So I came in my shift my pt was a 90 year old pt she was sedated and intubated. Diagnosed with AAA, Abdominal aortic aneurysm type A. Basically a bulging or ballon like bubble in the aorta that needs immediate medical attention can result in death by bleeding to death from the inside.
Family wanted time to decide what to do so we extubated the pt and waited for the sedation to wear off to get her opinion. It was taking a long time so family went home for the night around 8pm.
At 4am I walked past her room and to my surprise she was sitting up. Since arriving to work pt has not moved at all so I walked into the room. She was sitting up turned to me and smiled asked me when her daughter was coming back. I said soon I will call her right now. She said thank you then smiled. I turned and left the room picked up the phone called her daughter as soon as I started talking I hear the alarms. I put the phone down run to her room asystole rhythm, no pulse, pt eyes tell me everything. She has passed away. I can’t help but notice her neck is pulsing extending outwards almost like a toad. The aneurysm has burst and she was bleeding to death internally. All within minutes she woke up asked for her daughter then died. She smiled when talking right before she died so I tell myself she died happily thinking her daughter was on her way.
Early pregnancy loss less then 20weeks is called a spontaneous abortion. After 20, it is called stillbirth. There are different types and causes. So I’m just going to touch on the different varieties with brief descriptions.
Usually happen before week 5. Some woman aren’t even aware they are pregnant. So the sperm fertilizes the egg, but implantation never happens. The body passes the egg and usually heavy bleeding occur, so sometime a woman may not know a miscarriage happened. She may think she is late with heavy menstrual flow.
ETOPIC PREGNANCY Fertilization happens outside the uterus, in the Fallopian tubes. Very dangerous and painful. Not viable for life.
BLIGHTED OVUM also called an anembryonic pregnancy, the fertilized egg implants on the uterine wall, but no embryo develops. Meanwhile the gestational sac develops, eventually will stop developing and will pass with dropping hormone levels.
MISSED PREGNANCY Egg gets fertilized, implantation occurs, but for varies reason the embryo stops growing.
MOLAR PREGNANCY Egg gets fertilized, implantation occurs, embryo develops but there is tissue overgrowth. The embryo may have missing parts, abnormal placenta, complete and partial molar pregnancy cannot sustain life. GTD and Choriocarcinoma usually are discussed in molar pregnancies. These are just a couple of different types of miscarriage. All with different causes.
SOME CAUSES Chromosomal, Immunologic, Diabetes, Thyroid, Blood clotting disease, Infections, Hormonal, Uterine abnormalities (septum, polyps), lifestyle such as drugs and alcohol. MYTHSMiscarriages are rare, not true.Heavy lifting early trimester cause miscarriage, false.Past abortion will cause a miscarriage, false.Drinking coffee will cause miscarriage, falseStrenuous exercise will cause miscarriage, false.It is the woman’s fault, false.
SYMPTOMS Back pain, fever, cramps, bleeding, abdominal pain, weakness, if you are experiencing any of these symptoms while pregnant please seek emergency help.
Just touching on different types there are more but mainly just making people aware of the difference in early pregnancy miscarriages. Have any questions or want to add or debate the list feel free to comment or contact me.
So where else can you ask someone to wipe while you hold a strangers butt cheeks apart, and it’s perfectly normal conversation? Nowhere but nursing!! We instantly bond over conversation about the guy that got the fidget spinner stuck in his penis. Hahaha normal conversations overhead on the floor would not be normal anywhere else. Like hey, you hold her leg, you lift the vagina and I’ll insert the catheter on that 300 lb lady .. perfectly normal convo! On a serious side… when that cute lil pvc suddenly goes STV to asystole working codes with your fellow nurses is like going into battle!! Whatever the end result is you have to have 100% teamwork! The bond is amazing whether you bring that heartbeat back… or the dreaded family phone call. Nursing relationships are uniquely beautiful.
Recently I had a friend move from med surge to the E.R. My friend loves…Loves..LOVES it. I am an Icu nurse, but I do work in E. R at my other job, and I will agree it definitely has it perks. I love her enthusiasm and her spirit its very refreshing, its cute, but then you remember the dark side…the part you dread…the OMG DID THAT JUST HAPPEN part of nursing. The gross side. Here are just a couple off the top of my head
- THE DARK SIDE OF NURSING: THE GROSS EDITION PART ONE
- One time I asked someone for help turning a patient, we turned him and his butt was facing me and he farting this hot butt breath on me then poop started oozing and oozing like hot lava and got all over my gloves and unfortunately my naked wrists… I wanted to die.
