Just thought I would write a quick blurb and let everyone know that I was christened today. I was taking care of a patient who was unable to speak or understand more than a child's handful of English and was also in a state of moderate dementia. He was on one-on-one care (meaning someone was sitting in the room watching him all day so they didnt have to put him in restraints because the restraints 'agitated' him) because he had ripped out 3 catheters (1 for sure before the balloon holding it in his bladder was deflated......make my bits and pieces ache just writing about it) and numerous IVs. So, the person watching him needed a break and, while I was watching him for a bit, he began to flail about. Thinking he was having some problems, I ran to the bedside only to find out he had undone his adult diaper. He peed all over the floor and on my arm. At least pee is sterile.......though it did NOT make me feel awfully clean.
On the upside the person doing the one-on-one care did most of the cleaning up during the day as my patient had been prescribed Colace (a laxative) the evening before. I helped out a few times but lets just say that Colace is HIGHLY effective and leave it at that.
1 to go until Florida beckons!!!
Thursday, August 16, 2007
Wednesday, August 15, 2007
With deference to Margie from Fargo, "I think I'm gonna barf!"
Do not read this if you are of a delicate constitution as it will likely prove a mistake. You are warned :)
I have seen quite a few things that would make anyone, myself included, squeamish since I have started school. I have walked with bags filled with human offal, I have cleansed the genitals of the more corpulent amongst us (and the more malodorous), and I have observed a welling pool of urine more blood than urea and more solid than liquid. I will not pretend (even though it is my blog and I am well within my rights to augment myself both mentally and physically) that I have dealt with any or all of it with a smile, but I certainly have tried. Today was a different breed of animal......eh, like a liger or a tigon if they were repellent.
I had the option of working with another student today and, since I am mentally on vacation already I thought why the hell not. She thought the same. Turns out we did not know what we were getting into.
The patient has been on the floor for about a month now. I am learning that acute care spans the time frame between a day and somewhere just south of a year evidently. She was admitted looking something like a burn victim having succumb to some ill effects from a medication she was on. Her husband is a medical doctor, but evidently thought better of taking her in to attend to her problems until two weeks later, hence the severity of her ailments. Her co-morbidities are plentiful and I doubt I will cover them fully here. She has 100 pack years of smoking, severe COPD, she is on oxygen therapy, she has lost better than 60lbs in the past 6 months, she is diabetic, she experiences bouts of psychosis, she is unable to ambulate, she is fed through a peg tube in her stomach, and she is on contact precautions because of ORSA (Oxacillin Resistant Staph aureus). She is presently bedridden and in restraints to keep her from pulling out her feeding tube and/or IV lines. She is also shedding skin.
When I say she is shedding skin I dont mean the kind you see sheaf off your body after too much sunbathing. I mean the type of shedding that you really would have to see to believe. It comes off in sheets and sloughs off constantly. Her skin, despite this, has the tacky texture of a linoleum floor with a three day old soda spill dried upon it's surface. Bathing her yielded a bucket of wrinkled human detritus and putting lotion on her afterward necessitated changing gloves as they gathered up more flecks of skin than a rake would leaves on a fall day. It is probably beyond my words to explain it as vividly as I would like (though it will likely spare you the images I will have for some time). The smell I will leave to your imagination as typing this has proven enough for me.
The counselor told us when seeking employment not to make a list of what we like, but rather to make one of what we do not like. This has shot to damn near the top of that list. Were the profession limited in scope in such a way that this rotation was representative of the whole, I would have removed myself from it by now, but it is no more than merest of fractions of what can yet be. I cannot wait to move on. 2 days until that happy event occurs.
I have seen quite a few things that would make anyone, myself included, squeamish since I have started school. I have walked with bags filled with human offal, I have cleansed the genitals of the more corpulent amongst us (and the more malodorous), and I have observed a welling pool of urine more blood than urea and more solid than liquid. I will not pretend (even though it is my blog and I am well within my rights to augment myself both mentally and physically) that I have dealt with any or all of it with a smile, but I certainly have tried. Today was a different breed of animal......eh, like a liger or a tigon if they were repellent.
I had the option of working with another student today and, since I am mentally on vacation already I thought why the hell not. She thought the same. Turns out we did not know what we were getting into.
The patient has been on the floor for about a month now. I am learning that acute care spans the time frame between a day and somewhere just south of a year evidently. She was admitted looking something like a burn victim having succumb to some ill effects from a medication she was on. Her husband is a medical doctor, but evidently thought better of taking her in to attend to her problems until two weeks later, hence the severity of her ailments. Her co-morbidities are plentiful and I doubt I will cover them fully here. She has 100 pack years of smoking, severe COPD, she is on oxygen therapy, she has lost better than 60lbs in the past 6 months, she is diabetic, she experiences bouts of psychosis, she is unable to ambulate, she is fed through a peg tube in her stomach, and she is on contact precautions because of ORSA (Oxacillin Resistant Staph aureus). She is presently bedridden and in restraints to keep her from pulling out her feeding tube and/or IV lines. She is also shedding skin.
