dominos

Last night was my first night back at work, actually taking care of patients, after almost 3 weeks of time off to heal my little injury (which is getting better every day, thankyouverymuch).

My boss had called earlier in the day, as in 8am (like that the heck would I be doing at that time of day? Sleep?!?! Apparently not). He called to make sure that I was coming in because staffing is atrocious "see how I was feeling". I assured him that I'd be in and would see how I felt. I did make one request. I told him that I would prefer one very sick, preferable vented patient, over a few "walkie talkie" step-down patients. Have I ever mentioned that I loathe the call bell and think it was possibly invented for the sole reason of tormenting overworked staff??

I arrived at work early (after a year I still overestimate the amount of time it will take me to walk 5 blocks) and am surprised to find that my assignment is actually a "sickie". Oh wait, he's sick, but he's also a bariatric patient (a mere 206 kilos). Um yeah, so like how am I going to maneuver this man? With help, of course. My coworkers were great with lending a hand (or two, or three, or four) but my adventures didn't end with his size. All those with weak stomachs and/or those who want to eat in the next hour, don't read on. During the course of the night he started to blow snot bubbles-one popped in my face (amen to face shields). He projective vomited (did I mention he also has a tracheostomy), that was delicious. Despite giving pharmacy a 2 hour heads up that I needed a new ativan drip, they were 45 minutes late in supplying me a new one. You know how it goes from here...Patient sedation lessons, patient pulls out NG tube that the attending had placed. While I was replacing the NGT tube, the patients A-line pressure bag malfunctioned and I lost the waveform. After 2 attempts the NGT goes in but the patient just coughed off his trach cap and goo flies everywhere. I attempt to prop him on his side and what to do you know? Oh yes, some of the worst smelling farts ever. Only good thing is that there was none of that brown delight, to accompany the odor. That's when my foot skid on the floor. Oh yes, I had just stepped into a the pile of puke that I missed when cleaning up the vomit with cl0r0x wipes (remind me again why we pay a housekeeping staff?) I squatted down to examine the problem. WHOOPS, OUCH, F@c^! That didn't feel good. Now, stuck in a squat, I just started to laugh and laugh and laugh. What else could I do? I pulled myself up and just started to fix all my messes.

Clean puke: check

Get new pressure bag for A-line: check

Reinsert feeding tube: check

Suction out patients mouth and nose and tube for any residual vomit: check, check, check

Completely change patients linens and bed (2nd time in less than 2 hours): check

Wash patients face: check

Take off gloves; Rremove mask; Wash hands; Sit in chair; Pray that 8am isn't really still 5 hours away

I'm back tonight for #2 of 4. Stay tuned, it's always an adventure when nurse Kelly is around.