All out run...

Pt hit code blue button trying to turn down a/c.  I ran about 100 feet.  Let me tell you someone like me should not be running.   Haha!  That was not fun.  I have a back ache.

Bladder Scanning Competition

Last night at work was a slow night for once.  Someone got the bright idea to start a bladder scanning competition.  The rules were simple.  Drink as much as you can, hold it as long as you can, you get 1 scan, up  have until 5am, and the person with the most on their bladder scan printout wins the pot of exactly $7.  You had to pay a $1 to play.  You knew when someone was at their limit, because the bladder scanner wheels are very loud.  Our floor is pretty quiet at night, and thru the quiet you would suddenly hear the bladder scanner wizzing down the hall, and a door slam.

I drank 3L of fluid over a period of about 2 hours, until I felt I would bust.  I took a hat (urine collection device) with me to see if it would be accurate, being fat and all wasn't sure it would measure correctly through the big gut.  Mutliple tries resulted in 662.  After the scan I ran to the toilet and had out 1000 ml.  Even with these hard facts I did not tie G.B. because my scanner ticket said 662.  But I know the real truth.  I will let him have the win.  Although he did say we could have a rematch tonight.  Congrats on the big $7.  Hey, I just remember I owe R. a dollar for my entry fee.  Didn't have the cash so she had to spot me.  

The Results:

G  >999

R - 771

Me - 662 (at least it wasn't 66_)

S - 509

J - 473

J - 459

P - 277

Beter luck next time.

Projectile Poopage

I was talking to J last night and told her man nothing funny has happened to me lately. Everything has been pretty serious at work. She tells me well I have something for you, and begins to tell me her story. I will try to tell you as much as I remember. I was hyped up on 2 cups of coffee.

About 3-4 weeks ago, she had a pt who needed to be turned. They were in contact isolation. I tell you this fact to mention that she had the beautiful blue gown on. She helped roll the pt over and the next thing that happened was shocking. J said her eyes grew big as stool that had started trickling out from the bum cheeks start on a projectile coarse of action. She said blue gown or not I do not want that on me. She almost uttered a scream, then instinctively grabbed our wonderful chucks, aka bed pads. Stool continued to flow at a rapid pace, until it met its final resting place in a big puddle of brown goodness that saturated the bed.

Wow! Thank goodness that wasn't me.

Molasses Enema

Enema Kit

Never had to give a Molasses enema before...it is definitely different. My dear pal L asks me to help her. She definitely pulled out the friend card. She mixed molasses, milk of mag, salt, and warm water. She mixed it all into a bag, but somehow missed the closure at the top. Remember that for later.

We take this big brown bag of goodness and hang it on an IV pole, with some lube in hand I start reaching for the moon. Once in place, we notice the bag of goodies isn't moving. So I say give it a squeeze, which I ended up squeezing molasses right onto the floor (the top not closed that went un-noticed until that point). I did a tiny splash onto my new t-shirt that I designed. We threw some towels onto the floor and tried again. This time I held the top closed with both hands while L did the squeezing. We won't go into the details that followed, lets just say that was an experience, I am not looking forward to anytime soon.

Then tonight L tries to pull the same trick and say she may need help inserting a nasal trumpet into the rectum. I said I don't think so!!! haha!

This reminds me of a joke: There were 3 baby moles in a tunnel underground. The oldest brother was in front and starts sniffing the air. He says, "Smells like mamma is fixin' bacon." The 2nd brother in line starts sniffing and says, "Mmm smells like she is fixin' pancakes." The baby brother was last in line and starts sniffing, and keeps sniffing. Finally he says, "Man I only smell molasses."

Lose Weight

Can you say brainfart?

Sorry I have not written anything really funny for awhile. I haven't felt "funny". Work has been challenging lately. Anywho.... I think I must be stressed about getting my wisdom teeth out in the morning. I did two stupid things tonight.

Firstly: I was starting an IV because the current one was leaking fluids. Tried to save it, but no good. I inserted the IV no problem, put on the extension and was flushing the IV, when all of a sudden to extension popped off. Oops! Well blood started to go everywhere, it took my brain about 3 secs to react...then I applied pressure. I was able to save the IV, reattach the extension, and tape it all up. Told the patient not to move while I finished getting it all together. Well in the process of me walking to get the line for the IV fluids that were running, she moved her arm which had the syringe still attached (so I didn't have to clean off the hub again). Out comes the iv.

