 2009

Mr. Cunningham Goes Home

I had just taken Mr. Cunningham his evening medication. His brother had been in from out of town visiting, he came several hundred miles just to visit his brother who had been in the hospital for about a week now. Mr. Cunningham came in with dehydration and a UTI. He was on the mend however during the stay they found prostate cancer. It was not advanced and at this point treatable. The prognosis was pretty good. This man was 70 years old they were giving him several more years if he did the treatments.

When I gave him his medication, we had a conversation about how nice it was for him to see his brother. He hadn't seen him in several years and he was touched by his brothers devotion. Mr. Cunningham was in great spirits and was looking forward to his discharge tomorrow. His brother would stay another week and they would spend time together while Mr. Cunningham was home and they could enjoy each other more.

I left Mr. Cunninghams room, went back to the nurses station and began "speed charting". It was the close to the end of my shift and there were several things left to chart and orders to check before the next shift arrived. I had not been out of Mr. Cunninghams room 10 minutes when I saw his dinner arrive. Mr. Cunningham was pretty self sufficient. He was stong enough to and able to walk the hallways alone, as he did earlier in that day. He didn't require help with his meal and knew to use the call light if he needed anything.

Another 5 minutes pass, and I receive a call from telemetry.

"The patient in room 3215 just haed 15 beats of VT", the person on the phone informed me.

"Ok, I was just in there and I will go check on him right now"

His room was not even 40 feet from where I was standing. I hung up the phone and started walking, pretty quickly that way. My phone rang again, this time I heard. .
"Now it is sustained VT". Ok, now I am running. I was in the room before I even hung up the phone.

"CALL A CODE!" that is all I could get out of my mouth. There were several nurses at the nurses station and they saw me begin to run. Now, when you see a nurse running there is usually another one not far behind. Even if they don't know why they are running, a running nurse means trouble somewhere, so it is kind of an unwritten standard that someone follow just in case.

Mr. Cunningham was laying sideways across the bed. All 100 pounds of him totally sideways. I tried to get him to respond but he didn't. He did have a pulse, a very very fast one, but I could feel something. He was breathing really really shallow but at this point still breathing. We got him in the bed right, put oxygen on him and I hear what I believe must be a heard of elephants coming down the hallway.

Yep, you guessed it. . . I worked in a teaching hospital. Residents come out of the woodwork for a code. They immediately go him hooked up to the cardiac monitor and began compressions. Respiratory therapy attempted to intubate. This was my second code as a nurse and I was totally not into this at all!!! I had more nurses helping me than I knew what to do with. Administration came to help, someone recorded, someone else pushed meds, RT finally got him intubated and the residents took turns with compression. More residents worked together to get a femoral line. I stayed at the end of the bed, answering questions and telling the other nurses what we needed, so we had a runner for more equipment if necessary. I couldn't believe my eyes. He was just fine 20 minutes ago!!! He was chatting with his brother and ready to go home tomorrow. Now. . . it doesn't look like he will make it. I began to silently pray. I prayed that God would give him more time. More time to spend with his brother. That was all the family he had. Then it dawned on me, we didn't have a phone number for his brother. He was planning on being back tomorrow, but the only number we had was a neighbor. That was his emergency contact. I wispered this to the nursing administrator who then worked with social services to find a way to contact the brother. He had not even been gone 45 minutes probably.

They worked on Mr. Cunningham for over an hour. Shift change took place. The other nurses went back to their patients, nursing administration stayed to help me and everyone went about their scheduled tasks. I stayed. I stayed because he was my responsibility. I stayed because, I was afraid to leave. I stayed even after all the residents and ICU docs left and went back to their living and breathing patients. I stayed to get Mr. Cunningham ready for his next journey. The nursing supervisor helped me clean the room and get the paperwork done. She helped me get him cleaned up and we called security to take him to the morge to await his brother.

My heart broke that day. He was so sweet and so full of life that day. He knew he was going home. He looked forward to the time he was going to spend with his brother. He was on the mend and there was no warning. None at all!! I am very confident we did all we could for him and at the same time, no one wants to lose a patient. Tears fell to the floor as I picked up syringe wrappers, central line kits, empty medicine viles and threw them away. This was all the evidence left in this room that proved there was once a valuable life eating dinner here.

