Showing posts with label nurse's notes. Show all posts
Showing posts with label nurse's notes. Show all posts
Wednesday, June 18, 2014
The ICU is a field of knowledge. It grows theories and ideas that hovers on all of your senses. The beeping cardiac monitor wakes you up and speaks to you among its eerie lines. The sound of your patient’s breathing alerts you to start moving. The look and feel of your patient’s skin spells out the pages you’ve brood over in college. The smell of burnt air also gives you its own dire signs. Imagine these raking your senses all at the same time.
On Helping People
I once came across a quote here that says about one person drowning while the other person was just standing three feet away screaming to the drowning person to just learn how to swim.
In reality, if you see somebody in need of help and he’s just right there, would you just stare at him and say that he can do it by himself? Wouldn’t you compulsively do something to help him?
I go through so much of this at work recently. I see my colleagues sitting there watching me while I move about doing the things I’m supposed to do. I’m the junior, the bottom of the food chain, the person who get’s most of the tasks, while most of the time, they relax on their chairs waiting for time to go by. During such time, I just go on with my work, most of the time in a hurried pace, so I’d finish everything on time. Within 12 hours, I’ve got so much things to do and I feel like I’m always on the run. And yes, during that time, they’re just watching me.
I simply don’t get it. Is there some sort of wisdom they are trying to instill in me every time I go through this? And if there is a lesson in it, I can only name one and they speak of it too often, it’s like throwing paper on a rock. They always emphasize time management as the key to what ever I’m going through.
I thought I was way past that stage where I have to suffer on my own at work. I thought the people I work with aren’t what I thought of them on the first place. I always thought, whenever I’m “drowning,” they really wouldn’t help me because I have to learn to swim by myself first. I thought that when I actually do learn how to swim, they’d return back to their normal helping selves. But no.
There is a difference between letting somebody get drowned a little so he could learn to swim and a person who do knows how to swim but is actually drowning.
In reality, if you see somebody in need of help and he’s just right there, would you just stare at him and say that he can do it by himself? Wouldn’t you compulsively do something to help him?
I go through so much of this at work recently. I see my colleagues sitting there watching me while I move about doing the things I’m supposed to do. I’m the junior, the bottom of the food chain, the person who get’s most of the tasks, while most of the time, they relax on their chairs waiting for time to go by. During such time, I just go on with my work, most of the time in a hurried pace, so I’d finish everything on time. Within 12 hours, I’ve got so much things to do and I feel like I’m always on the run. And yes, during that time, they’re just watching me.
I simply don’t get it. Is there some sort of wisdom they are trying to instill in me every time I go through this? And if there is a lesson in it, I can only name one and they speak of it too often, it’s like throwing paper on a rock. They always emphasize time management as the key to what ever I’m going through.
I thought I was way past that stage where I have to suffer on my own at work. I thought the people I work with aren’t what I thought of them on the first place. I always thought, whenever I’m “drowning,” they really wouldn’t help me because I have to learn to swim by myself first. I thought that when I actually do learn how to swim, they’d return back to their normal helping selves. But no.
There is a difference between letting somebody get drowned a little so he could learn to swim and a person who do knows how to swim but is actually drowning.
Saturday, October 19, 2013
ICU Survival Guide: Junior
( I've devised a list of things I needed to take note on the day I realized that working in the ICU isn't as simple as it seems--just when I thought working in a medical-surgical ward packed with patients is already hard. My job itself is an overdose of reality, sometimes you have to do things like this to keep yourself sane.)
