Nilknarf News

I went in and did several ER patients, then I started on the inpatients, I had about five of those to start off with.

So, a little story about my last inpatient of the morning: I started off asking her a set of questions, which includes asking if the patient has any allergies to drugs or medications. The answer to that specific question was no.

Then, as I was getting her on the table, I asked her again, "Do you have any allergies to drugs or medications or any other substances?" This is pretty standard, essentially asking the same thing worded differently. I do this because, well, gosh, it's *important*!

Again, she replied in the negative.

So I set up the syringe and attached it to her IV and took the preliminary image. I checked her chart, and on a red allergy tag on the front of her chart were the letters "NKAD", meaning No Known Allergies to Drugs. I was satisfied. I planned the imaging that I would do and prepared the power injector.

I went out and explained to her what I was going to be doing and what she would feel, and, with my hand on the injection site to make sure that there wasn't an extravasation, I started the injector going.

The patient looked at me and said, "You aren't going to inject me with x-ray dye, are you? 'Cause I'm allergic to that..."

"O'shit!" I said silently. Half of the dose was in by this time, but it didn't make any difference what the amount was, if there is going to be a reaction, one ML will do it just as well as 125. And I couldn't prevent a reaction by stopping, so the best that I could do was to get the pictures as quickly as possible and prepare for an allergic reaction... so that's what I did.

So I got a good exam, and luckily, the patient did not have a reaction. I sent her back upstairs and called the nurse caring for her and told her to keep an eye on her for a while, but a reaction to iodine usually occurs pretty quickly.

Well, it was about noon, and I didn't have any patients left, so I came on home to see Karen for a while. Wound up being home for about an hour before I got called back, and I didn't get to leave again until 19:15. I'm kinda surprised that I haven't been called back again, I've been home about an hour... Karen is out with Kim somewhere, I might get to see her tonight if I'm lucky.

Anyway, this afternoon I did a chest CT on a patient who'd been admitted yesterday. She has a large mass wrapped around her aorta in her chest, and we needed to do a CT-guided needle biopsy. Well, normally, we do these on the other machine, and there is a radiology nurse who assists and the CT tech takes the images. However, it's a Saturday, no nurses are available, and the doc wants to do it on the main machine.

So, of course, that's what we do, tying the machine up for two hours, and while we are working on that the CT exams on ER patients don't stop being ordered. So I'm six patients behind when we're done with the biopsy.

So I run for a coupla more hours, then I get a little break, waiting for an inpatient to come down, looking for a pancreatitis. Done with that and I get to go home... but I forget to clock out. So I have to remember to tell the boss that I left at 19:15, otherwise I won't get paid at all....

And I'm beat, of course. Even at time-and-a-half, I get worn out. But it was pretty much a fun day anyway, some days I just feel good about doing my job....