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  1. The flu epidemic has been causing overcrowding all over across the United States. In northern California the outbreak is no stranger and flu season is only half way done. Like every hospital we test for the flu and are required to ask every admitted patient if they want the flu shot to decrease transmission. It seems as though, every patient being admitted is wearing a mask and being ruled out for the flu. I received my flu shot this season but was I bound to catch the flu from the start because of my increased exposure? Sure enough, I caught the flu this winter season. I experienced the fever, the chills, and the night sweats that are all common symptoms. I would have been more surprised if I did not catch the flu this season with all the sick calls from my fellow nurses. I only had to call into work for one day based on my three day schedule when I started getting sick. I believe the flu only lasted a couple of days because I received the flu shot and I was taking my immune boosters. I returned to work later in the week with no further signs or symptoms. However, a few days later I started getting this chest pain feeling that I believed was heartburn. It was at the center of my chest, a burning sensation, and I had that acid reflux feeling in my throat. This was a rare occasion for me to experience heartburn but I keep tums in my household for guest. After a couple tums the pain still took an hour to be resolved and I could resume my daily activities. Later on, I had another episode of heartburn that was not correlated with my meal times that day. I started to think to myself "am I starting to get older?" I purchased some Pepcid and took some at the start of the day to help prevent heartburn symptoms but again another case of heartburn presented itself. On day three, I decided to head into the Emergency room to try a GI cocktail to knock this heartburn out. I informed the ER clerk that I was experiencing chest pain that I originally attributed to heartburn but not was unsure. Unfortunately, all that was heard in the admission process was "heartburn" and I was told to wait. Two and half hours later I was finally triaged and seen by the MD to help resolve my heartburn. The MD told me the plan which I agreed with: Chest x-ray, EKG, Labs, and a GI cocktail for the pain. The MD did not have a good poker face when the EKG was handed to him by the nursing assistant. I asked to see the EKG because my background is in cardiology nursing. I presented with ST elevation is majority of my leads, which caused me some alarm. The ER MD told me he was going to consult cardiology while wait for my test results and have my chest x-ray. The x-ray results normal which was a good sign. The ER MD came to my bedside and informed me that I have Pericarditis. It finally all came together when I heard Pericarditis from my PCCN training. I had a viral infection first, then had chest pain that was affected by position, and can show ST elevation in an EKG. I was told I could be discharged from the ER and need to take Motrin 600mg every 8 hours for the inflammation. The last thing I needed before discharge was the results from my lab test. Everything looked normal besides a slight elevation in my WBC, which caused no concern because I was recovering from the flu. Then my cardiac enzymes test results were run and I had a troponin of 11.0. No longer was I able to be discharged from the ER, I was being admitted for observation and a bedside ECHO. In our line of work people are told worse news every day. However, I am told I need to be admitted for observation and I was actually scared. I started thinking of all the worse possible scenarios that could happen i.e. heart transplant from cardiomyopathy. I tried to be a good patient by putting on the grip socks and wearing the continuous pulse oximetry. I did refuse the SCD and tried my best not to silence my alarm monitor. I failed in the latter attempt and found myself silencing my bedside alarm because it was disturbing my sleep. I didn't want the nurses to experience alarm fatigue which is a new focus for Joint Commission. Finally, morning arrived and I was seen by cardiology. My troponin peaked at 12.6, but finally down trended to 7.6 later on. My ECHO results were normal, and I was diagnosed with Myo/Pericarditis. The medication regime stayed the same with Motrin 600mg every eight hours. This experience was an eye opener to see things from the patient's perspective and how disruptive those alarm monitors can be. I am happy to report everything is back to normal and I am able to resume normal activity. Thanks again for reading. To read more about alarm fatigue and participate in an academic research survey which I am doing for a MHA degree, please go to Alarm Fatigue Survey here on allnurses.
  2. chloram_24

