Super Girl!

I woke up at 2pm after working all night long, this is actually early considering the time I go to bed. Sometimes I think of myself as a vampire, sleeping during the day and taking people's blood at night. wahahahaha. It seems I am always doing IVs or poking people with needles at work. It doesnt phase me anymore.

My child self would be scared to death of me now. lol

My close friend Brachkoki called me. Brachkoki and I have a long history, we met in korean language school in the summer of 2000. He was 23 or 24 at the time and I was 19, I always looked up to him as older and more experienced in life. He called me for advise, I was grateful for the call because it woke me up one and two it was good to talk to him. A life long friend.

Sometimes I think if nobody called me in the morning (my morning is 2 or 3 pm) I would never wake up.

"Well buddy, I hope that all goes well. Call me again soon." I said and hung up on the phone. Just as I was hanging up I noticed a voicemail.

"Sarah, this is Stacy, we are really short staffed today. Was wondering if you could come into work. Call back if you are able to." I wondered if she liked my call tone.

MY CALL TONE: Michelle off American Pie saying "And this one time at band camp, we all lost our music and we were supposed to play this song, but we didn't know it, so we just made it up and we kept playing and the conductor didn't know what we were doing and it was funny."

It makes me laugh every time, especially since some people have said that I talk like her.

The voice mail seemed simple, but to me it was a plea for help. In my mind this is how it went.

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"The waiting room is full sir, of sick and dying people!" The unit clerk tells the charge nurse in a panic. "There are so many that they don't all fit in the waiting room, many of them are waiting outside in the cold, and by some freak of nature chance it is hailing hail stones the size of golf balls, people are getting hit in the face and limbs, furthermore breaking bones or worst of all concussions and head injuries."

"I know, I know. We are full in here too of the sick and dying, there are simply not enough nurses to care for all of these people!"

"Ahhhhhhh!!" Someone yells from one of the rooms, "help me I am sick and dying!"

"We need to call some more nurses into work or everyone in here will die." the charge nurse says with a worried face.

"I will call our emergency contact list of employees," the unit clerk says and rushes off to the phone.

"Sir," one of the nurses taps the charge nurse on the shoulder, "we had to send nurse Patty home because her son's deveriticulitis exploded within him ten minutes ago while he was at school, she has to pick him up and bring him here for emergency care."

"Her 11 year old has deverticulitis?" the charge nurse said surprised. "Can this day get any worse?"

After a horrible half an hour or so of relentlessly trying to get nurses into work an extra shift the unit clerk gets exhausted. She wonders if she will ever get anyone to work. "No, I can't," kept echoing in her mind.

The phone rings.

"Hello, this is Sarah, may I please speak to the charge nurse?" Stacy's face lights up relieved that this fair young lady would perhaps work.

"THis is charge," the charge nurse picks up the call hoping that it is a nurse volunteering to work.

"Yes, I can come in today, I shall be there as soon as possible."

The charge nurse hangs up the phone and is relieved, hope becomes within reach.

"Hey everyone! Sarah is coming in to help us." He announces to the nursing station.

Everyone cheers.

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It probably didn't happen that way, but I did feel like Super Girl swooping in to save the day. During the shift I had the Director of Nursing, Nurse Manager, Nurse Educator and the Charge Nurse thank me for taking the extra shift.

I felt appreciated. It was a good feeling.

Texas isn't So Bad

"I want to move here!" my sister in law Monyka told me as I drove her to the airport. It touched me that she was so excited about Texas. I wished inside that her, my brother and my sister, her husband and my niece would move here too.

Texas the land of opportunity.

I said goodbye to her and she left on her plane.

We don't hug in my family so there was no exchange of hugging like any normal family.
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ONe time at my brother's house sometime last year my sister was visiting.


"Goodbye" she said and waved. I stood up out of my chair..."What do you want me to hug you?" she asked jokingly knowing I would probably decline.

"Ummmm sure..." I said awkwardly, she seemed surprised at the awkward response, although I had just stood up to walk her to the door.

We gave each other an awkward hug and my brother stared at us in shock.

