Sunday, September 19, 2010

Nursing stuff....

So i ended up copying a doc's note about a patient that was hallucinating like crazy...Lol she was pleasant enough, but over the course of the day she started getting more and more confused, and by the time I had her at night, she was off her rocker lol She was havin visual and auditory hallucinations, mostly involving people in the room or little kids in the room, and one second shed know she was in the hospital, other times she thought she was home, or in a factory, or in some magical combination of all of the above Lol.
She redirected okay so if she was tryin to jump out of bed, then i could get her distracted by something else...though she mostly did that herself, ya know, like the man that was apparently playing very nice music in the room and she thought we would like to hear it
So, found out it was a bladder problem (and i'm still a bit shocked i'm the only damn one who made the connection...) and she got all better. yay.
So meanwhile, before they put the foley catheter in, the doc met with her and made his note progress note deal... and I copied it and printed it cuz it amused me greatly...

"She's oriented x 3 actually, right at this moment and cooperative, though asked me if I was the doctor and when I introduced myself, she said yes indeed, I was the one who was out golfing a year ago on a Saturday and didn't come in and discharge her on time. I do not golf." - LOL!!

I like the "I do not golf" added! hehe then at the end of his note:

"She'll be in the hospital at least another 48 hours at this point. I do not wish to aggravate her any more by not seeing her in a timely fashion, If I "happen to be out golfing."

I was busting up laughing at the nurses station when I read that... Lol =)

They took out her foley catheter, then she was only voiding incontiently, so no measured amount... and i counted how many times were charted for nearly 24 hrs since they took it out (and the intense confusion started about then) and I decided it would make a lot of since if her bladder is full.... 870ml stuck in there apparently! Tried getting her up to a commode, she still couldn't even come close to emptying it. And things were INSANE that night but i got the order to put a foley in, but i ended up not having time to do it (grr.....) and i'm a bit upset that i had to pass it onto day shift, and then they waited another 3-4 hrs of confusion and hallucinations and stuff, before the doc came in, and wrote a 2nd "place foley" order (?!).......(i bladder scanned her twice, two different post void residuals, and I got her up to the commode to try going in a natural position....but i was ignored apparently).
And NO ONE ELSE made the "full bladder=intense confusion" connection which i also do not understand.... thats not exactly uncommon! I mean its not the most common thing, but esp cuz the whole reason for her visit is a Urinary Tract Infection and "altered mental status" though she had been alert and oriented, with a little forgetfulness at times the whole time (i had her for 5 nights total..this all happened on the 4th night).
even after in report, no one stated the connection... HELLO!

I wonder how long it would have taken them to bladder scan her had I not decided that would be a very good idea at 0530, despite the insane crazyness that was that shift (stayed 45min late to finish charting and finishing my admits med list....course they discharged him home that day..grr - oh and no lunch lol but big deal, use to that only cuz i really suck at making myself take own fault).

anyway. i just had to vent/share. lol =)

Meanwhile in EDS land...
lots of joint twinges, and Sciatic pain intermittently annoying. should keeps feeling really weird and i keep adjusting it and sliding it back where its spose to be. (freaked my friend kristen shes never seen my joints do their thing).

i'm way sleep deprived. and wanna sleep sleep sleep...
aw well..
too much work for me.
ta-ta for now.

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