pauerish

If only I could be a stockholder of the following stores, I'd be very pleased and honored:

Starbucks: eversince I realized that there was such a cafe, I was already drawn to its frappucinos, hot drinks and pastries as well. I have already collected 3 different planners during the 3-year period that I was collecting stamps during the Christmas season. TMC Starbucks have kept me awake during the long duty hours and also during various seminars. I have watched the products change together with the staff. The baristas already know me by name and they already mastered my orders the moment I step into the stores.

My favorite outlet: The Medical City  

My favorite drink: Grande Java Chip Frappucino

My favorite snack: Oreo Cheesecake

Trends Taxi Service: Oh, for so long now, they have fetched me from home and brought me to school when I was in college. Now that I'm working at TMC they still do the same. For almost 4 years now, I have been one of their frequent clients that they already have mastered as well my address at home and at work and sometimes my duty schedule as well. Though the service is quite expensive I still chose to call them due to safety and comfort reasons.

My favorite destination: The Medical City

How much it costs: around 250php/trip

National Bookstore: since the moment I stepped into kindergarten, NBS has been part of my life. The weekend would never pass without a glimpse at the latest fiction/non-fiction or academic book that the bookstore has instore for me. When I am on the morning shift, the day would never end without me passing by the bookstore to buy the latest nursing book or the latest novel by John Grisham. I have invested so much in the store that probably if I accumulated all my receipts, it would sum up to more than a million pesos.

My favorite genre: Nursing books

My favorite authors: JK Rowling and John Grisham

My favorite outlet: Glorietta

Hush puppies: since I have very big feet and am flat footed as well, hush puppies have been my favorite brand of footwear. Although quite expensive, they provide the utmost comfort that one desires. Their shoe line is also varied--from casual sandals to duty shoes.

My favorite outlet: SM Makati

My shoe size: 8 to 8 1/2

pauerish

After the 3-day oncology seminar, I was blessed to have 2 days off from work. I'm happy because I'd be able to catch up some sleep and read John Grisham's The Appeal. At shempre, dahil malamig ang panahon, masarap matulog. Guess what, I've slept for around 12-14 hours for the past two days. Hindi lang ngayon nangyari ito. When I'm off duty, I usually doze off that long. Hindi ko rin alam kung bakit. Depressed again? Nah. Masarap lang talaga ako siguro matulog or it's just my way of coping with the stressors in life. Colored pa nga ako managinip.

Later, I'd be back on duty. I'm on the night shift once again. Bad trip lang pumasok kasi ang lakas ng ulan. I don't wanna be wet when I come to work. Shempre, the magical cab is there naman to bring me to work. Yun nga lang nauubos ang sweldo ko kaka-taxi.

***

I've discovered a wonderful website for kids with cancer. The site was mentioned by one of our speakers during the oncology seminar. Registration is required and you're supposed to be a health care professional for your application to be approved. The site has online and offline lectures which you could download and they also have an oncopedia and a huge repository of multimedia available for members only.

The site is: Http://www.cure4kids.org

pauerish

Hindi natuloy ang pagpapa-ESI (Epidural Steroid Injection) ko kanina because of several factors. Sabi ni Dr. Banzon, which I agree with naman, that I have to lose weight for the back pain to be relieved. Moreover, I need to continue my rehab so that my back will be strengthened. I need to continue as well for 3 more months the medications I'm taking. We had a long chat which revolved around weight loss and discipline. Ang hirap talaga gawain pero kailangan.

Tsk. I really got to do something about my weight.

pauerish

I'm beginning to become more confident in my job as a nurse. Last night, another patient succumbed to breast cancer. She was already on a DNR (Do Not Resuscitate) order. When I first handled the patient she was up and about, cracking jokes and making funny comments. During the past couple of days, she started to deteriorate. She became more restless and sometimes unresponsive to our calls. She died peacefully last night at 11:45 pm at the young age of 58.

I was the senior nurse last night and I was expected to know what to do in such cases. I was able to exercise my "people skills" while trying to explain to the patient's relatives on how the discharge will go about. I was happy that it all went good and the discharge was uneventfull.

