First Day Back at Work

Last night was my first day at work after coming back from a very long vacation to the Philippines to take care of my mom's wake.

It was just the usual day for me. It felt so strange for me to go back to work after a long absence, like six weeks seems long enough for me to forget the routines at work.

I started with three patients. The one at 869-02 was a 14-year-old with a ruptured appendicitis. He was status post laparoscopic appendectomy done by Dr. Hinika. He is a burly 14-year-old male. He has three small dressings on his tummy with a Jackson-Pratt drain on the left side of his abdomen on the left-lower-quadrant. He complained of moderate pain so I encouraged him to ambulate to ease up the pain caused by the accumulating gas in his stomach. He complied with my pushing and was very courteous in asking for some of his demands. At 8 pm, when I took his temperature he had a low grade fever so I decided to remove the thick blanket that covered him and gave him an ice pack to reduced the low grade fever. At 9 pm I retook his temperature and it went up to 100.6 fahrenheit. That's the time when I gave him two tablets of Tylenol 325 mg. At midnight and 6 am I gave his Zosyn antibiotic IVPB as scheduled. All night, he was doing fine and his saline lock was still in place. I endorsed him to Ms. Julie at shift change.

The second patient I have was a 1-month-old male infant with a history of viral meningitis for five days. He was been running high fever at home and had a lumbar tap five days ago which confirmed the meningitis. He was on the fifth day of combination antibiotics of Acyclovir, Cefotaxime, and Ampicillin given through his intravenous line with an IV fluid of D5 1/4 Normal Saline running at 15 ml/hr. His vitals were stable and he was been afebrile the whole night. His mom was been bottlefeeding him which he took it well and without emesis. He was been pooping ang voiding well. Mom was at the bedside all the time doing some of the baby's care.

The third patient I had was a 2-month-old male infant with congenital syphilis. The mom infected him with the disease during the birthing process. The baby was on an antibiotic regimen of Penicillin G sodium for ten days, which he already took for six days. His vital were stable and he has no fever the whole night. His mom was been breastfeeding him and he had no emesis the whole night. His IV fluids was set on KVO of D2 1/4 Normal Saline. Both babies were been endorsed to Ms. Shin at shift change.

At around 10:15 pm I admitted a 7-year-old male child who sustained a left arm laceration and avulsion wound because he was chasing his ball which go over a fence with sharp edges that lacerated his left arm. His parents brought him to ER and there he was seen by Dr. Keagle, the plastic surgeon and was then referred to Dr. Contreras, the trauma surgeon. His left arm was been wrapped with a bulky dressing. His circulation, sensation, and motion were within normal limits. Pulse oximeter on the affected arm was excellent. Ancef one gram was been given to the right antecubital heparin lock every eight hours which he received the first dose in ER and I gave the second dose at 4 am. At 5 am I draw his CBC and basic metabolic panel. He was resisting during the blood collection and I was fortunate to have gotten it, so I then labeled it and send it to the laboratory. I kept his affected arm elevated on the pillow as ordered to prevent the swelling. His vitals were stable and he has no fever. I endorsed him to Ms. Julie at shift change.

There were three of us working last night. Each has their own admission. We started with nine patients with three patients each. I got the second admission and we helped each other all through out the night. As the head nurse I did the assignments and ordered the nourishments. I also helped tidying up the medication room. We had our break together and shared our grace.

When my other companion went on her sleeping break, one of her patient was been having retractions and respiratory distress. I was called by the mom and as I assessed the kid he needed some nebulization treatment. I raised the head of the bed up and asked the mom if I can suction her baby nasally because it seems that he has a clogged nose. She then agreed and I suctioned a lot of thick secretions. After that I gave him extra nebulization treatment because he was really retracting and wheezing badly. The respiratory therapist was busy in another floor so I decided to give the treatment. After the treatment was done the baby was been bottlefed by the mom and went to sleep.

So far my night was uneventful. The unit was kinda busy and my night was excellently smooth. It felt so weird on my first day because I was even up all night without even getting sleepy. I had two cups of coffee to keep me up. It was a good night for me on this first day.