Looks like we may be in for a hurricane folks. Here the nurses are already getting antsy...reviewing hurricane prepardness charts...logging onto the weather net every hour or so...and the storm hasn't even cleared Cancun yet! Why do you thing we are so anxious. One word "Katrina"! Nurses got racked over the coals for making decisions in crisis situations. Everybody else can flee before the storm, but nurses are required to stay, and report to work. To hell with your family, to hell with your home, to hell with your safety. Even if a mandatory evacuation is called by the mayor, you still must report to your job and be prepared to work without leaving or lose your job. A hospital in Browsville fired a nurse who didn't report for work during a hurricane...came to find out she didn't report because she was killed on the highway trying to get to work ... now that is just wrong! Anyway, when "Rita" was coming in I worked at a LARGE hospital in a South Texas City, and the power's that be decided not NOT evacuate during the mandatory evacuation because the new building was rated for a "hurricane 3". My comment "Yeah, I believe that, remember the building was built by the people who forgot to caulk the window's and it rained inside the first time the wind blew"! Sure, and I really didn't like being their when the wind was whipping up to gusts of 60....it was scary as hell. Add to that the weather channel with hourly Tropical Updates...and the anxiety level is astronomical! So this time, guess I will risk my life in my trailer, because if I evacuate to safety I cannot report to work...and will be fired...then again...if the hospital blows away.....
Anyhow, anticipating being called in if they decide to evacuate to help with patient's. Good think census is low. Hey, maybe they'll send me to San Antonio and I can hang with my brother and nieces!
Monday, July 21, 2008
Saturday, June 28, 2008
TGIF!!!!
Last night should have been the easy..breezy, nice and easy. Three patient's and one of those a "medical", non-tele, DNR, no family, NPO, on his way back to the nursing home. Humm...do you think that caring MD...after 4 days NPO and positive for the BIG STOKE...in that...we are surprised he is even alive...will think to drop an NGT and give some nutrient's...or TPN...OR SCHEDULE A FREAKING PEG! Probably not. Poor little guy. Made me think of my Grandpa's last few weeks. Well last night...he got turned every two hours like clockwork...I personally changed him if I couldn't find the aide, I used my stash of baby-powder when we bathed him, I did oral care every time I went into the room...I pretended he was family and that somebody did care. By the end of shift, he wasn't totally comatose anymore...he was saying "water" in Spanish and a little eye opening was happening. His quality of life may not be much...but for the 12 hours I had him it was tolerable (as my grandma used to say).
Had one patient that was on the button all night...knew he was going to be the proverbal pain in the ass when every request was prefaced by "I hate to bother you", "I know you are busy" and "If you can make the time". Yes he was post-op day one, yes he had chest tubes and incisions...but why the hell do I have to fix a "crooked" foot rest (to look at it bothers me", "pull me up exactly 1 inch and I will be comfortable" (no lie..his exact request), 03 am...I want to walk...04 am...I can't sleep and nothings on t.v., 0430 I was sleeping and lab woke me up to stick me, 05 am the ace wrap is too tight. 0530 am the dressing near my neck is bothering me. 06 don't forget my pain med. 0630 Oh, now you're waking me up to take off my dressings (which is what I told him had to be done this morning...last night)...and you are insisting I get back into the chair (you slave driver bitch nurse).
Kodak moment: Unhappy patient, MD throughly pleased that patient is in chair, dressings removed, and he had a "good night"!
TGIF!!!!!!! oH, and what about that 6 am full admit I did....Damn...I rock!
Had one patient that was on the button all night...knew he was going to be the proverbal pain in the ass when every request was prefaced by "I hate to bother you", "I know you are busy" and "If you can make the time". Yes he was post-op day one, yes he had chest tubes and incisions...but why the hell do I have to fix a "crooked" foot rest (to look at it bothers me", "pull me up exactly 1 inch and I will be comfortable" (no lie..his exact request), 03 am...I want to walk...04 am...I can't sleep and nothings on t.v., 0430 I was sleeping and lab woke me up to stick me, 05 am the ace wrap is too tight. 0530 am the dressing near my neck is bothering me. 06 don't forget my pain med. 0630 Oh, now you're waking me up to take off my dressings (which is what I told him had to be done this morning...last night)...and you are insisting I get back into the chair (you slave driver bitch nurse).
