Got the call at 5:45, I was just about to pack my lunch box and my phone rang. It was Staffing letting me know that my services would not be required tonight. I couldn't be happier!
Last two nights were complete chaos which included a mysteriously bleeding patient and a self extubation. I have never been called off since I started working so I knew it was time and I am so glad that it happened tonight. Got a lot of things to do, tomorrow is the Mr's birthday!
Thursday, March 29, 2012
Tuesday, March 27, 2012
Garden Time
I had rather hoped to be called off on Saturday, no such luck there. While the ICU has had a low census the rest of the hospital is doing just fine, meaning they floated the extras upstairs. I got to stay on the unit and was given a new admit who had come just before shift change.
She had presented with flank pain and was a totally sweet little firecracker of a lady, who was more than happy to chat with all the nurses and her family were just dolls. I thought maybe, just maybe, I'd have a quiet night, no such luck. My little firecracker went into some funky cardiac rhythms and her blood pressure began to sink. Lucky for all of us our favorite Doc was on that night and came right down. My little fire cracker ended up having septic shock and landed herself on a couple of drips with a central line. So much for a quiet night.
After I said my good byes and the family sweetly thanked me for my help through the night I decided it was time to do something about MY blood pressure. So over the last couple of days Mr. has been driving me around to nursery's and hauling dirt around for me.
She had presented with flank pain and was a totally sweet little firecracker of a lady, who was more than happy to chat with all the nurses and her family were just dolls. I thought maybe, just maybe, I'd have a quiet night, no such luck. My little firecracker went into some funky cardiac rhythms and her blood pressure began to sink. Lucky for all of us our favorite Doc was on that night and came right down. My little fire cracker ended up having septic shock and landed herself on a couple of drips with a central line. So much for a quiet night.
After I said my good byes and the family sweetly thanked me for my help through the night I decided it was time to do something about MY blood pressure. So over the last couple of days Mr. has been driving me around to nursery's and hauling dirt around for me.
It might not look like much but this is what I have nicknamed my Zen Garden. Mr. dug this out for me, laid down the stones and added a couple bags of dirt so that I could have a semi raised garden last year. Unfortunately we made some big errors in the crops we planted. This year I did a little more research and settled on some more shade friendly plants.
So far I have lettuce which was transplanted from a neighbors garden, beans, peas, spinach and mesculan mix planted. All apparently need less than 5 hours sunlight, which is great because this plot is a touch shady.
My mesculan mix is already coming in nicely
And the peas are working their way up too!
I think the birds ate all my spinach seeds though, so I re-sowed those and am waiting for my beans to make an appearance. I also learned that if you just plant the little white ends of your green onions, you get more green onions! Who knew?
I also decided that I would like the humming birds in the area to hang out more in my backyard. But in order for that to happen some flowers might be necessary.
I potted up a bunch of flowers and settled them into a big bare patch that I haven't been able to get anything to grow in. Nice upside is that it hides all that bare dirt now!
Just for a little fun I added this sign.
Does this constitute talking to your plants?
Monday, March 26, 2012
Garnier B.B. Cream Free Sample Alert
Saturday, March 24, 2012
Floating
Last night I was floated up to Tele with two other ICU nurses, which was OK. I'd rather be working than called off due to census. The ICU only had 5 patients that night and Tele had apparently been slammed the night and day before.
What was NOT OK was when we got there the charge had our assignments ready for us and only the ICU nurses were slated with admissions. The usual deal is that when we float we take only four patients (the sickest) and no admits, when Tele nurses float to the ICU they get the easiest patients, no vents, no drips. So when I pointed this out to the charge she told me that was the way things were going. I then had to point out to her that two of her three floaters (myself and another gal) are fresh off orientation and have NEVER been on the floor. Giving us the first two admits would be a really bad idea unless she wanted to pick up the slack and take care of our other patients while we did the admit, since we could barely find their rooms let alone their meds.
Needless to say asserting myself did not make me overly popular with her, but being used to doing everything myself made me very popular with the aides. I did my own blood sugars and took care of changing beds. I think they were in love with me.
