Friday, June 18, 2010

It's been awhile....

Wow- time does surely go fast! I can't believe that it's been 3 weeks since my last post! Certainly work has been interesting and extremely busy. I mean ridiculous busy! Our census has been super high...if not completely full causing us to have to open up our overflow unit. Oh, and to add to it, we've also been short staffed. So that's a winning combination!!

School is done for the week. I finished up a super easy class....well, I'm assuming that it was super easy. Of the five things we did throughout the entire quarter, I have one grade. We were supposed to get grades by Monday. Ok, it's Friday and still, nothing! I'm just saying, if I get anything less than an A I'll be ticked!! Not just because it was an easy class, but on principle! How can you not give feedback an entire quarter and then give a student less than an A. If we could only give our professors a grade too....

Updates on work: still taking care of my teenage guy. Right before I went on vacation (oh yeah, forgot to mention we went away for our 5 year anniversary...CANNOT believe I've been a Mrs. for 5 years!!!) he wanted to keep me on my toes. Long story short, he basically decided to not breath well, causing his CO2 levels to sky rocket, causing him to be completely unarousable. So, he bought himself and breathing tube that day! As I left that night, I told him I was off work for 10 days but would be back and he better not be intubated (breathing tube still in) when I got back.

I held my end of the deal....I came back to work. He did not hold his! He was still intubated! BUT- apparently, he was just saving extubation (taking the breathing tube out) for me! So we extubated last Friday. Saturday morning I came back and he definitely was not looking so hot.

But this is where it gets interesting! Staffing is super bad....census is super high! I get to draw up intubation meds for my little guy b/c his breathing is not so great again. Oh, AND I also get to take back a liver transplant. At the same time! Yeah there's some fun for ya!

For those of you who know (ok, who am I kidding...there are no medical providers following my blog!) liver transplants come out bleeding, needing lots of blood, typically have blood pressure issues, needing dressing changes, intubated and needing sedation/pain medications, lots and lots of labs to be drawn...etc etc etc. = Liver transplant patients are EXTREMELY busy!!

Never ever is this assignment paired (one nurse, two patients). BUT for me it was!! And with a patient that needed intubated at that! Let me just tell you, if ever there were a day that I was "drowning" this was it! The only thing that could have made it worse was to have mean or rude parents. Sad that I'm so accustomed to this that it was kinda just an assumption. But, I totally lucked out and liver transplant mom and dad were the nicest people ever!

I made it out of there Saturday night at around 9 and got home a little after 10pm. LONG DAY!! As I was leaving the charge nurse said "Well, at least tomorrow will be better!" to which I responded "Um, yeah, it definitely will because I'm not here tomorrow!"

Sunday was a great day off....not relaxing but just so great not to have to be PICU nurse for the day.

Monday and Tuesday I was back at it. Because my little guy has "failed extubation" twice now recently, we decided that it would be best for him to get a trach (more permanent breathing tube in your neck) and a gastrostomy tube (tube in your stomach that you can be fed through). It's been sad for me to see how see how sad the little guy is because he knows he needs the trach, but he definitely does not want it. And, just when he was starting to talk to me, it's sad that he no longer has a voice....but that will come with time again, after the trach.

That being said, despite no voice...he still has his fiesty personality which keeps me laughing! Monday he was quite angry that he was intubated again and knew he needed the trach. We were playing Bingo and we were not not a good day for this guy! The nutritionist came in the room and he hand motioned her to "zip your lips" and then shoo'ed her out of the room with his arm! We had a brief talk about how even when we're mad we shouldn't be rude to other people, but then I just had to walk away and laugh! This delayed teen just told the nutritionist to Zip Your Lips! So funny!

He gets his trach and g-tube on Monday (I'm working which is good b/c I'll be able to send him to the OR and take him back). There will be tons and tons of family teaching involved with both of these new things, so I'm sure it will provide some interesting stories along the way (especially because all this teaching will have to be done with a Spanish interpreter for dad!).

So- it has been an exciting, busy past few weeks! School starts again on Monday....physical assessment class which I'm sure will be oh so interesting. I have to do history and physicals on video for assignments so that will be interesting! Keep a lookout, I might post a video so you can see me in action : )

Long enough blog post for now! That's why 3 weeks should not go by without posting, because so much craziness can happen in the PICU in that amount of time! I guess it's why I love my job so much! Always changing, always keeping you on your toes, occasionally maddening....but definitely rewarding!

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