Friday, February 27, 2009

Signature Suites

If you have ever wondered where celebrities can go for healthcare, ponder no longer.  Hospitals have special places for those who can afford the finest life has to offer.  My workplace, for example, has an entire floor called Signature Suites, where the rich and famous can have upscale amenities during their stay.  Honestly, it looks nicer than almost every hotel I've ever been in.  

How was I even privileged enough to catch a glimpse of such surroundings, you may wonder.  Well, I know people who know people who have powers to buzz us into the unit via the super secret, video surveillanced elevator.  All I needed was a sap story about being on orientation, which was totally legit.  

Anyway, imagine personal computers, fancy bed linens, flat screen tvs with dvd players and lounge areas for family members right in the hospital room.  Carpeted floors.  Granite countertops.  Marble tile in walk in showers.  And from what I hear, the food choices are close to gourmet.  

It was definitely eye opening for me to see the two worlds that exist in healthcare.  In one, every resource is available without question.  In the other, nurses and patients practically have to beg for supplies and extra comfort measures, for example radios, fans, and decent smelling bath products.  How is this fair?  *Sigh*

Wednesday, February 25, 2009

Catching up...

So I've been a slacker.  I apologize.  Lots of great stories are happening here, but not much blogging.  However, tonight I was reminded exactly why I blog.  My stories are insane.  Here are some of the highlights of patients I've cared for...

*16 year old with an open book pelvic fracture who ended up with abdominal compartment syndrome requiring immediate intervention...eek!
*Patient in ARDS on an oscillating ventilator, rotorest, and CVVHD... oh and by the way, he was on pressors, an insulin drip, had 3 chest tubes and 2 wound vacs.  Not busy at all.
*Motorcycle crash dude who ended up ripping off a leg on the road and was admitted to my unit via LifeFlight, then was put on our fluid resuscitation protocol shortly after (resus protocol = lots of blood products and fluids until you stop bleeding)
*24 year old car accident victim with a fatal head injury, who had a ventric/bolt placed at the bedside (I got to keep the drill).  She became the first donor patient I've had to manage, and I hear several organs were recovered.  This was also the saddest/most emotionally draining case I've ever been a part of for too many reasons to name.
* A woman who was 36 weeks pregnant got hit by someone involved in a high speed chase by the cops.  Her baby was emergently delivered in the ER, and she ended up in our unit with multiple wound vacs and on the vent.  I actually received orders (written, mind you) to put cabbage leaves on her breasts to stop engorgement.  WTF?  

While all of those were interesting in their own ways, tonight takes the cake.  I cared for a man who was in a Dick Cheney-type hunting accident.  He was obviously the one who ended up shot.  Anyway, the dude has abdominal wounds so extensive they started using maggot therapy on him.  Uggghhh!!!  So when the critters started escaping from the belly wound, I had the honor of catching them in a specimen cup so they wouldn't metamorphose into flies and contaminate our unit.  By far the absolute nastiest thing I have ever done in my life.  My patient had maggots.  Maggots!!!

At least my night wasn't horrible.  My filter never clotted off on the dude's CVVHD, AND I got to get in a ROTOprone bed last night!!!  It was so much fun, like a carnival ride, but it makes me nauseous thinking about having to be rotating for 20 out of 24 hours.  No thanks!  I'll post pics later.  

Oh, and I'm off orientation in 2 days!  Woo hoo!

Thursday, January 15, 2009

My Job Totally Rocks

I've only had a total of 3 shifts in shock/trauma, but already I've seen some crazy things--rapid resuscitation with fluids, a bedside fasciotomy to relieve compartment syndrome, a bolt being drilled into a man's leg to put him in traction, internal decapitation, bilateral chest tube insertion, cervical spine fractures, and the like.   

While it's awesome to experience modern medicine in action, it is also a little discomforting to realize how unattached I can be.  I do want my patients to get better, but I find it even more imperative in this environment to detach and to find humor in the little things, such as reasons for admission --my last patient ran his car into a 300 pound hog.  Yep, that's right.  No lie.  He was pretty banged up because of it too, yet I couldn't help but giggle at his tattoo choices.  I'm starting to realize how twisted I am.  But that's ok.  

I love working for a facility with the capabilities to be aggressive with treatment.  I love having a doctor in the unit at all times, so I don't have to sit and wait for someone to call me back when my patient is crumping.  I'm excited (and, at times, a little scared) about the level of autonomy I've just been handed through nursing protocols and procedures.  For instance, I can now initiate electrolyte replacement without a doctor's order, and I'm allowed to draw my own arterial blood gases.  All of it is really overwhelming right now, but I believe this career move was definitely a good change.  This job rocks!