Sorry about that.

Ring Ring.


"Floor nurse, how can I help you?"

"Hey floor nurse, it's ICU nurse. I have a lady here that says she is Mr. ETOH DTs estranged wife. I'm just going to send her on up ok?"

"That's fine ICU nurse. But could you do something first?"

"Sure."

"Stall her for about 10 minutes. He just shit on the floor. And now he's rolling in it."

"Uh yeh. No problem. But something tells me she's probably seen worse."

Sense of Entitlement

I'm going to be very vague, just in case the HIPAA monsters are trying to find me.

-You may not abuse rules and policies of your hospital simply because you work there.

-You may not stalk the nurses and question everything they do when your job title puts you as far from bedside care as possible and does not allow you to do anything patient care related.

-You may not be a bitch to the nurse who calls your bullshit-rule-breaking. You also may not try to report her to her supervisor. Didn't know I already report YOU to YOUR supervisor did you?

- After all this, you may not expect all the other nurse to be extra nice to you. Bitch nurse has already activated the Crazy-Family-Alert.

Thank you and I promise your family member lying in that bed is my first priority. You, however, are not.

Challenge Accepted

I've developed a sick pleasure working in the ICU. Nothing kinky or anything like that. Get your mind out of the gutter. It defies all instincts developed in nursing school.

When I was a naive little student, I dreaded the bed bath. Even more so than the poop clean. So we'll just say I learned to face my fears after I landed my job in total care nursing.

Now I pride myself in my ICU "admission bath" skills. In my unit, everyone gets a chlorhexidine admission scrub down. EVERYONE. Alert & oriented X 3 will not get you out of it, sorry.

Most people aren't gross at all. Maybe there's a little yeasty goodness down yonder, or dry skin. No big deal. But every so often, we get a good one. One that gives us the deer-in-headlights look after we strip the covers off.

Teeth are blackened and missing. Breath smells like a rotting corpse. Beards to the navel with God-knows-what living inside. Skin dry and scaly and falling off all over the sheets and drifting into air. Sweaty armpits and dirt (or what we hope is only dirt) caked fingernails. Blackheads in places that shouldn't have blackheads. Slimy pudding like substances caked in the reproductive orifices. Smears of fecal matter on the rear. And toenails like gnarled dead tree branches.

CHALLENGE ACCEPTED

For seemingly hopeless cases such as this, we break out the triple threat. Chlorhexidine, Aloe Vesta Shampoo/Soap (or what ever daily wash we are carrying in the Pyxis at the time), and a nice bar of Dial Soap. Lots and lots and lots of soap, little bit of water. And basically I pour the whole concoction all over. Forget saving the linens that were already on the bed, they were ruined the second they hit the sheets.

So there's my secret. The triple threat can turn the nastiest patient into an ad for personal hygiene. Don't forget the hit the teeth with a chlorhexidine mouthwash of some sort.

Happy Bathing!

I hate that feeling...

When I go home and go to bed with a feeling in the pit of my stomach. I want to call the unit up and ask how my patient is doing since I left. But I don't.

Then in the morning, the already bad feeling completely drops to the bottom of my stomach when I look at the assignment board, and that name is gone.

Then I go about my day wondering if I could have done anything different.

Some days are hard.

Excuse me, your ascites is leaking.

Typical ICU day, LOL with a nasty PEG tube is septic from the site. Serious ascites going on. Stinks to high heaven. GI doc comes in and removes old nasty PEG. No big deal right?

Wrong.

From the second he walked out of the unit (because, let's face it, weird shit never happens with doc standing at the bedside) she starts spewing from the site. A nice greenish smelly fluid. No big deal. We'll just put a nice big dressing on it. Right?

Wrong.

The dressing is soaked in seconds. Remove dressings. Hold wads of towels over site until we figure out what the heck to do. Our ICU brains get to work on a ghetto way to fix this. Hmm, a colostomy bag? Sounds like it would work right?

Wrong. 

We put the bag over the site and quickly turn and toss the patient to change her green soaked bedding. Then I hear something. Drip. Drip. Drip.

 The wafer has pulled away from the skin and that lovely greenish liquid is flowing over the edge of the bed. Onto my shoes. 

Great day in the ICU. 

In which I ponder spelunking. And I don't mean in caves.

I mean spelunking as in "Hey, KLynnRN! Wanna go spelunking with me on this new patient?"
I mean foley catheter insertion on obese people. Ladies in particular (but I've donea good cave diving on a male).

It's really an art. Almost a recreational sport, like the real thing. The similarities are eery.

1. You need to train for such ordeals. You can't just go traipsing through the deepest, darkest cave if you've never done it before. You might not recognize landmarks. And you could get lost. Spelunking is not for newbies. You should attempt smaller caves to hone your skills first.

2. Equipment is vital. You can't just grab some rope and a backpack and trek into unknown territory. You need to set up your tools. You need to know what all your tools are for. And grab a flashlight. You will always need a flashlight.

3. Don't go solo. You know that movie where the guys hand gets stuck under a rock, and he didn't tell anyone where he was going? Same thing. Don't assume it will be a typical experience. Let your coworkers know where you'll be. If fact, recruit a few helpers. You'll probably need it.

4. Be prepared mentally. Spelunking is not for the faint-hearted. You may see things that will haunt your dreams. You make smell odors that will ruin your lunch. You could have a cave-in rendering you trapped and claustrophobia may set it. Consider these things before beginning. Prepare yourself.

5. The finale. When all is said and done, and the legs are propped and the belly flop is held back, and XXL lady parts are parted like the Red Sea, you peer into the unknown. You see a little wink. Like the light at the end of the tunnel. You head for it. Liquid gold bursts forth and you've made it out of the cave to daylight!

Don't forget to wash your hands :)

No you did not just do that!

The other day, a coworker and I were helping another coworker get caught up so we could all eat lunch at some point that day. We decided to double team her intubated and sedated patient so we could get it done faster.

We blew into the room like tornados, checking blood sugar, scanning meds, scanning patients armband. All of a sudden the patients daughter appears out of nowhere. We quickly introduce ourselves and let her know we are helping the nurse. By that time we are actually finish and go to excuse ourselves.

"Wait! Wait!"she says "I need to ask him a question with you two in here."

Odd request, but whatever, families are usually weird like that. We stand by and listen.

"Daddy?! Daddy??" the patient opens his eyes "Do you want treatment. Like that chemotherapy and radiation like before?"

Pt nods enthusiastically.

"Daddy?! Daddy?!" he opens his eyes again. "God forbid something should happen, but if it does..."

At this point of course we are thinking she's asking about DNR status.

"...can I have your camper?!"

Seriously, I'd like to think he comes back to haunt her. Or better yet, rip her ass to pieces when he gets extubated!