Just finished my last week in the ICU. I'm glad. I learned a lot, but it's just not my thing.
Saturday was so dull. I read 3 chapters in my textbook. Yeah. I got a patient who had inhalation burns from a cocaine binge. Her throat was so swollen. When her tube was taken out, her stridor was so loud it could be heard everywhere in the unit. She was re-intubated, which was interesting to watch. The doctor was unable to visualize her vocal cords because of all the swelling, and said that the patient had been breathing through a tiny slit.
Sunday the unit was full. There was no one available to sit with the cocaine patient (she's a 2013-drug overdose. she can't be left alone), so I got nominated for the job. She was awake, so I handed her some paper & pen. We talked that way for a while. She wants help. Good for her. Her 17 year old daughter had been in DFACS custody until she disappeared from the case worker.
That was pretty much it.
Monday, April 28, 2008
Thursday, April 24, 2008
photos
boat entering the sea-po
my favorite kid, riley. isn't he a doll?
my baby, rocky, playing with a moth
Monday, April 21, 2008
expired time
I had a patient expire on Sunday afternoon. First time it's ever happened to me when I was actually there for the whole thing. We knew it was going to happen soon on Saturday, when her O2 saturation dropped into the 80's. After lunch on Sunday it was in the 50's, with a ventilator. We called in the family. When the sats got into the 30's we turned off the monitor. Then she coded.
Her color drained almost instantly. Her face turned to an ash gray color. A black-green fluid bubbled out of her mouth when we pulled the vent tube. Serous fluid started to pour out of every opening in her body: eyes, nose, wounds, IV site, everywhere. Her eyes rolled back into her head; the whites also now gray. The body was already stiff from her severe third-spacing.
We tried to stop the spouts of fluid and clean her up before allowing her family to view her. People crammed into the small ICU room to say goodbye.
An hour and a half later the funeral home arrived. Her body was strapped onto a stretcher and covered with a velvet cover from the funeral home. When she was being moved, I noticed that her blood had settled to her backside, which was purple. It was still warm. Her front side was cool.
I cared for her for 3 weeks. I watched as she deteriorated. I saw her last breath.
Her family cried. Her husband hung his head.
I wasn't sad. I wasn't upset. I wanted to learn more. I watched.
I feel so eerie. Like I should feel something more. But I don't.
I had a hard time falling asleep last night.
Her color drained almost instantly. Her face turned to an ash gray color. A black-green fluid bubbled out of her mouth when we pulled the vent tube. Serous fluid started to pour out of every opening in her body: eyes, nose, wounds, IV site, everywhere. Her eyes rolled back into her head; the whites also now gray. The body was already stiff from her severe third-spacing.
We tried to stop the spouts of fluid and clean her up before allowing her family to view her. People crammed into the small ICU room to say goodbye.
An hour and a half later the funeral home arrived. Her body was strapped onto a stretcher and covered with a velvet cover from the funeral home. When she was being moved, I noticed that her blood had settled to her backside, which was purple. It was still warm. Her front side was cool.
I cared for her for 3 weeks. I watched as she deteriorated. I saw her last breath.
Her family cried. Her husband hung his head.
I wasn't sad. I wasn't upset. I wanted to learn more. I watched.
I feel so eerie. Like I should feel something more. But I don't.
I had a hard time falling asleep last night.
Thursday, April 10, 2008
Dang Her Black Heart & Her Pretty Red Neck
Rocky, my mutt. The bottom picture is when I was sick yesterday. He stayed that way with me all day.
Yeah, I was sick yesterday. Overall weakness, n & v, and pale. I tried to go to school, but wasn't there but an hour. It was the first day of class that I've ever missed. Damn! There goes my perfect attendance. Haha. My senior year in high school, I missed 85 days, almost half the year. My, how I've changed. I hated missing the first day. But once I got home, I called Mom. She came over & cooked for me, played with Rocky, and took care of me. She stayed until Ben got home, so I was well taken care of. And now I'm better and trying to catch up on school work. Of course I had to miss Acid-Base balance.
That's all for me.
A sunrise on Tybee Island.
