Good evening bloggers,
I have been off from my unit since Thursday morning, & I have to say it has been refreshing to walk amongst the "normal people" with "normal schedules". But I've realized that I don't fit- I mean I love sleeping in my bed @ night & having a sense of fulfillment after my morning workouts, seeing my family & being able to cook & eat dinner with them. But, I miss my work family & taking care of my critically ill patients! I don't think people or doctors realize what happens during the night shift, it's a delicate dance between knowledge of anatomy, physiology, pathophysiology, mechanics, chemistry, luck & allot of faith! Which put this little medley in my mind that I created:
From receiving the pt from the OR we hook cables up, we level the arterial lines, flush them & triage them to make sure we have blood return, so we can draw labs & await the results so we can replace electrolytes & check the arterial blood gases to check Ph, bicarbonate & of the such. We check the a-line blood pressure to titrate the norepinephrine (levophed) &/or the milrinone (primacor), nitrogen , & the insulin. Blood sugars done every 2 hours to maintain a blood glucose above 70, but less than 150! We check the incision sites & the drainage systems to see if there are clots or over bleeding, & prepare to give either blood products or amicar, oh & don't forget the handy albumin 25%! Oh & please don't forget the oral gastric tube & the ventilator that requires silencing the alarm while you suction & watch your tidal volumes & the pt over/under breathing the vent & getting the appropriate volumes that are compatible with life! Then we have to decide if we are going to turn or tilt the patient in order to protect the skin from ulcers (skin break-down), which sometimes moving the patient is not an option!
And this is just the tip of the iceberg!
Now let's talk about devices!!!
From the intraortic ballon pump, Impella, Ekos, centrimag, LVAD (left ventricular assistive device), to the mother of all devices ECMO (extracorpeal membrane oxygenation)! Not only do we manage the patient, we manage the devices, triage the ventilator, titrate or wean the drips all while maintaining our cool & depending on each other for moral & knowledge support! So you see, this is why I love my colleagues, we've become sisters & brothers & rely on each other to keep the patients alive & I contribute by keeping it light & feeding my babies! Humor is what sets us free & my sarcasm is sick & I want to believe that it does help lighten the load on the nights that I'm @ work!
So you see, you all know me as a crazy & fun loving, adventurous person, but there is this side of me that respects life & death & takes my job seriously! Because it is very serious!!!
I have been off from my unit since Thursday morning, & I have to say it has been refreshing to walk amongst the "normal people" with "normal schedules". But I've realized that I don't fit- I mean I love sleeping in my bed @ night & having a sense of fulfillment after my morning workouts, seeing my family & being able to cook & eat dinner with them. But, I miss my work family & taking care of my critically ill patients! I don't think people or doctors realize what happens during the night shift, it's a delicate dance between knowledge of anatomy, physiology, pathophysiology, mechanics, chemistry, luck & allot of faith! Which put this little medley in my mind that I created:
From receiving the pt from the OR we hook cables up, we level the arterial lines, flush them & triage them to make sure we have blood return, so we can draw labs & await the results so we can replace electrolytes & check the arterial blood gases to check Ph, bicarbonate & of the such. We check the a-line blood pressure to titrate the norepinephrine (levophed) &/or the milrinone (primacor), nitrogen , & the insulin. Blood sugars done every 2 hours to maintain a blood glucose above 70, but less than 150! We check the incision sites & the drainage systems to see if there are clots or over bleeding, & prepare to give either blood products or amicar, oh & don't forget the handy albumin 25%! Oh & please don't forget the oral gastric tube & the ventilator that requires silencing the alarm while you suction & watch your tidal volumes & the pt over/under breathing the vent & getting the appropriate volumes that are compatible with life! Then we have to decide if we are going to turn or tilt the patient in order to protect the skin from ulcers (skin break-down), which sometimes moving the patient is not an option!
And this is just the tip of the iceberg!
Now let's talk about devices!!!
From the intraortic ballon pump, Impella, Ekos, centrimag, LVAD (left ventricular assistive device), to the mother of all devices ECMO (extracorpeal membrane oxygenation)! Not only do we manage the patient, we manage the devices, triage the ventilator, titrate or wean the drips all while maintaining our cool & depending on each other for moral & knowledge support! So you see, this is why I love my colleagues, we've become sisters & brothers & rely on each other to keep the patients alive & I contribute by keeping it light & feeding my babies! Humor is what sets us free & my sarcasm is sick & I want to believe that it does help lighten the load on the nights that I'm @ work!
So you see, you all know me as a crazy & fun loving, adventurous person, but there is this side of me that respects life & death & takes my job seriously! Because it is very serious!!!
