I have been wanting to buy the Littmann Cardiology Stethoscope. Since I wanted it badly and I do not want to break my bank, I decided to go for the Littmann Cardiology III Stethoscope: Burgundy 27″ with free engraving. I skipped the first website that I have visited since they charge extra for the engraving and they pass on a hefty tax. I settled for Medisave.net as they offer free laser engraving and everything was tax free . I saved about $30 for that. I have added 3 Liquid Syringe Pens and I was billed a total of $167.26 including the shipping fee. I tried to check out using my MasterCard and I have gotten the message that there was an error validating my account so I tried again, to my dismay, I got the same error message. I tried re-doing the check out procedure all over again and that time I was prompted that the authorization was declined. I have not gotten any confirmation that my transactions went through. Nervous that I was billed for the previous attempts, I called BPI’s phonebanking and got hold of Sabrina. She confirmed that I was billed twice for P7244.03 for my online transaction. She told me to get in touch with the online shop so they could void the said transactions since I have not received any confirmation which might be a glitch on the online shop’s part.
I have emailed them and got the confirmation ticket for my complaint. It was 3:00 pm then and I have not received word from them. I tried calling their hotline on MagicJack but all I hear was a recording that their office was closed at that time.
For the love of me, I need to have these things ironed out. I want my money back and I want my stethoscope.
I need someone to save me from this mess

This is crazy. I am nearing my mid-life but I am still to yet to get my own car. Yet being the operative word is not will be in the next 5 years. I am not fretting though because my long time friend promised to be my constant designated driver whenever and wherever. Being behind the wheel for almost three months, I made her promise to get cheap auto insurance. We have to be sure just in case.

I just want to scream in frustration. I have been staying in the ward after my shift for at least two hours. It is because my shift was not enough to fulfil my duty. We have 5 level 2s and so many high level 1s in the ward. To top it all off, the relatives are annoyingly demanding. I know that they want only the best for their loved ones but most of them are already going way over board. You have to make them understand that they are not the only patients in the ward.
I called the ward this after to check my sked tomorrow. I spoke with the then charge nurse and he quickly told me that he will just text me my sked because they were about to intubate one of our level 2 patients. I told myself that level 2 will be lessened but to my surprise. I got a text from my senior that although the said patient was intubate, the patient’s daughter who is a doctor fought her way to keep the patient in the ward.
Hospital and sanitation policy states that intubated patients should be placed in the ICU for close monitoring and it requires the expertise of ICU nurses.
Aaargh…
If someone says that nurse’s work is easy, that person has to be exposed to our lives.

I have so many cases to write about but I have little time to research on it. While most of our patients are getting better, the situation in the ward gets tougher as days go by.
We have this patient who we kept avoiding. Like what the one of the cardio fellows has complained, the patient’s case and attitude are toxic, her relatives are difficult to handle and to top it all off is her attending physician as demanding and as irrational as her patient.
We try our hardest to understand that the patient is on her end stage of cancer and she deserves all the best care that she could have. The thing is, the patient, her relatives and her attending are known to be inconsiderate. We just could take their attitude anymore.
They kept on complaining about our ward’s service but they kept on choosing our ward to have the patient confined in. It is just too much and our head nurse could not agree more.

While it is a shame, I admit that I lack knowledge to satisfy the inquisitive minds of the panellists, the head nurses and the division chief of the special areas.
I was asked to research on the following questions that I failed to answer. I know that I already got the grade for the pre-channelling interview and I know that the purpose of me having to research on these is to leave an indelible mark in my mind. So here the questions go:
1. Give three signs and symptoms of digitalis toxicity
According to medlineplus.com:
Signs and symptoms:
a. Irregular heartbeat or arrhythmia ( I answered tachycardia and then…mental blackout)
b. Confusion
c. Loss of appetite
d. Nausea and vomiting
e. Palpitations

2. Where is the JP drain (tip) insertion site located?
I was told by our Top 2 participant in the CCC that it is placed in the pericardial sac but I tried looking for its exact location on the net and it is taking me forever to get a specific answer. I need to ask a thoracic cardiovascular surgeon for this. I’ll get back to you on this
3. Purpose of CVP insertion
• According to healthsystem.virginia.edu Central venous pressure (CVP) is good approximation of right atrial pressure , which in turn is a major determinant of right ventricular end diastolic volume (or the preload of the right ventricle.) Recall that right atrial pressure (and thus central venous pressure) is a reflection of :
> Cardiac function
> Venous return to the heart
On the other hand, according to nursing-nurse.com the CVP monitor or insertion aims:
a.To serve as a guide for fluid replacement in seriously ill patients.
b.To estimate blood volume deficits.
c.To determine pressures in the right atrium and central veins.
d.To evaluate for circulatory failure (in context with total clinical picture of a patient)
Browsing through its purpose, CVP

I am really upset about what happened during our night duty the other day. My co-staff nurse dozed off in the nurse’s station as she cannot fight the call of sleep in the wee hours of the morning. I was busy arranging my patients’ medications that I will be endorsing the morning shift.
That night, our Division Chief’s husband was confined in our unit and she was there to look after him. At past 3:00 in the morning she went out of his husband’s room to get hot water, I saw her come out so I immediately tried to wake my co-staff nurse up discreetly. We greeted her “good morning” and as she went back she asked me how was our sleep. I felt insulted because in my almost one year of stay in the hospital, it was only once that I tried to sleep that was when I had to go straight to my night duty right after critical care course lecture.
Our Division Chief saw me standing when she went out and it is impossible that a sleeping person could be up and about at the same time.
I just wish that my co-staff nurse has a radar detector so she would have known that the DC will be coming out of her husband’s room.

It was around 3:00 in the morning when Mrs. S’s condition has deteriorated.
We have just finished tranfusing another set of 6 units of platelet concentrate. She reported that she is having difficulty breathing and the pulmonary fellow on duty ordered for an IV push of Furosemide, a diuretic that was supposed to ease her pulmonary congestion.
She did not recover, the fellow ordered for an NIV or the Non-invasive ventilation but as the respiratory therapist was starting to set it up, it did not work immediately. While the RT was trying to jump start the machine, the fellow prompted us to prepare for an intubation. I wheeled in the crash cart in the patient’s room. Everything happened so fast. She crashed and so we called code blue.
Resuscitative measures brought her back and as we prepared for her to be brought down to the medical ICU, she crashed again. At that time, relatives have told the code team to stop. They want a DNR.
We let her go. I shook my head in disbelief.
She has just been diagnosed to have Idiopathic pulmonary fibrosis

I feel so sad to learn through a Twit from a friend that one of her fellow bikers was hit by an unruly car driver. The woman who hit the victim told the police that she actually saw the biker wave his hand to signal that he is going to take the shoulder lane but she did not mind to slow down. The biker was not seriously injured but suffered some bruises. Good thing that he is a member of the roadside assistance club that helped me pull through this serious accident.

I was excited to report for work after hearing that we will be given with the sports allowance. Seeing that no one is in the ATM booth, I immediately tried checking my balance only to find out that I only have P300 in it. When I reached the ward, I learned that only regular employees were given with such an allowance. So I came to thinking where did that P300 come from? I did not avail of any : rv loans. Maybe it was a mistake.

I stayed in the dorm right after my blood extraction so I could get catch a nap before going to work for my night shift.
I was able to fall asleep easily but a few minutes after, I was awakened by a very loud noise. I got up and went out of the room to see what it was. I was so dismayed to see that the engineering people are trying to place some stainless steel drum in the comfort room.