My first week in review.

Lets talk day 1, shall we?

I am, obviously, new. I know where nothing is.  I am just getting to know my preceptor, just learning where clean holding IS, and haven’t even had time to browse it.

(I was at my last job for 2 years. for 300 nights I went to the same clean holding, grabbed the same things, and still couldn’t find everything on the first try. and then you have a new clean holding with supplies that look different. It is challenging)

They are getting ready to intubate a guy. He just came in with Resp distress, and bipap wasn’t cutting it.  I went in to watch, which is what you do on day 1, watch.  The med student starts to put in the tube, they give him a boatload of sedation, and starts to put down the tube.  He tries once, misses, pulls back and just as he puts it down his perfectly visualized cords, the guy starts... throwing up stool.

Have you ever seen someone throwing up stool? it smells, it is a weird consistency, and he was putting out A LOT! we had 2 suctions going, the dr stepped in to try to get the tube in and the guy goes into PEA and we start the nastiest code I have ever seen.  Every.Single.Chest.Compression (at a rate of 100/minute, mind you) was splattering this stuff out of his mouth while we tried to get a tube down him.  Once the tube went down him the stool started bubbling out of it (that is bad.)

I am standing there… holding up his gut so we can try to find a pulse with the doppler, and people keep asking me to get things, find things.  I know where nothing is, and fortunately other people were around to get it, but it made me want it to be 6 months in when I actually know how to find things.

We eventually got him back, and they started putting in central lines and arterial lines and dialysis ports (his magnesium was… like 9.  higher than I have ever seen it. normal is 2.5)  Eventually the doctor went in, told the wife what was going on and she said to stop.  pull the lines, pull the tube, let him go.  It took him less than 60 seconds after the vent was turned off to die.

They asked me if I had ever been in a code, to which I just laughed.  Yes, I think I have.   Leave it to me (known at pcu as the Code Queen) to have a code on day one.

Once I got home I took off my scrubs and found little splatters on my clothes, which is a perfect example of why work clothes only get worn at work.  nastiness.

Day 2 I had a patient with a bowel evisceration (she had parts of her small bowel sticking out of her incision).  I  thought it was kind of cool, my preceptor was freaked out, and the doctor didn’t much care, but still. Day 2.

Day 3 was boring.  Which was good after days 1 and 2.

I start nights next week.  I am kind of scared what is going to happen to my patients.

Healing Hands

My patients have an awful lot to say about me, I guess because I don't say much of anything so the silence has to be filled somehow, right? Nearly every single shift and sometimes a few times a shift, I get compliments on my hair. All the old people think it's natural and I can't lie so I have to confess it's bottled. But they love it anyway. All the little old ladies think I am so beautiful and I smile sweetly and say "Thank you, now don't move while I put this IV in!".

Last week I took care of an 82 year-old man who introduced me to his wife like this: "This is RaDonna my nurse, she takes really good care of me and she also has a really nice butt!". I was mortified! My face turned a brighter shade than my hair and I ran out there as fast as I could! The funny thing is I got a text the next day from a paramedic friend of mine saying that he was transferring my little old man to the next hospital over and he wouldn't stop going on about my nice butt. So now my derrière is apparently the talk of the county!

My favorite thing that my patients say about me isn't my hair or my tush, but that I have a very gentle touch. It made me so happy when I finished putting in an IV today, and my patient says "Thank you for being so gentle with me." So many times I see nurses or aids roughly turning patients or grabbing their arms to put the blood pressure cuff on them and it makes me so sad. One of the ICU nurses I followed around the last month of nursing school told me that patients can tell you care by the way you touch them. That has stuck with me throughout my year-long nursing career and I hope I never forget it.

I tell you what though, I didn't feel very gentle last Tuesday when I was holding a tiny little 7 week-old baby for a lumbar puncture. Poor little baby had a fever that wouldn't break so we had to give him the full workup: labs, IV fluids, cath urine, lumbar puncture, and antibiotics. I was terrified taking care of such a tiny baby and the worst thing was he never stopped crying the entire 6 hours I took care of him. Every time I walked into the room I brought some other method of torture with me. I looked for a vein on him but had to bring reinforcements because he had nothing that I could see. I catheterized him for the urine sample and that was hard because I had never cath'ed anyone under thirty before! When it was time for the lumbar puncture, we laid him on his side at the edge of the bed and bent him into a fetal position and held on as tight as we could without hurting him. He wailed the entire time but Dr. C was good and nailed it.

