Monday, July 31, 2006
Then I went back to my own patient's room [ed: another RN had been watching my patient and my monitors while I was in W's room], to continue titrating his levophed to maintain a blood pressure that actually perfused his organs with blood and adjusting the amount of oxygen the ventilator was giving him. He is really sick, at least as sick if not sicker than W had been. Some of them get better, and some of them don't, I don't know why. Maybe if I knew why then I wouldn't be hopeful when the situation was futile or I wouldn't distance myself when there really was hope.
There was also a code on the unit tonight, not my patient however. I was entering the room just as two young doctors ran onto the unit then stopped short in the doorway. "Shit, I hate it when we're the first doctors at a code. Have you ever run a code before?!" one said to the other.
Sunday, July 23, 2006
Thank you Jerry, and yes, it was yesterday! I'm officially an old lady, the big three-oh. It's a good thing, because now my knitting and sewing and old-lady name and wiener dogs all make a lot more sense. Plus, it feels kind of cool not being stuck slogging through my 20s anymore. I'm so over the 20s. The 20s were all about going to class and figuring things out and deciding what to be and what to do and what not to do. Not that I've got anything much more figured out, but I have learned things like not to keep drinking after you've thrown up (age 19), not to keep calling the boy if he stops returning your calls (age 20), how to read as little of possible but still ace the test (age 21), and how to get a real job that pays the bills (age 28). So now that I've got that stuff out of the way, I can be 30 and fabulous. And I'm going to try all sorts of new things. Already, I've been to Jack in the Box for the first time and eaten my first mussels (two different events, obviously). And it's only going to keep getting better from here!
I'm not going to tell you how hot it is here, nor am I going to complain about the weather. Contrary to popular belief (based upon the amount of people who do it), whining about the weather does not actually change it. Apparently, there are plenty of other blogs out there doing that if that's what you want to read. But I am going to mention that if you have absolutely nothing important that you need to be doing or anywhere you should be going, if you can get away with wearing nearly nothing, if you enjoy bad reality TV, and if you surround yourself with icy cold beverages, sprawl on the couch and point all the fans at you, this weather suits me fine.
I am also pondering why my neighbor, the Laundry Slut, continues to have at least eleventy billions loads of laundry to do EVERY weekend despite the fact that from April till October he NEVER wears a shirt. Tessa is currently barking up a storm at him because he's out in the yard, and even Tessa understands that public nudity is a privilege, not a right. A right specifically reserved for Colin Farrell and the Italian soccer team. And last I checked, furry Laundry Sluts were not members of that team.
Oof, I've left my post. Back to the couch, I don't think I've seen this particular episode of Kathy Griffin: My Life on the D-List.
Tuesday, July 18, 2006
Someone died this week. He was a cool guy. I want to link you to his obituary in the New York Times so you can read about his life and everything he did, but I'm too paranoid about HIPAA. He taught me that regardless of political affiliation, some people are just good people. He was warm, curious, funny, and open. He wanted to hear what you thought just because you thought it, not because you supported a particular party or 'side.' He wanted you to know more about politics, but he would give you a book or literature and encourage you to learn something through your own eyes then come back to discuss it with him. He found humor wherever he could. The love and compassion he inspired in his family members, evident from the way they looked at him and laughed with him was moving. He was genuine in a disarming way. When you strip away preconceived ideas and deal with people just as human beings, you are often surprised but always rewarded. It's unfortunate that sometimes it takes illness and suffering, or just putting someone in a neutralizing hospital gown, to approach that situation. So thank you sir, I feel lucky just to have met you.
I'm on stand-by tonight for work but I just received an 'ominous' call from my charge nurse, so I might be putting those scrubs on after all...
Monday, July 10, 2006
Tuesday, July 04, 2006
Although not a great photo, this is a view of the sunrise as seen from many of our patient rooms. After spending a darkened night making sure patients are breathing, whispering around sleeping family members, using a flashlight to check name bands, and ruminating over the horrors and unfairness of cancer, its always a comforting yet bittersweet surprise when the sun starts to come up, and the world outside starts to brighten. As if to say, "Things won't always be this bad."
My patient this week was going through probable benzodiazepine withdrawal, which presents somewhat similarly to alcohol withdrawal. Which is not a pretty picture. She may have taken up to 90 clonazepam tablets over six days, which is about 5 times the maximum recommended dose. She was delirious, narcoleptic, agitated, anxious, noncommunicative, impulsive...well, all that and a bag of chips. Oof. I'm drained from those three days of making sure she didn't pull out her central line, reaccessing her implanted port when she did pull it out, keeping her hands away from her foley catheter, listening to her cry, and hoping she didn't have any more seizures. Also, three deaths over the past three days on our unit, although all during day shift.
Then this morning I couldn't fall asleep because I was having this strange shooting and intense lower back pain each time I tried to lay down, which was rather bothersome. I couldn't remember hurting myself while bending or turning or lifting a patient, although it's certainly possible. All I could think of was, "Pt c/o lumbosacral pain, rated 7/10, nonradiating, sudden onset. Relieved with ibuprofen 800mg PO and diphenhydramine 25 mg PO. Reassess pt comfort q8hrs."
Saturday, July 01, 2006
For the past several weeks, although I've been feeling better for a few days, I've had basically a persistent headache which evolves into a migraine every third day or so, and had to take excedrin or nsaids on a daily basis. Last night, I admitted a patient from another oncology floor, a young woman in her early thirties who had mental status changes and a seizure. The nurse giving me report began by saying, "So this young woman presented to the ER last night with intractable headaches but appearing otherwise normal..." By this morning she was incoherent, unable to communicate, and thrashing in bed, agitated and unconsolable. At one point in the night she was foaming blood from her mouth because she bitten down so hard on her tongue. I had to pinch her nose shut to get her to open her mouth and stop biting her own tongue. We have no idea what is wrong with her. But yeah, I have an appointment with my doctor to discuss my headaches.