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charting mishap

so, if any of you have ever charted before in a medical setting, is it not part of your job to chart in a way that is legal-you have a certain format to follow, the wording needs to be correct, blah, blah, blah. I mean I've gotten my ass chewed for not using the correct abbreviations.

Well, sometimes the charts are quite comical. Usually it's because you don't know how to write in medically appropriate terms how the patient has communicated something to you, so you just put their words into quotations, and usually try to clean them up a bit. So I'm reading about this guy who comes in for shortness of breath and chest pain (just like every other person on my floors) and apparently he also had a cold a few weeks back (he's 80 by the way) and "cured" it with "his momma's recipe" that has worked since he was a kid. So, this consisted of whiskey mixed with a little water and then he took a big LEAP and added some cough syrup (by god, why can we not step into the 21st century). So not only am I laughing at that, b/c honestly there was no better way to word the fact that this guy drinks whiskey to cure all of his problems, that's how he was brought up. lmao. so then the chart goes on to address his past medical history/past social history/past surgical history and then the meds that he's on at home. Well, each of these categories are of course listed numerically and are always in a certain order (you know this if you're in the medical field). So instead of listing 4. Home medications, it lists, "Bag-o-pills." hahahahaha. omg, if that chart ever went to court or JHACO (the Nazi police that come in to investigate your hospital to see if you're treating your patients per protocol with the latest medical interventions, and of course everything that's documented has to be so a certain way). Not that I think this guy's chart would ever show up in court, and JHACO wouldn't look it it, he's 80, has heart failure, blah, blah, blah. Not interesting.

Sorry, just had to post how funny that was.

In other words, I've stepped down as assistant gymnastics coach. I'll do it on a volunteer basis, but even then i'm reconsidering. I am sooooo tired when I get home, I just want to work out, study and sleep and redo the next day. Plus, I'm already attached to the girls.

But, I have another job lined up. Through a friend through this church thing I do every other week I got hooked up with a babysitting job. I know, I know, so 6th grade. But these people are paying well, have the most adorable, well behaved daughter and just want to go out every other week or so and need someone for 4-5 hours. I can do that. Bring in a few extra bucks to help pay my debt off, lol.

so, last Friday I had a few people over to drink, then go out to Royal Oak and come home and drink more. It was a blast, minus Tricia. I've written about her before, the total drama queen. She went off into my room crying about something stupid after she got plastered, but luckily she has this new friend who sat there with her while I was able to have fun with the other kids. I was wiped out for the rest of the weekend. Haven't drank like that in a while. I just chilled the rest of the weekend, felt like shit on Saturday.....liquor before beer, have no fear....christie had lots of liquor, then beer, then more liquor. ugh. Besides that, I've just been feeling wiped every day now. Drinking or not, on the weekends I basically die and just want to sleep the whole time. My ass needs to get moving and be more proactive about getting a real job. I'm waiting to hear back from a few places, they were kinda jokes to apply to actually. But still.

I'm babysitting on Friday, so that gives me time to study and apply online for jobs.

Speaking of studying, I need to get my ass in the gym more often, and when I do that I study and when I work out and study I retain so much information. I want to be down 10 pounds by my birthday, which is the 27th. Totally possible. I want to be down even more than that by graduation from the program, November 15th. So about 15 pounds less than I am now. I've kinda let myself go. Stress has gotten the best of me. Ugh. Not that I've really gained weight, I just never lost the weight that I gained the second to last semester of college. But last year (my last semester of college) I went to the gym all the time and I was stacked. Now I'm just blah.

Anyway, once again this has become a Christie book, even though I just wanted to write about the most hilarious charting today. Although being in charge of a 50 bed floor and 15 bed ICU is nice, it's getting boring. Same patients day in and out, same conditions, same diet educations. I guess that practice makes perfect and some of the patients that I have worked with have just made my day, saying the smallest things like, "christie, you're amazing, you actually care about me, come say hi tomorrow." They could care less about the arrogant asshole doctors who are in and out of their rooms in 2 minutes, not even saying hi in a nice tone of voice.

yah. i'm outie. time for bed. I'm getting old. I go to bed too early, lol.
my mom and grandma are in town. we went to downtown Royal Oak yesterday, walked around and had dinner. Granted my grandma is 83, the went back to the hotel early and I went over this morning for breakfast. we went shopping at these outlet stores today; which is really like a mall, but the stores are inside. I had to buy some stuff, I was surprised my mom didn't whip out the car, but whatever. she got me these really cute (aka expensive) shoes, and I think they're a little tight, but they're leather, so they'll expand. Then we went downtown to this pizza place, awesome, and then home and looked throw my picture albums. Then I figured out my toilet was spraying water, and my mom being the handyman that she is, fixed it, and said that it'd be good for another 6 months or so, so if it breaks after I leave, fuck it.

