Quote of the morning

So, around 5am, I had a three-fer come in with vomiting. The 9 y/o didn't look well at all - had been vomiting since 2100. The 7 y/o vomited in the parking garage and mainly just appeared tired. After all, it was 5am. The 5 y/o was fine - she hadn't started yet. Mom wanted her evaluated simply because her siblings were ill. One of our MDs goes to assess the patients.

And the youngest one said, "We had chicken for dinner, and we ate too much!"

I'm sure it didn't have everything to do with it, but it's definitely a possibility.

A FOUR-fer

Who in their right mind brings all four of their children to be seen for fever and vomiting? None other than a parent tonight. All of them had the same symptoms - hence they are passing it to each other! Gees! Just had to get that out there! Needless to say, I'm in triage tonight. Woohoo! I have to say it hasn't been bad - just steady. Oh, I hear the machine - stamping up another card - meaning someone just checked in! It's a fever! Tylenol &/or motrin people!

2 hours, 80 miles later...

As most of you know, I work in Nashville, which is 40 miles one way for me. Today, I had to present a lecture on Burns for the new nurses in our department. I also have to go back to work tonight. So that'll be 4 hours spent driving, 180 miles later - in less than 24 hours! On my way home, I decided I need a chauffeur! :) Not likely, but the thought was nice. It's off to attempt an afternoon nap - before slaving away for 12 hours - listening to crying, screaming children. The story of my life - driving and work!

Exposed again!

Just checked my work email, and there was an email from Occupational Health. Guess what? Another Pertussis exposure! I really think the VPES(Vanderbilt Pertussis Exposure Study) is hand picking their subjects! Maybe if these children would get their vaccinations, we might not see it so much! Just a thought. What do you think? :)

I'll probably be given another dose (or two) of azithromycin. Antibiotics! Gotta love them. I feel like I've been on them for the last year, due to the sinus issues! So one day, when I really have an infection, nothing is going to treat it, because my body is so resistant!

I'm not bitter...really.

UPDATE: JUST TALKED TO THE OCCUPATIONAL HEALTH NURSE, AND I HONESTLY DON'T RECALL THE PATIENT. SO, IF I DEVELOP SYMPTOMS, TO NOTIFY THEM! THANK GOODNESS.

Meningitis, Pertussis & Influenza

How many people do you know that have been potentially exposed to Meningitis, Pertussis, & Influenza within an 18 hour period? (The only one, other than co-workers, I know would be Dr. Ward).

1. Sad story. @ 0426, we got a call from NFD saying they had a CPR in progress. We got our team together and waited. I was the primary/scribe nurse, documenting the case. I was approximately 5 feet away from the patient at any given moment. Unfortunately, the child didn't make it. What a way to end your shift?! I got home, went to bed. Received a call from Occupational Health informing me that I was potentially exposed to meningitis and I needed to come by. The next morning, I did go to Occupational Health, for them to tell me that I didn't needed to take the Cipro, because I was a good distance away from the patient.

2. I can't recall how old the child was, but he was less than 6 months old. I'm thinking around 3 months or so. Anyway, I got report on the child that he has been having a cough for about 2 weeks and having choking spells. (I wasn't informed that he was a rule out PERTUSSIS)! So, I got in to assess the patient and do my thing. Come out, and Mark, the attending, tells me that he's a rule out pertussis. Great, my night is getting better! (I mean, all I wanted was to be in triage, that's it. Hardly anyone wants to be in triage, and I even offered. Mark said that Veronica and I couldn't be triage. My thoughts were, so when did Mark--one of our attendings--get to decided nursing assignments? Oh well). Now, I start wearing my mask when entering the room. Trisha, one of the nurses, is married to a physician who's involved in the Pertussis study at VCH. And she calls to tell on me! Haha!

3. Another patient of mine had the flu! Didn't hear this till after I'd had been all in the room, with the patient, too!

Having all said this, I was called today to inform me that patient #2 results came back positive for pertussis. Now, I have to drive to Vanderbilt in the morning and meet with the lady at 8am. She will draw my blood and take a nasal swab to test me!

Then I go back to work that night at 7pm...but at least it's only til 3am! :)

Typical Tuesday night...

• 20 patients in the waiting room, not triage. I won't even tell you how long some had been waiting.
• 2 helicopters trying to land at VCH when we only have ONE helipad.
• 3 children from the same MVC with hippie names.
• Shovelling two slices of pizza in your mouth, because you won't get to eat any other time during your shift.
• PCPs sending stupid stuff to us.
• Back to back EMSs from outside hospitals.
• 3 admissions histories, assessments.
• Cohorting siblings in C1(2 of the 3 children from the MVC).
• 25 admissions in the ED waiting for beds.
• Plus, it was my Dad's birthday!

Thank goodness I'm not working tonight! :) However, I did pick up extra on Friday.