I cried all the way home. I prayed that Mr. Cunninghams brother would be found BEFORE he came for his visit in the morning. I prayed that he had someone besides Mr. Cunningham in his life to give him support.

Mr. Cunningham was so excited to get to go home, and I am not sure he realized at that moment exactly what that meant.

Mr. Cunningham went HOME.


Tuesday, May 12, 2009

Will You Be My Grandpa?

I spent several years working in a nursing home as a certified nurse aid. This was a great time in my life. It is an extremely hard job physically and can at times be hard on the heart. I loved each resident I cared for, even the most difficult ones who didn't want to be there or want us taking care of them. This is where I learned about adopted family.

I had several adopted grandparents during this time in my life. I remember one gentleman in paticular, Mr. Smith. He had a very poor memory, he had sons and grandsons and a wife. His wife was very diligent in coming to see him as often as she was able. He was a farmer, he was sure his farm was across the street and he would sit at the window "supervising" the men who worked the field. His son and grandsons came occassionally but it appeared they spent time working the farm and visiting with their mother and grandmother. Mr. Smith had suffered a stroke. He was unable to feed himself and unable to walk. He was reliant on staff to meet his daily needs.

I took care of Mr. Smith every day. I would bathe him, dress him, shave him, feed him, lay him down for naps, talk to him, listen to him, and at times cry with him as he would talk about his wife whom he missed and his farm and life before the stroke. He had what we called "emotional incontinence". One minute he would be laughing the next minute he would be crying and many times the emotion was not appropriate for what was really going on. For example he might cry when it would be more appropriate to laugh.

I remember when Mr. Smith stopped eating. He would not eat for anyone else but me. He kept saying he was tired of the nursing home food. He wanted something better. Because he was on a ground diet there wasn't much we could do to help him. Then one day I got an idea. I went to lunch before the residents would eat and on this particular day I went to taco bell. I got him a burrito with refried beans, cheese, onions and the "fixin's". When it was time for his lunch. I opened up that burrito and fed him only the insides of it. He wasn't able to eat the tortilla. He immediately thought he was in heaven. For the next several weeks, he would eat either a fish sandwich from McDonald's or a burrito from Taco Bell every day that I worked. And on some days when I didn't work I would still bring it to him. He was loving to eat again and was gaining weight.

The evening shift staff began to get angry with me. They had to feed him dinner and he wouldn't eat for them. His wife decided that it was ok, if he didn't want to eat dinner. He was getting calories and still gaining some weight just be eating what I was bringing him during the day. His health was deterioating so it really didn't matter what he was eating as long as he was eating. He was enjoying it and that is what mattered, at least to his wife.

The day that Mr. Smith passed, was a sad day for me. I felt I had lost a grandfather. I had cared for him and loved him like family. He was so sure I was going to marry his grandson. The funny thing is that his grandson was about 10 years or more younger than me. But Mr. Smith didn't care. He just wanted to bring me into his family.

Mr. Smith was a special man. Someone who touched my heart and blessed my life. I only hope that I gave to him as much as he gave to me.

In my mind that is what nursing is all about. Caring and compassion!


Sunday, May 10, 2009


Happy Mother's Day!!!
The celebration of Mother's Day goes all the way back to the ancient Egyptians. They held an annual festival in honor of the goddess Isis. Isis was regarded as the Mother of the pharaohs.
So, as you see, Mother's Day has been around for centuries. I find it sad that once upon a time people and society would celebrate goddesses and symbols rather than actual Mothers.
What I have learned is, the personal touch of celebrating Mother's Day is a somewhat new thing. It has only been in the last few centuries that celebration on Mother's Day actually turned into celebrating the woman who gave you life. The one who cared for you as a child through your adulthood.