    Hazards in the Field of Nursing

    Way back 2006, I was a newly BSN graduate waiting for the result of my board exam to be released. And while waiting, I volunteered in a private hospital for me to enhance my knowledge and skills and have a pertinent experience needed for my application for work to a bigger hospital someday if ever I'll pass the exam. Little did I know that some unexpected things might happen to me during my stay here. Well as a newly graduate, I am so eager to do first hand experience in handling different kinds of patient without the supervision of a CI. I am so active in attending patients such as interviewing them, giving medications, taking their vital signs and charting. I almost want to do everything. During the 8 hours duration of my duty, I spent more time staying at bedside of the patients. If there are procedures to do with the patients, I am volunteering to do it as long as I know it and I can. That's how eager and enthusiast I am during those days. My immediate superior is so happy to have me there. I encountered lots of patients here with different illness such as Dengue, Influenza, Stroke, Malaria, PTB and Vehicular Accidents to name a few. There is this particular patient who stayed longer in the hospital than others because of the severity of his case. He was a PTB patient with matching chest tube. Due to the severity of his case, we are monitoring his vital signs more frequently and check his tube placement. Sometimes, I was allowed to do the changing and cleaning his chest tube. We are wearing PPE such as mask and gloves when we attend to his needs and we also wash our hands after. But there were times that I forgot wearing mask when I go near the patient inside the isolation room and while taking his V/S, I only remember wearing it when I am about to finish. So careless of me eh. That's my duty routine everyday. Although it is tiring, it still feels good inside to see my patient reaching out to me for all their problems as if I can solve them all, haha. But more of it, their simple thank you brings a lot of joy in my heart. I really felt satisfaction in helping, caring, and nursing them. And I always end up teary-eyed every time I hear their sincere TY's .(So emotional eh) Moreover, while I am making myself busy on my duty, I also keep on praying everyday for a positive result of my board exam. Then comes January 15, 2007, it is my day off and little did I know that this will be one of the happiest moments of my life because I learned that I pass the exam. As expected, my family, relatives and friends were so happy for me. Furthermore, after knowing that I've made it, I seriously start planning what I will do next. I know this is the beginning of the next level of my life. I told my parents that I will start looking for a real job in order to help them financially. Then eventually, I will apply for a work abroad after gaining enough experience for me to qualify to work abroad. I hoped, my parents hoped that I will be the one to help them escape poverty and help my other sibling go to school also. So I promised myself to do everything in my power to fulfill my dreams because I want them to be happy and I don't want to disappoint them. But my grandmother who was based in Australia has other plans for me. She wanted me to take IELTS exam because she plans to get me there. So I told myself, "this might be the first step to the fulfillment of my dreams so be it". Then I went to the city to review for my IELTS exam. But there are unexpected things that happened along the way. I didn't take the exam on the supposed date because of the delay of the financial assistance of my grandma. Perhaps miscommunication happened between me and my grandmother. I got disappointed and frustrated so I did not pursue my exam, instead I tried applying for work here and abroad because I really wanted already to be of help financially to my family. I keep on passing to almost hospital here in the city and at the same time keep on hopping to different agencies for work abroad. And fortunately, I was lucky enough to pass an interview and exam for a work abroad. So I processed my necessary papers needed such as passports and authentications of my documents and lastly, I undergo medical exam. After my med exam, I was so happy because based on the situation, I am about to start attaining my dreams although it is not as exactly as I planned. But still I am happy and satisfied with the way things are happening. But the worst thing is about to happen because one day, my agency contacted me and informed me that there is a problem to my medical exam. So I went to the clinic where I took my med exam to verify it. I still recall exactly what the clerk told me about the findings. "I am sorry Miss, you've got Undetermined PTB Activity on your X-ray, and you need to consult a doctor". I was stunned for a minute and I did not know how to react so I just got the result and walk out of the room speechless. When it fully sinks my mind the indication of this problem, I told myself "It can't because I didn't feel any signs and symptoms and I am healthy! Maybe they just made a mistake. I am in a denial stage. Then the next thing I know, I am already inside a church kneeling while crying and asking God "Why me Lord? What now? It's not fair? How will my parents react if I'll tell them? Surely they will be as hopeless as me." I no longer know what to expect in the future. I felt so devastated and numbed in pain that time. As if it is already the end of my world. Although my parents are expecting that I am about to work abroad, I didn't told them immediately that I am not fit to work abroad. Instead I just told them that the result of my exam has been delayed and that my visa is not yet released. But I decided to inform them that there's something wrong with my med exam and that I need to complete a medication first. It also occurs in my mind that maybe it is better off if I will die than living in this world useless. I was really so hopeless that time but I come to realized that maybe God has a better plan for me that's why things like that happens. I began to hope again, besides I really don't want to lose hope because I am the only hope of my parents and I know they still needed me. At present, I already have a job but I am still hoping that someday I can still work abroad. And as I look back I know where I possibly contracted my illness. It is during the days that I am so eager learn without taking enough precaution to my health. I called it my carelessness days. Even though I regret those days, I can no longer undo it so I might as well just leave everything to the mercy hand of the Lord. I know He has a better plan for me. The lesson that I've got is that Good Health is one of the best gift that God bestowed on us so we need to do everything to preserve it because as I've said carelessness might cost everything we have. And one thing more, never hurry everything. We should develop a virtue of patience. Always put in mind that God knows best so never let our hope and faith fade in spite of many struggles and hardships we've been through. And lastly, in spite of what happened to me, I still love my nursing profession. I will never forget the good feeling that reigns in me every time I extend my care and help and most especially every time I see the thankful smiles of the ailing patients for the things I've done to them. So to all nurses out there, never lose hope and faith, treat every hardships and struggles as motivation for you to successfully attain your goal in life against all odds. I know this article of mine is quite boring, but as I finish writing this you don't know how happy I am to share this. And I know that in my heart, I already forget the pains that I've been through. Thank you for reading it.
  3. jadelpn

    Noro-virus Blues

    OK, so the old joke "The Postman Always Rings Twice" can be easily converted to "The Noro-virus CAN Ring Twice". And once is enough. And never is better. And it helps when one washes their hands raw, but even then sometimes we end up with the nasty little bug anyways. And then, as nurses, we are just smart enough to convince ourselves that we are about to die. For real. Is is really feasible to throw up 15 times in 24 hours?! I didn't think so. Until it happened. I literally couldn't get out of bed, but had to. Numerous times. I groaned, a LOT. I think at one point I was crying. I made the best dinner ever. Went to bed just in the BEST mood. Woke up with a start because, well, something was not right. And then, it began. And continued. And for every whining mess of a patient I have ever dealt with in my many years, no was was worse than me. For real. I blush at how I became a fluid leaking, gagging, crying demon. My dh says "do you think you want to go to the ER?" Me: "Uhm, Nooooooo (gag,spit,burp) I don't get sick, I am never sick long and I will....excuse me....(gag, spit, burp). And crying.....I took a temporary leave of my senses. I didn't leave the bed unless I needed to. Thought my end had come. Was funeral planning. Thought I would get decubitus if I didn't move. Swore up and down that I had aspirated and would now have a secondary pneumonia. Seriously. I said that out loud. "Do you HEAR this wheeze?!?!?!" (There was no wheeze). I was sure that I must now have an arrythmia from the lack of potassium in my body. "FEEL my PULSE.....I think I have put myself in A-Fib or something." Truly, said that. Out loud. "I am HOTTTTT, I have a FEVER......I am BURNING"....and yes, to my credit, I did have a low grade fever. However, I was not delusionally into the 103-104 range (which at least could have explained my very poor behavior). "Great. Now I have turned septic. I am going into SHOCK or something. Where is my blood pressure cuff? What is my B/P to pulse ratio?!?!?!" My dh got the kids off, got himself to work, so he left me. Alone. So what that I said "I just vant to be alonnneeee" like I was a 30's movie starlet. So, I called my mother. She was not very sympathetic. She told me that I was over-reacting because I am hardly ever ill. That I needed to lay off my poor husband, shut my eyes and get some rest. Humph. Like SHE knows anything. Coming from a nurse who's cure all is "take a shower, have a cup of tea, and I am sure you will feel soooo much better" this was a very, very poor performance. The more we know, the more suggestive we become. And I am somehow a big whiny baby with attitude. Not my best day. Like all horrible but swift moving viruses, the next day I was markedly better. I could open both eyes, sit up, and take nourishment. (And I was really, really careful to advance my diet with the slowness of a snail. Who the heck does this?! Uhm, me.) I am a hand washing fanatic. I bleach everything. My house smells like the laud-ro-mat. What I couldn't bleach, I disinfectant sprayed. Who knew that it said to "saturate" and let sit. Everyone reeks of lysol. But there has been no barfing now for a few days. Such as life, and life goes on...and if you can't laugh at yourself, who can you laugh at....especially when my dh and kids are saying "I vannnnt to be aloneeeeee" like they are making fun of me. IMAGINE. Humph. I was circling the DRAIN for heaven sakes...... (Disclaimer: The norovirus, stomach flu, bug, whatever you want to call it, it does stink. And this is certainly just my experience, I would never give anyone advice on when to seek treatment, and I don't make light of this sickness...which can be dangerous...only my reaction to it.)
  4. abemwe

