Wednesday, March 31, 2010

Eavesdropping....

Female 1: "girl, I can't stay late today. I got to go get my nails done and go by the hair store."

Female 2: "you going by the hair store?"

Female 1: "ummhmm, I gots to tighten up my locks"

Female 2: "girl, pick me up a bag a hair when you go."

Female 1: "what you like?"

Female 2: "I am thinking about some blue or whatever they got on sale."

yuck...

This past weekend I got the call. Yup, the dreaded evil call to tell me where I could be working and this particular day they were sending me to the very pit of hell. That is right the wicked vile step-down unit where nurses go to die.

I woke up listened to my voice mail and as I heard the coordinator give the assignment a cold chill went up and down my spine and a sudden sickness came over me. It was not to be a glorious day.

I tried to tell myself, "it won't be that bad." I am pretty on top of things and I can go with the flow - famous last words.

So I go to work and get my assignment - not bad. The within an hour everything begins to unravel. I have three of five patients leaving the floor all at the same time. The techs are playing hide n seek (once again) so I am getting patients out of bed and to stretchers and verifying they can go without monitors. Finally the last one is gone.

Next comes the slew of residents as far as the eye can see and they are all chasing me down to as some stupid questions. One tries to explain that the patient has the wrong size cuff. I tell the pinhead I have been here two hours and have not made it to the room but would be happy to look into that at a more appropriate time. It was freaking nuts!

Then swoosh all my patients that had been off the floor come back within seconds of one another. Still cannot locate the tech, is one working? I go back help the patients back to bed, help set them up to eat. Two of the need to use the bedpan (hello where is the tech). In the next hour I manage to give meds to three patients and I still have not seen the other two on the other hall.

I finally escape the front hall, walk into room number four and the first thing from the patient's mouth is, "I need relief immediately". I am like - what? She goes on to tell me she has not had a bowel movement in 10 days (the prior nurse gave a more realistic time frame). She insisted that I "fetch the doctor" so this could be addressed at once. I explained the residents were rounding and promised it would be handled today, however, she felt this delicate issue should not be handled by a resident. It must be addressed my an attending. By this time I am so over this argument so I put her meds in front of her tell her to take them and I head out the door.

It is now very close to 11 am and I still have one more patient to see. However, her daughter found me first and she was CRAZED! It seems mama had been transferred to the step-down from the other step-down during the night via a stroke alert. Mama was found on midnight rounds with right sided paralysis and facial droop with very slurred speech. Mama walked into the hospital a few days earlier with minor rectal bleeding, history of chronic a-fib. So, they stop her coumadin and scope her up and down and find nothing - now this!

Anyway, the daughter was not informed of the big changes upon transfer. A resident did call her at night and explained a "minor change" but nothing for her to worry about. Well, the daughter disagreed with the MINOR change and proceeded to freak out right in front of me. So, for the next hour or so I tracked down this doctor and that doctor and had them come to the room to explain in greater detail to this worried dtr what the fuck was going on.

The daughter was also freaked out because now mother was incontinent and needed changing.

Let me tell you...over the next six hours I cleaned this woman 9 times and still no tech anywhere in site!

So at about 1400 I had had enough! I tracked down the charge and told her she either find the missing techs or she start turning, feeding and cleaning my patients because I was about to walk out the door.

Every once in a while it feels really good to throw down a girl-scout-hissy-fit! They didn't see it coming from me, but it was well overdue!

Waalaa missing tech arrives and looks as if she just woke up. She tells me she has been in the patient's room who I have cleaned 9 times. So I bring her into the room and ask the daughter and patient if they have ever seen this woman and both state they have not. Hmmmm.

So, I get the tech to change the patient and place a foley (praise baby jebus). Then, the gaggle of residents decide this stroke woman needs a slew of stat orders. I love how the little resident tracks me down to inform me that there are stat orders. I walk over to the chart, that is laying on the secretaries desk with a pink post-it saying "stat". I had to chuckle as there were no less that 12 charts piled at the desk and the secretary was out smoking, eating or sleeping - who knows?

