Since beginning work as an RN, I have had quite a few people ask me…”What made you decide to become a nurse?”
For anyone who has been through or is in nursing school you know that in order to make it through, YOU have to want to be a nurse. You can’t be there for anyone else or because someone else wants you to be. YOU have to there for you and your dreams.
In the beginning, I entered nursing school to keep a promise I had made to myself regarding a friend. I wasn’t there because I necessarily wanted to be but rather because I felt obligated to be. As the classes got harder and harder I quickly began to struggle because I wasn’t there because I wanted to be…
As the years went on I changed my life theme to “Nursing??? Why not, it’s not the worst job, and I have already put so much effort into it”. This of course, wasn’t exactly wanting to be there but was more of a settling.
I made it to my senior year without an actual true desire to be a nurse. But that changed.
I began to struggle with an aspect in my life. I was having trouble, and a friend stepped up and made sure that I was not alone during the hard time. This friend was willing to push me when I needed pushing, as annoying as it was, was willing to let me figure things out for myself instead of just telling me what I should do…
Thanks to this friend I was able to make it through the struggle and through it all, I found my reason for wanting to be a nurse and helping people.
My answer now when people ask me “Why did you decide to become a nurse?” is “Because once upon a time, someone helped me during a tough time, and made a change in my life. And now that is what I want to do for others.”
Usually the next question to follow is “Do you like being a nurse?” My answer I have found over the past months is, “While I have the rough days and the rough patients, it is worth it, because I get to make just a small difference in other people’s lives in their time of struggle”.
It is rewarding to know that I am able to “pay it forward” and do what one friend took the time and energy to do for me. And of course it doesn’t hurt that I am amazing at helping others (had to get that big ego in there somewhere) ;)
Thursday, February 23, 2012
Wednesday, February 22, 2012
What a Night!!!
It is important as a nurse to stay on your toes and be ready for anything at anytime. Things don’t always go according to plan.
My first night of work this week, I was told that I had two patients that I needed to keep an eye on for signs and symptoms of sepsis. Now for those who don’t know…sepsis is not a very good thing and one that you really don’t want to happen on an acute care floor where the monitoring is not as intensive as in progressive or critical care parts of the hospital.
Well I kept a close eye on these two patients and they were fine all night long, in fact one seemed to be improving. I left for the morning and went to get some rest before I returned that evening.
As I received report on the first patient, I learned that she had continued to be fine all day long. Her temperature had maintained normalcy and her blood pressure was fine. I finished receiving report and went into the patient’s room to begin my assessment. She asked to be repositioned in bed…so I went to find some help…As the tech and I were moving her up in the bed, I noticed she felt really warm…I asked the tech to take her temperature before she got her some ice. Her temperature was 103.1!!! That is never a good thing…so I gave her some Tylenol to help bring the fever down. About 30 minutes later, the tech came and found me to tell me that her blood pressure was 72/54 Not good!!!!
I paged the doctor and he came up to assess the pt. He ordered blood cultures, a 500 ml bolus, chest and a chest X-ray. As he was in the nursing station entering the orders, the pt complained of her throat closing off as if it was swollen. The doctor came back in and very quickly called his upper level to get some help. The upper level doctor came up and ordered a STAT EKG, some antibiotics and a progressive bed transfer. I spent the majority of the night before midnight in with this patient getting her stabilized and ready for transfer.
It was a little sad because once she was stabilized, and she realized she was being transferred, she began to cry. “I don’t want to leave…you all take such good care of me up here…” I told her that I wish she would stay with us…but that she should tell the nurses in progressive care that she wanted to come back up to our floor tomorrow if she was able. She said she would. And off she went.
This left me with four patients, with a ton of work to catch up on since I had gotten behind caring for the septic patient.
I ran my butt off for awhile until I finally caught up, and the evening slowed down for a bit until about 0500. As I was taking pain medication to one of my patient’s (the other patient from the night before who I was supposed to watch for sepsis) wife came running out of the room. “There’s something not right with my husband!!!”