The rest of the shift was quiet. I was handling 7 patients and was happy with it. I was able to make NCP's for all of my patients (which was difficult to do on a busy shift) and carry out procedures with ease. I hope that this will last. The confidence is really overwhelming and I am continuing to be happy with what I'm doing. I've been interacting more with my patients and have helped them in the best way that I could. I am thinking that I'm now on a manic phase but controlled at that. I'm still medicating and have tried tapering off my meds, hoping that I can one day go about with life without pharmacologic support. I haven't seen my psychiatrist for quite some time because of my hectic schedule. I have been asymptomatic for the longest time now and I am hoping that it will last.

My back pain is back again and the leg pain has been bothersome. I am currently on physical therapy and pain management and I'd be undergoing a lumbar ESI (Epidural Steroid Injection) on the 21st of this month under Dr. Banzon, a pain management specialist/anesthesiologist. I had a repeat MRI which showed the following results:

• No significant interval change in the size of the small broad based central disc protrusion at L5-S1 level, with bilateral S1 nerve root contact, now also with posterior annular fissure.
• Small left paracentral disc protrusion, L4-L5 level, abutting the left L5 descending nerve root.
• Disc dessication changes and mild flaval hyperthrophy, L5-S1
• Schmorl's nodes, upper L2 and L3 endplates.

Here's a picture of how the findings look like:

Pregabalin (Lyrica) seems to have helped with the radiating leg pain but I still sometimes feel that my feet is numb. The therapy is also helping but Dr. Banzon said that weight loss is highly recommended. I'm on my heaviest weight now and I'm trying to shed some pounds to relieve the load on my spine. The doctor also said that I'm already on the "susceptible" group that I might have more problems when I come at the age of 40.

Wish me luck!

pauerish

Yesterday, I received endorsements from the morning shift of a patient who has a DNR (Do Not Resuscitate) order. Let me call the patient patient A. Her prognosis was already poor and the relatives are just waiting for the "time" to come. After my initial patient rounds, I took vital signs at around 4pm. Patient A was my priority since she was on a q1 (hourly) monitoring. I had no audible blood pressure, so I took it the palpatory way. The systolic BP I had was 90. I had also difficulty taking her pulse rate because her pulses was so faint that I had to squeeze hard to feel for it that my finger left marks on the patient's wrist. I opted to auscultate heart sounds but her breath sounds were really bad that I could not hear her heart pumping. At around 5pm I decided to hook the patient on the cardiac monitor despite the absence of a doctor's order. I am already having difficulty monitoring her status and the presence of a cardiac monitor will help me monitor her better.

She was tachycardic with cardiac rates between 130-140 bpm. The ecg tracings showed sinus rhythm. I was quite relieved that I now have "accurate" vitals of the patient.

At around 630pm the patient began deteriorating. Her cardiac rate began dropping to the 100's. I was alarmed with the sudden drop and called on my head nurse for re-assessment. After 15 minutes I went back to the patient only to realize that her cardiac rate already droped to the 60's then to 50's, so I was now really on semi-panic mode. Again, I called for my head  nurse. Then after a few seconds, the ecg tracing became flat. We had to call for our floor resident for re-assessment and to declare the time of death. We can't call for a code anymore because she's on a DNR order. The relatives were not around when the patient expired. We had to wait about 10 minutes before they arrived and had the ecg tracing showed to them.

After the patient expired, I was just so thankful that I had hooked the patient to the cardiac monitor. I just had this gut feeling that I had to do so. It was a good thing that we had our unit cardiac monitor around.

Instincts help.

pauerish

Lately, I have to admit that I'm already enjoying my work at the hospital. It's still hard to wake up during morning shifts but I have managed to pull myself out of bed and go to work on time. I have managed to juggle tasks efficiently and have been finishing them on time. I've spent more time with patients and have realized that there is more to nursing than giving medications and carrying out doctors orders. I'm trying more to connect with my patients and tailor care individually. Also, I've been trying to relate more with my colleagues and build my network of friends. Before, I was really stressed out with the work at the unit, now, I just don't know how my perspective has been magically changed that I'm now enjoying my work as a nurse. Maybe the lower nurse to patient ratio has helped me "transform" to a better me. After almost 2 years of hospital duty, I suddenly feel renewed and refreshed. It took that long for me to realize the meaning of being a nurse and understand the different aspects of the career I have chosen. I'm hoping that I'd have deeper love for the work in the future, besides, I'm still young and there will be more experiences for me to have.

...looking forward for more challenges in life.