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Haunting story from the ICU

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.

Nursing

Early pregnancy miscarriages some types..facts.. and myths

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.

CHEMICAL PREGNANCY

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.

floor nursing · gross stuff · male nurses · Nurse · Nurses · Nursing · nursing humor · registered nurse · rn · rn's

Just one of many reasons to get circumcised… from a professional point of view

So ….. yes we are nurses, and yes I would say about 90% of times we are professionals. But I mean, we are human. Just when you think you are prepared for pretty much anything..this happens. 

So guy comes in with several complaints of pain and different health issues. This and that, so get the usual order, labs, ekg, monitor, insert foley.

So basically guy takes clothes off,  the foley is ready for insertion, notice pt penis is swollen and not circumcised. Pull the foreskin back and MAGGOTS!! MAGGOTS MAGGOTS GOD DAMN MAGGOTS!!! 

So do you know how hard it is to be professional?? So moral of the story, one reason to get circumcised is that maggots can’t hid in the foreskin. 

Nursing

Things you shouldn’t find “inside” your patient’s… but you do. 

               So you come in to work, get report everything seems normal, and the prior shift leaves. So you go back in to see the patient, and they have a rectal tube, rectal catheter, however you refer to it. So it looks…different. 

     There is liquid in the collection bag , but it’s clear, small amount. Maybe they just change the bag. So you go to flush it and light clear pink tinged water comes out. Ok. So you look closer and realize it’s inside the vagina!!!! I believe the nurse went and got a second opinion just to verify. And yup it was inside the vagina. 

     This is bad .. real bad. I mean COME ON!! besides the complications this may cause, hello!!!! This is really bad!!! How this happened no one knows. Ok one the rectal bag goes in the rectum, and  two, pretty much nothing should be inserted in the vagina. 

     If you don’t know how to do something just ask, please just ask… please!!! 

     

floor nursing · gross stuff · Nurse · Nurses · Nursing · nursing humor · registered nurse · rn · rn's · Uncategorized

The Dark Side of Nursing, and things that accidently end up on your face…

screenshot_20170201-092550Recently 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.
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Don’t be afraid of the prolapsed uterus

So one day I came to work, and settled in , sipped on my red bull, and threw on my gloss, priorities. So my coworker, dayshifter, starts giving me report, the usual, then my last pt. my coworker tell me that my pt has a gross looking tumor on her “private area”. I’m like ok…. interesting… keep going, coworker informs me that they have been keeping it moist and there is a chuck (hospital bed pad) underneath it to hold the moisture. I asked who the oncologist was, coworker say, pt doesn’t have one, so they called the attending made them aware of his “findings” and the attending dr was going to come up soon. I said ok go into the patients room and introduce myself and  ask if I may do my assessment, patient says yes, because I’m very curious as to what this tumor looks like, pull the sheets down and low and behold …… its a prolapsed uterus. My male coworker thought it was a tumor, never seen one before, and he has been watering it.. like a plant. Holding my laughter in, not because of the prolapsed uterus, but because my coworkers tumor theory. I excuse myself and leave the room.

A prolapsed uterus is when the uterus falls.. well gradually slides down the vagina, eventually protruding outside the vagina. It happens for varies reasons, usually the pelvic muscles are to weak, or the ligaments are to stretched out or unable to support the weight of the uterus, so it falls down the vaginal canal. I wont post a picture of one, but like everything else, you can find images on google!

So we walk out the room, and i inform my coworker that it is a prolapsed uterus, my coworker, being a male, says ” Ewwww they do that” hahahahaha… yes, yes they do, I’m sure not on purpose, but it happens. So I call the doctor and make them aware of my findings, he tells me to push it back in, which you can actually fist it back into the vagina depending on the degree of prolapse, interesting! Even though i actually entertained the thought, for a good hot minute, I declined and said I didn’t feel comfortable doing that, so dr made a consult with another dr who would be up later to view the patient. Hopefully tonight, but it will probably be a resident who is on call to discuss treatments and options.

So moral of the story ladies and fellow “Murses” (male nurses), one do a thorough assessment, geez don’t want anyone hearing the tumor word or the big “C” word, nurses never diagnose, that’s a dr’s  job.  Be considerate of patient, i mean geez this lady had tumor running through her mind all day!!!! Murses, it happens don’t freak out, ladies drink water..do your kegels, add some yoga or pilates..maintain a healthy weight, avoid constipation, as much as possible, if you have any vaginal bleeding, or feel weird down there, like pressure in the pelvic area, see a dr. Preventative care   works, but you can’t treat something you don’t know you have!