- One time I was going to give some meds to a patient that came from a long term care facility , so you already know he was covered in cooties. So he had a peg ( a feeding tube that is connected to his stomach, imagine a long rubber hose connected to patient’s tummy) so off course it was clogged. I threw some coke in there to help unclog it, old nursing trick. Capped it walked away, came back 45 min later when I opened it, he coughed and it shot out right in my face, so everything that was in his stomach and intestines shot up right in my face , my hair, and I just got my eyelashes done, so clumps of crap was hanging from them, I could see them just dangling, the smell was horrendous. Contemplated burning my face off…and I wanted to die.
- One time I had a patient with 3rd and 4th degree burns over 60 % of his body, patient had pseudomonas growing all in his burns. Pseudomonas is a foul smelling bacteria combined with the smell of burnt flesh, by the way actually smells like mesquite and a fresh campfire to me. So long story short he pooped and we had to take the dressing off and we applied some Dakins (basically bleach) dry dressing and flexinet . Flexinet is like fishnet panty hose, so when I stretched it out to cut it off to change dressing because he was covered in poop and pseudomonas , the first cut snapped it back and flung poop..pseudomonas..and yellow sloth (dead infected skin) in my face and hit my lips…I wanted to die..really.. really wanted to die.
- One time I had a trauma patient that shot himself in the mouth bullet traveled from the top of the inside of his mouth traveled up through his left check, popped out the left eye and exit through the top of his head, didn’t die.. so I had to suction his mouth very carefully, because even though he was alive he had brain matter falling from the hole in his mouth, so one time I was suctioning and I caused a cough…and it all shot out so fast hit me in the face …after washing my face a billion times an hour later I scratched my ear and I had a small piece of brain matter in my ear… I wanted to die.
- One time I had a patient that was prisoner in federal custody, the cop watching over him unhooked the right hand so he could pee in a plastic cup , a thing we call a urinal, and when he finished I walked towards him to grab and empty it, he asked me for morphine I told him for the thousand time he couldn’t have any and he got mad, called me a rat taco eating bitch (I’m Mexican) and threw his urine on me and it hit my hair.. chest and face… I could smell his pungent yellow foul smelling urine the rest of my shift no matter how much I scrubbed everything for the rest of the shift… and I wanted to die…
- One time I walked in on my patient that rolled up his poop like a tootsie roll and was eating it.
- One time I had a guy who was in some kind of incident, I forgot why, but he had his butthole surgically closed up and the surgeon made a hole on the side of his stomach, pulled out a piece of his colon cut it, (made a stoma) and that is where he poops , he changes the bag or empties it when it was full of poop, anyways, he and his partner decided to have sex through it, and it got infected with a STD, so I had to give antibiotics, but also had to rub the colon (stoma) with medicine in a gel like form on it, and he said it tickled, because he coughed and I got colon ..green gross stuff, and STD all over my pretty pink scrubs and my neck…ugh.. I wanted to die.
So I started my work week with lil surprise. Emphasis on little. So I open the door to our ICU floor, to be welcomed by alarms, beeping, more beeping, and hello’s. Dayshift nurse already trying to give me report as I walk to the breakroom to put my stuff down. Put my stuff away, throw on some gloss, smooth my scrubs, and grab a paper for report. Two pt”s, blah blah blah, one intubated, one not, boo I prefer then sedated, and intubated. So report is normal , nothing to be concerned about, go flip one pt, then my other pt is in the bathroom, so I tell family members, all 4 of them that I will be back. dayshift nurse leaves. My night has started.
