1. What exactly happens when someone coughs up a nasty trach plug? Is it sputum or gastric contents?
2. If you can't tell the difference in #1, should they let you graduate as a nurse practitioner? I probably p*$s% off our NP student, but last time I checked, lungs should not (regularly) contain gastric contents.
3. What does no really mean in any language (pick several, but we're all speaking English--American, anyway--here)? When you refuse to see my patients (or in our local speak: decline) and say no, I take it to mean, NO you will not see them. Yes, there is a communication gap here.
Sorry if you don't like what your boss says to you after that when I tell him/her. Not exactly my problem. If I could write orders for what the patient wanted, I'd be practicing medicine, not being a nurse.
The color of the sky, football teams, and crabby patients are all up next. We'll see how the week progresses.
Stay tuned.
Showing posts with label plug. Show all posts
Showing posts with label plug. Show all posts
Tuesday, October 13, 2015
Friday, March 6, 2009
Hot Friday
The unit (and some of our patients) was steaming...literally and figuratively.
As usual, in our neck of the woods, it was hot today. No one told this to the HVAC people, who last year, were lucky enough to have the heat on in mid-May when we had a cold spell. Oh, the joy of rooms that are so hot, patients sticking around in them get sick and vomit. This happened to one of our characters today...just as I was finishing my lunch.
His nurse of course, was nowhere to be found when he first started retching. I got the lucky job of elevating his head, turning it and getting him a bucket. By that time, it was too late. He was a mess. His nurse did show up and I did stick around to help her clean him up and get the doc to look at him, since he's a nice guy and he just doesn't normally do that. He had some other complaints that seemed a bit strange, so we gave him the full treatment...EKG and all. No surprise that after we got his IV access started he tells everyone, "I sure feel better now that I threw up!"
I had the same two patients and Mr. Colo. (They're still working on a colostomy for him...he needs it). I was working with some new nurses, too, so that made things interesting. Trying to demonstrate new stuff and have patients cooperate can be a challenge. Fridays are busy days and one of my normally reasonable characters got crabby fast. He wanted to be "waited on first". Thankfully, the charge nurse helped me out, but I was guilty only of not being able to be in two places at once.
This character is an anxious respiratory mess and you know that ABC stuff (airway, breathing, circulation)...well, he knows the routine and he just hams it up. Just for grins, I put him on an O2 sat monitor, as I start his trach trial (he needs to be plugged for several hours for his trip home). What do you know, he sats in the 90s all the time. All his entreaties for suction, etc., were driving me nuts. I just made him cough up the little bit of sputum he has (always white), because he needs to know how to do it. I still had to suction him twice this afternoon and he made a big mess going back to bed. Happily, I had a helper, so we got done reasonably quickly, but it was still a mess.
My other patients were reasonably less demanding, even the more demanding one. We kept his water cup filled and he was happy. It didn't hurt that I found an ice cream for him at lunch, either!
Needless to say, this wet and tired nurse was so happy to get out of Dodge and get a shower at home. The temperature at home was a delight. The night is young and so is the weekend, which I'll enjoy two days in a row off.
It doesn't get any better! More to come...
As usual, in our neck of the woods, it was hot today. No one told this to the HVAC people, who last year, were lucky enough to have the heat on in mid-May when we had a cold spell. Oh, the joy of rooms that are so hot, patients sticking around in them get sick and vomit. This happened to one of our characters today...just as I was finishing my lunch.
His nurse of course, was nowhere to be found when he first started retching. I got the lucky job of elevating his head, turning it and getting him a bucket. By that time, it was too late. He was a mess. His nurse did show up and I did stick around to help her clean him up and get the doc to look at him, since he's a nice guy and he just doesn't normally do that. He had some other complaints that seemed a bit strange, so we gave him the full treatment...EKG and all. No surprise that after we got his IV access started he tells everyone, "I sure feel better now that I threw up!"
I had the same two patients and Mr. Colo. (They're still working on a colostomy for him...he needs it). I was working with some new nurses, too, so that made things interesting. Trying to demonstrate new stuff and have patients cooperate can be a challenge. Fridays are busy days and one of my normally reasonable characters got crabby fast. He wanted to be "waited on first". Thankfully, the charge nurse helped me out, but I was guilty only of not being able to be in two places at once.
This character is an anxious respiratory mess and you know that ABC stuff (airway, breathing, circulation)...well, he knows the routine and he just hams it up. Just for grins, I put him on an O2 sat monitor, as I start his trach trial (he needs to be plugged for several hours for his trip home). What do you know, he sats in the 90s all the time. All his entreaties for suction, etc., were driving me nuts. I just made him cough up the little bit of sputum he has (always white), because he needs to know how to do it. I still had to suction him twice this afternoon and he made a big mess going back to bed. Happily, I had a helper, so we got done reasonably quickly, but it was still a mess.
My other patients were reasonably less demanding, even the more demanding one. We kept his water cup filled and he was happy. It didn't hurt that I found an ice cream for him at lunch, either!
Needless to say, this wet and tired nurse was so happy to get out of Dodge and get a shower at home. The temperature at home was a delight. The night is young and so is the weekend, which I'll enjoy two days in a row off.
It doesn't get any better! More to come...
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