I figure it popped off due to the site not being totally dry. When the IV came out, once again blood went everywhere. I had to apply pressure while the daughter when to ask the nurse sitting in the hall to get my some 2x2. Didn't help that the pt was on coumadin. Can ya say we have a bleeder??? I apologized and said, "I usually do not spill a drop of blood but that IV extension just popped out". I cleaned up the floor, the patient, and myself.

That would be nice if that was all. I was changing the bag of fluids over, and I think my mind went completely blank when I un-spiked the current bag of fluids and spiked the new one. In that few seconds the old one started pouring saline onto me, the floor, and the pt's bed rail. Thankfully the patient was spared except a tiny bit onto their arm. Once again I said sorry. I think my head must be in the clouds because of nerves due to the wisdom teeth extraction. The pt was really nice, and said it was okay... mercy!

The stupid things we do. My shirt finally dried after about an hour!

Vacation

Sorry I have not been posting in awhile. I was gone on vacation for a couple of weeks. I am back in action.

The only thing that has happened to me that was remotely weird or gross: My little patient decided to chew tobacco which isn't that bad. Except the fact that they decided to spit it on the floor all night long, and I ended up cleaning up a big pile of tobacco juice. Pretty gross at 4 am.

The perks of nursing!

CorPak & Rectal Trumpet

CorPak

Goes in your nose for tube feeding, etc

(different sizes)

I was checking on my patient to make sure they were doing okay. The funny thing is I didn't notice anything wrong at first. The tube feeder was beeping and I was trying to silence it due to the roommate in the next bed. I loaded more juice into the bag and turned on the tube feed. I kept hearing this high pitch squeal. I asked the pt what that was and they said they lost their hearing aid. I went on a bed search for the hearing aid when I noticed there was something on the floor. Lo and behold I notice stool on the floor. I follow the trail and see it on the bed, and the end of the yellow brick road was the rectal trumpet. I called for help and sheets. No one came. I went out into the hall and yelled for my pal L. Asked her to come help me.

We get in there and are cleaning them up, when all of a sudden L holds this tube up and says, "Um, did they pull this out?" There in her hands she held the corpak that use to be in the pt nose. With of course the tube feed still running! ha! The pt said that they didn't like it, and please don't put that tube back in me (meaning the rectal one).

What is even funnier still it didn't dawn on me until we were talking about what happened that I had actually started the tube feed back up and didn't even notice it wasn't in the pt's nose. *Shaking my head*

Nurses call the shots

Blood

I had to hang blood last week for the 1st time since RN B. and I had to during orientation. I think the 1st 4-5 days of working we had already given 6 units of PRBC & FFP. I haven't given any since then. Which is my excuse for what happens next.

Well I remembered how to do everything, except one minor detail! Opps!

When you set up blood you always have a bag of saline hanging as well to use to flush the blood through, after is is done. I started the blood was monitoring my patients vitals and stuff for a reaction. RN G comes rolling through and asked if I was doing okay, I said yes at the same time as looking up at my blood. I realized at that moment that my bag of saline was red. I was like um.....what happened! G. says to me well you might want to clamp the bag next time! Duh! haha! Oh the stupid things we forget about. Can't really flush blood with diluted blood can you?

ABG's

Tonight I got a chance to do my 1st ABG. I really thought I would get it. You feel bad when you have to stick a needle straight down into someone's artery. It hurts! I stuck it in and got a flash back of bright red blood, which is what you want. Then it stopped. So RN J. told me to pull back a little so I did. Got a little bit more but not enough to fill the tube. I lost the artery, which sucks for the patient!

Smoking Patient

Tonight my patient was smoking in the bathroom. I didn't physically see him but the smoke rolling out the bathroom door, tells the tell. They told me on days he was doing the same thing. One of my patient's complained they could smell smoke.

Yet Another Amp of D50

For those of you who do not know what D50 is: It is what you give to a patient who's sugar is in the toilet. The real name is Dextrose 50%, that pretty much means its pure sugary goodness. It is a huge syringe, that about breaks your fingers trying to push in because it is so sugary! Not something you want to give. An amp is 50ml of the stuff. Normally you give 1/2 and amp, but in very low sugar an amp.

Since I have been working it is actually becoming a joke that I should carry D50 in my pocket. Tonight one of the nurses asked me, "Do you have your D50 in your pocket tonight?" The other night I was working I had to give 3 amps of D50 in a matter of 2 hours.

