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August 31, 2010

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I've never seen troponin rise this quickly...

Aug 30 2050 = 0.1
Aug 31 0220 = 39

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Owen's Birth Story

My last post left off with getting an epidural around 1am. We kicked everyone out of our room and tried to catch some sleep. I think I slept for an hour and maybe Jesse 2. From then on we slept in 15 minute increments. At around 3:30am Owen was having some late heart rate decelerations. The nurse decided to check me and I was 7cm dilated. We tried several positions until he was happy with me on my far left side. They inserted a fetal scalp monitor to capture a more consistent heart rate. I was instructed to essentially not move because every time I did his heart rate dropped. To decrease risk of infection I was told I wouldn't be checked again until I felt a change in sensation or pressure. We had high hopes for a delivery soon as with Easton I went from 7cm to delivery in about an hour. My sisters had just gotten home to rest and with the news of 7cm they all headed back worried they would miss it. We all kept thinking that this being my third baby things would go quicker. But w...

"5th floor this is Damaris"

Everytime the phone rings on the 5th floor from 17-0130, callers are greeted by, "5th floor this is Damaris." Most of the time my job is simple. Listen for who they want - and transfer them to who they want. But at least once a night, someone will call and just baffle me. Not so much in the sense that I don't know how to help them, but make myself question... really?? Are you for real?? For instance: The never failing... first name basis calls Caller: How's my grandma? Me: Who is your grandma? Caller: Shirley. Me: I need to know her last name. We have about 300 patients in this hospital, and about 150 of them are grandmas. That means about 30 are named Shirley. The I want to tell you my whole life story calls Caller: Hi, my friend is taking care of someone named, George I think, or maye Bill, and they were discharged from there yesterday. Me: Okay Caller: Well, he had heart surgery (in my mind I already know this call is for cardiac surgery floor - no...

Self inflicted injury...

Should they be treated the same? If I knowingly put my body at harm, not once, but multiple times... should I get the same kind of care? The healthcare motto is "Do no harm." Unfortunately that can't apply to everyone. I'll let you in on exactly what I'm thinking here. My last patient is the PERFECT example. Here's how the doctors dictated history and physical starts... "This patient is allergic to animals yet still has three cats and a dog in their home. They have longstanding chronic obstructive pulmonary disease and smokes 2 packs of cigarettes a day. They are here today with shortness of breath with normal activities worsening over the past week. They will be admitted for a course of IV steroid treatment to decrease airway inflammation." (Although inspired in part by a true incident, the previous is fictional and does not depict any actual person or event) Now, the nurses' response it to treat and do no harm. Have I lost my compassion or...

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