a quick word about piggy-backs

ha ha, just in case you guys forget, when hanging a piggy back the med needs to go ABOVE the maintenance fluid as opposed to below.  i can't think at 0400 and i but my vanco. below my TPN the night before last.  when i went in an hour later, the vanco. bag was about to burst because all the hyperal had gone into it...woops!  no worries, just re-timed her next vanco...ha ha, just a friendly reminder in case you guys forget too!  gotta love being new!

a christmas blessing!

not to continue on with the depressing but i wanted to let you know about a recent experience i had.  i had to work 5 days in a row (my last 2 eight hour classroom days followed by 3 12 hour nights) to finally get to an 8 day christmas vacation!  for whatever reason i didn't want to go to work on saturday night at all and had to hold in the tears while parking, only to find out that not only did i have the patient in the rainbow room (which for lack of better words is the dying room) but i also had a new preceptor that i didn't know at all.  we got in report that our patient, marie, was actively dying and i was honest with my preceptor from the beginning that i had never been when my patient actually dies before and that i was really quite anxious about it (not to mention having 2 other patients to take care of)  that night was the hardest night of my life, what ensued was a whirlwind of emotions and struggling between the profesionalism of what is my career and having a heart and wanting to break down and hold the family.

this pt. was one i had taken care of before and have struggled through dealing with the gruesomeness of death and dying already (kids dying of cancer is not as peaceful as i thought it would be for 2008, but i'll save that for another e-mail).  while she was in pain during the day, we increased her fent. and versed once in my shift and she seemed peaceful.  throughout the night, her resp. rate went from 30 at the beginning of my shift to 4.  what had made the process difficult up until this point was going in and out of the room; the door was decorated pictures of marie before cancer (just earlier this year, she had a quick battle with cancer) as well as at the beginning of her treatment as she started loosing her hair but looked like a normal kid.  the only marie i knew had a very edematous face from all the steriods, essentially no teeth, was diapered, hooked up to an IV pole with constant fent. and versed dripping, always bundled up and never opened her eyes.  it was so sad to se the child she once was and to know that she was leaving her little sister behind to be an only child.  a nurse from the OICU that knew that family from the beginning of treatment was in the room visiting and came out around 0230 sobbing and we knew she had passed (anyone else hate the word expired?).  going in that room was the most awkward and uncomfortable thing i have ever had to do.  the sound of parents wailing over their child's dead body is one i wish i would have never heard.  we asked them if we could do anything (what a dumb question) before leaving them alone to be with their child and calling a resident to "officially" pronounce the death.  after the death came a lot of tears.  i helped mom give her child one last bath and changer her so that she could lay in bed with her one more time.  after the parents left, we rolled her little body into a body bag and wheeled her down to the morgue where we opened a large refridgerator (where one of our other kid's bodies lied) and slid the body in (a terribly horrific experience i must say).  we helped mom and clean their room (they had basically moved in), loaded up both their cars full of stuff and said goodbye.  they go home to an empty house without the support of child life specialists, social work, case management, nurses, doctors, etc.  as they said, they're losing their family because that is what we had become.

while this is the toughest experience i have ever had to go through (and i must say the timing was sucky) i consider myself blessed to have been there for this family at their lowest point.  while i didn't do anything special and in fact felt awkward and dumb for the majority of the time i hold onto the fact that i "shined like a star in the universe" as i encountered death at it's rawest point and that shining made a different to the family.  going back to work 2 nights after that was rough, but i'm officially done precepting and will return to work the night of jan. 1st on my own, as a real nurse without anyone looking over my shoulder.  i love you guys and miss you all...hope you guys aren't working too hard!  have a great CHRISTMAS!!!  

-haley

Wanted to share my thoughts....

Hello, it's so great to read what everyone has been up to. I still can't believe we are actually finished with school, but I love the feeling of not having to write a reaction paper every time I leave the hospital. :) Anyways, I thought I would write and let you guys know what I have been up to these past 6 months. I have been officially off orientation for a little over a month now, and I still feel like I have no idea what I am doing. I go into work praying that God will let me make it through the night without killing my patient. I am currently working at UCI in the NICU and I love it. I love the fact that I get to take care of the whole family and not just the infant. It's so amazing to watch a mother finally hold her baby for the first time, even though the baby has been alive for a month, or the first time the mother finally gets to feed her baby. It's a great job, sometimes I go to work and all I have to do is feed 3 babies every 3 hours, so pretty much I get to cuddle a baby all night. However, there is also a terrible side to the NICU (like there is on every hospital floor) babies die. Recently, I had a patient die and I think it was one of the hardest things I ever had to do. I had this patient the previous night and I was super busy the entire 12hrs, pushing numerous blood products over and over just to try to bring up the Hgb, and also pushing D10 into her IV to get her blood sugar up from 32. This baby was overwhelming septic and was not responding to any of our interventions, but she somehow made it through our first night together, but when I came back the second night, her mother decided to DLS her and I had to watch the baby take her last breath in her mother's arm. Tears were streaming down every one's face, including mine. I had to do the post-mortem care and it was really hard to see this infant dead and lifeless. Also, last night, another father decided to DLS his baby. The mother died in a car accident and they managed to save the baby's life, however the baby was in really bad shape because the mother was down for a solid hour before they were able to get the baby out. So the baby's apgars were 0,0,0,0,2. The baby was brought to our NICU to be put on a cooling blanket and recently the baby was not responding to any of the interventions and has major brain damage. The outcome of her life would consist of lying in a hospital bed having to be suctioned every few minutes because the baby had no gag reflex, so the father decided to DLS the baby. I watched this father, whom buried his wife on Friday, cuddle this infant as she drowned on her secretions, terrible. Anyways, I am really sorry that is update is such a downer. For the record, there are lots of positives in my unit and I think that's why I stick around. Like we all know, nursing has the good and the bad, but I think helping a dad change his first diaper, or letting a mother finally hold her baby is so rewarding to be apart of. I hope everyone is doing well in all of the different specialities and that we can continue to be there for each other as our new careers really take off. Good luck with the job search Kari, and good luck to all of you who just started. This is a really exciting time for us and we should be proud of how far we've come. Happy Holidays. P.s. Sorry to those who have to work the holidays this year, I have to work Christmas Eve and I am so sad about that, so we are all in this together, right Heidi? ;)

The Job Hunt

So I just applied for some nursing jobs today out here in Hawaii. I know most of you are way ahead of me and already have months under your belt which is awesome. I realized it is tough starting from scratch where you don't have any contacts and nobody knows BIOLA. But, it is a stretching experience which is always a good thing. Anyways, hope everyone is doing well and know that if you ever need a break, you are welcome to visit Hawaii anytime. Just to tempt you even more, I rode my bike to Waimea Bay today which is right down the road. Look it up online and you'll see how great it is. ;O)