Coffee & Conversation in a smoky room
A Clinic RN and a Single Mom blogging through the depths of sanity. My life as I know it started with coffee and conversation in a smoky room. This is where I'm at now.
Apr 28, 2006
Apr 25, 2006
All Good things......
My actual invite, sans pesonal info. The color is the same as our scrubs
In the past I had mentioned how easy and boring our "Management in Nursing" course was. I wasn't kidding....I made a 94 on my final today!
Add that to my 96 on my midterm, and 2 projects with 100s and it equals a 96 in the class!
It's about time I get an A, I'm tired of those darn Bs.
Speaking of Bs....I have my last unit exam next Monday over Renal, Endo, Burns, and musculoskeletal diseases AND
My Final is in 13 days.
Rumor is going around that it may have "NCLEX" questions on it and may cover topics from ANY POINT in our program.
That could mean that those kidney stones we covered in the freshman semester could ALSO be on this final.
I REALLY hope that's not true. It's hard enough to study the material we've crammed into our brains this semester....but to add diseases we haven't discussed in over 18 months would just be appalling. I'm all for being quizzed on NCLEX questions but not if it means Graduating or not. My review course isn't until after graduation.....and our instructors aren't known for their fair judgment in selecting test questions.
But like I said...It was rumor.
Things are really getting close now......as of today:
Pictures are in for the graduation slideshow
Invites are out
The class photo was taken and presented to the school (thanks to me)
Clinicals are over
My thank-you in the program is written & turned in
The applications are in
The fees paid AND
The job is secured
So what's left to do.....hmmm.....Oh yeah!
Study & Pass!
Apr 21, 2006
"A scary Monster with Fangs!"
Thanks ya'll for all the support on the loss of "Roger" last week. I really do have a wonderful group of readers.
I buried him next to Tristan and Edie at my Mom's last weekend. The Texas ground was rock hard and it took a water hose, several hours of digging, and some hauled really big rocks to do it.
It was in the 90s all week here....getting up to 101 on Tuesday or Wednesday. Today it's supposed to get up to 85...much better.
I would like to say that my visit to Mom's was supportive, nurturing, and special but it wasn't. Last Easter weekend was a special kind of hell. My stepdad is still actively dying....getting worse little by little everyday. But he's still breathing. I'm giving credit to the feeding tube (G tube) which my Mom keeps hooking up to feedings and water, regardless of whether or not he wants it. I did a little education to her about the dying process and how the GI system is usually the first to shut down but she wasn't listening. By yesterday's report, he's now hallucinating and becoming less responsive.
I also had some family drama (unrelated to the dying) while I was there. I'm not gonna get into the grimy details....let's just say, I know now how my mom....really....feels about me. My aunt didn't have to come to my place at all, and after last weekend, I didn't really want her to.
On a lighter note, Ari's birthday was a blast once we came home. My baby is 5 now! We made cupcakes together and brought them to her class. I also made little party favor bags for them and she seemed to feel really special for the day. She has another party this weekend with all her non-classmate friends.
Clinicals are over! FOR EVER! Last night I completed my last clinical day at the hospital. Ironically it was my busiest all semester. We did this "Team Nursing" thing, where we worked in groups of 5.
We had a team leader (Like a charge nurse) , 3 "patient care" nurses, and a medication nurse.We rotated positions for 4 days. Each PC nurse took 4 patients assigned by the leader, that means the med nurse gives meds for 12 patients. I was the med nurse last night. When I was Team Leader last week I was so bored, as med nurse, I barely had time to go to the bathroom, much less, eat.
It was a pretty dumb project since nurses don't work that way anymore (except maybe in psych, but during my psych rotation, the patients went to the med nurse for meds) 11 out of my 12 patients had 2100 (9 pm) meds. You legally have an hour (early or late) to give them.
But it was my last day....Yay!
3 lectures, 3 tests to go before graduation. :)
Apr 14, 2006
I just got back from the emergency animal hospital. My newest and oldest cat, Roger died about an hour ago.
For those of you keeping count...That's 3....yes 3 cats I have lost in the span of one year. What's that they say about 3?
I was about to go to bed about 1 am and was just putting food in the cat's bowls. Roger is usually waiting for the food and wasn't as usual. Thinking maybe he got locked up somewhere or escaped out the door, I checked the closets, under beds, the dryer, the cabinets and outside.