Being a mother doesn't necessarily mean you have to have birthed a child. There are many ways to become a mother. One could become a mother through adoption, surragacy, fostering, loving someone as a "mother" would, or any number of ways. Being a mother means you care with your whole heart. You love unconditionally, forgive always, nurture, teach, guide, nurse, your child (as well as many other things). You do this from birth (or the time they become your child), until death. There is something in your heart, your soul even that won't allow you to not love this child, this person who calls you "Mom". You would give your own life for them. You would sacrifice your own happiness at times for their happiness. It is part of the nurturing part of being a mother.
You are happy when they are happy, you are sad when they are sad. When their heart breaks into a million pieces so does yours. Only your heart is breaking as you help pick up the pieces of their heart and gently hold it in your hands, and love it back together again. You give your child wings to grow and learn. You watch them make mistakes, sometimes really big ones. Then you are there to help them out of their mess. How ever many times it takes. You stand your ground, and have standards, and at the same time balance the love and affection you feel for them. You hold your breath with each step they make, praying they won't trip and fall. And when they do. . .and yes. . they do. . .you are there to hold their hand until they get their footing again.
Being a mother means holding them when they are crying, little and big. Wiping their brow when they are sick, no matter the age. And knowing that one day, they will move on. They will start their own lives with their own families and you will no longer be their everything. You will be the one sitting in the background silently cheering them on to the victory in life.
And in your mind you quietly pray that you instilled in them all that is important about life. All that will keep them safe and honest and good. You pray that you have been a good teacher about what it means to love unconditionally. What it means to care for someone as well as taking care of someone. You pray that one day, when you are really old and febble, they will remember all the times you held them close and wiped their brow. You silently pray that they will in your old age, come back from their busy lifes and care for you with the same love and compassion you have given to them since their first breath.

See, being a mother is not one thing or another. It is alot of things. There are many ways to become a mother. There are many ways to have children. You cannot have too many mothers, too many people loving you as a mother does.

On this day, I salute all the mother's. I want my mother's to know how much I appreciate them. How much I love them and how grateful I am that they are a part of my life. I am who I am today because of the Mother's in my life. What I have recently learned is that life is a precious gift. You never know when it will be snatched away from you. You may have one day or you may have 50 years left with your mother. Never take the time for granted. Love your mother with all your heart and tell celebrate her life today; the life she has and the life she has given to you.

Happy Mother's Day!!


Friday, May 8, 2009

Always Time. . .

Sitting out side her room she suddenly bagan to cry. Not just any cry, it was a whole body shaking cry. I jumped up to see what was causing her such anguish.

Me: "Are you ok, Mrs. Kimble?"

Her: "No!"

Me: "Are you hurting?"

Her: "No!"

Me: "Why are you crying?"

Her: "Why do I have to live like this?"

Me: quickly trying to think of something appropriate to say to a dieing 90 year old woman. . .

Me: I gently put her hand in mine. . "I am so sorry, I wish I could make it better. Is there
something I can do for you?"

Her: beginning to go from hysterical cry to hysterical laugh

Her: "Yes there is"

Me: "What is it you would like?"

Her: "A new body!" as she is giggling

Me: "Ok then, I will call Sears and put one on special order, how old would you like it to be?"

Her: "Ummm, how about 50, that was my best years."

Me: "Consider it done. I will call right away and ask for expedited shipping"

Her: "You might want to order three."

Me: "Why is that? One for you one for me and a spare to put in the closet?"

Her: laughing again. . ."You are really funny! I think I want to go to sleep now."

She was 90 years old, actively dying, she was scared and woke up from a deep sleep. She then couldn't go back to sleep, instead she lay in bed thinking back over her life at all the had accomplished and all she had yet to accomplish. All she had loved and those she wished she had loved better. She was in her final chapters. This was it, had she lived it best? Had she fullfilled her "bucket list"? Did she have regrets? Was there that "just one more thing" that she wished she had done?

It is interesting to me who people see their lives when they are at this moment. Waiting on death. Waiting to leave this world, leave their bodies and go to someplace better. Someplace we have heard about but have never seen. It is at this moment when people start realizing how messed up their priorities were.

What was important?

