Generally people are so nice and such a pleasure to care for, but every once in awhile you have that rare exception. Guess I was due yesterday. 40's male with a yen for the big gun pain meds.. Talk about sucking the joy out of the job! This guy was such a jerk. Nothing suited him. He didn't like his room, he didn't like the food, we didn't answer the call light fast enough.. (How could he tell? It was on again before almost before we left the room)
Being a nurse is such a study of human nature. You see people at their very basic. Sometimes it is pure pleasure. I remember the man that came in with chest pain and through tests was diagnosed with end stage cancer. He took the news with such dignity, his only concern being for his wife. I really admired him.
Anyway, today is a new day and "the jerk" should have been discharged by the time I get there!
Tridil
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Wednesday, August 18, 2010
Monday, August 16, 2010
Back to work
Had a nice week end but as always they go too fast. Is back to work for me today, tho got pushed back so will be a short day. This will be my last week at CVOPS and then it will be back to the tele floor. I needed the break but am looking forward to going back on the floor.
Good nursing care is all about teamwork and we have an incredible staff on our tele floor. Everyone pitches in and helps each other out and we are too busy to do much gossiping or whining. CVOPS has a lot of down time between cases and I had forgotten how women get with too much time on their hands... :-) Enough said!
We are taking a weeks vacation next week and heading over to Morro Bay, California. It will be such a treat to get out of the heat and there is just something about the ocean that really touches me. The sounds and the smells, it is all so special...
More later...
Saturday, August 14, 2010
Heart Healthy - Taco Casserole
1 1/2 lbs. ground turkey
11 oz can of corn
10 oz can of Rotel tomato with green chilies - mild
16 oz can of Fat Free Refried Beans
1/2 cup of Skim Milk
1 Onion - chopped
1 cup of low fat cheddar or monterey jack cheese
6 corn tortillas
Taco seasoning and pepper
Cook ground turkey til pink, drain and add onions. Continue cooking til onions are translucent. Stir in beans and milk until smooth. Season with taco seasoning and pepper. In separate bowl mix corn and Rotel.
Spray glass baking dish with PAM. Add three corn tortillas, tear to cover bottom of dish. Top with one layer of meat mix and then corn. Add another layer of tortilla, meat and corn. Top with cheese.
Bake at 350 degrees for 50-60 minutes. Serve with lettuce salad. ENJOY!
Summer in Phoenix Arizona
is not for the faint of heart.... As I told one of my patients if by chance we end up going to hell, we should feel right at home! Don't get me wrong I LOVE Arizona but by August the heat has gotten to be more than just a bit wearing.
We do have a swimming pool but the water is no longer refreshing. It reminds me of the walking into the gulf of Mexico off Padre Island Texas.. Just without the salt or stingrays (story for another day).
I long for the days when you can leave the doors and windows open, sit out on the deck with your coffee or glass of wine depending on the time of day and enjoy the lovely weather while others across the country are tucked in their houses due to snow and cold.
Of course the flip side is that we are the "snowbird" capitol of the country and as a nurse my workload increases significantly with the arrival of the northern seniors... Everything is a trade off....
All for now,
Tridil
Thursday, August 12, 2010
Yesterday's Shift
I've been working in CVOPS for the summer. This is where the outpatients come to have a heart catherization or pacemaker insertion/battery change out. It was a crazy day, patients came bam bam bam. It takes me about an hour and a half to get a patient prepped for their procedure.
I need to enter their home meds in computer, make sure I have orders, insert an IV, start fluids, take their medical history, get them shaved/prepped and get all the paperwork in order for the physician. We have just recently become entirely computerized and the doctors just HATE it.
One doc told me he spent 20 minutes looking for the "q" on the keyboard as he is not a typer. Hired his college papers typed for him.... I was talking to one of the super users that are there for a month to help all of us through this transition and he told me this is all Medicare driven. I don't know if this is part of Obama care or not but I do know that doctors and nurses are now spending way more time at the computer than with the patient. This sure isn't what I signed on for, but it is what it is...
Off for the week end now. Spending it with my love and my pups!
Tridil
I need to enter their home meds in computer, make sure I have orders, insert an IV, start fluids, take their medical history, get them shaved/prepped and get all the paperwork in order for the physician. We have just recently become entirely computerized and the doctors just HATE it.
One doc told me he spent 20 minutes looking for the "q" on the keyboard as he is not a typer. Hired his college papers typed for him.... I was talking to one of the super users that are there for a month to help all of us through this transition and he told me this is all Medicare driven. I don't know if this is part of Obama care or not but I do know that doctors and nurses are now spending way more time at the computer than with the patient. This sure isn't what I signed on for, but it is what it is...