So I have breakfast with them tomorrow and then something in the morning, we'll prolly go to the park and walk around, and then we're making this really good salad for lunch (spinach lettuce, mixed lettuce, black and garbanzo beans, corn, feta cheese, grilled chicken and choice of different types of fat-free croutons and salad dressing. After that they're leaving. I'm sad. I know I'll be crying for a long time.

I cried today after we left the grocery store. They went to their hotel and I went home. It's just this feeling of being left behind. I'm still a baby in so many ways. My family is so far away. Mom and Dad that is. And I won't see them until I move out or Christmas. It's like leaving CO all over again.



In other news, Cindy's funeral was today. I think that's part of the reason I had a sob-fest this afternoon. I wonder how my dad is taking it. I wonder how the other people in the office are taking it actually. I mean, I only met her a few times and I'm in tears. Granted, I cry at weddings and stuff like that; big events, but that counts, right?


But, I taste like pizza and vodka now. I had a Red Bull and vodka when we got home tonight. and I can taste it, ugh.

I've been smoking again. And that means spending money. But, instead of eating at certain times when I'm home (which I used to, which meant that I had to count those calories), I just smoke. And I've lost some weight.

I'm so bad.

I'm just full of emotions.

Tired.

vacation time!

i'm going far, far away.....

actually not. I'm just going to pitt, but i'm so excited to finally get out of this town that I hate so much.

I'll be back friday (29th) and then the 20 and july 1 i'll be in ohio for a bachelorette party.

I'll have my celly and prolly won't check my e-mail.

970-310-3163

smooches

accomplished......nervous.....surgery

So, let's start with the positive.

As part of the internship, we have to critique a journal article and present it. So, naturally I went back to my senior seminar project, I think the topic was "the effect of vitamin B12 and homocystine on cognitive status in the elderly" or something along the lines of which test (the above two measures) is more accurate. I did an artice on vitamin status and cognitive function. It was a great presentation and the only input from nancy was that I needed to simplify it and put it in a better order (the presentation) to link it to the future applications. I got input that I knew exactly what I was talking about, but it was really advanced and I might need to have some more future implications about better populations to study, etc and why Hcy is a much better marker of cognitive function in comparison to B12 (make the distinction). The other girl who presented did a decent job, but it was a little obvious she didn't completely understand what she was talking about and the order in which she presented it was ridiculous. Plus, she did such a simple topic that most people already understand; so essentially she talked about medications of diabetes and which one is better or whatever. Boring. Essentially, mine was very complicated and I need to tone it down so that people can understand it better, lol. Good thing I have a lot of other references that I kept from my senior seminar project to refer back on. I'm such a cheater.

After our clinicals (aka slavery in the hospital where all we do is look at charts, figure out what info is nutritionally important and make a diagnosis and recommendations for the MD's concerning nutrition, such as supplementation, etc. Which half the time they disregard and don't read our notes, as evidenced by the fact that I got a few consults this week for tube feeding rec's that I had already done, so clearly they didn't read my notes. To the original point here, we had some patients presented to us and we had to calculate their needs and plans/recommendations for intake/weaning them off of alternate nutrition support (tube feeding). I kinda cheated by copying the actual "test" last night and I brought it home to merely look at it to see what types of calculations I would need to investigate, etc, b/c I knew today I would find out about the surgery and i wouldn't be focused, etc.



