13th October (Monday) - Yesterday I came to work 10 minutes late, but it was a Sunday, so thank the Lord not many people are working. Highway jams, sudden loops, turning a big round to unfamiliar roads... A usual less than 30 minute drive becomes 30-45 minutes. Thank goodness I already knew about the crazy jam since I was working on weekends, so I came out early and managed to reach there by 6.45 am. Thumb in, and it's working time.
Here we go, I'm now aiming for procedures now. Besides the usual PEG and ECG, I'm now trying to aim for Redivacs, blood transfusions, chemotherapy and dressings. Super important procedures in the ward I'm working in. Redivacs, because of tons of Obs and Gynae case. Blood transfusions and chemo protocol because of tons of cancer cases. Hoo boy. We may not be an Oncology nurse, but you do have to learn fast if you want to survive. Dear God, I'm not sure how much I can keep this up. My head hurts, not to mention I'm having gastric again. The past three days I nearly fainted from hunger cause I'm going on a diet. Not going into that story right now.
Now, pulling out Redivac, I used to think it was all about sterile, sterile, sterile... Nope, two ways to remove Redivac drains. Medical hand wash - Forceps; Surgical hand wash - Surgical gloves. Ahm, okay. The one I saw was medical style, previously on the big drama incident, I use Surgical style. Well, everyone has their own style, as long as you don't spread infection, but as I always tell myself, follow the Standard of Practice and you'll never go wrong.
Blood transfusion - A simple procedure, but a mistake may cause a lot. Always check the blood bag with the stickers and form that came with it, a blood giving set with blood warmers, and most importantly, Normal Saline. Super important. If you give any other fluids with thicker concentration like Dextrose (Glucose Water), you'll end up clogging the whole tubing because blood is also a rather thick concentration of fluids. Lucky I remembered that thanks to my previous CIs drilling the rationale and theory into my brain.
Chemo drugs are so cytotoxic that you have to run them fast at a certain time limit. But follow the chemo protocols and you'll never go wrong. Just remember to hydrate after certain drugs. And make sure to wear proper PPEs. I even got the chance to witness staples to off, but it was super fast, done by the prof himself. Too quick, in my opinion. All he did was open the staples with the clip and ta-da. All clean. O.O
Remember the patient with severe anaemia? I said that he was in a critical case. But it's much much worse. I followed the primary prof on my Sunday morning shift and when he asked me regarding about the patient, he looked at me and shook his head, "Prognosis is not good, not good at all." Got that right, prof. He isn't looking too good, after several blood test results and scans, it shows a big capital D. His severe anaemia is one thing, but then his brain lost some function, his heart was a little inflammed, he got fluid accumulating on the right side of his lung, his liver is nearly shutting down, his kidneys already failed, and I mentioned to the prof that his toes are bluish-black. And it is. The prof then asked me to take his saturation, but it wouldn't get his reading. I stayed in his room for more than hour just to get his saturation but I just couldn't. I tried every fingers, forget about his toes, it was too bluish, I even tried his earlobes as per prof's suggestions, and I still can't get it. In the end, prof said then we have to accept the fact that we can't get his saturation level, although the senior nurse said when she first tried, she got a reading of 83% with 10L oxygen via face mask. when he wrote in his report, multiple organs failure, somehow I just knew with sinking dread, especially when he asked for somewhere private and told the family to gather for a meeting. It's already too obvious, and they are also unable to take him back to Sarawak. After I did oral care for him,and just as I left, he passed. That's what I found out on the following day, How awful.
Okay, I'm going to sleep now. I'm exhausted. =.=
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