1. pray before and after duty
2. take a deep breath and prepare to be intoxicated
3. assess your patient thoroughly
4. nursing is an art form
5. develop your deep-seated obsessive compulsion
6. answer all the doctors questions
7. move steady and fast
8. don't fuss about the harmless infusion pumps
9. endorse the proper IV level
10. don't feel stupid
11. you still have to wake up the sleeping doctor at night because your patient is desaturating, gone hypoglycemic or worse, coding
12. sometimes you really have to figure out things by yourself
13. ask when in doubt
14. do what you think you can do
15. don't feel bad when you're asking help for the simplest things. you're still a novice for crying out loud and they put you in the ICU
16. learn how to insert an IV on an edematous patient
17. learn the ECG tracings
18. taking the 12 Lead ECG takes a great amount if skill
19. you can learn things when you actually do them
18. use your time wisely
19. keep everything clean
20. replace your suction catheters, sterile bottles, ET tie every shift
21. get rid of the water from the mech vent tubes
22. night shift means deal with all the papers and deal with them fast
23. focus on the patient and not on the stack of papers
24. deal with the papers anyway
24. turn your patient
25. be present at admissions, turning rounds, daily hygiene, and everything you need to be in
26. master the stockroom
27. learn how to be a nursing assistant
28. deal with the special endorsement with a legitimate face
29. don't feel like you are at the bottom of a food chain even if you are
30. your co-staffs are still people
31. don't make stupid mistakes
32. you will get used to codes sooner or later
33. sometimes, you might know better of the patient than the doctor does
34. it's okay to cry. just don't do it in front of them
35. try to live
(to be continued)
1. pray before and after duty
2. take a deep breath and prepare to be intoxicated
3. assess your patient thoroughly
4. nursing is an art form
5. develop your deep-seated obsessive compulsion
6. answer all the doctors questions
7. move steady and fast
8. don't fuss about the harmless infusion pumps
9. endorse the proper IV level
10. don't feel stupid
11. you still have to wake up the sleeping doctor at night because your patient is desaturating, gone hypoglycemic or worse, coding
12. sometimes you really have to figure out things by yourself
13. ask when in doubt
14. do what you think you can do
15. don't feel bad when you're asking help for the simplest things. you're still a novice for crying out loud and they put you in the ICU
16. learn how to insert an IV on an edematous patient
17. learn the ECG tracings
18. taking the 12 Lead ECG takes a great amount if skill
19. you can learn things when you actually do them
18. use your time wisely
19. keep everything clean
20. replace your suction catheters, sterile bottles, ET tie every shift
21. get rid of the water from the mech vent tubes
22. night shift means deal with all the papers and deal with them fast
23. focus on the patient and not on the stack of papers
24. deal with the papers anyway
24. turn your patient
25. be present at admissions, turning rounds, daily hygiene, and everything you need to be in
26. master the stockroom
27. learn how to be a nursing assistant
28. deal with the special endorsement with a legitimate face
29. don't feel like you are at the bottom of a food chain even if you are
30. your co-staffs are still people
31. don't make stupid mistakes
32. you will get used to codes sooner or later
33. sometimes, you might know better of the patient than the doctor does
34. it's okay to cry. just don't do it in front of them
35. try to live
(to be continued)
Tuesday, February 21, 2012
the Brisk Walk
This day was the second day of my duty for our ICT training. The first day wasn’t much of a highlight because we just played as sponges observing all that’s currently happening in the tumultuous LMU and absorbing all the new information. Just so you know, LMU stands for La Milagrosa Unit. It’s the biggest unit in the hospital I’m currently in and also labeled as the most toxic area. Toxic, in nursing jargon, means you-will-never-have-a-chance-to-sit-down-on-yous-ass-because-there-will-always-be-too-much-things-to-do-so-don’t-forget-to-breathe.
For today, I didn’t just watch my senior do his stuff but I was to help him and accompany him to whatever he has to do. He was actually very good at what he was doing. I was overwhelmed with the pile of patient charts in front of him, and as he works through each of them, he makes specific calls to related departments either to ask about diagnostics or a need for reservation for the operating room. He zooms across the station getting the needed pile of documents while noting down doctor’s orders, while given a chance explains to me what he was trying to do, then noting things on the kardex and the charts. After much writing and discussing, he moves to prepare all the medicines for all his patients where he performs really quickly without any hesitations. Then he walks through the corridors of the huge unit, making it through each of the patients rooms accordingly to give them their treatments, ask how the patients is, remind them if they need to fast for a surgery or they can’t void until they undergo a diagnostic procedure. These entire is not yet even the whole thing I went through.