Kodak moment: Unhappy patient, MD throughly pleased that patient is in chair, dressings removed, and he had a "good night"!
TGIF!!!!!!! oH, and what about that 6 am full admit I did....Damn...I rock!
Thursday, June 5, 2008
"Brain Damaged"
Yesterday, before I got off shift, I got a late admit, you know...the kind where you really have to rush to get everything done. He came at almost 5 am. I still had a bed-bath to help with (aide is 8 months pregnant and the patient bedbound and way over 200 lbs and needed to be weighted in the sling scale). So, I get this patient who supposedly has practically no history of anything...just hypertension, high cholesterol, non-compliant on meds with vague chest pain, ambulatory, cardiac enzymes neg, everything pointing to a quick admission history and assessment, right? WRONG!
I step in the room and the patient is sitting in the chair, jeans on under the gown, muddy shoes on and the guy is literally shaking....so hard his arms are jerking and I think he must have Parkinson's or something. "Sir, are you cold, would you like to lie on the bed and cover up". "Hell no, I'm not cold, I'm scared!" "Well sir why are you scared? Have you ever been in a hospital before?" I ask, trying to assess the reason for his fear. Eyes darting around the patient yells "You Nurses Killed My Daddy, You gave him too much Medicine and you Killed Him Dead!" .....blink...blink...ok, now I know why the ER was in such a rush to get this guy upstairs...why didn't they give me a heads up??? I keep my voice soft and calm and assure the patient that I won't be giving him any medications unless he begins experiencing chest pain again because the only thing ordered from ER was aspirin which he had alread gotten, and nitro...which he would get if he was having chest pain.
Ok, now he is ready to get in the bed. I relieve him of the muddy shoes (wish I had a broom for the floor) and I put his monitor on him, explaining everything as I go...He informs me that his blood pressure is fine and that he quit taking his blood pressure medicine 2 years ago because he didn't need it anymore...his pressure is just fine. I ask him how often he checks his blood pressure....blank look, blink...blink...blink..."well I don't check it, I don't need too...it's just fine." Yup...and that's why it's called the silent killer. I explain the new BP guidelines 120's over 60's yada yada yada. The guy asks me to call his wife and give her the room number, which I do. Now he's calm enough I can start taking his history. I have one eye on the clock...it's almost 6 and I still need to bath the bedbound patient.
"Sir, other than Hypertension and high cholesterol, do you have any other medical conditions that might affect your care?"
"Well........." he drawled..........."I was born Brain Damaged." (ok, now the corners of my mouth were twiching). "You were?" I ask. ""Yup" he says. Well now I'm looking for a clue that this guy is pulling my leg....he looks normal (except for the shaking). He doesn't act like he has anything wrong with him. "My wife was born brain damaged too, that's how we met". (WHAT???) "She died two years ago." He states. Hummmmmmm maybe I'm confused...I just talked to his Wife on the phone. "Your 1st wife died two years ago?" I ask for clarification (as you can tell this history is going to take the rest of shift to complete). "nope, didn't you just talk to her on the phone? They did CPR". Hummmmmm ok, now moving on..............................
Well 1 hour later....yes I agree...the may is definately brain damaged and a little scary as compared to scared.
Wow was I glad to go home. Yes Big guy did get bathed and weighed but...it was a hurry up rush rush deal. I didn't go home until 9:30...gotta love 14 hour shifts....but today...Vacation. :)
I step in the room and the patient is sitting in the chair, jeans on under the gown, muddy shoes on and the guy is literally shaking....so hard his arms are jerking and I think he must have Parkinson's or something. "Sir, are you cold, would you like to lie on the bed and cover up". "Hell no, I'm not cold, I'm scared!" "Well sir why are you scared? Have you ever been in a hospital before?" I ask, trying to assess the reason for his fear. Eyes darting around the patient yells "You Nurses Killed My Daddy, You gave him too much Medicine and you Killed Him Dead!" .....blink...blink...ok, now I know why the ER was in such a rush to get this guy upstairs...why didn't they give me a heads up??? I keep my voice soft and calm and assure the patient that I won't be giving him any medications unless he begins experiencing chest pain again because the only thing ordered from ER was aspirin which he had alread gotten, and nitro...which he would get if he was having chest pain.
