Weird times, weird measures.
bone-dance.blogspot.com (Source: Head Nurse)
Source: Head Nurse - April 1, 2020 Category: Nursing Authors: Jo Source Type: blogs

We're all okay here.
Soggy and going to get soggier, but on high ground and not in danger of being flooded out.I ' ve had a number of emails from folks overseas, which is why I ' m posting this.The area of flooding is HUGE--as in, it would take the better part of a day (nine hours) to drive around the perimeter--but conditions vary widely. The majority of downtown Houston is toast, as are smaller towns northwest of it. A number of riverside towns in Central Texas are preparing for the worst as Harvey stalls out and rotates over us.But again, we ' re all fine here.If you have five bucks or two Euros or three Kroner, please consider donating to ...
Source: Head Nurse - August 27, 2017 Category: Nursing Authors: Jo Source Type: blogs

Say goodnight, Gracie.
Ladies and germs, I have worked my last shift at Sunnydale Hospital (Healthcare for the Hellmouth)(Fully-owned and operated subsidiary of Giganto Research and Education Corp., Inc., LLP).I start a few days from now at a very posh and very private surgical center, doing pre-op and post-op stuff. It was time. It was, honestly, past time.In the past couple of years, Kitty and Bethie and I have busted our asses to get and then maintain certification. Sunnydale just got magnet status. We ' ve earned five stars from whatever group it is that rates patient care that way. We ' ve earned gold medals from the folks who figure out ho...
Source: Head Nurse - November 24, 2016 Category: Nursing Authors: Jo Source Type: blogs

Once upon a time, there was a nurse named
Carol. Or Marcie. Or Kristen. Or Justin. Or Brandon. Or John. Or Tita. Or Lidia. Or David. Or Aimee.And that nurse taught me everything I ever needed to know about IV starts. Or dealing with difficult patients. Or dealing with difficult coworkers. Or handling death. Or handling survival. Or just surviving a shift.Once upon a time, there was a unit secretary named Harriet. Or Girlie. Or Mary. Or Joanna. Or Marlene.And that unit secretary taught me everything I know about finding the answers to tricky problems. Or about who to call when something breaks. Or about who to call when nobody else can fix something. Or about how t...
Source: Head Nurse - November 22, 2016 Category: Nursing Authors: Jo Source Type: blogs

What happens when. . . .
. . . .you drive hours and hours and hours and HOURS to the State Fair of Texas with four of your colleagues, one of whom is Filipina, one of whom is from Houston, one of whom is from Minnesota, and the last of whom is from the Texas valley, and you introduce them to (variously) corny dogs, fried cheese curds, and the concept of beer before noon?You learn that it ' s not a touch of nature that makes the whole world kin. It ' s fried cheese curds. (The girl from Minnesota was practically in tears to find her native cuisine featured at the Fair.). . . .your coworker says, as you ' re giving report, " Oh, come on. It ' s not ...
Source: Head Nurse - October 23, 2016 Category: Nursing Authors: Jo Source Type: blogs

History.
" Are you on any medications at home? " I asked. He was in for a swollen wrist--and I mean a swollen. wrist. The thing looked like he had a half a softball in there." Nope. Nothing. "" What about for the pain in your wrist? "" Oh, yeah, I mean, I take Tramadol for that. "" Okay. So. . . .anything for high blood pressure, anything like that? "" No. "Okay. On to the next question. I know this one will be fun because he ' s got dozens of missed follow-ups and lit up his last utox like a Christmas tree. Two weeks ago." Any street drugs? Heroin? Cocaine? Weed? "" Why you motherf.ers always askin ' me about street drugs? I don '...
Source: Head Nurse - October 6, 2016 Category: Nursing Authors: Jo Source Type: blogs

Lieutenant Lumpy: An Update.
Another year, another clean set of scans and a pristine checkup with Dr. Crane and his Irrepressibly Cheerful Staff. (They always seem happy to see me? I guess because I don ' t look like Frankenstein ' s Monster?)Next year, because the lung nodule I have has not changed in six years, I can start getting annual chest x-rays rather than an annual chest CT, along with my usual head/neck/orbits MR. I ' ll have to get all that every year for the foreseeable future, because (as Dr. Crane said), " These stupid salivary gland tumors have a really long fuse. " And they tend to recur in both the original spot and met to really weir...
Source: Head Nurse - October 5, 2016 Category: Nursing Authors: Jo Source Type: blogs

I have all the time in the world.
It was not an easy day.We were short-staffed, and I had a patient on palliative care, whose family needed my attention much more than the patient did. Let ' s face it: when their urine output drops below 20 ccs an hour (those Foleys are placed for comfort care, but it ' s more the nurses ' comfort than the patient ' s--we can tell how close to dying you are by how well your kidneys are working) there ' s not much we can do. We turn and do a partial bath every two hours and wipe their faces and clean their mouths, but it ' s all for the family. The person who ' s dying has long since ceased to care.So I had this palliative ...
Source: Head Nurse - September 24, 2016 Category: Nursing Authors: Jo Source Type: blogs