I went running in with all these thoughts going through my head of what it could be…especially since earlier in the evening I had witnessed him having hallucinations from a dose of dilaudid. He was talking about seeing people flying around the room, and a helicopter flying over his head with an elephant on it…needless to say I held the dilaudid for the rest of the night…
I entered the room, and saw the patient sitting there with a weird look on his face…his eyes were open really wide, and he was mumbling a bunch of nonsense and smacking his lips together…I knew what it was in a second and went to grab the glucometer.
As I checked his glucose level, he was talking all sorts of crazy talk and being really funny. His glucose came back at a critical low of 9. I was very surprised he was still conscious and able to talk even if it was nonsense. I quickly grabbed some orange juice with 2 packets of sugar missed into it. I was able to convince him to drink the OJ, but it was not helping as much as I wanted it to…so I grabbed a tube of glucose gel. I placed the gel in his mouth and tried to get him to swallow…he was not able to comprehend my commands…so I had him look at me and showed him how to swallow…He swallowed the majority of it down, the rest ended up all over me when he decided to begin spitting and smacking his lips. Even after the glucose gel his glucose was only up to 48 which is still not very good.
So I pulled out the big gun, an amp of D50!!! I knew the D50 would bring up the glucose. As I began pushing the D50 into his IV, he started to cry. Which was actually a good thing…it meant that his glucose was coming up…as I got about ½ of the amp administered, he suddenly came too…and knew where he was and who I was…But he couldn’t remember anything or know what had happened…I explained to him that his sugar had dropped but the D50 had helped bring it back up…but that he needed to eat some graham crackers and peanut butter so that it would stay up…
Overall it was a very busy stressful night at work…I had two incidents happen that I could not foresee so it was a good thing that I was able to think on my feet and that my training was enough to help me know what to do…Both patients turned out to be fine and I left work with both I and all my patients alive :)
My first night of work this week, I was told that I had two patients that I needed to keep an eye on for signs and symptoms of sepsis. Now for those who don’t know…sepsis is not a very good thing and one that you really don’t want to happen on an acute care floor where the monitoring is not as intensive as in progressive or critical care parts of the hospital.
Well I kept a close eye on these two patients and they were fine all night long, in fact one seemed to be improving. I left for the morning and went to get some rest before I returned that evening.
As I received report on the first patient, I learned that she had continued to be fine all day long. Her temperature had maintained normalcy and her blood pressure was fine. I finished receiving report and went into the patient’s room to begin my assessment. She asked to be repositioned in bed…so I went to find some help…As the tech and I were moving her up in the bed, I noticed she felt really warm…I asked the tech to take her temperature before she got her some ice. Her temperature was 103.1!!! That is never a good thing…so I gave her some Tylenol to help bring the fever down. About 30 minutes later, the tech came and found me to tell me that her blood pressure was 72/54 Not good!!!!
I paged the doctor and he came up to assess the pt. He ordered blood cultures, a 500 ml bolus, chest and a chest X-ray. As he was in the nursing station entering the orders, the pt complained of her throat closing off as if it was swollen. The doctor came back in and very quickly called his upper level to get some help. The upper level doctor came up and ordered a STAT EKG, some antibiotics and a progressive bed transfer. I spent the majority of the night before midnight in with this patient getting her stabilized and ready for transfer.
It was a little sad because once she was stabilized, and she realized she was being transferred, she began to cry. “I don’t want to leave…you all take such good care of me up here…” I told her that I wish she would stay with us…but that she should tell the nurses in progressive care that she wanted to come back up to our floor tomorrow if she was able. She said she would. And off she went.
This left me with four patients, with a ton of work to catch up on since I had gotten behind caring for the septic patient.
I ran my butt off for awhile until I finally caught up, and the evening slowed down for a bit until about 0500. As I was taking pain medication to one of my patient’s (the other patient from the night before who I was supposed to watch for sepsis) wife came running out of the room. “There’s something not right with my husband!!!”