Was it the job that took them to the top? Is that how people knew them? Was it because you were president of the PTO and attended ALL the funtions at the school and hid behind your child's identity? Was it your financial status? Were you the one with your name posted all over every charity in town? Is that was defined your life?

Or. . .

Was it that you were kind, gentle, loving. That you gave to others wholeheartedly without expectation. Was it that you chose to spend special days with your children even if they are grown showing them you love them by giving of your time instead of with gifts and money? Are you the person who will go out of their way to help a friend, to listen to a stranger who is standing in the grocery store and just needed someone to talk to for 5 minutes? Was it important that that you were a relection of the love of God? How important was it that people in your life new how important YOU were?

This time will come for all of us. Who will you be? Is there still time to make each moment count? Is there still time to show the people who are most special to you, how much you love them. Is there still time, for you, to change your priorities and put what really counts first?

Only you know those answers. . . . this is your time to reflect. Make each moment count, make each day count. Because when it is your turn to be 90 years old, who will be holding your hand ordering you a new body? Hopefully, you have people in your life that love you enough to hold your hand through the end, no matter how long from now that is.

There is ALWAYS time!


Thursday, May 7, 2009

Nurse or Family. . . .Which Role is First?

Today I am not a nurse, today I am a family member. Today I am on the otherside of my job. Someone I love very much had a major surgery. She is in the ICU currently and I am learning how it feels to be a "family member" instead of a "nurse".
Today I am not sure how pleased I am with my place of employment. There are things that have occurred that to some could be considered trivial, however to me they are important. It is my loved one this time that is laying in a bed, intubated and unable to communicate. It is my loved one who is in so much pain that she can't catch her breath and suddenly feels she might hyperventiliate and yet there is nothing she can do to stop this process. It is my loved one who is waking up from anesthesia and feeling sufficated by the tube that is in her throat and looking scared and feeling like no one is listening to the body language of fear, and yet because of this tube unable to make words. Unable to communicate verbally that she feels like she is smothering.

I watched an experienced nurse train a "baby" nurse today. It was refreshing in the beginning to see the experienced nurse being ever so patient and playing everything by the book. Then as my loved one began to wake up and start to feel the pain from surgery and begin to feel the need for the tube to be removed from her throat. I became a little concerned about the "baby" nurse. Baby nurse was doing a great job, however the tube was causing a feeling of panic and it was MY loved one who didn't feel like she could breathe. They FINALLY decided to extubate her. "Baby" nurse began first with the OG (orogastric tube) that was hooked up to suction. She ever so slowly began to pull this tube out. I understood being cautious, however what I didn't get was that when she got to the "gag" reflex she moved even slower. From the outside looking in, it appeared she was wanting to suction as she went, removing all unwanted saliva while removing the tube. She took a while to get this tube out. Once at the gag reflex she lingered, just suctioning. My loved one came up off the bed, gagging, feeling like she might vomit. My heart ached for her. She had just been cut open, I am sure this is causing unnecessary pain. I felt as if my hands were tied. I just wanted to scream at them. I am not by any means an ICU nurse. I have never seen someone extubated before, however they were nice enough to let me stay, to help keep her calm. She really wanted those tubes out!!!
At another point as she was waking up and coming out of the anesthesia, my loved one began to feel the REAL pain of surgery. She would moan with each breath. The older more experienced nurse proceeded to tell my loved on that she should "stop moaning, she was going to scare all of her family." I am so thankful at this point there was another family member in the room that was a nurse. I was not the only one TOTALLY offended by this comment. The other family member spoke up and told my loved one she could moan as much as she wanted, we understood she was in pain. I can't believe this older experienced nurse even said that.

Where is the compassion? Is it just me or does this senerio not seem right. If you are in pain, who has the right to judge that and tell you to lay there and not make noise? She was in obvious pain!

Today, I am not happy with my place of employment. Today, I question the integrity of some of those I work with. Today, I am not liking being a family member. Today I am learning to be a better nurse. Today, I am embarassed to say these are my co-workers. Today, I am family first, nurse second. Today, I have been fearful of the outcome of my loved ones illness. Today, no one has seemed to check in with us as a family to see how we were coping with this sudden illness. Today, I am sad I work with nurses who have seemed to have lost their compassion.