So, the surgery is scheduled for 4 tomorrow. I have to be there at 1:30 to get admitted, get pain meds going, etc. Just to stabilize me and have me sign forms, etc. Stupid shit. But, I figure if things go well and the other surgeries that day go as planned and are shorter, I might be in the OR before 4. My cousin, Cindy (I went to her wedding back in May of 2005 and since then she is divorced) is coming up tonight and taking me to the hospital tomorrow and sitting there while i'm in the OR and after when I'm in recovery and stabilized enough to go home. She lives in Dayton, Ohio which is like 3.5 hours away, but at this time of night, she'll make it in under 3 hours. So it's awesome she can come up here, especially tonight so we can catch up a little before I'm drugged up.


So, just pray that everything goes well, they can remove the adhesions and endometriosis w/ lasering and there is no need for further surgery. I'll go back to work on Monday and I'll be a little slow, but I get time to recover now. Now that i'm thinking about it, I'm getting nervous. ahhhh. But, I just have to keep positive and know that everything will go well.


So, as of midnight I'm on a clear liquid diet until 5 am (how weird is that, usually you can't eat or drink after midnight), meaning I can have water and liquids that are, well, clear. So I have apple juice.


ok, time to go and try to relax. hahaha.
So, summary of last few months (medically): passed out with pain in my uterine area, admitted to ER, sent home on main meds, follow-up revealed nothing, but concern, so sent to obgyn, concern for infection/adhesions/endometriosis, KCl test (ouch!) revealed infection of unknown origin, follow-up today with concerns. Options were to do a trial of heavy-duty medications which have huge side-effects and if they actually work, results would not be seen for another few months. So, preferred plan B: exploratory lapriscopic surgery to determine where infection is located, where it has spread, remove adhesions and laser endometrosis.

So next Wednesday I go in for surgery. If there are major findings that reveal I need to have more extensive surgery to remove certain organs, etc, I will be sewn up and further surgery will be pending.

Great. I went back to work (i'm working w/ the program director this week; which I love, and I'm kicking ass, she just signs my assessments and I'm flying through consults each day) and just had a blank stare on my face when I told her that I have to have surgery. So, instead of going to the renal hospital next week, I'll work clinical again on Monday and Tuesday afternoon and have the surgery on Wednesday. The time is not scheduled yet, I'll know Monday or Tuesday. I have to be admitted 2 hours prior to surgery, depending on what they find it will probably take about 1-2 hours, then i'm in post-op monitoring for a few hours until I'm medically stable enough to go home. Then I'll miss work on Thursday and Friday b/c of recovery time. When I had surgery back in 2004 to remove the tumor it set me back for 3-4 days. So I'll go to renal on monday.

So now I'm fucked. Maybe. I have to have certain hours of experience in each rotation, and now that I'm missing half of my renal rotation (actually if I missed a lot of any rotation) I have to stay longer in the internship. Maybe. There's this diabetic camp that I'm supposed to go to in June, but I would not pass the physical and being out in the middle of who knows where is dangerous with my meds, etc. So, that week we're going to try to work something out, switch my schedule around again. I can do it though, I can get through all of this and graduate from the program on November 15th (pending I don't have to have another surgery).


Great.

Also, the program director talked to the coordinator of the program and they won't let me have the surgery in MI unless I have a family member come out to take care of me, for the day of surgery at least. Which won't happen, unless my mom or dad flys out here, which is unlikely. My aunt from Ohio could come up, but Amanda (other intern) is going to help me find someone from the church to pretend they're my cousin or something so that I can go through with this. It wouldn't make sense to go home because the dr. who is doing the surgery has been following my case and knows what's going on with me. so, say some prayers and hope I find someone, soon.


sigh

quote of the day

"can I have a shaver to raze with?"

-Spoken by elderly man on my floor


Moments like that and comments like that make me more motivated to do my job and actually like it

i'm so lazy

i spent all of friday night dealing with the internet, screwing around on saturday doing a tiny fraction of homework and then going out with lauren and her hubby and then to jason's (my new boy interest, i wont go into the details of how i met him) house to drink some more. jason and i went upstairs to go mess around and then he just passed the fuck out, it was hilarious.

yesterday i was a bum and just chilled some more and then went over to jasons for a while and then we came back here and i finished some projects and we drank beer and talked and then went back to his house and i just slept there. i got up and home in time to go to school, but i just was NOT motivated at ALL to go. Therefore, I just didn't go and stayed home all day and slept. I've done like 2 seconds of homework all day.