I went running in with all these thoughts going through my head of what it could be…especially since earlier in the evening I had witnessed him having hallucinations from a dose of dilaudid. He was talking about seeing people flying around the room, and a helicopter flying over his head with an elephant on it…needless to say I held the dilaudid for the rest of the night…
I entered the room, and saw the patient sitting there with a weird look on his face…his eyes were open really wide, and he was mumbling a bunch of nonsense and smacking his lips together…I knew what it was in a second and went to grab the glucometer.
As I checked his glucose level, he was talking all sorts of crazy talk and being really funny. His glucose came back at a critical low of 9. I was very surprised he was still conscious and able to talk even if it was nonsense. I quickly grabbed some orange juice with 2 packets of sugar missed into it. I was able to convince him to drink the OJ, but it was not helping as much as I wanted it to…so I grabbed a tube of glucose gel. I placed the gel in his mouth and tried to get him to swallow…he was not able to comprehend my commands…so I had him look at me and showed him how to swallow…He swallowed the majority of it down, the rest ended up all over me when he decided to begin spitting and smacking his lips. Even after the glucose gel his glucose was only up to 48 which is still not very good.
So I pulled out the big gun, an amp of D50!!! I knew the D50 would bring up the glucose. As I began pushing the D50 into his IV, he started to cry. Which was actually a good thing…it meant that his glucose was coming up…as I got about ½ of the amp administered, he suddenly came too…and knew where he was and who I was…But he couldn’t remember anything or know what had happened…I explained to him that his sugar had dropped but the D50 had helped bring it back up…but that he needed to eat some graham crackers and peanut butter so that it would stay up…
Overall it was a very busy stressful night at work…I had two incidents happen that I could not foresee so it was a good thing that I was able to think on my feet and that my training was enough to help me know what to do…Both patients turned out to be fine and I left work with both I and all my patients alive :)
Tuesday, February 21, 2012
A Good Lesson to Re-Learn
For the past month I have been caring for a patient who is known as a “total care” patient. In simple layman terms, this means that the patient cannot do anything for him/herself. The care for this patient includes turning every 2 hours, dressing changes, completing trach care/suctioning, maintaining the patency of the PEG tube, cleaning any incontinent spells, and of course treating this patient as the person that he/she still is.
The situation that led to the patient being this way is very sad and heart breaking, not to mention the fact this patient has been in the hospital setting for an entire year.
When I first started caring for this patient, it was a bit overwhelming to think of all the things I had to accomplish during the night to give the adequate care for the patient, but as the nights built up with experience of providing care, it has become easier and easier to give all the care within the 12 hours.
In fact this patient may be one of the easiest patients that I have ever cared for.
In nursing school we are taught about the importance of communication with the patient…however when you care for a patient that you think is incapable of communicating it is easy to forget to treat this patient as much of a human as possible…that was before…
One night while I was caring for this patient, the heart rate increased to 138 and kept increasing to 145. I was a little concerned but not overly since the patient usually runs tachycardiac. As I was in the room, doing dressing changes and pushing some pain meds through the PEG tube, another nurse came into the room. (Now when you take care of a patient repeatedly, it is a little hard not to become attached and to form somewhat of a bond with them). She teasingly told me to take good care of her favorite patient. She went to the other side of the bed and started to talk to the patient. As the patient heard her voice, the heart rate began to decrease and the arms and legs began to move a little. This was amazing because we were all under the belief that any movements were based on reflex and there was no intentional movements left in the patient. She then began to ask simple questions such as “Are you in pain, Do you want the Light Left On, Are you comfortable?” She then asked the patient to blink once for yes and twice for no…and of course there was response and the patient was making preferences known!!!
While I always make it a point to talk to the patient while I am providing care, to be honest, I never really paid attention to see if the patient was trying to respond to the attention and care. I plan on making a more conscious effort in having a two way communication with this patient and not just see the non-responsiveness as all that is going on with the patient. It was a good lesson to re-learn.
The situation that led to the patient being this way is very sad and heart breaking, not to mention the fact this patient has been in the hospital setting for an entire year.
