Thursday, October 31, 2013

Happy Halloween everyone

Oooooo I love halloween. Especially now that I have children. I know why my mom loved this holiday as well. Children get sooooo excited about it. Here's a pic just to prove it - my little tyke digging into a pint sized pumpkin - small enough for her.

I thought (and so did hubby for that matter) that she wouldn't enjoy the experience. Mostly because she is ALLL girl that one! She hate slimy things (normally) but when she found out that tonight was the night we were carving the pumpkins, she was in her glory and she certainly dived right in. I couldn't get the "lid" off fast enough before she was diving in up to her elbows - LITERALLY! With a smile and determination plastered on her face. I hope that the picture depicted it well enough. I was certainly in my glory watching. I loved every second of it.

Of course I roasted off the seeds (had WAAAAY more than I expected) but when she woke up tonight in the middle of the night and I offered her one she said that she "hated" pumpkin seeds and would NOT try one for the life of me. Oh well, tomorrow is another day.

Speaking of tomorrow.... Tomorrow night she goes out as a fairy and we've been leading up to it for the last month or so. Every time she brings up the subject she talks about how she's going to "fly to every house and flap my wings really hard". OMG bust a gut!

Tonight I also let her choose the face that I would cut into the pumpkin. She wanted the vampire one - but it's not good enough if it isn't with a bit of blood - well the kids version anyways - I let her paint the teeth and I added the drops. She LOVED it. At least she was able to (mostly) keep within the lines!

For all those out there - have fun and happy halloween!!!

Tuesday, October 29, 2013

Back to square one

Starting back at square one has really sucked. I finally started feeling like I was getting healed.

The other day when I went to the hospital I stopped by my unit to see if any of the people I like were working (only one was and she didn't seem keen to chit chat) and I really felt depressed that it was taking so long to get back at the helm.

It was funny that when I was leaving there was the usual "neurology howl" coming from one of the rooms. Made me nostalgic of what I had before. Funny that things like that can make you nostalgic.

I'm off til the 15th nov - hopefully I will be healed enough to start back, even if it isn't full shifts at that time.

Thursday, October 24, 2013

Not just an ordinary infection

So a week's worth of pain, once I got back home the next day I had an appointment with my surgeon.

Turns out I have a NEW abcess. UGH! When I knew that I was right, I started crying. I was FINALLY starting to heal (somewhat anyways) or at least experiencing less pain, I go two steps backwards.

I knew from talking to the surgeon's receptionist that he wasn't back in his clinic for almost a month and so I asked when he was on-call again at the hospital. Figured that if I had to have an incision & drainage (I&D) that I would prefer to have MY surgeon do it. Turns out he was on-call that very same day.

I just had to head to the hospital while he was on-call. Then once there I had to wait another 2 1/2 hours for him to show up.

He was able to do the procedure and while he tried to be more empathetic and caring - I requested morphine so he gave me 4mg SC of it. And he tried to make sure I was good and frozen. Ya it didn't help much. Holy hell did it hurt!!! Then he gave me another 4mg of the morphine post procedure considering I was crying it hurt so much.

Now two days out, the surgeon actually called me this morning to ask how I was doing!!! How sweet eh?! I guess I must have made a bit of an impression. LOL

I have to see him again Monday for a follow-up. I also have to have home-care though in a clinic to pack the wound. Hurt the last time so I don't expect anything different this time around.

Surgeon says he won't know whether a fistula formed for another week or two. My goodness I hope and pray I didn't.

Thursday, October 17, 2013

ANOTHER infection???!!!

The day we were supposed to leave my pain started to increase - always indicative of an infection. The tract felt like it was getting more and more swollen so i went to my family doctor's walk-in and saw the Dr there. She agress, another infection rearing it's ugly head.

Now I'm on Keflex - this makes my SIXTH antibiotic in less than 4 months. UGH when will this end??!!

I'm on vacation - I shouldn't have to deal with this crap. I however, am starting to wonder whether it IS the tract or whether I've developed another fistula because what I'm feeling is a hard lump at the top - but when I press on it (not hard cuz it hurts MASSIVELY) there's no discharge. So I'm at a loss. Hubby says to wait and try to let the antibiotic work and not head off to the ER here. Ya we'll see.

Anyone have any suggestions??? \the sitz baths aren't doign anything - certainly aren't helping with pain or burning or itching. Clearly they aren't helping with the infection. The keflex I've been taking now for 24 hrs - and that hasn't done anything yet. I just want the pain to stop. Ibuprofen isn't really helping. I don't want to be put back on the morphine if I can help it.

Tuesday, October 15, 2013

Tomorrow's a busy day

Tomorrow is Eid al-Adha - a muslim celebration about the fact that Abraham was willing to sacrafice his son because God asked. Then there's the required prayers, which when it's warm it's expected to do it outdoors. Not so sure tomorrow it will be. And the ritual from eons is that you sacrifice an animal just like Abraham did instead of sacrificing his own son and so we celebrate it by getting together as a family and having a huge dinner. It's the day after Hajj - where MANY muslims flock to Saudi Arabia to pray at the holy site. So tomorrow we pray and we eat. Should be lots of fun, it usually is.

Also tomorrow after the family dinner and hubby is done at school then we're heading to my hometown. My bestie just gave birth yesterday to a little girl yesterday, so I can't wait to go there and meet the little princess. Plus my nephew's birthday is on Thurs so I can't wait to celebrate his first birthday. Oh I wish we were able to have more babies right now - but I have to wait until my BSN is complete. Working hard on getting that accomplished.

speaking of school - I'm done my placement and I'm about half way through my semester - and I'm averaging 90+%. I am really trying to keep that up. I think I should study more but the ADHD rears its head and I lose my motivation. More difficult than I can explain.