Ok, now he is ready to get in the bed. I relieve him of the muddy shoes (wish I had a broom for the floor) and I put his monitor on him, explaining everything as I go...He informs me that his blood pressure is fine and that he quit taking his blood pressure medicine 2 years ago because he didn't need it anymore...his pressure is just fine. I ask him how often he checks his blood pressure....blank look, blink...blink...blink..."well I don't check it, I don't need too...it's just fine." Yup...and that's why it's called the silent killer. I explain the new BP guidelines 120's over 60's yada yada yada. The guy asks me to call his wife and give her the room number, which I do. Now he's calm enough I can start taking his history. I have one eye on the clock...it's almost 6 and I still need to bath the bedbound patient.
"Sir, other than Hypertension and high cholesterol, do you have any other medical conditions that might affect your care?"
"Well........." he drawled..........."I was born Brain Damaged." (ok, now the corners of my mouth were twiching). "You were?" I ask. ""Yup" he says. Well now I'm looking for a clue that this guy is pulling my leg....he looks normal (except for the shaking). He doesn't act like he has anything wrong with him. "My wife was born brain damaged too, that's how we met". (WHAT???) "She died two years ago." He states. Hummmmmmm maybe I'm confused...I just talked to his Wife on the phone. "Your 1st wife died two years ago?" I ask for clarification (as you can tell this history is going to take the rest of shift to complete). "nope, didn't you just talk to her on the phone? They did CPR". Hummmmmm ok, now moving on..............................
Well 1 hour later....yes I agree...the may is definately brain damaged and a little scary as compared to scared.
Wow was I glad to go home. Yes Big guy did get bathed and weighed but...it was a hurry up rush rush deal. I didn't go home until 9:30...gotta love 14 hour shifts....but today...Vacation. :)
Tuesday, April 1, 2008
What's Wrong??? WEll doc...he ain't breathing!
Friday, had a code, 2 minutes into taking report. Knew nothing about the patient as yet, just the aides were putting him back in the bed from the chair and she runs out "I think he is having a stroke!" We go in there and like "call a code, get the cart...stroke hell...he ain't breathing"! The nurse I was getting report from was a Winter Worker floated from another floor, so I knew she didn't know where stuff was, I fly outta the room like a bat outta hell and get the crash cart...forgot to unplug it *grin* so the cord just popped outta the wall, I yell at the aides to get the Jerry chair outta the way (no way crash cart, doc's, nurses can all fit with it in the way). They do and I run the cart in shove the board under the dude and start compressions...the float nurse had already checked and he was PEA, they hook up the leads around my hands...and the ER doc arrives. By this time, the float nurse is outta the room in the hallway pretending to be a bystander...and I don't even know this guy! The doc looks and me and asks "Well what's wrong with this guy?"...I'm like...."AAAAA....he's not breathing?!" Did I sound like a dumb-ass or what??? He just gave me the evil eye and asked again...I'm like...well there's the day nurse...I haven't got report yet...but He's got Dobutamine running...so he ain't good!" Sad to say after 45 minutes of good CPR he didn't make it. And the Float nurse....well she was pissed that report was late and she was late going home. I did all the code paperwork, death stuff, called the tissue bank, comforted the family, called the funeral home and did post-mortem care after she left...but SHE was pissed.
Me...I was just sad. Oh and the rest of my patient's didn't get their meds until 11 p.m., and the rest of the night was not much better. By the end of the shift my co-workers were calling me Ninja Nurse...because I was kicking ass to get done!
Me...I was just sad. Oh and the rest of my patient's didn't get their meds until 11 p.m., and the rest of the night was not much better. By the end of the shift my co-workers were calling me Ninja Nurse...because I was kicking ass to get done!
Monday, February 4, 2008
Wow...a weekend to end a weekend!
Well this has been a busy weekend. It was so busy I can barely remember Friday...although I'm sure I worked and busted my butt! Apparently there can be drama all the time! Oh, now I remember ...Friday night was the Ms. Newbie Nurse ForEver night...so was Saturday...hummmmm, and come to think of it so was Sunday. Maybe I should just change rotations for a rest from Ms NNFE??? Anyway.
