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Jul. 14th, 2009

love

Doin' it for you....

Ok Shez, you asked for it.

I'm about ten seconds away from taking my book outside to soak up some sun before I have to hit the gym.... It's been raining an awful lot this summer. I feel like I should take advantage. BUT! My cuz has asked me to join her in journaling again. Can't pass up that request.

What to write about?? Went to Six flags New England on Sunday( which totally reminded me of the good ole days!). Dave and I met up with some of my crazy co-workers there. We hit all the big rides. I screamed my freaking head off. My throat is raw and my body hurts almost worse than a workout. We started with Batman which is usually my favorite and then moved onto Bizarro... used to be Superman Ride of Steel. I don't remember much because I had my eyes closed the whole time. Apparently it involves a lot of cold mist and a few flame throwers along with a sick vertical drop from oh say, 200 feet. Yeah.

Then my hubbie- ever respectful of my fear of heights- drags me on the human sling shot. We did sommersaults at about another 200 feet in the air. But that one actually felt really good. Kind of bouncy.

Feel free to look up any of these torture devices on YouTube if you need sound effects.

We finished off in the water park on the slides. I can't lie. It was a lot of fun.

Oops. I missed my opportunity. The hubbies home and I'm off to the gym to lose thirty pounds.
Later.....

Jul. 9th, 2008

love

Relief...

The thing is I've been in the process of having some dental work done because I have a tendency to break all of my front teeth ( little tiny bits at a time). We can't have chipped broken teeth in the wedding photos now can we?? So, off to the dentisit for filling, filing, bonding and whitening. Fun times. I used to loathe the dentist... but I don't mind it so much now. Anyhow, I am a clencher and a grinder... not just in my sleep, although apparently I do it then too. So I had a night guard made and I hated it. I didn't even attempt to wear it for more than 10 minutes the first night and I haven't touched it since. But I went back to the dentist the other day and had three of my front teeth bonded and filed down straight and it looks so much nicer that damned if I'm gonna break them again before the big day. So I wore the night guard last night. All night.....

I slept like a baby. I woke up this morning feeling like I never have before. I am in no pain. My head doesn't hurt, my neck doesn't hurt, my back doesn't hurt. I feel rested.

It's a freakin' miracle!

I love that thing.

Exciting times:

Showers coming soon, although nobody will tell me when.
Invitations are sent and are already coming back.
Got my jewelry yesterday and tried it on with my veil and tiara. While I was doing this my wedding song came on the radio. I made a little video of it on my phone to show Dave later.
My eyebrows are done, my toes are done, my nails are done, my hair is done. I started a little early because I'm not so much into the girly thing. Not very high maintenence but I think I've started a new habit.
I've been tanning and dieting and exercising. It's almost like living in a new body.
Speaking of which I'm off to do my core for the day.

Jun. 26th, 2008

love

Damn. I. Want. To. Sleep.

Somewhere along the line I seem to have developed a case of restless leg syndrome. Lately it is getting worse. I've actually gotten out of bed and went to sleep on the couch a few nights so I don't bother Dave with all of my fidgeting. So, it's 12am, I worked 12 1/2 hours today and I have to get up at 6 am and work another 12 1/2 hours. And all I want to do is sleep. Sucks.

Jun. 25th, 2008

love

Let's see...

Not feeling so much like writing in here today but I promised myself that I would start again and it seems like the best way to get started is just to well......start.

It's early in the day and I haven't had time to do anything besides walk the dogs, eat breakfast and shower.

Yesterday we had our first day on our new eating plan. It wasn't bad. Dave had brought home all our meals. They were delivered to his work and came packaged in little coolers with ice. Five meals for each of us. It wasn't too bad. Actually, the food was pretty good, but as expected, because we were eating so frequently, we were hungry all day. Go Figure...

Not that anyone cares but I think it's pretty impressive that I ate the following yesterday on my "diet":
----------------------------------------------------
#1 egg white popover with canadian bacon, spinach and chopped apple, side of sauteed sweet potatoes

#2 Chocolate protein bar ( I also added a protein shake post workout)

#3 Lentil salad with cranberries and pecans

#4 grilled flank steak with cauliflower and potatoes sauteed with turkey bacon, onion and mushrooms

#5 blue corn encrusted salmon with steamed broccoli
----------------------------------------------------

So far today today I've had turkey bacon and banana nut pancakes with sugar free syrup.

I have had nothing to drink except green tea and water for two days now.

I am swallowing ibuprofen and excedrin like a champ.
At some point today I have to get in my workout. Should be interesting since there is some guy here replacing all of the windows and I usually workout in the living room.

Off now to do random wedding related stuff, and schedule a gazillion doctors appointments I have to fit in before the big day...

