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NurseSonata's Latest Activity

  1. NurseSonata

    forced to work when sick?

    I'm not certain how I would handle the situation with your manager; however, I would point out the importance of NOT working when you're unwell. It really is a serious patient safety issue. Last year, I witnessed a nurse who was still recovering from Influenza A (yet expected to work) sneeze in a neutropenic patient's room. Two days later, the PT was febrile and died 1 week later from Influenza A. The PT had previously survived 5 cancer surgeries and considering her situation, was doing remarkably well - only to be brought down by something that could have easily been prevented. Of course, none of us can know for certain it was the nurse who passed the virus on - but the correlation is alarming, since the PT was isolated. In short - if you're sick - don't go to work. Even if you aren't contagious - you still have a duty of care to ensure you're thinking clearly. All I can think of is: What if a patient died because I made a mistake due to being unfit for work? Could I live with myself?
  2. NurseSonata

    Got a nurse aide fired... did I do the right thing?

    You did the right thing. These facilities have very tight budgets and can't afford people to sleep on the job. What disgraceful behavior. I've seen more of this than I care to over the years and good on you for having the courage to speak out. Folks in these homes need our full attention and care. And if she was slacking off in this area, I can only imagine how she was cutting corners elsewhere.
  3. NurseSonata

    Bicarbonate HC03 - As High as 43?

    No blood pH was taken at the time - so this is why just looking at this alone is a bit like stabbing in the dark. Sodium and Chloride lower than normal ranges - so definitely compensating.
  4. NurseSonata

    Bicarbonate HC03 - As High as 43?

    No ABGs were taken at the time - as just routine bloods. 02 Sats 88% on 1 L/min. Sats a bit lower than usual for this PT, but since she was laying flat and sleeping, not surprising.
  5. NurseSonata

    Bicarbonate HC03 - As High as 43?

    I haven't seen this before - and was wondering if this is common? I have a 72yo PT with COPD. Very fragile - multiple health problems. She is a chronic CO2 retainer. 24/7 02. Her HC03 has been as high 39 mmol/L previously over the years, but she seems to live a relatively normal life (within her range) despite being SOB, etc. Routine blood work today uncovered serum bicarbonates (HC03) of 43 mmol/L. The only difference between today and any other testing day is that she was asleep when blood work was taken and was also laying flat (which she shouldn't have been - long story). She is usually sitting up and talking when bloods are taken, so I wonder if this would make a difference (sleep versus wide awake and talking?) and also laying flat versus sitting up? Her urine output is also much lower than normal (despite a good eGFR). No diabetes, etc. Normal ranges in our facility are 20-32 mmol/L for HC03. I"m wondering if others have had PTs with HC03 levels this high? Am interested in hearing the experiences of others. Thanks in advance.

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