whitewriter | Chill Sunday in ICU

I had dialysis - a citrate circuit. Simple. Already set up. Just got to remember when to do the ABGs for the ionised calcium's.

Ironically the pt was also systemically anticoagulated on heparin.

I clearly need to study because whilst I know I need to repeat the iCa 6 hourly if stable and follow the flow chart, my understanding of citrate and calcium is pretty much zilch.

It bugs me that I can more or less successfully run a procedure on a person (continuous renal replacement therapy) and know so little.

I feel like I knew a lot more about ventilation and ABGs as a new grad than I do as a senior, running dialysis properly for the first time in 8 years.

I don't feel like writing in my journal when I get home anymore.-- Unlike last year in September and beyond when I couldn't wait to get home and pound the keyboard.

I feel like doing it when I'm on the floor-- and shock horror, I actually have time most days.

Did I tell you Bed 24 passed away on the morning of the 1/4? Candle lady.

I still have the candle. I haven't burnt it yet.

I used to be in the End of Life Committee and I used to think that sending cards to pt family after they passed away was a morbid idea but I was on the committee anyway because as a senior,

you should be on a committee -- when your on it, you get emails every week about every person that died in each of the units. So then you'd sort of know a little about what was happening.

Even when I quit to go to SSH, no one took me of the mailing list so it was an odd but nice? way to spy on my old workplace.

Since my Dad passed away I don't think the cards are morbid anymore. Actually I think they're rather nice.

I think about all the different things we do for people who are dying in ICU, and when my dad was dying I not once thought about doing any of those things.

Its funny how, when it happens to you - all your knowledge and understand takes second stand and when no one is there to make suggestions -

you'd never think of it until 1 year passes, then the 2nd year is halfway through and I'd think gee wouldn't it have been nice if I had taken a hand print. or some hair. Before he passed.

Anyway.

So I have citrate circuit today. ?Scleroderma induced organ failure.

She's only 41 and has a grandchild.

I thought of my mum in her 70s and she has none.

Last time I went to visit her - I probed her about what she talks about with her friends.

Apparently it's their grandchildren.

She's so good - she doesn't say anything to me about why I haven't got any for her yet.

Amazingly patient. Gold star to mum.

She's(the patient) is from the countryside and her mother in-law was in here with her from about 0830 all the way until 1600. Patiently knitting or doing crossword until the pt pipes up oh can I have some water

and she'd tend to her.

I was really impressed with her patience.

Some family just stick around for like an hour or two. To be fair, she's only in Sydney for the pt. She's staying at a cheap hospital accommodation site not far away where the rates are decent. I'm not sure the rooms have kitchens though so I don't know how they do meals and so forth. She had shockingly white hair and SUPER white eyelashes! I almost wanted to ask if she had them bleached.
No-one will care for the pt or be as gentle to the pt as their own family.

Period.

Staff cannot replicate it.

Apparently (the visitor) was once the tea lady at *a country hospital in an area famous for country music* and on country music festival days the food staff would dress up in country get up. - you know, boots and shirts and the pants and etc. That sounds pretty fun.

I like the incharge today. She's really approachable. So when I have issues she gives me advice beyond just how to fix things - like today, I had to ring around to the bosses for a drug from pharmacy and she advised me that some people that work there "aren't really nice" -- bearing that in mind, when I did the phone call, I got one of the not nice ones. But I found it funny how he delt with me. I needed a drug. Instead of just asking which one it was, he kept asking have I checked the ward, and have I checked impress or the ward fridge.

This drug is pretty special, it's an S4 because people might steal it to cheat in sports - darbepoetin. It's locked up and counted. It's not typical stock for anywhere except perhaps maybe dialysis.

I've almost eaten my weight in chocolate today. After all, it is Easter. Now I have a sugar headache. Or is it a lack of water head. Either is equally likely.

I think JH from NSICU is jelous because the staff in NSICU are still nice to me even after I've left. If she's in charge she doesn't like it if I go sit at the desk and ask them how it's going.

Today I walked past and one of the other staff offered me small Easter chocolate eggs and I took some, and then someone else offered me a (much larger offering) lindt bunny and JH was like She doesn't work here! She didn't take care of him!

lol. So funny. I just went away (laughing). I've had wayyyy too much free chocolate today.

I'm sad, though, 'cause I know when she left big ICU- she was essentially bullied out (but to be fair, she was asking for it with her difficult ways) and nobody likes her in Big ICU. Few of us tolerate her in NSICU. You sorta just have to let her do her. Work around it. and as long as the work is done (which it will be) let the behaviour go.

I should go around and say hello to NICU more often.

Maybe, I'll bake proper brownies and bring them and give them to both small and NICU sometime. I wonder what JH would think then. Usually when I make something I tell NSICU girls to go around to small ICU and have some too. Sometimes they come.

Today I made brownies for small ICU. They weren't very good. Never thought you could stuff up a brownie.

I had overheated chocolate for my Easter project, and I'd try to redo them in the chocolate before I realised why the chocolate was not shiny and slick (over-heated, twice no less) and I'd read you can put them in brownies.

What I didn't realise was I should have doubled the sugar content due to the 70% cocoa chocolate I had used.

And the oven was too hot.

I need to rebake these (with fresh chocolate). They were horrid. I brought them in anyway and I've explained to people that they are not very good/ But their still getting eaten.

It was made from good quality chocolate, butter, sugar, eggs, flour - so I loath to throw it out.

Now all I have to do is skip home, and copy and paste this whole thing into my dreamwidth and the whole night is mine.