Monday, July 21, 2008

Pictures of Matchstick Men

Thirteen-hour workday. Not bad.

Accompanied an esophagectomy patient to a modified barium swallow test in radiology because she had an epidural and required nursing coverage. It went well. It was cool to see the radio-opaque fluid go down into the stomach and gastric outlet. They pulled her naso-gastro tube afterwards, which made her rather happy.

Made a lot of phone calls and solved the usual time-consuming and knotty little problems that make the job a real pain in the ass sometimes. STAT labwork on a patient that ws off the unit for an ECHO. They needed coags drawn so the interventional radiologist had numbers to see before messing about with a PortaCath.

They went for that without the coags anyways, so all my conniving and begging went for naught.

Started a couple new intravenous lines for patients that had problems with theirs. That saved some of the other nurses a little time. I'm not great at it, but I seem to be the nurse that people ask when they miss. And if I can't get a line in them, then generally speaking they'll be getting a PICC line pretty soon anyway.

Another patient went to get an ablation and pacemaker/automatic-implantable-cardiac-defibrillator inserted, but they got nervous and claustrophobic so the cath lab team sent them back without doing the procedure. The patient was still in atrial fibrillation with a ventricular rate fluctuating in the 120 to 140 beats-per-minute range. But they were just sick of it all and they had work piling up at home so they wanted to leave.

We all would rather have seen them stay for a resumed Cardizem drip, monitoring, and another go at the ablation/AICD, but they wouldn't have it. Nothing doing. She dressed herself in street clothes and called her son to come get her. At least the on-call cardiologist gave us an oral Cardizem prescription for her before she left Against Medical Advice.

When she got on the elevator to leave, she chirpily said "Maybe I'll see you tomorrow after I go to my doctor."

That would be a best-case scenario. She'll be lucky if she doesn't stroke out.

The swirly black-and-white sixties psychedelia of The Status Quo.

My god how my mother hated that song. I played the 45 until it was worn through.

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