When I first started caring for this patient, it was a bit overwhelming to think of all the things I had to accomplish during the night to give the adequate care for the patient, but as the nights built up with experience of providing care, it has become easier and easier to give all the care within the 12 hours.
In fact this patient may be one of the easiest patients that I have ever cared for.
In nursing school we are taught about the importance of communication with the patient…however when you care for a patient that you think is incapable of communicating it is easy to forget to treat this patient as much of a human as possible…that was before…
One night while I was caring for this patient, the heart rate increased to 138 and kept increasing to 145. I was a little concerned but not overly since the patient usually runs tachycardiac. As I was in the room, doing dressing changes and pushing some pain meds through the PEG tube, another nurse came into the room. (Now when you take care of a patient repeatedly, it is a little hard not to become attached and to form somewhat of a bond with them). She teasingly told me to take good care of her favorite patient. She went to the other side of the bed and started to talk to the patient. As the patient heard her voice, the heart rate began to decrease and the arms and legs began to move a little. This was amazing because we were all under the belief that any movements were based on reflex and there was no intentional movements left in the patient. She then began to ask simple questions such as “Are you in pain, Do you want the Light Left On, Are you comfortable?” She then asked the patient to blink once for yes and twice for no…and of course there was response and the patient was making preferences known!!!
While I always make it a point to talk to the patient while I am providing care, to be honest, I never really paid attention to see if the patient was trying to respond to the attention and care. I plan on making a more conscious effort in having a two way communication with this patient and not just see the non-responsiveness as all that is going on with the patient. It was a good lesson to re-learn.
Sunday, February 12, 2012
Unpredactibility is the Name of the Game
One aspect of nursing I will never get used to is the unpredictability of the profession. It’s normal to receive report and to make a plan of how your evening is going to go…including which patients you are going to see first, what order you are going to do your tasks in, and what time you are going to do what. But the one sure thing about nursing is that as soon as you make a plan…your night is destined to do anything but abide by that plan. Hahaha
Another thing is the unpredictability of the patients. You may think you know how a patient is going to react or respond during the shift…but in reality they are just as much of an enigma as ever.
One night I had a patient who had an EMV of 8 or 9 (this pretty much means he was non-responsive and lethargic) . Until about 1 or 2 in the morning, he was sleeping and non-responsive to what we were doing around him.
The tech and I went in to clean him up and to change his dressing. In order to clean him and his bed completely, we had to roll him onto his side. As we rolled him, he became more alert and began shouting, “NO!!!! NO!!! Put me back down!!!! Leave me Alone!!!” The whole time he was fighting to roll back over…
I finished with his dressing and changing his sheets. We placed him back in his original position, and he began to fidget all over the place and began mumbling. Then he managed to sit up and get halfway out of the bed…It took three of us to keep him in the bed. When he was safely back in the bed, I went to get him some pain meds, because I thought he may be in pain. As I was checking the MAR to figure out when his meds were due…I heard the techs yell out “Alicia we need you in here now!!!!”. I grabbed the pain medicine and went to the room…as I entered the room, I noticed blood everywhere. Then I noticed the IV had been pulled out. We had to change the sheets and clean the patient up again. The patient continued to fight and managed to get in a couple of punches toward me and the tech…he also managed to get my arm within his grasp…I thought for sure he was going to snap it in half…I have no idea where he got all his energy from. I managed to get my arm free and once he was clean, I gave him his pain medications, which made him sleepy and he was back to sleeping like a dead person for the rest of the shift.
The next night when I came in, an order had been placed for restraints because he had managed to pull his dialysis port out.
It just goes to show that you can never know how your patients are going to act or what they are going to do…you have to be prepared for anything.
Another thing is the unpredictability of the patients. You may think you know how a patient is going to react or respond during the shift…but in reality they are just as much of an enigma as ever.
One night I had a patient who had an EMV of 8 or 9 (this pretty much means he was non-responsive and lethargic) . Until about 1 or 2 in the morning, he was sleeping and non-responsive to what we were doing around him.