Worst day, or worst day ever?
So we have this new thing at Sunnydale: the nurses from the neurocritical care unit charge for both the NCCU and an overflow surgical/med-surg/ortho unit on a different floor.Right now we have our usual nine beds in NCCU and eleven beds on the other floor. (I ' ll call it " ortho, " because it ' s mostly post-op and pre-op orthopedic cases, but there are important exceptions, one detailed below.) Once the NCCU expands to include epilepsy patients and an epilepsy monitoring unit, we ' ll have a total of twenty-six rooms to charge: thirteen on each floor, with the possibility of two of those rooms on each floor being double-...
Source: Head Nurse - August 30, 2016 Category: Nursing Authors: Jo Source Type: blogs

Minor corrections.
It is " welt, " not " whelp. " A welt is something you get on your skin. A whelp is a newborn puppy. If you tell me your patient gets covered with whelps when they take penicillin, I will be momentarily charmed by that mental image. I might miss what you say next.It ' s " stent, " not " stint. " I don ' t want you to stint somebody ' s heart, as that means that you ' ve given that organ less than it deserves. You can stent it, however, in order to improve blood flow and muscular function.It is pronounced " lairINKS, " not " lairNICKS. " Likewise, it ' s NUClear medicine, not NUCUlar medicine. I can forgive G.W. Bush everyt...
Source: Head Nurse - July 31, 2016 Category: Nursing Authors: Jo Source Type: blogs

OMG, y'all. SEATTLE.
Mom ' s birthday was last week, so I spent last week in Seattle with Beloved Mother, Sainted Father, Beloved Sister, and The Boyfiend. Other participants included Der Alter Jo, her husband, Archie the Mastiff, and A Number of Wild Animals. < br / > < br / > Mom and Dad are well, thanks for asking. Dad, after his last tumble-thump, tumble-thump-tumble, has been prescribed a neck brace (to be worn for 90 minutes at a time) and physical therapy three times a week. Mom is still dealing with the occasional Moment when her a-fib gets snarky, but otherwise is okay. Dad has a number of complaints about Seattle and its political le...
Source: Head Nurse - July 23, 2016 Category: Nursing Authors: Jo Source Type: blogs

Do NOT go there.
An incomplete list of websites I strongly urge you to avoid:Urban Remains ChicagoHygge & WestPlant DelightsIvey AbitzOn the upside, I know what I'll be doing with my lottery winnings. (Source: Head Nurse)
Source: Head Nurse - July 13, 2016 Category: Nursing Authors: Jo Source Type: blogs

A well-oiled machine.
"What you need to do," the house supervisor said to me, "is learn to lower your expectations.""F. you," I replied, with a sunny smile.We'd just gotten a patient in, a guy in his fifties who was, according who what we'd heard from the house soup, status post-TPA, hypertensive as a habit, with a dense left hemiparesis. We'd heard that from the house soup because there had been no report from the outside ED from which he'd come. There had been no warning that the patient was on his way; we'd been waiting since early afternoon and it was now five minutes from the end of the shift. Of course.Luckily, the dude could talk. Peej a...
Source: Head Nurse - June 27, 2016 Category: Nursing Authors: Jo Source Type: blogs

The Human Body: Major Design Flaws Edition
Knees: Why do knees have to bend the way they do, and why are they so out-there and unsupported by something stronger than ligaments? If you go sideways just once, everything stretches out of shape and you're left with a dicky joint forever. Plus each joint has to handle all the weight of the human body on an angle (especially if you're female).Elbows: Same thing, but with a really limited range of motion. Silly idea.Temporal Bone: Why such a thin casing over the brain in just a couple of spots? If you're gonna have a solid barrier of bone, make it thick all the way around.Cervical Spine: "Hey! Let's put an eight-pound lum...
Source: Head Nurse - June 7, 2016 Category: Nursing Authors: Jo Source Type: blogs

Ch-ch-ch-ch-changes. . . . .
It's been a rough couple of weeks on the neurocritical care unit.Marcie left; she went to neurosurgery's clinic, to cat-herd all their patients into craniotomies and gamma radiation. Kitty is in Europe as a whole for a month--actually forty days--and I'm wondering what the f. I'm supposed to do without her, since I can't get the EKG printer to work correctly. Deej is going to work in a post-surgical ICU near The Schw.iest Mall Ever. And I'm left, oddly enough, as the nurse that everybody turns to when they have a question.I wasn't expecting this. First I was a new nurse, but with experience in places much weirder than Sunn...
Source: Head Nurse - May 18, 2016 Category: Nursing Authors: Jo Source Type: blogs