Now my lil surprise, I walk into my patients room and he is in bed, mom and dad on the far side, girlfriend at bedside, brother by bathroom, and patient has his penis out for all to see. Now being a nurse, I have seen thousands of penis’s but I’m like really? just going to have it out like its a normal thing? His mom and dad, brother, and girlfriend at bed side don’t notice? So I’m thinking to myself, well maybe he is unaware, so I’m just going to play along like I don’t see it either, which was very easy to do. Hahaha true story. So I proceed to write my name on the board, hi my name is yesika, I’m going to be your nurse tonight, blah blah blah, I turn around and face him, when he LITERALLY GRABS HIS PENIS AND MOVES IT, well it was a grower not a show’er so it really didn’t move. So now I know this is intentional. I’m like oh god…. why me. So no one in the room is mentioning the lil baby elephant in the room, so I just ask him are you hot? Do you want me to turn the heat down? He says no, I’m fine. Ugh, I wanted to say please put your lil friend away, but I cant. Hcap scores and all, so I just look around and the family and girlfriend still don’t say anything. I give up and excuse myself, but not before making family aware that there is a two visitor rule, and one after nine, so pick who stays and goes. So mom, dad, brother leave girlfriend stays. I’m like yes! thinking to myself, they for sure said something to him, I mean what normal family would just be ok with that, keep in mind this is a man in his mid twenties, this is not normal, but then again this is vegas. So I’m charting and the nurse bell comes on and it is him, walk into the room covers on the floor, all of them, he is laying down, lil man is still out! Jesus, why me? Girlfriend at bedside, and she says he needs help getting comfortable. I am resisting the urge to name other things he needs help with so I bite my tongue, and say ok, I will help reposition you in bed, let me go grab my coworker so and so, I said a female name. He says great, lil pevert. So I go and grab our ekg guy, who I am aware doesn’t do that type of patient care, but he is big male, about a little over six feet tall, and wears scrubs, so he looks like a nurse, hehehe. Tell him whats going on and he agrees to play along, we walk into the room and the patient IMMEDIATELY covers himself and then has a quick change of heart and says, oh you know what, I’m fine, may I have some new covers. I say sure, I look at my ekg guy and say, I will be right back, so he stays in the room, I go and grab the warm covers, because I’m just so nice, and I come back into the room and give his girlfriend the covers, and ask do you need anything else, he says no, I tell him, ok, if you change your mind me or so and so (ekg guy) will come as soon as we can. Lil guy never came back out the rest of the night.
My other patient, well, hmm ok .. so patient is intubated and annoying boyfriend at bedside. which is funny because I had literally just got of the phone with the husband, yes husband , who informs me that if so an so ( patients boyfriend) is too much of a nuisance to make him leave because he doesn’t want him there anyways. I am slightly confused, but mind my business and say ok will you be in tonight to sign some procedure paperwork? He say no, but if boyfriend leaves, he will come. Sigh… family dynamics…I never get involved. but whatever. So I ask for phone consent because pt is scheduled for a something in the am, then being nosey I ask if that is ok, I can call next of kin or parents if they are in a delicate situation like divorce or something and he feels it would be best to get consent from family…he says no, no need, I love my wife, and I spoke with the doctor, although she may be there longer, we decided this is the best chance for her. Well ok then. got a second nurse. signed consent, and stuck it into my whatever file in my brain. So boyfriend is an idiot. he ask me for water for patient explained the whole, pt is not allowed to drink or eat, blah blah blah. he asks for mouth swabs, I give him 2. next thing I know beep beep beep , alarm alarm alarm, run to the room he has the pt wide awake, shoving swabs down her throat, and patient is just freaking out. I tell him to stop, step aware, suction about half a cup of water and secretions from her mouth and throat, and inform him to never do that again. he said that she TOLD him she was thirsty. keep in mind she has a tube down her throat, and is on enough pain and sedation medicine to put 12 rhinos to sleep, so I didn’t believe him. I just said, well next time she ‘says’ anything to call me. he then proceeds to grab her arm, rub her chest and say, are you ok, are you ok, after I had calmed her down and she went back to sleep. I’m like omg, what part of please leave her alone can you not understand? I didn’t say that but, I politely made him aware to not do that. so all night he kept calling me into the room saying I think she needs me, or I think she is in pain, or I think she wants water. it was never ending. The patient was fine, stable, and I had to walk in and tell him to not touch, shake, rub , bother pt, PLEASE! all night. I was going to make him leave but then he started crying, and as much as I love seeing men cry, I felt bad for him, pt was awake enough to grasp her boyfriends hand, so I just let him stay, and kept a closer eye on patient because even though he was an idiot, I honestly think he meant well.
Hello everyone and welcome back! if you haven’t figured it out yet my name is Yesika and I am an RN. Hence the name RNYESIKA 😀. But you can call me princess . HAHAHAHAHAHHAAHA jokes. I’m full of them and people always ask me am I a real nurse. Yes…yes I am. I am not a writer, I’m not an educator, I’m not an English major… so be patient with me and my writing skills. I’m just a floor nurse that wants to share my life as a nurse….. because it’s HILARIOUS . …UNBELIEVABLE … MOVING…REWARDING… but I always tell my friends I swear when I retire I’m going to write a book!
So we all know how I fell into nursing… but why did I stay. Good question. let’s see… let me make a list
- Helping patients . … no.. and yes. majority of the time mine are sedated and intubated…but when they aren’t. they are actually really mean. they yell, kick, scream, demand ridiculous things… one time I swear my pt asked me if I would “help” pull her poop out. 100% true story. then you have the pt’s who are just normal people with manners…that are sick, and you just want help and see them get better, or live. So it’s not the pts that make me stay.