The tech and I went in to clean him up and to change his dressing. In order to clean him and his bed completely, we had to roll him onto his side. As we rolled him, he became more alert and began shouting, “NO!!!! NO!!! Put me back down!!!! Leave me Alone!!!” The whole time he was fighting to roll back over…
I finished with his dressing and changing his sheets. We placed him back in his original position, and he began to fidget all over the place and began mumbling. Then he managed to sit up and get halfway out of the bed…It took three of us to keep him in the bed. When he was safely back in the bed, I went to get him some pain meds, because I thought he may be in pain. As I was checking the MAR to figure out when his meds were due…I heard the techs yell out “Alicia we need you in here now!!!!”. I grabbed the pain medicine and went to the room…as I entered the room, I noticed blood everywhere. Then I noticed the IV had been pulled out. We had to change the sheets and clean the patient up again. The patient continued to fight and managed to get in a couple of punches toward me and the tech…he also managed to get my arm within his grasp…I thought for sure he was going to snap it in half…I have no idea where he got all his energy from. I managed to get my arm free and once he was clean, I gave him his pain medications, which made him sleepy and he was back to sleeping like a dead person for the rest of the shift.
The next night when I came in, an order had been placed for restraints because he had managed to pull his dialysis port out.
It just goes to show that you can never know how your patients are going to act or what they are going to do…you have to be prepared for anything.
Friday, February 10, 2012
Tough Love...Umm...I Mean Care
As a nurse, sometimes you have to be very firm with your patients or they will pretty much make your life a living hell. For example, I was caring for this one patient who decided that he was going to be very difficult.
In report, I learned that he was in pain, and his pain meds may not have been exactly adequate to control the pain, but because of a history of abuse, the doctors were being cautious and did not really want to order any other meds.
Before I could even get out of my chair to begin my rounds, this patient was on the call bell. The tech came and told me that the patient was very upset and wanted to see me right now about his pain meds. I quickly checked when his pain medication was due…of course it wasn’t due for another 3 hours. Hmm this was going to get interesting very quickly.
I introduced myself and asked him what I could do for him…He started right in. “I want to see your supervisor” Ummm…does he really think my supervisor is here this late at night!!!! “She’s not here right now, but I will pass on that you want to speak with her”
“I want to talk to my doctor right now” I of course told him I would call the doctor and let her know…of course that didn’t stop his rant and rave…
“I want to take a shower and I’m gonna do it right now” “Well that’s fine, I really don’t care, let me check to make sure the shower is clean, and we can do that for ya”.
“Well this is stupid…I know how this is gonna go…you are gonna come back in here and tell me I missed taking a shower by like a minute because it took forever!!!” I quickly explained to him that I really didn’t care if he took a shower but I did care if he took a shower in a dirty shower.
I told him I would call the doctor and have her come up to see him right now…so I went and paged the doctor and she came right up…but of course sometime in between my leaving the room and the doctor coming up, the patient had gotten in the shower. Of course the doctor didn’t stick around to talk to the patient so I had to put that fire out.
When his shower was finished, he started right back in on the pain medication issue “I never got any pain meds all day and I want them now…I’m dying…you can’t understand how much pain I am in.” Of course the pain meds still were not due for another 2.5 hrs. I quickly decided that I was not going to deal with this all night…I very firmly explained to him that I would bring in the medicine as soon as I could, but he could not keep bothering me all night with this…I told him I would re-page the doctor.
He stood up and got right in my face…he took his finger and started poking my chest…going off on a tyrant…now of course he was much taller than me which made it a little intimidating…but I just stood there until he stopped talking…and then said
“Sit down!!!” He just looked at me. “Sit Down!!!” He quickly sat down. “You need to stop talking!!! And listen to what I have to say!” From that moment on the dynamics had changed and we were able to have a real conversation about what he wanted and what his expectations were….which changed the tide of the rest of the evening.
