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!