The shift was a sprint. It was basically walking to and fro in the long halls of the hospital in a very fast pace and doing the tasks promptly like some sort of relay. I practically did the brisk walk a lot so as not to run in the hospital hallways making an impression that there’s someone coding. But whatever type of walking or pseudo-running I did, it resulted with ending up sleeping on my bed as soon as I get home and sleep-walking towards my confused cousin to whom I was half-consciously asking for food that didn't exist.
For today, I didn’t just watch my senior do his stuff but I was to help him and accompany him to whatever he has to do. He was actually very good at what he was doing. I was overwhelmed with the pile of patient charts in front of him, and as he works through each of them, he makes specific calls to related departments either to ask about diagnostics or a need for reservation for the operating room. He zooms across the station getting the needed pile of documents while noting down doctor’s orders, while given a chance explains to me what he was trying to do, then noting things on the kardex and the charts. After much writing and discussing, he moves to prepare all the medicines for all his patients where he performs really quickly without any hesitations. Then he walks through the corridors of the huge unit, making it through each of the patients rooms accordingly to give them their treatments, ask how the patients is, remind them if they need to fast for a surgery or they can’t void until they undergo a diagnostic procedure. These entire is not yet even the whole thing I went through.
The shift was a sprint. It was basically walking to and fro in the long halls of the hospital in a very fast pace and doing the tasks promptly like some sort of relay. I practically did the brisk walk a lot so as not to run in the hospital hallways making an impression that there’s someone coding. But whatever type of walking or pseudo-running I did, it resulted with ending up sleeping on my bed as soon as I get home and sleep-walking towards my confused cousin to whom I was half-consciously asking for food that didn't exist.
Saturday, January 28, 2012
Best feeling so far
I just made it through a code simulation alive! It was packed with a good dose of adrenaline that triggered the sympathetic in my system that wasn’t much used for a long time.
The code simulation was much like what you get to see in the series of Grey’s Anatomy where a patient goes cardiac arrest, the cardiac monitor beeps furiously and the code team rushes in and tries to revive the patient to normal.
The feeling was amazing! Even if it was just a simulation, there was time pressure and I needed to familiarize myself with algorithms and ECG tracings and the medicine needed based on what heart rhythm the patient is giving. It was a huge challenge on my part since it was my first time and I’ve never actually seen such situation face to face. Now I am looking at it, and it brought chills in me, actually scared me a little, but yet it was some kind of opportunity to learn and do something new.
My bloopers, though awkward in many levels, keep repeating in my head and I vowed to never do them again. It was hilarious that during my turn as the one to give ventilation, I couldn’t figure out what to do with the things brought out in front of me. The bag-valve-mask was some sort of alien gadget that I attached the parts wrong with my hands shaking. Looking back at it makes me laugh because I must have looked really stupid but I did it anyway. (haha)
So going through, when it was then my turn as a Team Leader, I thought it was the best part. I actually want to do it again. The team leader was the one who analyzes the cardiac monitor whether the patient is having supraventricular tachycardia, ventricular fibrillation, or maybe going through an asystole. These are big words and I love to say them. After correctly stating what kind of heart rhythm the patient is having, I quickly make a decision to assess if the patient has a pulse (the dummy patient actually makes a pulse!) and note if it is stable. Then I go through telling my team if the patient needs to be defibrillated or given a dose of Epinephrine or Adenosine or Atropine. (I’m starting to love the medicines too.) I even get to try intubating the pretend-patient, which I haven’t ever done before (thus the shaking hands).
When the whole thing was done, I couldn’t stop smiling. One because I passed the simulation in one try. Second, because all my team members also passed. All our efforts of practice actually paid off. And by the end of the day, the same team actually won as 3rd best ACLS team!
Until now, I feel really glad! I want to feel again the same thing I felt in the simulation room. And maybe I will if I get myself stationed in the Emergency Room or in the ICU. Maybe I’ll even get to save a life and not just AmbuMan(my first pretend-patient). But for now, I’m just going to wait and see what will come.
The code simulation was much like what you get to see in the series of Grey’s Anatomy where a patient goes cardiac arrest, the cardiac monitor beeps furiously and the code team rushes in and tries to revive the patient to normal.
