My colleague asked me to accompany her to my dentist. She feels that she’s just been robbed every time she steps out of her dentist’s clinic and yet she has not seen any changes on her teeth condition. She wants to get orthodental treatment but she has been advised by my dentist to get assistance from Plano cosmetic dentist as her case is complicated.

I made it through my shift. Somehow, it helped me lighten up a bit talking to my head nurse. She forced me to cry. She gave me reassurance.
As I change my clothes for my appointment to my rheumatologist, I looked in the mirror and noticed some zits on my face. These are what I get when sleeplessness and too much thinking hit me. I know that they will go away eventually. I just need to shut my eyes and mind for a while. I do not need any acne scar removal treatments for these.

I woke up this morning to the voice of my dad and nieces. It is the usual morning for them, screaming running around the house being chased by my dad. With the morbid thoughts running on my mind, I could say that I have got some decent sleep after all. I just noticed that my fingers are throbbing a bit, yet again. I have stopped taking Plaquenil which is among the best yet pricey rheumatoid arthritis treatments out there.

While my feelings have lightened up a bit, I know that I will my fight my way to sleep through the night. Of course I am not guilty. It is just that it’s hard to doze off knowing that there are people out there who are having a hard time wrapping their minds around what has just happened. I want to get out of this mess as much as I want to get rid of blackheads that might appear on my skin due to sleepless nights.

I feel blessed for friends who do not forget to keep in touch with me once in a while. I got a call from a former colleague and I burst into tears infront of the ER. I felt relieved. I have been wanting to get this off my chest. Good thing I had my shades and pashmina on so I was kinda incognito. Now all I have to worry about is getting the best eye cream for wrinkles caused by constant worrying.

I am an orientee for almost a month now. Everyday, I get my share of learning experience that is in patient management. I was assigned to an American war veteran whose married to a Filipina. It is not the usual mail-order–bride or internet-hook up thing. The Filipina seems to be educated and at par with the American intellictually speaking. Actually she got the twang and was the one who interprets our message to the patient. It is not that I am not good at speaking the language but as I tried to sound professional, my English became business like which made it hard for the patient to understand. He’s used to slang. I could talk the talk but there’s a conflict within between professionalism and being comprehensible. Like saying throwing up instead of vomiting or saying cough out instead of expectorate or saying poop instead of bowel movement.
Talking the talk is one thing but walking the walk is another.
In my usual effort to help the patient “cough out” the phlegm, I had to tap his back to loosen it. Patient has an order of complete bedrest without bathroom priveleges so I had to do sit him up on my own. Well I asked for the help of his wife and other companion but the whole weight was on me. I was able to do the back clapping but I think I exerted so much effort I strained. He was apologetic to his wife for being a pain in the ass.
My duty has ended and after two hours extending finishing my tasks, I went home straight. As I lay my back in bed, I felt pain in my rear. I think I strained to much that I induced my hemorrhoid to come out. Literally a pain in the ass er rear.
Before I finally dozed off, it came to my senses that the American patient is just a taste of my future on the other side of the planet. I have to practice more.

Right after the endorsement, I did my usual morning rounds to check on and assess my patients. I was surprised to learn that one of my patients was out of bed, out of the room actually. He was at the penthouse hearing mass as he was among those who received the first communion invitations This event would not be up until lunch time so I had to take a raincheck on carrying out on my responsibilities to him.

I learned from our HR department that being a probationary employee does not require me to contribute to government agencies like the Social Security System and Pag-ibig Fund. This kind of alarmed me as these two are vital to me. I was informed though that I could make voluntary contribution but I have to remit the payment myself. I really wanted to continue paying my share especially the SSS as this will cover my social security disability

