Tuesday, December 30, 2008

Why I prefer vented sedated patients.

For the non-medical or people reading this...might be a little hard to understand but I will do my best to translate.  

The other night at work was probably one of the worst nights at work that I can remember.  After 3 days of decompressing from that day I can finally write about it.  It was my fourth night of the week.  I had my same patients as the night before-this was good. One was going to be transferred out.  This was fine but going to be busy since I get to be the one to get the next new patient.  The other patient was extremely critical, vented and on 7 gtts.  Two were pressors and if the bag ran out she would literally die.  So she was busy...this was ok, things were under control.  
Around midnight my new patient comes.  You are going to love this.  She overdosed on two of her bipolar medications...while she was in the hospital.  Ok, so she was a little drowsy and needed closer monitoring in the ICU.  As the transporters are wheeling her to her room she is shouting that "I better have a @#$% TV or I am leaving."  We were all fine with her leaving but unfortunately she was a suicide risk and we would be held legally responsible if she was allowed to leave.  Anyway, as she staggers off the stretcher to the room, she again amongst other colorful words states she wants a room with a TV.  "Sorry Miss, there are no other rooms available."  

In the mean time as she is drinking her Pepsi she starts to wander into my another patients room to do who knows what.   I take action and guide this lovely bipolar lady by the elbow away from where she is going.  The woman freaks and says, "don't you touch me,".  Then it happened, remember that Pepsi?  Well, she threw it all over me.  Head to toe I am covered in  high fructose corn syrup, sugar, and whatever else is in Pepsi.  I am more surprised than anything and I firmly escort BL to her room then call Security.  In the mean time every one else seems to have disappeared.  I don't want to leave the area because she is too unpredictable.  Some one shows up and wonders "what the hell happened to you."  As I notify the airhead doctor (AD) who sent me this "lethargic" OD patient to can walk, talk, A&Ox3, be dead accurate in Pepsi aiming and demand a TV while yelling at the top of her lungs on the way in, I get to watch every one take a good look at my high fructose saturated head and body to show that I am not joking since no one was there to witness.  Every one tries to encourage me by saying, "It could have been a urinal," True.  I think BL was just fine to stay where she was and have a sitter like every other suicide pt.  So after washing out my scrubs and putting on these ridiculously large paper scrub things BL calms down and everything is back in order.  Or not.

It gets better.  I find out that AD thinks BL might have PCP (an HIV/AIDS pneumonia that can be contagious).  So she needs to go to an isolation room until its ruled out.  Thanks AD for thinking of this after I have all of her backwash drying up on the side of my face and inside my ear.  Ok take a deep breath.  Charge nurse, after another 2 hours, figures out what room she has to go to since there are no open rooms.  I have time realize that my hair on one side is very crusty.  I go to a shower and rinse it out as I am overwhelmed with scenarios of how I should have taken BL out and banged her head in the floor and did what she wanted to do in the first place.  We do the room swap and I end up trading patients with another nurse because of the geography of the rooms.  BL says she is sorry about the Pepsi incident.  "You are?"  Then I strangle her to death with with her O2 tubing.  Actually I just said, "that's not a very nice thing to do, it really dampened my day," no pun intended.  Hope you get your TV, Bitch.
Glad to be rid of BL, but instead I get a crazy one eyed Hispanic guy (COEHG) who thinks he has to go home and is very confused.  So they restrained him for his safety...fine what ever will help.  By this time, the other patient...the one who actually is an ICU patient...died because her gtts ran out.  Well, ok, her gtts didn't run out and didn't die but she has been badly ignored because of BL.  She I tend to her for awhile.  I leave her room to get a few things and pass by COEHG to find him covered in blood and on the floor.  Well, ok, I guess I am getting a little carried away.  Really he yanked out his IV, O2 was off as was sating a little low, blood was only on his arm and he was only trying to get out of bed and not on the floor yet.  

Where is everybody?  Am I the only one working this in this unit?  

Wait, I cant believe I didn't tell you yet about the Hispanic lady (HL) whose room was next to my 2 patients.  HL accused me and another nurse of trapping her somewhere.  Through out this whole night of disorder, HL would shake a scolding finger and yell Spanish obscenities through her bipap at me when ever she saw me.  Actually I have no idea what she was saying, I don't speak Spanish.  But from knowing the universal language of all people she was telling every one that I was the  devil. 
Any way the night ended day shift came, late as always, I went home.  I took a nice hot shower to rinse away the rest of the Pepsi on the back of my neck.  Went to sleep and dreamt of me strangling BL.
Needless to say the night was a bad one but could have been worse.  But now you may understand the title of this blog.  Sedated vented patients compromise much easier.