When I say she is shedding skin I dont mean the kind you see sheaf off your body after too much sunbathing. I mean the type of shedding that you really would have to see to believe. It comes off in sheets and sloughs off constantly. Her skin, despite this, has the tacky texture of a linoleum floor with a three day old soda spill dried upon it's surface. Bathing her yielded a bucket of wrinkled human detritus and putting lotion on her afterward necessitated changing gloves as they gathered up more flecks of skin than a rake would leaves on a fall day. It is probably beyond my words to explain it as vividly as I would like (though it will likely spare you the images I will have for some time). The smell I will leave to your imagination as typing this has proven enough for me.
The counselor told us when seeking employment not to make a list of what we like, but rather to make one of what we do not like. This has shot to damn near the top of that list. Were the profession limited in scope in such a way that this rotation was representative of the whole, I would have removed myself from it by now, but it is no more than merest of fractions of what can yet be. I cannot wait to move on. 2 days until that happy event occurs.
Sunday, August 12, 2007
Consuming booze and gut fuel
What a bummer weekend. It went downhill faster than Britney's career. It actually wasn't altogether horrid, so you will have to excuse any hyperbole, but the condo situation is deteriorating rapidly. This could be a good thing in the long run because there is a lot less incentive to stick around ROC if we dont have inexpensive digs within spitting distance of campus. The main issues are twofold (three if you count the owner being a complete tool): there is asbestos tape on a small piece of piping coming out of the furnace that needs to be professionally removed and the piping repaired properly and one of the breakers kept shutting off and heating up whenever you turned on anything upstairs. The first problem will cost about $375 to repair and the second could range anywhere from replacing the breaker to all the wiring in the house being aluminum, bringing with it the whole 'fiery inferno' potential that, aside from those of us with an arson bend, is not appealing. So, we feel he needs to get that stuff fixed and he is the kind of guy that keeps bills in his wallet so long that the Lincoln is getting an ingrown beard. It sucks. No more looking at FSBO (for sale buy owner) homes.
In an effort to check out the other fish in the sea real-estate wise, we popped into a condo community today for a gander. The place itself is nice if a bit dated. The rooms were large (as were the taxes) and the real estate agent pretty much said outright that the owner was extremely motivated to sell. What we fell in love with was the community which includes an Olympic-sized indoor heated pool, two indoor raquetball courts, an indoor basketball court, a fitness center and the nicest people I have met. It was pretty sweet. It is closer than this house, but not as close as the other place. The downside is that it is not altogether that much less expensive. A head scratcher at the moment.
As for school......it goes. I was so nervous and excited to get to clinical, and now I can't wait to move along. I, as well as most people I have spoken with, have our eyes on the vacation ahead and have pretty much had our fill of cleaning up feces and wiping ass. We got to give meds, injections, put info in charts, and attend to other types of patient care........and that was good, but having one patient also makes for a LONG day once you have the general care down. Much like having one table as a server or one customer in retail......they will keep you moderately busy, but only for so long. The rest of the day is spent trying to busy ourselves with whatever is, or at least appears to be, productive. I am glad I feel that way though, because it beats the hell out of feeling overwhelmed.
Also, as a post script to my usual rants, check out Scott Baio is 45 and single if you get a chance. Compelling stuff.
Off to learn about the Alaris pump.
In an effort to check out the other fish in the sea real-estate wise, we popped into a condo community today for a gander. The place itself is nice if a bit dated. The rooms were large (as were the taxes) and the real estate agent pretty much said outright that the owner was extremely motivated to sell. What we fell in love with was the community which includes an Olympic-sized indoor heated pool, two indoor raquetball courts, an indoor basketball court, a fitness center and the nicest people I have met. It was pretty sweet. It is closer than this house, but not as close as the other place. The downside is that it is not altogether that much less expensive. A head scratcher at the moment.
As for school......it goes. I was so nervous and excited to get to clinical, and now I can't wait to move along. I, as well as most people I have spoken with, have our eyes on the vacation ahead and have pretty much had our fill of cleaning up feces and wiping ass. We got to give meds, injections, put info in charts, and attend to other types of patient care........and that was good, but having one patient also makes for a LONG day once you have the general care down. Much like having one table as a server or one customer in retail......they will keep you moderately busy, but only for so long. The rest of the day is spent trying to busy ourselves with whatever is, or at least appears to be, productive. I am glad I feel that way though, because it beats the hell out of feeling overwhelmed.
Also, as a post script to my usual rants, check out Scott Baio is 45 and single if you get a chance. Compelling stuff.
Off to learn about the Alaris pump.
