First ED Summer

Sep. 12th, 2009 06:47 pm
Today was my first day back working in the ED in the past month....I was really hoping to get time in the main ED but with the downtime and lack of patients I just hung out in Child Express with Kristal. It was a good day and I got some homework done while I was there. Just wished it had been a little more interesting.

So yesterday in my Med-Surg class I was quite proud of myself. The topic was trauma and the emergancy dept!! I really had no idea how much I had learned from being a nurse tech at MB until I heard my classmates struggling to answer the questions that I figured were pretty basic. I never thought that me defining "triage nurse" would be such a big deal but apparently people took note at how much more knowledge I have. I will acknowledge that I feel my confidence has increase and I'm quicker on my toes.

All is going well. This is going to be a crazy semester!

Sep. 10th, 2009 06:02 pm Life
I was playing with Angelica's I-phone in class....I was trying to squish all these ants trying to eat my food which was pretty entertaining but I soon got bored and decided to try another game. Ends up that I chose the one that makes noise despite the volume setting on the phone so before I knew it the phone was making jungle noises. The elephant was priceless......Great first impression on the first day of class.

Today I locked my keys in my car after trying to fix the original problem of my antenna not going down.....FML.

Sep. 10th, 2009 05:59 pm Beginning of the end
Two days ago was my last first day of school.....or at least for a while. Kind of a sad thing to think about given I have always started school each Sept. since I was a little kiddo. I am a senior nursing student now. I really don't know when that happened. I just have to go with the flow.

Aug. 15th, 2009 10:15 pm Moving into South
So today I moved out of Steven's house into Kelsey and I's apartment in South. I can't believe that the summer is ending and I am entering my SENIOR year of nursing school! It is surreal and I am not sure I am ready for it. When I walked into the apartment I got so excited to make it my own and can't wait to have Kelsey there!

Aug. 15th, 2009 10:14 pm Puke
I am at work and I kiddo just puked all over his mom.....poor lady.

Aug. 2009 Another Day at the ED
Today was a crazy one in the ED. We had numerous patients at the same time with low acuities (meaning really sick). My first patient was a teenage girl complaining of abdominal pain but her respirations were out of control and her body temp was in the 94's. We rushed to heat her up and slow down her breathing. The girl started to vomit but since she was in so much pain she couldn't move so I just had to suction everything out. Once we got her to CT, they discovered that her abdomen was full of fluid and she had a mass in her spleen. She also had pancreatitis. The mom was very grateful as I took her up to the PICU. It was nice to feel appreciated and know that we did a good job.

The other patient that I was with for a good duration of the night was a teenage girl that ODed on Clonidine. She came in with black stuff oozing from her mouth which I later found out was carcoal that the medics had given her to counter the effects of the drugs. I helped the patient change into a gown and she started to cry. When I asked her what was wrong she said that she was stupid and didn't know if she was pregnant or not. She told me that she lived with a friend and hadn't seen her parents in a long time. She was only 13 and we couldn't find a single person who would come be by her side. I hope that the OD will scare some sense into this girl.

I got to hold the cutest little baby! He was 2 weeks old, sleeping with his little hand smushed up against his cheeks. We had to put an IV in the little guy and he took it like a champ. Since the parents didn't want to watch I got to cuddle the baby afterwards!! :)

Jul. 15th, 2009 09:57 pm ED Memories
July 20, 2009
Today I got to handle my first solo trauma simply because there wasn't enough techs to have me watch someone. We had a car accident come in with two traumas. My patient was a little 9 yo that was in much serious condition than her little sister who sat in the neighboring bed chatting it up. Ends up that my patient had a fractured liver which I didn't even know was possible. The sisters were very cute and I am happy to say they were both okay.

With the lack of techs tonight I was quite busy! And I swear I dipped urine at least 20 times which is double that that I have ever dipped in my life. Dawn and I were the IV starting team and she called me her lucky charm because she didn't miss a vein. Although it was a crazy night, I still took the time necessary to calm down the kiddos and make the ED a good experience. At one point I heard a kiddo crying so went into distract him while the RN was working on him. Ends up that asking him questions made him quite happy and calmed him down. While I was distracting I was asked to go transport another pt but I made sure to stisk out the other procedure to keep the little boy happy. I hope I always remember the importance of bedside manner and how a few minutes can make a huge difference.