Wednesday, December 24, 2008

Happy Holidays to All

Starting January, I will be living in Manhattan for a very reasonable price with my friend Ursula.  I was able to extend at this hospital for another 13 weeks.  This new place will be much closer to work.  It will be a relief to not have to have such a long commute to work and back.  It will be one train ride instead of 3.  Plus I started working 4 nights a week instead of 3.  You think 3 really isn't much.  Its not really, but since I started 4...well 4 is hard work.  Much more exhausting.  

Tuesday, December 9, 2008

A good reason why sailing is for me.

Me Sailling last summer
You think I would have learned my lesson from last last time I had poison ivy (which was just a month or 2 ago).  Since then, I have made a point of not even going in the woods, or doing any Geocaching by anything that has to do with long grass or weeds of any kind.  How did I get this poison f---ing ivy/oak/sumac/whatever it is this time?  It's November!  Just from raking Maggie's backyard this past Sunday?  The yard is about the size of a small bedroom and most of it is a patio and rocks, no long grassy weedy area.  Yet this is the only lead to where the contact dermatitis has come from.  The good news is I was covered from head to toe ( I mean with cloths) ...it was cold.  But wait...where does it show up?  Right in the corner of my mouth...like I have a bad case of oral herpes oozing and crusting up my mouth or some disgusting disease from some STD.  I can't really cover it up with a bandaid with out affecting my speach.  It would have been nice if it was nice and hidden on my upper arm or calf or somewhere else.  BA!   
At first I thought it was a cold sore, but I never get cold sores.  I walked to the City Island Pharmacy to buy some make-up (easy to pick since the selection- was only 2  brands) to cut the redness down a little and hide the blisters, since I was going to work and didn't want to scare my patients (oh wait...they are sedated or demented anyway) or co-workers (oh wait...some aren't much better than the patients here at Bronx-leb).  I think I applied it right (the make up)...was never really good at that since of the times I try to look flattering with make-up -I look like a clown.  OK...so the blush from 9th grade is a little out of date.  
I did the routine -wash everything I touched and everything that that stuff touched- and so on.  Any way through out the night it turned to small blisters and itching like crazy...then moved to the corner of my eye, only to find a few more areas on other part of my body.  To the urgent care center I went this afternoon.   At least they knew me from last time.  So they believed me this time that I get it bad since I had to go for a follow up visit the last time because their initial  treatment was not enough the first visit.   So prescriptions of  antibiotics, steroids and some acetone ointment that they say don't use too much or it will thin the skin was the answer this time.  So instead of blisters I will have a missing chunk of lip and eye.  Anyway I should be set now.  I almost forgot, Dr. Ahn reinforced that avoidance is the best treatment.  Thanks Doc...I will try to remember that next time.
The good news is that I got the doctor to prescribe me an EPI pen for my medical kit on the boat ( just in case some one goes into anaphylactic shock from eating seafood or something while with me in the middle of the ocean).  Also some blood work for some booster shots I needed and few refills on some other medications and a list of doctors in the area for dermatology stuff in regards to high susceptibility to contact dermatitis and also for a physical that I need to get updated on.   
Any way, I think I will just stick to boating life away from this nonsense.  Enough run-on sentences for now...

Friday, December 5, 2008

Down payment on the Contessa 26'


(this is the whole picture)

I am getting a new boat.  The 26 Contessa is a foot smaller than the Catalina.  It has a full keel, and more stable in structure.  Basically it is better for more off shore cruising and set up better for a single handed sailor as myself.  I pick her up in April.  She is way up in Newfoundland Canada.

The Catalina is now on the hard, emptied, cleaned and ready to be sold.  She has treated me well.  I will miss her...  

Tuesday, December 2, 2008

I miss my house

I am officially off the boat and at Maggie's place with her and her sister Agatha.  I already miss my boat and the space that is practical for just me.  It's strange that the area that I sleep on at Maggie's house is bigger than the boat all together.  You would think that it would be good to have all this space.  It's just not the same.  I don't feel as cool any more.  I can't say to my co-workers I live on a boat and see their faces of "what did she just say," or "who is this girl," and all the following questions that go with the whole picture.  I was interesting.  Am I still interesting now that I live on land?  Am I starting to just be like everyone else?

Despite all the sorrow, I don't miss the walk across the boat yard to take a shower.  I enjoy the fridge with a freezer, a real oven, a nice bed, and the best of all I can go to the bathroom and not worry about how soon I have to empty the port-a-pot. 

All for now...