Earthquakes, dog, and Best Buy.

California is such a cool and happening state that it does it's own rattle and roll. We had an earthquake last weekend in Riverside County. Monday, we had a tremblor under the ocean by the Northern California coast. Today, we had another 5.1 quake in San Bernardino. The way I see it, something big is going to happen. Gotta get ready with water and food supply.

I got my puppy today. An AKC Pekingese. He is a sweetheart. Kinda timid to start. After feeding him his dinner, he begun to explore around the house. He is now running around the living room and it's 11:00 at night. He had blessed the carpet with pee and poop, it didn't take long. House training starts today.

He didn't enjoy the the car ride home. He was shaking and a bit shocked. Fortunately, he recovered and is now acting like a dog. Oh he stopped, great hopefully he's tired and ready to go to bed.

I went to Best Buy to use my gift certificate. I was eyeing the Canon 20D digital camera. The store I frequented didn't have it on stock. I drove 10 miles to the next store and they won't let me "test drive" the camera. Idiots, they don't know how to sell a camera. They do have it on stock but the saleman need to earn his commission if he gets one. Oh well, I'll check the internet for a better deal.

No Code.
I'll quit being an ICU nurse when my work gets boring. Yesterday was one of those memorable days. My patient was very sick and might not make it past the shift. Medications and a ventilator were keeping him alive. The family was hopeful for his recovery but I have to break to them the bad news. He was getting worst and it's not looking good.

I've refrained from telling loved ones that things are bad. This case is different. All the signs of death is present. Agonal breathing, high doses of pressors (drugs that constrict veins and arteries so the organ gets perfused.) No pulse oximetry signal. (a device that reads oxygen saturation, usually place on the finger tip or in worst case scenarios, the ear lobe. A red light reads the content of oxygen delivered by the capillaries.) Lab values were worst than 12 hours ago, indicating liver and kidney failure. Blood pressure in the 80's systolic, above 90 is desired. Normal is 100-120's. Overwhelming sepsis has set in. The condition is MODS, multi organ dysfunction syndrome. Bad news.

The day was an endless attempt to keep him alive. Family members trickled in during the day sobbing and praying. The doctor was talking about no code. The family wants everything done, can't blame them. It's their father, brother, uncle, grandfather on the bed dying. The surgeon went in to see the patient and concluded that he is so unstable, anesthesia will kill him. A representative of the family signed the DNR. Do not resuscitate. Well, he's already intubations and on the vent and the drugs are the ones we use during a code. So basically, I have been coding him for 8 hours straight.

After 8 hours of pumping medications into him, his heart just gave up and died. His family surrounded him. His passing was particularly hard on his daughters. They hugged his body as if it was alive. He was a lucky man. So many people love him. The crying can rip the heart out of any human being. I carried a sad face but kept my professionalism. There are paperwork to fill, organ donation number to call, and doctors to notify of the death.

I was a little peeved at my charge nurse. She wanted to control the visitors in the room. She kept asking me to control the crowd. I told her that I'm not able to, but deep inside I'm not even trying. I'm letting them mourn their loss. I don't care if there are 20 of them there. The charge nurse employed the help of a Spanish speaking social worker. She spoke to them that we need to clean the patient and the crowd needs to be controlled. Great, I don't want to look cold to this people, I've been their advocate all through out this struggle.

There is a double standard. When one of our nurse's father passed away, they were allowed to watch the code. It was a different feeling watching loved ones watching me do chest compressions. All the managers are available, consoling and the director was even assisting with the other nurse. No such people in this patients case. Hey, I call this work benefits or perks.

I kept thinking about the double standard as I usher the family away from the body. I'm upset but nothing I can do. We let them stay for an hour but was unable to grant their request to wait for a son coming in from the east coast. He will be arriving at 9 pm and state law doesn't allow the deceased out in the open for more than 4 hours. This is due to public health reasons.

