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I'm a nurse who's working in a crazy MICU in DC.

thisgirlsanurse's Latest Activity

  1. thisgirlsanurse

    Shaving Cream & Expiration

    I hadn't planned to. I'd planned to shave my patient. When I mentally scheduled his "bath appointment" for 1600, he was still alive. But later, when I arrived for our engagement, he was already pretty near dead. In truth, I really wasn't expecting it. But then, at the same time, I really wasn't that surprised. I was next door in my other patient's room, helping her on and off of the bedpan when I noticed, via the bedside monitor, that his heart rate had dropped. He had been ticking away at around 83 beats per minute for the majority of the day, so when I saw the big, white numbers dive down into the low 50's, my eyebrows raised. "Oh, man...is this it? Is he really gonna go for it this time?" I said to myself. I gave him a silent cheer of encouragement. This might seem like a callous reaction, possibly a heretic. But it was necessary if I freaked out at every dipping vital sign, or critical lab value I see, I'd be a burnt out, nervous, wreck of a nurse. Also, I knew this man's story, and based on countless medical opinions found throughout his chart, he deserved some sympathetic, go-for-it cheering. He'd come to us without a chance in hell of being anything but a mechanically ventilated body. He'd suffered a massive head bleed, and his family had decided against the idea of risky surgical interventions. Just that morning, the attending on our unit had upped his "Code Status" (aka what we do if someone's heart stops) from "Allow Natural Death," which only excludes chest compressions, to "Allow Natural Death, and Limit Therapy," which means that, in the event of cardiac arrest, we don't do anything at all except make him comfortable, and pronounce him when his heart stops. Pretty much just about everyone had signed off of his case because of his extremely poor prognosis. I finished up with my other patient and made my way to his room to investigate the monitor's fluky readings. He had done this before - yesterday - his heart had slowed down and then picked back up again, ticking away without a glitch. But this time was different. I didn't even have to look at the monitor or feel a pulse to know that he was dead. In the short time since I'd been gone in my other patient's room, his face had gone from pink and rosy to yellow-ish blue, and he had started cooling down. I ran a cycle of the blood pressure pump-no reading. Thready pulse. Called the resident, and we both agreed...even though this man's heart was still beating 70 times a minute, he was almost completely gone. It only took a few more moments for it to become official. While the monitor beeped ASYSTOLE! ASYSTOLE! ASYSTOLE! the resident did his death assessment, pronouncing the patient just a few minutes after four o'clock. I did my best to keep our delayed appointment, lathering up his face to give him his last shave, only five minutes late. Sick? No. Weird? A little. But let me explain. When a patient dies who is a family member to anyone - girlfriend, niece, daughter, wife, brother or cousin - the best thing that can be done is to make he or she look as normal as possible. After having looked at their loved one with tubes and drains sprouting from their mouths for the past week, all the family wants to see is that the patient's face has become familiar once again, even if in death. So, I took out his breathing tube and feeding tube, and the tape that held them in place, and I shaved his slouching face. The cut came out clean; without any life behind it, his face had no reason to resist or turn away from the razor's blade. When I was finished, I took out his IV's, put on a new gown, made sure his hair was in place and laid his hands open on the bed for his family to hold. It's peaceful to help someone leave this place when it's right for them to go. There's something strangely holy about watching a person's life change from breaths and words, to numbers falling to nothing on a computer screen. Hospital policy: Patient's families have two hours to come and view the body after their time of death. Two hours passed, and no one came. The resident, who had spoken to the family, told me that they couldn't make it. No one to see how well I'd shaved him.
  2. thisgirlsanurse

    Anyone ever heard of the "International White Heart" symbol?

    cool! thanks! i like the white heart, too. know of anywhere else that it's sold? not a bad price, but the shipping to us is pretty steep.
  3. thisgirlsanurse

    Anyone ever heard of the "International White Heart" symbol?

    They're an international group that serves as representation of nurses worldwide...kind of like the ANA only for the world. Seems pretty relevant to me: http://www.icn.ch
  4. thisgirlsanurse

    Why no nursing love from Grey's?

    Maggie - I agree, nurses get the boot on TV. I disagree with your idea, though about RN sub-plots: What makes doctors so exciting?! I'd never want to be a doctor -- you think RNs have a lot of paperwork?? That's all dr.s do! Nurse's have far too long waited for their "chance to shine" with little subplots (most of which, I agree with you, are about sleeping with Dr's). It's time for us to have our own show - showcasing the quirky, fun, exciting and INTELLIGENT profession of nursing. Now is the time to be excited about being a nurse! What other job allows you to: travel around the country, set your own schedule, reap tons of benefits, and have 4 days off a week?! Many, many academic studies on the nursing shortage site the media's poor/inadequate representation of nursing as a CRITICAL part of the overall problem. And, while Hollywood makes its living on making things that are not exciting, exciting (cough, surgery, and residents...in the case of Grey's)...and nurse's portrayal, just like dr's may not be completely accurate...nurses need a show of their own!!! #1 way to fix the nursing shortage (in my opinion): make the country realize how COOL it is to be a nurse.
  5. According to the International Council of Nurses, the international symbol for nursing is....(drum roll, please): A white heart. Yup, you heard right. A white heart that looks like this: http://www.icn.ch/bookshop.htm Anyone ever heard of this? (I hadn't) What do you think? Specifically male nurses? Would you buy/wear one of these pins?
  6. thisgirlsanurse

    Why no nursing love from Grey's?

    So, I did a rare thing the other night: I watched Grey's Anatomy. I generally avoid the show for two main reasons: 1. I work in the ICU, so the last thing I want to see is the ICU (or whatever make-believe "unit" it is where they practice) when I'm not there. 2. It portrays doctors as NURSES and nurses get NO credit! Three examples: Dr. Meredith turning a patient?? Dr. in OR with concrete-block-boy pushing D50 and Insulin?? "Figuring out" to put a foley in the patient? In my time as a nurse (albeit short -- life-longers please disagree if you have contrary experience), I have never seen a doctor do any of these things. ONCE in a while, I'll get a rare, rare doctor (resident, mind you) to help me pull up a patient, but usually that's b/c the patient is in respiratory distress and needs a position change to breath, and I have only seen a doctor push a med ONCE, and it was again, a resident, TPA, and during a code (b/c that's hospital policy). And the foley?? What nurse would allow a patient to even ENTER the ICU (much less bolus them with excessive fluids) without making sure they have a foley? Has anyone ever seen a physician put one in a routine patient? Ridiculous. So, this is my question...why no love for nurses? We not only DO these things (most without being asked, mind you), we double check them before we do, know when they're needed and usually are the ones asking doctors for orders for them...so, why, when positive media-attention is needed for nurses MOST...are these super-unrealistic-suave-RESIDENTS getting the credit? I noticed another thing while suffering through the show...when the young boy fell down and had a seizure, what did Dr. Gray immediately do? She yelled, "NURSE!" Because, even her distorted, fictional, unrealistic character-self knew that the nurse would be the one who knew exactly what to do. It's about time that Hollywood woke up to the fact that nurses are the award-winning, exciting, realistic, intelligent, juicy people they need to be spotlighting on prime-time TV. Then, maybe we'll start to see a break in this nursing shortage. Any thoughts?