Friday, October 17, 2014

What I'm learning about that will help me post ebola

Guess you could say I'm a bit obsessed. Much to hubby's disapproval. He thinks I'm over reacting.

But being prepared for the shit hitting the fan (SHTF) could mean the difference between life and death in a few months time.

Tampons will be more beneficial than just stemmin the flow of my menstrual cycle - it can be used as a bandage if the gauze is split open flat and applied to the wound.

Nylon can be used for filtering or as a tourniquet rataher than on my legs.

Fruit cake is an excellent food source to hoard as you don't have to worry about storage because it will last outside cling wrap or storage containers for MANY a years and it's high calories (if a bit empty).

For heating a room - put black plastic bags on the windows - but leave a gap in the bottom and the top - that way the cold air is drawn into the bottom gap, is heated and flows out the top gap.... thereby heating the room.

Did you know that snow with a red tinge is bad for you?! Don't know why exactly but don't eat it or you'll regret it!

You're going to want to keep warm - boil water, heat or even cook some food - in order to do that you're going to have to make a fire..... a couple of tips from survivorman -
1. Use cotton balls and petroleum jelly to create a fire long enough to ignite wood
2. Use corn chips as well
3. Did you know that DUCT TAPE will work too?!
4. You're going to want to bring your fire with you so that you don't have to go through the steps all over again at your next stop..... so bring cigars with you - a puff here and there will keep it ignited
5. If you think it's going to rain, build a big fire and then put big pieces of wood on top and protect the fire as much as you can and that way you don't have to rebuild and sacrifice valuable resources!
6. If you don't have cigars, make your own with wood products and simply roll a big enough package of them into a giant cigar.

I just hope I can make it to my parents cottage in time instead of trying to make it through the winter weather on foot because you knkow that if you don't leave early enough EVERYONE is trying to be leaving as well and you'll end up stuck where you are. If you leave too late then you're going to get screwed over because then you'll experience anarchy where everyone is trying to take from everyone else... and I don't want to be on the receiving end of that crap storm. If by some unfortunate possibility, I don't make it before hand or I only get part of the way there, then that means I have to somehow get my family north by foot - and it take 8 hrs by CAR... so just imagine how long it will take if we have to go by foot. Also - how in the world are we going to survive the wilderness in the WINTER?!

So ya, I'm worried - just a weeeeeeeeeeeeeeeeeeeeeeeeeeeeeee bit..... and personally I think everyone should be. Ebola isn't being stopped in its tracks and that means it WILL spread to here in North America. It's only a matter of time where it's not being contained over here as well. Time shall tell really.

Wednesday, October 15, 2014

Ebola should scare everyone!

I don't know how many people are paying any attention to the news... Check out this most recent report Ebola is out of control and its effect on nations. Don't think just because we're a 1st world country that it won't be the SAME THING! Schools will shut down, as will hospital - look how many health care professionals are losing their lives because of this virus.... you honestly think ppl will VOLUNTEER to care for the sick when they have families that they don't want to infect.

You better believe that the first signs I see of infection in my province I am hightailing it out of here! I WILL go north - to my hometown - so that we can ride out the storm and SURVIVE! Yes I became a nurse to help others but this virus is going to kill BILLIONS of ppl before it is stopped or putters out. If you don't believe that you're nucking futz. Hell, the CDC believes that 1.4 million are going to contract this virus by January - right now that number sits at approx. 5 THOUSAND right now (though they don't quite know because these countries have a lot of back countries and so numbers being reported aren't exactly accurate by any  means) - so rest assured that they are UNDER reported... but that's besides the point.

The point being that the numbers are only going to exponentially go further out of control. Just you wait and see. Things are so close to out of control - and yet things are being downplayed so to not create riots - though those are coming as well. It's just a matter of time. Hubby is STILL in denial tho.

Sunday, October 12, 2014

Dead in the water.... and Ebola

I've gotten the official word that I'm dead in the waters for this semester. I couldn't make clinical work out to get to the university so now I have to start from scratch next semester. I'm so pissed I got screwed over. I hate that clinical objectives are subjective. At no point am I being told that I'm a bad nurse, or are showing bad skills - quite the opposite. I was told that I'll make a great critical care nurse but that the hospital I was in was run by physicians and once you set that in motion, then you're doomed. Man I feel fucked over!

I guess the only good part about this is that I will have the time to dedicate to the elective I'm taking. Especially because I felt overwhelmed taking the elective with the nursing course. I felt like I had to dedicate all my time to the nurse course and so of course the elective took the brunt of the hit. The only lucky thing is is that my mark hasn't suffered (yet) because of it.