More drama....we had a nurses aide, one of the few that really seemed to love his job, going to college, has a spouse and a child...and...apparently a very short fuse! He got mad at somebody (?) and just left. Packed up his crap and buzzed out of the farm! Didn't tell anybody, didn't do anything but pick up his stuff and go. Is that Ball's or utter stupidity. Oh, and for two hours we were looking for him, then we thought perhaps he had left to go to the closest burger joint to get chow and forgot to tell anybody...then we were checking the emergency room...finally the power that be decided to check the security camera's ... and there he was ... all packed up...and ....fade-out into the darkness (kinda like riding off into the sunset!). Wonder how that will look on his next application.
Reason for leaving last place of employment: I got Pissed. Oh, and when they check the "reference"....................hummmmmmmmmmmm.
Then tonight, our Nurses Aide got sick and didn't tell anybody...until she suddenly just grabbed the other aide to take her to the Emergency room. We had to hunt down everything she hadn't charted (like the vital signs, weight, and glucometers..) finish her work...empty foleys, nun's caps and urinals, throw trash, clean up linens. Now don't get me wrong....she was sick...but a little warning...like "I don't feel so hot, and I've thrown up three times" might have been helpful. You know throwing up three times is a clue something is up...and we wouldn't have been caught running about like the KeyStone Cops!
This KeyStone Cop didn't even start charting until 6:15 a.m. due to Ms NNFE's patient almost coding, the need to speak to the MD for her because she freaked and just handed me the phone! I didn't even know the patient's name! I didn't even know who I was talking to! But I did impart the facts pretty swiftly ! Then I had to drop the NGT because "I've never done it" says Ms NNFE (what do they teach now-a-days in Nursing School??? Gee I want a BA degree too!). Then although she "apparently" had all the tubing and paraphanilia for the suction hooked up...it was an illusion. My bad, I didn't check to make sure it actually WORKED before attempting to use it on the projectile bile vomiting patient! Can we say ASPIRATION! Oh, and her answer later when I questioned if she knew how to hook it up .... ditto..you guessed it. NOW THAT IS SCARY, SHE'S BEEN WORKING PCCU FOR 8 MONTHS AND SHE DOESN'T KNOW HOW TO CHECK A SUCTION SET-UP AND CANNISTER FOR ACTUAL...SUCTION??????
I'm tired...a little wired up, a little pissed at myself for still trying so hard to teach somebody...then I make a stupid little New Nurse Mistake myself! Humbling....and I will try harder to have patience...after all I certainly don't know it all, and sometimes I need the little slap down to remind me of that.
More drama....we had a nurses aide, one of the few that really seemed to love his job, going to college, has a spouse and a child...and...apparently a very short fuse! He got mad at somebody (?) and just left. Packed up his crap and buzzed out of the farm! Didn't tell anybody, didn't do anything but pick up his stuff and go. Is that Ball's or utter stupidity. Oh, and for two hours we were looking for him, then we thought perhaps he had left to go to the closest burger joint to get chow and forgot to tell anybody...then we were checking the emergency room...finally the power that be decided to check the security camera's ... and there he was ... all packed up...and ....fade-out into the darkness (kinda like riding off into the sunset!). Wonder how that will look on his next application.
Reason for leaving last place of employment: I got Pissed. Oh, and when they check the "reference"....................hummmmmmmmmmmm.
Then tonight, our Nurses Aide got sick and didn't tell anybody...until she suddenly just grabbed the other aide to take her to the Emergency room. We had to hunt down everything she hadn't charted (like the vital signs, weight, and glucometers..) finish her work...empty foleys, nun's caps and urinals, throw trash, clean up linens. Now don't get me wrong....she was sick...but a little warning...like "I don't feel so hot, and I've thrown up three times" might have been helpful. You know throwing up three times is a clue something is up...and we wouldn't have been caught running about like the KeyStone Cops!
This KeyStone Cop didn't even start charting until 6:15 a.m. due to Ms NNFE's patient almost coding, the need to speak to the MD for her because she freaked and just handed me the phone! I didn't even know the patient's name! I didn't even know who I was talking to! But I did impart the facts pretty swiftly ! Then I had to drop the NGT because "I've never done it" says Ms NNFE (what do they teach now-a-days in Nursing School??? Gee I want a BA degree too!). Then although she "apparently" had all the tubing and paraphanilia for the suction hooked up...it was an illusion. My bad, I didn't check to make sure it actually WORKED before attempting to use it on the projectile bile vomiting patient! Can we say ASPIRATION! Oh, and her answer later when I questioned if she knew how to hook it up .... ditto..you guessed it. NOW THAT IS SCARY, SHE'S BEEN WORKING PCCU FOR 8 MONTHS AND SHE DOESN'T KNOW HOW TO CHECK A SUCTION SET-UP AND CANNISTER FOR ACTUAL...SUCTION??????
