Telepathic Doctor

So the patient is admitted and is diabetic: on insulin at home with unknown dosages.

The admitting doctor puts the patient on a regular diet and does not order any insulin because the patient does not know the dosages.

The next day the patients blood sugar is >400.

So nurse Jane calls the doctor and says: your patient is on insulin at home, do you at least want to order a sliding scale for insulin coverage?

Dr Dirty Coat: No. 

Jane: The patient is on insulin at home.

Dr Dirty Coat: I do not know the dosage. You want me to be telepathic?

Jane: (ewww) No. I do not want you to be telepathic. I do want: You to know that your patient is diabetic, put them on a diabetic diet and even if you do not know what the patient takes at home, I expect you to cover the high glucose while in the hospital.  So…. the blood sugar now is > 400, do you want to leave it like that or do you want to give the patient some insulin?

Lame Nurse Blog

So I suppose I have been neglecting this blog  lately in pursuit of other creative endeavours. I feel lame. That and nothing really exciting has been going on: on the job.   Either I am becoming an experienced nurse and nothing is so shocking anymore, or it has just been sort of–(I do not want to say it)    q u i e  t.    ooops I said the  “q” word.    sorry.   The truth is my last few shifts have been pretty much hemodynamically stable.  No alcoholics in tremor or metabolic encephalopathy with ninth month looking bellies trying to climb out of bed, no little bitty grannies cursing me out refusing their lasix, no one in septic shock from urinary catheters left in for months at a time at the nursing home with tanking blood pressures: strange just a semi stable bunch of atrial fibrillation, CHFers and, chest pains with rule out MI that are discharged after all the cardiac enzymes are negative and no ECG changes.   And it seems that the best hospital in the universe (aka: where I work) is admitting everyone (aka: the census must be low) and everyone must be admitted to telemetry of course.

I think I am going  to head on over to the hospital down the way for some emergency nursing PRN; I heard they would give me a job and I am an adrenaline addict: I need some more action.

I miss my heart doctor

Ahhh…..I felt a twinge of chest pain rated about 5 out of 10 on a scale of 1 to 10 with 10 being the worst pain ever. It did not radiate anywhere, just a big rectangle sitting on my chest, and a pit at the bottom of my stomach leading to a self diagnosis of stable anxiety, relieved by pleasant memories and one big *sigh*,  all at the end of my last shift as I watched my favorite cardiologist walk off the floor for the very last time into…..retirement.

I am not alone in this feeling.

We are all going to miss him.

He is a mix between a Zorro MD and Indiana Jones with his leather vest and cowboy hat and jeans.

He has energy unlike others and passion unmatched by any other cardiologist I have worked with yet.

It is hard to imagine him in retirement but hey: that is is his business.

What I take away from him in my 2 years as a new nurse is priceless. His teaching was endless and never seemed to be tiresome. I will remember him at the monitor surrounded by all the nurses explaining something heart related in a language that we could all understand.

Regular Insulin

RN tired after work and only a teaspoon of gas in the tank of her car goes to the local gas station down the street from Community X hospital.

RN rolls down the window and says to the gas attendant.

“Can you fill it with Regular, Insulin.”    hahahahaha Instead of   “Can you fill it with Regular, Cash”

Gas Attendant: “What?”

Wow…..when you associate the word “Insulin” with the word “Regular” you know that you are in nurse speak mode and super tired.

Bloody

Yaay. My career has turned into blood transfusion after bloody blood transfusion. Maybe I should go work in infusion therapy… Not.

Seriously Mr. Surgeon, why not take him to the OR already, enough of this!

Transfusing unit after unit of packed red blood cells helps the patient, but it is just coming right out again till you decide to stop the bleed.

New job?

I think I like adrenaline. Maybe I should go work in emergency or as a first responder. Seriously. Blah.