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.

       

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.  

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...

Down payment on the Contessa 26'

http://lh5.ggpht.com/_EHb1D5Z-k4o/SRDQ5m3efsI/AAAAAAAAYlk/KbE1kZOasg4/s640/Picture%20432.jpg

(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...  

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...

Niagra Falls

Today I spent a little time going through some old pictures.  I came across some I took back a few months ago of Niagra Falls.  This was prior to passing it on the boat this past June on the way to NY.   It was a little weird seeing on the charts danger signs and then seeing on the water, more danger signs about going towards the falls.  

That would suck. 

This is what I feel like most of the time with only eyes showing...it is getting cold.  It still in the 30's but man, with the wind it is chilling.  I have been moved a little further in the marina by the other live aboards.  It is much more protected here and the risk of getting seasick at the dock is less now.  Will be soon off the boat and living on land for the winter.  

Birds

So its been a little while since a post. Things are going good.

Last week I took the week off from work while Rolland my brother-in-law came over from Newfoundland to do a few errands while in the US and also help winterize a few things on the boat. We went for a nice little sail on Saturday for the last time this year. The motor and sails came off and stored, the rub rail was replaced, the stantions resealed, and now I am putting a few more layers of varnish on some of the wood that needs a little more protection during the winter months.

This week I go back to work.

Self Guided tour of Hart Island

Hart Island is just a dingy ride away from City Island. I heard that there are inmates who come there to dig graves for the John Does and other unclaimed bodies. Last week I went exploring when there was no one there. Weekends are the best time to go. I checked out a bunch of abandoned buildings. The building pictured above was like a huge dormitory. Multiple community shower bathrooms, rooms with old bed springs and mattresses, washing machines and a lot of other miscellaneous stuff.
You can hardly see it but there are a bunch of burial markers. Also, you cant see it in the picture but there were these vent type pipes coming out of the ground like they have at landfills. I have read a few different ways the buried the bodies. But the general idea is each body gets a coffin and they stack a few on top of each other.

Hart Island History Menu This website you should visit, a lot of this I can see from by boat.

Statue of Liberty

This past Sunday we (Dad, Mom, Carly and Maggie) took "Dances With Wind" for a trip to the Statue of liberty. Its a good way to see NYC. Its just a differant view and new perspective. Dad took the helm on the way out, we had a little lunch while puttering around the statue and headed back to City Island. It was a good trip.

The Walk Across George Washington Bridge

Last week I did a little site seeing/geocaching. I had been wanting to check out the George Washington Bridge which at one point I had anchored near while on the way to City Island. The GWB connects NJ and NY. It is a mile long and it sways when you walk on it. I took the camera, of course, since bridges are usually a good subject for photography.

This is looking south. NY on the left, Hudson River in the middle and NJ on the right.


While searching for caches there were some great views of NY along the trail/cliff I was following.

As I had my head buried in the GPS to find the cache I walked into a young dear who was

grazing about 10 ft from me right in the way of the cache! It was not startled at all. I got a few pics and then it trotted on its way as the sun was setting over the sky scrappers of NJ.

Self portrait

A walk across George Washington Bridge (on the way to do some Geocaching)

And the answer is....

Good guesses every one. I am so happy to have a few contestants!!! If you haven't figured it out yet from these new pictures...the answer is.....



My hammock!!! It was getting to windy and cold out to sit in it any more for the day. Before I took it down I noticed how cool it looked when it caught the wind.

Take a guess at what this is...

The faithful Swans

Row around the Island

So here are a few pictures from my little adventure of rowing around City Island.

Storm Misfortunes

Oops!!

This one was washed ashore on to someones front yard.

Wet computer cord!!!

City Island Cemetary overlooking to Hart Island

So this past weekend was a wet and windy weekend. I made the mistake of 1) not closing up the companion way all the way and 2) leaving the computer cord on the table to get wet while I went away to work. So needless to say, the boat got wet and so did the computer cord. What am I trying to say? I haven't posted in a while because the computer has been out of commission due to wet and non functioning computer cord as evidenced by no blog posts. How do you like that fellow nurses? A nursing diagnosis for my computer. Stupid care plans. Ba!

The best news of all is my friend Carly brought me to this great big Goodwill thrift store. It even had carts and a dressing room you could fit the whole cart into! I found a nice coat/fleece, new pair of winter hiking boats which I needed to find sooner or later, and a few t-shirts and pants. That was the highlight of the week!! Heaven...

Any way, here are a few other updates. I decided to extend my contract for another 13 weeks. This will bring me into January. I will see from there. I will live on the boat weather permitting through November. We will see what December looks like. From there my friend Maggie has a room for me here on the Island for when ever I decide.

Bronx-Lebanon Hospital is still a crazy place to work. I really am not sure how these staff people actually can stay here and be sane. Oh, I forgot, that's why us traveler are there. Because they don't stay there and all the rest are insane. Saint Marys RULES!!!

I think I found a church for the short amount of time I am here. Its not so traditional like I have experienced but more relaxed and mostly young people 20-30 something. We meet in this coffee place type setting. http://www.gracenyc.org/.

Today I took a row in my dingy around the entire Island. It took about 4 hours. My arms are sore. I hope they are not too much worse tomorrow. Tomorrow afternoon I will taking out the boat with some friends. It should be a nice time.

The Fish

OK so I have had a few questions about the "Wooden Fish Series". There is no meaning behind it. Just a sunny day in the cemetery on City Island. I found the fish there and that wooden thing its on is a grave site. I thought it made a few good pictures. So I put them all together. He starts going down the curve, goes farther and slides off on to the ground. I might go back there later and put him in a different spot. I guess you will all have to wait and see.

"Dances With Wind"

So to give you a little idea the size of my boat compared to others...here is a visual. The boat to the left is Al and Miriam's boat "Mr. B." And "Dances With Wind" as you may have guessed to the right. I am very protected on this side and feel very vulnerable and unprotected when they take the boat out of the slip.

Stay Tuned For the "Wooden Fish Series"

Times Square