In the wee hours of the morning, we had a couple come in with their baby that was only days old. They explained that the baby was crying alot and had diarrhea. When I went in to take the baby's vitals, I asked about the poo and the description sounded like normal baby poop when a kid is breastfeeding; yellow, runny and seedy....They continued explaining their concerns and everything was pretty normal just you could tell that they were first time parents and were paranoid. It got me thinking.....Through my nursing experiences, I am I going to be the opposite of the crazy over protective mom? If my kid isn't about to bleed out then we'll just leave it be cause I have seen worse? I am sure that's stretching it but it was a thought. I was proud that I recognized the norms for the baby though cause it shows I am learning!

Funniest patient of the night was this 15 yo girl that freaked out when she had to get an IV placed. Don't get me wrong, IVs can be scary things but this girl said some of the most bizzard things. Like "my tears are burning my skin" as she's sitting there screaming! I had to hold back from laughing because she was soooo over dramatic even for me.

July 18, 2009
Today I was suppose the orient with Sara but she called in sick. Roy asked that I tried managing the night by myself and sure enough I did! There was a dog malling where the boy had 6-8 huge lacs on his arm and his lip was hanging from his face. We had to call in a special Plastics Dr. which made it extra tricky to set up for because I didn't know exactly what he would want for the procedure. The Doc showed up and barked out a bunch of sutures and other items he needed asap. I ran around and did a pretty good job gathering everything up. Later on in the evening I was successful with a blood draw in a 8mo's hand. Big trauma of the night was a 2yo girl that had been kicked in the head by a horse. No external trauma however she had a temporal skull fracture. She is a very lucky kid. It was a good night and I am proud of how I managed the busy shift by myself.

July 15, 2009
Today was a slow night with nothing too exciting although I did get to run my first trauma by myself!! Chris watched of course however I was the key tech with the 10yo male came in. He had been run over by a boat trailor and ended up having a fractured liver but nothing more. Another lucky kid. One skill I have to work on is listening to other people discussing the situation while I am completing my treatment plan.

July 14, 2009
I was in Child Express and Triage today. Not too exciting but I get to have more time with the kiddos. Two kids left quite the impression though. First was a little girl about 4 yo who had a popcorn kernel stuck up her nose. We convinced her that if she let us get it out, she could plant the kernal in the ground and grow a popcorn tree....she was pretty cute!! Down in triage, we were graced with the presence of a 17yo boy that was drunk off his behind. He told me that I was his favorite nurse ever and that I was "super cool." The RN, who had just walked in, introduced herself right at the same moment the boy asked me my name. He assumed my name was "becca" which he decided to tell me was a great pirate name and that we should name our ship! He was a wacko!

Jul. 13th, 2009 11:31 pm Can't believe I have a stomach for this.....
Here is my catch up on memorable ED patients I have seen thus far in my new ED job:

-4yo girl with a huge abscess to her inner thigh. We sedated her and popped the bugger. The docter squeezed it a good 5-6 times shooting at least 60ml of pus out onto the chuk. I swear I almost passed out. The nurse and doctor both said it was their personal records for largest abscess given the size of the child.

-15yo girl came in via ambulance with a dislocated patella after tripping off a curb. After we knocked her out, the doctor just climbed up on to the bed and popped the baseball sized bump back into place. We heard a huge crack. Thank goodness there was a resident there to help the doctor or else I would have had to hold and felt the pop.

-Spring and early summer is fall season. Lots of kids bouncing of the concrete after falling out an open window. We had a trauma come in that fell from a second story window onto the hood of the car. When the little boy got there he was screaming and had a huge bump growing off the side of his head. We rushed him up to CT only to have the patient seize and start going down hill. We rushed down to the ED where we intubated him and knocked him out. Ends up that the little boy had multiple skull fractures and a huge hematoma. When the boy got in surgery and they attempted to release the pressure from his skull, I guess the blood shoot all over the room. Last I heard the kid was in ICU and pretty lucky to be alive. Hopefully he'll get off of the ventalator and go home soon.

So if you watch the news you would have heard that a little girl was rushed to Mary Bridge after falling out of the back seat of her family's moving mini van. To top it off, the girl was run over by the back tires. Well I was the lucky tech who got to help with the trauma. The little girl was about 7yo and pretty banged up although the only real injuries were internal bruising to her abdomin. I don't really understand how you can be run over by a car and be a-o-k but kids defy the odds. The little girl was sweet however her parents were definitely on the weird side. Mom showed up first and her story just didn't add up. When dad arrived the parents began arguing in spanish in front of the police officer who asked them to speak english so he could document the story. The parents just kept going in spanish or else they just stopped talking. I don't know what really happened to that little girl but I doubt she fell out of the moving car....

