Thursday April 11 2024

Ado Annie, ASN, RN · Apr 11

The sun is shining brightly and it's a little cool and breezy. Hubs discovered yesterday that there are (at least) 3 kittens under our back yard shed. Kittens are so cute but I guess I should take them to the shelter or something 😞

Tweety, you are giving me flashbacks, too. The ER providers and their director don't like it when M/S nurses question admissions (you're sending her to us with a BP of 180/108? What have you tried?) but I still remember the patient I coded shortly after he arrived to the floor. That was at the big teaching hospital and the residents came up at some point asking about him and when told that he had coded and was in ICU, they said, "Oh, I didn't think he was that sick"... 😞

I hung up on a zoom meeting this morning because the leaders (from the mothership) were being so condescending. I'm trying not to let that leave me in a sour mood. I'm going to have to address the whole situation but ... not today.

Our risk management group is meeting in Arizona yesterday and today. I'm joining by zoom. Yesterday it was from 10:30 - 6:00 (Arizona time is 2 hours behind us). Today will be similar. It's kind of exhausting trying to stay engaged via zoom for that long period. So I went late to choir practice. Apparently, our lay leader got mad at the choir director because he wanted us to repeat the last line on a hymn that we have used in the past as a weekly routine and the lay leader argued that the congregation would be confused by that. I hope he was just having a bad day and realizes that his reaction was out of proportion to the situation.

Well, time to prepare for the marathon zoom meeting.

No Stars In My Eyes · Apr 11

Ado, Sorry you have to be subjected to that L-O-N-G meeting! And good for you for hanging up on the ZOOM meeting!

Joe, Oh the ever-elusive Pickleball Games! Might be a "sign", like a spooky omen for you, that it isn't something you should do? I don't get why it is supposedly such a popular game anyway.

Cloudy today ... and depending on which forecast you read, it could be 56% chance of rain, or 80% chance of rain. It isn't raining at this time, but it sure is windy! It gusted wind all night long. I want more rain to wash the pollen off my car! Mother Nature isn't cooperating with my desires, but when did she ever do that? The temp is predicted to be 76 degrees.

More dishes for me to wash; I have them soaking in hot, soapy water. Nannie made her bed up and laid down on top of the bedding again, this time with a towel under her, as if that would stop urine from soaking through. I have peeled the sheets and blankets back and have the ceiling fan set on high, as the wet area isn't nearly as big as it was yesterday (at least 24"). I DON'T want to do any of her laundry today, because I have to give precedence to MY laundry! (Which I also don't want to do, but is necessary.)

Have run out of yogurts for Nannie, so I guess I will have to duck out to get some. Bleh!

SiL said she has put Nannie's name on the waiting list for "part-time" ... 2 days a week of daycare at the Senior Center. She even volunteered to come over and get Nannie up on those days.....EARLY in the morning...to get her up and transport her there. SiL gets up at about 6 or 7 AM, and says it is no problem for her to do that. YAY! I sure can use a few Nannie-free days every week! Of course, I'd probably have to go pick her up at the end of the day, but I can deal with that, even if it is during rush hour. However, we don't know how long the waiting list is, so I am not holding my breath.

SiL and BiL are going to go to the viewing of Nannie's last living relative from her age-range....Nannie's SiL has just passed away. She asked me if I thought they should take Nannie, but I said no. It's a several hours drive to get there, and lots of people will be there, most of which she won't remember, or doesn't even know, which would be exhausting for Nannie to deal with, and then the several hours drive back home. She never asks about or mentions her sister-in-law, so I see no need to bring it up at all. I always tell Nannie, when she mentions her parents or Uncles/Aunts, etc., that she (Nannie) has outlived everyone in her family, except her youngest son, and she accepts that. Then we both say she is "Too Mean to Die!" which makes Nannie laugh.

I've had a large mug of coffee, and am feeling somewhat more awake now, thank goodness. I think it may be almost time to nuke some taquitos! (Yes, I am addicted!)

Out to get yogurt. Will be back here later on............

nursej22, MSN, RN · Apr 11

A 2 hour Zoom meeting! That just sounds painful. At least with Zoom, you can get up and walk around from time to time.

Crazy shift change transfers:

open heart patient on an insulin drip hung just before transfer, arrives with empty bag. Yup, they got a bolus 100 units of regular insulin.

Patient with 2 degree heart block, pulse of 40. Transporter took them off the monitor and walked them to the bathroom, " a little lightheaded".

Patient with "heart block" actually in intermittent ventricular standstill 3-10 seconds at a time.

Atrial fib with a rapid ventricular response. ER gave a cardizem bolus, slowed the heart rate to 70, then sent them up. heart rate 140 coming off the elevator.

Congestive heart failure, lasix and CPAP in ED. Took off CPAP for transport, agonal breathing as they came off the elevator.

Fractured hip, only pain med ordered was IV morphine. No IV or saline lock.

Middle-aged guy, recent circumcision now in pulmonary edema, got IV lasix in ED, couldn't pass urine. Hospitalist didn't want to bother urology, poor guy was gasping for air and sobbing because we couldn't pass a catheter.

Anyhoo, that was a different time, a different place. Today I have been a domestic goddess. Laundry, cleaning bathrooms, cleaning kitchen, doing some mending. Now I'm going to sip some cocoa and watch TV. It's been sprinkling off and on, only 48 degrees. I thought it was supposed to warm up. Grr.

I almost want to try pickleball. almost.

Ado Annie, ASN, RN · Apr 12

J22, those are some nightmare transfers.

Yeah, they were more like 7-8 hour zoom meetings. But they're over! Today had fewer little crises to deal with. Although the state board of pharmacy did show up for a "routine inspection" and our pharmacy manager was not in today. And the CEO is in Arizona at the conference. We handled it.

No Stars In My Eyes · Apr 12

Harumph= Nannie's 'Bough-ell' Report: 🙄sigh

Per her request we attempted mini-enemas first....But 2 blew out, because the stool was so solid nothing could get through it.; the third one went in by the side of the mass. Managed to get a few flecks and a small ball out. Had her do bending and twisting at her waist. No luck. Can't tolerate anything IN her rectum, so no digital disimpaction. I wish we had a regular enema kit, I'd give her one of those high and 'hot' soap-suds enemas and just run it wide open to 'lavage' her lower gut. (I'd have to wear protective glasses and then also line the bed and floor with heavy-duty plastic first, though !!)

Mid-afternoon, I gave her 1/2 sm can of prune juice with 2 Tbsp applesauce, teaspoon of bran, and butter, warmed up. Then supper was kind of early---hot potato soup with some veggies added, a sm piece of "Texas Toast" and a Klondike Bar; full glass of cranapple juice.

Says she feels better.

HAH!

I told her *I* wouldn't feel better until she got some of that poop OUT! It's a thousand wonders she isn't sick from constipation. I mean, how much intake can you have before SOMETHING moves along to its 'final destination' ?

When I had my 1st nsg. job a MGH in Boston, news came up from the ER and OR that a maximally impacted woman had come in and had to have surgery, and they removed FORTY POUNDS of fecal material from her intestines! Whoa!

Have done nothing else today except the earlier yogurt run.

No Stars In My Eyes · Apr 12

If 'nothing' happens again tonight, I will go get some of that Mag-Citrate. If THAT doesn't work, I am turning her over to the doctor or ER. I thought by me telling her she'd have to go to the ER in an ambulance, it might scare the S_ _ T out of her.

Tweety, BSN, RN · Apr 12

Good evening.

J22, other than maybe the urology situation, I've seen it all.

Hope everyone has a good evening/day tomorrow.