short stay

this week I was off the floor (finally) and in an ancillary unit. not that I didn't enjoy the floor, but it is nice to experience different areas of the hospital. and I ended up really loving short stay. a lot. I am actually going to apply to be a cna (if I can't find a nurse tech position) and hope that I am in short stay. it was great. anyway, the short stay unit is just that...a unit where patients usually have a short stay, usually less than 24 hours. I think that sometimes they are there longer if they have to leave and come back (like for a procedure). they take care of a variety of different patients...like people who come in for dressing changes (for their wounds), antibiotic treatments that are iv, some cardiac patients who are waiting to see if they are going to have a stress test and beyond...depending on what their stress test reveals. they also get people who have gone for procedures, and need only a shorter time to recuperate, like simple ortho surgeries (like hands, wrists, etc.....not hips or knees). other procedure patients are the cardiac patients who had a catheterization (and another site), and who may or may not have had angioplasty or stenting (there is an animation on this link which is fairly informative). some of the patients who have had the procedure but not an intervention come back with the sheaths already removed, and they have some kind of closure (like a star or angioseal) already in place. the nurses then just assess for hematomas or other adverse reactions of the procedure. they are able to go home a lot faster than patients who have an intervention. many of those patients come back with the sheaths still in place. the nurse then waits until their clotting time is faster, and then is able to pull the sheaths. I actually got to watch a couple of nurses pull out both an arterial and venous sheaths. the sheaths were located in the femoral artery and vein. the arterial sheath was pulled first, and because of the high pressure system that arteries are under, pressure is supposed to be applied for at least 20 minutes, with full occlusion for the first three minutes. it took 30 minutes of pressure for this patient's incision to clot off. the venous sheath was then pulled, and pressure was applied for only about 12 or so minutes. it was pretty interesting to watch, but my feet were killing me by the end because I was just standing in one position for so long.

during my time in short stay, I did a dressing change on a foot wound (the guy had some toe amputations and...well if you really want to know how I changed the dressing ask and I will email you. it's not the most pleasant thing in the world), I also accessed a mediport (and apparently hit the sweet spot), I attempted to start an iv (it obviously didn't work), did a couple of iv pushes, hung some piggy backs, did three assessments and had them all charted by 0900. I also just tried to help out around the unit. it was a lot of fun. actually when I went home on monday I was really happy. part of that might have been the fact that I was not going to have to stay up all night looking up medications, but nevertheless, I was still very happy.

in other news, I start my tutoring job this afternoon. I tutor for two hours on wednesdays and fridays, at least for now. it's not a lot, but it will pay for the gas to drive home a couple of times. I'm kind of nervous about tutoring...just because I know that I still don't know everything that I am supposed to about that particular class or about nursing. but I think the nice thing will be the fact that if I don't know, we can look up the answers.