I read through the orders and there are stat MRA/MRI orders. I attempt to call MRI and after multiple rings. I call radiology and am informed that MRIs don't happen on weekends. I explain this is stat and am told they do not care, they WILL NOT be performed on weekends. So, backup plan..the gaggle of residents order another stat CT to see how the stroke has progressed.

This time the patient will be leaving the floor monitored. I tell the monitor tech I need the patient taken on monitor to CT stat. He says, "I am going to lunch." WTF!!!
It is like 1630 the fat bastard has been on 5 breaks and been stuffing his face all fucking day and now when I need something the idiot is rushing off to lunch?? I track down the charge yet again and explain how this is unacceptable. She then helps me take the patient to CT and back.

Finally, after two enemas a few feeds and some iv starts the day is settling down and it is only 1800 just one more hour to go. I decided to dash down to the cafe to grab a soda since I have not had a lunch and I am sorta hungry and exhausted. I am in line and who do I see? The fat-assed monitor tech with more food. I could have punched him in his fat face!

I hate step-down! There is a reason I am a critical care nurse! I do not ever want to go back there again!!

Saturday, March 27, 2010

huh...what...

Sleep thy name is , er I forget.

Last night was not very kind to me. I could not for the life of me fall asleep. It was one of those nights where you are aware of how much time is left until it is time to wake up. So every hour I would check the clock and stress.

midnight, ugghh only 5 hours of sleep are possible. okay, i am going to sleep now.

two-thirty??!! Damn, now I really have to get to sleep - no more playing around.

three-twenty!! Oh God let me get at least an hour in!!

four-ten!! FUCK!! I have to be up in an hour! Twenty minutes of sleep, please so I don't kill someone - accidently!

five o'clock. Shit may as well go get some very strong coffee and take the hottest shower possible!!!

That was pretty much my night! The good news is that I got downstaffed by noon and came home for a glorious nap! I feel refreshed and hungry. I just hope I can fall asleep tonight!

Friday, March 26, 2010

List of 5

Five things that make life better:

1) My IPod and the great feeling I get after my run.

2) A really cold Sam Adams draft.

3) The Lobster Nachos at Red Lobster (they rock & the cheese biskets are pretty good too).

4) That giddy feeling that comes over me when I clock out from work.

5) That first glorious cup of coffee in the morning.

My own stupid...

Okay, so when I landed back home after my years of travel I benefited from a regiment of strict diet and exercise. Well, at least I was solid of the exercise part. I ran 3-4 times a week and lifted twice a week. I was not ripped to shreds, but I was working my lean out.

So what happens when the routine is interrupted by coming back home and a sudden increase in eating out (drinking mostly) and a sudden reduction of exercise. I will tell you what happens - Rob gets FAT! Rob is not happy with this at all and is searching reverently for someone to blame this sudden weight gain upon.

I tipped the scale just this morning 15 pounds heavier than when I arrived in this beer-swilling city. Wha-happened? Better yet, wha-ma-gonna-do-nah to shed this new found blubber?

Dumb ass me purchased brand new scrubs that are on the snug side in efforts to showcase my hard work that I put in on the road. Now those new scrubs reflect my recent ingestion of adult beverages and my fondness of all things covered in cheese.

So, now I have to admit that I am a fat slob and set the coarse right. I am going to begin April first to regain my svelte-ness and try to turn that keg-gut back into 6-pack (yea right).

I think as it warms up I will be able to shed these pounds and find the motivation to say no to all those tasty and delicious foods.

Thursday, March 25, 2010

the dreaded...

It seems that I look forward to days off in a row. When I am off I dread the thought of returning to work.

Wednesday, March 24, 2010

sounded good at the time....

I met one of my newest friends for lunch today. Lunch, funny I do not remember eating so much as pounding down drink after drink. I seem to be drinking so very much lately. My poor liver has been assaulted over the past few months - meh..the liver is a resilient organ and I think mine can handle the onslaught of copious alcohol.