However as I was leaving in the morning and walking by his door, I saw him standing over one of the techs doing the same thing he had tried on me…Hmm…guess being firm only makes a difference while you are in the room ;)
In report, I learned that he was in pain, and his pain meds may not have been exactly adequate to control the pain, but because of a history of abuse, the doctors were being cautious and did not really want to order any other meds.
Before I could even get out of my chair to begin my rounds, this patient was on the call bell. The tech came and told me that the patient was very upset and wanted to see me right now about his pain meds. I quickly checked when his pain medication was due…of course it wasn’t due for another 3 hours. Hmm this was going to get interesting very quickly.
I introduced myself and asked him what I could do for him…He started right in. “I want to see your supervisor” Ummm…does he really think my supervisor is here this late at night!!!! “She’s not here right now, but I will pass on that you want to speak with her”
“I want to talk to my doctor right now” I of course told him I would call the doctor and let her know…of course that didn’t stop his rant and rave…
“I want to take a shower and I’m gonna do it right now” “Well that’s fine, I really don’t care, let me check to make sure the shower is clean, and we can do that for ya”.
“Well this is stupid…I know how this is gonna go…you are gonna come back in here and tell me I missed taking a shower by like a minute because it took forever!!!” I quickly explained to him that I really didn’t care if he took a shower but I did care if he took a shower in a dirty shower.
I told him I would call the doctor and have her come up to see him right now…so I went and paged the doctor and she came right up…but of course sometime in between my leaving the room and the doctor coming up, the patient had gotten in the shower. Of course the doctor didn’t stick around to talk to the patient so I had to put that fire out.
When his shower was finished, he started right back in on the pain medication issue “I never got any pain meds all day and I want them now…I’m dying…you can’t understand how much pain I am in.” Of course the pain meds still were not due for another 2.5 hrs. I quickly decided that I was not going to deal with this all night…I very firmly explained to him that I would bring in the medicine as soon as I could, but he could not keep bothering me all night with this…I told him I would re-page the doctor.
He stood up and got right in my face…he took his finger and started poking my chest…going off on a tyrant…now of course he was much taller than me which made it a little intimidating…but I just stood there until he stopped talking…and then said
“Sit down!!!” He just looked at me. “Sit Down!!!” He quickly sat down. “You need to stop talking!!! And listen to what I have to say!” From that moment on the dynamics had changed and we were able to have a real conversation about what he wanted and what his expectations were….which changed the tide of the rest of the evening.
However as I was leaving in the morning and walking by his door, I saw him standing over one of the techs doing the same thing he had tried on me…Hmm…guess being firm only makes a difference while you are in the room ;)
Welcome to the Hilton...My name is Alicia...What Can I Do For You?
A few nights ago, I had this patient that seemed determined to push my buttons all night long. The first thing I noticed when I went into introduce myself was that he did not treat his girlfriend very well at all. She was trying to help and all he would do was complain and yell at her that “she didn’t know what she was doing and how could anyone be so stupid”! Well that should have been my first clue as to how my night was going to go…
He set in on me before I could even finish my sentence of explaining who I was. “I’m in pain and I want my meds right now…why did you come in here without my pain meds!!!! What kind of nurse are you?!!!!” Goodness was I livid…but of course I smiled and went and got his pain meds (and they weren’t even laced with arsenic lol). After that he had me running all night long. If it wasn’t the pain meds, it was dressing changes, the television wasn’t working correctly, he wanted to eat and had no regard for his diet, and of course the big issue…he was not happy he was on a 1800mL fluid restriction and of course he wanted something to drink NOW!!!!
I honestly have to say…by about an hour into my shift I was ready to pulverize the guy…Let me tell you it was the longest night of my career because of course he was too busy making demands to get any sleep. I was so glad to be able to leave in the morning, only to return the next night to find that this patient was still there and assigned to me…I wasn’t sure I could do two nights in a row. The second night was just as bad as the first night...I have never been more tempted to neglect a patient and walk away but I smiled and pushed through it. And I learned that for some people I just need to tell them "Welcome to the Hilton".
