Somnambulist

Up at 0630. Did the bare minimum morning routine and dragged myself into work for ECMO recert. I do enjoy being on the ECMO (extracorporeal membranous oxygenation ~ like a heart-lung machine) team. The patients are so sick, and the balancing act is much more nurse driven than anything else I do. The physicians set the parameters, but the nurses are the ones who juggle the balls and decide which drips to titrate and how, and how to adjus the machine to maintain the patient. They've come up with a new protocol for the Cardiothoracic ICU to prevent the excessive bleeding from their post-op hearts. I'm excited to see the figures. Also, they're considering getting new pumps for the short-term post-op hearts. This will mean cross-training for the CTICU and the PICU.

We also got to work on a practice pump. Walking the raceway within 40 seconds. Repairing the raceway. Reparing the bladder. Removing air from the circuit.

Then we had a discussion about what our worst EMCO nightmare would be, and how to deal with it. Personally, I would freak out if the cannulas dislodged. Blood spurting, patient decompensating, machine beeping like a banshee. I've never had it happen to me, but it's known to happen when surgeons aren't careful, when moving the patient, or even spontaneously. If it ever happened, I'd have to apply pressure to the cannula sites to prevent a bleed-out, and yell for help. Someone else would have to maximize the ventilator settings, go up on the pressors (making sure that they were actually connected to the patient and not to the circuit), administer volume (saline, then someone drawing up the blood or FFP we keep at the bedside), get the crashcarts in position and start drawing up code meds, while someone calls the surgeons to come stat and replace the cannulas. It would be especially bad if this happened on a post-op heart patient, because their cannulas are generally inserted directly into the heart, the chest is left open, and an iodine patch is left in place. If the patient accidentally decannulated, there wouldn't be a place to effectively apply pressure.

And on that happy note, ECMO recert was finished.

Went and got a Thai massage. My calves were a little sore from getting used to my new Aris Allen shoes. The masseuse really worked me over. So good, even though there were a couple times that I yelped. T Diddy would have laughed.

For some reason, I didn't end up taking the nap I sorely needed. Instead, I ended up going to see Pirates of the Carribean II with Boss and a couple of his friends. Not normally a movie I would have chosen to see (at all, even less in the theatre). However, it was good to connect with Boss and chat a bit. He's a hard guy to get a read on. A little closed off. But I respect his opinion.

After the movie (I saw #1, but didn't see #2 because of the awful reviews), everyone gathered in the vestibule. Someone asked me what I thought of the movie. Trying to be diplomatic (because I didn't want to be the one to say, "Whoever wanted to pay $10 to see this in the theatre has no taste or sense of proportion.") I said that it was a good movie to see in the theatre because of the special effects. Then, everyone started trashing the movie. Ha!

I decided not to go to dinner with the crowd. Afterall, there was dancing at Do Something Blue to attend. Stopped by at Borders to get a copy of Stigma. The author is a pediatrician, and knows one of my managers. Frannie is having the bookclub at her house in June, and Hawley will be attending. I haven't been to my work bookclub in a while. Mostly because they are on nights when I have other things planned, but also because of some of the flops they've chosen to read. Now, Running With Scizzors and A Million Little Pieces aren't flops in the conventional sense, but I stopped reading and threw them away because they just made me feel *icky.*

Anyway, as I was standing in line, I read the back cover, and had to keep myself from laughing out loud. Either the book is really bad, or the publisher needs to hire a new backcover writer. It was that bad.

After walking back to my place, I decided to take a nap before heading out for dancing. Dancing would go until 0200. Drank a diet coke just to make sure I didn't sleep too deeply.

When I finally woke up, the clock read 0300. Bummer. Turned over and slept until the morning.