- Money…. yessss that mean green! yes and no. I have worked at a place where the pay was disgusting . I did stay knowing I could make 3 times as much literally anywhere else. But I still stayed because I was comfortable there. Not money wise.. I got a part-time job nursing at a different hospital just to make up for the pay. Now I work at a great hospital where the pay is great… but those taxes kill me…. so it’s not the money. …. but I’m not complaining neither 😉.
- Coworkers . … *sigh* ok so…I’m 90% of the time the only Mexican nurse. My culture is different, my upbringing is different, my stories are different , my background is different. Not better or worse just different. On a side note …it was usually worse 😂😂😂😂.So I never instantly clicked with anyone. I’m quite, keep to myself, takes a while for me to open up, and people take that differently. Either you love me or hate me. if you take the time to get to know me you will find out I’m absolutely FABULOUS . ..or you just choose right then and there that you don’t like me and we are enemies . I have some amazing coworkers who I call friends… and then I have some coworkers that unfortunately have to be in the same floor with for 13 hrs. They can ruin your day.. or make your job super fun. so it’s not the coworkers.
- Nursing….. I love science . . I love learning..I love nursing. I love the human body. We are amazing ! It’s super neat to me, if I do this.. give that.. tritate this.. titrate that.. try this ..try that.. keep doing this… stuff happens and you made it happen. I feel like I did something and it is very rewarding. Then you have your days where you literally do everything right, your on top of everything, your sweating because you’ve been running around all night trying to make things happen, but the pt dies anyways…or just gets sicker. It’s devastating. With nursing you never know, great days bad days it’s constantly changing. New medical advances, new rules, there is always change. I’m an adrenaline junkie… and nursing gives me my fix. We fit. I’m good at it. I’m not good at a lot of things…. but I’m good at this. It’s my thing. I like it. So that’s why I stay.
Why and how did I become a nurse. Well that’s a good question. I ask myself that sometimes during shifts. I would love to say it’s because I love people and I have an overwhelming desire to help those in need. But that would be a lie. I don’t hate really hate people,even though I prefer dogs over people, let’s just say it grew on me.
So backtrack many many years ago. I find myself a separated housewive with an amazing biology degree that I haven’t used in years and the realization that I am going to have to get a real job. Housewives don’t pay much. So I’m at chipotle having lunch and a see someone walk in with scrubs. So a light bulb pops in to my mind…. google nursing income… well my my my… I’ll be a nurse!!! That’s easy right??? Hahahaha oh if I knew then what I know now I wouldn’t of been so cocky.
So I find that with my degree I can skip over prerequisites and be that much closer to becoming a registered nurse. Sounds great right? WRONG WRONG WRONG … I see the price of college tuition. Anxiety. So I swallow my pride and ask my soon to be ex for money. After all I help but him through college. He hangs up on me and tells me to not call back because him and his new girlfriend sleep early now.
So I get two crappy jobs ..grab my kids, tell them I love them and drop them off with their dad. So for the next 3 years I work two full time jobs and go to school full time. Sounds fun right. Well it was the beginning of a new world, it sucked. Big time.
I will talk about nursing school later. Let’s just say I suffered my first of many full blown anxiety attacks in the first year of nursing school. I ate fast food, gained 60 lbs, got addicted to red bull, and only slept about 3 hrs a day. I was fat, and my skin looked horrible, and I had bags and dark circles under my eyes for 3 years. That was just the school part. Horrible why would anybody continue with it…. nursing.
Nursing was exciting to me… I loved it. From day one I was hooked. Learning this and that.. going on clinicals and actually being hands on, interaction with real people. I saw my first code during my E.R rotation. Although i was just watching, it was the biggest rush I have ever had. Basically someone’s heart stopped, breathing stopped, and with a bunch of chaos.. meds..chest compressions.. scrambling back and forth.. person was alive again HOLY CRAP!! Right then and there… I decided this is for me. I will be a nurse.. I want this. I almost quit nursing school… I was making ok money with my two jobs and I was thinking what I was doing to myself wasn’t worth it, until this day came. I vowed not to quit. And to see it through. Best choice I made probably my entire life.
So that’s how I became a nurse. I’m not a professional writer, truth be told English is my second language. So bare with me. But the nursing world is amazing and I have to tell my story of how nursing will make you crazy, laugh, cry, all within the first 2 hrs of your shift. True story.