-One of my first days in the ED a kid came in who ended up being diagnosed with Moyamoya Disease. The kid was showed seizure-like symptoms. I remember hearing the doctor say that he was luck to see one case of moyamoya in his lifetime because it was so rare. Figured it was worth documenting.... Moyamoya is a disease where arteries in the brain constrict. To compensate for the constriction, the body makes alternative pathways, called collateral circulation, to go around the plugged area. Problem is that the collateral circulation is weak and has a high risk for hemorrage, aneurym, and overall just takes up alot of space in the brain. It is most common in Asians. It was interesting however sad because the child's outlook was not good.

-I had a 5-6yo boy that we had to dope up to sew up his arm....While I was leaning over him to hold his arm still, the kid just started stroking my arm like I had the softest skin in the world. He was a creeper.....

-If this doesn't scare people away from circumsion, I don't know what will. We had a little baby in that had the little ring that connects the tip of the foreskin to the base of the foreskin, because the middle portion has been removed, fall off. Without the ring, the end of the foreskin would fall off so the doctor had to stitch the skin to the skin at the base of the penis. Yep, stitches all around the penis holding the foreskin together....of course there's nothing you can give the babies to help with the pain so the little kiddo just screamed...The doc said he personally sees this kind of complication at least once a month.

-One of the mothers of a kid I helped care for said, "thank you for your great bedside manner." At first I didn't think she was talking to me but she point and said, "yeah you. You did a great job." Made me feel good.

-I successfully drew blood on a 12mo. Boy was I nervous because kids have such tiny veins. But somehow I got one in the kiddo's hand. Woot!! I am actually pretty good at getting them if I can see them. I need to work on the feel though....

-So there was a patient rushed into the adult ED that had a self inflicted gun shot wound to the head. It wasn't a kid so I didn't work with the patient directly but the whole ED area was buzzing. I was hanging out with Kristal upstairs in Child Express but some of the people who worked on the patient needed to talk and wanted drinks after work. I was shocked that Kristal decided to invite me too!! I took the opportunity to go out and meet some new people. I soon heard from Dave that the patient hadn't survived. Guess he got his wish of suicide. Dave said that while he was doing compression, brain matter was oozing out. I don't think I could handle that and really hope I'm not ever put in the position to do it. Overall the night out was fun and I appreciated Kristal taking me under her wing. I hope that young patient is finally peaceful.

-So my first night in triage....Robert says that we're going to head out to the front but first he wanted to prep me. He explained that a patient had been brought in to TG with a gun shot wound to his leg. The wound was gang related and there were people in the waiting room threating to finish the job if the patient didn't die. Robert continued to say that many of the guys waiting had guns on them and to be on the look out. GREAT! Just want I want to deal with. I was on high alert but the other employees up from didn't seem all that concerned. Rumor has it that they get threats all the time and gang violence isn't all that uncommon in Tacoma....After I got off work, my mom asked if I had seen the 'critically ill patient that was shot and sent to TG." It is amusing to compare the media to the really incidence. The patient was never even close to critical and was quickly moved upstairs to recoup. It was an interesting and eye-opening evening.

-I finally had the patient that made me break down. 7yo girl with at least 25 bone fractures. Broken ribs, legs, arms...skull fractures, bruises, cuts....The doctor explained that she had the injuries as though she was hit by a train and survived. Her lung was completely full of fluid which required a chest tube to drain it. She laid there crying with no family there to hold her hand and soothe her. Why? Because they were the one's who beat her so badly that you could hardly recognize her. Most of her fractures were old, indiciating that she's been harmed and not treated. That's what got to me. I couldn't handle thinking about this little girl walking around with broken ribs, enduring the pain, without any care or comfort from her family let alone a medical professional. This trip to the hospital only occured because "the girl fell" and the injuries were too great to be brushed under the rug. The only thing that got me through caring for her was that I knew she was going to finally be out of that situation. I hope her parents get the karma they deserve.

-I attended the EST meeting. Candi asked us all to come up with words that describe a great EST so she could write them on the board. We had a pretty good list; caring, accountable, knowledgeable, team player, etc. After the list was up, Candi commented that she tired to hire people the had these qualities. Chris looked at me and said, "Alex, I see all of these qualities in you. You have been doing a really great joband should be proud of yourself." Everyone did the classic awwwww sound because it was so nice. It really meant alot that he said that. Chris always seems to have more confidence in my abilities than I do. I appreciate his support and faith in me.

