ICU eavesdropping

Our redoubtable night shift charge is fond of challenging us to think outside the box. On the question of patient/family complaints about noise, he had this to say:

Pretend you're not a nurse. Walk down the hall, stop and listen outside of each room for a moment, then move on.

Some results:

1. "Don't put that thing in there!"
2. "Squeeze!"
3. "Work it!"
4. "Suck it in harder!"
5. "Blow blow blow blow blow!"
6. "Yes, you do have to do that."

There was nothing inappropriate going on in any case, but feel free to guess what the actual situation is. I'll post the real answers tomorrow.

Publishing vs Nursing

I freely admit that I am an aspiring author who would very much like to leave my current career to write full time. But isn't that the dream of every aspiring, unpublished author? I am at least realistic. I know the odds are against me.

And after today's news of publishing houses laying off, restructuring and possibly placing freezes on acquisitions, now is clearly not a good time in the publishing industry. Publishers Marketplace dubbed it 'Black Wednesday' and bad news seemed to come from every direction.

Agent and editor bloggers that I follow and admire seem beside themselves as they worry about what's going to happen next. My heart goes out to all of them, and I hope they all weather this crisis in good form with their careers intact.

It's at times like these that I reflect upon my day, er, night job. As a Registered Nurse in a cardiac ICU, I don't have to worry about lay-offs. I have to worry about mandatory overtime and whether or not I'll get Christmas off.

There's a nursing shortage. If the hospital I worked for went under, I could find a job within days if I wasn't picky, a month at the utmost if I was picky. And given that sort of job security, I'd be crazy to want to leave the field.

And yet, as an author, I'd be able to set my own hours, eat like a normal human being, use the bathroom on an as needed basis, and see more of my family. But I'd be at the mercy of the economic climate and how well my books sold.

For now, I shall remain a CVICU RN. Yes, it means I'll have to work Christmas and New Year's, but at least I'll get holiday pay on top of the overtime.

Brevity

As an aspiring author, my work is often critiqued as being too detailed. I am told that I need to keep it short and sweet, giving only as much information as the reader can handle. Okay, I can see that. We don't want to bog the story down unnecessarily. But if you're too scant on the detail, the reader ends up confused, and puts the book down in frustration. Me, I err on the side of abundance.

Perhaps it's a knee-jerk reaction to work. I spend a lot of time writing a lot of things as briefly as is humanly possible. For example:

'9/26/08 1830 Nsg. Report rec'd, assumed care of pt. Assessment per flowsheet/path plan. VSS, afebrile. Pt NPO 2400 for LHC in AM. SR on monitor. BP, HR WNL. Will cont. to monitor pt.
2030 Pt c/o CP. CP protocal init. EKG shows no changes. Pain relv'd nitro tab x 2. Physician updated, orders rec'd and noted.
9/27/08 0130 Pt c/o CP. See flowsheet/code sheet. Physican notified, orders rec'd. Vent settings: PRVC 16, TV 450, Peep 5, FiO2 100%. Pt to OR.
0430 Pt back from OR. Vent settings unchanged. MT & PL CTs to LWS. Pacer wires taped. VSS, afebrile. SR on monitor. BP, HR WNL. Assessment per flowsheet/pathplan. Will cont to monitor pt.'

Now, from this, can you tell what happened?

Here's the translation. 6:30 pm. The patient is fine, and going for a cardiac catheterization in the morning. Because of that, he can't eat or drink after midnight. At 8:30 pm, the patient had chest pain, which was relieved by two nitroglycerin tabs. The EKG was fine, the doctor was updated, gave a few orders, which were done.
At 1:30 in the morning, the patient went into cardiac arrest, was given CPR, drugs, and several shocks. He was also sedated, intubated and placed on a ventilator. Since he was already in the ICU, he wasn't transferred, but the Cardiothoracic surgeon came in (yes, at 2 am) and took the patient to surgery for emergency bypass surgery. (guess the cath got cancelled).
Patient came back at 4:30 in the morning, with chest tubes hooked up to suction, pacing wires attached to his heart, and many other new wires and tubes. And yet, stable once more, by nursing standards for a fresh post-op open heart patient.

Is it any wonder I rebel and give the detail?