I'm tired...a little wired up, a little pissed at myself for still trying so hard to teach somebody...then I make a stupid little New Nurse Mistake myself! Humbling....and I will try harder to have patience...after all I certainly don't know it all, and sometimes I need the little slap down to remind me of that.
Saturday, February 2, 2008
One Good Night!
Don't know why I had such a good night last night. Could be cause we ran out of tele packs before I ran out of empty rooms (hurrah!) and they didn't send any medical admits....(hurrah)! So I had 4 stable mables and no crash-n-burns or circling the draino's! (hurrah!) I had sssssssssssuuuuuuuch
a good night I was able to help my less fortunate co-worker Ms. Newbie Nurse Forever with her patient's...and do all the things she claimed she hadn't done yet (guess she forgot who trained her and signed off on all the things that she did!). Any how...even then there was some drama. The lady Ms. I'm Confused and Don't Know it Yet (ICADKIY FOR SHORT) managed to pull out her IV and she was on a heparin drip ...and drip she did...drip dripdripdrip...drizzle...drip.drip.drip. , and the little pregnant aide freaked out!!!! HEY...HEY ... HEY SHE'S BLEEDING IN HERE...DO SOMETHING...DO SOMETHING...HEY..HEY...HEY SHE'S BLEEDING IN HERE. Ms PG stands there wringing her hands watching the steady flow of blood onto the clean gown and floor...flowing down the arm and steadily dripping. Hey Ms. Newbie Nurse Forever..your patient has pulled her IV out and HEY..HEY..HEY she's bleeding in here (picture blue gloved hand wringing...notice no body has bothered to apply pressure yet) Ms. NNFE sniff's...well I'm too busy...I'm doing something...I'll be there in a little bit.
More blue-gloved hand wringing. I look around the corner as I trot out of my patient's room. HEY HEY HEY....SHE'S BLEEDING...DO SOMETHING. I holler, well put some pressure on it...I put 4X4's in there an hour ago when it was leaking and I fixed it for Ms. NNFE! I get a blank look. Either she didn't understand 4x4 or I didn't understand that she wasn't touching the patient for love or money....maybe a lot of money...but not what she's getting paid! I go in and save the day. Amazing what some 4x4's and a little reassurance will do to a bleeding patient. I clean her up, change the gown, wrap her in a warm blanket and put her back to bed. Super Nurse Has Once Again Saved the Day for Newbie Nurse Forever (and that was between taking care of my job and two others of her's). sigh, and i just thought she was getting the hang of it.
a good night I was able to help my less fortunate co-worker Ms. Newbie Nurse Forever with her patient's...and do all the things she claimed she hadn't done yet (guess she forgot who trained her and signed off on all the things that she did!). Any how...even then there was some drama. The lady Ms. I'm Confused and Don't Know it Yet (ICADKIY FOR SHORT) managed to pull out her IV and she was on a heparin drip ...and drip she did...drip dripdripdrip...drizzle...drip.drip.drip. , and the little pregnant aide freaked out!!!! HEY...HEY ... HEY SHE'S BLEEDING IN HERE...DO SOMETHING...DO SOMETHING...HEY..HEY...HEY SHE'S BLEEDING IN HERE. Ms PG stands there wringing her hands watching the steady flow of blood onto the clean gown and floor...flowing down the arm and steadily dripping. Hey Ms. Newbie Nurse Forever..your patient has pulled her IV out and HEY..HEY..HEY she's bleeding in here (picture blue gloved hand wringing...notice no body has bothered to apply pressure yet) Ms. NNFE sniff's...well I'm too busy...I'm doing something...I'll be there in a little bit.
