Ni hao ma

So, it’s been a while since my last entry. Today is October 29 in the year of our Lord 2020.

It is my third day of immersion at NCCU or the Neuro Critical Care Unit. If you are not aware, I am a Float Pool Nurse, so I am rotated to various units because I don’t have a permanent unit. I was assigned with Ma’am Joanna Mae on my first day, and with Ma’am Denisse on the next succeeding days as my buddy nurse. I’ve handled a level 4 patient.

I am thankful that my manager already assigned me to have my duty at the critical care unit… Does she trust me already? I don’t know. I hope so.

I have learned so many things today. My patient today, Mr. W is a foreigner. He doesn’t understand English. He has a Glasgow Coma Scale of 7. It means that for the eye opening (2: to pain), verbal response (1: none), and motor (4: withdraws from pain). The patient is from time to time having abnormal extension of his upper extremities, whenever he feels stimulated. My patient, Mr. W was asleep. I tried introducing myself with the google translate.. I typed “My name is Jae. I’m your nurse for today from 6am until 2pm” in his own language. Although, he is asleep.

Does the ears still function when a person is asleep? Hmm. Something to think about.

Glasgow Coma Scale Perfect Score is 15 (Eye Opening: 4, Verbal Response: 5. and Motor response: 6)

So, the things that I am grateful for today despite, my patient’s intravenous lines were removed. I inserted three intravenous lines which were all patent and intact for my first try (Right arm : two gauge 22) and (Left arm : one gauge 24), with the use of the vein viewer. I am really improving when it comes to inserting lines. So, yay! On the other hand, I have learned today that I should secure my patient’s lines with the use of a wrist splint or secure it with a transpore.

My patient has ongoing D5W at 60 cc/hour, with Precedex and Midazolam at doctor’s desired dose. My patient got febrile awhile ago as well, so he perspired a lot and soaked what he was wearing. I changed his gown twice. The nasogastric tube was also fixed because it was already seen protruding at the patient’s mouth. So, NCCU nurses does the NGT insertions. So I assisted Ma’am Denisse. Stat ECG was done. (ECG has 6 color leads for the chest area and 4 leads at the upper and lower extremities).

Chest leads (Red, Yellow, Green, Brown, Black and Violet)
Arm Leads (RL – Red, RL Black & LA – Yellow, LL – Green)
So, for me to remember the color placements in the arm leads : 
(Color placement in the way I see the patient frontal view)
Right Arm - Marcos (Red)
Right Leg - Dead (Black)
Left Arm - Cory Aquino (Yellow) 
**due to Laban sign
Left Leg - (Green) Since Cory Aquino provided CARP or the Comprehensive Agrarian Reform Program
Right – Marcos (Red, black) & Left – Cory (Yellow, Green)

STAT Chest (AP) XRay was done (**Make sure you are at a distance from the Xray technician especially when you are a girl or a woman). Urinalysis specimen collection was done as well from the Foley catheter. (But be careful not to puncture the balloon, so the FC will still be secured).

My patient was toxic today, but I learned a lot, so I’m very thankful.

I prepared Norepinephrine (4:1) Levophed of 16 mg was given as well, since the patient had hypotension, just to increase the blood pressure to maintain Systolic BP of not less than 110 mmHg.

I monitored his intake and output hourly, and I accomplished it.

I had a challenging day today as well with my coworkers. I remember a Nursing Aid, asked me if what was my duty just before my shift ended in the pantry.. I told him, “morning”, then he said, “buti na lang hindi kita ka-duty, may narinig kasi ako na toxic ka”. Maybe he jokingly said that to me, but I am a new person at the unit. I am still adjusting, and I’m really sensitive. hehe

I pray that God will give me a supernatural patience and the ability to communicate well with the people around me, because they tend to misunderstand me most of the time because I am quite the serious and rigid type at work. I have an authoritarian attitude sometimes. So, I pray for P-A-T-I-E-N-C-E, and the will not to give up, dear God.

Thank you. Til next time, I pray for a good night sleep.