I've been shopping at walmart a lot the last 6 or so months. i barely shop at target. i'll say 2x. the first cuz i was coming from work and needed to buy hot cocoa but didn't want to drive further down to walmart. The 2nd time was because i was so sick and needed the theraflu badly.
I saw the black friday ad for target and decided i'll go get the $3 toaster and return the one at walmart. I also planned on getting the $3 hand mixer. When i got there around a little close to 7am, the $3 deals were gone. One of the target sales associate mentioned people took 6 of them at time and they later found them in the aisles so they're bound to come back on the shelves. i walked out after 7:30 with just a pantene conditioner in hand.
I came home, looked online and decided to go to walmart after seeing their deals.walmart had a similar deal as target $3 deal but for $2.97 (the rival chopper, slow cooker and hand mixer). Target actually had the chopper, toaster and chopper for $3.
Anyway,i got to walmart and found the hamilton beach slow cooker for 14.88, savings of $1.12. It was a 5 quart cooker but maybe they were out of the $9.97 5qt one they'd advertised for. Their rival toaster was $6.36, down from $6.54. I actually purchased it for $6.54 a week ago and the difference was insignifcant so i didn't see the need to buy it and return with my other receipt. I walked out of walmart with nothing in hand. To me, walmart deals were no deals.
In the end, i walked out of target with a $3 mixer and a $8.99 hamilton beach slow cooker. Total was $12.97, tax included. Last month, i was looking for a slow and the best i found at walgreens was $14.99 but i had to pay $19.99 and send in for a $5 rebate which is something i tend to forget to do so i gave up. From where i stand, i got what i wanted for a really good price.
Friday, November 26, 2010
Tuesday, November 23, 2010
Saturday, November 20, 2010
saving time
I hate it when people tell me come here and let me tell/ask you something when it's something they could've asked you without you walking over to them. I get this a lot from one PSR and it's usually something like what A1c or something like that. Honestly, unless you want to ask a person a private question in a public avenue, i don't think you need to have them stop whatever they're doing just to hear somethng they could've heard while away. Afterall, we listen with our ears.
My roommate yells "come here for a minute." Not wanting to get out, I tell him i'm indisposed and asks if he needs something. He tells me i'm leaving it at your door, i was paying my bills. Obviously, it's rent check. He's notorious for that and after going through it the first weekend, i've made it a point to respond to him without going out because it's always been him showing me something he either could've told me about or something i don't care to know about.
I mean, at this time, i'm usually sleeping. I don't see how he expects me to get up from bed to come pick up a check that he could leave at the table like the last time.
Maybe, it's my fault. I already have a sign on my door that says "please leave all communications at my door and i'll respond asap." maybe i should get something that says "do not disturb."
The last thing i need is to be interupted while taking a FL exam. Honestly if that happens, i'll not respond.
My roommate yells "come here for a minute." Not wanting to get out, I tell him i'm indisposed and asks if he needs something. He tells me i'm leaving it at your door, i was paying my bills. Obviously, it's rent check. He's notorious for that and after going through it the first weekend, i've made it a point to respond to him without going out because it's always been him showing me something he either could've told me about or something i don't care to know about.
I mean, at this time, i'm usually sleeping. I don't see how he expects me to get up from bed to come pick up a check that he could leave at the table like the last time.
Maybe, it's my fault. I already have a sign on my door that says "please leave all communications at my door and i'll respond asap." maybe i should get something that says "do not disturb."
The last thing i need is to be interupted while taking a FL exam. Honestly if that happens, i'll not respond.
roommates again
so i go into the kitchen and my roommate tells me his doctor told him his cough is from his blood pressure medicine he's been taking for years. yeah right! Yes, drugs like ACE inhibitors can induce cough but seriously, guy had a cold last week that spread to me.
I do my usual uh, huh-huh, good for you, and i don't say much. when i say see you later, he goes "you're going back to your cave?" As opposed to sitting outside and hearing needless ignorant remarks? my answer was "huh, huh," then he laughs. Annoying!
my appropriate response would be "i'm going to my room" but i don't see the sense in saying much to a too-knowing ignorant person. why flog a dead horse?!
I do my usual uh, huh-huh, good for you, and i don't say much. when i say see you later, he goes "you're going back to your cave?" As opposed to sitting outside and hearing needless ignorant remarks? my answer was "huh, huh," then he laughs. Annoying!
my appropriate response would be "i'm going to my room" but i don't see the sense in saying much to a too-knowing ignorant person. why flog a dead horse?!
Wednesday, November 17, 2010
Packing on the pounds
Last time i went to the docs office,which was in october or late september, i weighed 9lbs less than i do today. I'm over 130lbs now. Now that was shocking. While it's obvious in how i can't fit into my pants, i think my belly is taking most of the fat. I need to do sit ups now and i also need to hit the gym and start running. Lord, I loved the way i was. i loved being able to fit into size 0 italian clothing. Now, i'm a 2 in US clothing and a 6 in my italian abito. I hope i can nip it in the bud here.
