Sunday, February 8, 2009

And the Wind Blow's wildly!!!

Wow. We are having wind excess of 40 mph. No sprinkles yet, but a kite hasn't got a chance in hell today of survival! I've had a tough few weeks at work.

Baratric nursing: Nursing care of the morbidly obese. Well I don't know what the exact definition of morbidly obese is...since I had a Doctor tell me I was very 180 lb and 5'8"...which pissed me off to no means! Made me want to gain more weight just to spite him...the skinny so and so.

Well our hospital is getting geared up to start doing baratric surgery. They have prepared by getting special "bari" beds and giving us "sensativity" training. What I have noticed they have not get any kind of lift device or lift aid to help the nurse's caring for the post surgical patient's. I recently had a pt who weighed #681 pounds. He was miserable. He was in respiratory distress; with C-pap ....the man couldn't breath. They had him in a "bari" bed. I had to use a stool to reach him to do any care...suctioning....anything (and I am a tall woman!). He was not doing well on my shift..I managed to get a second line in him (I felt like the IV Diva!) and just before 7 a.m. he vomited and aspirated. The bed was up as high as it would go to sit him up, and there was literally nothing I could do except suction and bag him as I called for the rapid response team. Thank-fully since my respiratory therapist had been working closely with me all night, we were able to keep him oxygenated enough this way...but he was going downhill fast. We had to move him to ICU, which was no small feat in itself because the ER doc was hesitate to attempt to tube him (short neck, adipose tissue) due to probably only having one shot...and if he didn't get the tube the 1st time the man would die. So here we go down the hall with every man we could snag...ER Nurses, ER MD, all the floor nurses but took 8 people just to push the bed, bagging all the way. THEN the HUGE BED got stuck in the ICU room's doorway... it was literally forced through the door (GUESS WHAT...NO ONE HAD THOUGHT TO MEASURE THE DOOR TO BED RATIO WHEN THE BEDS WERE ORDERED TO BE SURE THERE WAS ENOUGH CLEARANCE TO GET THE DAMNED BED INTO A ROOM WITH THE BED-RAILS UP!!!!) . We were still bagging...thank God the Respiratory Therapist was on the head side of the bed, stuck in the room. We finally got the bed unstuck ... now we know the trick for transport, let the rails down before going into the room, and hope like hell the patient doesn't fall out!

Update....that was 4 weeks ago. Pt was surgically intubated, then later trached and now he is doing well, and has lost almost 200 lbs, the first 50 was probably all fluid. He is getting his strength back, and communicating...sitting up watching tv. He's a really nice guy, I sure am glad he made it !


Reddirt Woman said...

The unfortunate truth is that there will be a huge need for the bari unit with all the obesity in our world. I think that all you nurses that take care of fols deserve some extra stars in your crown.

In other news, I think your wind has headed up north, across the Red River. We've been under burn bans because of the low humidity and high winds. But we have a 70 percent chance for a rain tonite, which is good since I transplanted a bunch of daylilies. Dug 'em up yesterday and planted 'em in there new home today.

I hope your week is not so hectic. You have to be able to stop and smell the roses once in a while.


Vegas Linda Lou said...

Wow--this is a fascinating post. Nurses are angels on earth, no doubt about it. And "obese" at your size? You gotta be kidding.