The feeling was amazing! Even if it was just a simulation, there was time pressure and I needed to familiarize myself with algorithms and ECG tracings and the medicine needed based on what heart rhythm the patient is giving. It was a huge challenge on my part since it was my first time and I’ve never actually seen such situation face to face. Now I am looking at it, and it brought chills in me, actually scared me a little, but yet it was some kind of opportunity to learn and do something new.
My bloopers, though awkward in many levels, keep repeating in my head and I vowed to never do them again. It was hilarious that during my turn as the one to give ventilation, I couldn’t figure out what to do with the things brought out in front of me. The bag-valve-mask was some sort of alien gadget that I attached the parts wrong with my hands shaking. Looking back at it makes me laugh because I must have looked really stupid but I did it anyway. (haha)
So going through, when it was then my turn as a Team Leader, I thought it was the best part. I actually want to do it again. The team leader was the one who analyzes the cardiac monitor whether the patient is having supraventricular tachycardia, ventricular fibrillation, or maybe going through an asystole. These are big words and I love to say them. After correctly stating what kind of heart rhythm the patient is having, I quickly make a decision to assess if the patient has a pulse (the dummy patient actually makes a pulse!) and note if it is stable. Then I go through telling my team if the patient needs to be defibrillated or given a dose of Epinephrine or Adenosine or Atropine. (I’m starting to love the medicines too.) I even get to try intubating the pretend-patient, which I haven’t ever done before (thus the shaking hands).
When the whole thing was done, I couldn’t stop smiling. One because I passed the simulation in one try. Second, because all my team members also passed. All our efforts of practice actually paid off. And by the end of the day, the same team actually won as 3rd best ACLS team!
Until now, I feel really glad! I want to feel again the same thing I felt in the simulation room. And maybe I will if I get myself stationed in the Emergency Room or in the ICU. Maybe I’ll even get to save a life and not just AmbuMan(my first pretend-patient). But for now, I’m just going to wait and see what will come.
Friday, December 2, 2011
Stereotyped Nurse
People should stop stereotyping nurses. But it can’t be helped when most of the reasons why a high school graduate chooses to take a difficult four year course of Nursing was to get herself somewhere else than the Philippines and earn better.
I wasn’t thinking about that part a lot. I didn’t know what to do back then in high school. I was clueless, indecisive and scared. I haven't exactly made a framework for my life. So I just listened to my mother and my encouraging uncle and took the course I never thought would change me.
The truth is, I don’t want to go anywhere right now. I can’t just go abroad and be rich, as my mother says. Being that seems a blur and I can’t take it. It sounds dark and gloomy because I’m going to be sent to some far off place, alone for the sake of some things. I can’t grasp the thought of putting that as part of my dreams. When I told my mother this, she was upset that I’d be okay being just what I am right now, taking my steps slowly and not looking and running toward the a ‘bright’ future she sees ahead of me.
I feel contentment. I haven't exactly understood the concept of people working hard for the sake of getting rich. It seems pointless and endless. As humans, we do keep asking for a lot of things, and when we finally get hold of that thing, there will be a time when the object will wear us out and we'll get tired and look for something else. I'm the person who thinks there are much real things to keep.
I don’t have those expensive things my batch mates show-off every time I go to school. Yes I do want those things, clothes, gadgets, and what-else, but the crave is dead so long ago. I’ve been contented with the fact that I can’t have everything that I want. I really do. Yeah, I complain a lot about it but it just ends there and nothing else. I’m just this, plain shirt and pants, and I don’t want to ask anything anymore since I feel like can’t really have it and having it doesn’t exactly mean true happiness.
Is this bad? People taught me to always dream big. Always hold on to a dream and you will get it. I seem to have not let these words sink in to me. It’s like I’ve given up on a big dream and go contented on little ones. What is my dream?
My dream, if I could remember well, was finish college, find a job that I’d be happy with, help my family, own a dream house and travel places. I’ve said this when I was like in a retreat back in elementary. It sounds so good. Well thought of. No specifics. Just that. I’ve done the college part. Great.
Next is find a job I’d be happy in. This part is difficult now. Because one, I haven’t found a job yet. But I 'm on my way on it having passed my very first job interview in a hospital. Two, I’ve had this idea or something that the only way you’d be happy with your work is when you like what you do and people in that workplace keep inspiring you. Where do I find this place?
