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spotangel MSN, RN

ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds
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spotangel is a MSN, RN and specializes in ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds.

spotangel's Latest Activity

  1. spotangel

    I Have to Go to Work!

    Friday the 16th of August was a busy day in the clinic. I was on triage duty. Mr Grainer had signed in for shortness of breath and near syncope. I called him in and observed him walking in breathing normally. As he sat down, I noted that he was neatly dressed in summer clothes; shorts and cotton shirt with a straw colored hat that he removed displaying his salt and pepper hair. His ankles didn't have any edema and he did not look like he was in any acute distress. I sat across him observing him as I spoke to him quietly. "Good Afternoon Mr. Grainer! My name is Nurse Annie and I am the triage nurse in the clinic today. How are you doing?" "I am good! Can't complain. Please call me Carl!" "Thank you Carl. Why did you come today?" " Nurse, something's not right." "You seem worried. What do you mean by something's not right?" "I am normally pretty healthy and can walk four miles a day but for the last two weeks, I feel like I am going to pass out after walking one block." 'Is this something new? " "Yes. I never felt like this way before." "Do you get short of breath? " "Yes! Just in the last two weeks." My mind went into overdrive as I scanned through his chart. He was a diabetic and hypertensive. In my mind I always equated shortness of breath with the heart in a diabetic until proven otherwise. Just in case, I asked him questions to rule out a Pulmonary emboli. He had no risk factors, no travel, no smoking or recent prolonged immobilization. I took his pulse manually and immediately figured out what was wrong. His vitals all were great except for one. He had a heart rate of 38 bpm. Probably a heart block but totally asymptomatic! "I have some good news and bad news Carl! Which one do you want first?" "The good news " "I figured out what is wrong with you and why you feel this way." "Why?" It's your heart. It's beating really slow and any activity puts a huge strain on it." "What do you mean?" "For some reason your heart is beating very slow and that is causing your symptoms. I need to send you to the ER right now ." " Nurse! What about work? I have to go to work tonight!" I realized that he did not grasp the seriousness of the situation. I had to give him a verbal jolt and be honest. After all we nurses are known to be the most trusted profession! "Carl, let me be very frank. I am surprised that you made it into the clinic after walking four blocks from home. It's only a matter of time before something happens to your heart. Do you think your work will care if you drop dead? At this time you need to take care of you!" He stared at me and saw the truth in my eyes. "Nurse you are right. OK, I will go. What happens next?" "Just relax. You are safe here. Let me make a few calls." I called for an ambulance ALS team, informed the front desk and lobby about their impending arrival, printed out his paperwork and informed his doctor that I was sending him. She agreed 100 percent with the plan. I then called our main hospital and gave report to the ED charge nurse who was named Carl too! I informed Carl what to expect in the ED; Labs, line, EKG, portable chest, being hooked to a monitor, no food and possibly a cardiology fellow visit and a recommendation of putting in a pacemaker. The ambulance crew came and whisked him away to our main hospital. In three hours he went through all that was discussed and was taken to the cardiac cath lab with a second degree heart block and a pacemaker was placed. He went home on Saturday with no complications. I followed up with him via phone on Monday and got him an appointment for a follow up with a provider the same week and in two weeks with his own PMD. When he came for his first visit, I was out sick and he went around the clinic looking for me. One of my nurses told me. Yesterday, I saw him in the clinic for his two week follow up waiting in a room for his doctor. He jumped out of the room and hugged me and kept thanking me. I went into the exam room, sat down and caught up with the latest in his health. He showed me the dual pacemaker site and I noted that the skin was healing well. "Nurse Annie, thank you. Thank God you were there that day." "Carl, lets give all glory and thanks to God! He put me in your path that day and I am glad that I was able to help you." 'Nurse, I want to treat you to dinner!" "Thank you Carl! That is very sweet but not necessary! " "Nurse! I want to do something for you!" "Just say a prayer for my family and do something good for someone else and pass it on!" I left the room feeling grateful and feeling appreciated. It is not often that one gets appreciated in our profession. I reflected how my years of experience kicked in when needed but more than that I marveled at the way our skills are utilized to help others in the grand plan of our lives and in the lives of others. Each person is created in God's image and likeness but we have been given strengths and weaknesses that together as a human race fit together perfectly like pieces of a puzzle. It is wonderful to be a nurse! I have a question for the readers. Can you share your stories where you felt that you made a difference in a person's life in and out of work? These stories need to be shared with each other and the world!
  2. spotangel

    Spouse of nurse

    This year marks 25 years of married life. All through out, I have earned more but it has been a non issue for us. My husband used to have hangups about making less and it took a lot of convincing for him to trust that I was more into him than into money. At home we have a policy. Home is a safe place and we are a family and not our titles. We have one account. He is better at managing money, so he manages it. We trust each other and speak frankly if the other spouse is doing something that may be an issue. Be honest with each other and ask what you can do as a team to manage expenses. Comforts and bank balances does not provide security and happiness in the long term. Don't lose a marriage but look for opportunities to make your spouse feel loved and cared for. This is the one you promised to stay with through richness,poverty,health and sickness. Tough but doable.At the end of your life how much comfort will money bring you? Thirty years is nothing to sneeze at. God bless! All luck. Take one day at a time, trust in God's providence! I will be praying for you. Peace!
  3. spotangel

    September 2019 Caption Contest

    Time for the Flu shot before the grim reaper and the invisibles take you says the overworked robotic nurse!
  4. spotangel

    Your most bonehead moment in nursing. Or 2. Or 3.