Jun. 23rd, 2008

love

42 weeks ago...

It's incredible how quickly time flies. It's been almost a year since the last time I posted, so many things have happened I'll never be able to catch up! Just quickly:

Dave and I were engaged in October and I have been busy planning the wedding since then. We will be married on August 23rd, just around the corner. I can not wait!!! So expect lots of posting on the wedding in the next few months. Also we are going to be spending two weeks in Hawaii for our honeymoon. Definately looking forward to that.

I decided the other day to re-commit to my journaling. Other topics that I'll probably be talking alot about:

The dogs (of course) cuz I love 'em. And because they are holy terrors so we plan on attempting to show them who's boss. Again.

My personal mission for self improvement. It's been almost a year and a half since I quit smoking. (I have to say that is probably the single biggest reason why I stopped writing here, because I couldn't get on the computer without smoking like a chimney).So I gained about 20 pounds and can no longer fit into just about everything I own. The fubby (fiance soon to be hubby) and I are starting an eating plan with a nutritionist tomarrow (eek!) and have been attempting P90X for the wedding. It is painful but it feels good to be getting healthy again. I will probably bitch alot about it....

Books....Still reading...all the time. Gotta write about it you know.

Last but certainly not least, WORK!!! Everyones favorite topic. Still as crazy as usual in the MICU. Always a story there. I've been precepting non stop for the last year. Also finally managed to take that damn CCRN exam...and PASSED!!!!!

Life is good enough to write about!

Later.

Aug. 21st, 2007

love

Knock Knock....Hello????

Uh. It's been a very long time. It's been so long in fact that I've been knocked off a few friends lists. But I'm not bitter because life is good. It's so good that I haven't felt compelled to write in here for a very long time. But now I kind of miss it. Here's the short version of the last ten months or so:

Generally:
I met the love of my life and he moved in. This one is a keeper. He is most definately without a question "The One".

On the Home front:
Got a new dog. He's cute but he's half beagle and he howls incessantly when we aren't home and then he tries to eat Gretyl. We love him.

My upstairs neighbor complains but shes a miserable bitch and her son and his girlfreind are selling drugs in our driveway so we don't give a shit really if she hates our dog.

Work:
Love it/ hate it.
Getting a wee bit burnt
Precepting again and I need a break.

It's a rainy day. I think I'll go read in the tub. Later. (But hopefully not ten months later)

Nov. 1st, 2006

love

Contrasts....

This weekend was another one of those that just broke my heart. My job does that to me sometimes, and yet I won't give up. A friend of mine said to me on the phone the other night "You need to get out of there, it's so bad for you". Well....maybe...maybe not. I could blog all day and still not be able to put into words what this job has done for me as a human being.

Even if we weren't understaffed, it would have been hell this weekend. Actually it could have been worse. We had two orientees on board on the acute side, so they were like extra hands. If they weren't there, it would have been a nightmare. There was the usual bullshit going on...Dialysis in the corner pocket, a chronic vent at the end of the hall, G's patient had a sheath which they came and took out, and of course she started hemorraging, dropped her blood pressure and demanded alot of nursing care. Barbie got an admission in DT's who tried to kick her in the face and was levitating off the bed so we had to call security to come up for that. Our patient near the nurses station was pretty much status quo, and the lady next to him was the same, but awake and what we rudely call "needy". That pretty much means she's critically ill and very scared and uses her call bell alot. Hell, I probably would too if I was her, and I don't think I would like to be labeled as "needy" because of it.

And in the middle of all that we had two deaths in progress. Our patient was one of them. She was 92 years old, and the family withdrew care. Really she was only on a little bit of levophed. We shut it off at 5pm and she went pretty quickly. Her breathing became very slow and shallow, her blood pressure dropped immediately ( and then I stopped looking at it) and then her heart slowed down and stopped. It only took about ten minutes. The family hadn't spent more than maybe 10 minutes with her all weekend, and they didn't want to be with her when she died. I was orienting P, so the two of us pulled up chairs next to the bed and held her hands and stroked her head. I told her to go someplace better than the MICU. One of the Kathy's came in and stood with us also. The chaplain came up and said a prayer. P cried and I got a little teary (I mostly held it in...I cried later in the car on the way home). The chaplain took some time to talk to P, and she mentioned how upsetting it was to her that the family didn't come in. She didn't die alone, we were there, but she died with no one familiar around her, no one to tell her they loved her, no voices or sights that she knew. How sad. But it was peaceful. She just left us quietly. Afterwards, I called the family to let them know she was gone.

