I'm in the ICU today. I helped Roger, the really nice resident who introduced himself as "Roger, like Roger Rabbit,” get an arterial sample being very careful to practice sterile technique. Since we don't use alcohol wipes, I poured Betadine on cotton balls to wipe the area clean. I had to pour 6 inches above the cotton ball, which required aiming. I'm not even good at birdie-drinking, so expecting me to aim and not be nervous didn't happen. The day went by with many patients that came in for sad and shocking reasons:

The first patient was more of a typical case: an older woman, 9 years shy of being considered a centurion, that came in with for pneumonia.

The second patient was a 45 year old man, healthy, who overdosed on prescription medications in an attempt to kill himself. He had an NG tube filled with black charcoal. The stomach lavage saved him. He had trouble breathing the whole day. It made me sad to think what could have brought him to such depths that he would want to kill himself. The doctors that visited him were very direct to ask him, "Fernando, do you still want to die?" His beautiful wife, or maybe girlfriend, was at his bedside. She caressed his hair and said sweet things to him in a shaky voice that sounded like it was holding back tears. I wonder how Fernando is doing today....maybe he has changed his mind about dying now that he has been given a second chance.

The third patient we had was a man who came in with bruises on both eyes. "Raccoon eyes"- I recognized this sign from photos in my Med-Surg class. It was a classic sign of a basilar skull fracture. He had a huge dressing on the back of his head with a Jackson-Pratt drain. He had been accidentally pushed off a moving bus and hit his head hard on the concrete. We tried to keep him in bed by restraining him with twisted and knotted bed sheets, but the man was uncooperative and kept trying to get up. He seemed confused; my job became the alarm to warn others when he was getting out of bed. Each time he tried to get up, I'd hold the 160 lbs man down. The nurses and doctors would immediately come, coaxing the patient back to bed.

The last patient was a child, just 14 years old, weighing maybe 80 lbs. I couldn't get a hold of her chart to find her illness. From observation I could see that she was in shock and had a collapsed lung.

As far as the practice of nursing skills, Yovanda, a really nice nurse, had me draw up dopamine and put it into a saline bag using that extra port; now I know what that extra port on saline bags are for (we use the same type of bag, but we don't use that extra port. Instead, we just use an extra bag called a piggy back for additional medications). I practiced snapping open glass vials also.