Everybody I know in NOLA got out okay, 'cept one friend had to leave her horse stabled about 45 miles north of the city. I woke up this morning to hear an interview with a man whose biggest worry was the three cats he and his wife had to leave behind when they evacuated. *That's* a buzzkill.
My easiest patient yesterday was the one with blood pressure problems, sugars that ranged from 21 (0700) to 538 (1730), a half-inch thick clot the size of the palm of my hand covering her incision line (the order read: "Shampoo patient's hair and remove clot covering incision." Three hours of H2O2 later, I'd gotten an inch square chipped off), a crazy husband, as in paranoid schizophrenic not on meds, and incontinence of bladder and bowels (the order read: "Do not diaper patient." I guess they were worried about skin breakdown?).
Then there was the guy with the leaking scalp incision who kept throwing PVCs on the monitor. For non-medical types, the heart has its own electrical system, independent of the rest of the body. Sometimes the ventricles (the big chambers at the bottom of the heart) will Contract Prematurely, leading to Premature Ventricular Contraction, or PVC. This is a bad thing if it happens more than, oh, eight times in a row. Like the heart will get its electrical signals all flummoxed and, well, have to be shocked.
I showed the EKG tracing to the PA, who was unconcerned. The damn thing looked like a test strip you'd get on the NCLEX, but PA-Man just shrugged and said he was aware of it.
So I parked the code cart outside that patient's door.
Add in two lumbar drains, a post-angiography patient who kept leaking, and Doctor Asshat, who yelled at me for something that I had nothing to do with, and you have a typical day. Oh. I forgot about the 410-pound patient with the shoulder scope who needed pain medicine every hour.
It got bad enough that, as Dr. Asshat revved up in his bitching, I slapped my hand flat on the chart he was writing in, leaned forward, and hissed "I am trying to make your job easier. Do not bitch at me about policies that I did not write."
It's nice to be considered the Go-To Girl when people are having crises. Even when I'm working sick and putting out only about 80% of my usual effort, that's still better than a lot of people's 100%. Really. Still, it's *not* so nice to be such a go-to girl that I end up with six complex patients when other nurses are carrying three. Especially when two of them are Dr. Asshat's and the third belongs to a resident who's unwilling to write the orders necessary to get things done.
Chef Boy asked last night "Again, why are you doing this? Wouldn't you rather be in a lab somewhere?"
Sometimes I would. It's not the patients that get me; it's the doctors.