Fucking computer

you know what pisses me off?!?!? I had anice long retrospective little posting all set to spell check and post. The FUCKING computer us acting up and instead of spell checking if fucking deleted my post. BASTARD!!!

OK, I'm frustrated now. Have to go to bed shortly.. maybe will try again later.

Karma

Friday night I was off and the cop was working. We made arrangements for me to do a ride along in his precinct that night. I didn't ride with him (we thought it would be a safety issue) but with a girl that he graduated the academy with. I've hung out with this girl several times and she is NUTS!!! We did some traffic stops (god people are stupid) and did a couple of other calls.. nothing big, but we had a good time.

When our night was almost over we responded to a house in an up and coming area of the city. Well-off white couple, security alarm had gone off and the Brinks people had heard screaming in the background. The house was beautiful... Martha Stewart cover easily. She was drunk, half naked and crying... her husband was dressed and had a shitty attitude. It looked like they had a party that night... food and booze everywhere. In his words "she drank too much and made an ass of herself." He didn't want her taken to my hospital, but to the private one in the county. "Her dad is the head of surgery there." Ummmm, thats where I went to nursing school. I saw her ID and the name was familiar for two reasons.

When I was in school wearing my cute white uniform a certain surgeon got pissed about something (even now I don't know what..... not my patient I was just the only person in view) and threw a chart at me. Now I would have kicked his ass or pressed charges, but as a 19 year old student nurse I just went and hid. Well, this surgeons daughter and dick head son-in-law have had issues before. She showed up at the hospital drunk and combative... he was at home with the 1 year old and CPS (child protective services) was called. The good doc and his wife showed up to collect their adult daughter. He was unhappy that she was tied down with a catheter.... (it happens to all the drunks). Swore that he would never do surgery at my hospital again. Oh well.... we don't need you.

So, he threw a chart at me, and I get to see his family's dirty laundry on more than one occasion. Oh, and my new favorite.... the last patient that hit me DIED..... do you feel like taking your chances???

ICU stuff

SO last night was better....I guess I have proved that I can make it through a shift by myself without killing anyone. I pretty much got to do my own thing. Ummm.... ok, I do have a contender for the Darwin Awards for ya'll. 18 year old female hanging out with her boyfriend. Not sure where they were going, but they decided to try to "beat the train" Ummmmmm..... what the fuck?!?!? So the stupid it bitch got hit by a freaking slow moving train. Her boyfriend was fine, she broke almost every bone in her back. Even better, she kept wanting to sit up. The way her fractures were she could have easliy severed her spinal cord and made herself a paraplegic.

The whole time I kept thinking "I sure hope you were high as shit when you did that." 'Cause if she did that sober then she is even a dumber bitch than thought.

So I am going to stick it out in the ICU. As much as I am miserable I know I can suck it up. My goal is to be a flight nurse. I would get more autonomy and be able to work traumas at the scene. In a sense I would really be the front line of care for sick as shit patients. Most flight nurses can put in breathing tubes, central lines, some can put in chest tubes and they can do a surgical airway (think Father Mulcahy from MASH). In order to fly you really have to have a combination of ER and ICU experience.

In the ICU you are supposedly using the invasive monitors, fancy medicine drips and following the patients more closely. You are supposed to be able to recognize when a patient is going down the tubes and know the appropriate interventions. Lately I've been thinking that maybe the Surgery-Trauma ICU would be more my style. I tried Neuro because it was more of a change and it would "broaden my view" Ugh... whatever. I'm just glad to be home.

Riding along with the cop tonight... actually with one of his buddies. Riding with him would be too much of a liability. I'm riding with one of the female officers, shes NUTS, so we should have a good time!

Another night

Unfortunately, the stories from the ICU don't even compare to the ones that I have from the ER. What can I say.... it is both routine and (in my humble opinion) DULL. I'm back in the ER tonight, THANK GOD, so I hope to have some good things to talk about later.

Things are still going in the ICU. My preceptor is bound and determined to make a critical care nurse out of me yet. I don't think she sees the dazed expression on my face when she starts to talk about the stuff we have been doing downstairs for years. One of the other nurses was watching and told me later that she could tell I was getting frustrated. I really wish I was doing more Neuro stuff and not just being taught 'how to be a nurse.' I wish she would just come downstairs and shadow for a shift.... I think it would open her eyes..... and probably scare the shit out of her.

SO I had 2 patients last night (2, thats all.... no 16 traumas.... no drunks, 2 whole patients) the first was nice, quiet and slept most of the night. The second was a little old man (I called him my turnip) with a head bleed. I got him straight from the OR, which was at least something fun to do. He was opening his eyes for me by the end of the shift.... but is still a pretty sick guy.

The cop can tell I'm not happy. I know its hard for him to see me like that. He has been going above and beyond at home just to make sure that I am happy. I have to keep telling myself that this IS going to be worth it soon.

Where Were You?

I heard the asked many times at work last night... Here is mine.....


I had rescue squad duty 9-10-01. Got off at 7am and was at home watching the Today show, getting ready for clinicals that night. I watched the confusion about the first plane and the Pentagon. I watched the second plane hit. It was surreal. My home is driving distance from the Pentagon and friends have family who work there.

I did clinicals at the Trauma Center that afternoon/evening. I was in the STICU (surgery trauma) and the burn unit. The whole hospital was "on hold" anticipating getting patients from the Pentagon. It was so beautiful here that day... blue skies. Blue like they didn't know something had happened that was going to change everything.