-I was leaning up against the counter when I felt myself knock something off the desk. I looked down to see what had fallen but didn't see anything.....Then Gemma looked at me and asked "did you pull that button?" I truly didn't know what she was talking about but I quickly had everyone's attention. "she pulled the panick button!" "Oh, no. the panick button got pushed!!" Apparently on the underside of the counter is a button that you flick down when there is an emergency in the emergency dept. we can't handle.....it calls the Tacoma police and fire dept. along with various panick teams throughout the hospital! Gemma called security and let them know it was a false alarm and to inform the police....it was just fabulous! :)

-I had a 15yo boy that came in with a huge gash out of his right leg. I guess a pile of wood fell on him....Anyway, I watched the resident put at 20-30 stitches into this kid's knee in the SQ tissue with an additional 18 stitches on the surface to hold the skin together. The kid didn't take it all that well and kept screaming although we knew he couldn't feel anything....He was pysching himself out so I just feed him otter-pop after otter-pop....

-I had a little 8yo girl I was trying to distract....."what's your name?" I asked. She informed me that it was Laura so I decided to share that my name was Alex. "Alex?! That's a boy's name." I couldn't argue with that so I agreed that boys could have my name too but I decided to shake things up and told her that I knew lots of boys with Laura as a name. She looked at my with disgusted and said "Boys can't be named Laura because it's a pretty name unlike Alex." BURN! Her mom's jaw about hit the ground and I pretended to weep a little.

Jul. 13th, 2009 06:21 pm Summer 2009
Boy has life been crazy lately. The summer is almost half way gone and I truly don't know where it went!! I finished my junior year of nursing!! Can hardly believe that....and watched some of my great friends graduate and start the new chapter in their lives.

Since school has let out I have been busy working and hanging out with my AMAZING roomies, Meagan and Allison. Living at Steven's house is great! The three of us girls keep each other laughing and support each other when we're done. I love our cute little chorse list and our roomie list of to-do's.... Last night Stu and Erics came over to watch a movie on the projector. The thing wouldn't turn on so I climbed my way up into the attic and fiddles around. We eventually figured it out but then the sound wouldn't work.....Could hear the music but no voices....the boys gave up and went home and Meagan and I watched the movies in my room. Note to self: never ever watch "Knowing" again. Worse ending I have ever seen!!!!

I spend alot of the time working hard so that I can truly enjoy my breaks when they come. The school year leads to a relaxing summer.....but since when have I had one of those?! I don't think there will ever really be the day that I just stop for a large amount of time. There too many opportunities out there. It's just not me. I wonder though when I'll truly realize that the hard work is never going to really end and the resting motiovaion ceases to exists......

Anyway, this summer I work at MB as a nurse tech in the Emergency Dept. What a different world!! It's hard to explain but I really do love the action and taking care of the kids. I feel terrible sitting at work hoping something crazy comes in to give me a shot to learn something new and help another life. I just try to remember that I will have plenty off sick people in my lifetime so to be patient. I really love the job though and know that I want to be a nurse!! I love the kiddos too! I handle the sick kid issue much better than I even thought I would be able to. I wouldn't be honest if I didn't admit that some situations have gotten to me and broken my heart but all the other families that I help makes that pain cut a little less deep.

I have realized that I am seeing and expereincing things that I may never come across again so I have decided to make a greater effort in documenting my ED stories; good or bad. I conglomeration of memories that I can keep with me for a long time. Look back at where I started; when rectal temps were a challenge! :)

Summer continues to roll on. Let's see what it has in store for me.

Apr. 19th, 2009 07:34 pm South Africa
I had a South Africa reunion today! We had a mexican theme to the party as we enjoyed enchiladas, salsa, chips, and beer!

Seeing everyone has got me missing Africa all over again. It seems like I was there years ago and there are truly moments that I doubt I ever actually went. How do I keep my amazing experience in mind throughout the average everyday things that I do?

Today was finally sunny and I got to wear a skirt!! Reminded me of SA and how I only had the same four outfits to wear each day in the heat. I miss the food and all of the laughter. I miss though beautiful sandy beaches that I had all to myself. I miss the music and the people. The food and the animals.

I went to the other side of the world. I stood on the tip of Africa and looked out at the endless ocean that is too large to comprehend. I flew 24 hours to get to a place that I will hold dear to my heart forever and ever. Oh how I miss South Africa.