Sunday, December 6, 2009

another week, another sledd patient...why me?

just a few pictures from university lake over the week. well, actually the one just below was taken from my back yard. i love when the sunset makes the snow covered mountains all pink. very pretty. i guess the correct term is alpenglow. a pretty word for a pretty site.
we hit the dog park twice during my work stretch. the first day we missed out as the heater was acting up so i was waiting for the heater people. i won't use that company again. they were okay, but the guy mentioned that the other two heater places in town are the only ones with parts for my particular heater. he cleaned and serviced it and it seems to be working just fine now. the guy repeated told me there were "no guarantees" that this would totally fix the problem. he said it like 10 times and made sure his helper (his son) wrote it on the slip. i never asked for a guarantee so it was annoying. i just looked at him and said...yes, nowadays nobody will guarantee thier work will they.

spent my week of work again at the SLEDD machine. an 11 year old with a not so good new diagnosis. at least an 11 year old is less stressful having on the machine than the last 2 kids we had...which were babies. still i'm no expert at setting up the machines and was supposed to set it up the second night. i called dialysis to assist me as it was change of shift and it would be nice to not tie up the adult icu charge nurse with this. the dialysis nurse used to work with me in picu. he initially gave me some attitude about helping and saying we were supposed to be independant and he was going to talk to our educator about it. i reminded him that he and another had been the first ones sent to training and that they had both quit picu and transferred down to dialysis...they never sent anyone else for training. surprise. anyway...he showed up to help and had difficulty with the set up so i was all sloppy nice with how much i appreciated it as these kids lines all have thier own quirks and it was so much easier with help....blah, blah, blah. sometimes in life a little manipulation goes along ways. he felt badly for giving me tude and all was well.
my third night with her i was on a clot watch. there was a big ol clot in the arterial chamber and i knew her venous access was sticky. the gods were with me and all went well overall through my 3 nights. she is doing okay...not sure how things will go long term, but for the immediate there is improvement. she seemed perfectly normal up until a week or so ago. then the parents get hit with a diagnosis of wegeners. some sort of autoimmune issue. not sure how long term is....nice family. so sad.
for me, the stretch was pretty sweet really, i just run the machine and help out as needed with patient care. we had good staff on (except one night we had to deal with the bipolarish doc.) i got about 60 christmas cards written. most of my "work" happened on the hour every hour.
they called me on night two to see if i would just take the patient on my own. in the adult icu SLEDD patients are staffed 1:1. in peds they have been staffed 2:1 as they aren't trained to run the machine. i'm the only one who could do it. i have before, on a 14 year old, but first, there was no thanks or appreciation and secondly, i have zero back up on the floor. it would take 2 nurses to break me every time i wanted to even pee. the adult icu nurses aren't comfortable with a child or the PICU and the peds nurses can't deal with the machine. as it is, i only get breaks by calling down to the adult icu and having thier charge come relieve me. they have been very supportive and helpful in this. it's been frustrating that i can't get the picu management to send a proper thank you too all the adult icu folks for helping them out. not sure why people don't understand how a simple thanks goes a long ways.
we had a situation with another patient that night as i refused to be a 1:1 and the float they sent wasn't comfortable with a new vented patient. they had a 17 year old near drowning. they switched her out for another float nurse not oriented to peds who does adult icu. i knew her and was able to help quite a bit, but she was a trooper for going someplace totally new and taking this on. i hope they give her the thanks she deserves.
i made it to the native hospital annual christmas craft sale. wish i hadn't been so sleepy. it's very short hours and only the one day. i found a few little things. brought my co-worker from acc a little basket. when i told her the sale was today she was really bummed that she was working and would miss it. i worked with deb in ketchikan and again in the adult icu here. she has also gone on a few of my annual trips ( round and kayak islands). she moved out of state, but quickly discovered that this was a mistake and moved back 9months later. i guess she sold everything when she thought she was moving for good. she loved her little basket and when my other friend kara came in this morning she brought a hand painted christmas card that deb had painted for me. very sweet. i love water colours and it's a beautiful mountain scene. i think i will have to get that card framed. we'd been talking about it the day before.
the SLEDD machine requires big jugs which we change out at various times. i always draw a little picture on my bottles. i am no artist so i was laughing that it would be embarrassing having her, the artist, see my pathetic artwork. i guess she always draws on hers now after she saw me do this in the past. she does little landscapes though . she said she loves my critter drawings. later, i was talking to the mom and mentioned the drawings. she was saying she had noticed and appreciated it....such a stressful situation and something like that put a little lightness into it she was saying. i told her about deb being an artist and that we were laughing at my skills...i told the mom my walrus drawing had really been pretty sad...she laughed and said, "oh that was a walrus, i was wondering". hehe. so drawing skills are limited. i did remember that it's christmas time and drew some decent snowmen and then a christmas tree. of course, i totally put my foot in my mouth with kara in the morning as i joked that i hoped i didn't offend anyone with a "christmas" tree. that perhaps we should think of a more politically correct name.....i came up with "festive bush". oh my god, we laughed and laughed.
well, back to baking cookies. monday walk tomorrow.

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