I recall it all starting about 800. Lab calls to tell me that my patient has a 'critical lab value,' meaning that it's waaaay out of normal range. So it's my job to call the doctor to let him know. This is not just any doctor. It's Dr. Green. Even the old seasoned nurses cringe when they hear that Dr. Green is on call or covering that patient. Of course, they told me not to be nervous or let him intimidate me...them saying that was enough to make me quake in my socks. So I call Dr. Green, tell him the lab values, he goes "WHAT?!" All I can say is "......yes sir." So he gives me some orders for one electrolyte and has me recheck the level of the other one. He showed up a few minutes later, after deciding it sounded serious enough to come check out. My other patient, although, decided to have her heart change rhythms from a beautiful sinus, regular, normal rhythm to a freaky, nervous-making atrial fibrillation. I did my dutiful EKG, wrote the order for it, and realized I was supposed to tell the doctor. HE HAD JUST LEFT! So I paged him, told him the problem, and he decided to tell me that Dr. Ridley was on-call for him. Then why was Dr. Green even there?!?! Who was I to comprehend what goes on in the minds of doctors? I told Dr. Ridley, and *he* told me that Dr. Green had just told him. Why couldn't Dr. Green have told me, "Thanks for letting me know. Dr. Ridley is here, I'll pass it onto him." But no, I, the newbie, got to make the most doctor calls that morning.
By this time, it's about 1000. In between talking to doctors and answering all those phone calls that were concerning my patient, I passed meds, got some people up to potty, helped them sit up and wake up for breakfast, normal nursing things. In the midst of all this calamity, a third doctor came by, Dr. Siu (like sue) came and wrote a bazillion orders, in addition to the many the Dr. Green and Dr. Ridley wrote when they decided it was important enough to stop by and see my patients. My first patient, for HIPPA sake's I'll call her X, had enough IV fluids ordered to float a small boat. Not only that, they all decided to call them 'stat/now' orders, only one IV fluid per IV site, please. PLUS X got 20 more meds (before she only had an aspirin daily). While all that was going on, my second patient, L for HIPPA sake's, had all sorts of changes made to her orders as well. I was informed that this makes for a crappy day at work. No kidding!
By this time it's about 1130, and X has about 9 or 10 blood tests ordered. Does X have good veins? No. Were we able to utilize both arms for the best vein selection? No. Did I attempt to draw blood? Yes. Did I get it? No. Oh, I didn't tell you that she had blood drawn at 700, and at 900, already. That poor lady's arm was bruised like nobody's business. But the blood does get drawn; most of her IV fluids get hung, and it's 1230.
I didn't get off for lunch until 115. But I'm still on orientation so I can have flexible lunch times.
After lunch...this is where my memory gets fuzzy. I'm really tired, and I'll leave the rest of the day up to your imagination. But it goes pretty much as busy and as running-like-a-chicken-with-my-head-cut-off as anything. But I'll let you in on some things I learned.
1. Constant vomiting (flu like symptoms) could be because your stomach is full of fluid that's not passing through your intestines.
2. Pamidranate (or something like that) is for cancer related hypercalcemia (high levels of blood calcium), and brings the calcium levels down.
3. The cardiac enzymes that they use to detect heart attacks can be elevated because other electrolyte levels are out of whack.
4. Old people like it super hot in their rooms.
5. Always have a bottle of water handy when you're working 12-hour shifts
6. I can't do it all by myself!