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!