You see. I might be really lost right now. I just want to be good at what I’d be doing soon. Being a nurse. That’s just it. I want to be a good nurse.
I wasn’t thinking about that part a lot. I didn’t know what to do back then in high school. I was clueless, indecisive and scared. I haven't exactly made a framework for my life. So I just listened to my mother and my encouraging uncle and took the course I never thought would change me.
The truth is, I don’t want to go anywhere right now. I can’t just go abroad and be rich, as my mother says. Being that seems a blur and I can’t take it. It sounds dark and gloomy because I’m going to be sent to some far off place, alone for the sake of some things. I can’t grasp the thought of putting that as part of my dreams. When I told my mother this, she was upset that I’d be okay being just what I am right now, taking my steps slowly and not looking and running toward the a ‘bright’ future she sees ahead of me.
I feel contentment. I haven't exactly understood the concept of people working hard for the sake of getting rich. It seems pointless and endless. As humans, we do keep asking for a lot of things, and when we finally get hold of that thing, there will be a time when the object will wear us out and we'll get tired and look for something else. I'm the person who thinks there are much real things to keep.
I don’t have those expensive things my batch mates show-off every time I go to school. Yes I do want those things, clothes, gadgets, and what-else, but the crave is dead so long ago. I’ve been contented with the fact that I can’t have everything that I want. I really do. Yeah, I complain a lot about it but it just ends there and nothing else. I’m just this, plain shirt and pants, and I don’t want to ask anything anymore since I feel like can’t really have it and having it doesn’t exactly mean true happiness.
Is this bad? People taught me to always dream big. Always hold on to a dream and you will get it. I seem to have not let these words sink in to me. It’s like I’ve given up on a big dream and go contented on little ones. What is my dream?
My dream, if I could remember well, was finish college, find a job that I’d be happy with, help my family, own a dream house and travel places. I’ve said this when I was like in a retreat back in elementary. It sounds so good. Well thought of. No specifics. Just that. I’ve done the college part. Great.
Next is find a job I’d be happy in. This part is difficult now. Because one, I haven’t found a job yet. But I 'm on my way on it having passed my very first job interview in a hospital. Two, I’ve had this idea or something that the only way you’d be happy with your work is when you like what you do and people in that workplace keep inspiring you. Where do I find this place?
You see. I might be really lost right now. I just want to be good at what I’d be doing soon. Being a nurse. That’s just it. I want to be a good nurse.
Saturday, August 20, 2011
The Pessimist Just Passed Her Licensure Exam
The clouds were always dark and gloomy since she knew it was going to come any day now. She tried to shake it off by planning stuff to shoot up her serotonin to its supposed normal level. It all summed up with her trekking for her beliefs and getting disappointed with doors closed in such a time she actually did something fruitful. She was planning to pray. The sky was raining where she stood.
In a few hours, she was now sure it was going to come. And just then, the lights went off and she has no other way of finding about what was coming with just her battered phone. The battered thing happened to have delivered the news just few minutes after the current went down where she was. She stood highest where she dwells wondering what will it be this time. She can’t make anyone else see what her fate was. She has to see it with her own eyes. Staying by the rooftop showed signs of lights from houses afar. They hadn’t had any of what she has. Gazing high, the sky was dark gray again and a distant star stayed lit with from all its worth.
Sunday, August 14, 2011
anything way past my bedtime
(here, written, is anything random that’s running through my head. mind i take note now before my time runs out and it all wanders off to nowhere)
If I am perfectly accurate, there is at least a week before the exam results swerves up to the news and start blaring it to every single being that has been dreading it from the moment they stepped out shaking from their exam rooms, including me. I had my share of fun. Fun that is defined by the first painstaking day after the exams where I didn’t know what to do because every negative thought kept building up in my head until I snapped (not what you think) and continuing on to this very night where, again, I find it hard to sleep.
