Showing posts with label ER. Show all posts
Showing posts with label ER. Show all posts

Friday, January 30, 2009

Those who wander are not always lost

I graduated from nursing school the Spring of 1999 working my first 2 years on medical surgical units and the last 8 I have been primarily based out of the Emergency department along with several side jobs. The first 3 years I worked exclusively in the ED 32 hour day shifts. I was VERY naive when I first started in the ED but it did not take much time to realize that you cannot always be Mr. Nice Guy, drug seekers are AMAZING actors, people with personality disorders are masters of manipulation, people really DO fake seizures, NEVER trust a drunk, and a good portion of the population should have had their children taken from them at birth. This list truly could go on and on........


After being an ER nurse for a short time I experienced a tragedy that will forever be sketched in my brain. It was toward the end of a 12 hour shift when paramedics came rolling in with a young woman in her late 20's. She had been in a MVC (motor vehicle crash) while driving to a local Fair with her 2 young children. She was pale and unresponsive on arrival without a blood pressure. Not a scratch on her. Before long a surgeon determined she had an aortic dissection.
Within minutes he cut her chest open then proceeded to manually crack her ribs. He used his fingers to clear the blood that was pooling in her heart chamber. In awe I watched her heart beat after beat. We all work so hard to save her life. As blood, fluids, and medications poured into her we rushed her to the operating room leaving a trail of blood from one department to another. The surgeon and the OR staff did all they could but were unable to save her. The surgeon, OR & ER staff weeped as they told her family of her demise. Her oldest boy (I think he was 8) wanted to say goodbye so along with his family they went into the OR. The boy thought she was merely sleeping and tried to wake her. As he stood beside his Mother a tear came down her face. This would be the last memory of his Momma.

Little did I know how MANY more traumatic injuries, experiences, and deaths I would be encounter over the next several years.

You never forget the sadness of parent after the loss of a child from SIDS. The memory of a mother and father rocking their baby for the last time before handing their precious bundle over to the nurse who has the dreaded task of delivering the baby to the morgue. We had 2 of these cases in the ED when I was pregnant with Leah.

You never forget the reaction of a parent when they think you are coming out to tell them their toddler did not survive. I can vividly remember walking out into the ambulance doors to update a family on a child's condition. (10 month old near drowning in a bucket of water) The mother dropped to the ground crying and screaming unable to comprehend that he was still alive after she found him lifeless after getting distracted for a moment while washing her floor.

You never forget the blood curdling scream of a parent when they find out their teenage son was killed in a car accident while his sister was driving home from the methadone clinic and fell asleep at the wheel.

Again this list could continue on and on. As you can imagine it is the illness and death of a child deeply affects health care providers most.

When you work in the ED for any amount of time there are so many stories to tell, not just sad.

There are funny ones, the guy with an "object" stuck up his behind that does not want to share the information with the triage nurse for fear that everyone will find out. Well honey when you have to go to endoscopy to have something so deep removed the word is gonna get around.

Then there are sick ones, like the middle age man that is caught having "relations" with the families Golden Retriever. Then there was disturbed teenage boy that was caught sodomizing 2 dogs with a broom stick, his grandfather was a convicted serial killer.

These lists too could go on but these are just a few blips of the last 8 years that pop into my mind as I type. I always said I could write a book about the experiences of being an ER nurse. I journaled a bit about it but that was far as I went.

While working in the ED I was actively involved in education, attending seminars, a member of Emergency Nurses professional association, and one of the few that tested and became a Board Certified Emergency Nurse.

After a few years as a positioned staff nurse I went per diem so I could spread my wings looking for new horizons. I worked at a trauma center in the ER, as a critical care transport nurse, a critical care nurse, and as a college health nurse. Despite all my endeavors nothing quite did it for me. I always returned to working mainly in the ED until I started working in Radiology as an Interventional Nurse. It did not take me long to realize this is where I wanted to be.



It is hard to describe our role in Radiology and nobody else really knows either. It is a unit like no other. It is a combination of working in day surgery, the OR, PACU/recovery. In addition we respond to all emergencies in our department and we care for critically ill patients and our patients become critically ill after some high risk procedures which sometimes lead complications. In a nutshell that is what it is! I explain this because I have recently had to answer some annoying questions from others that do not know what goes on radiology. Like, "what do you do, take pictures all day?" or "aren't you bored". NO, actually it is a pretty busy place, always something to do!