Being a nurse does not just begin with vital signs taking and recording, patient assessment, medications and does not end with charting.
The nursing reponsibility involves knowing the disease process the medications, its mechanism of action, side effects and the precautions.
A female in her early 30s was admitted with complains of right upper abdominal pain. Tests revealed that she has cholelithiasis and cholecystitis.
According to medterms.com cholelithiasis is “the presence of stones in the gallbladder or common bile duct. The process of formation of such stones. From the Greek roots chole, bile + lithos, stone.”
On the other hand. cholecystitis refers to the “inflammation of the gallbladder, a complication of gallstones which are formed by cholesterol and pigment (bilirubin) in bile.”
Bile according to answers.com is a bitter, alkaline, brownish-yellow or greenish-yellow fluid that is secreted by the liver, stored in the gallbladder, and discharged into the duodenum and aids in the emulsification, digestion, and absorption of fats. Also called gall.
There are a few doctors who are thoughtful enough to share the diease process to the patients. So they (patients) end up at a loss as soon as the doctor steps out of the patient’s room. Most of the time, the nurses are the one being asked about for the information they need to know.
My patient was informed by her attending that she needs to undergo explore laparoscopy to remove the gallstones in order for the bile to have patent way to the colon. Otherwise, gallbladder will be filled with bile and sign and symptoms will worsen. Chronic gallstone disease may lead to fibrosis and loss of function of the gallbladder and predisposes to gallbladder cancer.

I was on the PM shift. I came in almost an hour before my shift. I want to have enough time to browse through my patients’ charts. As I looked at the board for my patient assignment, I was not surprised to see that I have 2 level 2 patients out of the 4 assigned to me while the other bedside nurse has only 1 level one patient out of four. I was appalled though that I will be receiving the first admission should there be any. The division of labor is really not fair. Then again, my only consolation for playing the underdog for the next 6 months is that, the bedside and the charge nurse are not allowed to go home without me. A fair deal.
The outgoing bedside nurse get to endorse the concerned patients to me just before the grand endorsement happened. I asked her to slow down a bit as I list down the medications of each patient but she commented that I should come in early to do it. Bitching out aside, I asked her that the reason I came in early is for me to do that exactly but she asked me to make an early endorsement. She rested her case because I was not gonna take it sitting down.
In almost a month of being an orientee, I could say that this was the most smooth shift. We call it suave shift. At 4:30 a.m. I was done doing my final vitally signs, input and output monitoring and charting! I was only waiting for my 6:00 am osterized feeding and medications. This was my best shift ever! Until the admission group called in as there was a patient that will come in from another hospital. Aaargh, admission is the most toxic job for me as there are so many forms to fill out plus there is the task of doing the patient assessment. I am kinda obsessed with the assessment part as I do it thoroughly from head to foot including the patient’s medical background. This was the comment of my preceptor and I am guilty for that, if that is a sin. The patient came in at 5:30 a.m. and I hurriedly but thoroughly did the assessment. At 6:10 a.m. I was done with it, I hurriedly prepared my feeding and medications. At 7:00 a.m., I was done with all of it. I set aside the task of finishing the documentation for the patient who just arrived. I had to make the endorsement for my four other patients. At almost 8:00 am my other patient who will undergo coronary angiogram buzzed for help. She pooped and the daughter needs assistance for a diaper change. As soon as I finished changing her diapers, I went back to the endorsement table. The same patient buzzed again after ten minute. This time she wants to have her hair shampooed and she is level one patient. This means that even though is on complete bed rest, she does not have any contraptions and her Glasgow coma scale or GCS is 15. But in the private ward, you cannot say no to a patient’s request. Technically, she is no longer my patient but since the endorsement is still ongoing, she is still under my care. I went in to shampoo her and as I was patting her hair dry already she insisted on having her daughter to do it for her. My ears flapped in joy.
My preceptor handed me a time table giving me an idea what tasks should be done by when. I looked at him with my eyes speaking “seriously?”. He told me that it was just a suggestion and he does that to all the orientees that he handles. He noticed that I was quiet finishing the newly admitted patient’s chart and I was not laughing at his jokes. He began filling out some forms for me while the other bedside nurse was chitchatting with some nurses from the other ward. It was nearly 9:00 a.m. I was done doing all the charts and as I told them to go home already, they insisted on waiting for me.
Nurses are like diamonds. Undergoing trainings and real life experiences are like series of tests in fire to make them as polished and as priceless as they could ever be. I am hoping though that I could withstand the tests.