I know floor nurses are forever bashing ICU nurses and telling us we can't handle the work of floor nursing. Honestly, aside from the little snit with the charge it was a very pleasant, easy night. No drips to monitor, charting is way lighter and most of patients just wanted to be left alone and sleep, hey cool with me! About the most work I did was save an IV in one patient and drop one in another and neither of them tried to kick or hit me! In fact both of them thanked me!
I will say it was nice to actually have patients who were awake and chatting for a night.
What was NOT OK was when we got there the charge had our assignments ready for us and only the ICU nurses were slated with admissions. The usual deal is that when we float we take only four patients (the sickest) and no admits, when Tele nurses float to the ICU they get the easiest patients, no vents, no drips. So when I pointed this out to the charge she told me that was the way things were going. I then had to point out to her that two of her three floaters (myself and another gal) are fresh off orientation and have NEVER been on the floor. Giving us the first two admits would be a really bad idea unless she wanted to pick up the slack and take care of our other patients while we did the admit, since we could barely find their rooms let alone their meds.
Needless to say asserting myself did not make me overly popular with her, but being used to doing everything myself made me very popular with the aides. I did my own blood sugars and took care of changing beds. I think they were in love with me.
I know floor nurses are forever bashing ICU nurses and telling us we can't handle the work of floor nursing. Honestly, aside from the little snit with the charge it was a very pleasant, easy night. No drips to monitor, charting is way lighter and most of patients just wanted to be left alone and sleep, hey cool with me! About the most work I did was save an IV in one patient and drop one in another and neither of them tried to kick or hit me! In fact both of them thanked me!
I will say it was nice to actually have patients who were awake and chatting for a night.
Friday, March 23, 2012
Trial By Fire
Last night was my first night of orientation, meaning my patients all mine. I wound up with a fellow who came in a few days ago a very sick man and ended up vented and a lady who has been with us for a couple weeks now and was really looking more and more like a Hospice candidate if it wasn't for the family wanting everything but compression's done.
The fellow began my night with a sudden high fever that required a call out to the Doc on call who laughed at the charming notion that a nurse was calling him for a Tylenol order. After he rounded and teased the newbie things seemed to settle into a decent flow of the night.
Until my lady went down hill and fast. One minute I'm on the phone with the lab and the next I'm trying to get the code cart open for Epi. I would love to say that we heroically saved her, but not so. Part way through the code the family got the idea that the meds we were pushing were not going to save her and requested us to stop. The thanked us for all our efforts and let her go.
I somehow was left at the end of the night feeling like I had not been on my A game and if I had the night would have ended differently. I'm not sure what I have could have done, even the Doc had spoken to the family and let them know that it was best not to continue with life support. I just guess I have that feeling like that should not have happened on MY shift.
The fellow began my night with a sudden high fever that required a call out to the Doc on call who laughed at the charming notion that a nurse was calling him for a Tylenol order. After he rounded and teased the newbie things seemed to settle into a decent flow of the night.
Until my lady went down hill and fast. One minute I'm on the phone with the lab and the next I'm trying to get the code cart open for Epi. I would love to say that we heroically saved her, but not so. Part way through the code the family got the idea that the meds we were pushing were not going to save her and requested us to stop. The thanked us for all our efforts and let her go.
I somehow was left at the end of the night feeling like I had not been on my A game and if I had the night would have ended differently. I'm not sure what I have could have done, even the Doc had spoken to the family and let them know that it was best not to continue with life support. I just guess I have that feeling like that should not have happened on MY shift.
Monday, March 19, 2012
Sunday, March 18, 2012
BzzAgent Review of Garnier B.B. Cream: Nurse Approved!
A little while ago I told you about Garnier's Miracle Skin Perfector BB Cream that BzzAgent sent me to test and review. Now that I've had a week or so to play with and use it under different circumstances I can share with you my initial feelings.
