the perfect kind of night

last night was the perfect kind of night. not entirely perfect,because no night really is, but it was a good night. One of the best I have had the last couple of weeks. For starters, no one needed an IV which instantly makes it good because these days my failures at IV will instantly ruin a good night.

I started with 4, 3 of which I had had the previous 3 nights, and got an admit immediately. ED called before they brought him up, which totally surprised me but I completely appreciated. I was able to get him settled quickly, and do my meds before his admission. I had a patient who was very much dependent on a wide variety of drugs, and I was able to make some decisions about what to give her and when that I don't think I would have made last year. Last year I would have seen scheduled zanax, and I would have given it. This year I didn't mention she had it, she didn't ask for it and I was able to help her system clear out just a little.

Word to the wise... when you take so many meds that you have a perpetual slur, something is probably wrong.

I had a colon ca patient with a bowel resection that threw a fever in the middle of the night. I hate bowel surgeries, they can go wrong so fast, but I was able to sit her up and make her do her incentive spirometry, deep deep breathes, that it came down. The body amazes me. 4 hours of sleeping and not taking deep breaths and it gets a fever. I like fevers. The body is telling you something is wrong, and it is working to correct it. Her fever came down, I actually let her sleep, and all was well.

I got another admit around midnight that I still can't tell you why we bothered admitting, but hey, census is low so why not. I got her pain meds reordered and then she was happy and sleeping.

Note to the wise ED Doctor: if you have a patient that takes oxycodone, oxycontin and morphine at home, and choose to admit them to the floor with a kidney infection, PERCOCET is not going to cut it. Or even pretend to cut it. All it does is make me call someone in the middle of the night to get the right stuff ordered.

I don't know. Nothing major happened, but it was a good steady pace. I was never overwhelmed, I had time to spend with each of my patients, but I wasn't bored out of my mind at 3am.

Another fun thing: all of our CAs have gone back to school now. The one I was working with is going to have to work on priorities, because she pulls out the study books way to early in the night, but she still did a pretty good job so I didn't say anything. Anyway, she is studying rhythms, and not understanding it at all, so I spent around an hour working with her on it, explaining strips, counting them out with her, showing her AFIB and some blocks on the monitor.

I am going to get my Masters at WSU, and then I am going to teach, and it is going to be wonderful. I am excited about that part of my career, because I love doing it. I love explaining things and having people understand it... such a high. I loved tutoring. It just makes me happy.