I am on night shift for the next 10 weeks. Getting used to this is a bear. If any of you have noticed my posting quality dropping off, that’s why. They have me on the 4 pm to 4 am shift. The extra $6 an hour in shift differential is nice, but it’s been awhile since I worked nights and is taking some getting used to. I’m just getting to bed while the wife is getting up to go to work. I worked on Labor day, which gets some good bonus money. Time and a half, plus the $6 an hour for shift differential. Still, tired.
Since I have been dragging, I didn’t get a lot of time for researching the news today, so instead I will tell you what’s up in emergency medicine. This week, we saw some interesting stuff. Here are some of my more notable patients:
- A guy complaining of abdominal pain and constipation. He had a large blood clot in the main vein that runs from the digestive system to the liver (Portal Vein). It was 85 percent blocked. Because he was so big and the clot so large, he got the largest loading dose of Heparin I’ve ever given- 10,000 units.
- A man who came in with groin pain. We had to let him know that he has testicular cancer.
- A woman with congestive heart failure. She damned near died when her lungs rapidly filled with fluid. She was joking with me and fine. I left the room and 10 minutes later, she was gasping for air and needed BiPAP, a nitroglycerine drip, and Lasix. At one point, I thought she was going to code.
- A guy who did code. Wasn’t my patient, but a code is all hands on deck. He used the bedside commode, passed about 1 liter of blood, then went into cardiac arrest.
- A woman who stabbed herself 10 times because “I was sad.” She remembers feeling sad, and said the next thing she remembers is seeing the knife on the floor and being covered in blood.
- A woman who took some penicillin and had an anaphylactic reaction to it.
- A woman that had been trapped in a burning vehicle who had a hoarse voice and a cough.
- Interestingly enough, I didn’t have any COVID patients this week, but other nurses did.
We have been mostly at 3:1 nurse:patient ratios until 9pm when the mid shifters leave, then we go to 4:1. That means I see anywhere from 10 to 15 patients per day. One thing that gets me is how grown adults who are covered in tattoos can be afraid of needles. I’m talking people in their 30s, 40s, and 50s who cringe, and even cry when you start an IV on them. Three of my patients in one night were actually SCREAMING at the top of their lungs because I started an IV on them. In one case, a woman’s heart rate went from 90 to 150 while I was getting her IV.
Anyhow, since my work week is done, I now have 5 days off in a row. That means I have work to do around the house.