Pros
Pros
- All in one product saves time and skips needing to put on multiple products
- Lightweight product
- Sheer coverage evens skin tone
- Works with my Asian skin tone
- Only two shades Light/Medium and Medium/Deep nothing for Fair skinned complexion
- Sheer coverage doesn't completely cover all spots and blemishes
- Only SPF 15, could use a higher level of coverage
- Contains glycerin
This products brags to contain Vitamin C as an antioxidant to help with overall radiance and Hyaluronic Acid along with glycerin to help maintain moisture. Further reading the box ingredients I noticed Caffeine was also listed as an ingredient. BB Cream also uses 4% Octinoxate for suncreen.
Out of the tube this cream has a consistency that reminds me of toothpaste, very thick and holds it's shape when squeezed out.
When first applied to my face I noticed that the cream had a very "wet" feel to it, but as I smoothed it around I began to notice it worked into the skin much like moisturizer. After a few minutes my skin no longer felt "wet" but velvety and well moisturized.
I noticed that the B.B. Cream gives very sheer coverage, meaning you can see some of my acne scars and blemishes but they are less visible. This also blends my discolorations and makes my skin tone more even and consistent. I was also pleasantly surprised to find that it has a very beige base tone, and seems to do quite well for my Asian skin tone, though this may be a problem for those with pink based skin tones.
Now here are a couple of Before and After shots:
As you can see I have some dark spots on my cheek that give it a blotchy look and my skin tone is far from even. After putting on the B.B. Cream the spots seem less noticeable and more blended and I think my skin tone looks way more even and less blotchy.
Again I think the pictures speak for themselves, I feel like my skin looks fresher and more even in the after picture without that cakey look that foundations can give you. Also you don't get those hideous foundation lines at your hairline.
The Verdict:
So far I am pretty impressed with Garnier's B.B. Cream. It goes on very easily, I just smooth it into the skin in an upward motion (towards the hairline, this was suggested by an Asian makeup site) with my fingers, no need for a sponge or special brushes. I love the fact that once it's on you barely notice you're wearing any makeup, it's lighter than a number of moisturizers with SPF that I have used.
Yes there are a few things that I would wish for. I wish it had a better SPF than just 15, a number of designer brand B.B Creams offer SPF's of 45. And I do wish that this came in a greater range of shades, I think the Light/Medium that I chose may be just a shade light but am concerned that the Medium/Deep might be too dark and leave me looking like Snookie. Also some people may not be thrilled about the glycerin in the product as it has been known to aggravate sensitive skin. Personally I'm O.K. with the sheer coverage as I like to look as natural as possible, but I'm sure that some people will grumble. To those folks I will say, go find a foundation.
With a MSP of $12.99 for a 75 mL tube, this is a great value. I use about a nickle sized dollop to cover my face and neck each day AND the product held up great over a 12 hour shift, without smudging or wearing off in strange places. Add that to the fact that it now takes me 15 minutes to moisturize and put on a "foundation" layer before heading out the door and you have me sold.
I have heard that over time wearing this product can result in better skin tone and lightening of discoloration, which is supposed to be a perk of B.B. Creams found in Asia. I will continue with the product for the rest of the Bzz Campaign (37 days) and weigh in on those benefits later. For the time being I'm sticking to my one tube beauty secret!
Legal stuff: I was provided with this product compliments of BzzAgent for testing and review purposes. The opinions contained in this blog about said product are solely mine
The Verdict:
So far I am pretty impressed with Garnier's B.B. Cream. It goes on very easily, I just smooth it into the skin in an upward motion (towards the hairline, this was suggested by an Asian makeup site) with my fingers, no need for a sponge or special brushes. I love the fact that once it's on you barely notice you're wearing any makeup, it's lighter than a number of moisturizers with SPF that I have used.
Yes there are a few things that I would wish for. I wish it had a better SPF than just 15, a number of designer brand B.B Creams offer SPF's of 45. And I do wish that this came in a greater range of shades, I think the Light/Medium that I chose may be just a shade light but am concerned that the Medium/Deep might be too dark and leave me looking like Snookie. Also some people may not be thrilled about the glycerin in the product as it has been known to aggravate sensitive skin. Personally I'm O.K. with the sheer coverage as I like to look as natural as possible, but I'm sure that some people will grumble. To those folks I will say, go find a foundation.