    Gilbert Changed Me

    It led to my limping and stopped cycling. But it led to something good... for me. I became a patient when my leg fractured, I heard triage team calling it compound fracture. I was conscious; saw villagers moving up and down, ambulance sirens and seriously injured patients. I never knew that my fracture will make me stay in the hospital for six months. In the orthopedic ward, all staff members were friendly like in the imaginary heaven. Patients were there like brothers and sisters in the earthly home. Together with other patients, we used to get out and busky on the sun. I thought for long, 'Who is a patient? Why me? Why these friends of mine in ward 9 (orthopedic ward)?' The only answer I could get was 'It's me and these other patients and our needs as patients.' The nurses are the one I saw frequently. They are the only who could meet my needs. My friends(other patients in orthopedic) gave me a satisfactory social environment; we could watch the TV together and discuss topical issues - politics, business and even the weather from the ward. What beautiful friendships. I admired all patients-their co-operation to the staff. But I know it is because of how the staff handles them from the word go. I only imagined that I could handle any patient more friendly than those staff members only if I get a chance. Gilbert also had a fracture, one midnight we were not asleep. He was in the next bed and we were talking about our goals. I asked him, "Do you think I can nurse you and everyone in this ward" He told me, "In fact, you can be a good nurse if only you want to be one." "But how?" "Just that way," he said, "I have been watching you, you have the heart and the potential to be." "Be serious Gilbert." "I am serious. Walk out of that hell fracture of yours, walk or limb, train, practice and be your best." "It's okay. Remember it's night. Lower your tone. Others are sleeping." "I assure you-you can be a good nurse."He said softly. In subsequent days I thought of how Gilbert (a patient) could see what was in another patient(me). I left him in the hospital. But I visited him always. And every time we met he told me "Go and be what you are." Later he was confined on a wheelchair. He could make jokes, "Go and be what you are, then come back and take me out of this hell wheel-chair. Those nurses did a lot and I guess you could have done better. Just go and come back to me." I decided to train certificate, diploma and degree nursing while Gilbert was on the wheel-chair. Because I had promised to come back to him,I finally did. "Look here men. I am a nurse happy to be and I will be happy to do it." I hugged him. "I told you." He said, "You are Mr. Good. And it's my sincere hopes that as you go to practice you will be Mr.Best. Go and do it better than them." With a lot of psyche, I have started orthopedic nursing in a provincial hospital. I limp because of the fracture I had a few years back. But I enjoy limping from one bed to the other attending my good patients. The only sad thing is Gilbert passed away week. 2 weeks into my practice. I wish he could see how I limb from one bed to the other. What could be his comment? He changed my heart from cycling to be a nurse when both of us were patients. He remained a patient as I hurried to go and come to nurse him. It's unfortunate he is no more. But inside me, he planted one thing, "Be what you are; a good carer,a good friend, a good nurse. Do to others how you could have preferred it to be done to you." Gilbert as a patient changed me as a patient to a good nurse in me. This is the fourth week of practice I limp and enjoy being a good nurse.
  5. General E. Speaking, RN