Now changing gears....

I tried to have a serious talk with the hubby this AM after he came home from work.... about Ebola. I'm not sure how many of you have Ebola on your radar but you should! I've been watching things and I am afraid of what I'm seeing.

For those of you who don't know, the rates of Ebola are doubling every 21 days - almost literally. I don't put myself up as being very adept at writing about this sort of thing. Another person on the web is though.... Aesop is quite proficient at scaring the shit out of me. The great thing is that it is entirely realistic.

Population as well as the press are stupid if they think that Ebola will stay contained in Africa. Yo ppl, wake the fuck up, it's coming across the pond and doing so soon! Once it does, don't be surprised at the swiftness that it spreads. It's VIRULENT!!! Like as in 70% of the ppl infected DIE!

I tried to explain this sort of thing to my husband - who is a biochem major - and he LAUGHED AT ME!!!!!!!!! Wow was I furious! I couldn't believe how foolish he is to think that it won't come to Canada! It's already come to the US so what makes him think that it'll stay on their side of the border?!

Frankly, all this makes me want to run north to my mommy's cottage and stock pile a whack load of food and hope for the best! Hubby said that he wants to wait another two months to find out whether it will be contained on the other side of the world.

I'm willing to wait a bit but man am I nervous. When I was at clinical I got together with a girlfriend and talked to her about Ebola. Now, I'm in healthcare.... I know nothing about how to get by without modern things - I certainly don't know how to break down wheat into flour, make my own soap, etc... So how the hell would I get by in the world if 70% of the world's population died?! I'm not sure I would want to. However, who's to say that I wouldn't be one of the 30% who survive or are immune to this (unlikely tho cuz I'm pretty sure I have an autoimmune disorder - more on that in another post - I have an appt with an immunologist for November so we'll see how that goes).

Would I really want to live in a world where my husband or my children no longer are around - where I'm all alone? Or what if my parents die? How in the world do I survive? I suppose I could go live around the memonite (there's a community of them outside my parent's city) and learn from the experts.

The good thing about being up by my parents is that there's an ample supply of firewood and fresh water, and quite a bit of land to potentially get food to survive - so at least it has that going for it. Too bad it's 8 hrs away and there's no way that my husband would allow us to stockpile gasoline and we would need two tanks of gas to get to my parents.... so how in the world do I convince hubby of the seriousness of this situation???? ANY ideas are appreciated!

Thursday, October 9, 2014

I'm so pissed and embarrased

Hubby thinks I should keep things to myself. However, this is my blog and it's my story and frankly I need to get it off my chest.

I was failed for clinical because they didn't like me!!! I was failed because I was too much of an eager beaver!!! Because I am too assertive!!! Is that enough punctuation marks for you?!

I'm pissed at them... and at myself that I can't keep my emotions in check. That I am passionate about being a nurse and trying to get my BSN.

Hubby warned me that my placement had stuff on the internet that indicated that they are known to be like this.... of course this was the last day that he informed me of this. And it was rather too late to do anything about it.

I can't believe that I get 3 1/2 yrs into my degree again and this sort of thing happens and puts a big stop to it. I can't believe I'm being stopped again. All because clinical is subjective.

At no point was anything that was told to me about whether I was a bad nurse/incompetent - just that I rubbed people the wrong way. And that they were under the impression that I was there to OBSERVE and not actually DO anything!!!! like WTH???!!!! What clinical placement is observational?!

The only upside is that my clinical faculty advisor sees things as being primarily interpersonal and is willing to give me a second chance.

Unfortunately, she wants me to come to the university but I can't get a temporary license because I can't get one of the aspects required for it and so now I think I'm pretty screwed. I will find out tomorrow I guess. I don't know what options I have now :(

I had difficulty finding a hospital in the first place and now I can't do placement at this one (not that I want to anymore). UGH!!!! WHY MUST THIS BE SO HARD????????

Saturday, September 20, 2014

My placement rocks!

Finally got a moment to post about placement. The hospital is ginormous! I couldn't believe how big it is. My hospital is BIG.... this one trumps it almost three fold! It's amazing. I found out it's about 15 years old, so it terms of newness, it's pretty new (IMO).

I saw some pretty cool things. Didn't do much myself until the last day there. I put in three foley catheters and discontinued one as well as an IV. Nothing spectacular but at least I can check it off my clinical skills checklist. Oh and I did a TON of EKGs so now I feel pretty confident about doing them myself. At my hospital we have a tech that does them all. I was thrown into the lions den with those the very first day.