Anyway, I got into a drunken gripping conversation with my new bro-friend and we decided that we should both join a branch of the military. We figured (Sam Adams assisted) that we are both manly men and we should be jumping out of planes or carrying AK-47's (remind me to return Hurt Locker to Blockbusters) and not wiping the asses of 80 year old ladies.

Alcohol allows one to dream the dreams sober folk dare not mention. However, the idea still is bouncing around in my head. Maybe a good night sleep will smother the fledgling idea and banish it to the place where all my other far out notions died.

Tuesday, March 23, 2010

to the head of the line....

Several years ago i worked in an ICU in Florida. We were a single ICU for the whole hospital with 48 beds. So instead of having neuro, cardiac and surgical specialty units we took it all.

One shift we had a patient being flown in from some woohaa town outside on Ocala. The reports were sketchy so we waited till the flight team arrived to get the details.

Well, the team arrived and they were chomping at the bit to give report on this doozie.

The patient was a 28 year old obese female who lived in a mobile home with her boyfriend. The patient and the boyfriend were enjoying one another this fine evening and she was well..lets say she was performing a service for her boyfriend.

The boyfriend, enjoying the attention until the girl stops, looks up and her eyes roll back in her head and she collapses.

The boyfriend - keeping his head (slight pun intended) - goes for help. These are poor woodsie folk who do not have phoen or cell phone so boyfriend must leave the trailer to seek help. Boyfriend runs more than two miles to find a home with a phone so they can call rescue.

When rescue arrives the boyfriend gives them a blow by blow description of the events that led up to girlfriend laying on the floor covered in drool.

Myself and five other nurses are listening to this story whit looks of amazement. First, we wonder wht boyfriend did not just make up some story..

One coworker stated, "see blowjobs are hazarders to my health and that is what I am telling my husband". The women had much fun with this little story.

We got the patient settled and later the family along with boyfriend came in to visit and I believe every nurse, physician, secretary and housekeeper got a glimpse of boyfriend that evening and we al wondered if he told the girls parents exactly what was happening when girlfriend had her little incident.

Sadly, the girl did not make it. She had a huge bleed and life support was withdrawn a few days later.

people are strange...

The other day I was having a conversation with a patient. He was in his sixties and in the hospital due to a recent bout with pneumonia. He was a walkie-talkie but he was distressed because it had been 5 days since his last bowel movement.

As any nurse can tell you older patients depend on those daily bowel movements and to miss a day is a HUGE deal to an elderly person. The older generation are fixated on the timing and number of bowel movements and they discuss their movements with everyone they come in contact with..

So I spoke to my patient about the options relating to his lack of movement. The man told me he has a problem "taking a shit" anywhere but in his own home. He told me that when he and his wife were first married he would leave his house and drive to his mother's home to take a dump! He said it was a couple of years before he could move his bowels in the house with his wife present.

By this time I am fascinated! I am asking, "why could you not take a dump with your wife in the house?" He said, "because I didn't want her to know I did nasty things like that."

Wow! Now she took many dumps in the house, but for some reason he wanted to present the image that his bowels simple absorbed all that waste.

So, later in the shift I gave the man prune juice, coffee, mag. citrate and nothing would work. I suggested he sit on the toilet and give it the old college try. But no dice!

I had an order for an enema, but as you can imagine....a man that will not poo outside his own home is not about to allow a dude to administer an enema.

My shift was cut short as I had to float to another floor, but I wonder is that patient ever found relief. Lord help the pipes when he finally does!

Work - A - Do

I am off!! Four full workless days and it feels amazing! With all this time off I cannot decide what to do.

To start the off time I slept my lazt ass in until 1000 - woohoo! The I proceded to do a whole lot of nothing. I watched some boring television and then became inspired to bake a box cake. It was the only thing that looked semi-tasty in my kitchen.

As the cake cooked I set off for a run, but I was not feeling it today so I only did a 3 mile run. I usually get in 5-8 miles, but I was feeling a bit off.