    The ER was very busy with an unusual amount of pediatric patients, a few of them wailing infants. As I focused on getting a line into an old lady with spider veins, she whispered "Nurse Annie, check your scrubs". I look down to see 2 big wet patches. I had started to leak with the "let down effect" listening to all those infants crying! I felt like diary queen, smelt of milk and was mortified! Luckily I kept extra scrubs in my locker----!
  5. Annie! Your break is over! They are sending up a patient from the ER to this bed!
  6. spotangel

    An Ode to Hospice Nursing

    Beautiful post! Thank you for your article. Being there for a family when they are at their most vulnerable and the emotions are on their sleeves is hard and will take a toll on you. You have to replenish every day! God Bless! Keep writing!
  7. spotangel

    Any nurses that love nursing and love their job??

    30 years this month and absolutely love being a nurse! Read the articles I have written for the why part. I am very humbled to be part of a pt’s life and be a person they trust. Many a time my venting after a hard day sounds like bitc—ing and mourning! I don’t hate my job, I just need to vent! If you work with a good team you are all set and even better if you have a great boss!All luck! It is a hard but satisfying profession . As a Christian. I always say. “Here I am lord! Let me do your will. Let me be your comfort and strength to anyone in need!” He puts me to good use every day and I go in wondering who He will send to me each day, patient, staff or colleagues! This is my ministry of caring , not just a job!
  8. Sounds like my clinic. No med Tecs but 4 PCTs, around 25 LPNs and 3 RNs . Around 30 providers including family medicine, ObGyn, Psycologist, psychiatrists, podiatrist , cardiologist, Dermatology NP, nutritionist, social workers, Health educators etc. We offer many services!
  9. It is frustrating on most days but you touch many lives and after a while we are part of their family----! I would rather a new grad that I could train but that will happen only i f you have input into the hiring process!
  10. spotangel

    Nurse in Germany Convicted of Killing Patients

    Report him to the BON and let them know about the camera. I happened to walk in during rounds as a nursing supervisor into a room in a pediatric long term care facility and heard crying behind a curtain. I peeked and saw the a new LPN on her last day of orientation, roughly handling a peds kids with Cerebral Palsy. I had her relieved of her duties and wait downstairs in the lobby while I called my boss the Chief Nursing Office at 8pm. We send her home suspended and she was let go the next day. I never regretted speaking up and thanked God, I walked into that situation. I am not one to make you lose your job but abuse should not be tolerated. Period.
  11. Thank you Kooky Korky! Will definitely tighten up as I know you all have good intentions.I honestly do not give my number to every patient, just 1 in 3000! Lol! Did not mean to exhaust you with details of a clinic day but you are right. It is understaffed as even the management that runs the place do not get what the nurses do! Most people have this "all they do is vital signs attitude "and I am guilty of that too before I started working in a clinic.I guess, when you don't work in a place, you don't realize the details whether it be inpatient or outpatient.
  12. Wow! That's a lot you are doing super nurse! Thank you for helping your patients in spite of all the work they throw your way! I have to stand my ground and ask them to put patients on my schedule if they want me to see them that day. I am not afraid to say no. I say it nicely though! When I am scheduled to attend interviews for new staff and they put pts on my schedule, I skip the interview as I can only be at one place at one time.It is a tough job but I am glad I can make a difference. Don't underestimate the good you can do where ever you are. It does sound like a lot for one LPN. We don't have access all the time and sometimes I send pts to the ED or Urgent care the same day. If they can wait for one more day safely, I put them on the next available slot. Sometimes I speak to the doctor and overbook them if it is urgent but does not warrant an ED visit or is unstable for Urgent care like an asthma exacerbation.
  13. So true.It is like a PE! If you are not looking, you may miss the boat! You hit the ground running and most days are fast paced. You also have to know what to do and how to stabilize a patient while waiting for 911. I once had a patient on Coumadin with a non healing foot ulcer and a tendency to bleed. He went to the bathroom and turned his wheelchair hitting his foot against something and bleed like crazy. Luckily he pulled the emergency cord and we went in to a blood bath and called 911! Between the doc and I, we tied a tourniquet, lifted his leg up and put an IV in, all in the bathroom. I walked out of the bathroom feeling like I was in a murder scene! Lol! Later he came back and thanked us as they transfused him with 2 units in the ED! I joked with him that I was a blood relative at this point!
  14. Thank you! I love my job! You are spot on especially about the extra work(lol)! More than anything else, the phone number inspired trust and decreased anxiety. I remember, as the evening nurse manager , a patient in the ED, call me once as he was threatening to leave AMA and was desperately ill. I talked him into staying, spoke to his nurse and expedited his admission to the ICU----turns out he needed a CABG , got one and walked out of the hospital a week later--alive.Once you gain a patient's trust, they will walk with you and you can walk them off the cliff edge to safety! Like I said, I rarely got calls! Sometimes you have to walk your own path away from the conventional method of caring for patients to the road less traveled.
  15. Thanks . I respect your opinion.The funny thing is they rarely call! It’s a security blanket for my patients. The patients are very respectful of our time and privacy. I hear your concerns and normally give my work number to the patients not private cell. She is desperately ill and beginning to go downhill and is a mother to 5 kids,the youngest being 6. She has had a few close calls recently and I am her point person. She has yet to call me!
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