The story of my day

I have always liked words. The dictionary was my friend as a kid. I always liked to look up obscure words so I could use them in my spelling sentences....when I had to do them (I got out of this homework frequently through some other endeavors...)

As I finally got a minute last shift to start documenting, I thought about what was really happening and a couple of words came to mind.

While I ran myself hither and yon the first four hours, I really wasn't idle (my first word), but I'd suspect some of the chitchat here and there was. As I'm running around, I don't mind speed chatting or bantering with the patients as I hang all of my patients IVs for the shift. My night--come in, run an IV, stop, flush, run another IV of Vancomycin, stop, flush, hold and run another IV, and so on, like a bad TV commercial. I can't get too in-depth.

Unfortunately, sometimes oncoming report is a little too idle. We have some nurses who will give you the new orders list (we write one as we take things off) and your report the same way every time and it's complete. A couple of our people are new and they still haven't learned how to give report, so they tend to engage in idle chatter and miss the big stuff. Like the blood cultures ordered three hours before end-of-shift that have to be done today or the 102 temp that the patient getting blood just spiked near the end of his transfusion, or the report on the patient who returned from acute. It wasn't a big deal for anyone else, but it was for me, since I was his nurse.

Eventually, the last four hours drifted into the idyll category. Our neighborhood isn't exactly pastoral, but sometimes, it is pretty, just before dark, and this night, it was exceptional. The sky was a pinkish-red that glowed as the sun set. I only noticed it because I had a minute to look out the window when I called my husband. It made me think of that old saying, "Red at night, sailor's delight." My patients, including the returning one, were quiet and happy. They got all their nightly pills and drifted off to sleep. The only thing that broke the idyll was a fever in another patient, which required an all-hands fire drill to get all the labs pulled before the oncoming shift came.

So we left our coworkers with an idle, idyllic moment of their own, with sleeping patients, as we walked out the door into the cool of midnight.

More later...

Pondering the universe

When it's a slow shift, I often go out looking for stuff. It's just my nature to be busy. Perhaps a little too much of the "idle hands are the tool of the Devil" stuff when I was a kid.

I was surfing away this morning and ran into this post at Reality Rounds. Thankfully, in rehab settings, we don't drop "the bomb" on people too much. That bomb has already exploded by the time we get people, due to accident, illness or other random idiocy, and we're busy picking up pieces and putting things back together for the rest of life.

As a result of too much time, I started looking at labs, and found a high alkaline phosphatase on one of our old timers. We don't diagnose, of course, but when you can historically look at trends, it makes you wonder what's going on with people. I also think it helps me to talk to doctors to see what their take of the situation is with said patient.

Of course, when we have free time, there's always something silly. One nurse buggered up her iPhone and it would not vibrate. We tried to get her to check out www.apple.com to find out what was wrong with it (maybe in the user's guide...hmm?!) but she waited to see what her significant other would say about this problem, since he could fix it since he has the same phone.

Another patient got a generic gadget catalog similar to Harriet Carter. But, he was in for a surprise when he opened one page...they weren't selling any Billy Mays stuff or SlamChops, no they were selling vibrators. He's wondering if the person who gave him the catalog is trying to drop a hint. We shall see, as this becomes yet another inside joke on the unit.

Yes, we have inside jokes everywhere at our place. It's simply a way of coping with time, space and personnel for a lot of our people, who spend an enormous amount of time with us. One guy has his "wife" on our unit. (that's what he calls one of our nurses, who constantly nags him to check his blood sugar).

Finally, a couple of our people said goodbye this week. They went home. One is travelling to a home he's never seen with his long-time fiancee. Another patient is going home, then travelling across the country to live near relatives and meet his online girlfriend. His wife has been gone for a long time and he's finally decided he doesn't want to be alone anymore, after surviving one health issue after another. He is a very smart man, often moody, but frequently nice when he wants to be. With all he's gone through, he deserves whatever happiness he can get.

More later...stay tuned.