Pain Pills Coming out the Ears

I can't tell you how many times I have given Percocet since I have started working here. Percocet is like the wonder drug. In the last two days I have given roughly about 40 Percs. That is for about 4 patients. I gave 4 Vicoden to another. Multiply that times 3 days a week is 60, and times 4 for a month that is about 240, and take that times 12 for a year. I could potentially give about 3,000 Percs this year. That doesn't take into account for all the Morphine, Tordol, Demoral, and Dilaudid's. It is pretty bad when I go to get into the Pyxis and do not even have to count how many are there. I know how many is in there just by looking, I can tell if it has changed since I was last there. Just now another pt called for some Perc treatment. haha!

Just call me PPQ the wonder nurse (pain pill queen). Don't get me wrong I don't mind giving pain pills if it makes the pt's happy, because a happy patient means a happy nurse. I don't know if that is true because I just made it up, but I'm sure it is close to the truth!!!

EJ vs IJ

Did you know that an EJ (external jugular) IV is considered a peripheral access? Well now I do.

I came into work tonight and RN A. we will call her says to me, I didn't know if you knew this, but from now on you can't draw blood from an EJ. We got Pt X's lab results back today, which were all out of wack, and the MD ordered her to get 2 units of PRBC stat. She also says to me I thought I remember you telling me in report that you drew the blood. (On our floor RN's draw all central lines, and PCA's draw the peripheral sticks, which might be like that most places.) Anywho she re-drew the blood through the arm this time. The labs all came back normal, imagine that! ha!

They were about to give stat blood to a pt with critical Hgb/HCT. Nice! That is just one of those things that fall through the cracks you know! Unless someone says hey an EJ is a peripheral you wouldn't know. Its in the neck, looks like an IJ, smells like one, why not be one!!

Keeping it real!

Codes

The other day we had a code at 0430 some yelled for me to get the crash cart, so I went and got it, nearly ripping it from the plug. I was pushing it down the hall when someone said hurry. Then it registered oh yea I have that pt's life support in my hands. Duh! Then I took off running, and let me tell you fat white women can't run!

I get in the room they are yelling all kinds of things, like you learn in ACLS, and I was looking for what they were yelling for but couldn't find it. First code and all. The 1st thing I couldn't figure out was how to get that blue tab thingy off of the crash cart. I didn't have scissors. RN M. comes up behind me and said like this and yanks down. Another tid bit that could have been helpful. Finally I said I don't know what I am doing someone give me something to do. So my pal, RN G., says you record. Which worked out better because I got to see more of what was going on. Let me tell ya night shift nurses have it going on. There are 5-6 nurses for about 35 patients at night and all 5 were in there running the code, then there is me who didn't really count! I am like 55% of the 6th RN. :) It's a great floor to learn on though. Over and out.

Beginning

I thought I might start a blog for kicks and giggles. Not sure how long it will last since I have commitment issues! ha I tend to forget or am to tired, etc. I thought I would talk about the things that happen to a new RN.

So first on my issues list is trying to fit in as a new nurse, because we don't know enough. Yes, we went to school and they taught us how to do it by the book, but now comes the application. Like on all those nursing tests. I feel I have the knowledge base, but my base just got a whole lot smaller once I started nursing in the real world. They have to teach you all those rules so you know where to start. Without some kind of structure, how could you learn.

I always felt very comfortable with nursing school, except when it came to tests. Clinically though I always enjoyed what I did. I didn't think real nursing would be as challenging as it has proven to be. Being sure of yourself is one of the biggest hurdles. I remember the 1st few days I worked I wanted someone to check my meds, or to double check my insulin. I still need to ask other nurses if they think it's okay to hold that BP med.

Yes, I did decide to work on a hard floor, but that is because I like a good challenge. I love the heart, and critical care. It gets my blood pumping. The flip side of that is I feel like what do I really know? There is so much critical thinking skills that you need to have to work on this floor. Even more so when the CMR calls out and says your patient is in rapid A-fib. So you have to do a few things. Check on your patient, who is sitting there eating crackers and peanut butter and feels perfectly fine, and then go look at the strip yourself, flip some leads and low and behold it is really just sinus all along. That has happened to me twice now, same patient. It gets your heart racing the 1st time, and the 2nd time you say to the CMR are you sure it is A-fib? haha Which turned out not to be again. It might be all the PB cracker movement.

Anywho... that's my latest!