ER Float feat....
Ok. It wasn't a great night to start with...my hubby was having chest pain again, and I couldn't call in (he started hurting just before time for me to work...and they require 4 hours lead time to get a replacement). Dave had just had a heart cath two weeks before and basically everything is ok, except they cannot figure out why he is still having chest pain off and on. I was totally concerned because this was exercise induced and his blood pressure was very high. He was clutching his chest, two nitro's and 3 baby aspirin later, no change, I gave him his BP meds and loaded him up...after all I was going to the hospital anyhow. (Now if you are having a heart attack or having symptoms it is not really advisable to drive yourself or your loved one to the hospital, you have no emergency resuscitation devices) Given that he had just had the cardiac workup and is awaiting a GI workup....they are leaning towards some type of "spasm" causing this, but none the less, he was not feeling good. I drop him off at the ER bay, park, and ride the elevator with the supervisor to the time-clock (we arrived at the same time), I apprise her of the situation, she knows him and knew he was just here for the same symptoms. She offered to check the schedule to see if I could get off when they call somebody in, and of course I am very appreciative.
When I get to my floor I see that I am assigned to float to the ER. Cool, I'll be able to work and keep an eye on the spouse at the same time. When I arrive to ER, I suggest to day shift that they don't assignment me so and so's room, since he is my hubby, and they give me the opposite corner, so I can still spy the man...but not be "involved" in his care ...fine with me...just let me know if he balks at any needles...I'm always available for the ol' IV start (since he is still complaining about our registry nurse from England mangling his arm two weeks ago).
I have two patients. One is an elderly gent that I actually cared for a couple of weeks ago on the PCCU floor. He was status post a fall with fractured ribs, had been to rehab, and was back with pneumonia...not unexpected since he had fractured ribs...he was stable, pleasant, and appreciative of everything. I got some extra pillows and drafted some man-hands to help me turn him and get him comfy on the gurney...and I was his best friend!
The other dude not so. He was SIO (sleeping it off). Doc had ordered seizure precautions and neuro checks for r/o "stroke" . You get to the door of the room and the Oder of alcohol had you reeling in seconds. Wow...and I'm an accomplished drinker all by my lonesome! Hated too, but had to wake the dude for the neuro check, now I have a wide awake belligerent drunk (oh God, why didn't I just let the dude sleep). He's crawling off the gurney, staggering around, loud, obnoxious and getting a bit aggressive. (Not a good move dude...my Significant Other is across the room...and believe me he can't help but hear the commotion). Drunk Dude is insisting I let him go to the bathroom. Practical request, offered the usual solution...how about the urinal...nope nothing doing. Ok, I'll walk you to the bathroom (dude could barely stand up). Nope, nothing doing...I have to go outside. Outside? Yup, I only pee outside. Outside? Yup! Well dude you can't do that here, you're at the hospital, in town, all we got outside is a parking lot, and they arrest you for flashing your wares outside in town. Dude was getting loud and obnoxious. I went and drafted man-hands again (Thank God for the 200 lb 6'2" nursing student sporting the big buff biceps! *grin*). Suddenly dude was all for using the toilet like normal people do. I staggered him back to his cubical, put him back on the gurney. Now he is demanding food. (Great idea...lets sober dude up). I bring him a sandwich, coffee, juice (no ice water...seems to just make them drunker). He eats and falls back on the gurney to snooze again. (Point's to my hubby...he didn't disconnect himself from the monitor and come to my rescue). I'm thinking at about this point, maybe being floated to the ER wasn't such a great assignment after all.
Later I take Dude another little snack. I'm able to question him as to what brought him to the ER. Of course, he cannot remember. So, I ask him what happened that day. "Well I woke up, and got a beer...." (No shit Sherlock). I ask him who brought him to the hospital.....he jiggles his keys and states "Nobody, I drove myself". OMG, I am so glad I wasn't on the same road with him. His ETOH level was 300 over the level (.01-10). I suggested that when he was released he would need a friend to drive him home. He got belligerent...."I haven't had a beer in 6 hours, they can't stop me from driving". OK dude, whatever you say...I just drew the next serum alcohol level. I cannot even imagine still being that drunk 6 hours after my last beer. But, hey, who am I to judge...remember I'm the idiot that was puking in trash can's at the State Capitol last October. I inform the ER supervisor that dude is planning to drive himself home...supv. tells me we can't stop him, but we can call PD the second he steps out the door. Wow, that's comforting.
