She Knows It's Coming

Okay, I show up for work in the ICU Thursday.... my orientee is sitting in a chair. Ha you say, so..... So this gal never sits, she is usually 30 minutes early for work, has report underway, makes me look terrible all the time. So I'm thinking, what's wrong......

We start report. Now, I'm not the most observant person in the unit, but I could even tell Zippy ain't feeling so good. First clue, she can't finish a sentence without having to stop for a breath (and when the sentence is "No, I'll stay." it isn't a good sign). Second clue, I've seen pt's that have better colour than she had (you can include 1/2 dead pts in that), third, my co-workers all said she was sick.

Give her credit, Zippy was determined to work!! She refused to go the ER, she said she couldn't drive home, she was gonna work. We had a balloon pump pt and something else, nothing serious. I kept telling her that it was fine for her to stay, when she passed out we could do anything we wanted (the chaplain later told me that this statement was pivotal in her relenting to care while she could control some of it). When she was trying to give the 9am meds and couldn't get the meds down the NG tube and realized that someone would have to help with that - she thought it was stopped up, reality was she was too weak to push the meds, it flushed easily with the healthy nurse. She finally said that maybe she would go to the ER. I knew there was no way this gal was going in a wheelchair, but her audible wheezes were unnerving to me as we walked down to the ER (yeah, not very observant, I didn't hear them with all the racket in the unit, in the hallway, oh my!) And of course, she was breathing 37 times a minute.

I also work in the ER pool, so I was hoping that would speed things up for us, alas, not to be. We got back rather quickly but getting respiratory was a little slow. I went back and forth (I was charge in our unit, hated to be gone long) and Zippy was in good hands. However after her 1 hour updraft and CXR her sat on room air was 85%. I suggested maybe O2 would be in order, but didn't put it on in case they wanted gasses. Epi and steroids were given, and she ended up on 40% veni mask. Long story short(er), she got admitted to ICU for bilateral PE's (blood clots). Two days later she is doing much better, I did manage to care for HER patients without killing any of them, and she is ALMOST cooperating with her care.

I can't tell you how scared I was. We lost a blogger in the fall to this, of course I've seen pts die with it, one of our nurses mom died with one (sorry babe - I know it still hurts and I know you were very scared), and I'm quite attached to the girl. I'm hoping that Zippy will take this serious, will actually cooperate with the docs (we did hand pick them), and will heal quickly. After all, I am having to do my own work, God save the patients!!!!