Positives! Tell us one good experience lately!

  1. Guess I am feeling good about my shift ( was called in early and did a 12 hr). I thought it would be nice to hear of some feel good experiences from everyone again. We sure need them now and then.
    I had a line pull to do on a PTCA/ with stents. I knew he had a problem with vasal vagaling. Did a lot of teaching so maybe he would relax about the line pull and feel more comfortable. His HR was in the 40-50 range so gave him Atropine .5mg x2 and got the heart rate up to the 70s, BP low 100s. Took the Tegaderm off and just started to put a little pressure on the clamp and he GOT THAT FEELING!! Dang, if he didn't drop his pressure in the 6os, fluids running in ahead of time too, and turned Nitro off, Integrillin on. Heck my hands were busy with holding the sheath and had to call for help. We worked as a great team, 3-4 other nurses came quickly when I called for help- meanwhile BP still dropping and I kept him talking to me. 2nd IV line in and more fluids, with my coworkers help, Dopamine on, cuz by now he has pressures in the 52/14, still with it and talking. Cardiologist called stat. He said guess you have it all under control and surprised we didn't call before. Oh, he got another 1 mg Atropine too during all of this. The MD just kept talking to my pt to distract him and after we got his pressures in the 70s/30s, told me to go ahead and pull the line. Geez, I was more nervous pulling the line with the Cardiologist (only my 4-5th line pull) there, and with the patient in Trendelenbury, than when he was dropping his pressure. It went fine, no hematoma, no other problems. Poor guy was so embarassed that he does that and kept apologizing. I also had a 97 year old lady that was infarcting and having problems with Pulm edema. They knew they couldn't give anymore patients at that point.
    Just had to tell someone, sure felt good about the results!!!!
  2. 1 Comments

  3. by   hoolahan
    Can't resist, Cafe...Ole!!! Well done! It's nice when we can have one of those days where we can feel we actually had the time to help someone, and the staff to do it. You sound lucky to have a good team of people to work with too.

    I used to do all that ICU/CCU stuff, but here is my warm fuzzy for the week. I was admitting an 80 yr-old man to home care. He was S/P old CVA and has to walk very slowly with a evry weak L leg, uses a walker, has an SP tube. He is extremely intelligent, lives in a nice home, and it is so sweet to see how much he and his wife care for one another. He was cursing about a few things, his experiences in the hospital, how he was so constipated and tried to tell his nurses that he needed a laxative, but, according to him, his "nurse" didn't even speak english. But, to be honest he says, he couldn't tell who was a nurse and who was housekeeping, and he swears that someone who was mopping the floor earlier in the day drew his labs (at least he didn't have an arms full of bruises, so whoever did it, hit the vein!) As a result of the constipation, he strained so hard (now this guy was post acute MI/VT for the admission, why no colace was ordered is beyond me), and burst a hemmorhoid, he's on both coumadin and plavix for several years, so you can guess the results.

    So, he was telling me he used to be nice when the hospital made the phone calls after D/C, but he has decided since he turned 80, he's not going to be Mr. Nice guy anymore, and he's going to give them a peice of his mind. While explaining this he used the word ba$tards and a-holes a few times. I tried not to laugh, it was funny the way he did it. I did steal a glance at his wife at one point, she was so cute, she says, We're going to have to wash his mouth out with soap! And we all laughed then.

    Later in the visit, he showed me a computer generated log of all his BP readings, he has a machine, and all his glucometer readings, he actually keeps a chart, then at the end of each week, and then each month, he types it up, then averages all the numbers, but he wasn't sure how to avg the BP, so I said he should avg the top, then avg the bottom, he was happy, that's what he thought, etc...

    We got into a conversation about computers, and I was surprised that he himself was the one creating these charts on the computer, and he was so excited to have someone to "talk computer" with him, he kept asking me to write things down, I was telling him the purpose of the R mouse button, he was amazed. (Made me think I could start a business of beginning computer use to the homebound!But, the joy it brought him made me think, how could I charge anyone for this??) Anyway, he was so happy, I was in that place for 2 hours! His wife warned me, now he'll go in that room, and I won't see hime for hours! He said, yes she reminds me to get up every hour or so to walk so I keep my circulation going!

    It was such a great visit, made me forget all about the plastic surgeon a-hole I had to deal with in the later part of the day.

    I love home health. (It only took me 2 more hours to complete all the paperwork.)