Month: August 2009

Weird morning so far. We only had one patient to dialyze and he cored
20 minutes into treatment. It was the first core I've seen. He went
into respiratory arrest and we called the team, then cardiac arrest
while they were working on him. I wasn't working on him, so I mostly
stood aside, brought out supplies, and gave information. He made it
and was transferred to ICU. What a rush. So now we are documenting
and decompressing. I guess codes are really rare for our unit. Still
no other patients. Weird day.

Ben inspired me to put together that video I was filming the day of the hailstorm.  It’s a 25 second movie – 5 second clips from 5 parts of my day.  I like it.  I hope I’ll make more of them.

http://vimeo.com/moogaloop.swf?clip_id=6237769&server=vimeo.com&show_title=1&show_byline=1&show_portrait=0&color=&fullscreen=1
July 5×5 from Rachel Mason on Vimeo.

I’m writing from my repaired macbook! When I got the message after work that it was ready for pick-up I went straightway across town to Park Meadows to pick it up from the Apple store. They cleaned up the screen and gave me a new keyboard and frame too, so it’s quite pretty. I’ve resolved to limit my eating and surfing to a minimum and to be more careful. I really really love this thing.

What a day of work it was! One nurse didn’t hear his alarm and didn’t leave his house until 6 am, his house which is in Conifer! The other nurse called in sick. So it was up to the remaining nurse and me, still in training, to get the day going. Ay yi yi. Crazy crazy. We got enough staff by mid-day but I don’t think I sat down all shift. I was only supposed to be there until 1 pm but I stayed on to help out a bit. The last patient I was working on pissed me off. She’s one of the type who won’t hold her own access to clot, so I have to stand there holding her puncture sites with gauze for 10-15 minutes while I could be doing other things. During this she inquired in broken English where her lunch was. What? Lady, you refused to eat your breakfast tray, which is sitting there cold. You know you’re about to leave dialysis for a floor bed, why are you asking me about lunch?? I told her no, I didn’t have lunch for her, and she rolled her eyes and sighed like I had caused her the greatest grief imaginable. We have a few patients like this. It’s a real challenge for me. I’m ALWAYS nice to them, don’t get me wrong. But inside it steams me to know that they come here for FREE life-saving treatment, don’t take care of themselves by following our advice on diet, exercise, and treatment regimen (this particular patient always comes in too far gone, she should come to us a day earlier), and don’t even do the little things like holding their access which would save us a TON of time. Then they get pissy about my not putting their feet up fast enough, or not having a lunch that they like, or not have three blankets. I don’t know what it would be like to be in their shoes, but I like to think that I would act a tad more polite and grateful.

Whoa, got a bit ranty there, didn’t I? Sorry about that. Really, I love my job. It’s been a long week.

Right now I’m having a power lunch of coke zero, cheddar baked lays, and a snickers. I have to put together a short lesson for the Young Women tonight at mutual. Tomorrow I have to attend CPR class because my CPR card doesn’t specify “Healthcare Provider” on it. Grr. I just certified last summer and attended two CPR courses during my school nursing rotation. I’m really looking forward to that massage Friday night.

Ben and I are both hurting from my computer being gone. We’re both too heavy on computer use to only have one.

Good day today. I added 2 more grafts and 2 more fistulas to my count. One of the grafts was on a sweet lady we haven’t seen before, and I was able to stick her way up into her armpit and got great flows. I see site rotation becoming one of my issues that I have strong opinions about 🙂

At the end of my shift we had one of our regulars come in not looking so hot. She had anasarca pretty bad and was unresponsive, barely arousing to her name. She also had a face mask on 10L of O2. Yikes. While we were trying to reposition her I noticed that her face mask had blood in it and there was blood on the sheets between her legs. We got a little panicky because there was nothing about any of this in report from her nurse. We checked vitals and blood sugar and everything came out normal. The blood in her mouth was all her rotten teeth bleeding at the gums. We couldn’t find a source for the bed blood – her diaper was clean and there were no skin breaks. With the renal fellow’s ok we started treatment – she didn’t even flinch when we put the needles in and she normally uses lidocaine. Finally we got an interpreter in the room and was able to talk to her husband (he accompanies her on every treatment since she is a 1:1 patient and we can’t staff it). He told the interpreter, who told us, that she has been very tired for a couple days but otherwise is fine. He noticed she was bleeding a bit from her mouth and in her stool and so he stopped giving her Coumadin, and was that the right thing to do (YES! MUY BUENO! we told him). Sure enough in a couple minutes she “woke up” and started talking to her husband. After some inquisition we found out that she was getting a nebulizer treatment shortly before coming up to us. RT left her on 10L after the treatment and she came up that way for no reason. Holy smokes were we confused though. I mean, sure this is acute care, but if someone needs 10 liters of oxygen, is way below baseline mental status, unresponsive to pain, and bleeding from every orifice, then we do dialysis in their room in the ICU.

Sorry my story had a boring ending. I don’t have many cool experiences yet.