Monday, April 7, 2008
Day of Rest
Yesterday was a blur. But clinicals weekend #1 is over =]
I was assigned a patient who has had an incredible amount of health problems in her 55 years. She had multple sclerosis, which had affected her for 30 years. She came in last week just feeling crummy. A chest x-ray showed that her lungs were inflamed, so the docs diagnosed pneumonia. Her abdomen was scanned, and turns out her intestine had gotten twisted into a knot. Surgery was performed to removed part of her intestine. When I walked in her room Sunday morning, her abdomen was distended & tender, usually a bad sign. Her entire body, except for her face, was swollen and pitting. Her heart rate was in the 140's, pretty high. She was also unconscious, thank goodness. She had 3 consults that day. She was very high maintenance, but I barely got to see her b/c so many people were in & out of her room. After her consults, she was taken to ICU to get better care. I went to radiology with her to get another CT scan of her abdomen. Her heart rate got up to 207, extremely high. The tech in radiology took the time to explain her scan to me. Her bowel had perforated (opened inside), releasing fluid, fecal matter, and air into her abdominal cavity. Medical emergency. She was rushed back to ICU while the surgeon was called. I learned how to distinguish between air, fluids, and organs on a CT scan. Last I heard, she was in surgery.
Once she was no longer on the floor, I helped the nurse I had been working with, Katie, and tagged along with Ali & her nurse, Rose. I had a patient that I just wanted to hug. She also came in with a cold, and was diagnosed with pneumonia. The docs found some heart issues with her. One of her valves wasn't functioning correctly, causing high blood pressure. She was scheduled for an endoscopy today, and may need surgery. What made her situation worse was that she gave birth to her 2nd child 2 weeks ago. She was so upset, and there wasn't much I could do about it. I brought her soup & magazines, but that was all I could do.
I helped Ali & Rose again with all the dressing changes. Even in just a day you could tell a big difference. Things went faster; I remembered more than I thought I would.
Then, the day was over.
Monday is my day of rest. =]
I was assigned a patient who has had an incredible amount of health problems in her 55 years. She had multple sclerosis, which had affected her for 30 years. She came in last week just feeling crummy. A chest x-ray showed that her lungs were inflamed, so the docs diagnosed pneumonia. Her abdomen was scanned, and turns out her intestine had gotten twisted into a knot. Surgery was performed to removed part of her intestine. When I walked in her room Sunday morning, her abdomen was distended & tender, usually a bad sign. Her entire body, except for her face, was swollen and pitting. Her heart rate was in the 140's, pretty high. She was also unconscious, thank goodness. She had 3 consults that day. She was very high maintenance, but I barely got to see her b/c so many people were in & out of her room. After her consults, she was taken to ICU to get better care. I went to radiology with her to get another CT scan of her abdomen. Her heart rate got up to 207, extremely high. The tech in radiology took the time to explain her scan to me. Her bowel had perforated (opened inside), releasing fluid, fecal matter, and air into her abdominal cavity. Medical emergency. She was rushed back to ICU while the surgeon was called. I learned how to distinguish between air, fluids, and organs on a CT scan. Last I heard, she was in surgery.
Once she was no longer on the floor, I helped the nurse I had been working with, Katie, and tagged along with Ali & her nurse, Rose. I had a patient that I just wanted to hug. She also came in with a cold, and was diagnosed with pneumonia. The docs found some heart issues with her. One of her valves wasn't functioning correctly, causing high blood pressure. She was scheduled for an endoscopy today, and may need surgery. What made her situation worse was that she gave birth to her 2nd child 2 weeks ago. She was so upset, and there wasn't much I could do about it. I brought her soup & magazines, but that was all I could do.
I helped Ali & Rose again with all the dressing changes. Even in just a day you could tell a big difference. Things went faster; I remembered more than I thought I would.
Then, the day was over.
Monday is my day of rest. =]
Saturday, April 5, 2008
First Day = Done.
Today was the first day of the quarter. My first 12 hour shift at a hospital, in a new hospital, no less. It wasn't as bad as I thought it would be. I did have lots of support from my friends Caffeine and Medications. After a tour of the hospital, we branched off to our assigned floors.
2 East Wing is one of the Med-Surg floors. My patient was on his way home, so nothing eventful happened with him, other than me spending an hour trying to figure out his labs and put it all together in my head. The nurse I was supposed to help didn't want anything to do with me. Luckily, Ali had an awesome and helpful nurse who didn't seem to mind me as a 3rd wheel.
The nurse taught us so much about wound care. We had a pitiful patient who had several pressure ulcers and burns from his waist to his feet. His story was interesting. Paraplegic after a fall. Unable to care for self and reluctant to get help outside his home. Has previously been emaciated. Had burns from a cooking accident. It took us almost 2 hours to do the care required for 7 of his 8 wounds. For the most part, he was in good spirits. I mean, he could have been much worse. I'm not a mind reader, ya know.
I had a refresher course in protein metabolism. Protein -> Ammonia -> Liver -> Urea + Nitrogen -> Kidney -> Urine. Or something very similar to that.