Today, my loved one had surgery. . .


Wednesday, May 6, 2009

Tuesday, May 5, 2009

Not A Hunka Burning Love!

Decadron, is a drug that can be used for many things. It is a steriod and is often times used as an anti-inflammatory, however it can be used during chemotherapy as well as to help control post-operative nausea.

There are several things I have found in common with people who are on decadron. We monitor their blood sugar, even if they are not diabetic. It can increase their blood sugar during their hospital stay and require small doses of insulin to correct this. It is important to keep the blood sugars down to promote healing. Also, these patients seem to be very hungry most of the time.

Something else I have found in several patients is that when it is given IVP (intraveneous push) it causes perineal burning. For those of you who are not familiar with the term perineal, according to websters it is: the area in front of the anus extending to the fourchette of the vulva in the female and to the scrotum in the male.

After doing some investigating, it appears this is happening when this medication is pushed into the IV too quickly. It should be pushed 1ml over 2-3 minutes. That is a long time if you are the one pushing the medication, especially if you have other patients to give meds to. However, let me tell you, it is a good thing to do, take your time and use all 3 minutes. I have seen women cry over this burning sensation it causes. I have yet to see or hear of a man complain about this. I have had women state it felt like they were on fire, felt like they were going to be incontinent (even if they had a foley), and that the burning just plain hurt. It has NEVER been described to me as a "good" burning sensation. I have watched this medication be pushed and as it is going into the IV, I have seen the patients facial expression change immediately. Suddenly they have this very confused look on their face. They want to ask what is wrong, what is happening, however they are a little embarassed to say it. Who wants to reveal to their nurse that their vagina is burning!! Especially if the reason they are in the hospital has absolutely nothing to do with their vagina!! However, they become forced to say something when they feel like they want to run and jump on a block of ice just to stop the sensation.

So I guess this is more of an educational post. Look it up, google it, remember what you read and next time you have to push Decadron, be mindful. . . .take the full time and then some. This is NOT a normal 1ml/min drug!


Monday, May 4, 2009

Do You Hear What I Hear?

Did you know nurses talk alot? Well, just in case you have never been a patient in a hospital or a family member of a patient in the hospital, let me enlighten you.

During the day it is feels normal to hear papers shuffling, doctors and nurses talking in the hallway or nurses station, visitors in the hallways, carts, that despirately need their wheels lubed, moving up and down the hall, TV's from the patient room next door, who obviously has someone in there who is next to deaf, the beeping of pump alarms, bed alarms, and any other alarm that may or may not be necessary and then there is the ever so loud announcements over the intercom.

All of those sounds (noises) seem very appropriate or "normal" during the day. However night time is OH SO different. Sitting in an ICU room with a sick patient, I have heard, very loud nurses at the nurses station. I could tell you what they are doing for vacation, whose child is acting up, who is dating whom, and which doctor and patient they like the best. I actually think they have forgotten they have patients trying desperately to get some rest before the respiratory therapist, physical therapist, speech therapist, occupational therapist, doctor, or nurse actually come in and wake them up for another treatment, exercise, meal, or medication. Patients no longer come to the hospital for exhaustion. They actually leave the hospital after an acute illness and go with a diagnosis of exhaustion.

Patients are often times woke in the middle of the night to check their vitals every 4 hours and sometimes depending on why they are there, more often than that. They are woke to check their pain level and give medications, they are woke BY THE NOISE!!!

I am so suprised at what I have heard. I promise I will be ever aware of my own personal noise level from here on out! Not that I think I am a loud person, but it is something I will certainly pay attention to.

Patients need rest!! I understand they need assessed, they need meds they need therapy and all those things, but the body needs rest too. We need to be more aware of caring for the WHOLE patient and not just the illness. Florence Nightengale was really on to something with the whole patient care role she introduced. We should follow her example and see if our patients happier and recover a little faster.

I will be a better nurse because of this.