August extras
1 day ago
So, Taylor was up for another donation!
He finally pulled the trigger. . . .
Before with 21 inches :
and after
with 21 inches GONE!
Gotta luv this!!!!!!!!
It is 7 pm.
"Janet's your Charge nurse tonight"
"Janet's your Charge nurse tonight"
Wha. . . , oh someone must have called in sick, I think
and up I jump up from my seat in the huddle room and carry my backpack
and water bottle to the nurse's station
to greet the off going Charge nurse.
"Am I glad to see you", she greets me, and off we go the the report room
for a report of the day.
"I had 4 sick calls and 7 admissions! "
"Sorry, but I had to put you in Charge".
No problem, I say.
16 patients on the unit, 1 still to come in, 4 surgeries tomorrow, not including
the sternal closure on one post-op to be done at the bedside.
One ECMO on the unit that just came back from the OR and
has been bleeding profusely , one of the ORs is a patient on the unit
that has been having cyanotic spells all day, one patient just finished
a delayed sternal closure at the bedside and few others
with a miscellaneous bag of ills.
It'll all settle down, I think, we got this.
My second in command, or Resource nurse, is an ECMO trained
efficient one with a quick sense of humor and is highly
independent, as she should be. My Fellow on call is
calm, easy and efficient.
Even our UA (unit assistants) are fun and easy with a joke but all business and highly efficient
when the need comes.
It will be a good night, alright.
It will be a good night, alright.
OK, a little levity here.
Emergency checks, check with my Resource that breaks will work out and then
figure out staffing for tomorrow, check surgery and cath lab schedules,
a quick update from the Fellow and down to huddle with the rest
of the hospital's charges with the House Supervisor.
I'll let them know my census, my bed availability, expected admits, surgeries, and
transfers. Then, I'll let them know I am short-staffed in the morning.
PICU wants to send me an ECMO nurse, but I'll have to replace her.
NICU is right on, with no nurses to spare.
My step down unit can take my transfers. As a matter of fact, they need
patients and want one ASAP! Good news!
I head back to the unit and let my Fellow know we can transfer one patient out tonight.
I call the nurse in charge of that patient and my Resource to make it happen within the hour.
Then, I round. Check in with each nurse to see how things are going,
trouble shoot problems, take notes on changes, make suggestions for
the newbies.
The ECMO room needs breaks after they draw their labs. They are almost done,
I'll be back in a few minutes.
Then, I hear "Janet, we need some help here!" The ECMO alarm is sounding
and I rush in. The pump stopped, I check the pressures. We have a clot!
I look at the oxygenator and it is clotted black!
We have to come off ECMO. Clamp, open the bridge and support the patient
while we trouble shoot, call perfusionist, grab a new oxygenator, a new ECMO circuit,
call the Fellow simultaneously while making sure the blood bank and OR are called.
The Attending shows up, the kid is doing fine, thank goodness!
The clot moved, now circuit is moving off the patient, but the clot is ???
We've got to move fast, the cannulas connected to the patient will clot.
We're stuck between a rock and a rock.
Emergency checks, check with my Resource that breaks will work out and then
figure out staffing for tomorrow, check surgery and cath lab schedules,
a quick update from the Fellow and down to huddle with the rest
of the hospital's charges with the House Supervisor.
I'll let them know my census, my bed availability, expected admits, surgeries, and
transfers. Then, I'll let them know I am short-staffed in the morning.
PICU wants to send me an ECMO nurse, but I'll have to replace her.
NICU is right on, with no nurses to spare.
My step down unit can take my transfers. As a matter of fact, they need
patients and want one ASAP! Good news!
I head back to the unit and let my Fellow know we can transfer one patient out tonight.
I call the nurse in charge of that patient and my Resource to make it happen within the hour.
Then, I round. Check in with each nurse to see how things are going,
trouble shoot problems, take notes on changes, make suggestions for
the newbies.
The ECMO room needs breaks after they draw their labs. They are almost done,
I'll be back in a few minutes.
Then, I hear "Janet, we need some help here!" The ECMO alarm is sounding
and I rush in. The pump stopped, I check the pressures. We have a clot!
I look at the oxygenator and it is clotted black!
We have to come off ECMO. Clamp, open the bridge and support the patient
while we trouble shoot, call perfusionist, grab a new oxygenator, a new ECMO circuit,
call the Fellow simultaneously while making sure the blood bank and OR are called.
The Attending shows up, the kid is doing fine, thank goodness!
The clot moved, now circuit is moving off the patient, but the clot is ???
We've got to move fast, the cannulas connected to the patient will clot.
We're stuck between a rock and a rock.
It seems longer than it takes, but the perfusionist and surgeon, (who was in the shower)
show up and calls are made, the decision to check the cannulas is made, a new circuit is
primed, the cannulas are bleeding!! We can connect the new circuit!
Back on we go and replace lost blood to the patient and a big relief is felt by all.
Parents are updated and clean up is done.
It is time to round with the Fellow. We get to the first patient and we get a call, that the
new patient has arrived on the other end of the unit.
We abort rounds and head to see the new patient. All the while the Fellow
answers calls from the nurses: BP dropping, titrating medication drips, giving
volume, checking labs. Fortunately, the new patient is just as cute as a button, here for obsevation
and possible work up for surgery,
and just upset that we've held off her feedings for the ride over.
We continue with rounds.
It goes well, we catch up.
I call the step down to let her know we'll have 2 more patients to send her in the
morning.
I call staffing to let them know of sick calls and low staffing,
census and acuity numbers.