As soon as I got home, the phone started to ring. My Dad & Mom, wanting to know how my first day at the new hospital was. I was probably rude, but I honestly don't remember. I just kept saying, "I just got home."
My neck is stabbing jolts of pain, my hands and numb & tingling, I'm exhausted, but I survived. Ben just got home from picking up a pizza. All in all, a pretty good day.
=]
2 East Wing is one of the Med-Surg floors. My patient was on his way home, so nothing eventful happened with him, other than me spending an hour trying to figure out his labs and put it all together in my head. The nurse I was supposed to help didn't want anything to do with me. Luckily, Ali had an awesome and helpful nurse who didn't seem to mind me as a 3rd wheel.
The nurse taught us so much about wound care. We had a pitiful patient who had several pressure ulcers and burns from his waist to his feet. His story was interesting. Paraplegic after a fall. Unable to care for self and reluctant to get help outside his home. Has previously been emaciated. Had burns from a cooking accident. It took us almost 2 hours to do the care required for 7 of his 8 wounds. For the most part, he was in good spirits. I mean, he could have been much worse. I'm not a mind reader, ya know.
I had a refresher course in protein metabolism. Protein -> Ammonia -> Liver -> Urea + Nitrogen -> Kidney -> Urine. Or something very similar to that.
As soon as I got home, the phone started to ring. My Dad & Mom, wanting to know how my first day at the new hospital was. I was probably rude, but I honestly don't remember. I just kept saying, "I just got home."
My neck is stabbing jolts of pain, my hands and numb & tingling, I'm exhausted, but I survived. Ben just got home from picking up a pizza. All in all, a pretty good day.
=]
Friday, April 4, 2008
first post
Today is the last day of my spring break. I miss Savannah more everyday. I know that if I left my mountain home for there, I would also miss it. The grass is always greener. My trip was refreshing and fun, as always. We did the typical Savannah things-River Street, Bonaventure, Shell House, Breakfast Club, and shopping. If not for my neck we would have gone kayaking in the ocean, one of my favorite things.
I haven't been very productive over my break, aside from reading. I finished two books, and am halfway through a third. All medical, of course. I just can't get enough. I bore Ben discussing Mad Cow, Kuru, Alzheimer's, and how I believe they're related and incurable. Now I'm reading a journal of an abortion provider. I usually stay away from such political things, but this book has been interesting. Protesters will do astoundingly dangerous things, especially when misinformed.
Ok, I didn't start this blog to release my political agenda or to write reviews. I simply like to write. Always have. And with less and less time, this way seemed easier. Plus, I check Ali's blog almost daily for new pictures of my favorite toddler.
I'm nervous about starting clinicals in the morning. Even though I now Northside Cherokee will be a positive experience, I'm not comfortable there yet. Different instructor, different place, different staff. It's also longer hours and a longer distance. I'm worried about my neck. I know I'm "young" but my body doesn't behave that way. Some days I barely survive an 8-hour shift; I get home with a fuzzy memory. What will a 12 hour shift and a 40 minute drive do to me on a bad day? I guess that's why some people told me not to be a nurse. I know I'll do fine and find a way to push myself through the day until I get home. I love it too much to let the physical aspects make me quit. I'm halfway done! There's nothing saying that after school I have to work 12-hour shifts, right?
I haven't been very productive over my break, aside from reading. I finished two books, and am halfway through a third. All medical, of course. I just can't get enough. I bore Ben discussing Mad Cow, Kuru, Alzheimer's, and how I believe they're related and incurable. Now I'm reading a journal of an abortion provider. I usually stay away from such political things, but this book has been interesting. Protesters will do astoundingly dangerous things, especially when misinformed.
Ok, I didn't start this blog to release my political agenda or to write reviews. I simply like to write. Always have. And with less and less time, this way seemed easier. Plus, I check Ali's blog almost daily for new pictures of my favorite toddler.
I'm nervous about starting clinicals in the morning. Even though I now Northside Cherokee will be a positive experience, I'm not comfortable there yet. Different instructor, different place, different staff. It's also longer hours and a longer distance. I'm worried about my neck. I know I'm "young" but my body doesn't behave that way. Some days I barely survive an 8-hour shift; I get home with a fuzzy memory. What will a 12 hour shift and a 40 minute drive do to me on a bad day? I guess that's why some people told me not to be a nurse. I know I'll do fine and find a way to push myself through the day until I get home. I love it too much to let the physical aspects make me quit. I'm halfway done! There's nothing saying that after school I have to work 12-hour shifts, right?
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