My shoe situation makes me unhappy. I love my Danskos, but I still have achy legs and feet at the end of the day. Like, -I have to stand up slowly like an old lady-sore. I need to find a reliable second pair to switch it up now and then. I’m looking at MBTs ($$$ + ugly), Z coils ($$$ + ugly), New Balance (porous), and crocs (ugly). Does anyone have any other suggestions? Should I just get a second type of Danskos? In the mean time I scheduled a massage for Friday. I always tell myself that I should get them more often. It’s money well spent. I feel recharged and luxurious afterwards, and for not much money since I use a student clinic. Yet I go just once or twice a year. I should make it at least a quarterly treat. I spend more on my hair than my muscles.

Can’t wait for fall. There will be chilly weather and more time off with orientation finished. If I could sign up for dance class too my body will be oh so happy.

I slept like a log last night thanks to the cooler temperatures. Summer sucks.

I had my last class for orientation today. I took my final and got 100%. They said they had never seen anyone get all the high/low pressure alarms right. Woot! Since class only consisted of taking my test I went to the hospital to work and ended up staying until 6. Long day.

Stick scores:
Catheters: 18
Grafts: 6
Fistulas: 23

We’re having a great storm right now with rumbling thunder. Cat and dog are cowering in the basement.

My mac will soon be in the repair shop. Thank goodness for property
insurance that covers what warranty doesn't. Thank goodness for my
iPhone that keeps me connected and acts as a backup. Thank goodness
I back up my computer – even though the hard drive was spared. Thank
goodness I have a job – even if insurance pays for it.

Despite all these blessings, I broke my favorite thing that I own. I
let myself down and feel pretty crummy about it. Doesn't help that
the day before the spill I had to buy a new car battery and wiring.

(Thank goodness Ben was home and let me take his car while he arranged
the repairs. Thank goodness for husbands).

Last night was the finale of So You Think You Can Dance season 5. Some great stuff this year. I watched it with Amanda this week and was sad to hear that she hasn’t seen any of seasons 1-3. I sought to educate her. I decided I was qualified when I exclaimed at the TV screen “What, ANOTHER Paso Doble? That’s the third one this season!” Huh, funny how my brain tracks these things.

I was also thinking about how this show aired the summer that I got my first real job, working for the psychiatrist. Now 5 years later I’ve gone back to school and started my second real job as a dialysis nurse. Amazing how much can happen in 5 short years.

Since I went through the trouble of hunting down clips for Amanda, I’ll post a few of my favorites here for you. I’m sorry that many of these clips will be dead soon, that’s the nature of music rights. That’s why they can’t air the shows on hulu or release DVDs. Damn dirty copyright laws.

Season 1

Solo: Blake

Yes it’s totally cheesy when he takes off his shirt – but he does it during 4 back attitude turns en dehors! His crisp transitions are what get me – he’s in controlled the whole time and doesn’t waste a single second.

Season 2

Top 10/20 Group Dance by Wade Robson

This is one of their manically popular dances. Everywhere on the internet the next day. They repeated it later with the whole set of 20 dancers and then brought it back this summer with Wade dancing in it. I prefer the larger group, but sadly they have been hunted and taken down by Fox. You can only see the full cast in this poor version.

Top 4 Group Dance by Wade Robson

Utter brilliance.

Mambo by Alex De Silva: Benji (winner) and Heidi (4th place)

They are cousin ballroom dancers with a long history of partnering together, and that communication is what makes this so good.

Season 3

Top 6 Group Dance by Wade Robson (are you sensing a theme?)

Love the lights, costumes, netting, performances, and musicality. Great piece.

Top 16 Group Dance by Tyce Diorio

Tyce does most of their “broadway” genre and they generally suck hard. This is one of his rare moments of genius, unfortunately ruined by overzealous camera work.

Top 20 Group Dance by Wade Robson

Love the use of Busta, love the stark costumes, and love the blatent rip off/homage of Fosse’s Rich Man’s Frug at the end. I’m a sucker for Fosse when it’s well done.

Hip Hop by Shane Sparks: Lauren and Pasha

A strong contender for my favorite piece, this one is so creative. I love when the lights and music and costumes and movement come together so well. Pasha is a cute, gentlemanly Russian ballroom dancer, so seeing him work so hard on hip hop is an awww moment.

Season 4

Hip Hop (sort of) by Napoleon and Tabitha: Chelsie and Mark

Another “Favorite dance” contender. I could watch this over and over. It brings out the teenage girl in me.

Contemporary by Mia Michaels: Twitch (4th place) and Katee (2nd place)

Mia does some great ballad-type stuff, but I prefer her upbeat numbers like this one. Kudos for props well used.

Season 5

Solos: Brandon (2nd place)

Possibly the best dancer on this series yet. His cabriole from the floor kills me.

Contemporary by Mia Michaels: Jeanine (winner) and Kayla (4th place)

Gorgeous.

Jazz by Wade Robson: Brandon and Janette

So fun and sharp. I can’t believe this wasn’t an encore last night.

Contemporary by Mia Michaels: Kayla and Kupono

This is the encore which has worse lighting. I can’t embed the original so you should go to it here. Such a good piece on addiction, so perfectly played.

Contemporary by Tyce Diorio: Melissa and Ade (who were my favorites this season)

Yeah, this made me cry. So how about I end on a fun one?

Hip Hop by Shane Sparks: Jason and Kayla

Zombies!

I’m thrilled their bringing back season 6 in the fall, but worried that I’ll spend too much time in front of the TV. Is it worth it to buy a DVR and cable for one TV show??