WILTW 1/22: Cozy Up To Gas Exchange

[LadyFree28]

This week's WILTW takes a break from the nuances of being the teacher to being the student.

The best thing about this week was about gas, supergas, SVO2, sweep, FiO2, cavation, cannulation, bypass and the like.

When I went to my boss about going to an ECLS class; my boss asked me what would benefit me and the unit-it was me first THEN the unit.

In retrospect, it was a personal goal of mine, however, when I observe how sometimes there is hesitation or more than a healthy fear of taking care of cardiac kids, after the course I can see a project on the horizon.

I still have to actively sit on pump; I will be orienting, going to meetings, and actively connecting what I can do as a nurse on my home unit to prepare pts that could look like a potential candidate for ECMO.

Upcoming this week is my presentation-have to tweak some parts and I can't wait until next week to opine on learning how to be a charge nurse in a trauma simulation.

What have you learned this week?

[aeris99]

Big squishy hugs right back at you pixie!

I'm sorry that you're dealing with health issues but it's good that you're addressing it. Hopefully it will turn out all right. You'll be in my thoughts.

[smartassmommy]

Alkalosis. Acidosis. Fluid and electrolyte balances

[AvaRose]

A bonus lesson I learned today was that Glucerna smells like baby vomit and the smell doesn't go away all shift. I had to brush my teeth three times and blow my nose at least 6 times to get the smell/taste to go away. In addition, feet are quite possibly my least favorite things to do any kind of wound care on even if it is just applying Betamethasone cream. Also that I can't trust one of our doctors to put his orders in correctly and have to spend precious minutes clarifying and re-entering the order so it comes up on the MAR, something I will not have time for tomorrow since we only have 2 nurses and likely at least 2 admits considering our census is down to 18.

[OrganizedChaos, LVN]

A bonus lesson I learned today was that Glucerna smells like baby vomit and the smell doesn't go away all shift. I had to brush my teeth three times and blow my nose at least 6 times to get the smell/taste to go away. In addition, feet are quite possibly my least favorite things to do any kind of wound care on even if it is just applying Betamethasone cream. Also that I can't trust one of our doctors to put his orders in correctly and have to spend precious minutes clarifying and re-entering the order so it comes up on the MAR, something I will not have time for tomorrow since we only have 2 nurses and likely at least 2 admits considering our census is down to 18.

I hate feet too. They gross me out!

[calivianya, BSN, RN]

I learned some of our docs are idiots with wound care.

We have a patient with bad pressor hands/feet on my unit - I mean the entire feet on both sides have no pulses, solid black past the ankles... and one hand is black and pulseless past the wrist but the other just all five fingers are dead but the palm may be salvageable... and they want us putting wet dressings and vaseline gauze on this guy's rotting dead stuff. To what extent? Wet black dead stuff smells a lot worse than dry black dead stuff. I don't get it.

Patient is "too unstable" to go to OR to have hands and feet amputated, if anyone is curious as to why the dead black pulseless hands and feet are still present. I don't see how they expect him to get any more stable with the dead black stuff leaking rot into his bloodstream, though...