Driving to work the past couple of mornings reminded me of the flower farm at home. I couldn't ever see any flowers though, so it could have been the weeds :) Anyway, it made me miss the harvest (although lately I've suffered from some mild allergies around this time when I'm home, so I didn't miss it all that much). I looked at the pictures from Aunt Sherri. Looks like it's been fun down on the farm. And lots and lots of work as always.
We've got the workload back up in the ICU. The cardiologists have been finding lots of heart surgeries. this week there are four. A bypass yesterday, today, tomorrow, and a valve replacement on Friday. We were slow so it's good to have patients. I'm on call because we had 6 nurses scheduled and only needed 5. I had first call off because I hate three days in a row. I get cranky, especially when the patients are confused and spend all their time taking their clothes off and pulling at things.
Yesterday the man I was taking care of was more awake then the day before. During my morning assessment he asked if I had any dumb questions for him while he was laying here. He actually was looking better than the day before, but still very sleepy. The day before he gave us a scare, he started having long periods where he would pause breathing (up to a minute by the end of my shift) and his heart started slowing way down during that time (take your pulse while you hold your breath, a little slowing is normal, a lot isn't). We ran some tests and then decided a lot was due to obstructive sleep apnea, and bipap helped a little. He gave a good enough scare we thought he was going to try to die on us that night and the doctor was good enough to come in and talk to the family. They were comfortable making him "do not resuscitate", which means if his heart were to stop we wouldn't do CPR. He actually had a good night, and was stable but sleepy during the day. He even behaved better and didn't get undressed every other minute (some of the other nurses asked if I ever thought that people must be naked in heaven because we come into the world naked and lots of confused patients seem determined to go out that way. I said if people were naked in heaven, we'd be the only ones not shocked because we're nurses and have already seen it all). The first day I had him he could tell I was getting frustrated with him. He said, "I hope I'm not making you sound as aggravated as you are." A little off, but a clear statement nonetheless. I did dig deep and manage to find a little more patience. I was told this morning when I was put on call that he passed away last night. His heart just suddenly slowed and stopped. It just gave out. We were all surprised. Sometimes they rally before they go. I was relieved he was spared the trauma of CPR. If they had managed to bring him back, which we doubted he would, he probably wouldn't have healed. He was frustrating because of dementia, but we liked him. He was ready to go, and thankfully his family had a little time to prepare.
On one side of the floor we have heart surgery row, and on the other it's dementia row. Some with a history of it, and others with some narcotic induced, and some with some ICU psychosis. We discovered there are very few safe TV channels for confused patients. If they watch the food channel they think they're in a kitchen and want to get up and check the oven. The history channel, lots of wars -no good. Then there's animal planet, which left one patient seeing flying alligators. I went in to help her stand (she was too weak to walk yet), and after we got her back into bed she said she hoped she didn't offend us because her hair looked better than ours. I thought, great, I've just been insulted by someone who sees flying alligators. flying pink alligators. (I got my hair cut short again last week, by the way.)
I think now I'll try for a nap in case I get called in.