Time for a break! It is now 2:30 in the morning.
I get back from break and I hear there is a patient in the NICU, just arrived
with incorrect diagnosis and now has been identified as a heart patient and
needs emergent intervention as the baby is rapidly deteriorating.
I move a patient, to free up a nurse for the admit.
They call back. We are cleaning the room, the cardiologist is going to take
the baby to the cath lab I told her.
Then I find out, no time, the cardiologist is doing the procedure bedside, in
the NICU.
By 5:00, procedure done, they call. Are we ready?
Yes, send the patient.
It'll take a while, they say, so much equipment.
OK.
They arrive at 7 am.
Next shift. Time for me to give report to a new, fresh Charge nurse and
her Resource and Situational Awareness to the oncoming team.
And I'm out by 8.
Christmas came fast and it came quick this year!
Luckily for me, Terry was up to the challenge of winging it
much by himself, as I nearly worked right up to the end!
The shopping, the cooking and even picking out and hauling in the
bloody tree!
Taylor was once again on board helping the night
before the Eve in the kitchen with the last
minute goodies!
Although, I made some goodies for the Christmas party,
I gave my homemade Granola in quart Ball jars for gifts!
That, I could make ahead of time and jar up!
Taylor helped with a few treats
and I made the pies.
The rest of the dinner was basically left to the "Chef"!
Colleen brought in some lovely mashed potatoes and
of course, Maureen and her famously delicious ham.
Terry spatch-cocked the turkey, I made the gravy and
Terry put his homemade stuffing in the crock pot.
The green beans were left and it was getting on.
Luckily, the crew was up for the challenge of all the
green bean snapping last minute!
After a glass of the French wine Eileen and Marty brought in, we were all in the mood
for snapping!
Maureen started carving the ham
and I started on that beautifully browned bird
and in no time the Feast was on!
And the Holiday Crackers were popping and snapping!
The party hats went on, the jokes were told,
and the games were laughed at and saved for after dinner high jinx!
Scratchers for everyone!
A full deck of teeny tiny cards in one cracker!
And a game of poker was on!
A little clean up help after dinner. . .
Thanks Colleen!
And coffee and dessert was on!
But not before the "Gift Exchange"!
It was a Happy Christmas Everyone!
So, this is going to be Thanksgiving and a little more
that I had on my camera
and thought I'd share.
Happy Thanksgiving and I hope yours was!
We spent the day at Maureen's with Terry's family.
We brought apple pie and green beans and
got there early to help Maureen.
Terry got his apron on and right away set to work in his environment-The Kitchen!
It got a little crazy in there with Colleen making the potatoes, Terry and his beans,
and Maureen and her squash, all at once in her, shall we say, space challenged
kitchen. At the same time, I was starting the gravy and trying to carve the bird!
sorry, this is the only pic, my horrible "selfie" !
Meanwhile, Rita inspected the varietals offered, after she had roasted the turkey
to perfection!
Dorothy, if I'm not mistaken, I believe Maureen has your china pattern!
It all turned out amazing and dinner was served!
Great food, wonderful company!
We had a lovely night!
Before I go, I just wanted to include a few pictures of Terry's
accomplishments with his culinary arts!
Bon Appetit
!
Ran across this tweet online of Patrick Stewart's frustration with
setting up his TWC.
Mr. Stewart, only 36 hrs????
I've been trying to set mine up for over a month!
I've spent over 36 hours alone on the
phone,
"chatting" with their "solutions team" on the internet
in the stores
with their "escalation team"'
and with the technicians in my home!
(who have come and couldn't do a single thing
because the so-called "supervisor" didn't order the right
equipment on the truck)
Frankly, Mr Stewart,
you just gotta laugh at their extreme incompetence.
And their excuses.
I could never in my wildest dream come up
with their explanations for their B@#$S**#@!
(such as "that internet speed you have is
not available at your address"
and "you do not qualify for the package you
want because you already have that package we
installed that you didn't want"!)
Thanks for the giggle, Mr. Stewart.
Last night, Mr. Stewart tweeted the following lament, which demands to be read aloud in his deep British timber:
So far, over 600 people have retweeted it, so clearly Mr. Stewart’s frustration with the cable service has struck a chord.
Really??
October has been busy and Halloween hasn't even officially arrived!
The prep work for the Halloween party has been brutal!
There is the tasting:
After all, we don't want any surprises or misses at the event
so we must be diligent
And on and on it went
It was hard work testing out recipes till we found the right one!
And that's not all, there was more
And that is not even the event planning
Jeesh, it was grueling work
Testing out party strategies to see what would work
We started with scoping out the latest . . .
Joe's 30th birthday bash
complete with beer tasting!
which included more merciless tasting trials
But, we kept on and on working till all hours
No task too difficult
There was just no end to our diligence in working
to find the secret to the perfect event!
And so on we worked, ever closer to the masquerade event
setting the scene
no detail left untouched, down to the changing of the artwork on the walls
keep to the theme of the Masquerade!
We set the stage
Ready or not, the guests began to arrive!
The masks were incredible, the costumes magnificent!
Whoops! Caught Terry without his mask!
But, Maureen caught it!
And we had winners!
The Champagne tasting winners were Bill and Jill
with a real French Champagne!
We do have excellent tasters with such distinguishing taste!
and the bottle
My ballot winner, too!
And the Costume prizes for
Most Unique
Most Mysterious
Most Extravagant
and
the Funniest!
It was a most outstanding group of Masqueraders!
Happy Halloween to all!