We ended up transferring that poor little boy to a hospital with a PICU to rule out sepsis. One thing I hate about emergency nursing is that I rarely get to find out the end result of my patients, and the few times I do find out, I usually don't like what I hear. The little old man who like my butt was transferred because he had a massive aortic aneurysm and he only had a 50% chance of surviving the surgery to repair it. A sweet man I took care of last week for gallstones ended up coding the following day. This morning I cared for a man with a 106.9 F rectal temp and after I finally got him cooled down enough that he wasn't delirious from the fever, all he wanted to do was hold my hand because it was warm.

I don't know if any of these patients lived or died but they touched my heart, each in their own way. I am so glad I can make a difference to them by the gentleness of my touch and hopefully bring God's comfort through my hands.

I found the following blessing for nurse's hands on the internet and I wanted to share it with you.

Blessed be these hands that have touched life.
Blessed be these hands that have felt pain.
Blessed be these hands that have embraced with compassion.
Blessed be these hands that have been clinched with anger or withdrawn in fear.
Blessed be these hands that have drawn blood and administered medicine.
Blessed be these hands that have cleaned beds and disposed of wastes.
Blessed be these hands that have anointed the sick and offered blessings.
Blessed be these hands that grow stiff with age.
Blessed be these hands that have comforted the dying and held the dead.
Blessed be these hands, we hold the future in these hands.
Blessed be our hands for they are the work of Your hands, O Holy One

For Randi and Rachel

Happy Nurses Week to all my fellow nurses out there!

This was my first time celebrating it as an actual RN and I was blessed to be nominated as the "Rookie Nurse of the Year" at my hospital and I won! The ceremony was beautiful and I had no idea I had won til I got there. My boss called my parents and they were able to come and share this special moment with me. I actually got 4 free tickets to Disney world too!



I had a very boring three day weekend at work last week. Nothing happened and I was hounding the doctors for stuff to do and annoying my fellow nurses with constantly asking them if they needed help. So yesterday I had to pay for all my boredness. I had a 44 year old woman come in as a diabetic unresponsiveness but that was actually the least of her problems. She had liver cancer and her prognosis was very poor, her oncologist had told her already that there was nothing that could be done for her. She was a train wreck, all her systems were already shutting down. Her lungs were filling up with fluid, her abdomen was distended with what the ED doctor thought was blood because her hemoglobin was half that of a healthy person. She wouldn't keep her blood pressure up, her kidneys weren't working and although she was conscious, she was confused and unresponsive to everything going on around her. Her core temperature was only 91 degrees.

She was going to die. I knew it, the other nurses knew it, and the doctors knew it but her sisters wouldn't accept it.

Liver Cancer runs in their family, one of the sisters had already had a liver transplant. I don't know if they thought this one sister could survive the cancer because the other sister already had or what. Either they didn't understand how grave my patients situation was or they just didn't want to accept it but they told us that they wanted everything done for this poor woman.

EVERYTHING.

I let the two sisters stay in the room because I knew they didn't have much more time together. I had to work to keep my mind busy on all the interventions I was doing like foley catheter, NG tube, and managing all 5 of the IV pumps, because every time I let myself focus on the three woman in the room with me, I would tear up because they reminded me of myself and my beautiful sisters. The nurse in me was incredulous that these women would allow my poor patient to suffer like she was but at the same time, the sister in me could understand because I am sure I wouldn't want to let go of one of my sisters at such a young age.

I stabilized her as much as I possibly could and had my charge nurse help me transport her to the ICU. We were a very grave procession going down the hall followed by the chaplain, the sisters, and the rest of the family. They coded her 3 times in the ICU, the second time was right at shift change and since I didn't have any patients, I went up with the ED doctor to work it. I found out from the ICU nurses that the patient hadn't wanted all of this...she didn't want the tube down her throat or her heart being shocked back into rhythm. But family members can overrule the patient's wishes. Finally, after she coded for the fourth time, her family signed the DNR and let her go.