Day one was pretty awesome, there was like 5 traumas in like a 4hr period of time. The first one was the best. Maybe I'll write about it another time. HIPPA might come back to bite me in the ass because it's an interesting case so I need to figure out ways to change details to get around it. I did get  involved on a little one who was dropped and suffered bilateral skull fractures..... the poor little one cried the ENTIRE time... I mean, I would too.... I'm pretty sure he/she was experiencing a pretty terrible headache.

Another person we sort of dropped into our lap. We were floating in the unit and were doing something to help another person when my preceptor Anna noticed that a fellow nurse was running towards CT with a patient and knew that something bad was going down. So she called for me and off we went running to help. Well it turns out that their pt was having a seizure when the chief complaint they cam in with was COMPLETLY different.... as in they were classified as a NSTEMI and when they were questioned further told the nurse & Dr that they also had a headache with hypertension and so the doc wanted to clear this person's head..... just in case it was something else!

Well good thing they were already on their way there.... too bad this pt wasn't protecting their airway very well. Completely non responsive. Got an emergent CT scan and the oxygen level remained high enough that an emergent intubation wasn't required at that point. We were able to get the scan and found the pt had a subdural /ventricular bleed... neurology was pretty sure it was an aneurysm that burst. While they were trying to get a scan with gallium for a more definitive determination, the pt started to come back neurologically and respond to pain and shortly after that to voice. We then moved him/her to trauma bay "just in case".... good thinking!

Neurology decided that they wanted him/her to be put on a cardene drip to control the BP to be <140 systolically... well for those who don't know, you have to wait 15 min after starting to know what the response will be on the BP. Well the BP dropped from a SBP of 150ish to 103.... not a good thing so we paused it. And for the next 15 minutes, we hung out in the trauma bay while different hospital services came and did their assessments. We let the spouse come in and sit and chat during this time. The doc also came in and talked to both of them to find out what their wishes were for treatment and such.... good thing, especially considering what was to come!

The pt was complaining about how their chest and their head was killing them... I asked a couple of people for orders for a pain med. It's not fair to the pt to stay in pain (IMO) but I wanted something that wouldn't strew neuro findings (as a narcotic may). Because the pt had soiled themselves during the previous seizure, we also took the time to cleam them up. And we also put a foley catheter in because we knew that the pt was sick and would need close monitoring.

After we were done, the pt asked if they could sit up some so we put them at a 60 degree angle from about a 15 degree and didn't do so quickly, but simple took our time. Then not even 2 minutes later the pt started SCREAMING about how their head hurt and that it was "stabbing" so my preceptor went out of the trauma bay and I dropped the head back flat because I figured that THAT was why there was a change.... then the pt stopped responding and had a tonic seizure right in front of me while I was trying to do a neuro assessment. Lost consciiousness and was super rigid. Before this happened, I had given her a mouth swab to wet the mouth and tongue since we wanted the pt NPO (nothing by mouth).... mouth swabs were cleared by the doc though provided they didn't swallow. So when the seizure happened they clamped down on it and I had to pry it out of the mouth. Then I ran to the door and yelled that the pt was having another seizure.

Then a code was called so that the necessary people come running and I swear, 20 ppl arrived in like a minute! It was quite impressive. One of the residents that was involved in this case during the original seizure came to the head to try to protect the airway. I was at the head of the bed and was responsible for monitor. I did another BP and it was now 198/130 (I know the top number but I kinda forget the bottom one.... though most often we generally care only about the top one anyways).... so that was quite shocking. We turned the cardene drip back on, this time higher than it was originally while the docs got situated. During this early phase the spouse was still in the room (OMG right!) and I made contact with them to try to let them know it was going to be alright and that we had things covered. At some point the spiritual care person took the spouse out of the room and comforted them.

In the meantime the pt's heart was going crazy and doing all different (very bad things) such as torsades which then progressed to 2nd degree heart block (FYI this one can lead to cardiac arrest) so out comes the code cart... all while other people are pulling up meds to intubate. THANKFULLY her own heart cardioverted back to a normal rhythm (probably because of the cardene drip) so we could focus on intubating... which went without incident.

Then things calmed down a bit and a lot of the people left the room, and we proceeded BACK to CT to get another scan.... which showed a progression (we kinda figured that though). And then we brought th pt back to trauma and by then neurosurgery made their decision about what they were going to do.... they were going to do a "bolt".... which means that they were going to do a ventriculostomy - drill into the pt's brain to stick a tube in to drain some of the fluid off the brain while measuring the intracranial pressure (ICP). I stayed pretty darn close since I'd never seen it before.