    The Patient Nurse

    I had an elective orthopedic procedure requiring a three day stay. "Elective" is a bit of a stretch- a joke actually. I guess there are some superhuman people who could walk around without any cartilage on the lateral side of their knee, but I am not one of them. Tired of the pain and limping, I finally consented to a total knee replacement at the tender age of 43. I begged to be put on my own Telemetry Unit although I do not have any cardiac issues. My rational was that I would give up at little anonymity and be around people I actually work with because at least I would know something about the skill level of my caregivers. Call me crazy but I have been doing this for a while. Not trying to be insensitive but some do make you wonder where in the heck they received their diplomas. You know the type. Asking to be placed on the Tele Unit was a gamble because we rarely get total knee patients with a CPM (continuous passive motion). I am not even going to address our lack of knowledge regarding nerve blocks (gulp!) But, I figure if I can get over the embarrassment and shock of my backside hanging out of those lovely gowns, perhaps they can too! Hopefully, it wouldn't require too many counseling sessions on a comfy couch. There was a shimmer of hope in my warped rationale about my room assignment. As the Unit Educator, I have done many in-services on my Telemetry unit. I recalled doing one on CPMs about 6 months before and wondered if any that attended would be my nurse? My hopes were suddenly dashed as I remembered the low turn out. Poor attendance despite all my brilliant efforts. I advertised well in advance with colorful clever posters. I offered it numerous times during the day and night. Lastly, I had bowls of chocolate that I brought as a... well...bribe. Even chocolate couldn't reel them in. Certainly a sharp skillful nurse was a top priority but also I wanted to assure I would get a nurse who had some compassion. It is ironic to think about nurses in our profession who do not possess this one attribute but, sadly, I have worked a few. I know that there are days when staffing, patient load and needy families with unbearable patients make this almost impossible but a girl can hope, can't she? So, let me add all this up. I guess I was hoping for skillful nurse with a kind face who had an empathetic nature with a manageable patient load without lots of family and visitors around. It could happen, right? (Eye roll) What if my plan didn't work out? What if the opposite occurred? What if THAT nurse was assigned to me? The one you loathed to work with. The one that you actually felt sorry for her patients and would spend the next day cleaning up the mess and doing some serious customer service butt kissing to undo all the things she didn't do. What on earth was I going to do then? I decided that if someone did get assigned to me that didn't meet my 'expectations' I would scream at them to get the (blank) out of my room and then later just blame it on the narcotics or say I had some sort of post-anesthesia delirium. It just might work. I am happy to say that my surgery went as planned without any complications (other than that one time that I had to use the bathroom during shift change). I was pleasantly surprised that the house supervisor had a master plan of her own. She pulled a Med Surg nurse who had lots of orthopedic experience to our unit to take care of me that night after surgery. I was rather loopy from the morphine PCA so I doubt I would've even been able to tell if it was a nurse taking care of me or a giraffe in scrubs. I received great care. My privacy was respected and hardly anyone saw my backside. I do feel terribly sorry for the kitchen staff though. Having to make and serve terrible food day in and day out must do something to your psyche. I was on a regular diet too! I don't even want to think of what a cardiac or renal diet tastes like. This turned out to be a good experience for me. No doubt, I will remember my stay when I am back on the floor again caring for patients. I will listen to their concerns attentively despite having already stood in the doorway for 15 minutes trying to slowly make my escape. I will be sympathetic when they lift their lids from their dinner trays and turn up their noses in disgust. I promise to faithfully continue to assure no backsides are hanging out while traveling. Heck, I may not even complain when someone calls to go to the bathroom during shift change.
  6. Sonjailana

    On the other side of the IV

    First, I'm an RN in Med/Surg/Onc/Tele with 2 years experience. I take care of post ops everyday, but I was still very scared going to OR as I've never had anything done myself. I went and signed in, and the clerk was helpful as I was in the wrong section of our big hospital. My mom and I were walked down to the right room, and I was all checked in. Then they brought me back alone, weighed me, and did a pregnancy test, asked me the most embarrassing questions alone, got me in a gown, and THEN brought my mom back. I was impressed at the considerate behavior. After the usual pre-op screens, pepcid, decadron, and versed IV, I wasbrought back to the OR. The staff was jovial, teasing me about being skinny, and the next thing I knew I was under. The next thing I remember was being in PACU. I couldn't talk at all. Mind you, this was a tonsillectomy and adenoidectomy. I was in excruciating pain and I started bawling. I felt like I was still on fire from the cauterizing machine. The RN says to me "WHY ARE YOU CRYING???" Then, my anesthesiologist apparently heard my commotion and backed me up and asked the nurse what was going on. So, in my post op brilliancy I remembered that I could make non verbal signs of pain. I squeezed my eyes shut, clenched my fists, curled my toes, and furrowed my brows. Then I started heaving and the RN says "SONJAILANA, SIT DOWN." OMG!! Should I lay down to vomit so it can go in my lungs?? Finally she gave me 1.5 mg of dilaudid and 12.5mg of phenergan. My pressure was 140/80 and I usually run 110/60. I was disappointed with my RN because I always expected a PACU RN to be assessing my pain level and actually ask me what it is, instead of assume that for a small procedure it was nothing. I had to ask for an ice collar, ask for ice chips, and a tonsil tip (haha) suction for all my drool. I think I must have finally gotten the drugs, because my nurse was nowhere to be found, and I kept waking up to myself desatting into the mid 80's, with no nasal cannula to be found ( I would have put it back on if I could have). Whenever I get report from PACU nurses, they're right there with the patient, but I can only guess where my nurse went to do it. Next, I went to Short Stay. The nurse immediately asked if I was pain. Again, the bawling started and I was looking for my mom. I kept trying to talk but I couldn't. She explained that I had local anesthesia, intubation, and general, and even at 24, still had adenoids that had to come out. She explained that the coordination of my throat muscles would be poor for several hours, and that's why I couldn't talk. Next time I opened my eyes, my mom was at my side and morphine was going in my IV. Next set of vitals, sherbet and reassurance. I was much more pleased and then she started me on po meds with a popsicle. Someone was there holding my arm when I needed to use the restroom and guiding me when I was so dizzy. Even better, I wasn't pushed out the door. My RN suggested I take a nap to see if it would help some of my nausea and fogginess wear off. I went home and felt pretty good and pushed the limit on full liquids. Around 10pm the decadron seemed to be wearing off my uvula is the size of a small finger. The pain is intense, but I'm waking every 4 hours to take my lortab elixir, drink some water, and change my ice bag and humidifier. All things considered I'm happy with my experience at my own hospital..and I'll remember that pain is what the patient says it is!
  7. Brian

    Nurse as a patient...

