Archive for July, 2010

I’m starting to pick up loads of little things.  Such as … make sure everything is done before proceeding.

Like, when you get a new admission, and the patient’s family is waiting in the lounge to come in and see her when she’s all set up in the room … and you’ve put on all the leads on her and set up her telemetry pack and started her on cardiac monitoring … and you’ve set up her call bell and bedside table … and you’ve gotten her vitals … and you’ve gotten her blood sugar … and you’re pretty sure everything is all set up … and she asks to see her family …

And you go out, with a smile on your face, and say, “She’s all set up and ready to see you!”  And the family looks so happy, and they all start to file in, and you follow them down the hall.

And then you see the nurse about to walk into the room with the foley kit, ready to start her catheter, with a look on her face, like, “Why did you let the family in already?”

Oops.  Forgot about that part.

“Sorry, entire family, please go out to the waiting lounge again.  We’ll be with you shortly.”

My bad.

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So, I worked 3PM-11PM again today.  In fact, this is the 3rd day in a 6-day-straight stretch of working 3PM-11PM.  Which is good … gives me a sense of continuity that I think I crave in a strange way.

Around 2:45PM, charge nurse:  “Ken, you’re getting pulled over to another unit to work the floor there.”

I work 3PM-7PM over there … do my thing … meet some new people … get my work done.

Around 7PM, charge nurse:  “Ken, we have a patient in that room over there who needs a 1:1.”

Grrrr …

In fact, 1:1s aren’t all that bad.  You check the patient every 15 minutes, drink some coffee, read a good book, chat up any bystanders, watch the Phillies on TV.  Not all that bad indeed.  But you sorta start to lose your routine and you sorta start to lose your touch and you sorta start to lose your ability to stay awake.  Not to mention, you feel bad watching the other staff rush to and fro getting things done that normally you would be helping with.  Instead, they rush by you as you read that interesting paragraph on p. 43 of your book and sip at your piping hot coffee from Au Bon Pain downstairs that didn’t cost you anything because they were closing and just wanted to give it away!  Woooo free coffee!

Ahhh, did I mention that my 1:1 patient needed the 1:1 because he was 1) attempting to rip out his indwelling catheter, 2) rip out his IV access, 3) take off his sling after having a permanent pacemaker installed (which might result in undoing everything they just did in the OR), and 4) trying to change into his clothes so he could go home?  No, I failed to tell y’all that.

Reason just doesn’t work in that situation, eh?  However, I find that restraints do.  And then he exhausted himself from the restraints and fell asleep within the hour.

And then it was back to my book.

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Went to change a patient tonight, who said he had just gone to the toilet.  This particular patient has been wearing a diaper for the last few days.

So, RN and I head in to change him.  We can smell the poop.  Patient said he had the poop.  So we roll him a bit to get the blue diaper off of him and … no poop.

Where’d it go?

We roll him more, take a peek in every little nook and cranny, and … hmm … still no poop to be found.  We looked and looked and couldn’t find anything.  Not that I was complaining or anything, but yeah, it just … up and walked away.  Or something.

So, all you experienced RNs out there:  where’d his poop go?

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I’ve been spoiled, my friends.

Working on the unit I do, I’ve taken little things for granted.  Tonight I worked 3-11:30, and at 6:45 the charge nurse said, “Ken, you’re being pulled to another unit to help them out.”  I thought, “Ok, that’s cool, I’ll just do the same stuff I do here to help out some folks who don’t have as many ancillary staff.”

Hmmm, “as many” ancillary staff?  Try, “no” ancillary staff.  So yeah, I was the only one there from 7-11:30.  That’s ok, I told myself, it’ll be a nice challenge to see how well I can time-manage, right?

So, after a little while on the new unit, I promised myself I would write down some of the reasons why I’ve been spoiled on my current unit:

  • The nurses are pretty much way awesomer there.
  • The AccuChek machines actually scan the patient’s ID number, instead of having to type it in manually.
  • The cardiac monitors are all touch-screen, and not powered with actual push buttons (the horror!).
  • I can develop nice relationships with the heart transplant patients, because they basically live on our floor for months while waiting for a heart.
  • Way better nurses’ lounge with lockers!

Some other tidbits from tonight:

  • Was asked to switch a patient for the first time because the patient “didn’t like me.”  Hehe.  She asked me to come wash her legs for her, because she couldn’t reach them, which I dutifully did, and next thing I know, she doesn’t like me.  Oh well.  Not everyone will be pleased with NurseExternKenny.
  • I have decided that the least pleasurable part of my job so far is walking around getting I/O.  (And you thought I’d say “wiping butts?”) — Not sure why, I just hate asking people what they’ve had to drink in the last few hours.

And that is all.

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Other stuff:

  • I did my first 1:1 last night, meaning from 11PM-7AM, all I had to do was sit at a patient’s room and watch her.  That’s right … just watch her.  I had to get up every now and then to help her go to the bathroom, or move stuff around, or whatever, but yeah, it wasn’t all that fun.  I just sat there and read almost all of a book.  And tried not to fall asleep.
  • Maybe I’m just being really naive, but why is it that some nurses at night don’t lower their voices when they’re chatting in the hallways?  All of these patients are sick and are trying to rest, and yet some of the nurses let their voices boom throughout the unit.
  • The people working in the pantry have a very thankless job.  Kudos to them.
  • Walking through the city to get coffee at 3:15 in the morning is a surreal experience.
  • I very much like doing EKGs on people.  I like watching all the little lines turn green, signaling me that I can capture the shot.

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Stuff that happened last night:

  • Helped out with my first ever hot water enema on a patient.  Boy, that was a real pleasure.
  • Did 1,684 EKGs and 2,391 AccuCheks on patients (could be a slight, but only slight, exaggeration).
  • Helped take care of my first Swan-Ganz catheter (way above my head at this point).
  • Patient who needs assistance to the bathroom + patient on Lasix = super busy NurseExternKenny.
  • Successfully terminated a 2-inch-long water beetle of some kind.
  • Got to eat dinner at 1:45 AM.  Will never, ever get used to that.

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