When I got home last night, I just wanted to hug my sisters. Being the young age that I am, I still have that immortal mentality that hard things will never happen to me. Days like this show me that I don't know what the future will hold for me and my family. I hope that if I ever find myself in a similar situation I will make the right choice. But I won't know what the right choice will be until I get there. So for now, I won't yell at Randi Jean when she steals my perfume or say no to Rachel when she asks me to ride bikes with her. God truly blessed me when he linked me for life with these two women(oh my word, I'm crying right now!). I pray that I will always cherish them for as long as I am privileged to have them.













2004


2009

She is your mirror, shining back at you with a world of possibilities. She is your witness, who sees you at your worst and best, and loves you anyway. She is your partner in crime, your midnight companion, someone who knows when you are smiling, even in the dark. She is your teacher, your defense attorney, your personal press agent, even your shrink. Some days, she's the reason you wish you were an only child.
~Barbara Alpert

Because I am bored and I was reading my facebook notes...

I posted this on facebook last fall. It made me happy to read it today, so I thought I would share.

1. I have a Wii. With Mario Kart. I am very bad at Mario Kart. I run into the walls. I also have a Wii Fit board. I am considered unbalanced. Probably true. I beat Tiffany at Mario Kart, but not on the fit board. she is more balanced.
2. I read a lot. My mom says I am an emotional reader in ways that people are emotional eaters. Does this make sense to anyone?
3. I am turning into my mother. Which is okay, cause my mom is cool.
4. I have gotten very good at chest compressions in the past two months. Which is not especially a good thing.
5. I love the idea of living in Alaska. Someday I will travel nurse there and stay for a while. Feel free to come visit me.
6. My favorite places in the world: 1. Axtell/Hillcrest (aka grandparents). 2. Paradise Valley Nature Reserve (waterfall beats ocean any day). I wish there was something like it here 3. Florida. Hate the place, but a lot of my favorite people are there.4. My couch with a good book. even better, at home where mom is cooking while I sit on the couch.
7. I just bought a new car. A 2009 Hyundai elantra. I love it like mad, but I still kind of miss my old grandma car. A lot of good memories happened in that car.
8. There are squirrels that live in our ceiling. I listen to them a lot, and am thinking about naming them. The one that keeps running into the duct work I think I shall name crash.
9. I watch a lot of Sci Fi, which is kind of funny. I was very sad when they canceled Starga te:Atlantis.
10. Some people thrift store shop for clothes or furniture. I buy books. I have more books than I have room for, which is sad. Because I totally plan on buying more (such as the one that is in the mail right now that I bought cause I felt sorry for myself cause I was sick and I had to go to work. That is the kind of excuse I use to buy books)
11. I feel guilty when they call and ask me to work extra. Even if I already have plans, and I say no, I still feel guilty. I need to get over this soon, since they tend to call a lot.
12. I have lived/am living with the best group of roommates ever. They were an answer to my mother's prayer that Corrie make good friends at college. They make me happy. Keep me grounded. God is good.
13. I love my job. I complain about it a lot, but I really do love it. I wouldn't want to do anything else, even be a waitress in Alaska, which was my backup plan throughout college.
14. Calling and bugging my brother is high up on my list of favorite things to do. It is a game to see how long I can make him talk to me before he finds an excuse to hang up.
15. I am very proud of the e-mails I write, especially to my grandparents. They make people laugh.
16. I am the only person in my family with red hair. I have been to family reunions, no red hair. It does appear in the beards of various brothers/uncles/cousins. On the same note, my mother has always been very opposed to me dyeing my hair. I did it, and she didn't notice for 4 days. I told her she is no longer allowed to comment.
17. My birthday is my favorite day of the year. My apartment will be turning green sometime in the next couple of weeks. Everyone should celebrate it. ( and no, chelsie, it is not just about beer and greed.)
18. I love Africa. I am planning on going back. Maybe this year, if I can find a good trip. Anyone know of any good medical missions to Africa?
19. I love school. I am planning on starting my master's soon, for no other reason than I want to take advanced pathophysiology.
20. In my opinion no one who graduates from nursing school has any clue whatsoever how to be a nurse. I have been doing this job for 6 months, and I still feel clueless. Slightly less clueless, it is true, but still clueless.
21. My dad thinks I should be able to write a book since I read so many. I tell him it is not quite the same thing. He doesn't believe me. Maybe some day I will give in and write a good mystery involving a nurse who solves the crime and gets the guy.
22. I am a greenbay Packers fan. Thanks to my roomie from WI. It helps that their team color is green.
23. I love being the baby of my family. I am spoiled, I freely admit it, and it is nice. Very nice.
24. When I am bored at work I sit and look at house through www.frontdoor.com I picked out my dream house on Roosevelt road, College Hill, Wichita. I really want a house. With a library. And a dog. Lots of windows. Laundry room where I don't have to use quarters. Ahhh... dream big.
25. Freshman seminar I called myself Chatterbox Corrie. My prof laughed at that, because up until that point I had said, well, nothing. But I do chatter. a lot. My dad tells me, Corrie, your mouth runneth over. I eventually started talking in class too, so my prof believed me. I discovered it was faster to give the right answer and move on than wait for anyone else to talk ( I have not yet decided if that is a good attitude to have, but honestly, 4 hours of HR a day called for that attitude).
26. (cause I like going over) I think I like the person I have become. That makes me happy.