The other death, in contrast, went on for three days and it was like a war zone in that room. A young woman, 42 years old. Septic. She was awake for the first day and a half, and she was terrified. And we couldn't do anything to stop it, although we tried everything we knew. Her room was full of doctors and nurses and family and the chaplain. We did CVVH, her pH was 6.9, she was vented. There were about 8 IV pumps in the room, she ended up on two bicarb drips, a calcium drip, Levophed, Dopamine, Vasopressin... They started her on Xigris. She turned purple from her toes to her belly. Her hands turned purple. She went into DIC. I called on Monday to see if she had died overnight and she was still "alive". They didn't let her go until early monday evening. I got a phone call. I had been thinking about her all day. I actually woke up in the morning thinking about her. It affected me, I guess because I had taken care of her the two weeks before and we had talked, she had told me how scared she was, and how it wasn't fair. Her death wasn't fair. It wasn't peaceful. She fought it. We fought it.

Yesterday at work, we were still trying to get over it. Everyone was remembering her. It was just one of those times when you wondered what was the point? What were we doing to these people? And then I walked around the corner and saw that the corner pocket, who we also thought wasn't going to make it, had been extubated and was sitting in bed using her incentive spirometer and drinking decaf coffee. I stuck my head in the room and said "you look fabulous". Her daughter was there and said to me... "I know you all had a horrible weekend and are upset ( she kind of nodded in the direction of the war zone) But sometimes you do make miracles happen and you do wonderful work." Later that night, my patient started hemorrhaging. I took him downstairs for a study to see where the bleeding was coming from. He asked if I would stay with him and hold his hand. The procedure took almost two hours and I stood next to him and the radiation the whole time and held his hand. We had a lovely conversation about his wife, and our dogs,and his family. Every once in awhile he would look at me and smile. He reached up and rubbed my cheek.

And so yesterday is one of the reasons why I don't quit my job.

Oct. 23rd, 2006

love

Disgusting....

It was just brought to my attention that somewhere out there in cyberspace there is an ugly debate going on.....Doctors vs. Nurses.

I won't post the link here because quite frankly I don't feel that it deserves any more attention than I'm going to be giving it here right now.

Just one of the more disturbing points/generalizations that was made (not taking into account all of the character bashing/ swearing/ name calling)

A direct quote taken from the post
"We all know nurses aren't stupid. I know a fair few on my course at med school. They're proving they are not stupid, and are readdressing their desire to do more in the most beneficial way to them and their patients by retraining"

Ok, so heres the thing...#1 I'm quite sure that if we wanted to be doctors there are a fair amount of us who could have gotten through med school. If med school is your thing...great. Lord knows that people need doctors. Aaargh. I absolutely find medicine to be an interesting subject. But if I was a doctor, who would make sure my patients were comfortable, turned, cleaned, had someone at their side to talk to and cry to, who would be at the bedside taking care of the family members?? Who would be starting the IVs and giving the medications and putting in the foleys and watching them like a hawk during a 12 hour shift writing down their vitals every hour on the hour and letting the doctors know that their blood pressure or urine output was dropping or that they spiked a temp at some point? Who would make sure they were fed and their dressings were changed? Who would stay with them and hold their hand while they were dying? Thats not to say I've never seen doctors do some or all of the above, but for the most part thats what nursing is....If every nurse in the world became a doctor because it was the most "beneficial thing" for the patients, it would be a tragedy for the patients indeed.

I can't tell you the number of times I've walked into a patients room and found a doctor standing there staring in panic at an intubated patient agitated and thrashing and choking on oral secretions. I simply reach around them and grab a yankaur and suction them and then adjust their sedation on the IV pump. Do I laugh at the doctor for being stupid and not being able to handle the situation? No. Use of the equipment in the room isn't their area of expertise. Thats what the nurses are for.Just like I don't know how to do their job, they aren't trained to do mine.

I remember one day at work, I was doing dialysis on a patient. It required me to sit at the bedside for eight hours straight. I took some time to study. One of the interns came up to me and asked me what I was reading. I said "an article on hemodynamics". Basically, it was about interpreting hemodynamic waveforms and different treatments and interventions and how to assess the effects of those interventions based on the waveforms...PA pressures SVR and CVPs and so on...He picked up the article and looked at it and said to me "Well, this is great, You should be in med school"

*headdesk* These are not concepts that belong to a secret society of physicians. Nurses need to have at minimum a basic understanding of anatomy, physiology , microbiology, pharmacology and pathology...as well as a strong working knowledge base on how to use all of the technology on the unit. There are many of use who are motivated to know more than the minimum...not because we want to be doctors, but because we find it interesting and relevant and it helps us to help our patients and to be safe.

I don't want to be a doctor. I want to be a nurse. I'm good at it. I would make a horrible doctor, especially after being a nurse, because I would be trying to micro-manage my patients care....besides, if there weren't nurses who knew and understood hemodynamics ( and yes, some of us are smart enough to grasp these concepts)then it would be up to doctors to be at the bedside of every patient with a Swan Ganz catheter, managing the monitors and equipment and IV drips. Then who would be down in the ER or the clinic assessing and diagnosing the patients???

