Nursing Influence

My hospital switched to uniforms about 3 or 4 years ago;  all nurses wear red tops, techs where teal tops, respiratory techs wear wear black, etc, etc…all with black bottoms.  The cath lab staff (along with all of the other staff in the procedural areas) wear hospital issued scrubs that are all teal in color. I’ve always been one to make sure I wear make-up to work or one to wear fun holiday-themed earrings, but since working in the cath lab I’ve been particularly interested in what I can do to have a little fun with my uniform. During shifts when I scrub a case (where we have to wear a hat/mask/sterile gown) I started wearing a patterned scrub cap instead of the disposable caps that the hospital provides and really liked wearing the fun, fabric caps.

So, I started making my own. Sewing has become a hobby of mine over the last few months… I find it very rewarding to see the product that I have created with my own hands. I’ve made a few now with fabric that I had laying around the house, but since I’m in Arizona and spring training season is here, this is my new favorite:

Let’s play ball :) Happy spring everyone!

It’s still been pretty weird at the hospital… our outpatient caths are at a crazy low point (we only had 5 scheduled cases when I got into work yesterday morning when we usually have around 20), but our acutes have been crazy sick. While, I talked about my thoughts on the reasons for this issue last week, I think it’s interesting how the issue affects the staff directly. Since we don’t have many scheduled cases, the managers can’t justify keeping twice the number of staff members in to work and about half of the staff members get cancelled. Knowing that I was one of the few who was going to work yesterday, I brought a magazine with me (my AJN, of course) to help pass the time. Actually, I didn’t end up sitting down for more than my lunch break – we had about 3 cases added on, plus an acute, plus staying 2 hours late to finish a Bi-V ICD insertion, plus getting called back in 30 minutes later for another acute…. I was at work until midnight.

I really don’t mind being busy; I actually prefer it to sitting on my tush all day long, but I think it’s interesting to think about the impact that our current state of health care is having on the hospital staffing. I wish I had the answer to our health care crisis.

I really don’t understand why people don’t seek medical attention when it’s so obviously needed. I mean, I understand that money is tight for most Americans and co-pays are expensive (if they have insurance at all) but your health is everything. I can see foregoing the doctor’s office if you have a rash, the flu, or a painful knee trying to save the cash in these tough times, but if you can’t breathe…. no, I cannot understand that.

A woman presented in the ED with shortness of breath for the last week; worsening each day and decreasing her ability to perform daily activities. Upon presentation, the 12 lead EKG showed mild elevation of the ST segment (suggesting a heart attack) and the patient was placed on BIPAP (an oxygen mask that also delivers pressure to help open the lungs). The ER doctor had consulted a cardiologist who took the patient to the cath lab within the half hour.

The patient wasn’t able to lay flat for the procedure due to her difficulty breathing. Her lungs were filled with fluid and the diuretic was not working. The physician from the ED was called to the cath lab to intubate this patient. After she was intubated, her blood pressure began to plummet. She was started on multiple medications to increase her blood pressure as the procedure was underway. One of the main blood vessels in the heart was 99% occluded and after over an hour of attempts, they were unable to get it open. By that time, the bloodwork had returned from the lab showing myocardial injury (heart attack), anemia (low blood count), and renal failure. During the catheterization, the physician checked the heart function and it was at 5% (normal is 60-80%) meaning that the heart was not effectively pumping blood to the vital organs (such as the kidneys) and the blood then backs up in the lungs causing difficulty breathing.

The outcome for this patient was not good. She made it up to the ICU, but not for long; not even long enough for her family to get up the 2 flights to see her.

It really is sad that people are not seeking necissary medical care, even when they do have available insurance. In this case, the patient did have insurance, but did not seek care for some other reason unknown to us.