Wednesday, August 08, 2007
A poo free day!
There haven't been many and there may not be many up ahead, but today was finally poo free. It was touch and go all shift though because my patient did wear adult briefs........but today the fates smiled upon me clearly (my patient is also morbidly obese, so it could have gotten ugly quick!) I do have the same patient tomorrow, so who knows if my luck will hold that long, but here is hoping that he chooses to do so in the care of the evening or early morning crew.
I also gave my first injections today (my mom will likely cringe just reading about it). It wasnt as bad as I thought it would be, although honestly I hadn't given it too much thought altogether. I just kind of assumed we would have to do it and I hoped that I wouldn't cause the patient too much grief. Mission accomplished. Injected some heparin (an anticoagulant) into his stomach and some insulin into his arm. I can now say this much, though I didnt really enjoy giving shots, it is both a hell of a lot better than getting them and, as you can imagine, infinitely better than the whole cleaning up poo thing that I love oh-so-well.
So far, the techs seem to love us because we do the grunt work that they no longer have to (at least for some patients in our care) and the nurse's like us because they have one less patient to tend to. i am sure the hospital digs all the free help too.
Off to read and relax. Two more days and a write-up to get to before the last pre-vacation weekend. I cant wait to have some time off, see my parents, and enjoy a real beach.
I also gave my first injections today (my mom will likely cringe just reading about it). It wasnt as bad as I thought it would be, although honestly I hadn't given it too much thought altogether. I just kind of assumed we would have to do it and I hoped that I wouldn't cause the patient too much grief. Mission accomplished. Injected some heparin (an anticoagulant) into his stomach and some insulin into his arm. I can now say this much, though I didnt really enjoy giving shots, it is both a hell of a lot better than getting them and, as you can imagine, infinitely better than the whole cleaning up poo thing that I love oh-so-well.
So far, the techs seem to love us because we do the grunt work that they no longer have to (at least for some patients in our care) and the nurse's like us because they have one less patient to tend to. i am sure the hospital digs all the free help too.
Off to read and relax. Two more days and a write-up to get to before the last pre-vacation weekend. I cant wait to have some time off, see my parents, and enjoy a real beach.
Sunday, August 05, 2007
Smells like poo
Ah clinicals, what is it about you that I love so well. Is it the early mornings? No, I hate that. Is it the white uniforms that breathe like Hefty bags? No, not a fan of that either. Must be the poo. As the song in Scrubs says, everything comes down to poo. (http://www.gibbleguts.com/scrubs-poo-song.html)
How many days does it take to get the smell out of your nose? God only knows, but I can tell you it isnt an easy thing to forget. Here is how Friday went: Our patient on Friday must have had 4-5 BMs and, instead of putting her in an adult undergarment, they seem to think that a pink pad is appropriate. Suffice to say, that can get messy........kind of like pooping directly onto your sheets. Clean up involves a lot of wet washcloths and, since the patient is largely bedridden, quite a bit of rolling her to and fro as we attempt to clean her linens (you have to roll up the dirty linens and roll the patient over top of them and onto the clean linens......not as easy as you think it might be. Next time you are extremely bored try making the bed while someone lies in it). The attending MD wanted her in her chair so, our fellow nurses (the nurse for our patient and the GN she was working with) decided we should move her with just the linens (it did not go smoothly) and then, once in the chair, the RN did not securely attach the feeding tube so the pt ended up with chocolate all over her. When we moved her to clean up, she had had another BM, so they thought we should move her back to the bed. Instead of using proper technique yet again, they opted to stand her up and pivot her, smearing poo all over her newly changed sheets (meaning we had to change them again). The patient is on contact precautions also, so while cleaning her we have to wear protective garments that are made of plastic......so now we are sweating hot on top of the smell and poo pretty much everywhere. Suffice to say, it wasnt the worlds greatest day, but mostly because the RN and GN we were working with were not pleasant (and when our NP notified the head nurse about our experience the head nurse just said, "without assigning blame, lets just say it isnt your students' fault whatsoever). We had worked directly with the head nurse and a different GN the day prior, so they knew that we did a good job. Moral of the story is that nurses (or GN in this case) with a tramp stamp are complete tools (not sure if that is a moral that can be applied elsewhere, so mold it as you see fit).
Does any of this make me want to give up? Not whatsoever......but I think we are getting to experience the worst of it for sure. I do not envy the techs and CNAs at all, but I appreciate the hell out of them. Hopefully I always remember to let them know how much I appreciate the work they have to do when I am a nurse.