They are two different jobs and each one is dependant on the other. The whole post is infuriating. It was degrading and bullying and very disappointing to read. It was hurtful.

It made me feel like there is no such thing as a medical "team" working together, all of us on our patients side. We are in the middle of a huge nursing shortage and a huge part of the reason is this steroetype that all nurses are stupid sluts who a) either were too dumb to get into med school or b)who wanted to be at the bedside to increase their chances of banging a rich doctor. Please.

There was a whole argument centering around the idea that nurses go home and read "Bella" ( which I deduce is the UKs version of Cosmo). Is this kind of ammunition necessary? It reminded me of a conversation I had with a pulmonary fellow once in the unit. We had a stroke patient and there was a goal blood pressure of 180 systolic. I asked a question, based on an up to date article I had just read in the American Journal of Critical Care, which I get in the mail and, *GASP* read, which said that the goal SBP for a stroke victim was, say, 160 (this was a while ago, so I could be off on the exact numbers but you get the idea....) Anyhow, the fucker looked at me and laughed and said something along the lines of "*snort, hahahaha* and where exactly did you get that information from? *snortHAH*" And I remember thinking in my head.... "Mademoiselle, you fucking arrogant fuck". I mean I'm just a bedpan slinging bedside bimbo. Where else would I get my information?

How depressing.

Aug. 20th, 2006

love

Inbox...

Email I recieved at work yesterday that we all shared a laugh over:

Subject: Pus and wound description

Body: When charting descriptions of wounds/pus please use the following phrases:purulent, pus filled, or filled with pus etc....

Please DO NOT use "pussy" wound for obvious reasons.

Hehe. Love my job ;-)

Jul. 29th, 2006

love

Yesterdays break....

I went to visit my patient from a couple of weeks ago. The heart attack guy. His family came looking for me yesterday to update me on his progress. I guess he was moved out of the ICU last week. I ran into them a couple of times getting off the elevator. I got called to the front desk in the afternoon and they were there looking for me. So when I took my break last night I walked over to see him/them. He looked really good. I stood in the doorway and said hello, and he looked up and got this big smile on his face and said hi. His sister asked if he remembered who I was and he said "of course I do, it's Tracy"....Awesome. Apparently he walked during the day for the first time. When they told me that I was like, oh, with a walker?? But, no. He really did walk. His speech still gets a little strange they said but he's eating and next week he's off to rehab. He's getting an implanted defibrillator first. Hopefully he does well.

My new patient in room 9 has been taking up alot of my time at work. I keep getting assigned to that room. Me and that room go waaaaay back! The family of the patient thats there now is very "difficult". I don't find them to be that bad, probably because I've spent so much time with them that they trust me. On Thursday they left me a pastry. Yes, I said a pastry. I guess they brought them in for the nurses but I wasn't working so they took his nurse aside and said "make sure you leave one for Tracy". So when I got there yeserday it was all wrapped up in a little baggie in the fridge with a note on it that said "for Tracy". Heh. I don't eat pastry, but OK, thanks :-)

Room #9. I almost quit because of that room. Once upon a time, I had a patient there. He was a youngish guy. It was a really sad story. He had a daughter and the mother had died over the holidays from brain cancer. I think the girl was in her very early 20's. Anyways, he found out he had lung cancer but he didn't want to tell her because she had just lost her mother. Except it was too advanced. The tumor was in his right lung and it was eroding through his right mainstem over to the left. He started hemorrhaging. So basically he had absolutely no right lung and his left lung was filling with blood. The tumor was also sitting right on his superior vena cava and they were concerned that it was about to erode through that. They had to tell the duaughter and she made the decision to take him off life support. I was still fairly new as a nurse and hadn't quite mastered the "art" of comfort care. He was on a morphine drip but I couldn't get it right. I gave him ativan. He struggled alot. The family was screaming. It took him a long time to die. He fought it so hard. He kept trying to tell his brother something. Like, he just had this really important message he had to get out before he left them. But it was too hard for him to talk. I spent the whole day in there with them, crying and listening to stories about him and laughing with them. They didn't want me to leave. It was really hard to watch. I was just so upset over the whole thing that I went home and cried and called out sick for a whole week. I felt like I didn't make him comfortable enough. Like I didn't do a good job. But they thought differently. His sister wrote a letter to the editor of the newspaper about me. It was titled *Nurse Tracy at **** is an angel* ( I so used that for my screen name here...) Its hanging on my refrigerator now and when I have a really bad day at work and want to quit I read it.

So yeah, room #9 is all mine.

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