{"id":205448,"date":"2010-01-20T14:00:00","date_gmt":"2010-01-20T19:00:00","guid":{"rendered":"tag:blogger.com,1999:blog-28943539.post-8865070833808341056"},"modified":"2010-01-20T14:24:55","modified_gmt":"2010-01-20T19:24:55","slug":"day-shifter","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/205448","title":{"rendered":"day shifter"},"content":{"rendered":"<p>So much for a nice, calm first time on day shift for me!<\/p>\n<p>But first, I need to say that just my three days off to turn my body back onto a day schedule were amazing. I immediately felt like myself again. It was as if a light has been turned off and now it is on. I have motivation and energy and a spark! I woke up at 7 in the morning and I was so ready to go! I missed that.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/shop.advanceweb.com\/images\/products\/2006\/NW\/NW_Gift_Items\/desk_stationary\/02388_SyringePen_NW\/02388_syringepen_med.jpg\"><\/p>\n<p>Back to my first time alone on day&#8217;s&#8230;it started off calm. I had two patients with the same exact problems: admitted with infected hemodialysis catheters who needed them removed and became septic, and were now awaiting new HD catheter insertion. Both needed their dialysis. Kind of bizarre how similar their stories were. My one guy was totally confused, but was pleasant, love that.<\/p>\n<p>My other patient got an order to transfer out once I brought her down to interventional radiology for temporary catheter and then onto dialysis.<\/p>\n<p>During all of this, there was a code on the unit and my manager was there all day. I kind of wondered if she was watching me, gauging how I would react in situations. During a second code, she asked if I would walk around the unit to make sure everyone was okay. The minute I stepped out of the room, the nurse next door frantically asked me to grab a suction set up, intubation, and to page RT. Alright&#8230;<\/p>\n<p>And then, the craziest of the day&#8230;they aren&#8217;t allowed to give me three patients since I am still new, but they needed a 1:1 nurse for a new patient coming up from another ICU because he needed to be on a <b>rotoprone<\/b> bed! I have no training in this, at all. I knew my manager did NOT want to give me this patient, but she had no choice. These patients are SICK. My preceptor from orientation (aka: my ICU Mom) was like, &#8220;I cannot believe they are going to give you this patient. This is insane. I had to take a 10 hour class on this bed&#8230;&#8221; My manager felt that since it was at the end of the day, it wouldn&#8217;t be a huge deal and she reiterated that she would never want me to have this patient for a whole shift. Not that I&#8217;m incompetent or anything, but I simply just do not have the experience.<\/p>\n<p>After I gave up my patient to another nurse, I spent about 2 hours with the bed representative going over how the bed works. Wow, I feel like I don&#8217;t need to go to weight lifting this week because I actually got a work out.<\/p>\n<p>The bed looks like either a torture chamber or some sort of NASA device.<br \/>\n<img decoding=\"async\" src=\"http:\/\/www.kci1.com\/cs\/Satellite?blobcol=urldata&#038;blobkey=id&#038;blobtable=MungoBlobs&#038;blobwhere=1226632259398&#038;ssbinary=true\"><\/p>\n<p>Numerous straps and buckles and controls.<\/p>\n<p>I felt so anxious, I just wanted to go get the patient and bring him up! However, the bed representative was so helpful and reassuring. She kept saying how she would not leave me and I could call her day or night. Knowing that my shift was coming to an end, my fears began to alleviate. <\/p>\n<p>My manager actually went up the open heart unit with me to help bring the patient down! The best part: I got report from my preceptor of my final semester of nursing school!! YAY!! She is so down to earth and similar in personality as me; sarcastic, etc.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/calstate.fullerton.edu\/news\/2006\/photos\/nursing.jpg\"><\/p>\n<p>In short, this patient was definitely sick. For those who have no idea what the heck this bed is or what it does: the basic premise is that it helps patients with severe respiratory issues, like <a href=\"http:\/\/en.wikipedia.org\/wiki\/Acute_respiratory_distress_syndrome\">ARDS<\/a>. Basically, the patient goes into the bed (or&#8230;we put them in the bed) very tight, snug, and strapped in, and then the bed turns them upside down (prone) and starts rotating back and forth like a rotisserie. The purpose is to help perfuse other parts of their lungs and increase oxygenation to those other areas. That is the best I can explain it.