With a MSP of $12.99 for a 75 mL tube, this is a great value. I use about a nickle sized dollop to cover my face and neck each day AND the product held up great over a 12 hour shift, without smudging or wearing off in strange places. Add that to the fact that it now takes me 15 minutes to moisturize and put on a "foundation" layer before heading out the door and you have me sold.
I have heard that over time wearing this product can result in better skin tone and lightening of discoloration, which is supposed to be a perk of B.B. Creams found in Asia. I will continue with the product for the rest of the Bzz Campaign (37 days) and weigh in on those benefits later. For the time being I'm sticking to my one tube beauty secret!
Legal stuff: I was provided with this product compliments of BzzAgent for testing and review purposes. The opinions contained in this blog about said product are solely mine
Garnier B.B. Cream Coupon
Did I pique your interest with that Garnier BB Cream?
If I did and you are thinking you want to try it
grab this coupon for $1.00 off.
I'm still loving it. I wore it three nights in a row to work.
Each night I still had great looking skin, even better it seems to be
controlling my skins oil production because I haven't been shiny like I
normally am by the end of shift.
I'll have some comparison pictures up soon!
Friday, March 16, 2012
Time Flies...
Wow time flies, I just completed my very last day of orientation. Next week I will officially be an ICU Nurse, geeze what a weird feeling. It feels like I just stepped into nursing school and already I am stepping out on my own.
My patients, my decisions, my license. There are days when I sign the chart I stop a moment and stare at the "RN" behind my name and it feels so surreal.
My patients, my decisions, my license. There are days when I sign the chart I stop a moment and stare at the "RN" behind my name and it feels so surreal.
Sunday, March 11, 2012
Miracle Cream by Garnier Put to the Nurse Test
For any of you who didn't know, on top of trying to figure out this whole nursing thing I love to review products in what little spare time I have. I am a BzzAgent, which means I am offered products through a program called BzzAgent in return for my honest opinion and asked to spread the word to all my friends. Super easy, I think you all can tell I love to gab.
I was offered a chance to try a product called
This product promises to do it all, deal with dull, blotchy skin, even out skin tone, moisturize all while correcting your issues. It is an all in one skin care and beauty regiment, use the stuff in this one tube and look like you are glowing PLUS fix all those nasty issues.
The "BB" in the name means "Beauty Balm" and the concept comes from Asia where girls have been using these all in one formula for years to achieve that enviable porcelain complexion. If this is true why the heck have my relatives been holding out?! Of course I would jump at a chance to try something that would make my life easier. How many of us would love to show up to work with a perfect complexion and only having to had slapped one cream on? That equals to 20 minutes extra sleep!
So to really test these claims I'm going to do the unthinkable and post a before picture of myself with no makeup. Then we will have an after picture when I put the stuff on. A couple weeks later I'll post another picture to see if it really has cleared up some of my complexion issues. Sound fair?
Great, so here is my before photo which is totally untouched
So here is my skin breakdown; I have super oily T-Zone, dry cheeks and am hugely prone to blackheads on my forehead and chin. I have a number of acne scars because I can't help squeezing my spots (yep I'm gross) . I'm hoping this stuff will give me enough coverage so my dark spots don't show and that it won't turn my face into an oil slick like so many foundations and tinted moisturizes do. It would be even better if it actually matched my odd, tanned Asian skin tone and didn't leave me looking oddly colored.
Stay tuned folks!
Tuesday, March 6, 2012
Monday, March 5, 2012
A Perfect Ending to a Perfect Night
Last night was pure chaos in the ICU. I took the first admit from the ED while trying to balance a patient who was busy trying to hop out of bed restraints and all. So here is the initial report I got,
60 something male c/o SOB, Respiratory failure and now intubated and ventilated.
