Sunday, September 12, 2004
Gah, teach me how not to touch, pulled one of K's keys up the other night and now she reckons it is sitting up a funny way. So I had to fix it. Wont be touching that again anytime soon will i? I knew it was the wrong thing to do as soon as I saw the look on her face, but I had done it by then! Honestly, I don't care how my keys sit exactly as long as they work, but she is so bloody thingy about her computer that I shoulda guessed it would cause an issue.
This week has been interesting so far, was in charge one of my nights and it was nice, we had 6 RN's and nothing major happening, so it was great. Wasn't in charge last night so only had my 9 patients to deal with, my biggest issue was doctors. The registrar caem up to review one of our new patients, her potassium was low, so he decided just before he went that he would write up an IV bag of normal saline with 60mmol of potassium in it, well.. policy in our hospital is that we cannot add more than 40mmols into our bags of IV fluids if it is going through a peripheral cannula, that is the normal every day iv, and even then, if it is anything other than premade IV fluids (we have bags with 30mmol of potassium) then a doctor has to load the bag. So I called him back and he had a go at me... "well I wanted 60mmols of potassium cause she has a cardiac history and I don't want to overload her system" my answer, "Well the policy is...40mmols only via peripheral cannula" his answer, "Can we put it in a smaller amount of fluid? Its stupid that we can't treat the patients as we need it." me.."No, we can't put it in a smaller bag, only 40mmol in 1 litre of fluid. If you want us to send her to cardiac ward to have more and be monitored fine, but I can't do it." He says, "Get the evening RMO to come up and chart 3 bags with 40mmol of potassium and load them for you". So I do that, the evening RMO and I talk it over, and she charts the premixed bags of potassium and normal saline, and we all go about business as usual... Tada! lol .. she didn't want to mix up the bags, I didn't argue. She also had a Nasogastric tube on 2 hourly aspirations which was draining pretty much liquid poop that was building up from her tummy, and she was hourly urine measures, so we ended up increasing her fluid through the iv anyways cause her urine output was low.
Then I had a confused guy who had his IV in his elbow, so the pump kept beeping at him every time he bent his arm, and every time he made it beep he would buzz, by the end of the night I felt like stapling his arm to the bed so that we would have some peace and quiet for the night, I couldn't get a new IV put in cause his veins were so bad and he was bruised all over his arms. I asked him again and again to keep his arm straight... dint happen.. GAH!
Anyways, I am gonna go I think, will update you after my shift tonight maybe, looks to be a crappy one.
Laters!
This week has been interesting so far, was in charge one of my nights and it was nice, we had 6 RN's and nothing major happening, so it was great. Wasn't in charge last night so only had my 9 patients to deal with, my biggest issue was doctors. The registrar caem up to review one of our new patients, her potassium was low, so he decided just before he went that he would write up an IV bag of normal saline with 60mmol of potassium in it, well.. policy in our hospital is that we cannot add more than 40mmols into our bags of IV fluids if it is going through a peripheral cannula, that is the normal every day iv, and even then, if it is anything other than premade IV fluids (we have bags with 30mmol of potassium) then a doctor has to load the bag. So I called him back and he had a go at me... "well I wanted 60mmols of potassium cause she has a cardiac history and I don't want to overload her system" my answer, "Well the policy is...40mmols only via peripheral cannula" his answer, "Can we put it in a smaller amount of fluid? Its stupid that we can't treat the patients as we need it." me.."No, we can't put it in a smaller bag, only 40mmol in 1 litre of fluid. If you want us to send her to cardiac ward to have more and be monitored fine, but I can't do it." He says, "Get the evening RMO to come up and chart 3 bags with 40mmol of potassium and load them for you". So I do that, the evening RMO and I talk it over, and she charts the premixed bags of potassium and normal saline, and we all go about business as usual... Tada! lol .. she didn't want to mix up the bags, I didn't argue. She also had a Nasogastric tube on 2 hourly aspirations which was draining pretty much liquid poop that was building up from her tummy, and she was hourly urine measures, so we ended up increasing her fluid through the iv anyways cause her urine output was low.
Then I had a confused guy who had his IV in his elbow, so the pump kept beeping at him every time he bent his arm, and every time he made it beep he would buzz, by the end of the night I felt like stapling his arm to the bed so that we would have some peace and quiet for the night, I couldn't get a new IV put in cause his veins were so bad and he was bruised all over his arms. I asked him again and again to keep his arm straight... dint happen.. GAH!
Anyways, I am gonna go I think, will update you after my shift tonight maybe, looks to be a crappy one.
Laters!
8:14 PM
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Writing since January 2003!
web-counter? Maybe one day
BJ T now was S
Born in April on the 21st!
Australian but living in the USA.
Allison
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