i laughed, i cried....

I've been having some great shifts! I feel more and more confident everyday and am proud of the work i'm doing. I'm actually taking on some extra shifts to get more practice and make a lil extra money :)

Some interesting scenarios:

#1 I walked into a another nurse's room to grab some gauze and happened to look up at the patients monitor. I noticed the heart rhythm was very fast (supraventricular tachycardia) so I glanced down at the patient. His eyes started twitching, rolling around in his head and then it began...the seizure of all seizures. He was having a tonic clonic seizure:
Tonic–clonic seizures (formerly known as grand mal seizures or gran mal seizures) are a type of generalized seizure that affects the entire brain. Tonic–clonic seizures are the seizure type most commonly associated with epilepsy and seizures in general, though it is a misconception that they are the only type.

I called for assistance as he was flailing and banging his head and neck repeatedly on the bars of the bed. He was biting down really hard on his tongue and blood was spraying all over the floor. We managed to protect his head but the seizure kept coming and coming. Ativan (seizure medication) was given and slowly he relaxed into a calm state. His vitals were all over the place and he was admitted to the floor immediately. The doc and nurse were thankful i 'happened' to be in the room at the time. You just never know......

#2 50 yr old male, addicted to cocaine with a family who loved him very much. A regular guy who couldn't kick the habit. He must of wanted to get more of a high so decided to take morphine with his daily dose of cocaine  and his wife and son found him on the floor. They didn't know how long he was out and by the time he arrived he'd been asystole (no heartbeat) for 20 minutes. Epinephrine, bi carb and the defibrillator could not save this man. He died. His wife and family were screaming for what seemed like an eternity. Moral of the story; say no to drugs.

#3 Disclaimer:not for the faint of heart
30 year old woman, 4 months pregnant..She was having clear fluid leaking and was concerned. We did an ultrasound and the baby still had a heartbeat. She was informed to go home and see her OBGYN the next day because in the ER if the baby has a heartbeat we can't perform a D&C ( also known as dilation and curettage, is a surgical procedure often performed after a first trimester miscarriage. Dilation means to open up the cervix; curettage means to remove the contents of the uterus. Curettage may be performed by scraping the uterine wall with a curette instrument or by a suction curettage (also called vacuum aspiration), using a vacuum-type instrument). I cleaned her up, gave her all her information and discharged her. 5 Minutes later a paramedic tells me someone is calling for me from the bathroom near the exit of the ER. I run over and it was my patient, she was sitting on the toilet crying and screaming. I close the door to help her and ask what happened. She said " my baby is there, my baby is there"! I look into the toilet and the 4 month old baby was hanging from the umbilical cord. His little heart was not beating. There was a lot of blood and to be honest with you, I felt my utterly devastated for this woman. I felt my eyes well up and my heart ached. I called for help from the doc and he advised me to get her back into a room and we would admit her to the OB department. Here's the problem: the baby was still attached. She had not birthed the placenta. I had to scoop the baby into a basin and assist her and the baby to a stretcher. She sat down with the little basin between her legs and I dashed to cover it up so she wouldn't have to see it. I was instructed not to clamp or cut the cord and for me that was the hardest part. How that woman sat there for 30 minutes with the her dead baby between her legs is beyond my wildest comprehension. Woman are so strong when we have to be. We push on and overcome so many horrific things. I don't think I will EVER forget this patient or the moment when I had that little baby in my hand. God bless him.

Being a nurse is a huge mix of highs and lows but at the end of the day, the fact that I can be there for my patients and absorb some of the hurt....makes it all worthwhile.

New post coming ASAP ... Need to gather my thoughts...

I was so proud of myself! My first shift alone went way better
then expected! I didn't fall too far behind and I had four patients
tell me what a nice nurse I was. That felt amazing :)The doctor I worked
with is known for admitting a lot of patients to the floor which creates A LOT
of work for the nurse but in a way I was grateful my first night was with him.
I felt like, if I can handle him... I can handle anything! Tonight is my second
night on my own... I'm excited and of course a bit weary of what lies ahead....