Off for the week end now. Spending it with my love and my pups!
Tridil
Wednesday, August 11, 2010
Blood does not thin...
My pharmacology professor reiterated over and over that blood does not thin. He discussed it so much that now when I hear someone call an anticoagulant a blood thinner I literally flinch.
The clotting process is very complicated. One doctor told me they actually spent 6 weeks on the topic in med school. There are different kinds of anticoagulants such as coumadin (warfarin), heparin, lovenox, plavix, and aspirin just to name a few. Aspirin and Plavix are actually anti-platelets. They make the blood cells slick so they don't stick together and form a clot. Heparin is a short acting anticoagulant. It is out of the system within a few hours. Coumadin is a long acting anticoagulant and takes several days to get your blood to the clotting time needed. They work on the actual clotting process, slowing down clotting time.
When you take coumadin you will need to have your blood clotting time checked. A test called an INR (International Normalized Ratio) is how the drug is regulated. Say for example the 1:1 ratio of blood clotting is 10 seconds. If you need to take coumadin we would want your ratio to be between 2 and 3 which would mean we want it to take 20 to 30 seconds (using 10 seconds as an example of 1) for your blood to clot.
We see a lot of people on coumadin due to Atrial Fibrillation, an abnormal heart rhythm.
Til next time,
Tridil
The clotting process is very complicated. One doctor told me they actually spent 6 weeks on the topic in med school. There are different kinds of anticoagulants such as coumadin (warfarin), heparin, lovenox, plavix, and aspirin just to name a few. Aspirin and Plavix are actually anti-platelets. They make the blood cells slick so they don't stick together and form a clot. Heparin is a short acting anticoagulant. It is out of the system within a few hours. Coumadin is a long acting anticoagulant and takes several days to get your blood to the clotting time needed. They work on the actual clotting process, slowing down clotting time.
When you take coumadin you will need to have your blood clotting time checked. A test called an INR (International Normalized Ratio) is how the drug is regulated. Say for example the 1:1 ratio of blood clotting is 10 seconds. If you need to take coumadin we would want your ratio to be between 2 and 3 which would mean we want it to take 20 to 30 seconds (using 10 seconds as an example of 1) for your blood to clot.
We see a lot of people on coumadin due to Atrial Fibrillation, an abnormal heart rhythm.
Til next time,
Tridil
Tuesday, August 10, 2010
My first blog
This is something I have been thinking about doing for a long time now. Not that I have any preconceived ideas that what I write here will some how change the world...
I am a registered nurse. More specifically I am a Cardiac Nurse. It is fascinating work and generally very satisfying. Let me clear up one point about doctors; they are not Gods. They may tell you they are, but it is only in their own minds that this misguided title exists. I spend a great part of my shift calling doctors to discuss things they missed or ordered incorrectly. Yes they are busy and yes they have numerous patients, but most doctors rarely acknowledge how many times their butts have been saved by a nurse. And they would never admit how much more difficult they make life for the nurse.
One day in particular I remember being in a patient's room with the doctor. He was discussing treatment plans and his idea of what was causing the patient's current symptoms. He motions me out of the room and tells me he is going to start the patient on a specific antibiotic all the time whispering so that the patient wouldn't hear him. He did not want to take the time to tell the patient so he was prescribing this medication without their knowledge and leaving it up to me to provide information on what the drug was, it's purpose, and it's side effects.
Doctors do not like to talk to patients. They will get together and discuss how nurses give the patient too much information or wrong information but they leave the patient with numerous questions and no one, but the nurse to ask.
It is all about time. Too many patients and too little time.
Enough for now,
Tridil
I am a registered nurse. More specifically I am a Cardiac Nurse. It is fascinating work and generally very satisfying. Let me clear up one point about doctors; they are not Gods. They may tell you they are, but it is only in their own minds that this misguided title exists. I spend a great part of my shift calling doctors to discuss things they missed or ordered incorrectly. Yes they are busy and yes they have numerous patients, but most doctors rarely acknowledge how many times their butts have been saved by a nurse. And they would never admit how much more difficult they make life for the nurse.
One day in particular I remember being in a patient's room with the doctor. He was discussing treatment plans and his idea of what was causing the patient's current symptoms. He motions me out of the room and tells me he is going to start the patient on a specific antibiotic all the time whispering so that the patient wouldn't hear him. He did not want to take the time to tell the patient so he was prescribing this medication without their knowledge and leaving it up to me to provide information on what the drug was, it's purpose, and it's side effects.
Doctors do not like to talk to patients. They will get together and discuss how nurses give the patient too much information or wrong information but they leave the patient with numerous questions and no one, but the nurse to ask.
It is all about time. Too many patients and too little time.
Enough for now,
Tridil
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