Week in review

OK not the real week, but my 'workweek'. Saw awesome things this week!! Monday was crazy busy and the hospital was at critical occupancy (a.k.a. super full), so it was a little miserable I had boarder patients and I don like that. I'm not a floor nurse for a reason. We fix em up and ship em out, I like it that way................

CCU pt #1
Had a pt come in with a heart rate (not atrial rate, but ventricular rate - the main, larger portion of your heart!) in the 230's (TWOHUNDREDTHIRTYS)! I'll insert pics ASAP............And then I got to stop his heart (using a certain medication) .....................See other picture. And the vwalah, it starts back up in the normal rate range, but in a funky rhythm. Point being, it was awesome to see it happen. The pt became symptomatic was saying 'I don't feel so good, I think I'm going to pass out' and then his eyes kinda rolled closed......And 45 seconds later the pt was looking at us saying ' I don't feel like my hearts gonna fly out of my chest anymore'. Well that's cause it wasn't. Man it was a rush! The pt was then started on a medication drip that should prevent any relapse into a rhythm like he had before.

CU pt#2
pt came in found unresponsive, unknown downtime, oxygen sats in the low 80's, and needed to be intubated as EMS was unable to do it in the field. BP was like 180/100.......pt was intubated and once some oxygen started getting in the pts system, became more alert. Mind u there was a tube down her windpipe making her breathe. So this poor person was wide awake, wrist restraints in place (to prevent removal of the breathing tube by the pt), and was trying to talk - which of course doesn't work so well. Needless to say I began a drip of a sedating drug. Once I barely got the pt under the BP went to hell in a handbasket, which this med can do, but she was on the lowest dose..........her BP got down to 60/44 and I had to stop the med for a while, get the pressure back up, which of course allowed the pt to become more alert...And start bucking the vent and moving around. It was horrible totally between a rock and a hard place. Bottom line is after I left at 7am the pt ended up being flown out, as it turned out she was having an acute mi, which may have been what caused the fall/unresponsiveness in the first place. her ekg did indicate a possibly mi, but the blood tests confirmed it. Cardiac enzymes were WAY HIGH. Out to St. Joes for a cardiac cath.....

CCU #1 didn't stress me as he was fairly stable since we stopped the heart and place him on the other med. CCU#2 stressed me OUT............she just wasn't stable for nothing and I had 2 other pts and it was not easy handling all that since I couldn't really leave the room

last night, got a drunk unresponsive even to painful stimuli/sternal rub. And we intubated, however this pt was breathing on his own, we just had his airway protected so he wouldn't aspirate considering he was vomiting all over the place - chunky and scented. It was the closest I've come thus far to blowing chunks @ work myself. I've seen and handled a lot, but this was awful. I had to walk away while holding my breath in order to not loose my cookies! He was also placed on a sedative, which was EIGHT times the dose the pt above was placed on. And somehow his BP held steady. When we stopped the med, he came out within a few minutes and was trying to break out of the restraints to pull the tube out of his mouth. I had to get in his face and yell at him in order to get him to listen to us about relaxing and that we would take the tube out in a few minutes. Finally, he relaxed and did what we told him.

Working 12's on mon-tues, 8 hrs weds, and then 12's sat-tues. 10 year high school reunion and Tera & Mike's wedding weekend after this one! Holy freaking cow the time has flown, and I only have 1/2 outfits for the wedding and rehearsal........crap better get a move on that!