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jmwaggoner
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Name: Jessica
Birthday: 11/14/1982
Gender: Female
Interests: Sunday dinners with my family, furry blue slippers, theatre, Lifeline reunions, being with the girls, hair products.
Expertise: Saving lives in Virginia, cuddling, dish-washing soap wars with my brothers, giving shots.
Occupation: Nurse
Industry: Healthcare
Message: message meEmail: email me
Member Since:
8/22/2005
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| I have the biggest crush today (mind you, just today) on Hugh Laurie. Maybe it's the icy blue eyes, the British accent, the ubiquitous 5:00 shadow...who knows, but holy cow...
 How can you not love this?? Seriously. Maybe he wants to move to Virginia...
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 Crabtree falls...there's nothing more to say...
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| Hey, guys, thanks for letting me get all that out in the last post. I know you can't really get much more intense and I usually try to filter...but, you know...it was needed. So thanks...you're a true friend. :)
I've come to the realization that my life is strange...and I'll tell you why. Not only do I deal with the things I do at work (see previous post, if you are unsure) but working 12 hour shifts 3 days a week gives me four days (nearly) completely off. So here's what usually happens: I'm exhausted from work and I sleep in. And I'm talking...really sleep in. I won't give you a time, but use your imagination. Then I just have enough energy to climb out of bed, brush my teeth, put on fluffy slippers and pad around my apartment, making coffee and eventually settling on the couch. At which point I cuddle up with a blanket and succomb to watching such quality TV shows like "What Not To Wear" and "E! True Hollywood Story." There's so much to do around Charlottesville, and I would take a friend and go exploring, however - normal people are at work!! No one else has this schedule! Seriously, the only other people that do are other nurses and sometimes you just need to see people that don't have anything to do with the medical field on your day off. I'm at a loss. So for now...I'm here...I need more coffee.
I did accomplish one very important thing recently...rather someone else did and I stood by and took pictures. My fireplace made it's debut!!
 Special thanks to Eric, UVa's premier sport's medicine PhD student and boy scout. We pulled out all the stops for this baby, and finally got it lit with several editions of The CVille and The Hook, starter sticks and very flammable Fire Starter gel packs (I have no idea). It was a fantastic little fire, although no news yet on whether it will be attempted again. I think I need to take firebuilding classes.
Well, y'all I have a busy day...LOTS to do...like, dusting.
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| "She's not bad, Jess. It'll just be good experience for you to admit a fresh trauma."
"How old again?" I ask leafing through her patient treatment plan.
"73"
"Oh man" I thought. Elderly people and car accidents are never a good combination.
"She and her husband were out looking at the leaves on the Blue Ridge Parkway, and were T-boned by a dumptruck...on her side."
Doors open and I hear the familiar beeping of the cardiac monitors...the beeping that always makes my heartrate increase a little as well. "Here we go..." I blow out a shaky breath. People line the bed that's rolling - a little too quickly - through the door...ER doctors already updating myself and Barry about her status...respiratory therapist bagging her until she can get in the room and on the vent. As I grab syringes for labs, I notice a deep red stain quickly spreading on the sheets underneath her.
"What do we have for labs?" I ask
"Platelets - 64, INR - 1.9, H and H -10 and 30"
"Not for long..."
"Bicarb - negative 16"
I blink. "Excuse me?"
No one answers me, but suddenly my pace picks up. "I need these labs now..."
I work on getting the lines untangled...trying to assess the mess I'm realizing we just had dumped on us. Temp is 32 C. She's under - thankfully, but continuing to bleed profusely from the chest tubes that were clearly thrown in in quite a hurry...from her groin lines...from her nose...ears. "This is not good..."
"Metabolic acidosis" the trauma doctor announces.
"Ya think?!?"
"Push two of bicarb...we have to get this up."