Thoughts a year later: I have been doing this job for 18months and I am starting to feel like I have got it. I desperately want a house, to the extent I am not sure about going to Alaska anymore. They have stopped calling and asking me to work extra, and started calling and asking me to stay home. I am done saying yes. I am now living alone, thanks to people getting married all the time, but I still have the best group of friends. I still enjoy my job.

I do like the person I have become. It is official. And that does make me happy.

Thursdays.

Here is the e-mail I sent my dad the other night:

I think maybe I am just cursed in winter.

My patient just coded.

Drats.

It might be a long couple of months.

(in other news... I have no news. i was having a good night. until I walked in the room and my patient wasn't breathing. that kind of killed the good night. )

I hope you have a good day. And that no one stops breathing during it.

At least I didn't have to do compressions, although those are kind of fun.

I would still rather not have to do them... I will take a beating heart over a not beating heart any day. Even without breathing.

Now, give me a patient with both a beating heart and the ability to breathe, and I am a happy camper.

I don't think I ask for much, do you?


Sometimes the way my brain works while I am taking a 5minute lunch break at 5:30am worries me. I don't really think chest compressions are fun. Really. I do like it when my patients are breathing, that much is true. I really cannot tell you how much I liked going back to work last night and having that patient back on our floor... he is okay! Or as okay as someone could be who stopped breathing for a bit. Life is Good. I finally had a code patient live.

Queen of....

Last winter I went through a tough spot in my nursing career. all 6 months of it. Over the course of December-February, I had a either a code blue or a rapid response every week. every-single-week. Not all the codes where my patients, but I worked them all. and to be honest, most were my patients. The first one never should have happened. A healthy 60-somethingish woman post heart cath... no complications, the most routine thing ever. Until she went into sustained VFIB and we had to shock her 3 times to get her out of it. Fortunately, she woke up and talked to us and actually made it out of the hospital alive. That was the only one of my codes that ever did that. There was the lady who blew her fem-pop, spraying blood all over the room. She didn't code, but came super close. There was the guy whose doctor I call 3 times over 2 hours telling him that something bad was going to happen, and it did. The guy's wife had to take him off the vent the next day. One day they floated me to 3north. The charge nurse assured me that I got the easiest group. 6 hours later as I transported my second patient to the ICU for post-op complications I realized there was no such thing as easy. There were more... on and on it went. I was on a first name basis with every ICU nurse there was. People started talking... and somehow I became known as the code queen. I am good at chest compressions... and let me tell you this, compressions on a 400lb man are SIGNIFICANTLY harder than on the little rubber dummy in class. So life was hard and I was about to think I was cursed and then it was march and I love march and people stopped dying and life was good again.


Until this week. In the past week I have had two patients fall. Hit the ground and do enough damage that I had to fix their problems. One dude was peeing blood clots after pulling his foley out... wasn't that fun to fix. My lady this morning slammed her hip into the ground... hopefully it isn't broken. 2 incident reports. 2 calls to doctors telling them I let their patients fall. I don't like falls. I don't like patients getting hurt on my watch. I don't like bad patterns either.


I really don't want to be queen of falls.