I'll talk about my night in the ICU later. Today is not the day. I would love to here from you guys out there. Where were you?



For FF Smagala NYFD My art teacher's brother.

Big Mammas ICU

Another night in neuro. Let me tell you....you haven't lived 'til you have a 350lb woman pissed at you. It didn't help that she was confused and trying to swing at me. Good thing the bitch was tied down! I went to brush her teeth and she tried to spit on me!!! At least in the ER when they try that shit we can be mean to them... put a mask on her and drug her up. My preceptor said "awwww.... isn't she cute?"

Ummmm.... puppies and kittens are cute. Some babies are cute, but a big fat black woman who screams like Scarlett's mammy in 'Gone With the Wind' is definitely not cute! She actually said to me..... 'getonupouttamyface 'foreIhaftahurtyougurl!' go ahead and decipher that.... I can't help it... thats exactly what she said.

My gsw from the other night is now on a breathing machine. He was awake... but just waiting to be strong enough to get off of the ventilator. He is definitely paralyzed from the chest down. He was able to squeeze my hand... and he knew I was there. His mom gave me a hug when she saw me.

Back for the next 2 nights in the ICU... gonna get some sleep!

Home Sweet Home

Was back in the ER last night!!! Doing overtime down there is much easier than the unit since 1) I'm on orientation and 2) their staff is so great that they don't have holes. So I waltzed in to a full trauma room and patients swinging from the ceilings. Ahhhh.... some things never change.

I spent most of my time catching up with folks that I haven't seen in a while. The consensus is that they miss me and really want me to come back. I miss them too. Try as I may, I doubt that neuro will ever feel like home to me.

Had one whole trauma all night (at least til 650 this morning). This kid was sitting on the sidewalk talking to a girl at 1am. Some guy cam up, robbed him, took his car keys and shot him in the back. Then he stole the car. Kid was 22 years old and is now paralyzed from the upper chest down. Bullet fragment went into the spinal cord. Ironically, he is now in my ICU. I hope I get to take care of him tomorrow night. That would be cool as shit. He and I got along pretty well also and he had a nice family. God that just sucks. I wouldn't wish that on anyone.

The cop was unable to join us at a birthday breakfast this morning (the medic's 31st) The cop is at present, getting ready to kick in a door and do a search warrant. I know he loves that stuff, but it scares the hell outta me.

To all of you who have offered such great words of encouragement about my transition to the ICU I must say thank you very much. Your thoughts mean a lot to me, and I will continue to hang in there. Oh, and Izzy.... the typical urine output for a healthy person is about 30ml an hour. Drunks or sick folks can squirt out almost a liter. And there ladies and gentlemen is your thought for the day!!!

Turn /Suction /Tube Feed

Yes, the ICU is a bit different. I have to commend the staff up there, they have the patience of saints.

I'll give you the run down of my night....

1900: Meet in the staff report room. Here we get a brief report on all 14 patients in the department at the time. There we choose up patients and usually drink coffee.

1930: Get individual report from the offgoing RN that had out patients the previous shift

1930-2000: Initial assessment of our patients neuro checks. Give meds if they are ordered. Turn the gorked-out ones, suction them, check tube feeds. Dump urine.

2100: Chart (if you haven't already done that)

2200: Turn, suction tube feed. Dump urine. Give meds if they are ordered.

2300:

0000: Turn, suction, tube feed. Meds, dump that urine. Neuro assessment

0100: Chart. Bathe the gorked out ones.

0200: Turn suction tube feed. Urine, meds. (are we detecting a pattern here?) Draw Labs.

0300: ZZZZZzzzzz God I'm bored

0400: I think you know the drill now!!! Don't forget the urine!

0500: Write the NOTE (focused note about what happened during the shift)

0600: T/S/TF. Urine, meds. Fluff and puff. Make 'em pretty for days.

0700: Report to oncoming shift after they get group report and drink their coffee. Usually out by 0800.

I must say, last night I looked out the window at the skyline listening to my confused patient yell that I needed to untie her and her IV pump beeping for the millionth time. I wondered if I want to be a flight nurse badly enough to put up with this bullshit. Ugh.... yes, I do. But that doesn't mean I have to like it.

ICU

Not sure if I'm loving this ICU situation. The patients are interesting but I'm sort of over the 'dump the urine and re-orient every 2 hours' routine. I know it will get better when I get sicker patients, but for now I feel like I'm just babysitting at a higher rate. It also hasn't helped that I haven't really been sleeping. Yesterday I was tossing and turning, worried that Ernesto was going to take down the tree in the front yard or flood the creek next to the house. The cop was driving home in the middle of it and that didn't help either.

He's home now....so things feel like they are slowly getting back to normal. Not much else to add. Had a patient last night tell me that the reason that I wouldn't untie his arms and let him walk upstairs to see his mom and dad was because I was white. (and you had brain surgery yesterday) We also have a 13 year old who was shot by her boyfriend and is now paralyzed and a couple of my 'drunk, high no seatbelt wearing' folks that are now what we call "turn/suction/tube feed" essentially the larger variety of a houseplant. Before I get much farther on that subject let me just say.... my family and I have talked and they know do not EVER...EVER keep me on machines and just let me linger. That is the cruelest, most selfish form of torture I can think of.