WE ARE NOT AMUSED!

I arrived a little after 7:30 and found Dorothea with Brown Crusty Lips. As I was cleaning her lips I noticed that she had a hardened crusty leakage from her stoma dressing. Her right arm was up on a pillow with a dressing that indicated they had taken a draw for blood gasses but the elbow was over extended and the fingers were cold. As I was finishing her lips, Victoria (THE best RT), came in a cleaned up her stoma dressing. Victoria tried to suction her thru the trach tube but the suction tube would not clear the botton of the tube. She then got a finer tube and was able to get some very thick mucus from Dorothea's lungs. Victoria put in a call to the Dr. to replace the trach tube entire. Her Day CNA, Emily, came in to check the SO2 sensor on her finger as they had a low reading. THe reason it was low is that they had kept the sensor on her finger for two days with tape. After removing the tape we could see why it was so low. It was so tight it had cut off the blood flow. After moving to another finger it was fine. Her Day nurse, Steve, came in to add some food to the bag and I asked him to change the connector to her PEG tube as it was loking crusty. Victoria asked him to get the Charge nurse. I explained to the charge nurse that it look like Dorothea got either very little or very poor care overnight. She agreed and said Dorothea would have a different crew tonight and she will write it up and talk to the nite crew. The Dr. called back with the ok to replace the trac tube and she did a very good job of it by first suctioning the crud off the top of the cuff and then replacing it very quickly. She saved the old one for show and tell to the DR. and night crew. Victoria then cleaned Dorothea's mouth and redid the stoma dressing, Steve replaced her wrist dressing and at 8:30 I got a new cup of coffee.

By 10:30 Dorothea was turned twice, bathed, and shamooed. At 10:45 Donna called for an update.

After lunch Dorothea said she can't breathe but she is clear and holding good SO2 levels. Steve was able to give her something to calm her down and she fell asleep. Later the Dr. came in and said he will take the fluid off her Left lung on Monday.

Dorothea got a new roommate this afternoon.

6pm and heading for the house.

WE are content.