Ok no problem, I actually like working with vented patients, and no it's not because they are out cold, I've actually worked with them before as an LPN. So we get the respiratory room set up complete with a special bed that rocks and shakes them. Next thing I know I get the SBAR faxed over and it says: 60 something male, c/o SOB CHF exacerbation, 16L O2 non rebreather mask.
Hold up, what on earth made them think he was vented earlier? Ok, whatever I take report and tell them to bring him on over. Five minutes later the ED nurse arrives with a patient on a gurney and the following equipment: heart monitor, IV pole with a Nitro drip hanging and the fellow on a nasal cannula. Not to mention one measly 20 gauge in his arm.
Nurse Twit then gives me a quick bedside as we are transferring him into his new digs.
"Oh yeah BTW he still has that inch of nitro paste on his chest in addition to the drip because I couldn't find a doctor to give me an order to take it off"
Ok Brilliant, now the guy is getting a double dose of nitro, wonder what his blood pressure looks like.
"Um yeah and he was diagnosed with pneumonia in the ED but we didn't start any core measures. He's going to need two antibiotics and he's only got the one IV. So you'll need to start another one. Lucky for you he's got veins."
Great, how many hours has he been here and you couldn't draw the blood cultures or get a sputum? And that IV looks like a field stick so how the heck would you know what his veins look like since you obviously haven't examined them?
Nurse Twit heads back the the ED and I settle our guy in and tell him that I need to poke him again. He's pleasant as all heck about it and I don't tell him this is the first time I have ever stuk someone without a person hovering over me giving directions. Oh yeah his veins were crap, huge and easy to see but all gnarled. I found a decently straight one in his hand and dropped a 22 gauge in there like a pro. Thank god because my other guy was trying to crawl out of bed again.
I somehow manage to survive the night. I nearly kill my relief who takes 30 minutes to get report from the nurse with her other patient and then finally makes it to me. Great now Mr is late for work (yes we still don't have enough for another car so we carpool) and the director is giving me the evil eye because I'm overtime.
I bolt from that place screaming TGIF (my Friday at least) and hop in the car. Almost home free! Until we get to the intersection a block form home and wonder why no one is moving. I poke my head out the window and my heart just sinks.
From around the big truck blocking my view I see feet, on the concrete, in the middle of the intersection. I holler at the Mr to sit tight and jump out, to take a look. Yep hit and run in the middle of a busy intersection at rush hour, on a Monday with some dear strangers standing around him to keep the jerk drivers who are trying to cut around because they are too busy to care, from hitting him. Thankfully an EMT was on the scene and paramedics were screaming up as I got the the fellow.
I got back into the car and the Mr just looked at me and asked
"Is it a full moon?"
60 something male c/o SOB, Respiratory failure and now intubated and ventilated.
Ok no problem, I actually like working with vented patients, and no it's not because they are out cold, I've actually worked with them before as an LPN. So we get the respiratory room set up complete with a special bed that rocks and shakes them. Next thing I know I get the SBAR faxed over and it says: 60 something male, c/o SOB CHF exacerbation, 16L O2 non rebreather mask.
Hold up, what on earth made them think he was vented earlier? Ok, whatever I take report and tell them to bring him on over. Five minutes later the ED nurse arrives with a patient on a gurney and the following equipment: heart monitor, IV pole with a Nitro drip hanging and the fellow on a nasal cannula. Not to mention one measly 20 gauge in his arm.
Nurse Twit then gives me a quick bedside as we are transferring him into his new digs.
"Oh yeah BTW he still has that inch of nitro paste on his chest in addition to the drip because I couldn't find a doctor to give me an order to take it off"
Ok Brilliant, now the guy is getting a double dose of nitro, wonder what his blood pressure looks like.
"Um yeah and he was diagnosed with pneumonia in the ED but we didn't start any core measures. He's going to need two antibiotics and he's only got the one IV. So you'll need to start another one. Lucky for you he's got veins."
Great, how many hours has he been here and you couldn't draw the blood cultures or get a sputum? And that IV looks like a field stick so how the heck would you know what his veins look like since you obviously haven't examined them?
