As I've gotten more and more comfortable calling docs, I've really began to learn what is needed in situations. Before I was simply tongue-tied even talking to the MDs, much less able to know what to ask for. In fact I was in awe of the nurse who could call and say, "So and so has this going on, I need orders for this, this, and a little of that." I know that in time it will come to me. Every new situation is a time to learn this and file it away.

The other morning, one of my folks, a sweet older lady fours days out from an AVR called me saying "I feel like I can't get my breath, having a hard time with it." Let me tell you, this is one tough broad. Here she was just recently undergoing a standard AVR with her chest cracked, and the only thing she has asked for is Tylenol. I've had grown macho men in the same situation crying for their Oxycodone every 3 hours, so I knew something was not right. Sat her up, put on some O2, listened to her. And there it was, widespread crackles and just that wet blanket kind of sound of too much fluid on board. Told her, "I'll be right back, gonna call the doc. Call me if it gets worse." Lucky for me it was 6 in the morning, not that I care about waking docs up in the middle of night, but I like having my docs awake when they talk to me (had a friend where the doc tried to give him orders for a Vitamin K drip, before correcting himself to an insulin drip - he then called back and asked my friend what he had said.) Asked for Lasix and duonebs and got a basic panel thrown in too for good measure.Gave her the Lasix and by the time I was wrapping up to go home she was right as rain. The next night she had scheduled Lasix and potassium...guess they figured her CHF hadn't quite totally improved, but yes, but not quite there.

The thing that took me aback, was that I didn't hesitate, just did and got the problem fixed. Guess I'm learning.


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