Blue hand

I think I knew when I woke up on Thursday that it was going to be a bad day. I woke up AGAIN with a sinus headache and I was very hot. It was really warm Thursday morning and it got up into the mid 80s that day. I hate waking up hot. (It is now in the 30s.....crazy freakin Texas weather)

I took Ari to school and her teacher informed me that the check I wrote for Ari's yearbook a few months ago came back because I addressed it wrong. I was supposed to have addressed it to the publisher instead of the PTA. I distinctly remember the lady saying PTA when I asked for whom to address it. The deadline has passed now for order. Oh well, it's only Pre-K.

I needed to drop off my application package(fingerprints for FBI, photos, etc) to the school before clinicals started at 1:30. I had attempted this already 4 TIMES this week but the secretary who needs to notarize it was NEVER in her office. The deadline was Fri, 10 am. I drive out of my way to the school, find parking and march my butt all the way to the office only to find she was gone in yet another long meeting. So I had to drive up there again, on my day off, yesterday.

So I head to the hospital early to wait for clinicals. I put my 20 ounce coke in my bag so I wouldn't have to carry it the few blocks from parking to the hospital. By the time I got to the cafeteria, my backpack started to feel wet on my back. Upon inspection my coke decided to explode inside and my backpack was now a bucket. My syllabus and patient paperwork was destroyed, my stethoscope sticky, and by the grace of God, the plastic in my folder sleeve had protected my fingerprints and photo.

On the floor, I discovered that one of my patients who just had a new dialysis fistula placed the day before had a blue hand, very hard to find pulse, and it felt significantly cooler then the other hand. My co-nurse with her patronizing style shrugged it off. (Patronizing in a way like saying "She's on Lovenox, which is a blood thinner to prevent clots" DUH! What med-surg patient isn't on Lovenox and I think I know that by now) So anyway, she shrugged it off, so I called my instructor. When co-nurse saw me telling the instructor she decided to go in and investigate with us.
Co-nurse is seeing good capillary refill where I don't and feeling a good pulse when I don't. My instructor got the Doppler and we found a weak pulse only after searching for awhile for it. She tells me I've done all I can do and to make sure I document it thoroughly.

I know the patient was in End Stage Renal Failure but I thought maybe the patient would like to die with both arms.