Side note: winterguard is going amazing! The kids were absolutely remarkable
last weekend at the premier show. I mean....the reaction from the crowd, the staffs,
the judges. I KNOW this year will go down in history. I can feel it.

independance

My orientation is complete. 6 long long weeks of classroom training, hands on robot labs and 6 weeks of actual ER training. I learned the ropes, the ins and outs of an emergency room and the crazy life of an ER nurse. I definately learned a lot and feel that i'm as ready as i'll ever be to be on my own with my 5 patient load.

Random things i've learned:

-Always wash your hands
-Wear a mask....often
-Make friends with the paramedics cause they will be able to get the IV lines when you can't
-Stand up to the doctors and say what you think
-Coffee grounds in a bowl in a stinky person's room, takes away 50% of the stink
-Smiling at people makes a big difference
-Sad things make me cry...i hope i'm always that way
-Dilaudid & Morphine are strong strong medicines that make people projectile vomit...duck
-Wear comfortable shoes
-Bugs do crawl in people's ears
-Always have red bull on hand
-When people feel sick they are sad, be nice to them.
-Smoking does awful things to people.
-People should not be alone in an Emergency Room
-Pregnancy and drugs don't go together
-I wish I could wear those cheesy festive scrubs I used to always make fun of.
-Being a nurse is hard hard work. And I love it.

Sunday is the superbowl and although it is a huge day for those players, its an even bigger day for me...its my first day with a full patient load all by myself with no mentor to guide me. I am ready. I don't feel scared because I know I have tons of people around me to help. I just want to give the patients the best care and don't want them to feel weary in my hands. I hope the patients aren't too critical---when that happens you end up spending all night with that patient and the other 4 don't get enough attention. One thing i've learned though is that the ER is NEVER predictable and i'm sure sunday i'll get 5 ICU patients ;) Bring it on!

Remember...life is a gift. Live it!

holy shitballs

The chain of events.

Night shift has been a trip. I love the people i work with and love the work environment. Night shift makes you so autonomous. You must make decisions without the help of a million member team. The day supervisors, workers, cafeteria people, janitors etc are all at home tucked into their beds. We must work independantly and make calls based on the doctors advice. I love it!!! The doctors i work with are young, fresh and so approachable. They allow me to offer suggestions and respectfully discuss them with me. I feel truly invigorated at work. What a gift!

I had an interesting night the other night...let me summarize :)

#1 "i have a bug in my ear!, I know its in there, I can feel it and hear it! Please help me!!!!!!!!!!!!" Doc investigates and pulls out lots and lots of ear wax. I figured that's all it was in there but then I see the doc digging a little deeper. He asks me to get the forceps and I begin to wonder.....He slowly pulls out what I was dreading all along......a BUG! ewwwwwwwwwwwwwwwwwwwwwwww. I seriously was grossed out. The patient's mom screams  " what the hell is that?" What do I say to that lol? So we show her. I think all of us in the room were trying very hard to stay cool but when I saw those pinchers on that sucker. I about barfed. Anyways...bug came out, end of story :)

#2 Walked into the shift to the sound of the ambulance at the bay. CODE BLUE was called. Man hadn't been breathing for over 10 minutes. He had a large device strapped to his chest that pumps his heart for him. Very barbaric but very reliable. My mentor and I jumped into action. The code team ran to the room and all began with protocol.He had not had a heart beat for quite some time so he was looking rough. I began to feel the weight of the situation. I did all I could to assist but the situation was growing grim. After some time the doctor pronounced him expired and the room cleared out. I stood there a minute and truly tried to grasp what had just happened. One minute alive. The next dead. We gently closed his eyes and a watched from a distance as the doc told the man's wife the news. How people respond are so different. She just nodded quietly and said she had to tell the family. My heart ached. Over the next several hours different family members kept pouring in to say their good byes. Some screamed, some wept but all felt the effects of the death. Including myself.