    Have you ever taking care of a patient who is a nurse? How did they behave? Demanding? Understanding? Please share this with friends and post your comments below!
  8. luvRNs

    Murphy's Law Experienced

    Kinetic energy carried me forward into the saddlehorn, and I suffered an open book fracture of my pelvis. My horse, alarmed at falling behind the others, began to gallop again. I decided it was time to bail off, and tried to control my fall to the ground. Shortly, the others returned when a riderless horse caught up to them. I informed them of my injury, 911 was called, and help sent. Then the anxiety and lack of control set in. I was loaded into a rescue and brought to the local trauma center. So far, so good.... I was fortunate to receive good pain management, but found that I urgently needed to relieve myself thanks to my fluid resuscitation. A nurse came in and offered a bedpan. I refused, saying there was no way I could tolerate being placed on a bedpan and asked for a foley. Those of you who are TNCC trained know that this is a 'no-no'. Pelvic fracture can be accompanied by a torn urethra, and foleys are not inserted until a urethral or bladder tear can be ruled out. The nurse placed the foley, caving to my pressure. Outside my cubicle door I heard the physician berating the nurse. Lesson # 1; do what's indicated, even if it angers the patient. I was sent to the floor shortly after, and scheduled for surgery on Sunday. On week-ends normal procedures were MODIFIED. Pre-operative patient were brought to recovery rather than put in a preop holding area. Several of us were lined up on stretchers waiting. A nurse came over to me, called me by the wrong name, and told me they would be coming to start my knee surgery. I corrected her and she walked away. After several minutes, she again retured. Once again she identified me by the wrong name and surgery. I became agitated and requested the staff return me to my room until they could properly identify my name, MD, and planned surgery. The lessons here were myriad. First, routine IS a safety mechanism. Whenever a procedure is modified it expose risk for error. This is taught by Crew Resource Management programs. Second, best practices such as marking the site, and confirming personal identifiers protect all involved from the patient to the staff. They are a necessary safety practice. Thankfully, the rest of this hosiptal staff proved uneventful. Two days after discharge, I rolled over in bed, felt a clunk and was thrust into severe pain. My internal fixator had broken. Back to inpatient status I went, this time for both an internal fixator, but for an external fixator as well. The surgery was performed, and I awoke to my loving husbands face. I dozed for much of the evening, awakening only to say good night to my husband when he left. I woke again around midnight to find my nurse irrigating my foley. The nurse in me kicked into higfh gear. What's my urine output? None for two hours. What are my vital signs? Fine, not hypotensive or tachycardic. What is my hemovac putting out ? 300 cc bloody an hour. WOW....how fast is my IV? What is my hemoglobin and hematocrit? OK. She left. Frightened, I struggled to stay awake. I kept feeling my pulse, checking my IV, and checking my foley and hemovac. My urine output was scant, and my hemovac still filled quickly. despite me best intentions, I does again, only to be awaked by a concerned RN irrigating my foley once again. I still had no urine output? Very little. She left and I stayed awake. After an hour, I noticed a significant change, my hemovac contents changed from sanguinous to reddish-yellow. As a ICU nurse, I put the pieces together. My bladder had been perforated, and my urine was draining out the hemovac. The nurse returned to the room. When I informed her of my suspicions, she freaked, and asked ME what she should do. I told her that bladders were often left to heal by secondary intention in order to lessen scarring. Urine is sterile, and therefore a leak into my pelvis was not exposing me to the risk of sepsis. The long night ended and morning FINALLY came. With the daylight came my husband. I cried on seeing him, and felt I could FINALLY go to sleep, as someone would watch over me. Moring also brought the doctor, and emergency testing. My suspicions were correct. My bladder had indeed been perforated. That night was the best and worst night of my life. Horrible to experience, it was transformational to my nursing care. I vowed to never again become complacent. What is routine to us is NOT to others. It is a very individual experience. Seemingly dumb requirements, like checking ID and adherence to routines are truly safety measures that should NEVER be compromised. Listen to your patients. You will be surprised at what you may learn. Hospitals are NOT safe places to be. Any and all systems can fail patients. Errors are rarely staff-caused, they are system-caused. As health care professionals it is our job to identify threats to safety and to advocate for related enhancements. Both your patients health and your liability depend on it. Finally, there is one safety enhancement that can not be denied. It is receiving well-deserved attention recently. It is called family-centered care. Caring family are a patient's first safety net. The know the patient, thus quickly spot subtle changes. They care for the patient, and thus advocate for the patient who can't speak for themselves. Appropriately-guided, they can assist the nurse in providing basic needs. They are a PARTNER in care,and we need to collaborate with them as such. New hospitals are designed with this concept of family in mind. Will there continue to be abusive, and disruptive families? Of course. Life is not perfect. I for one celebrate the change for what it is. Safety for all of us.
  9. I am never a better nurse than when I have just been a patient. A recent ER visit highlighted this fact. I was in pain, anxious, and very very tired of being sick for the past year. I will stress quite clearly that I do not like being on the gurney side of a hospital bed and that, coupled with my pain, made for very bad vital signs. The next few hours were what I had expected as a former ICU nurse-EKG ,blood work, etc. However, what struck me the most (probably because I DID expect those things and had time to think about the other stuff) was how different I was treated between my doctor and the two nurses who cared for me. Now, I want to make a very clear distinction here because I don't want to get into a conversation about doctors vs. nurse. I want to clarify that it was THIS doctor and These nurses who I was comparing. All of them did assessments and history and monitored me for the hours that I was there. All of them were competent at their jobs. The doctor had more knowledge base but was neither congenial nor friendly and truly looked at me as vital signs, symptoms, and orders. The nurses did their assessments, talked to me about my year long struggle, and cared why I had chosen to come in on that day at that hour. They advocated when I didn't want a particular pain medication due to a bad reaction in the past and requested we try something else-the ultimate outcome of that little adventure. As we go into the next chapter of nursing I wanted to take a minute to capture these two very different approaches. Nursing is changing. A whole new role of Nurse, and more specific to this case, Nurse Practitioner is developing across the country before my very eyes. The scope and practice of this new nurse will be different. I don't know what the parameters will be but I for one am very excited to see it unfold. Having said that, this new knowledge base brings with it a new set of responsibilities as well as a very new set of challenges. As we move into this new era of nursing we need to be very cognizant of our foundations. We are nurses; we chose nursing school for a reason. We have been taught the codes, ethics, and beliefs of nursing. They were drilled into us at the same time as those new IV, blood draw, and suctioning skills were being practiced. If this new brand of nurse and nurse practitioner does have more of an independent role and voice in the upcoming years, as I suspect, we will all have a say in the shaping of what that new nurse will be like. Not only of what is expected of him/ her but also what they will stand for and represent. A new paradigm will be created and I, for one, hope that our old codes and ethics evolve, not change. Evolution keeps fundamental components and adds to them, making them more adaptable to their new climate while keeping the best of the core individual intact. Evolution, for the most part, is an improvement to an already functioning thing. Change is like a mutation, it could be good and it could be bad- favorable or deadly. So, as the medication infused through my IV line on that gurney I began to imagine a day when one of those two nurses might choose the path of more autonomy through education, all while keeping to their listening abilities, their full assessments, and their great advocacy skills. For one calm, pain free moment I was much like Don Quixote in his madness; I saw the windmills, the knight, and the world not as it is but as it should be.
  10. Lindsey McGraw