After about an hour of searching I found him lying next to my bathtub in the corner, laying "funny" and in respiratory distress. I scooped him up and ran next door to Cathy's (My vet tech best friend) She said his color was bad (How can they tell with all that fur?!) and I should take him to the critter ER.
The diagnosis......Congestive heart failure with an associated pleural effusion.
He was about 12 years old.....My Great Grandmother-in-law's cat that I took in last August. I couldn't see spending thousands on what the Vet said would probably be a futile fight. So I said yes to putting him down and he will be laid to rest next to Tristan and Edie this weekend at my mom's. Which, by the way, I have to leave for her house in 5 hours.....I've had no sleep.
I have one Cat left, 4 Year old Easter. Who's going on a weight management diet as soon as we are out of our current brand. I'll be damned if I'll let her die anytime soon. All this as we go take a trip to see my stepdad for the last time.
Apr 10, 2006
Apr 9, 2006
Soooo My stepdad will be passing away sometime soon. This is by my mother's guess and from her descriptions of his daily activities (sleeping, not eating, not drinking) I must agree with her. It's what my first semester Nursing instructor and Death expert would have called "actively dying". Which kinda sounds like an oxymoron but perfectly describes it.
So for support for my mom, my Aunt V, my mom's sister is flying down from VA on Thursday. She's flying into my "BIG CITY" because it's cheaper then flying into my mom's little city. She'll stay the night with me and she, Ari and I will drive to mom's on Good Friday. Too bad it won't be for good reasons.
My house looks like tornados hit it, and my Aunt is super OCD about cleanliness. That and she's super allergic to cats and dogs....which is why I haven't cleaned yet. I'm gonna have to lock the cats in the bedroom so I'm gonna clean closer to the time.
Her flight comes in an hour before my clinicals start, not sure how I'm gonna get her back to my house and then to the hospital in BIG CITY traffic in time.
Listening to: "Cry me a river" by Harry Connick Jr.
Aunt V has decided to get a rental car and drive...Yay! I can take my time cleaning and I won't be late for clinicals.
My stepdad's still hanging in there.
Apr 6, 2006
Sentinel Event Alert - Issue 36, April 3, 2006
Tubing Misconnections—a persistent and potentially deadly occurrence
Tubing and catheter misconnection errors are an important and under-reported problem in health care organizations. In addition, these errors are often caught and corrected before any injury to the patient occurs. Given the reality of and potential for life threatening consequences, increased awareness and analysis of these errors—including averted errors—can lead to dramatic improvement in patient safety.
To date, nine cases involving tubing misconnections have been reported to the Joint Commission’s Sentinel Event Database. These resulted in eight deaths and one instance of permanent loss of function, and affected seven adults and two infants. Reports in the media and to organizations such as ECRI, the Food and Drug Administration (FDA), the Institute for Safe Medication Practices (ISMP), and United States Pharmacopeia (USP) indicate that misconnection errors occur with significant frequency and, in a number of instances, lead to deadly consequences. Types of misconnectionsThe types of tubes and catheters involved in the cases reported to the Joint Commission included central intravenous catheters, peripheral intravenous catheters, nasogastric feeding tubes, percutaneous enteric feeding tubes, peritoneal dialysis catheters, tracheostomy cuff inflation tubes, and automatic blood pressure cuff insufflation tubes.
The specific misconnections involved an enteric tube feeding into an intravenous catheter (4 cases); injection of barium sulfate (GI contrast medium) into a central venous catheter (1 case); an enteric tube feeding into a peritoneal dialysis catheter (1 case); a blood pressure insufflator tube connected to an intravenous catheter (2 cases); and injection of intravenous fluid into a tracheostomy cuff inflation tube (1 case).
A review by USP of more than 300 cases reported to its databases found misconnection errors involving the following:·
- Intravenous infusions connected to epidural lines, and epidural solutions (intended for epidural administration) connected to peripheral or central IV catheters. ·
- Bladder irrigation solutions using primary intravenous tubing connected as secondary infusions to peripheral or central IV catheters. ·
- Infusions intended for IV administration connected to an indwelling bladder (foley) catheter. ·
- Infusions intended for IV administration connected to nasogastric (NG) tubes. · Intravenous solutions administered with blood administration sets, and blood products transfused with primary intravenous tubing. ·
- Primary intravenous solutions administered through various other functionally dissimilar catheters, such as external dialysis catheters, a ventriculostomy drain, an amnio-infusion catheter, and the distal port of a pulmonary artery catheter.