#3 Last patient of the night. Woman came in with her family. She had been having trouble breathing for a few hours. She looked sick. We ran tests, gave meds, and ran some more tests. She was slowly deteriorating. I sensed she was going downhill. At one point I ran to the pharmacy to get some meds that weren't readily available because I felt the urgency. The doc and I were in the room going over some things when the cardiac rhythm on the monitor began fluctating wildly. Something was going on. Her heart was switching patterns every few minutes and we were analyzing as quickly as we could. Then......her heart stopped. The doc jumped onto her chest and began CPR, we called a code blue (again) and the full production began. I am a new nurse and codes are not common to me at all so I knew I had to record all procedures and meds given so we had an accurate record but everything was happening so fast! I was scribbling on every and any thing i could find. The nurse administrator came into the room and gave me the correct sheet and and guided me as to how to record the event. I was responsible for calling out when new meds were ready to be given and the time frame that the code had been going on for. After 45 minutes of blood (literally), sweat and tears the doc had to stop it. There was nothing else we could. We did everything for her. She was too sick. God it was awful. She was TALKING to me an hour before. The responsiblility of bagging the body was given to me. I didn't want it but knew I had to learn eventually. I cleaned her up, removed some tubes and wrapped her in a plastic sheet. I kept waiting for her to sit up, grab my arm or gasp. She didn't. I bound her feet and arms and put a toe tag on her. A toe tag....just like the movies. I wheeled her to the morgue and placed her in the fridge. Jesus...that was so terrifying. It blows my mind to think you could be alive one minute and locked in a fridge the next. Creepy is an understatement.

Well, as you can tell I had a day. Of course I had many more patients but 2 deaths in one day kind of overrules everything else.
I love my job, and although it sounds sad or depressing it truly isn't. It teaches you to appreciate what you have, health and the miracle of waking up everyday.

Here's to many more miracles........ :)

XMAS UPDATE!

WELL!!!!........i've been a stranger! finishing out those training classes was exhausting. I learned a lot but i was definately ready to get some hands on. To finally apply all of the knowledge i've learned.

This past thursday was first day on the floor.  I LOVED IT. I started 4 iv's and did some other cool procedures. Its so funny how when you're in nursing school, these things are so daunting and scary and now I feel so much more confident doing things. I'm still a novice and have so many questions, but I feel empowered by my knowledge and feel like i will become a great nurse sooner rather than later!

I already saw some sad things, some happy things, and some overwhelming things. This will be my life from here on out. I cannot wait.

Well its christmas eve.....i had a lovely dinner at April and Marcos' house. A real italian feast :) I thank them for letting into their family celebrations xoxo

I miss my family so much but times change and there was no way for me to go home. Being away from them has really opened my eyes to so many things. Distance truly does make the heart grow fonder. I have seen christmas in a new light this year. I am hyper aware of all the smiling kids, happy families and love all around me. It has made me realize that I am healthy, I am happy and I am loved. Life is good....christmas will come and go and my family will always be there.

To my immediate family-- Mum, Dad, Sally, Andy, Lys, Ethan, Caitlyn, Mike and Tom: I Love you all and wish you nothing but joy and laughter this upcoming year.

To my urban family--Dean, Evan, Lauren, Shawna, Sean, Hayden & Matt: I could not survive without you guys. You make me laugh everyday and keep me sane. I wish you guys so much happiness.

To my new nurse family: Natalie, Rebekah, Nat, Betsy and Alex...here's to saving lives and to laughing our way through night shifts!

MERRY CHRISTMAS TO ALL, AND TO ALL A GOOD NIGHT xoxoxoxo

i cannot wait till tomorrow

test day. no more of these ridiculous online modules. 100 questions and I have no clue what to study. I am so overwhelmed.

I have to stay calm, use my common sense and trust my knowledge.

After tomorrow I will be doing clinical certifications, cool stuff like trauma hawk helicopter and robot simulation. I can't wait to not be reading out of a textbook!!!!!

Here's to tomorrow..................