    Nurse Heal Thyself

    Arriving with full knowledge of what the procedure entailed and with promised results being nothing less than glowing, I was experiencing a kind of anxious, queasy feeling that day. After giving health care for over thirty years, anyone would have a slightly "different" reaction to being a patient and quite frankly it is not something most of us old nurses are good at. No one really ever wants to be on this side of the coin but we are grateful to our colleagues when there is a time of need. Saying "goodbye" to my best friend, who has been my support person through this so called project, I followed my admit nurse back to the surgical suite to wait my turn. After an hour delay, and partially out of boredom, I found myself watching the different OR teams closely. When I graduated from nursing school for the second time and completed an RN program 17 years ago my intent was to become an OR nurse. I watched as they followed through with all the stringent protocols of checking names and confirming allergies and procedures with each individual patient, and an unexpected feeling of envy and sadness came over me. For the past 15 years I had put my heart and soul into long term care management positions and each day given some of myself to each of my "special friends." I rarely, if ever, had given much thought to what could have been different had life dealt to me a different set of circumstances...quite possibly, had cancer not derailed me, I would have been working in this capacity all these years. This was very much an "in your face" reality check, and at a very un-anticipated time. When it came my turn things did not progress as smoothly as my nurse anesthetist anticipated. When the shot in my IV failed to give me a nice glow, I quickly mentioned this to her as they were wheeling me down to the OR. I was wide awake and should have been far off in the land of La. A quick assessment revealed that my IV was not patent, so when I arrived in the OR a new one was promptly placed. During this process, a caring special nurse made every effort to make me comfortable, giving me kind words and explaining the basics of what was happening around me as I could hear the team moving about setting up equipment and getting me ready for surgery. I thought, "Wow! I am a nurse and I understand all of these processes. I can't even imagine how a lay person would feel right now." This is a perfect example of why nurses play a special role because no one in that OR team had any idea that I was a colleague. To them I was just another case that they were doing their best to keep safe, secure and bring through a surgical procedure to return home for recovery. Given the emotional ups and down I had experienced that day, this nurse was there to ease me into my experience and was doing a fantastic job. As a fellow nurse, it meant the world to me; as an OR lay person, it meant everything. A few days into my recovery process my thoughts went back to that surgical team quite often. "What if" is always something that will be in my mind about my success as an OR nurse but in a few weeks I will return to my "special friends" and my real world of nursing. As I look in the mirror I feel whole again and realize that while I will always wonder, the sadness about this "what if" moment has already started to subside and I truly believe that we all have a purpose and find them sometimes by fate, sometimes by force. The right person there to guide us at just the right time can make a world of difference, and one way or another that was my fate. As this thought sets in, the mirror reflects my smile on the inside as well as on the outside.
  11. rnsheri

    The Nurse as a Patient

    As healthcare professionals, we may forget how to be a patient. We love our patients, we sometimes get frustrated with our patients, and occasionally we will BE patients. I had the opportunity to be an inpatient at the hospital I worked at. I found out several things during this experience I would like to share with you. Perhaps you can relate. The ER is scary, and while my nurse was pleasant, the doctor intimidated me. The waiting room was busy with frightened patients, angry patients, and crying children. I could barely concentrate on my forms and felt terrible and dizzy and nauseated. I had just found out my H & H was very low when I attempted to donate blood. The doctor looked at me like I had lost my mind, which is understandable. I had just thought I was I admired the amazing IV and bloodwork skills, but finally understood how uncomfortable the IV catheter is in the antecubital space. It was like a huge splinter that annoyed me whenever I made the mistake of moving my arm. Once I was on the floor, I had my RN re-stick me in the forearm. She said she understood how I felt-she'd had IV's placed in the AC too. It is very embarrassing when the hospitalist ordered an occult blood sample x 3. I did not want my caretakers to see my poop. I never thought twice when I collected stools from patients, but I felt embarrassed. I didn't want food before the NPO status, but as soon as I knew I couldn't eat, I felt ravenously hungry. Everything and everyone looks different from a supine position. Hospital gowns are horrible. The prep for my procedure was horrible. Having funny, compassionate nurses and nursing assistants make the most awful things a little better. The IV "colonoscopy cocktail" is the best thing ever-except it makes you tell the whole truth to whoever will listen. If there's something you don't want everyone to know, plan your visitors accordingly. Having a list of medications you're taking makes life so much easier for everyone involved. Laughter is good medicine. I know everyone differs, but I loved laughing with my coworkers. It calmed me down and made me feel normal-even in the horrible gown, even when I was choking down It is very hard to look good in the hospital. My hair was a rat's nest, I was very pale, and and my skin felt oily. I worried about how I smelled. I wished I had a razor, or had taken care of shaving my legs before my hospital visit. I wanted my teeth brushed before anyone assessed me, every day. As you may know, assessments happen all the time. You can't lie about your weight when you get weighed daily. Nor can you hide the smell of your GI bleed poop. I realized that to be a good and competent nurse, I needed to "practice what I preached". I took better care of myself because I was aware of how easily health can slip away. I know it seems obvious, but I also know I'm not the only nurse that does this. I realized how truly exposed you feel as a patient. I still get nervous going to the doctor-even for check-ups. Kindness, professionalism, and humor matter. I think that my experience as a patient made me a better nurse.
  12. Elvish

    It's your turn now, nurse!

