The pet orthopodita

1 Aug

This morning while purchasing coffee from my favorite local deli, the deli man asked me, “What kind of nurse are you? Did you say cardiac?”

My response was vague: I mean yeah I work in progressive care, most of my patients are: in CHF,  Heart Attacks, post heart cath, Atrial Fibrillation, some type of arrhythmia, a bad pneumonia or COPD exacerbation, PE, septic, acute bleed, or some other condition that requires every 4 hour blood pressures and assessments. Or the patient is a post operative patient with NPO status requiring vasoactive medications that can only be administered to patients on cardiac monitors. Drugs are given in PCU that can not be given on medical floors such as cardizem, amiodarone, hydralazine, and many others. So yeah it is a mixed bag thay lay somewhere in the middle of medical and intensive care although we are classified in the critical care arena as labeled by the American Association of Critical Care Nurses.

I am quite pleased with this arena, this circus riot that is progressive care. I am happy with the adrenaline rush, the fast turnover of patients, and the edginess of it all.

Being so pleased with this arena I stroll into work today to find myself being pulled to a medical floor for the shift: the orthopedic floor. Oh noes!

I get report in the morning on 6 patients. I happily receive the first two patients both medical diagnosis in nature. Then panic sets in: the next four patients: orthopods. 3 total knee replacements and 1 hip replacement. All post operative day 1. I nearly lost my mind.

The pain medications and assessments around the clock. The continuous passive motion torture devices with prescribed schedules: on 2 hours off 2 hours. The PRN medications in between. The hemovac drains, the foley cath removals, the painful walks to the bathrooms, I mean it was frightful!

When 12 noon and 4pm rolled around I did not know what to do as I normally do blood pressures and reassess at this time! wOOt a  non-invasive hemodynamic breather!

And the doctors: Who were they? Orthopeds I never met, and I did not see one cardiologist all day and of course I am biased towards Cardio, pulmonary MDs…who were these bone crushers?! Ew!

I am happy to say that I made it though, it was an experience but I am ready to get back to PCU.  I would much rather give cardiac drugs, assess hemodynamics, monitor strict intake and output. Give lopressor every 4 hours even rather than give pain medications, chasing pain medications all shift long. Give me dysrhtymias and NSTEMIs all day long. Heart failures, lasix, and morphine to decrease resp rates and vasodilate in flash pulmonary edema. Give me bipaps on and off all day!  Give me titrated heparin drips! Just keep me on telemetry……..please!

Oh but the ortho nurses found me charming!

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