Nurse Twit heads back the the ED and I settle our guy in and tell him that I need to poke him again. He's pleasant as all heck about it and I don't tell him this is the first time I have ever stuk someone without a person hovering over me giving directions. Oh yeah his veins were crap, huge and easy to see but all gnarled. I found a decently straight one in his hand and dropped a 22 gauge in there like a pro. Thank god because my other guy was trying to crawl out of bed again.
I somehow manage to survive the night. I nearly kill my relief who takes 30 minutes to get report from the nurse with her other patient and then finally makes it to me. Great now Mr is late for work (yes we still don't have enough for another car so we carpool) and the director is giving me the evil eye because I'm overtime.
I bolt from that place screaming TGIF (my Friday at least) and hop in the car. Almost home free! Until we get to the intersection a block form home and wonder why no one is moving. I poke my head out the window and my heart just sinks.
From around the big truck blocking my view I see feet, on the concrete, in the middle of the intersection. I holler at the Mr to sit tight and jump out, to take a look. Yep hit and run in the middle of a busy intersection at rush hour, on a Monday with some dear strangers standing around him to keep the jerk drivers who are trying to cut around because they are too busy to care, from hitting him. Thankfully an EMT was on the scene and paramedics were screaming up as I got the the fellow.
I got back into the car and the Mr just looked at me and asked
"Is it a full moon?"
Saturday, March 3, 2012
Saturday Cartoons: Nurse vs Doctor
These videos have been making the rounds at work.
I'm sure some of you have seen them but if you haven't
here's one that should make you laugh or cry
depending on if you have ever been in this situation!
depending on if you have ever been in this situation!
Friday, March 2, 2012
Physicals Suck
I hate going to the doctors office, in fact I's rather cut off my right arm most days then end up in a gown, perched on the edge of the exam table talking to a Doc about "what is going on with me". But this time around it wasn't the four shots (MMR booster, Varicella, HepB and my birth control) that broke the camel's back, it was that blasted scale!
I found myself looking down at the weight it was brightly flashing at me and I had an overwhelming urge to whip out an anime style, over-sized mallet and smash the thing. Somehow I managed to keep cool and get out of the appointment with some measure of dignity intact. Thankfully my company offers a killer deal on gym memberships, and the very next shift I emailed the HR Lady who sent down the paperwork and vouchers.
Yesterday I headed to my local gym with papers in hand and did something I have never done in my life. I became a member.
Wish me luck!
I found myself looking down at the weight it was brightly flashing at me and I had an overwhelming urge to whip out an anime style, over-sized mallet and smash the thing. Somehow I managed to keep cool and get out of the appointment with some measure of dignity intact. Thankfully my company offers a killer deal on gym memberships, and the very next shift I emailed the HR Lady who sent down the paperwork and vouchers.
Yesterday I headed to my local gym with papers in hand and did something I have never done in my life. I became a member.
Wish me luck!
Thursday, March 1, 2012
Care of the Complex Respiratory Patient & Power Point
Another hand me down for all you nursing students as my hard drive purge continues. This is part of a recorded lecture by my critical care instructor, Ellen Cummings MSN, RN, along with Power Point slides. I loved my instructor and always found that she explained things in a manner that connected the pathophysiology to the interventions and treatments. It is a large file so do beware but I think you will find it very helpful.
As always this packet comes with the caveat that I make no guarantees that information contained in the packet is up to date or correct, so please do not take it for gospel and do not come back screaming at me if you find any inaccuracies.
As always this packet comes with the caveat that I make no guarantees that information contained in the packet is up to date or correct, so please do not take it for gospel and do not come back screaming at me if you find any inaccuracies.
One thing I ask out of respect for the kindness Ellen showed by allowing me to share this powerpoint with everyone, is that if you are going to share it please give her the credit she so very much deserves for putting together this great lecture.
Thank you!
Happy Purim?
Hmmm I think I'll stick to another flavor of hamentashen thanks.
One that doesn't include cannibalism.
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