    I am an OB nurse; I do mother/baby, newborn nursery, and high-risk antepartum nursing. I'm used to being the one in control. I'm used to doing the teaching, reading the monitor strips, and reassuring the fears of many an anxious mama (pregnant or delivered). That's where I'm 'in the zone'. Give me a 35-weeker feeder/grower, give me an antepartum mama in preterm labor, give me someone who needs that kind of help, and I am good to go. What I am not used to, however, is when the tables are turned and it's me in the hot seat! 'Roundabout late September, that all changed. Just under a month after miscarrying, in the aftermath of a rollover MVA (thankfully no serious injuries), I found out I was pregnant again. Having a pregnancy so quickly on the heels of a loss, it was a bit nerve-wracking and considering the seriousness of the wreck, I sat around for a few weeks and essentially waited to miscarry. It was still a bit surreal, even after seeing cardiac activity at the 6-week ultrasound done to confirm that this was a new pregnancy and not a surviving twin or retained products from the miscarriage. Since then, this pregnancy has (at least for me) been one bit of drama after another. I lost about 20 pounds in the first 20 weeks because of a near-complete aversion to food. At 12 weeks the doctor couldn't find a heartbeat with the doppler, so we did yet another ultrasound that revealed a baby too busy to be still for the doc to listen to her. I've done two O'Sullivans, resulting in two 3-hour glucose tolerance tests. While both were technically normal, I've still been checking my blood sugars and tweaking my diet a little given my family's propensity to grow macrosomic babies (no one was very impressed with my 8lb 1oz critter last time around). Blood pressures have been up and down the entire pregnancy and I've been obsessed with whether I'm spilling protein or not. At the anatomy ultrasound, they diagnosed her as complete breech; she has since flipped and her head and bum are right where they need to be. Even as late as the last doctor appointment, however, it took my doctor (he is usually the go-to guy for hard-to-find fetal heart tones) forever to find her because she just can't be still in there! (As my 6yo would say: "She's a busy little girl! I bet she's making lots of parties in there.") Right now I'm at 37+ weeks and all systems are go; just waiting to go into labor. Other than wanting the usual discomforts of late pregnancy to be over, I'm in no real rush. Given this one's clear propensity to do things her own way, however, I'm not sure what to expect. It will be completely like her to either a) send me into labor at work and have me haul backside to get home in time (I work 50mi from home); or b) go to 41+ weeks and eventually need to be induced one way or another because she's just. not. coming. out. (Heck, a flipped truck at 75mph didn't do it...) Neither scenario would surprise me. For someone like me, who likes to know what the scoop is, this is hard! When I had my first, I wasn't an OB nurse and didn't have the knowledge I have now. This time around, I've had the entire pregnancy to worry about my blood sugar, blood pressure, fetal presentation, and just about everything else OB nurses see on a daily basis that can throw a wrench in things. The biggest concern now is labor. I know what bad things can happen in labor and delivery; I also know the odds are very good on my side that those bad things won't happen. The control-freak nurse in me is trying really hard to relinquish that control and trust the process. I'm always telling other women that their bodies know what to do, and finding it much harder to tell myself the very same thing! I've got a great primary OB, great labor support lined up, and it should be easier this time around. Physically, it probably will be. Mentally, it might be a challenge. I know myself and know that once she's born and I feel semi-human again, I will want to analyze her labor and birth from the OB-nurse perspective. For now, though, all the prayers, lit candles, and good thoughts anyone wants to send this way will be most appreciated. PS - For those of you who are superstitious about these things: My birth plan is about five sentences long.
  13. JulieRomanoLee

    How Do You Want Me to Remember You?

