Sunday, February 25, 2007

How To Save A Life

Okay, I'm going to try something different. I'm going to post both here in my blogspot and my AOL journal. Read and comment where-ever you want. :)

Well, to get started, let me say that work last night was just a thinly disguised chaos (I am an RN and have worked in the ER for 11 years in case you don't know anything about me). I get there and see my assignment, which included the "code room". We don't keep this room occupied all the time and try to save it for critical patients only. And that's exactly what I happened to inherit last night. Mr 43 found down by his roommate, who initiates CPR after calling 911. EMS arrives, intubates, and begins ACLS (advanced cardiac life support - drugs & shocking). Mr 43, it seems, had been indulging in a massive amount of drugs. Positive for marijuana, benzodiazapenes (valium, ativan, etc), and opiates (heroin, pain pills, etc). Most probable scenario would include respiratory suppression followed quickly by cardiac arrest. No pulse or respirations when EMS arrived. Was a PEA (pulseless electrical activity - means electrical activity put out by the heart w/o contractability, otherwise no heartbeat) on the monitor at the scene, same when he arrived at the hospital. Pupils fixed and dialated. No neuro response at all to deep painful stimuli.

Okay, here is where the story gets a little more interesting. Mr. 43 was found by his roommate after seeing him "just fine" before getting in the shower, and not breathing 10 minutes later when he got out and started CPR immediately. Okay. How many of you have seen anyone walk by someone, get in the shower, bath, get out and dressed, check on someone, and initiate CPR in 10 minutes, male or not? I found that hard to believe. It was probably more like 20 minutes. Add another 10 minutes or so for EMS to arrive, intubate and begin ACLS. Then add transport time to the hospital and another 30 minutes of code activity to obtain a sustainable rhythm. Are you keeping score? Looks like at the least 1 hour of minimal-moderate cardiac perfusion activity. Ending result? Massive cerebral edema (brain swelling caused by drug overdose and hypoxia - no oxygen), no spontanous breaths (so total ventilator assisted), cardiac output by drugs only. Basically...dead.

When I arrived at 7pm last night, Mr 43 was just returning from CT Scan. I hurried into the room and helped get him re-situated, i.e., placed back on the monitor, vent reconnected, etc. I come back out and go to the day nurse "Okay...tell me about the other rooms" because I not only had the code room, but another three additional rooms. Here is where my night went bad right away because I can't handle a 1:1 patient and be expected to have any free time to take care of 3 other patients! I said as much to the charge nurse, too, but what could she do? Every other nurse there had 4 patients. Could I expect them to have 5 apiece? Neither situation was safe. So what happened? My patients waited anywhere from 1 hour to 2 hours to receive much needed medication. Thank the good Lord they were all stable because if not...never mind, I don't want to think about it. Oh sure, if something bad had happened I could argue in Court that the charge nurse should have made sure my other patients were being taken care of while I had my critical 1:1 patient, and I'm pretty positive that I would be exhaunerated, but I really don't ever want to face that situation.

Okay, this is what I'm going to do. I got name stickers from each of the patients I had at the beginning of the shift and wrote down what was wrong with them and how long it took me to get to them from the time the orders were written until I completed the task. Now I'm going to write a very long letter to our Nursing Director and Medical Director and explain the situation and the hospitals legal liability, along with making suggestions on how to fix the problem. I can only hope this catches someone's attention and changes be made accordingly.

So, because I had to start my shift drowning, I was so far behind on my charting by the end of my shift that I didn't clock out until 8:54am, a full two hours after my shift ended. That sucked! I didn't get home until after 9:30am and I was so worked up I couldn't go to sleep until 11:30am. Add that to the fact that I couldn't sleep past 1:00pm yesterday, and I wasn't 100% at my game because of getting over my tummy virus, and I was pooped! Up side? I slept like a log!

I do work again Sunday and Monday night, so here's hoping for calmer nights. Oh shucks! I probably just jinxed myself, lol.