What?! What kind of moronic neanderthal nurse connects an IV to an NG tube, Foley, or epidural?! The connection ports aren't even compatable! I guess this should teach a lesson about labeling your IV tubings but something tells me if the nurse found a way to do this she/he would probably miss the label. I really thought when my professor sent us this link that this was an April Fools joke.
Frustrating day in clinicals. Patient with severe edema to penis and scrotum, severe pain and tenderness, also incontinent of stool with severe diarrhea....you do the math.
Patient had a urethral stent placed and had a circumcision-like incision on his penis yesterday. Edges were approximated yesterday. Today his penis looked like a cauliflower. Incision had split open.
I told nurse (who didn't see him yesterday) who called doctor. Doctor said "It actually looks better today" The only time he saw him was at 4 am, he either didn't look or it happened afterward.
I also asked nurse for something better then vicodin for pain. She refused to ask the MD for that saying it would make him too altered. (Did I mention the pt had alzheimer's?)
Bottom line....No one is gonna listen to the student, my patient is suffering and being tortured, and I'm not allowed to call doctors or family to do anything about it. My instructor caved to the majority too. (His family is only available by phone....they live locally....he's had no visitors)
Apr 4, 2006
Tagless MeMe...Where was I?
I wasn't tagged. But I have to prove to Dr. Flea that he didn't alienate me by answering another "meme".
Well, that, and I really like these things. :)
Where was I one year ago?
I was finishing my 2nd semester of Nursing school (Level 2). I was finally feeling more Nurse-y with the greater responsibilities I was given. Planning my daughter's 4th birthday party, swearing I was going to lose weight and quit smoking over the summer during my Psych rotation. I was also thinking that this time, this month (Now) could not possibly come any sooner.
Where was I 5 years ago?
Was just about to give birth to my first child, my daughter Ari. I was just about to start maternity leave at the hospital and attending my baby showers and finishing up the final touches on the Moon and Star themed nursery. Mike was still alive and in remission having just completed radiation therapy. All residual side effects had faded and he was feeling pretty good. The plan was for me to have baby, stay home with hubby and baby until June and then go back to work part-time. That worked until Mike got really sick again in August.
Where was I 10 years ago?
Still in Newlywed status, Mike and I were just growing accustomed to living in the armpit of the US; Shreveport, LA. The smelliest,rudest, most crime infested city I've ever lived in. Mike was in the Air Force doing his police thing. I had just begun working at a discount drycleaners, where I would stay for 2 years. I worked about 55 hours a week there for minimum wage and managed the store by myself for a year of that. I dealt with it because it was an easy job....take in clothes, tag them, bag them,wait for boss/owner to pick them up, give clean clothes back, count register, deal with complaints. It was a job.(and it was me and Mike against the whole world....sigh)
Listening to: "With Imagination" by Harry Connick Jr (on Blue light, red light)
Apr 1, 2006
I feel so Blah this week. I keep telling myself I only have 3 weeks of clinicals left. That thought is what is getting me through.
I'm on Advair for my asthma. It's a combination drug with Fluticasone, a corticosteroid and Salmeterol, a bronchodilator. For the most part it works, I actually get wheezy when it's wearing off. As long as the pollens aren't too high, I rarely have to use my albuterol rescue inhaler.
Here's my problem.
Advair is actually a powder inhaler and so when you take a "puff" some of the medicine sticks to the back of my soft palate. Since 1/2 of it is a steroid, it creates a very happy environment for yeast (which is naturally a part of the environment or flora). Thus creating the condition of Mucosal Candidiasis aka "Thrush". I have it again this week for about the 7th time this year.
Originally, I started out being half-assed about rinsing my mouth after. After the second time I was religious about it. After the 3rd or 4th time I started using Listerine to rinse after.
Every occurrence I took all my medication to get rid of it. My doctor isn't worried and says it's a common side effect of Advair and she says maybe I'm just more suscepible to it. My doctor's colleague, a PA, tested me for Diabetes and HIV, just to rule those out. (Thrush is common in both those conditions)
Thankfully (I wasn't worried) those tests were negative.
It's just really annoying and the only medicine that works for my thrush is Clotrimazole FIVE times a day for TWO WEEKS.
That means I have to take medicine with me to school and work. It's a lozenge type "Troche" and I have to hide the fact that it's in my mouth at clinicals. It's just kind of embarrassing ya know?
Any other asthmatics have this problem? Is there an equivalent med on the market that works just as well?
I was just diagnosed 2 years ago and Advair and Singulair is all I've ever used.
Listening to: "Only the good die young" Billy Joel