I seriously don't want to do anything else today except just go to bed and sleep and maybe i'll be more motivated tomorrow. although I don't have lab tomorrow, i need to stay at the school so that I can get the Bagel Place menu analysis done b/c who knows when I'll have time for that again. I need to start studying for my lab final, but I think that if I read or did anything tonight it would be in one ear and out the other. I don't know if it's depression or what, but I just don't want to do anyting. I seriously took the whole weekend off and now i'm just bumming around. Maybe I'll read some microbio, but prolly not b/c that doesn't even help at this point, just reading over the notes before the test works. I need to get my final study guide done for that class. I think tomorrow if I can get my work done, i'll go see that gymnastics movie with amber, come home, read more microbio, nap and then study for the lab. I just hate the fact that I've had to take that fucking class and the lab b/c it has nothing to do with my major. oh...we maybe did 2 lectures on food spoilage, but i don't need to know the microbial properties behind that and it's all common sense and i've learned all of that before in other, more beneficial nutrition classes.

so, i'll read microbio, fuck doing more study guides, watch tv, get coffee ready for tomorrow morning and try to go over some of my microbio lab stuff. ugh.

new friends, new opportunities

so, i'm glad that I joined nutrition and fitness club. make a few new friends, always good. get more involved in this nutrition family. and by family i mean that i have the same people in all of my classes, no joke. we had an in-class test in microbio today and have actually had a copy of the test (it was all essay) for the last week and i barely answered the questions. maureen and kim did most of the work. i swear, i feel so stupid compared to kim. she just gets all of this stuff, it's not fair. i'm trying and trying to study more, but it's just so hard sometimes. i'm so distracted at home. in the dorms i actually could leave my room and study for a while and come back. maybe that's why i never sleep b/c i use my room as a study room also. so friday a few of us from N and F club decided that we're going out to get drunk at lunch and maybe FN470 will make sense when we come back, lol. it's just good to be going out with new people. I need a new network of friends. I also need to understand 470, so i think that after class i'm going to start going to the teacher's office and getting him to go over the lecture again and actually listen to my questions b/c i'm so lost in there. again, kim understands it and I don't. i feel so bad for having her explain everything to me. college has made me stupid, i swear. in high school i was the smart kid who understood everything. now i'm totally lost. i just can't wait for spring break. i'll be working all the time, but i'll also need to be studying for FN360 b/c we have a midterm in there the week after spring break. I also need to get started on my project for microbio. maureen again has done a lot of the research for us. I have a bacterial disease picked out and I just need to do some more research on it. that could be a weekend project since i seem to do nothing else on the weekends these days. i guess shane is having something going on this saturday so i'm going to hit up amber and see if she wants to go. for now i have 40 minutes to kill and then i'm having dinner with laura. peace

cutting

alone, depressed

i started cutting again tonight

no one is here

i can't sleep and i've already maxed out on meds and i've had a whole bottle of watermelon puckers and some beers and i can fucking sleep or settle the fuck down.

i need a sharper knife, maybe a smaller one that i can make better cuts with

i just need someone here with me, someone who i can lay in their arms with be held, etc

maybe i'll go search for another knife, a sharper one.

nightmarish night

christina and i talked about how frustrated we are w/ our bipolar conditions and our meds.

i had a huge cry session about not being able to sleep and all. i have a huge stash of seroquel (the meds that make my chol go sky high) and they work, so i'm taking them w/ a very high dosage of chloryl hydrade to sleep, but i'm still waking up in sweats and hives. fuck taylor. didn't help sleeing in that bed this weekend. it's nice being home, but that bed....the position...the ceiling, the decorations. so many bad memories.

fuck dr. waurin for not getting back to me at all last week. i'm going to get her cell number and have it as urgent.

if the next drug doesn't work and my condition worsens (all i want to do is drink, cry, b/p and go OCD manic cleaning) i'm going to check myself back into Mountain Crest. It's my birthday week and I shouldn't have to do that.

it's a huge week and i got a lot of my homework done ahead of time in prep for my bday on thursday, so i'm good to go.

my mental health is just number one and i'm not doing well.

i'm off to bed. maybe. i might sleep w/ jess so that i have someone to comfort me.