On an aside rant, Tia and I went to Wegmans grocery tonite and they have the most inane alcohol policy that I have yet heard of. Tia neglected to bring her driver's license so they wouldnt sell me the beer even though I had my ID. Tia tried to argue that it was a good means to stop the sale of beer to the underaged, but that would really only prevent the sale to the truly stupid. All I would have had to do is to have Tia not be near me when I bought it and there would be no issue. Same goes for if I were 21 and was buying it for the underaged. So, all the policy really does is piss people like me off and prevents NO ONE whatsoever with a valid ID from buying beer for the underaged unless they are standing directly next to them. Kudos Wegmans!
On the other side of that coin Tia, being the overly sweet super-GF she is, went out to pick up some beer later that night. yeah for Tia and yeah for a cold Sunday night beer.
Condo inspection tomorrow. Hope everything comes our all right........or if not the inspector at least finds it. The inspector Tia had for this house couldnt have found water in the ocean.
Off to finish Potter. I am having a hard time finishing it because it will be sad that it is all over.
2 weeks til vacation!!!
How many days does it take to get the smell out of your nose? God only knows, but I can tell you it isnt an easy thing to forget. Here is how Friday went: Our patient on Friday must have had 4-5 BMs and, instead of putting her in an adult undergarment, they seem to think that a pink pad is appropriate. Suffice to say, that can get messy........kind of like pooping directly onto your sheets. Clean up involves a lot of wet washcloths and, since the patient is largely bedridden, quite a bit of rolling her to and fro as we attempt to clean her linens (you have to roll up the dirty linens and roll the patient over top of them and onto the clean linens......not as easy as you think it might be. Next time you are extremely bored try making the bed while someone lies in it). The attending MD wanted her in her chair so, our fellow nurses (the nurse for our patient and the GN she was working with) decided we should move her with just the linens (it did not go smoothly) and then, once in the chair, the RN did not securely attach the feeding tube so the pt ended up with chocolate all over her. When we moved her to clean up, she had had another BM, so they thought we should move her back to the bed. Instead of using proper technique yet again, they opted to stand her up and pivot her, smearing poo all over her newly changed sheets (meaning we had to change them again). The patient is on contact precautions also, so while cleaning her we have to wear protective garments that are made of plastic......so now we are sweating hot on top of the smell and poo pretty much everywhere. Suffice to say, it wasnt the worlds greatest day, but mostly because the RN and GN we were working with were not pleasant (and when our NP notified the head nurse about our experience the head nurse just said, "without assigning blame, lets just say it isnt your students' fault whatsoever). We had worked directly with the head nurse and a different GN the day prior, so they knew that we did a good job. Moral of the story is that nurses (or GN in this case) with a tramp stamp are complete tools (not sure if that is a moral that can be applied elsewhere, so mold it as you see fit).
Does any of this make me want to give up? Not whatsoever......but I think we are getting to experience the worst of it for sure. I do not envy the techs and CNAs at all, but I appreciate the hell out of them. Hopefully I always remember to let them know how much I appreciate the work they have to do when I am a nurse.
On an aside rant, Tia and I went to Wegmans grocery tonite and they have the most inane alcohol policy that I have yet heard of. Tia neglected to bring her driver's license so they wouldnt sell me the beer even though I had my ID. Tia tried to argue that it was a good means to stop the sale of beer to the underaged, but that would really only prevent the sale to the truly stupid. All I would have had to do is to have Tia not be near me when I bought it and there would be no issue. Same goes for if I were 21 and was buying it for the underaged. So, all the policy really does is piss people like me off and prevents NO ONE whatsoever with a valid ID from buying beer for the underaged unless they are standing directly next to them. Kudos Wegmans!
On the other side of that coin Tia, being the overly sweet super-GF she is, went out to pick up some beer later that night. yeah for Tia and yeah for a cold Sunday night beer.
Condo inspection tomorrow. Hope everything comes our all right........or if not the inspector at least finds it. The inspector Tia had for this house couldnt have found water in the ocean.
Off to finish Potter. I am having a hard time finishing it because it will be sad that it is all over.
2 weeks til vacation!!!
Thursday, August 02, 2007
A quick blurb
I havent a lot of time or energy tonite, so this will likely be shorter than Tom Cruise standing in a pothole. I just wanted to write how exciting it is (though wickedly tiring) to be on the floor doing actual nursing work. Sure, we also still do a lot of CNA/tech work, but we also get to distribute meds (oral and peg....which is through a parenteral feeding tube), take vitals, and clean wounds. Today I even put in a Foley catheter (which was actually less nerve wracking than I thought it would be, but largely because the patient has dementia). We are going to learn to give IV meds next week. I wont hide my terror at practicing injections on an orange and then trying to do it on a real person. Hopefully that patient will have dementia as well (so she/he can forget my feeble attempts at putting a needle in their arm). My only wish, and a longstanding wish at that, is that the days didnt start so bloody early. I am not now, and will likely never be, that agreeable in the early AM hours.
Off to finish Potter and then sleep. I have to know what happens.
Off to finish Potter and then sleep. I have to know what happens.
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