<br \/>\n<img decoding=\"async\" src=\"http:\/\/www.odec.ca\/projects\/2005\/thog5n0\/public_html\/lungs.jpeg\"><\/p>\n<p>Here&#8217;s a video I found on youtube. I have no association with this video, I am only trying to show what the heck it looks like:<br \/>\n<object width=\"425\" height=\"344\"><param name=\"movie\" value=\"http:\/\/www.youtube.com\/v\/52P5QDlgF0g&#038;hl=en_US&#038;fs=1&#038;\"><\/param><param name=\"allowFullScreen\" value=\"true\"><\/param><param name=\"allowscriptaccess\" value=\"always\"><\/param><embed src=\"http:\/\/www.youtube.com\/v\/52P5QDlgF0g&#038;hl=en_US&#038;fs=1&#038;\" type=\"application\/x-shockwave-flash\" allowscriptaccess=\"always\" allowfullscreen=\"true\" width=\"425\" height=\"344\"><\/embed><\/object><\/p>\n<p>I don&#8217;t want to give too much info about the patient. He was young (30&#8217;s) with a GI issue and surgery that led to sepsis.<\/p>\n<p>He was obviously on the ventilator&#8230;with 100% FiO2. He also had the following drips: propofol, levophed, neosynephrine, xigris, D10, bicarb, potassium, protonix&#8230;I can&#8217;t even remember what else! For lines, a swan, two central lines, and an A-line. Also, had a J-tube, G-tube, NGT, foley, Chest tube, JP drain, and blake&#8230;! In other words: sick.<\/p>\n<p>Let&#8217;s just say, it was A FREAKIN&#8217; pain in the ass to get him transferred, detangled, and assembled in the bed. Fortunately, the next shift had arrived, so the oncoming nurse (who happened to be my night shift preceptor) helped to set him up.<\/p>\n<p>For this bed, all the lines need to be straightened  (ha!) and placed in this wheel-device that turns with the patient and prevents everything from being pulled. All of that goes at the top of the head, while the foley, chest tube, and dignacare (or any fecal-management device) goes through the hole by the feet.<\/p>\n<p>It took us about an hour and a half to get him mostly set-up. I left work at 6:45 (shift ends at 6), but I wanted to stay since we hadn&#8217;t gotten to the point of proning him yet. The bed representative and I strapped him in. The freaky-ish part is this handle that you have to crank, which moves all of the cushions in towards the patient, squeezing them super tight. You need to turn the handle until you cannot anymore. It feels like you&#8217;re going to just squish the patient to death!<\/p>\n<p>When I left work, my legs hurt worse than they had in all of my life! I actually took an excedrin for them when I came home, and I never take medicine!<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/nursinglink.monster.com\/nfs\/nursinglink\/attachment_images\/0012\/3724\/tired_nurse_crop380w.jpg\"><\/p>\n<p>\nHowever, I can say that I did have a good day. Sure, I was nervous, but I learned something new. I feel like I need to be more confident and that is what I am going to work on. I need to prove to my manager and everyone else that I will survive on day&#8217;s and everything will be ok! I think that majority of nurses trust me and think I am competent, but I just need the experience. For the most part, I want my manager to be comfortable with her decision to let me move to day&#8217;s.<\/p>\n<p><b>Click  <a href=\"http:\/\/gingeristhenewpink.blogspot.com\/2010\/01\/ice-cream-you-scream-giveaway.html\">here <\/a> and enter to win an ice cream maker!<\/b><\/p>\n<div class=\"blogger-post-footer\"><img width='1' height='1' src='https:\/\/blogger.googleusercontent.com\/tracker\/28943539-8865070833808341056?l=www.raspberrystethoscope.com' alt='' \/><\/div>\n<p><a href=\"http:\/\/feedads.g.doubleclick.net\/~a\/07bhepWkME8BNGtp-M39WOPH6Ic\/0\/da\"><img decoding=\"async\" src=\"http:\/\/feedads.g.doubleclick.net\/~a\/07bhepWkME8BNGtp-M39WOPH6Ic\/0\/di\" border=\"0\" ismap=\"true\"><\/img><\/a><br \/>\n<a href=\"http:\/\/feedads.g.doubleclick.net\/~a\/07bhepWkME8BNGtp-M39WOPH6Ic\/1\/da\"><img decoding=\"async\" src=\"http:\/\/feedads.g.doubleclick.net\/~a\/07bhepWkME8BNGtp-M39WOPH6Ic\/1\/di\" border=\"0\" ismap=\"true\"><\/img><\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/feeds.feedburner.com\/~r\/RaspberryStethoscope\/~4\/oSoDf8Bpi3g\" height=\"1\" width=\"1\"\/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>So much for a nice, calm first time on day shift for me! But first, I need to say that just my three days off to turn my body back onto a day schedule were amazing. I immediately felt like myself again. It was as if a light has been turned off and now it [&hellip;]<\/p>\n","protected":false},"author":1890,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-205448","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/205448","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/1890"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=205448"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/205448\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=205448"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=205448"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=205448"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}