He set in on me before I could even finish my sentence of explaining who I was. “I’m in pain and I want my meds right now…why did you come in here without my pain meds!!!! What kind of nurse are you?!!!!” Goodness was I livid…but of course I smiled and went and got his pain meds (and they weren’t even laced with arsenic lol). After that he had me running all night long. If it wasn’t the pain meds, it was dressing changes, the television wasn’t working correctly, he wanted to eat and had no regard for his diet, and of course the big issue…he was not happy he was on a 1800mL fluid restriction and of course he wanted something to drink NOW!!!!
I honestly have to say…by about an hour into my shift I was ready to pulverize the guy…Let me tell you it was the longest night of my career because of course he was too busy making demands to get any sleep. I was so glad to be able to leave in the morning, only to return the next night to find that this patient was still there and assigned to me…I wasn’t sure I could do two nights in a row. The second night was just as bad as the first night...I have never been more tempted to neglect a patient and walk away but I smiled and pushed through it. And I learned that for some people I just need to tell them "Welcome to the Hilton".
Wednesday, February 8, 2012
The Worst Part of My Job
While there are many aspects of my job I do not like, I think there is only one that I absolutely despise…trach care/suction….<br />Now while I know how to do it and have no problems accomplishing the skill, I just do not like doing it at all. The other night I was providing care for one of my patients who just so happened to be trached. The orders were for trach care every 12 hrs and suction every 4 hrs. Normally respiratory therapy will do the suctioning, but this particular night there was only 2 RTs for the whole hospital, so of course their trips up to the floor were few and far in between.
At around 0430, I decided, I probably could not put off this dreaded task any longer…but wait…YES!!! I still had a sandwich and it was imperative I eat it right then ;) Believe me when I say this made my night even better…putting off the trach care for another 30 minutes…
Finally at 0500, I could put it off no longer. I went into the patient’s room and began to prepare for the trach suctioning. I set up my sterile field, prepared my necessary instruments, and checked my catheter, now to begin the suctioning.
As I advanced the suction catheter down the cannula, I felt for the resistance and then quickly pulled the catheter out, yielding a ton of mucus from the trach/lungs. I did this two more times and noticed a difference in the patient’s ease of breathing.
I pulled out the inner cannula and cleaned around the trach. As I began to insert the new cannula I was having difficulties putting it back into place. I couldn’t get the final twist to lock it into place…finally I was able to snap it into place. With the snap, the patient began to cough and gag. As I went to put the trach collar back into place, to ease the breathing, this huge mucus plug comes flying out of his trach and lands on his bed. It was beyond disgusting!!! This led to more suctioning to clear the airway and more cleaning around the trach site. My happiest moment that morning was when I could strip off the gown and gloves and leave the room with a clean trach and airway!!! How I despise trach care/suction!!!
At around 0430, I decided, I probably could not put off this dreaded task any longer…but wait…YES!!! I still had a sandwich and it was imperative I eat it right then ;) Believe me when I say this made my night even better…putting off the trach care for another 30 minutes…
Finally at 0500, I could put it off no longer. I went into the patient’s room and began to prepare for the trach suctioning. I set up my sterile field, prepared my necessary instruments, and checked my catheter, now to begin the suctioning.
As I advanced the suction catheter down the cannula, I felt for the resistance and then quickly pulled the catheter out, yielding a ton of mucus from the trach/lungs. I did this two more times and noticed a difference in the patient’s ease of breathing.
I pulled out the inner cannula and cleaned around the trach. As I began to insert the new cannula I was having difficulties putting it back into place. I couldn’t get the final twist to lock it into place…finally I was able to snap it into place. With the snap, the patient began to cough and gag. As I went to put the trach collar back into place, to ease the breathing, this huge mucus plug comes flying out of his trach and lands on his bed. It was beyond disgusting!!! This led to more suctioning to clear the airway and more cleaning around the trach site. My happiest moment that morning was when I could strip off the gown and gloves and leave the room with a clean trach and airway!!! How I despise trach care/suction!!!
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