travel post:
Sleepless in Seattle.

Our flight landed in Seattle and we headed off to find the Smarte Carte Luggage Storage (where Kens Baggage was formally located). I had made notes that it was on the baggage claim floor and located somewhere in the center of all the carousels.

After speed walking through the right side of baggage claim, we did not find it, so my mind raced towards figuring out how to rent a car so we could store our duffel bags in the trunk of a rental.. then we traced backwards along the opposite wall and found Smarte Carte between carousels 9 and 10, alongside the wall that leads outside.

Definitely a good deal for all day storage, you can find my yelp review here: Smart Carte SEA-TAC. Continue reading “2018.01.04 – Seattle, WA”

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nurse post

I survived! Made it through three straight night shifts, but I will admit that night two felt long and night three felt even looonger. But I will blame that on the fact that night three gave us the lull of only 3 patients from 0200-0445.
Continue reading “2018.01.03”

nurse post

Late afternoon, she wakes up! *Honk Honk Honk* from her phone..

I woke up to my alarm and hit snooze for about a total of an hour, but I also put my alarm an hour early. Maybe 1.5mg Melatonin was a bit too much, I’ll be trying 0.75mg tonight to see if I can fall asleep AND bounce up with time to spare.

Continue reading “2018.01.02”

nurse post

I started my year sleeping in until 1600 (or 4:00pm). Why? because I had my first night shift on my own, I ended 2017 with my last orientation night on 12/28/17 and three days to celebrate the new year.

Well rested and prepared, I came into huddle to find that we are short staffed with 40+ waiting in the lobby and a full Emergency Department. Yes, my luck would entail such a first solo shift entrance! Continue reading “2018.01.01”

RN 03of56 : Acid Base Disorders.

Acid Base Disorders.
aka one of my weaknesses.

Today my preceptor and I got assigned to rooms 1a/b, 3 and 5.. and our wonderful combination included:  ICU admit for Acid Base Disorders, M/S admit for abd pain, Psych on restraints and one up for D/C.

We looked at each other with a “bring it on” vibe.

To our luck: 1b got admitted shortly after shift report and 5 was d/c’d before we even got to bedside report.  This left us with 1a and 3, and to be honest, we didn’t get to 3.. the pt got reassigned because 1a became our pt for 8 of the 12 hours, and we did a lot of trying to stabilize.

I realized today that I am truly lacking in my Acid Base Disorders chapter.
NTS: study this. asap.

Our tx today included a lot of Sodium Bicarb, liters of NS, Kayexalate, Calcium Gluconate, Dextrose.. Levaphed.. along with Vanco, Zosyn and one other abx that slips my mind at the moment.  Oh!  Levaquin.  There was a bipap machine, coude cath turned foley, a PICC line insertion and a Quentin cath insertion.

I. was. overwhelmed.

The BPs were fluctuating from systolics of 50s to 110s, with diastolics of 15s to 60s.  I could not wrap my mind around how low the bps were, and was nervous to even titrate the Levaphed to maintain a MAP of 65.. raising it by 2mcg/min from the initial 0.01-3 mcg/kg/min.

Where was ICU?  Why didn’t they have a room ready yet?

But we managed.. and eventually I got to start up on a few patients of my own from triage to discharge for the day.  But it definitely got me realizing that I still have so much to learn!

 

we had a young adult whom had a seizure after three beers.  a polysubstance abuse dx who originally came in for cold/flu-like sx.  an incomplete miscarriage needing blood transfusions.  and ended the day with a lower abd burning pain radiating to the mid-sternal chest pain with a prior visit dx of gall stones.

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