Hope your Friday and Saturday were spent with family and friends. Catch up with you later! De ;)


Extra Food For Thought:


Saturday, February 24, 2007

Saturday Six - Episode 150

How do you rate? It's a simple question, really. But then again maybe it isn't. We'll soon find out!

Last week, it was Nichole of "My Two Cents" was first to play last week for the second week in a row and who, like me, ranked as "Bob Barker" in the game show host quiz. Congratulations again, Nichole.

Here are this week's "Saturday Six" questions. Either answer the questions in a comment here, or put the answers in an entry on your journal...but either way, leave a link to your journal so that everyone else can visit! To be counted as "first to play," you must be the first player to either answer the questions in a comment or to provide a complete link to the specific entry in your journal in which you answer the questions. A link to your journal in general cannot count. Enjoy!

1. Rating them on a scale of one to ten, which of the following aspects of your life would you think rates the highest: mind, body or spirit? Spirit.

2. Rating them on a scale of one to ten, which of the following aspects of your life would you think rates the lowest: friends/family, love or finance? Finance.

3. Considering all six categories, which do you think would rank closest to the middle, a "5"? Body.

4. Take the quiz: How does your life rate?


This Is My Life, Rated
Life:
7.5
Mind:
7.1
Body:
5.5
Spirit:
8
Friends/Family:
7.2
Love:
5.5
Finance:
8.5
Take the Rate My Life Quiz


2008 Version:
This Is My Life, Rated
Life:
5.2
Mind:
5.4
Body:
4.5
Spirit:
6.7
Friends/Family:
5.3
Love:
0
Finance:
6.6
Take the Rate My Life Quiz



5. Of the first three questions, how many of your responses match the responses of the quiz? One.



6. Which of the test's responses do you disagree the most with and why? Well...it rates finance as number one and perhaps that is a very stable part of my life right now, but I do consider my spritial life more important.

Monday, February 19, 2007

The Sunday Seven - Episode 77

Some call it soda, some call it pop. Others call it Coke or Pepsi even if it's the other one. But how ever you refer to soft drinks, it's time to name your top choices.But first, Frida, of "I Really Hate Blog Names," was first to play last week, and had quite a few interesting selections for Valentine's Day candy messages! Congratulations, Frida!On to this week's question!

THIS WEEK'S QUESTION:Name your top seven favorite soft drink flavors or varieties.

1. Diet Dr Pepper
2. "Real" Dr Pepper
3. Diet Berry Dr Pepper
4. Diet Vanilla Coke from Sonic
5. Peach Fruit 02
6. Strawberry Fruit 02
7. Rasberry Dannon Water

**As you can see, I ran out of soda (and I call them all "coke" btw except for water) flavors. I'm pretty much a stick in the mud.

Saturday Six - Episode 149

Come on down! You're the next contestant on the Saturday Six! And if you can't figure out the topic of today's themed-edition, then you're on your way to a big loss with nothing but a case of Rice-a-Roni for consolation!

Last week, it was Nichole of "My Two Cents" was first to play last week. Congratulations, Nichole.

Here are this week's "Saturday Six" questions. Either answer the questions in a comment here, or put the answers in an entry on your journal...but either way, leave a link to your journal so that everyone else can visit! To be counted as "first to play," you must be the first player to either answer the questions in a comment or to provide a complete link to the specific entry in your journal in which you answer the questions. A link to your journal in general cannot count. Enjoy!

1. Take the quiz: What game show host are you?
Hmmmm. I'm not totally surprised by this answer.
2. What game show do you think you would be best as playing? Either "Who Wants to Be A Millionaire", "Wheel of Fortune" or "The Price is Right".

3. What game show do you think you would be worst at playing? "Jeopardy". I don't think I would ever remember to phrase my answer as a question.

4. Have you ever applied or auditioned as a contestant for any game show? If so, which one? I tried several times to get on "Millionaire" when Regis was hosting. I kept missing the third question.

