Yeah, it's 0300H and the cold Autumn December morning was been emanating outside the facility. The heater for the whole building was on but it seems that I am still freezing with cold plus I am really really sleepy but I am holding myself not to succumb to it. I still need to finish some of my psychotropic summaries and other reports.
Sometimes, I may be closing my eyes in seconds unconsciously and unpredictably because I just couldn't hold on to it any longer but as soon as my head started to snappily nod, I am suddenly awakened from an instant debilitating stupor to a full massive awareness of my surroundings. It was really funny to look at!
I don't know why I am feeling so tired lately. Usually, I'm always awake most of the night doing something or writing something little bit of things r pieces to do. Tonight it was just eerily and naggingly boring and it seems that my highly produced internal endorphins were trying to win me over from being so focused to lagging greatly tonight and thus I felt so unwaveringly sleepy and relaxed.
Earlier on my long-dragging twelve hour shift (I worked 7 PM to 7 AM), I wasn't sleepy at all because I have million of things to do and think to accomplish. I was turning like a spinning wooden top because of a pile high endorsements and complaints mostly from my CNAs and other attention seeking residents.
Actually, we send one resident to the hospital earlier because I spotted him having a lot of respiratory congestion and shortness of breath and when I tried suctioning the back of the throat I only got a little bit of thick whitish secretions yet the crackles and the gurgling sound in his thriat was still audibly heard. It seems that he was clamping down on the uppe rairways because he really sound so awfully bad.
I instructed my charge nurse to get the vital signs while I ran to pick up the big oxygen tank and non-rebreathing mask to give him high flow oxygen. When I came back pushing the enormous green tank, my charge nurse told me that the resident's oxygen saturation, when checked using the pulse oximeter, was 85-86% which is understandingly very very low and on a critical or panic range.
I was greatly surprised as well as nervously panicky about the finding so I instructed her to raise the resident's head, stopped the G-tube feeding, and then I attached the non-rebreathing mask and instructed my charge nurse to give a bronchodilator inhalation to help open up the resident's alveoli in the lungs. Shortly after the treatment the oxygen saturation picked up until 90% gradually which is a good sign.
I gathered all the data and went to the nurse's station then dialed the attending physician's number. The phone rang for several rings and then the attending doctor picked up the phone. I said hi and then introduced myself then proceeded nervously to tell and update him about his new patient that just came yesterday. He paused a little bit trying to pick up and understand what I told him then commandingly instructed and ordered me to transfer the hapless and suffering resident back to the hospital where he came from.
After talking to the attending doctor I immediately placed the order on the EMR (electronic medical record) then picked out randomly and immediately called a willing ambulance from our wide array of transportation lists to transport the poor resident to the emergency department. After making a positive confirmation I then went back to the EMR and filled up the Discharge/Transfer Assessment Form and proceeded to make copies of the necessary papers needed to be sent with the resident to the ED. I then called the emergency department of the receiving hospital informing them that a very critical patient is on its way there.
After doing all the preparation I went back to the resident's room to assess his response to nebulization treatment. It seems that he is getting worse. I stayed at the bedside to keep an eye with him until the transport came. When the transportation arrived I turned him over to the team and then they proceeded to assess him and then did their routine assessment then readied the resident for transfer. They left at around 0100H.
After the resident left everything was been relax and drab. I was starting to get sleepy and extremely tired maybe because of the epinephrine rush I've expended earlier from that transferred resident. It was quite a mental and physical workout that's why I got exhausted and felt tired thereby felt so soporific and closing my eyes at times.
Suddenly, I remembered that I left my rice cooker at home still plugged from the wall socket. I was wishing that nothing will not happen but I'm also expecting that the cooked rice was been burnt at the bottom. My mistake but well I hope I'm not having those lapses of forgetfulness. I refused to admit about it but when that time comes I know I will eventually have to deal with the reality. Poor me!
My emotions right now were a pandemonium of mixed feelings which are unpredictable as well as unexplainable. From being boring to getting sleepy, from being tired to getting hungry....... it was very confusing yet undenyingly normal. It was quite a conundrum of mixed feelings and emotions yet quite satisfying and appropriate to happen because it is naturally happening anyway. Can't complain...... At least, all the paperworks were all done and charted and I just have to worry how to compose the morning assignment later.
Well, although I am quite being swinged and lulled to feel sleepy and slumbered I still fought it by listening to Pandora setting to the "Christmas Songs" station and the nagging sound of the call lights, playing like humming bees, just kept me abreast and reminded me that I am at work and needed to be awake all the time so as not to jeopardize resident's safety. You know what I mean!
It's 0300H and the night is still young, long, and deep. Whatever happen still depends on time and I know I have to remain awake and aware of the surroundings. Cold December morning air is cold so I decided to go out of the parking lot and embraced the foggy and cold space outside which also had helped me get awake. The cold misty air enveloping my face was the touch of panacea which send me back to the current reality.
Now I'm quite living to it because I'm totally awakened by the cold and misty fog that blanketed this early morning wee hours. Smart idea though and yet it worked greatly. Oh yeah!
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