    Hi members of allnurses my name is Julia and the story I am about to tell you is true. Over 30 years ago I was hit by a car and pronounced dead shortly afterwards at a hospital I was taken to by an ambulance. The miracle is that I came back to life a few minutes later. I was given a second chance at life, but the road was a tough one for me. The memories I have of the following months I was in traction has to do with the men and women who provided nursing care to me. My first memory was a female nurse who came over to me as soon as I opened my eyes in intensive care and she looked like an Angel. Her delicate hands started taking the sticks and dirt from my hair and told me "let's make you look pretty again and we will start by washing your hair." These few words made me feel human again. My mind and body were in shock, I was hooked up to machines, tubes, you name it I was hooked up to it. She proceeded to delicately clean me from head to toe. I was so afraid, I did not realize the extent of my injuries BUT, I WILL NEVER FORGET the nurse's compassion in seeing how scared I was. Then there was a nurse who refused to clean my private area a day later because I had gotten my period? She turned to another nurse and said "I'M NOT GOING TO DO THAT!" and walked away from me. Please let me remind you I was in traction and was immobile. I was NOT comfortable letting anyone clean me but had no choice. I bled all over myself until my cousin came and helped with that. I was transferred to a hospital closer to my home and those nurses were pretty much the same. Some I will NEVER FORGET while others I was glad to. I'm only human and want to be treated as such. Remember that people are scared to be in hospitals and what you do and how you treat them will remain with them for the rest of their life! My most memorable experience was when a nurse stayed overnight with me because I started to have flash backs and was terrified because I did not know what was happening to me. This woman clocked out and stayed with me overnight making sure I slept and each time I awoke in panic she was there to immediately calm me down. The compassion inside you saves lives. Always remember why you chose this field and never lose sight of it. Once you just think of it as a nine to five job the patient feels it. The patient could be you, your child, your mother, your father, your brother or sister~ just because you might have heard it all before, or have seen it all before does not make it less dramatic for the patient who is experiencing it for the first time. I'm NOT saying to spend the night with patients, or go above and beyond, but MAKE SURE THAT YOUR PATIENT WON'T EVER FORGET YOU. Kindness and compassion goes a long way for patients young and old. Trust me your schooling will teach you everything you need to learn to become an excellent nurse BUT what lies in your heart will make the difference for a patient and YOU WILL ALWAYS BE REMEMBERED FONDLY. Maintain your quest in healthcare education and retain your knowledge in human relations. Excellence and heart breads heroes in the minds of all people. When dealing with difficult patients, refer to what you have been taught in school, learn through your experience, but never look at any two patients as if they are the same because they are not and never will be. An important fact I would like to say is, when you walk out of a patients room DO NOT TALK ABOUT THEM to anyone unless you are in a private room. Voices carry and your conduct is very unprofessional! Being a patient in the hospital for 3 months allowed for me to see it all (at least in the orthopedic ward that is.) Thank you for reading this~it was my pleasure to have shared a time in my life that I WILL NEVER FORGET. Sincerely, Julia L.
  14. Her mother and her sister had to leave the country for the much needed medical attention for her sister's leg (open comminuted multiple fractures on her right lower extremity) which according to relatives she could get from the United States of America. Its been a long 2 years without her parents' guidance and here she was diagnosed with a rare disease, Ovarian cancer (Teratoma), with only a hired help to accompany her every day at the hospital. This day was the start of her 6 cycle chemotherapy session. She has long black shiny hair which you can tell is a pride for her. She was quiet but always smiling. She was asked who was her guardian who can sign the consent by the nurses and doctors but she just smiled and said "I'm of legal age, I can sign it myself" still smiling. After the various procedures needed to be undertaken before giving her the first dose, a nurse accompanied the doctor and hooked the chemo agent. She stayed for a week, then she was discharged with Chona their family's hired help. she was to return 2 weeks after for the next cycle. 2 weeks after, she came. Her head as bald under a cap, the cap she said smilingly was gone by her sister from the US who was also undergoing some operations on her leg. According to her, the falling hair was bothersome that she decided to get rid of it. After she was taken into her room, Chona came back out and gave the nurses some food. At first, the nurse was resisting but Chona was very persistent and told the nurses it was her birthday the other day. That 2nd course, she stayed for 3 days. She insisted to come back every day for the remaining doses which her doctor agreed but with a condition that if she wasn't feeling ok she needed to stay at the hospital. That's how she finished her chemotherapy course, coming in for a couple of days staying at the hospital and coming back for the remaining doses. The reason why she chosen to stay at home: was for her youngest sister(12 years of age) have stability in her life. Their mother was out of the country. She was constantly smiling never complaining always with the rosary on her hand, praying before the course. The fact: She was taking care of herself at the same time she was taking care of the family, the house, & the livelihood left by her mom to her. Hmmmmm that patient was me. I remember when an instructor asked me why I decided to take up nursing when I could just continue being a Physical Therapist, I told her. " Being a Physical Therapist, I feel its still not enough. I needed to broaden my scope of expertise because I really wanted to help... people, who are stricken by some disease, wanting someone to understand what they're going through. I wanted to be that someone who says, I'll be with you throughout your fight. whether you lose or win. God Bless! P.S. My hair grew back but it's not as thick as it was. ahihihi positive thinking. I passed our local board twice (because of the leakage issue). I just wanted to share my story, I hope you find inspiration from it as I did.
  15. I looked around at the people in the waiting room, wondering....... what's wrong with that lady? Does she have cancer? Poor thing. Then I thought... Gee..... Maybe she's wondering the same thing about me. I wanted to reassure her that I was not really sick...... just something wrong with my blood. I don't have cancer...... nothing that bad...... But what do I have?? I have been asking myself this for several weeks...... since the day that I realized that something wasn't quite right. Then when my blood tests came back abnormal and my primary care physician referred me to a hematologist.... who just happens to be an oncologist........ that just seemed very strange. Hey...... I am the one who helps other people deal with this kind of information. But now it's me. The nurse who took me back to the room was very nice. In fact, everyone was very nice. Very soft spoken and reassuring. Again, I wanted to tell them...... I'm not sick..... not really. Not like the other patients. But still, I wondered....... what will they find out is wrong with me?? Oh..... it's probably nothing. Nothing really bad....... or at least I hope and pray. Prayer......... been doing a whole lot of that lately. Oh I always pray.... but it's usually for other people. Then came the questions. Oh I hope I remember to tell him everything. What was that he just said??? Hmmm........ I'm having trouble remembering the order in which things happened. I hope I don't sound like an idiot. I am a nurse and should know this stuff. Oh yeah..... I remember reading about that when I was googling things trying to figure out what is wrong with me. Good thing I brought my notebook with my list of questions. Now why did he ask that? Does he think I have that??? Oh my. He wants to order what test??? Why??? When will I get the results........... Then I was ushered to the lab. Again....... the lab tech was very nice and reassuring. But when I saw all of the vials that she was going to fill with my blood......... I did get a little queasy. The tourniquet felt tight..... I turned my head. Ouch..... it did pinch a bit. How long is this going to take?? Sure.... I'm fine. I would sure be embarrassed if I fainted. I have to go where to get what other test?? Why? Where exactly do I go? When? OK. Come back in 3 weeks??? Seems like a long time to wait. OK. Sure that date is fine. Wonder what I'll find out then?????? This is not the first time I have been on the receiving end of medical care........on the other side of the bed rails, so to speak. Each time, I learn something new....something I can use to make me a better nurse..... treating others as I would wish to be treated. Today, I realized how much a reassuring and caring voice means to a patient who may be afraid of what they might hear or what they might experience. It might seem like a small thing when we as nurses take a few more minutes to offer compassionate caring......to meet the emotional needs of the patient.......but to the patient, it helps alleviate some of the worries and fears, thereby lowering the stress level. While we can't always offer a solution or reason why things are happening, we can always take the time to show genuine compassion.