The New Job

It seems like the last month was full of new things. And this month is shaping up in quite the same manner. I began my new job at Alvarado this past Saturday and worked again yesterday, Monday. I'm a Nurse Extern in the DOU; it's basically a step-down unit from the ICU. The nursing ratio is 3 patients per nurse. ICU is a 2:1 ratio. Med-Surg floors (the basic nursing floor of all hospitals) is 5:1 in most San Diego hospitals, but I think the California regulation might be 6:1. Back east the ratios are as high as 8:1, but since California is more litigious than any other place in the world!!!! we have to take more time out to chart so that we don't get sued if something wrong happens ( incidentally takes more time away from patient care, go figure). But, I digress...

The DOU is fun. I like all the nurses I get to work with. I'm following Linda and Joe, two exceptional nurses who have a good head for taking care of their patients while keeping everyone involved in their patients' care well-informed of their current status (this is very important usually and more so in the DOU). I had a patient who was on a ventilator yesterday. He had a mass removed from his lungs which was exacerbated by COPD (emphysema in his case). I really enjoyed taking care of this patient because I saw him progress throughout the day. I think he surprised himself in how far he was able to walk. We put him on a less invasive ventilation setting in the morning, which he tolerated well, and then put him on a Trach Collar, which means their is no longer any machine operating, only oxygen being blown near his trach. The machine helps the patient breath by creating a positive air pressure. We normally breath by negative air pressure (we create a vacuum in our chest when we breathe, which sucks air in). So what he did yesterday was a vast improvement for him. AND considering how small the trach tube is to begin with also emphasizes this point. My nurse compared it to trying to breathe through a straw. Well, maybe an over-sized slurpee straw (see above pic)!

I tried to choose tame, non-gross pictures this time, so hopefully they're more interesting than overwhelming. Above is a ventilator (not the same model we use, this is more bulky), top right is a drawing of what someone looks like with just a trach tube in, bottom left is a trach tube, and bottom right is a drawing of where the trach tube goes. The hole where the tube enters is called the tracheostomy (stoma = "hole" and trach refers to the windpipe). Click on the images to make them bigger.

I'm really looking forward to learning more. I feel slightly overwhelmed by all the new info and the huge responsibility of keeping someone alive, but I feel like I'm able to bear it. But, yes, I need God's help so much. I can't do this without him. I don't want this to just be a job. I want this to be worship. Come Lord Jesus.