On the other hand, i called out of work today. Wanted to show up and suck it up but i'm way too sick. Still having chills, i can't even breathe through my mouth and the doc is telling me i have an ear infection in addition to my throat being red and inflamed. Plus you're very congested and your heart rate is high. Those are here words, not mine. Honestly, i wanted to go to work simply cuz i figured i'd make more with the differential but i'd be jeopardizing my patients. i mean i spoke to my roommate for couple seconds in the kitchen saturday and 2 days later i was coughing like he was and sick. For something this contagious, i wouldn't want a poor patient recovering from surgery catching it. Yes, i could wear a mask but i remember the situation back at UPenn when one of the nurses wore a mask throughout the shift and somewhere along the line, i heard him telling Jackie that his patient was complaining about catching the cold from him.
Anyway, i wouldn't want some hypochondriac to tell me at 4am in the morning that they think they're experiencing the onset of a cold.
Anyway, bedrest and amoxil - that's what the doctor ordered. If only this fever would come down...
On the other hand, i called out of work today. Wanted to show up and suck it up but i'm way too sick. Still having chills, i can't even breathe through my mouth and the doc is telling me i have an ear infection in addition to my throat being red and inflamed. Plus you're very congested and your heart rate is high. Those are here words, not mine. Honestly, i wanted to go to work simply cuz i figured i'd make more with the differential but i'd be jeopardizing my patients. i mean i spoke to my roommate for couple seconds in the kitchen saturday and 2 days later i was coughing like he was and sick. For something this contagious, i wouldn't want a poor patient recovering from surgery catching it. Yes, i could wear a mask but i remember the situation back at UPenn when one of the nurses wore a mask throughout the shift and somewhere along the line, i heard him telling Jackie that his patient was complaining about catching the cold from him.
Anyway, i wouldn't want some hypochondriac to tell me at 4am in the morning that they think they're experiencing the onset of a cold.
Anyway, bedrest and amoxil - that's what the doctor ordered. If only this fever would come down...
Monday, November 15, 2010
Another reason
To not have a roommate. Spreading germs. My roommate came back from Michigan with whatever germs he got and here i was this morning coughing like he was. I've only spoken to him twice. Once on my way to work the day he was sick, i said hello and goodbye. Then yesterday when i came from shopping and found the toaster broken, he decided he wanted to fix it. i stated i don't need it fixed and once he opens the bottom up he tries to lecture me on how it works. My whole body language and how i went about doing whatever i was doing should've given him a clue to stop talking because i wasn't listening. I've taken enough physics to know how stuff works and who said i needed him to tell me how a toaster works. So as soon as i was done doing whatever i had to do, i walked away. I can't stand people who think they know stuff when they're actually ignorant.
Also, i'm sick of the noise. He's loud. Very loud. I can hear him talking on the phone no matter where he is. Plus he sometimes has his phone on speaker and with my door close, it's still the person on the other loud and clear. I remember thinking saturday night, i never heard what Corey was saying.
Oh well, 7 more months.
Also, i'm sick of the noise. He's loud. Very loud. I can hear him talking on the phone no matter where he is. Plus he sometimes has his phone on speaker and with my door close, it's still the person on the other loud and clear. I remember thinking saturday night, i never heard what Corey was saying.
Oh well, 7 more months.
Friday, November 12, 2010
The strange case of the rising blood sugar
So, patient whose dinnertime blood sugar was 88 jumps to 528 at bedtime when the tech checks it. i check it about 20minutes later it was 574. Order said give 16units SSI and notify HO. Patient refused SSI and self-administered 9.7units of novolog via her insulin pump. recheck a little after an hour later, was more than an hour cuz i was busy and the fingerstick was now 584. Patient finally consented to getting SSI but the max she'll take is 10units. spoke to doctor who ordered it and administered. Rechecked a little over an hour and it was 594. at that point, gave 10 units and notified doc again.
Doc says give 20units. Then she says "i'm afraid she'll go into DKA, how much do you think i should give her?". I reply 10. She's NPO. She goes "If she keeps going up, she may not be able to go for surgery in the morning. give her 20units. if she drops too low we can always give d50." Surprisingly, i saw where she was coming from and didn't argue about the dose. Now was that a faulty logic? I don't know and i think it's hard to decide.
The thing with blood sugar levels is that too high is bad and too low is also bad. How will a person's body respond to insulin administration? It's hard to tell. For example, this lady's fingerstick kept climbing up despite multiple administration of insulin. Did the doctor think it was going to keep going up? Yes. She told me over the phone that "she needs a high dose of insulin".
Anyway, i recheck at 440am, it had dropped to 212. At 0639, it was 93. When i left patient, she said she was fine. After walking into the room to introduce new nurse, The patient stated i feel 'low'. Since i was done report, i told my coworker to have the tech check it while i complete the patients OR checklist. So at 0735, it was 31.
