5/31/12

Interesting day yesterday. 

I was at work.  A pretty sick patient comes in.  Not communicating verbally, from a nursing home with a history of dementia.  Not sure if he normally talks.  Physician orders a standard type treatment.  Nurse administers treatment.  Treatment appears to make patient worse.  Nurse doesn't like this and decides to monitor patient more closely.  Nurse sees patient growing much worse, much faster. Nurse gets doctor and pulls him from other patients. 

Doctor doesn't like what he sees and comes quickly to same conclusion nurse suggests.  Changes treatment tactics as standard treatment previously prescribed may have contributed to patient condition change.

Now the patient is in real distress.  As in, life or death distress.  The nurse is not leaving the room.  Constant monitoring and heading back to the doctor to ask for new interventions to help the patient.  After an hour the patient finally stabilizes enough that the nurse can leave the room.  Another hour or so and we have a  room and get ready to take the patient up. 

Here is where the cool part is.  The patient is now speaking coherently.  Awake and alert and oriented.  Asks where he is and laughs at some of the things I told him he was saying when he was distressed.  Apparently he was surprised at who he is calling out to for help.  Another nurse comes in to relieve me for lunch and the patient listens as I report off about everything that has happened.  Patient grows very quiet, looks me straight in the eye and solemnly says, "Thank you."  Makes my day. 

Off to work again. 

5/29/12

Seems like everything breaks at once.  There is a leak in the power steering of the truck somewhere.  Thanks to the Duramax forums, I am pretty sure that it is just a hose.  Still, needs to be fixed.  Also, there are a couple of things with the RV we need to get checked out.  The roof is bubbling near the front enough that I am concerned.  One of the cables that pulls a slide out in is frayed and near breaking.  There is a soft spot in a floor and there may be trouble with another slide.  I could fix most of this myself, but there is 1 month left on the warranty.  I have already talked to Open Range and I have to haul it to Ventura to get it in somewhere.  So, that needs to be done.  The computer is not booting correctly and requires several attempts to get it started each time.  The camera lens zoom is sticking intermittently.  The car's paint needs cleaning and touching up.  I should be writing something or updating the website.  The list goes on. 

So today we went to the beach.

Yeah, it is a special kind of neglect, but it's mine.  We played in tide pools, a little estuary.  Max and I played football in the sand.  Sarah got some beach time. 

All teh problems were still here when we returned, but our attitudes were different.  Now maybe we can do something productive.  Things will get done.  Just not as much today.  Some days are like that. 

Some pictures.

5/26/2012

Safely home after a wonderful visit with my family in San Marcos.  Much fine conversation was had along with much consumption of fine beverages. 

One of the highlights of the trip was the boys meeting Sylvia.  Sylvia is an adorable little blond girl that is their cousin by marriage.  Immediately upon seeing her both boys lost their minds and began doing whatever was in their imagination to gain her attention.  Thirty seconds after meeting her, Max said, "Sylvia, you can come over here and sit with me."  Patted the couch and smiled.  Michael wrote her a note saying 'your hot' at dinner.  I suppose it is never to early to teach them the difference between their, they're and there.  She was complimented on her hair, her necklace her shirt and anything else the boys thought she would like.  It was hilarious.  We also go to see Sam, Sylvia's older brother.  While the boys seemed to enjoy his company, he was but a moon obscured by the sunlight that was Sylvia.  Awesome.

We had a great time and are going to try to find time to get back down there again soon.  I was planning on taking lots of pictures, but I didn't break out the camera much.  I'm going to blame the scotch.  Or the wine.  Or the fact that it was so comfortable being there that it didn't feel like an event.  It just felt like family. 


Back to work tomorrow. 

5/25/12

Here in sunny Southern California.  OK, so not so sunny today...and cold.  I packed mostly shorts and it seems at least as cold here as it does up in Oceano.  That means I am donning my official California wardrobe.  Shorts, crocs and a t-shirt with a hoodie. 

It is nice getting to visit with family.  I think I actually see many members of my family more with this traveling lifestyle than when we were planted in one location. 

Went for a run today with Sarah, which is nice.  We so rarely get to do things with just each other.  Satchel was his usual pain in the behind when running. If he isn't dragging you then he is making you drag him.  I am going to have to start doing some longer runs and more intense workouts.  Tough Mudder is coming soon. 

Tonight, Julia's family is coming over and I am looking forward to seeing them again, it has been too long.  Good food, good drink, good company. 

5/24/12

Not much to share today.  Worked 12 hours and came home.  There are stories, of course, in any ER on any given day, but there are privacy laws that prevent me from sharing most of them.  It is interesting. While I am at work I will think about a way to post about an interesting patient or story, buy by the time I finish the shift and go home I have forgotten what I was going to write about much less that cool way I was going to write it.  Every once in a while a memory returns and might make it into the blog.  Not tonight though.

Tomorrow we load into the truck and head South to visit family.  Looking forward to it.  I may or may not post a blog on the road.  I plan on taking the laptop.  Again, we will see.


Short post tonight.  Good night.

5/21/12

First day of work in the real ER is done.  It wasn't as useful as it could have been.  At 6 AM they are going to move into the new hospital next door and so I didn't spend much time trying to learn where everything was.  And, with a new environment, there will be process changes.  So I just tried to help out.  Tomorrow should be pretty chaotic with no one really knowing where anything is, so I suspect it will be more just trying to be helpful while watching how things work.  Then, maybe Wednesday I can be productive.  We will see. 

This place essentially uses paper charting with a computer system in place to satisfy a Medicare/Medicaid requirement for reimbursement.  No really useful at all.  They are going to a  more integrated system in October by report, but they were supposed to move into the new building in March too.  So, time will tell. 

Another contract, another system and fresh challenges.  Keeps it interesting. 

5/20/12

Well I found out today that one of my cousins died.  He was 25 years old and died of what sounds like a self inflicted gunshot wound to the head.  That sucks.  More for his immediate family than anything else.  As an ER nurse I have some pretty negative views on suicide.  Views that I won't air right now.  Whatever he was dealing with is now over for him, but just beginning for his mother, sisters and family.  Again...it sucks.

Today was cleaning day.  We got out and washed the RV, truck and car.  This as all before we found out about Anthony.  After that, Sarah and I were a little down to say the least.  So, for a while, we ditched the chores and went out in the dunes to play with our kids.  They manage to brighten us up.  I wish we could do the same for Debbie, Jaymee and Kelsey and Uncle Rick and all the others that are tangled up in this.

Back to work tomorrow.  Real work.  In the ER even.  I will get oriented to the new unit on the last day of the unit.  Tuesday, they move to a new hospital right next door to the old one.  Possibly a new computer system too.  Should be interesting.  I get to be there for the move too.

There are a few problems with Irv that I am going to have to start getting serious about too.  That is a project for next week.  Shaping up to be busy.