Nurse Failure – Where’s the Vet?

Amy Sellers

My dog wasn’t eating… she had obviously lost weight… she was so weak that she was having trouble getting out of her bed (even bad enough that she was laying in her own urine, and she’s completely house trained). I’m a nurse, so I should know what to do, right? Wrong. Other than taking her to the vet, I had no idea what was wrong. I even tried listening to her heart and lung sounds with a stethoscope, and heard an irregular heart beat (but the vet ended up saying it was normal inspiration-expiration changes, which sound more exacerbated on a dog)… so I obviously had no idea how to even assess her the only way I thought I knew how. I felt helpless.

I took her to the vet, where they loaded her up with the camel-hump of saline (they inject saline subcutaneously on dogs and the body absorbs it to rehydrate), an IM shot of steroids, and another of an antibiotic, along with drawing blood work and taking an xray. They gave me some extra-calorie dog food to help her gain back some of the weight she had lost and a prescription for oral antibiotics (and a bill for a few hundred dollars…ha). Turns out, she had a really bad respiratory infection, which I would have never guessed because she looked like she was breathing okay and didn’t have a cough of any sort. But, a few days after the visit to the vet, she was recovering nicely.

I know I’m not a veterinarian and I’m not expected to know how to diagnose or treat an animal, but it seems like the symptoms of a respiratory infection would be universal.

I guess I’m just lucky to have a very accommodating vet office, who snuck us in for an appointment and a dog who loves the heck out of me for taking such good care of her. (Photo credits to the boyfriend, who snuck the shot of me listening her to heart and lungs after I got in from the hospital the night she was really sick. Jinx, our puppy, is a 2 year old Boxer/Pit mix.)

For The Love of The Team

Amy Sellers

99 years old… that’s how old this patient was. He lived in an assisted living facility with his wife; they lived in an independent apartment, but had assistance with things like cleaning, shopping, cooking, etc. He was admitted to the hospital with an exacerbation of a preexisting medical condition, but it sure took a toll on his body. He and his family were faced with the decision to take steps to aggressively treat the disease (which would make him feel worse in the short-term) or resign to hospice care.

He and his family had spent two days discussing the options and still were unclear of the path they wanted to take. The patient fell asleep for an afternoon nap and when I went into the room to wake him for dinner he said “no thank you. I don’t want to do this anymore. I’d like to stay in bed and be left alone.” After sitting down next to his bed and asking him what prompted this sudden decision and listening to his thoughts about this being “the end”, I let him sleep awhile longer and I called his son and asked him to come in. His son brought a radio, for him to listen to the Arizona State University Sun Devils in the baseball Super Regionals as the patient played baseball for ASU before the school was ever called ASU. They talked and the family agreed to his wishes and he would go to a hospice facility the next day.

The next morning, the family came in to visit. The first thing out of the patient’s mouth was “Did the SunDevils win? I didn’t get good radio reception.” His son confirmed that they won and that they would be playing in the College World Series the next week, the patient grinned, and then his eyes opened wide, he stopped responding, and the nurse called a Code Blue. Fortunately, the code was cancelled before the patient was revived (due to the fact that he was going to hospice that day, and this was confirmed with the family who were at the bedside).

I had a chance to speak with the son shortly after the event and he commented on how fitting it was for his dad to pass away just seconds after hearing about the SunDevils victory. He would surely be missed in the family, but his wishes were clear and he wanted to go in peace… and he did.

Life Plans

Amy Sellers

No matter whether you love your job or dream of something new, I bet that you would like to see something different from your career 5 years from now. This “something new” can be as simple as seeing your company blossom to serve a new clientele or as drastic as going back to school to change careers all together. It’s nice to think about these changes but nothing will come of it until you make some concrete plans.

Insanity has been defined as “doing the same thing over and over again while expecting different results.” If you are not seeing the personal outcomes you want, then you need to make some adjustments.