Coworker who left me in a crappy situation comes in this morning and tells me you shouldn't have administered 20units. Well, if the lady kept climbing high as she was and went into coma, first it would've been my fault and i'm sure this same person would've criticized the doctor for not being aggressive. Can we treat DKA? yes, insulin drip, IV NSS and a whole bunch of crap. I remember when i worked at Jeff, i had a lady who came in with bloodsugar reading "HI" on machine, she was on a insulin drip, q1hr fingersticks and it took more than 12hours for blood sugar levels to come to the 500 range. And we've had patients here at who've had to be transferred to the ICU so they can get an insulin drip. Can you push D50 and have the blood sugar come up in 30minutes, yes. Sometimes, you may have to administer D50 twice.
So was the doctor's reasoning faulty logic? i don't think so. I mean she could've looked the other way and said, let's not give her anything and the bloodsugar could've gone past 600 and she coulda been in a coma. Neither one of us can predict how the patient would react. It's bifurcated road that leads to the same place. You don't treat aggressively, you risk the patient going into DKA. You treat aggressively, you risk the patient bottoming out. At least in this case the patient was conscious and communicative and action was taken.
There's been times when i've looked at out comes and thought, this doctor could've done this or this should've been implemented in the patients care to avoid such and such. Today, i support the doctors judgement. I know on my drive home, i tried to think if there was anything i could've done differently and honestly? i couldn't think of any. Between 10p and 6am, the lady got 8 fingersticks. One almost every hour except during the hour between 5 and 6am. I did 6 of those fingersticks myself and my tech did 2. i documented 6 times each time i took it. Knowing i'd given the patient 20units insulin, i checked the blood sugar levels afterwards and 20minutes before shift change, i rechecked and documented. She was 93. How was i supposed to know she'll drop considering i held her AM dose of insulin? The doctor didn't play God. I feel like she did the best she could do. Her reasoning led her to the choice she made. It was based on sound logic considering the inability predict an individuals reaction.
I know some nurses look at medical judgement and think it shouldn't be done that way but i think we see things differently. Doctors stand far away and see a picture those of us standing close to the patient don't see. This time, i think the medical judgement, however aggressive it may look, was a fine decision.
Doc says give 20units. Then she says "i'm afraid she'll go into DKA, how much do you think i should give her?". I reply 10. She's NPO. She goes "If she keeps going up, she may not be able to go for surgery in the morning. give her 20units. if she drops too low we can always give d50." Surprisingly, i saw where she was coming from and didn't argue about the dose. Now was that a faulty logic? I don't know and i think it's hard to decide.
The thing with blood sugar levels is that too high is bad and too low is also bad. How will a person's body respond to insulin administration? It's hard to tell. For example, this lady's fingerstick kept climbing up despite multiple administration of insulin. Did the doctor think it was going to keep going up? Yes. She told me over the phone that "she needs a high dose of insulin".
Anyway, i recheck at 440am, it had dropped to 212. At 0639, it was 93. When i left patient, she said she was fine. After walking into the room to introduce new nurse, The patient stated i feel 'low'. Since i was done report, i told my coworker to have the tech check it while i complete the patients OR checklist. So at 0735, it was 31.
Coworker who left me in a crappy situation comes in this morning and tells me you shouldn't have administered 20units. Well, if the lady kept climbing high as she was and went into coma, first it would've been my fault and i'm sure this same person would've criticized the doctor for not being aggressive. Can we treat DKA? yes, insulin drip, IV NSS and a whole bunch of crap. I remember when i worked at Jeff, i had a lady who came in with bloodsugar reading "HI" on machine, she was on a insulin drip, q1hr fingersticks and it took more than 12hours for blood sugar levels to come to the 500 range. And we've had patients here at who've had to be transferred to the ICU so they can get an insulin drip. Can you push D50 and have the blood sugar come up in 30minutes, yes. Sometimes, you may have to administer D50 twice.
So was the doctor's reasoning faulty logic? i don't think so. I mean she could've looked the other way and said, let's not give her anything and the bloodsugar could've gone past 600 and she coulda been in a coma. Neither one of us can predict how the patient would react. It's bifurcated road that leads to the same place. You don't treat aggressively, you risk the patient going into DKA. You treat aggressively, you risk the patient bottoming out. At least in this case the patient was conscious and communicative and action was taken.
There's been times when i've looked at out comes and thought, this doctor could've done this or this should've been implemented in the patients care to avoid such and such. Today, i support the doctors judgement. I know on my drive home, i tried to think if there was anything i could've done differently and honestly? i couldn't think of any. Between 10p and 6am, the lady got 8 fingersticks. One almost every hour except during the hour between 5 and 6am. I did 6 of those fingersticks myself and my tech did 2. i documented 6 times each time i took it. Knowing i'd given the patient 20units insulin, i checked the blood sugar levels afterwards and 20minutes before shift change, i rechecked and documented. She was 93. How was i supposed to know she'll drop considering i held her AM dose of insulin? The doctor didn't play God. I feel like she did the best she could do. Her reasoning led her to the choice she made. It was based on sound logic considering the inability predict an individuals reaction.
I know some nurses look at medical judgement and think it shouldn't be done that way but i think we see things differently. Doctors stand far away and see a picture those of us standing close to the patient don't see. This time, i think the medical judgement, however aggressive it may look, was a fine decision.
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