Today, we had 3 intubations in the span of 5 hours. One patient didn't make it. They coded her for 3 straight hours. I did chest compressions and I was exhausted. This was the first code on this patient, they coded her 3-4 times in 3 hours.

There is an unwritten law about sets of threes in the ICU. Death comes in a set of three. One died yesterday, one today and one more and the law is obeyed. I'm glad I'm going home. My arms are sore from doing chest compressions. I'm off tomorrow, and I will use the time to rest and hope that I don't witness the set of three again.

New Unit, New Life.

I transfered to the CCU (coronary care unit) about a month ago. My old unit was just way above my willingness to work like a dog. Don't get me wrong, I love to work hard and see my patients do well and live their lives. What I don't like is working with no direction. Doctors don't return pages so patients suffer. The fruits of my labor is rather bitter due to long hours of no breaks. This means hours of being hungry and tired. I can't take care of the sick when I'm tired, it's just not possible. My satisfaction level at work declined rapidly as this condition persists.

The amazing thing was that there are nurses who are willing to work with little or no break. No one complains so no problem exist. I hate to complain since I'm the new guy. I wanted to hang in there but I'm just not happy anymore.

In the new unit, we get our breaks and I am more stisfied with the pace of work. My satisfaction level remains high as I work there these past weeks. I'm not too tired and can even pick up extra shift to make extra money. Who says change is bad? I've made quite a few changes in my life and it's a mixture of bad and good choices. The best part of it all is that I learned a lot with each decision. I just need to concentrate on the good part and not the bad part.

Getting report from my co workers is also a lot easier. No one asks me why things are not done and no one tells me what to do. It's great. Life is finally good. People are civilized and well adjusted. We joke around and people are smiling all the time.

I hope things remain the same here for a while. I hate to keep looking for a new job. Some of the doctors have not changed but hey, nothing is perfect. They are the spice to my like. The fucking jerks that makes my day interesting. One of them got pissed because I didn't call him about a lab value. I called the cardiologist and not him the nephrologist. He was asking me if I know what he does and who he is. I told him that I know who he is and that I missed his name on the list. Deep in side I wanted to tell him that he needs to go to work on time so that he knows what the hell is happening to his patients. Stupid rag head. This is one of the reasons I quit dialysis nursing. Fucking nephrologists are making so much money on dialysis they think they are fucking gods. One of them even wears Armanis to work, reeking of expensive cologne, expensive eyeware, diamond studded watch, and the latest in wireless technology. The bad part is that his accent is so thick, we can't even understand what the hell he is talking about. One pulmonologist is so bad tempered he reminds me of a bad chihuaha. This dude is about 5 feet tall, dark skinned and ears sticking out. He thinks he is god. He never orders sedation to his ventilator patients. A mean and cruel way to treat a patient. Nurses already know what to do with him when he gets on a vent. NO FUCKING SEDATION. He can suffer the same way his patients did. Fucker. Pay back sucks. Bwahahahaha.

Dogs, cats and fish.

There it was, a white cuddly looking puppy. A lhasa apso. He is so cute. Price $999. He is AKC (American Kennel Club) certified, pure breed dog. I've done so research on dogs and have realized that I'm not qualified to have a dog. They can't be left at home for long hours without company. They will develop bad habits that will ruin the dog's great qualities.

I can't have a cat because of allergies. Cats would have been ideal as they require very little exercise and can just stay put sleeping at home for long hours at a time. They are as affectionate as dogs but they don't do tricks or fetch.

I think I might go back on re-opening my aquarium. I do own a 15 gallon tank. The thing is, I lost the passion I used to have with fish. I can't seem to get it back. I want something I can touch, pet, and cuddle.

There are several animal rescue places that adopt pets. I learned that two dogs are better than one. Dogs are pack animals and they require company. There are a few paired dogs that are available for adoption. I will visit some of this pounds so I can meet the animals and see if we are compatible. There are adoption fees to cover the cost of shots and to rescue other animals from being put to sleep. Older dogs are better as they are house trained already. Keep tuned for details on the search for a new pet.