CRT

CRT-critical response team. At our hospital it's a Seasoned nurse (the charge from ICU or ER) a Resp. Therapist and a house supervisor. They are called when a patient hasn't coded yet but has had some downward turn or when something just doesn't seem right. That way the nurse is not alone.

I've called 2 CRTs in the past month, my first 2. The first one was when I had floated. The patient's BP dropped suddenly into the 70s over 30s.

The other was last week. My patient with Liver Disease had an Ammonia level in the 200s (Outrageously high) and became unresponsive and had periods of Apnea. The night nurse had done nothing about this but I was not comfy handling this situation on my own and I thought he needed a higher level of care (ie. a monitored bed and a floor where the nurses had less then 6 patients each)

The first CRT made me feel foolish, all we did for the man was get a reliable IV in him ( a PICC) and started pushing fluids into him. The fact that this man looked like a hospice patient seemed to escape the team. The second one was different. Good things happened. The team agreed with me and had him transferred to one of our Critical care floors. I like that we have this Pre-code system.

In the old days a nurse was left alone to deal with a gradually crashing patient and couldn't "call a code" until the pt stopped breathing.

Texas Ice storm

I have absolutely no excuse for not blogging for awhile. I was snowed (Iced really) in last week and only worked one day. I should've blogged. I guess me and Ari were too busy playing in the ice and keeping warm.

Here in Texas we have roads not built for ice and drivers who shouldn't drive on ice. I think there were like 300-400 accidents last week.

The hospital went into "Code Ice, level II" That means everybody goes into 12 hour shifts and they need to stay the night. I didn't get there before the roads got bad so I was stuck at home. If they had gone to level 3 they would've sent police officers out to come get us. They did have child care set up but by the time they had a guaranteed set plan, the roads were too nasty. The day before my boss had only been "pretty sure they'll have something set up" and they were going to allow me and Ari to sleep on a stretcher in Daysurgery. Sounded too scary for Ari for me to risk our lives on the roads.

They need to have a better plan for these ice days.

As for this past week It was really good. We were well staffed and I had sweet patients. Everything ran smoothly. I only wish everyday went as smoothly. I'm getting my resume prepared to apply at the new hospital they are building like 5 mins from my home. It's the same company running it so I feel like I'm not really leaving my peeps. It doesn't open until early 2008 anyway. The commute will be nice.

Here's some pics of our ice storm:




Ice off my car

Same shot with a weird reflection cloud


My car doors were frozen shut


Ice on my car, about an inch and a half


The fun part, Ari and the neighbor kid
catching snowflakes in their mouths
















Icicles on my house

Stressing the body

I'm making myself post at least once a week.

It's hard to come up with a topic because I either lack an interesting experience or I'm too overwhelmed with experiences to pick just one to write about. (and remember clearly)

I worked only 3 days this week because Ari is suffering big time from a nasty sinus infection and Pharyngitis thanks to the ugly Cedar monster that has enveloped this area of Texas. My friend, Student Nurse Jack has eloquently written a funny post about that.

My paychecks suffer when Ari's sick or when I get cancelled. Cancelled is what we call it when we are overstaffed with nurses and someone gets called at 0430 in the morning to be told to stay home for the day. We take turns and it's been happening to everyone at least twice a month. I'm annoyed by it later but at 0430 I'm always happy to hear I can fall back asleep under the covers all snugly.

++++++++

I'm stressed out.
Stress does funny things to me. I feel it in my bones and joints. I don't sleep well at all and I get headaches. I get heartburn at night. I have a skin thing called Pompholyx a.k.a. Dyshidrotic Dermatitis on my hands. That flares up pretty bad when I'm stressed. (Yes I realize the dangers of having this at work...especially on my unit....I wash my hands a lot...keep them dry....and cover any of the blisters with Tegaderm when I need to)

Am I stressed right now? I don't know. Mentally I feel fine but all these little body alerts are telling me I am.

So I take benadryl to sleep and for the itchy hands.
Tums for the heartburn, Aleve for the headaches and joint aches. I medicate.
medicate. medicate.

What am I stressed about you ask?
Beats me. I would say every thing's going OK. Sure the job is tough right now but getting easier for me to handle...I'm adapting. And I still love it.
My daughter is healthy and happy.
I have a roof over my head and the rent is paid and the bills are slowly but surely getting paid. I have great friends and people who love me.
Still....Yet..... here I am at 1 am blogging with itchy hands, heartburn, and my hips and ankles are killing me right now.
And I can't really think of anything else to write about.

The Med Room

I've had a rough week in nursing. It actually seems like I have a lot of rough weeks in Nursing. The bad outweigh the good anyway.
Is it possible to burn out after just 7 months?

Maybe it's just the time of year, the holidays and such. I'll hang in there because I still like the job....I still love the career.

I just know some of my co-workers feel the same way.

It seems the Med room on my unit is the the dumping ground for frustrations. We nurses don't get too much time to chat with one another if we are really working our tails off.

Although there are some units who have Nurse's stations for that. Ours is pretty open with lots of people hanging out there. Interns, Residents, Physical therapists, patients even. Some one can overhear the venting and take offense.

We Nurses, We run into each other in the Med room getting our Narcotics, Insulin, Saline bags, IV supplies, and etc.

While we are in that tiny, hot, and somehow soundproof room it seems we have the perfect opportunity to vent to each other about our frustrations of the day or vent about the one or two nurses or aides who aren't pulling their weight.

The door has a code lock and a thick window....you can see and hear people coming in.

I have on many occasions heard and uttered the phrases "Is your patient load as bad as mine?"; "What is WITH these people today?" and "Why are all these sick people here?!"
That last phrase is my favorite sarcastic one.

The Med room is a safe place to utter and hear these phrases. It won't be overheard by someone who will take offense....the only people who hear are the other nurses who understand.

I like our med room, it's quiet there. You can hide in there if only for a few moments and collect yourself.

I need that in a particularly crazy shift.