The day before the knife...

Let me start off by saying, the next time I say that I can do four nights in a row (especially leading up to surgery, which I hope not to have again, at least sinus surgery), please convince me otherwise!

Had a good Saturday and Sunday at work. We actually had beds to place our admitted patients. I didn't sleep much on Monday, because the furniture store came to the house at 3pm to deliver my new TV stand! It's so pretty...I love it! (Going to buy a TV today)!

Go to work Monday night, tired...it was a good night. A little busy, steady at first. Nothing exciting happened. However, I seem like intubating (placing a tube into your lungs) little babies that don't want to breathe. I mean, come on...why don't you want to breathe?! Hehe. I say this because I've had three to do this recently (10 day old, 19 day old, 57 day old). And of course, this happens at shift change. Being the good nurse I am, I stayed throughout the procedure and waited for our critical care consult. The coolest thing of all, I stuck my first scalp vein! Meaning, I placed an IV my baby's scalp! I know you're thinking, "Oh my, that's horrible!" I enjoyed the pleasure of knowing I got it! :)

I slept really well yesterday (Tuesday). I was able to leave this morning (Wednesday) at 3am. I've slept from 5a-8a. And for some stupid reason, I'm awake...typing this blog! Haha.

Tomorrow is my surgery. Scheduled for 0730. Mean, I have to leave the house around 5:15am, to be there by 6am. Depending on how good or bad I look post-op is whether or not I'll post pictures! Hehe.

Thanks for reading...have a great day! :)

After working four nights...the braces came off.

So, it was my weekend on @ work. Friday was pretty eventful. Saturday was a good night. Sunday started off slow, then we had two level one traumas come in. Very sad story. Monday. It was a typical Monday. Extremely busy. I was hoping to get to leave early, however, that didn't happen.

Yesterday, I had my appointment at the orthodontist to have my braces removed! Woohoo! I struggled to make it home. I so should have stopped at Starbucks on the way home, but you know, I thought I could do it! I ate breakfast at Stones River Grill. I got some chocolate chip pancakes! Yum! To stay awake, I stopped by to see my Mom at work. Saw some of the ladies there that I hadn't seen in quite sometime.

I arrived at the orthodontist a few minutes early. Took me back and seated me. I nearly fell asleep, waiting! Now, I don't recall how intense removing my braces were ten years ago, but I thought they were going to rip my teeth out. I kept thinking, 'this isn't going to be good.' However, they were able to remove the brackets and glue. Now, I have a (semi) permanent retainer on my top teeth! Yay! Now, I'm enjoying rubbing my tongue across my smooth teeth!

I made it home. I had every intention to have dinner with some friends, but with lack of sleep over the weekend and how long I had stayed up, it just didn't happened. Obviously, I needed the sleep, because I slept from 11:15am till 10pm(with a 30 minute period of being awake).

I must say I feel better after having slept! :)

What the heck is wrong with people?

There are days, nights where I don't quite understand the thought processes of people. I mean, you bring your child to the Emergency Department to be taken care of, but you think we as health care providers(and I'm speaking for nurses here) are simply there to torture your child. I know I say that that is what I do for a living, but honestly, I think it takes special individuals to take care of screaming, crying, kicking children.

Last night, we were attempting to place an IV for antibiotic therapy. The parents were already telling us that they wanted someone good to start their child's IV. There were three of us nurses in the room. All of which totalled to about 30 years of experience (& they both work with Peds IV therapy). I attempted, I got a blood return, and when I went to flush the IV, the vein blew. At that point, the parents were telling us that they wanted someone who could get it on the first try. Well, I must say, when you're trying to hit a moving target, it's a little hard. So, one of the others tried, and the exact same thing happened, which isn't uncommon in children. Well, that was it, we were verbally abused by the parents, and the three of us walked out of the room. We let the charge nurse handle the situation, and none of us walked back into that room again. We notified VUPD, and they spoke with the father. Of course, he denied everything.

Regardless of the matter, there are just times where you can't make people happy, and tonight was one of them.

"Do you have real coffee here?"

As many of you know, I work in the Pediatric Emergency Department. Over the last several years, the 'purpose' of the ED has changed. Now, emergencies are fevers (which some are), ear aches, etc. We tend to replace what we call our primary care physicians. However, we do see many sick children.

Last night was a record breaking night. We got up to 216%. Meaning, we were well over our serving capacity. When I left this morning, we had 21 admitted patients sitting in the ED. Crazy!

To top it off, as I was wrapping up report, I had a family member approach me, "Do you have real coffee here?" (We have a nourishment room with water, coffee, tea, cereal, crackers, etc). I informed him where he could get himself some coffee. You would think I would be use to this by now, but honestly, I'm not. Our name should be the Hilton, instead of the Pediatric Emergency Department!