"Wow that was awkward." My sister said outloud after hugging me.

"We aren't a hugging family," my brother said and laughed.
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So Monyka and I didn't hug goodbye, as I expected. I know we have a strange non touching family.

On my drive home I thought about how much Monyka loved Texas, and I started to wonder why. I guess I didn't realize how lucky I really am to live here as I looked back at all the fun we had in San Antonio on the Riverwalk and in Austin at the Highland Mall where we went to the haunted house, not to mention all the shopping outlets we stopped by.

I guess Texas isn't so bad.

My first DKA

I had my first Diabetes Keto-acidosis (DKA) patient. For those of you who are not familiar with this condition, it occurs mainly with those people who have type one diabetes. It is an acute metabolic condition that is characterized by hyperglycemia (we are talking like 400 blood glucose and up), hyperketonemia, and metabolic acidosis. It causes nausea, vomiting, abdominal pain and can progress to cerebral edema, coma and worst case scenario death. The patient will also present with symptoms such as low blood pressure, due to dehydration and a crazy high heart rate from acidosis, to compensate for this acidosis they breathe rapidly. So I am sure you can see what a critical patient this is, in the absence or tardiness of care the patient WILL either end up in a coma or die. I can't say this enough, it is very serious. One thing about the patient is severe dehydrated, like almost 6 liters behind. With such insane dehydration a patient's kidney's with lowered perfusion can also be permanently damaged. The hyperglycemia causes an osmotic diuresis that leads to increased urinary excretion of water and electrolytes, particularly potassium. Sometimes DKA patients are unaware that they even had type one diabetes. What a shock right?

So I get this patient.... I will not go into details because of HIPPA (patient privacy rights). I already had three rooms of patients needing my care...

Right when I felt like I was on top of my game.... This patient comes in with one of the most critical conditions we are presented with in the ER, and he was assigned to my room!

When I first walked in the room and saw this patient breathing rapidly, with a crazy high heart beat and low blood pressure...What a stressful situation.

"AHHHHHHHH!!!!!" I screamed on the inside.

I had to collect myself, stay calm, this patient's life was in MY HANDS! This is not the time to lose it.

"First thing is first, let's put him on oxygen," I thought to myself and immediately put him on two liters a minute. I looked at the monitor, that worked, his Oxygen Saturation was at a normal level.

I didn't touch my nursing notes, I would rather have incomplete notes then a dead patient. ....... "Dead patient," I kept thinking in my head, "nobody is going to die here, not in my room."

"I need help in here!" I loudly announced to the nursing station where the doctor and nurses were intermittently gathered. Two nurses came in my room and one doctor.

"We need some lines on him and labs drawn," I said taking charge as primary nurse.

"We better start the DKA protocol," the M.D. said to me, "I know this is your first time but you can do it, let's start an insulin drip at 5 units an hour and get him 2 liters of fluids stat."

"Sarah, Room 13 needs you." I heard overhead.

"DAMN patients!" I knew exactly who it was and what they wanted. I imagined their whining faces....... "How much longer is it going to be till we can go home?"

"You are NOT the only patient in this ER!! You CAN wait! Now, don't bother me right now for the love of everything that is good and holy!" I answered them in my head while walking to the medication room to gather the necessary insulin for my DKA patient.

"Dead patient....." I couldn't stop thinking...

I will be damned if I am going to stop doing what I am doing to answer stupid questions, I ignored the overhead and proceeded to concentrate my insulin drip. I was at the mercy of the other float nurses to cover every single trivial question and complaint my other less serious rooms had. Surely they knew I would be tied up for the next half an hour or so.

Alot can happen in half an hour.... Mr. E in room 12 can fall off his bed.... I would have to fill out an incident report... Answering all the questions on the computer..Was he in non slip socks, were the side rails up, the call light within reach and how much morphine did he have before the fall? Basically asking. "was it your fault as his nurse?"

"I just gave room 12 five mg of Morphine, I wonder...Are the side rails up?" I thought to myself... I imagined him fallen in a pitiful position on the floor, he looks to me... "if only you would have put the side rails up I wouldn't have fallen."