More blue-gloved hand wringing. I look around the corner as I trot out of my patient's room. HEY HEY HEY....SHE'S BLEEDING...DO SOMETHING. I holler, well put some pressure on it...I put 4X4's in there an hour ago when it was leaking and I fixed it for Ms. NNFE! I get a blank look. Either she didn't understand 4x4 or I didn't understand that she wasn't touching the patient for love or money....maybe a lot of money...but not what she's getting paid! I go in and save the day. Amazing what some 4x4's and a little reassurance will do to a bleeding patient. I clean her up, change the gown, wrap her in a warm blanket and put her back to bed. Super Nurse Has Once Again Saved the Day for Newbie Nurse Forever (and that was between taking care of my job and two others of her's). sigh, and i just thought she was getting the hang of it.
Thursday, January 31, 2008
Codes at Work and other stuff
Wow. Yesterday we had a hell of a Code Blue. I was floated to ICU and had a relatively easy night, two tele patient's with no bed to send them to, and one ICU pt. No drips, no real challege...nice and easy...breezy. Then about 6 a.m., bam! (it's the BAM that get's ya every time!) Move the tele pt to another room, then recieve the "tele" pt to ICU to start NTG drip...stat dialysis ... non-rebreather...ect.
I'm right in the middle of stabilizing my new pt (at 6:05...that's how fast I transferred and got my room cleaned and mopped...should get a medal for that one), the patient in Cardiovascular Recovery Codes! She had been up walking around just fine hours before. Started feeling "funny", suddenly like blew a gasket or something. Her chest tube starts pouring blood and she goes asytole! The other ICU nurse runs to the code...and now I have one tele pt, and 4 ICU patients...and still stabilizing my admit. Well if that's not challengening enough....three minutes later they call a Code Orange Haz-mat decon code in the ER (what the heck is going on....what day of the week is it anyhow??). Back to the Code blue...this lady is not doing well (remember asystole!), Everyone's running, nursing students trying to see and stay out of the way...Cardio-thoracic surgeon CRACKS the chest BACK OPEN AT THE BEDSIDE (shades of Gray's Anatomy!). All that...and I missed most of it... (remember the other 5 patient's! Not to count dealing with the family who wanted all 45 members to be in the patient's room at the same time...and wanted to wander around in the hallway while we are running with equipment to the code...."Sir I'm sorry, but could you wait outside of the ICU for a little bit, I'm attempting to stabilize your *mom* *aunt*grandma*cousin* and If I could be in the room rather than running traffic control I could probably do more good for her".) Well eventually it all got done. My patient was doing better, painfree, hemodialysis in progress, NTG titrated up significantly when the actual day shift ICU nurse relieved me (late because everybody coming in also went to help with the codes).
I was glad to leave to go home. Unfortunately...even with the cardiothoracic surgeon at the bedside...the CVR lady didn't make it. Her nurse had tears in her eyes when she left that morning. Sometimes it is just so damned hard to be a nurse.
I'm right in the middle of stabilizing my new pt (at 6:05...that's how fast I transferred and got my room cleaned and mopped...should get a medal for that one), the patient in Cardiovascular Recovery Codes! She had been up walking around just fine hours before. Started feeling "funny", suddenly like blew a gasket or something. Her chest tube starts pouring blood and she goes asytole! The other ICU nurse runs to the code...and now I have one tele pt, and 4 ICU patients...and still stabilizing my admit. Well if that's not challengening enough....three minutes later they call a Code Orange Haz-mat decon code in the ER (what the heck is going on....what day of the week is it anyhow??). Back to the Code blue...this lady is not doing well (remember asystole!), Everyone's running, nursing students trying to see and stay out of the way...Cardio-thoracic surgeon CRACKS the chest BACK OPEN AT THE BEDSIDE (shades of Gray's Anatomy!). All that...and I missed most of it... (remember the other 5 patient's! Not to count dealing with the family who wanted all 45 members to be in the patient's room at the same time...and wanted to wander around in the hallway while we are running with equipment to the code...."Sir I'm sorry, but could you wait outside of the ICU for a little bit, I'm attempting to stabilize your *mom* *aunt*grandma*cousin* and If I could be in the room rather than running traffic control I could probably do more good for her".) Well eventually it all got done. My patient was doing better, painfree, hemodialysis in progress, NTG titrated up significantly when the actual day shift ICU nurse relieved me (late because everybody coming in also went to help with the codes).
I was glad to leave to go home. Unfortunately...even with the cardiothoracic surgeon at the bedside...the CVR lady didn't make it. Her nurse had tears in her eyes when she left that morning. Sometimes it is just so damned hard to be a nurse.
Subscribe to:
Posts (Atom)