Unfortunately the pt was a fighter of the propofol and started to move when neurosurgery was making meaurments so I was asked to go under the sterile field to hold the head in the correct plane. Well it's a good thing that I kept my hands there because there were several times where the propofol amount wasn't enough and required more.... in a one hour period of time the pt recieved 400mg!!! As well as Versed.... so it was shocking that this person kept trying to move. We also put restraints on - just in case.... good thing for that because I'm sure that the pt would have pulled the ET tube out or at least broken the sterile field.... bad things either way!

It took a bit for the bolt to go through the dura but once it did you could immediately tell the pressure in the pt's brain was extreme because the fluid came out immeasurably though once the bolt was in a tube was threaded through and then hooked up to a measuring device that was based on gravity to draw the fluid out. Immediately 18cc was taken off which is a SUPER high amount. But you could tell that the fluid that was draining wasn't just blood but cerebrospinal fluid AND blood mixed. The closest comparison I can explain it to is serosanguinous fluid.

We eventually got the pt stabilized enough to take to ICU. Boy was the entire thing from start to finish crazy though! I must say, I can't wait to go back!

Tuesday, September 9, 2014

Gutted

Had work over the weekend. It sucked. Had to take care of a person who came as a direct admit from another hospital's ER to our unit that really should have gone to the stepdown ICU - as in RR of 34 with nasal flaring and major abdominal and shoulder breathing (just shy of sternal indrawing) so ya, pretty serious! ABG's came back as respiratory acidosis, however, person was DNR (including no intubation - YAAYYY finally!) but even said "If I knew dying would be this difficult I would have signed up for something different!" WHAT DO YOU SAY TO THAT?!!! I mean, they're 85 years old - so it's not like they haven't lived a good long life!

I tried to get ahold of family - called the contact number and left a message. Got a different phone number for a different family member - tried that one and was told it was the wrong number/person - and the other person was in another country several hundred miles away by plane and didn't want us to call them. We have to abide by their choices.

Next day, come in to find out that I would be now transferring this person to where they should have gone in the first place. Family has shown up. On the way to the SIMCU we talk about what would happen once we arrive - that the person would be put onto bipap since ma/pa decided to be a DNR - they didn't take that information well - they were shocked that this person would choose this without consulting the family! How incredulous of them! I explained that this was decided at several different points along the way - before any extreme fatigue and hypoxic confusion set in - spoken about to SEVERAL different HC professionals. That I (as well) spoke to ma/pa about this and was confirmed that no heroic attempts be made to save their life. What the family was so upset about was that one of the children was in another country and should this person die, that this would be a very bad thing and that THIS part should have been discussed first so that this person would be given the opportunity to make it should things turn south. 

THAT part I could understand. But again, I had to stress to the family that the ultimate choice was still up to ma/pa and that all they could (we included) do was speak to ma/pa about their decision and maybe postponing it a bit until said family member could arrive at bedside since they were doing so poorly and required such measure as the bipap to be able to continue breathing.

Situations like this make me wish that I was finished my BSN and could follow this story. The little ol ma/pa was a sweet ol soul who I enjoyed taking care of. They had a bit of a spit fire about them. I hope that should they decide to maintain the DNR that the suffering is minimized. I think dying from a respiratory issue is a terrible thing since you are so acutely aware of air hunger when unable to breathe anymore. ya never know, ma/pa could pull a miracle out of a hat and turn a corner - crazier things have happened!

On an entirely separate note - almost started bawling this evening.... saw that Kate Middleton is pregnant with baby #2 - yay for them but boy does it make me feel blue (and green).... one of the girls is pregnant at work, I was happy for her.... then I found out one of my pals is also pregnant (was told just this past weekend)..... I'm really jealous (I'd say envious but I think I'm past that point). I WANT A BABY!!!! I WANT IT TO BE MEEEEEEE!!!! I know that when hubby decided no babies for us that I was crushed, but I figured that I could get over it. I'm not so sure. I want what everyone else is having but me. I know getting my BSN takes precidence but how do you balance the needs and the wants?! So ya, I was gutted by the news of everyone else getting the chance to be pregnant and have babies and I don't. It sucks and I just want to crawl under my blankies and wallow in self pity. Maybe I just will.

Saturday, September 6, 2014

I don't share stuff very often

Facebook is a place where I procrastinate on and the other day was no exception....

And what I found was all kinds of awesomeness!!!

Hopefully this link works....  http://www.viralnova.com/patty-cake-song/#.VAjefplZPuA.facebook

I like the song and what they did DURING the song is spectacular!!!

What do you ppl think?