We do TONS of procedures! Just a few examples: nephrostomy tubes, embolizations, arteriograms with stenting and arthroplasty, portacaths, thoracentisis, biopsies, peg tubes, VCUG's (yuk, we have to cath kids), bronchoscopies........and on and on.....

And NO I won't "loose my skills" working in Radiology. (excuse my sarcasm) We start LOTS of IV's, insert catheters, place chest tubes, sedate patients (that is a major role of ours), and cardiac monitoring......

Ok, so we try not to defibrillate our patients unless needed and if someone is having an MI (myocardial infarction) we do not TNK (clot buster) them in our department. But there are SO many of the skills that I have learned in the ED that I use on a daily basis and I am SO thankful to have had such a solid foundation.

I have enjoyed working in the ED and have learned SO much both professionally and on a personal level.

I will miss the most the AMAZING NURSES, DOCTORS , PA's, TECH's, SECRETARIES, PARAMEDICS, EMT's, POLICE OFFICERS and SECURITY.

I will miss the acute MI's, the trauma patient, the adrenalin rush of a code, and the successful resuscitation of a patient but I will not miss all the BS that goes along with it nor will I miss working nights, weekends, and holidays! :)

I now enjoy working in a department when EVERY ONE of your patients is appreciative and thankful for your care.

I love the people I work with: the techs, radiologists, secretaries, and of course the AWESOME nurses I work with.

Lastly, I am SO THANKFUL I have this job and despite the failing economy I pray I am not on the chopping block for upcoming layoff's that are said to happen at our hospital in the next 2 weeks because I'll be back working in the ED and that will be a whole other post;)


I apologize for the long drawn out post but these are a few things I had on my mind and wanted to get out.
Anyway, with 10 feet of snow and freezing temps there is not much farm activity to report.


~SWEAT DREAMS~ Kim

Wednesday, July 9, 2008

Can you guess who got skunked?

Yes...Callie the Naughty at 9:30 tonight after I had just walked through the door after a long day of work and errands. First thing I did was call my neighbor even though it was after 9, that is usually my cut off for night time calls. They have a kennel with a self- service pet wash but....after 4 rings I assumed they were in bed. Sorry Dawn I was desperate. Then I googled "skunked dog". Lots of info popped up and they all had a similar recipe as the one below and they unanimously said tomato juice is an old wives tale.

Mix one quart of Hydrogen Peroxide (3% solution) with a ¼ cup of baking soda and a squirt of dish soap.

I thought great, I have all the ingredients then I read this one article that said use only fresh hydrogen peroxide because old stuff turns to water. I pulled out two "old" bottles and sure enough they had turned to water. I never knew that, you learn something new every day.
Note to self, always have fresh hydrogen peroxide in the house!

Regardless, I donned my gloves, pants, and boots, and hose and went at her with some stuff John suggested that he had out in the barn. Then I used a washcloth with baking soda and detergent when I finally let her in. Thankfully the little devil only got her head so it was not too hard of a job.


Ok, next topic. I need some advice on growing herbs, this year is a first. I have cilantro, basil, dill, parsley, and mint. I have used a good share of it cooking but a bunch went to seed before I knew it. What do you do to keep up with it, cut and dry, but will it grow back?...I just have no idea! I know I am going to need LOTS of cilantro when my tomatoes ripen for salsa making so I planned on planting more.....HELP!

Laying chicken are up to 8 - 10 eggs/day. It has been over a week since I bought any. We consume quite a few. Leah makes a 6 egg omelet in the skillet almost every morning.
Even one of the "injured" chickens laid one for a first today.

Lastly, I wanted to mention some sick ER excitement I had today. Electricity....a wonderful thing. Kinda wacko but I love defibrillating people. Well today we had a middle aged gent code not once but four times...we got to juice him 4 times. That is what I like most about the ED....things that get you adrenalin pumping. About 1 hour later I felt suddenly exhausted, my high had worn off.