A is not for Apple. Its for Autumn and Anxiety.
It hailed last night. Hail + Grey's Anatomy = A Tacoma-missing Heather. Which is odd, I hated it when I lived there, but love it now that I'm not there??
Anyways, after the hail, I smelled winter. That weird its going to get cold soon smell. Its August. In Montana. Huh. That smell brings back so many memories, some good some bad. All of them intertwined with anxiety. Fall makes me anxious. School starts, the coldness comes back and countless other things. It marks the end of summer, the time where I need to kick it into gear and become serious again. Although I'm not all butterflys and cupcakes in the summer, either. I start to really miss my friends. I always miss them, but the fall likes to rub it in my face making it near unbearable.
I saved a woman's life two days ago. It was at work, one of my residents. I went to go check on her, and I found her on the floor, flailing around. A chair was upturned, clothes were scattered everywhere and she was tangled in her oxygen cord. At first glance it looked as though she had fallen, and possibly broken a hip. I radioed for the co-worker who was on the same floor to meet me in X's room. I rushed over to the lady, bent down, touched her chest and said "Person X, are you alright? Do you remember what happened?" She incoherently mumbled while rolling around on the floor, her eyes were slightly sunken in and clamped tightly shut. Her hair was matted down, she was dripping sweat even though she was cold to the touch. I ran over to her med drawer, unlocked it and pulled out her glucose monitor. I tested her blood glucose. It read 25 mg/dL. Extremely low. A normal fasting range is 70-100 mg/dL. Below that you start getting into the hypoglycemic range. When it drops as low as 40 mg/dL your brain is no longer getting enough glucose, the fuel it needs. The body starts the process of burning ketones for energy, which your body rarely does. Breaking down ketones produces toxins that your body can't readily excrete, so it builds up, causing damage to your brain. This is known as neuroglycopenia. If the levels drop even further, around 10 mg/dL most neurons become electrically silent and nonfunctional, resulting in a diabetic coma. At this point I radioed for the nurse that luckily was in the building, told her to meet me in X's room, that is was an emergency. For the next 2.5 hours the LPN and I were fighting, literally, to get her blood glucose up. The woman was still incapacitated on the ground, but was able to try to fight us off. She wouldn't swallow and would spit the glucose gel up, she wouldn't let us get a syringe in her mouth so we could pour OJ down her throat. Sugar packets were strewn about the room, granules stuck to her face, next to none made it into her mouth. The LPN and I sent the other CNA on the floor to get this woman's chart. She was a DNR. This meant we couldn't call an ambulance to get a dextrose IV started or an IM glucagon shot. We had to do what we could, and that was it, no extraordinary measures. We re-tested her blood sugar every 15 minutes. As soon as it looked like we were out of the woods, it would dip again. She was fighting us so hard, she was burning the little glucose we had gotten into her. Her breathing stopped and she went limp 2 separate times. After shaking her a little she would go back to squirming and screaming. It took all of my strength to pin this woman down, or prop her up to syringe honey and syrup water down her throat. By this time, all 5 of the CNAs were in her room, standing around. Not a thing you want in an emergency. When I did manage to get some sugary liquid down her throat she aspirated most of it. Very, very slowly she came out of the stupor, and started to recognize me. I put her oxygen back on to help her o2 sats and to help clear the liquid in her lungs. 3 hours later she was stable, her blood sugar in an acceptable range and her lung sounds clear. I helped her shower to clean off all the sticky, and monitored the woman for the rest of the night. Quite an exciting thing to happen in assisted living. My first emergent situation. Thanks goodness I'm a nursing student and knew what was going on and what to do. I really don't know what I would have done that night if things had gone differently. I was disturbed as it was, and she survived >.
Anyways, after the hail, I smelled winter. That weird its going to get cold soon smell. Its August. In Montana. Huh. That smell brings back so many memories, some good some bad. All of them intertwined with anxiety. Fall makes me anxious. School starts, the coldness comes back and countless other things. It marks the end of summer, the time where I need to kick it into gear and become serious again. Although I'm not all butterflys and cupcakes in the summer, either. I start to really miss my friends. I always miss them, but the fall likes to rub it in my face making it near unbearable.
I saved a woman's life two days ago. It was at work, one of my residents. I went to go check on her, and I found her on the floor, flailing around. A chair was upturned, clothes were scattered everywhere and she was tangled in her oxygen cord. At first glance it looked as though she had fallen, and possibly broken a hip. I radioed for the co-worker who was on the same floor to meet me in X's room. I rushed over to the lady, bent down, touched her chest and said "Person X, are you alright? Do you remember what happened?" She incoherently mumbled while rolling around on the floor, her eyes were slightly sunken in and clamped tightly shut. Her hair was matted down, she was dripping sweat even though she was cold to the touch. I ran over to her med drawer, unlocked it and pulled out her glucose monitor. I tested her blood glucose. It read 25 mg/dL. Extremely low. A normal fasting range is 70-100 mg/dL. Below that you start getting into the hypoglycemic range. When it drops as low as 40 mg/dL your brain is no longer getting enough glucose, the fuel it needs. The body starts the process of burning ketones for energy, which your body rarely does. Breaking down ketones produces toxins that your body can't readily excrete, so it builds up, causing damage to your brain. This is known as neuroglycopenia. If the levels drop even further, around 10 mg/dL most neurons become electrically silent and nonfunctional, resulting in a diabetic coma. At this point I radioed for the nurse that luckily was in the building, told her to meet me in X's room, that is was an emergency. For the next 2.5 hours the LPN and I were fighting, literally, to get her blood glucose up. The woman was still incapacitated on the ground, but was able to try to fight us off. She wouldn't swallow and would spit the glucose gel up, she wouldn't let us get a syringe in her mouth so we could pour OJ down her throat. Sugar packets were strewn about the room, granules stuck to her face, next to none made it into her mouth. The LPN and I sent the other CNA on the floor to get this woman's chart. She was a DNR. This meant we couldn't call an ambulance to get a dextrose IV started or an IM glucagon shot. We had to do what we could, and that was it, no extraordinary measures. We re-tested her blood sugar every 15 minutes. As soon as it looked like we were out of the woods, it would dip again. She was fighting us so hard, she was burning the little glucose we had gotten into her. Her breathing stopped and she went limp 2 separate times. After shaking her a little she would go back to squirming and screaming. It took all of my strength to pin this woman down, or prop her up to syringe honey and syrup water down her throat. By this time, all 5 of the CNAs were in her room, standing around. Not a thing you want in an emergency. When I did manage to get some sugary liquid down her throat she aspirated most of it. Very, very slowly she came out of the stupor, and started to recognize me. I put her oxygen back on to help her o2 sats and to help clear the liquid in her lungs. 3 hours later she was stable, her blood sugar in an acceptable range and her lung sounds clear. I helped her shower to clean off all the sticky, and monitored the woman for the rest of the night. Quite an exciting thing to happen in assisted living. My first emergent situation. Thanks goodness I'm a nursing student and knew what was going on and what to do. I really don't know what I would have done that night if things had gone differently. I was disturbed as it was, and she survived >.