"AGHHHH!" I screamed on the inside again.

"NO, you have to focus on this now!!" I brought myself back to my critical patient and wheeled the IV infusion pump into the room with my bag of insulin drip.

I started it and the patient's fluids.

NEXT...... "I need lab results." I say to the unit clerk, "like now."

We needed to know how much potassium he lost in order to start replacing it, low potassium can kill.

Within a few minutes I had a print out of lab data.

Thank god!! Potassium looked good. I ordered more potassium in Normal Saline from the pharmacy per the DKA protocol, which I have never done before!

While I waited for the potassium I made sure a room was ready in the ICU for my patient. They had one room left, for codes. It was mine! I called the ICU nurse and gave report.

After about an hour of running around, I finally got my patient transferred to the ICU. It was a good feeling to have the craziness over, and to know that you made a difference, the patient is alive...

I got back to the floor with an empty bed, once occupied by a VERY critical patient. I couldn't believe I handled that situation without freaking out.

I did it...

I am an ER nurse...

I helped save a life....

And thankfully, the float nurse covered my three other rooms. Everyone was okay, nobody fell out of bed or coded on me.

Shrimp

I woke up at 4 pm after working a full sixteen hour shift, I know it seems bad but considering all of the overtime, bonuses, night and weekend differentials it was well worth the strain and stress of a sixteen hour shift on the busiest night in the Emergency Room. Which by the way I only sat down for maybe ten minutes during the whole thing. "Hell Night"

ALONE.....

It didn't feel so bad this time, usually I feel that loneliness is my worst enemy. It was a relief to be rid of people begging for pain medication, asking how long till the doctor is going to see them among several other needs and wants that keep me on my feet in the ER.

ALONE...... at last, it felt like a breath of fresh air.

I decided to live it up, I bought some shrimp.

Strangely enough, I didn't start liking shrimp until last summer in Las Vegas when Dulce cooked them for me on the grill at her house. It was incredible. Now I can't have enough shrimp.

If only my step sister Rachael didn't cause me to loathe shrimp when I was fifteen years old.

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"Leo Ho, I dare you to eat 10 plates of shrimp," my step sister Rachael, 21 years old at the time (which then seemed so old to me) said across the table with a candid smile.

"Do you?" I asked, unaware that the joke was on me. "What will you give me if I do?"

"I'll pay for the meal and you will have bragging rights for the rest of your life," she said looking over the menu and laughed.

"You were going to pay for it anyway," I said catching on that there was nothing in it for me.

It wasn't unlike Rachael, the sadistic step sister, to dare me to do things and me having no benefit of having done it. I suppose bragging right, but who brags about:

"I can drink a 60 ounce drink and not use the bathroom for four hours."

or

"I can eat 11 plates of shrimp at Sizzler."

I try my hardest to include these in my everyday conversation now.... I did the dares for a reason right?

"And what will you be having?" the waitress asked me.

"The all you can eat shrimp," I said with motivation and a mission in mind.

"I love you," Rachael laughed at me.

The challenge was on....."I hate you." I told Rachael as we drove home.

I ate 11 plates of shrimp, and I felt sick! Right after I went on a bike ride with my best friend at the time, Holly. I tried to pretend nothing was wrong, surprisingly I managed not to puke leaving a trail as I road off into the sunset with my friend.

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I marinated my shrimp with lemon and olive oil, cut up some tomatoes and marinated them too. Then added some fresh parsley. I don't know why I added parsley because still to this day I am not sure how to apply it to cooking. I understand the theory of parsley but I don't get it in practice. Does anyone know the point of parsley? It just sounds nice to say

"I added fresh parsley," makes you sound like you know what you are doing.

"But of course you did!!" someone would reply somehow trying to act like that was somehow a good thing and in reality they have no idea what parsley is for.

THANK GOD for parsley!! What would I do without it.....????

Get off the parsley, you are probably thinking.

I snacked on shrimp, lit some apple pie smelling candles and watched Knocked Up. It was bliss...