5. If you had to apply or audition for a game show, which one would you most likely choose? Either Millionaire or Wheel.

6. If you found out you had to host a game show, which one would do you know well enough that you could actually host? See #5.

Sunday, February 11, 2007

Saturday Six - Episode 148

Do you ever think about where you live? Rarely, if you're busy working, raising a family, trying to find a little time for yourself. There's something special about every place. Maybe this week's edition will give you pause to think of what's special where you are! We had lots of players last week, but it was Wil of "The Daily Snooze" was first to play last week. Congratulations, Wil! Here are this week's "Saturday Six" questions. Either answer the questions in a comment here, or put the answers in an entry on your journal...but either way, leave a link to your journal so that everyone else can visit! To be counted as "first to play," you must be the first player to either answer the questions in a comment or to provide a complete link to the specific entry in your journal in which you answer the questions. A link to your journal in general cannot count. Enjoy!

1. A friend arrives from out of town and wants to go to dinner at a nice locally-owned restaurant: where would you take her? OMGosh! I have no idea. We tend to be stick in the muds and visit what is known. Probably something Mexican.

2. Your friend then says he wants to learn something about the history of your city: where would you take him first? The Phoenix Musuem of History sounds like a good place to start.

3. Does your current hometown have any specific kind of weather threats (i.e., tornado alley, etc.) or natural disaster threats (i.e., earthquake faults, volcanic activity) that concerns you? Generally the biggest weather threats in my part of Arizona are Heat/Cold/Flash Floods.

4. Take the quiz: What city shares your personality?
You scored as Paris.
You are Paris, France! You are fiercly independent. You have very refined tastes and enjoy extravegance and a bit of self-indulgence.
Paris 70%
Provo 65%
Killarney 65%
Boston 60%
Rio de Janeiro 55%
5. Have you ever visited this city or lived there before? Nope, but from what I’ve heard Paris is very pretty, if you can get past the "hate Americans" attitude.

6. Based on what you know about that city, either firsthand or from others, do you think it would be a good fit for you? Do you think it would be a better fit than the city in which you now live? Well, I don’t know a whole lot about what it would be like to live in Paris, but personally, I like a big city with all it’s ammenities, so it would probably work for me.

Sunday, February 04, 2007

Saturday Six - Episode 147

My best friend likes to quiz me each year on who's playing in the Super Bowl, or the World Series, or any other major sporting event. He knows that I'm not much of a sports fan. He might be surprised that I'd dedicate an edition of the Saturday Six to such an event.

But before we get to the questions, it's time to recognize Otowi of "Otowi," who was first to play last week. Congratulations! Also, I must thank Frida of "I Really Hate Blog Names," who was first to visit, and pointed out that I had inadvertently copied a wrong link from the previous week's edition.

Here are this week's "Saturday Six" questions. Either answer the questions in a comment here, or put the answers in an entry on your journal...but either way, leave a link to your journal so that everyone else can visit! To be counted as "first to play," you must be the first player to either answer the questions in a comment or to provide a complete link to the specific entry in your journal in which you answer the questions. A link to your journal in general cannot count. Enjoy!

1. Who's going to win the Super Bowl? The Colts! And this has been my answer all along, not just as I’m watching the game. See my post yesterday in my other journal De’s Thoughts.

2. Have you been invited to any Super Bowl parties? (Or are you throwing your own?) Not this year, DH is working and I’m off for a change.

3. If you were invited, would you go, even if you hate football? Yes.

4. Have you ever thrown a party focused on a television program? Yes.

5. If you were given free tickets to the Super Bowl, would you attend? Why or why not? Yes! I’ve always wanted to attend a Super Bowl, and I hoping that since I live in Phoenix that there will be a possibility I will be able to go in 2008.

6. Do you worry about security at such an event? Would those worries prevent you from attending or in any way make you less likely to attend? I worry about security at all events since 9/11, but I’m not letting the terrorist win.