Night 2/4

[whitewriter]

Yesterday I had 2 "cute pts"
The 33 yr old who still has her mother caring for her
Congenital heart issues, Hx multiple surgery, fluid overloaded with unknown preciptating event.
How did the family notice? Her swollen eyes for which the GP prescribed Abx for wasn't getting better and she was sleeping through the day (high CO2).

She was used to going in the toilet with family there, and her mother would wipe her bottom. In ICU, I wiped it.

Her mother had been staying overnight with her. She was a sparky thing, argued for what she wanted. She was making a scrap book for the year? and took photos with the staff (including me) - I should have asked for the photo to be sent to my phone. It was a nice one, actually- from what I could see. My face is covered with a mask and I'm wearing one of those plastic aprons.

At 0200 I was informed that we were doing a direct swap with CCU and I was to take her up.
At 0300 (my break time) I was wondering around wondering when the damn ward would be ready. Apparently, we couldn't just ask them. We phoned afterhours who wondered why we couldn't ring the ward directly. Like a parrot I explained the incharge said there was a protocol thing whereby I had to go through somebody higher up (pt flow) which, at night I don't think actually exists.
So AH phoned the ward who were ready.
0400 I was upstairs trying to help the ward staff figure out if she was "cleared to use the BIPAP machine from the RFS that had been asked for by CCU and which she had been using for 4 days in ICU (like come on, are we going to stop the treatment that has been working just because of a night time transfer?)

I managed a quickie nap at 0600-0630

The other guy
Ex security guard (Is it just me or are obese people commonly work in Security?)
now carer for his parents, 61 yr old male with NASH cirrhosis. What's NASH ? (I had to look it up myself)- non alcoholic Steatohepatitis. Apparently it's common in the obese, in those who have had gastric banding surgery (funny you'd think those two would be linked). He'd had his liver transplant (lucky guy) and was needing dialysis thereafter. He was funny.
He slept all afternoon and at 2am was wide awake asking me "what were we doing now" and "what is next?" and "Can I put him through a hole?"

I offered him endone. He declined. At 0700 he was rolling about the bed all funny and said he had pain. I offered him endone again and this time he said "Well I need to have something".

Damn straight.

pt number 3: The pt they swapped with the 33 yr old
mild DKA. and not mild anxiety.
That meant arterial line.
2/24 ABG
1/24 finger prick BGL and ketones
and personal titration of the insulin infusion +/-5% dextrose (or 10% depending).

I left on time after writing my notes on pt number 3 in 5 mins flat. They weren't the worlds best notes, but they were completed.

When I was a teenager I would use LJ to whine about how I wasn't doing enough in school to get ahead and the big unknown (the future) and wondered a lot about how it would pan out. Now the future is here I'm just trying to make the most of my good fortune in a career I really enjoy.


5 things I like about night shift

This was a hard list to write.

1. If your next to someone really nice and chatty, you can have a really good heart to heart about something.

Coincidentally if your stuck next to someone you don't get along with you may have a very lonely night.

2. It's generally quieter and you can organise your night to a T provided nothing goes wrong/no one gets sick.

But if the shit hits the fan your plans will be uprooted with a scan or change in allocation whereby your doing the work of admitting and discharging someone in the middle of the night.

3. If your working with someone with good time management, you'll get good breaks at night.

More managers around in the daytime, so you watch your back more.

4. You can live a double life.
Say your working Monday night shift: you can have a super busy morning and early afternoon, have a nap - go to work (and feel like shit staying up all night) then come home, and push through (not everyone can do this) and have a normal day - then go to bed at night.

If you have more than 1, 12 hour shift in a row though, the lack of sleep will catch up with you pretty damn quickly.




Pre wrote these and I'm posting them at the end of my nights 18/6