Similar to the ones you may have written for college entrance applications, it might just be time to write an updated personal mission statement. Include aspects of your personal life; In 5 years will you have children? Do more international traveling? Buy your first home?

“To fail to plan is to plan to fail.” If you are not actively planning your life journey, then it is extremely unlikely that you will arrive where you ultimately would like to go. It’s time to start on the next segment of your life.

Patient Teaching

Amy Sellers

Between nurses and patients, teaching is often a two way street. There are many instances that patients teach us about life and about ourselves – redirecting our morals & values. In this particular instance, I took care of a patient who had surgery to remove a part of his lung that was overtaken by cancer. The surgery was successful, the margins were clean (meaning that all of the cancerous tissue was able to be removed). Although, it was a tough surgery… the surgeon had even told the patient (in jest) that there were many times that he was cursing him during the operation (because he had such a hard time getting through the patient’s thick chest cavity and tough lung tissue). I first took care of this patient on the 2nd day after his surgery; he was doing well, getting in and out of bed relatively well, starting to walk in the hallways, but having a lot of pain issues related to the drainage tubes in his side.

He was one of those people that I really enjoyed taking care of. I would bring the computer on wheels into the room to do my charting just because I really enjoyed talking to him. He told me everything about his life- from his time in the service, to how he met his first wife… and then his second wife, and how much he had learned about himself between these two women. He had several children and I felt like I knew every single one of them by the time I transferred him to a telemetry room (which was a good sign because it meant he was leaving the ICU) that afternoon.

I stopped by his room every day that I was at the hospital to say hi and would spend a few minutes talking to him and his family. Then, it was the weekend and I was off work (yay!). I came back into the hospital on Monday morning to find his room empty and I was thinking that it was great that he was able to go home, but as I did rounds in the ICU, I saw him… laying in bed, eyes closed, hooked to a ventilator. Oh no… it can’t be…

Turns out, the mix of his chest tubes being removed on Friday and the effectiveness of his blood thinners caused his chest to fill with blood and him to need emergency surgery at 2am.

I now think back to the long conversations we had and the biggest thing that stands out is him telling me not to wait to live my life. He and his wife had put off traveling, waiting for the kids to get older, waiting to have more money, waiting to retire, etc and he went and got lung cancer… and needed major surgery… twice, before they got to follow through with any of their plans. He talked about spending quality time with the ones you love; while you may see your significant other on a day to day basis, remind yourself to cherish the moments – all of them.

So, I’m doing just that. I’m going to Hawaii with the love of my life. I don’t have the proper “emergency fund” set up per Suzie Orman’s standards, but it’s time. At 26 years old, I’ve never seen the ocean and it’s about time to change that with the best company that I could possibly ask for.

So, I’d like to thank D (as I lovingly call him) for the words of wisdom. He was discharged from the hospital a week and a half after his second surgery and I saw him almost every day in between. Who wouldn’t love a patient who’s going through hell, but has a smile and a positive outlook through it all?

Busy Little Nurse

Amy Sellers

For me personally, life has just been crazy as of late which has left me with very little time to sit and write as I enjoy doing with my “down time”. About a month ago, I started as a clinical instructor for a group of nursing students at my hospital. They’re in their fourth block and going to be ready to graduate in just over a month, which means they’re doing their “Acute Medical-Surgical Nursing” rotation, which includes shifts in our medical and surgical telemetry units as well as the CVICU, taking on a full patient load, working 12 hour shifts, and taking/giving report. Overall, they’re doing fabulously but grading careplans and planning for post-conferences has really kept me busier than I expected. And of course I still have my full-time position as a bedside nurse.

From a non-work perspective, we recently took a family vacation out of state and it was so wonderful to get away for awhile (the picture of the pool is at the hotel where we stayed… amazing). But the day after we got home, our living room (aka big) TV stopped working as well as our air conditioning (a necessity in May in the desert). What are the chances? Both in one day? Hmmmm.

I just wanted to check in and say hi since I feel like I haven’t been posting as often over the last few months. I’ll get back on track here I’m sure. :)