Son of a Gun/RN

How Google Buzz can take Twitter Down

2010-02-11T11:53:00.000-08:00

Google's Buzz is getting to be very fun. The maps integration is, IMO, going to be the key to its success and eventual domination of Twitter. How is that, you ask? Well, Google just need to incorporate one more key piece of functionality that Twitter doesn't have. Following an area.

Define an area in Maps, or a location and get the Buzz from there. Follow your workplace, rather than coworkers. Hear the buzz in your neighborhood, automatically, without locating it in Maps. Follow your favorite team's arena. Business owners could follow their business to assist them in developing a client base and respond to their requests or concerns.

Anyone else have ideas about Buzz?

Anyone else find this amusing?

2009-08-19T05:47:00.001-07:00

So, I had to snap this shot. Just in case the MD yells for, "4 ounces of chocolate pudding stat!" in the midst of a code.

Chief Complaint of the Day

2009-08-16T05:53:00.000-07:00

Image by size8jeans via Flickr

Patient: My urine tastes like honey.

Me: Well...that's not normal.

So, instead of going to the PCP to ask what this could mean, this patient decides to take a trip to the ER. Of course he's in DKA at this point, however, he should have seen his PCP long before this.

Order of the Day

2009-08-14T19:45:00.000-07:00

Image by Getty Images via Daylife

"Change Aspercream (sic) to Aspercreme cream..."

So, a pharmacist apparently decided the original order was not clear enough, due to the missspelling. Really? Let's waste more time!

Have you ever watched someone die on Telemetry?

2009-08-13T20:45:00.000-07:00

Image via Wikipedia

It happed to me the other day at work. This patient was actively dying, post hemorrhagic stroke and ICU stay, and the family finally decided to change the code status to DNR. It was amazing to actually see the process from ischemia to injury to necrosis play out in front of my eyes. It only took 30 minutes from the beginning of ST elevation to asystole. Morbid, I know, however when learning how to read EKGs you see the models of how ischemia translates on an EKG. You just don't see it play out it before you without interventions frequently.

Order of the Day

2009-07-16T18:35:00.000-07:00

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D/C Foley catheter when AM labs are done tomorrow morning (3:00, 4:00, etc. It doesn't matter when. The INTENT is to not disturb the patient twice during the night.)

Uhhh, why not at 9 AM? Seriously, I think I would be more disturbed by them pulling the catheter in the middle of the night than by being disturbed twice.

A Bad Night

2009-07-09T20:20:00.000-07:00

Image via Wikipedia

Tonight was bad! I got a call that I was receiving a patient transferring in from a county hospital, which has a reputation for sending our all their trainwrecks. This patient was a 30 y/o with dilated cardiomyopathy, CHF, and a ischemic thalamic stroke. All new diagnoses, so patient was a little withdrawn. I complete the admission paperwork, and await the MD. He comes 2 hours later and contacts the Stroke program MD, who orders a CT angio of the head and neck. At 6 the patient goes down to CT, comes back @ 7:05 lethargic and responsive to noxious stimuli only, right pupil fixed and dilated. I replace the tele monitor, start vital signs, call the rapid response team, page the on-call MD and the Stroke team. Charge RN ushering family to waiting room. I call CT tech, "How long had she been unresponsive?" They say, "She was like that when we got her. We thought it was odd, because you said that she was eating dinner before she came downstairs." I say, "She was." Click. Radiologist calls, patient has had an acute ischemic stroke from a partially occluding thrombus in the right basilar artery. Stroke team says no tPa. Transfer to ICU, now it's 20:00, I was off @ 19:30, but I still have to report off for my other patients, and fill out paperwork. Barely in time to see my son before bed, and it hits me. The biggest part of this tragedy is that the patient is a single parent, and likely not coming out of this without some residual effects are not great. Crap

A day in the life

2009-07-06T19:45:00.000-07:00

So, seriously - I'm not complaining, I LOVE my chosen profession. But it can be stressful and busy, the life of a float RN! I was working on the med/surg floor, I have 5 patients I am looking after, let's see what was happening on this day.

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Patient #1 - Dx: Microscopic colitis - bottom line - 4.5 liters of liquid stool out on my shift, oh yeah, I had to collect every ounce for a 24 hour stool collection.

Patient #2 Dx: GI Bleed - bottom line - this was caused by Coumadin, which the patient was taking for by mechanical Aortic and Mitral valves. Of course patient also recently had to have a lung decortication for a hemothorax, also caused by the Coumadin, which at this point had recurred and was whiting out 3/4s of the lung. From the MD - mostly likely will rebleed necessitating a re-op with placement of tissue valves, so patient will no longer need chronic Coumadin therapy. So here I am just waiting for a rebleed.

Patient #3 Dx: Respiratory distress - bottom line - Nursing home patient with new Laryngeal mass causing inspiratory stridor necessitating a tracheostomy placement. Oh yes, Hx: of Stroke with right hemiplegia. Now patient has ileus, c/o severe abdominal pain, but can no long have narcotics due to the ileus, which has also required than a NG tube be placed.

Patients # 4+5 Dx: Both Malaise, both elderly, both Dementia, both need "placement." Meaning I get to watch them, keep them from falling, while the Social Worker attempts to find a nursing home for them. Seriously, look at the waste of medical resources because the family cannot coordinate a way to get their family members the appropriate care.

I got a call at one point from the hospitalist taking care of two of those patient's,

MD: "Man, you got all the train wrecks today."
Me: "I guess so."
MD: "My condolences."

To sum up, I was running all day, it kicked my butt! And I still love my job!

Number 1

2009-07-05T10:53:00.001-07:00

Wel

Image by Getty Images via Daylife

l, this shall be my first entry, in what will hopefully be many! First things first, I am a nurse at a major hospital in Oregon, I work in the Float pool here, which I love. I have been a RN for 2 years now, but have worked at the hospital for six, the previous 4 years working as a nurse's assistant or unit coordinator. I must say that those 4 years did a significant amount to prepare me for a career in nursing. Anyway, I also have recently been helping my father set up a blog for his business, and decided, why not have one myself!