Either way, can't wait to get to my hometown and be around all my family and my friends.

Friday, October 11, 2013

Fever seizures

Had placement today, it was my last - at least I think so. I've enjoyed it and today was no different.

My preceptor seemed to have enough trust in me to attend to one of the physicals today, and I nailed it.

We saw a little one who had bilateral ear infections - boy did they look painful!!! OUCHIE

Then we had a dad who brought his 5 month-ish daughter in for a check up cause his wife thought her cold had gone into her chest and was sounding congested - NP said nope but dad had also brought his approx. 2 yr old. And boy did HE look sick!!! He certainly looked MUCH worse than the one he came in for in the first place!

Dad indicated that kiddo had been fighting this "thing" for almost 3 weeks - had gone to an urgent care and the docs there had prescribed amoxicillin - which he had just recently finished. His nose was draining but not purulent - it was clear. When the NP touched him though, immediately she asked for a temp and it turned out that he had spiked one - 102.4 F (39.1 celcius) - and his poor eyes just told u everything about how sick he felt. We went out to get him tylenol and I went back in to give it to him - and take it he did. Then went back out. The NP was unsure what she was going to do plan wise because aside from the temp, his sinuses didn't look infected, no nasal drip indicating infection, chest clear - so what to do? And while we were discussing this amongest ourselves, the dad brought the kiddo out to the main area and exclaimed "he's having a seizure".

Sure enough, tonic clonic seizure (really rigid then the convulsions - and loss of consciousness - and his eyes rolled back in his head)- NP instructs the dad to put him down on the ground and she ensured that he didn't aspirate - tells the clerk to call 911 and stayed with him. Unfortunately there was no suction machine so I grabbed a kleenex so that she could wipe out his mouth - the seizure lasted approx. 2 minutes. When he started to have secretions in his mouth she turned him on his side and wiped his mouth again. Thankfully no vomitting, which meant that he kept down the tylenol. He also lost control of his bowels during this time. But that was the least of our concerns!

Once the fire fighters arrived, he had just completed the seizure and was in the "post ictal" phase of the seizure which is where they are no longer seizing but have not regained consciousness. Or if they do regain it, it may only be for a second. Our little guy went from the tonic clonic to post ictal then back to tonic clonic. Before he started to seize again the NP was able to get him to respond and open his eyes and his pupils were equal and reactive (good sign) - then he started to seize again, but it didn't last long before he went back to the post ictal phase. The guys arrived and put oxygen on him (didn't realize that there was oxygen in the office - don't know where anything is pretty much in that office!) and a pulse ox on him. His oxygen saturation was 94% without the oxygen and with blow-by oxygen it went to 100%. I tried to put the oxygen mask on him but he swiped that away so I just held it next to his face. You just felt for the little guy and his daddy who was standing near by just staring and trying to get a hold of his wife who was at work.

I got his little girl's stuff all together and got her in her car seat and brought her to him. Then once the paramedics showed up, they took the little one and away they all went with dad and baby in tow.

Wasn't expecting that for the last day of clinical - tho that's sorta how one of my last days of clinical placements went when I was doing placement on my unit at my hospital - so maybe it's a good omen for me???

Friday, October 4, 2013

Mondays are for suckers

Don't think I've ever mentioned but I HATE MONDAYS, even worse still are MONDAY DAY SHIFTS!

I'm not working but wanted to post a draft that had sat without posting... the reason why I hate mondays...

Mondays is like you get crapped on. It's the beginning of the week so EVERY doctor is in, and of course writing orders because things happen over the weekend and pt's get ignored over the weekend. Also, everyone who is due for tests get them then, because tests usually don't get done over the weekend. Also, EVERYONE gets bloodwork done on mondays, very rare for someone NOT to have blood work done on mondays.

So of course you, as the nurse, are responsible for checking bloodwork and ensuring that the Dr knows the results which generally = more orders to try and correct the weird blood work values. And charts are checked for said orders and ensuring that any NOW or STAT orders are done in a VERY timely manner. And ensuring that pt's are washed and ready to go for their test. On and as if that isn't enough, you always have discharges on this day because doctors wait until the weekend is done to discharge.

I haaaaaaaaaate monday shifts, ESPECIALLY monday DAY shifts

Wednesday, October 2, 2013

Nursing care plans (NCPs)

We have one due this coming week. We were given a case study where it's evident the pt is constipated, but the pt also has fluid vol deficit. However, there isn't enough data other than the fact that the pt has only consumed 1000mL in the last 48 hrs. No lab values, no assessment values. I figure that considering I can't really go with the fluid vol deficit since I only have one factor, might be hard to truely prove my point about why fluid vol deficit is more important than the fact that this person hasn't had a BM in 5 days (in the case study anyways).

I like doing NCPs, I find them interesting and I find that I'm always learning something from them that I can always put into praxis. My one book by Ackley & Ladwig provides truely evidence based interventions - provides direct references to the studies in fact. Supposedly I'm the only one who actually likes them - LOL - I wish they didn't take so long though.

We have discussion boards weekly about what we're doing for the week. It really surprises me the different levels that all these nurses are at when attempting their BSN. I talked to hubby about this and he pointed out that possibly the reason it seems so easy for me is that I've done so much of my BSN already. I hadn't thought of that though. I wonder how much that plays into me finding it relatively easy. I always feel like I'm just bull shitting when I do the assignments. The times that it's truely real to me are when I'm doing the quizzes and tests - sometimes it's good and a couple times not so good (though not failing bad just not as good as I want it to be). I'm REALLY hoping that I do good enough this semester to apply for scholarships. Though I'm not so sure that I would be selected considering I'm a Canadian going to an American school. We'll see though. I hope the marks that I'm getting right now hold up.