My hubby's cardiac enzymes all checked out negative, although his myoglobin and ck-mb were elevated...that could be a result of the heart cath, who knows, but I'm calling the cardiologist at 10 a.m. when they open. His appointment is for Thursday, but he was hurting a little last night, and his blood pressure was pushing up again. My boss let me take my hubby home from the ER, and they gave me last night off (census was down again, so it worked out). We just need to get his medications for his BP where they are therapeutic and find out what is causing his pain. No more mowing and hoeing for him! I'm riding that bad-boy John Deer myself again today.
When I get to my floor I see that I am assigned to float to the ER. Cool, I'll be able to work and keep an eye on the spouse at the same time. When I arrive to ER, I suggest to day shift that they don't assignment me so and so's room, since he is my hubby, and they give me the opposite corner, so I can still spy the man...but not be "involved" in his care ...fine with me...just let me know if he balks at any needles...I'm always available for the ol' IV start (since he is still complaining about our registry nurse from England mangling his arm two weeks ago).
I have two patients. One is an elderly gent that I actually cared for a couple of weeks ago on the PCCU floor. He was status post a fall with fractured ribs, had been to rehab, and was back with pneumonia...not unexpected since he had fractured ribs...he was stable, pleasant, and appreciative of everything. I got some extra pillows and drafted some man-hands to help me turn him and get him comfy on the gurney...and I was his best friend!
The other dude not so. He was SIO (sleeping it off). Doc had ordered seizure precautions and neuro checks for r/o "stroke" . You get to the door of the room and the Oder of alcohol had you reeling in seconds. Wow...and I'm an accomplished drinker all by my lonesome! Hated too, but had to wake the dude for the neuro check, now I have a wide awake belligerent drunk (oh God, why didn't I just let the dude sleep). He's crawling off the gurney, staggering around, loud, obnoxious and getting a bit aggressive. (Not a good move dude...my Significant Other is across the room...and believe me he can't help but hear the commotion). Drunk Dude is insisting I let him go to the bathroom. Practical request, offered the usual solution...how about the urinal...nope nothing doing. Ok, I'll walk you to the bathroom (dude could barely stand up). Nope, nothing doing...I have to go outside. Outside? Yup, I only pee outside. Outside? Yup! Well dude you can't do that here, you're at the hospital, in town, all we got outside is a parking lot, and they arrest you for flashing your wares outside in town. Dude was getting loud and obnoxious. I went and drafted man-hands again (Thank God for the 200 lb 6'2" nursing student sporting the big buff biceps! *grin*). Suddenly dude was all for using the toilet like normal people do. I staggered him back to his cubical, put him back on the gurney. Now he is demanding food. (Great idea...lets sober dude up). I bring him a sandwich, coffee, juice (no ice water...seems to just make them drunker). He eats and falls back on the gurney to snooze again. (Point's to my hubby...he didn't disconnect himself from the monitor and come to my rescue). I'm thinking at about this point, maybe being floated to the ER wasn't such a great assignment after all.
Later I take Dude another little snack. I'm able to question him as to what brought him to the ER. Of course, he cannot remember. So, I ask him what happened that day. "Well I woke up, and got a beer...." (No shit Sherlock). I ask him who brought him to the hospital.....he jiggles his keys and states "Nobody, I drove myself". OMG, I am so glad I wasn't on the same road with him. His ETOH level was 300 over the level (.01-10). I suggested that when he was released he would need a friend to drive him home. He got belligerent...."I haven't had a beer in 6 hours, they can't stop me from driving". OK dude, whatever you say...I just drew the next serum alcohol level. I cannot even imagine still being that drunk 6 hours after my last beer. But, hey, who am I to judge...remember I'm the idiot that was puking in trash can's at the State Capitol last October. I inform the ER supervisor that dude is planning to drive himself home...supv. tells me we can't stop him, but we can call PD the second he steps out the door. Wow, that's comforting.
My hubby's cardiac enzymes all checked out negative, although his myoglobin and ck-mb were elevated...that could be a result of the heart cath, who knows, but I'm calling the cardiologist at 10 a.m. when they open. His appointment is for Thursday, but he was hurting a little last night, and his blood pressure was pushing up again. My boss let me take my hubby home from the ER, and they gave me last night off (census was down again, so it worked out). We just need to get his medications for his BP where they are therapeutic and find out what is causing his pain. No more mowing and hoeing for him! I'm riding that bad-boy John Deer myself again today.
posted by GingerJar | 6:44 AM
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