I want to try drawing like a kid again. Who cares if it happens to be an abstract figure of a landscape. Seriously. I’d rather make myself preoccupied this coming week rather than being tormented by myself. I want to cook! I wanted to make different pasta dishes. I’ve only made spaghetti and meatballs once. it is a pasta isn’t? I want to try hiking too. Then when I get to the top, I’d have my camera with me. I’d always imagine an amazing view anywhere. And then I’d walk around, just walk maybe, or have a joyride and look for a place to fit in. I mean look for a job. I never thought this part could be really hard. I always picture the part where the interviewer asks questions and I answer with all my deep seated unspoken words, not the seeking part. It never has happened because I seem to have acquired the stupidity of not being able to properly open an office door. Oh well.
My plans seem to always get stuck for some reason. Some tend to wither away though some still grow back. I do wish they all grow back and save me from sinking more in my made-up pit. I hope I’d be able to accomplish something this time. Now that I feel like I’m just going to grab anything that would take my mind off what is keeping me awake this long.
I’m going to write more too.
TAGS: THOUGHT AUGUST 14 PAST MIDNIGHT
If I am perfectly accurate, there is at least a week before the exam results swerves up to the news and start blaring it to every single being that has been dreading it from the moment they stepped out shaking from their exam rooms, including me. I had my share of fun. Fun that is defined by the first painstaking day after the exams where I didn’t know what to do because every negative thought kept building up in my head until I snapped (not what you think) and continuing on to this very night where, again, I find it hard to sleep.
I want to try drawing like a kid again. Who cares if it happens to be an abstract figure of a landscape. Seriously. I’d rather make myself preoccupied this coming week rather than being tormented by myself. I want to cook! I wanted to make different pasta dishes. I’ve only made spaghetti and meatballs once. it is a pasta isn’t? I want to try hiking too. Then when I get to the top, I’d have my camera with me. I’d always imagine an amazing view anywhere. And then I’d walk around, just walk maybe, or have a joyride and look for a place to fit in. I mean look for a job. I never thought this part could be really hard. I always picture the part where the interviewer asks questions and I answer with all my deep seated unspoken words, not the seeking part. It never has happened because I seem to have acquired the stupidity of not being able to properly open an office door. Oh well.
My plans seem to always get stuck for some reason. Some tend to wither away though some still grow back. I do wish they all grow back and save me from sinking more in my made-up pit. I hope I’d be able to accomplish something this time. Now that I feel like I’m just going to grab anything that would take my mind off what is keeping me awake this long.
I’m going to write more too.
TAGS: THOUGHT AUGUST 14 PAST MIDNIGHT
Tuesday, March 22, 2011
Monday, February 21, 2011
I’ve seen unconditional love
Today, at the emergency room, pediatric section, a grandpa was cheering his 1-year old grandson. His grandson had just vomited milk and started to cry uncontrollably. So his grandma made him sat on her lap while his grandpa do funny body gestures to make the child stop his sobs. Even until the child has calmed down, he kept comforting the child to the extent that he was blowing the site were a needle was inserted for his IV. The rare scene lasted for a few hours until the grandpa and his grandson finally slept side-by-side on their bed.
It was such an inspiring sight. Hopefully, when the child is all grown-up, he’ll never forget this part of his life where someone never left him alone and gave him all the protection he needed without anything in return.
It was such an inspiring sight. Hopefully, when the child is all grown-up, he’ll never forget this part of his life where someone never left him alone and gave him all the protection he needed without anything in return.
Tuesday, February 15, 2011
going off for Emergency Room duty for the last time as a student...
today.
Feb 16 2011.
goosebumps.
i can’t believe it.
~__~
Monday, February 14, 2011
Blockbuster
this was the medical mission i went to…
with all kinds of people, mostly elders, mothers and children…
we were tasked to…
there were generous people handing-out free medicines…
and dedicated doctors in different fields…
it was truly a hit. everybody received all the care they deserve.
(February 3, 2011)
5 Quizzes all in 1 day
made me think that
i need to start liking memorizing, though i more love analyzing. T_T
screw it.
i can’t!!!! ~___~
graveyard shift
bagay ba ang mga insominiac sa mga graveyard shift?
kasi naman, kung di lang naman sila makatulog ng maayos kapag gabi,
mas mabuti pang meron silang nagagawa na kapakipakinabang imbes na magpagulong-gulong sa kanilang higaan
-insomniac T__T
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