I slam them in as fast as I am physically able and run to the computers to check on my labs...not there. I run back into the room to see the monitors start to alarm....pressures dropping. Blood is now dripping from the sheets onto the floor. I start to sweat.
"She's on 15 of epi..." I tell the trauma doc. "Can I go up?"
"Yeah, put her on 30."
I do it, and watch the monitor...she plateaus at 85/40. "Not great, but I'll take it, for now."
"Did you check again on those labs?" Barry says to me
"I did...CBC's usually the first to come back, but there's nothing."
"Alright, I'm drawing an ABG...we can check from our machine."
I run to check the computers again when I hear Barry yell out to George, the trauma doc - "We can't wait any longer for the labs...this blood looks like pink koolaid...you have to put in an order to transfuse...she's bleeding out."
The monitors start to alarm again...70/34...62/28. I reach to adjust the epi - 35."
"Go up to 50, Jess."
She responds, but not well. Just then the charge nurse enters. "I did your ABG and it looks like your crit is 6."
"That can't be right." My eyes flash back up to the monitors as both heartrate and blood pressure numbers start to blink and alarm. I watch in seemingly slow motion as her HR drops to 58...46...39... Barry takes the liter of LR off the pump and starts squeezing it with his hands.
"Can...can we start another presser?? What about dobutamine...can we try that?" I ask
"Dobut would do nothing...it's not a heart issue, and we're already mini coding her with the epi...she just has no volume left." Barry looks up at me "Have you ever done chest compressions, Jess?"
"No."
"Get ready then." he says looking back up at the monitor. "You're about to do some."
I swallow hard, but she then starts to respond to the fluid and epi. "Avoided that...for now." Someone enters the room, "Your labs are back, crit is 5.5 and INR is 3.3."
My shocked eyes meet Barry's over the patient's chest.
"Go tell George, Jess...he'll probably want to transfuse FFP as well, and ask him if wants to give Factor 7. Hurry. She's in..."
"DIC, I know." I say as I run from the room.
"She's coagulopathic," I announce out of breath as I enter the resident room. "Her INR is 3.3"
"Ok" George reponds as calmly as possible. "This is bad...this is really bad. How many units FFP do you think we should give?"
You're asking me!? I wanted to say, instead I came back with, "Three?" I'm a really smooth guesser.
"At least." he says. "I'll put the order in right now...slam it in as soon as it comes up."
As I run back to the room I catch our charge, "Call the blood bank and see what the hold up is. I need this blood now, and send someone to get me the Level 1. There's no way I can squeeze the blood in with my hands fast enough."
I enter the room watching the blood still consistently dripping onto the floor...though not as much as I'd expect.
"Barry, if her crit is 5.5...where is all that blood going?? She's not bleeding out that fast."
"Check her belly."
I shove a gloved hand under the bair hugger and feel her abdomen - hard as a rock. Dang.
The next hour and a half are a blur. As I'm checking blood, working the Level 1, pushing more bicarb, atropine, Factor 7, calcium gluconate and calling for more fluids, people are putting gown, mask, shoe coverings on Barry and I as the docs also gown up and prepare to open her abdomen at the bedside.
Walking away that night was so incredibly hard. "I'll give her to you tomorrow, Jess." the charge nurse informed me as I gather my stuff to leave. "If she's even alive." I thought.
The next day I come in, almost not wanting to know... I make a beeline for her room and peek in. It looks like a war zone...blood on the floor and walls...and my patient, the woman I worked my tail off to save just 12 hours previous...covered in the death shroud.
"She went around 3 am, and she would have gone sooner, but her husband couldn't let her go..." the night shift nurse I reported off to informed me. "We did everything we could...both of us. Listen to me, I want you to know that you did a good job."
A good job!? I was thankful she said it, even if it wasn't all that comforting...there are the days when you have to say it to yourself over and over. "I did all I could...I did my best...if nothing else, I wiped blood away from her face as she was dying...I AM making a difference...even when I don't feel it..."
Life is a gift...
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