Thursday, July 16, 2009

Bites, car accidents and emboli, Oh my!



Today was wild. All information has been changed to conform to HIPAA.

I walked in to a new place, with my nurse educator on vacation, which she had told me would be the case. Not a problem. I was paired with an AWESOME nurse, also named Nicole.

Holy crap today was busy.

Pulmonary Embolus, or more specifically, R/O pulmonary embolism, fit the description of one of our first patients of the day. A 30 year old young woman, into exercising, with chest pain had a D-Dimer level of 5500. HUGE. The cutoff for a negative is <500.
Her CT scan showed some interesting stuff, but no clot, so we did what we could to keep her comfortable.

15 year old girl kicks the dog dish and gets bitten. Sucks. Maybe we don't kick things at the dog anymore?

Pneumothorax took the cake though. The Chest X Ray (CXR in medical abbreviation speak)
was amazing! I asked, "um, what's wrong with the left lung?" and the doc looked at me and said, "Wow! Yep, that's a pneumothorax." And all of a sudden a bunch of surgeons were in our ER and the patient was on a gurney, and I was helping the surgeons with the insertion, and I was silently thanking Pam for all of her lectures on chest tubes since I immediately knew how to set up the Pleur-Evac device. A pneumothorax means something is in the chest wall between the lining of the lungs and the lungs themselves: in this case, air. Usually it's caused by a hole in the lung. By placing a tube in the chest wall that keeps negative pressure on the lung and allows it to expand, you allow your patient to breathe and heal. Docs place the tubes, nurses monitor the tube and make sure the suction device (Pleur-Evac) is working. Very cool.

And then there were the psych issues. Wow.
And the pediatric patients.
And the people with heart attacks.
And the irrigation of a skin issue the size of a tomato.

Oh yeah, and there was that Stage II pressure ulcer I saw this morning on a patient when admitted.
I asked if we had checked this patient's back, and everyone shook their head. "Ok, I'll do it." So, sure enough, it stared at me like an angry eyeball, red, painful, and begging for healing. One of the nurses documented it, and then I repositioned our patient so there was no weight on that spot.
I felt like I actually did something there. I have no computer access, medication access, or ability to chart, but I *do* have the ability to care.

So that's what I did today.

When I stop caring, I stop being a nurse. And a human.

1 comment:

Jewels said...

Yowza! Looks like you are having quite the adventure!