Now the cake is done and set on the stove to cool. I frost it and take a huge piece! Ugghhhh! All the sugar makes me feel like a nasty slug so I return to bed!

When you spend so much effort avoiding sugar and all of the sudden give into it the body no likie... Now I have a hung-over feeling and I have wasted most of the day....

Hmmm.. I almost wish I were at work~!

Saturday, March 20, 2010

saturday...

It promises to be a beautiful day here with highs in the sixties. So I plan an outing to have lunch with a friend.

I have been craving some seafood and a beer or two. Plus I have a wicked work schedule for the rest of the week.

So cheers to a beautiful day and to a much deserved day off!!!

all at once...

I have tried blogs before, but never with any purpose. I enjoy reading a few and find some quite fascinating. Others are less than spectacular which is probably where this wee little corner of the web will end up.

*****
I decided with this particular blog I would stick with my time here in Pittsburgh. I believe that my time here will be short and I wanted to journal/blog about my time left. I came back to da burg at the end of January and secured myself a job with one of the local hospitals. To protect the innocent the names and dates may be altered a bit. However the experiences are far too real to disguise.
*****
I have been a nurse for round about 187 years give or take a day or two. I have worked in med/surg, rehab, gi lab, IV team, ED, ICU, CCU, CVICU, NICU, Trauma and various other float places (especially in travel) and now I find myself back in an ICU pool position with floats everywhere.
*****

Lists of five....

Five things I like about Pittsburgh:
1) The city is small enough to enjoy and diverse enough to have a little something for everyone.
2) The people are very friendly. It feels like the different ethnic folk get along well here and I like the differences.
3) Food. I can satisfy all my food lust here from Thai to Italian, sushi, vegan, seafood and anything in between.
4) The climate. Summers are beautiful and mostly bug free. The winters are not that bad and the streets are plowed better than other northern cities.
5) The drink. There are pubs/bars all over the place. Within one mile of my home I can drink at no fewer than 15 places - makes you understand why there are so many alcoholics here.
5 + 1) Sports town. This town loves and strongly supports sports of any kind - I Love that!!!
Things I hate about this city:
1) Small ass roads. People park on the street and it makes it difficult to get down many of the streets.
2) Smokers. It seems like over half of the people here smoke - yuck! It is a filthy dirty disgusting habit.
3) Taxes. This state/city is money hungry and tax the living shit out of everyone. My take home is but 64% of my gross after all the fees/taxes and insurance and I still end up paying at years end.
4) The hospitals. By far the worst of any I have ever visited or worked. They run on the cheap and could care less if safety is skirted or staff are miserable.
5) Steeler waiting list. I have been on the list for 6 years and will probably die without ever owning season tix.

Just A Job...

Moved back to PA after many stops as a traveling nurse. I thought I would give home one last shot, before packing my belongings and leaving for good.

About traveling. I enjoyed seeing different places and learning how things are done in different hospitals. I met some great people and more than a few I hope to never see again.

Traveling taught me that I can live with just the essentials and be very happy. When you work as a travel nurse you understand you can't load everything you own into a VW Jetta - so you have to pick and choose exactly what is important. When you reach your destination and find you are without something - go to walmart and buy it or learn to live without. I learned to live without and it was a very freeing experience.

So when I decided to come back home I wanted to free myself of all the excess possessions I had accumulated over the years. First I tore through my closet and donated 2/3 of what I owned to charity. We are talking boxes and boxes of clothes (I am a clothes whore) and shoes and anything else I had held onto for years.

Something felt so good about letting go of the things I not longer felt that I needed.

What was bad about traveling was never feeling that I belonged to a place or unit. Plus living in apartments - ewwww! Nothing against apartments, but I own a house to do what the fuck I want when I want to do so. Rental furniture is also yuck. Sleeping in a horrible queen bed when my pillow-top king was all the way back in PA.

Back in PA, but just to try it back on for size. I am not sold on staying here, but wanted to give it one last chance to lure me home.. we will see...