#trach patient

[denex-international]

Discover the essentials of tracheostomy tubes in our engaging blog! Learn about their uses, different types, sizes, and expert care tips to ensure optimal comfort and health. Get informed and empowered with our comprehensive guide!

[2024skin]

My unfeminist trait is that when healthcare workers tell stories about how they wore makeup to work and then some type of patient excrement got stuck to it, that makes me really happy

[gardenstateofmind]

i can handle absolutely any body related functions so long as it's not from the mouth. idk why it makes me feel so ill. it's not even just vomit (though i very much am a sympathy puker) bc phlegm also nauseates me. i can handle mucus if it's coming from elsewhere, but being coughed up? i can't handle it.

[dhampir-dyke]

this mfer smoking in the hospital is about to cast spell of explode meemaw

[the-winds-of-destiny-xxx]

.

[severedfromthesource]

Been thinking about little resus touches that I like

When the patient has a hand laid limply on their belly and it rocks with every compression, or it’s bent up near their cheek and bounces with the force

That moment just after time is called and the rescuer loses their rhythm, hesitates, then finally stops compressions, but their hand lingers a moment longer on the patient’s chest as if not wanting to let them go

If I’m in a time called mood then there’s also the quiet minute or so where they disconnect leads, gently tending to the body as they unhook the ambu bag from the trach tube and it hangs from between the body’s teeth, tenting the fabric when they pull the sheet over

The patient’s eyes are open and their head is tilted towards their rescuer, silently watching them work to bring them back

When the rescuer lays their head on a patient’s chest to check for a heartbeat, and they readjust and press their ear harder against their sternum in search of a pulse that’s not there

Absolutely love when the rescuer grunts with compressions or growls in frustration when they can’t find a pulse, vocal rescuers are my favorite so lots of “stay with me” “I’m losing him” “come on, come back”

And of course when the patient finally comes back, and they’re panting and disoriented but the rescuer is there to hold their hand, maybe lay their palm on their heart and assure them that everything is alright

[andhumanslovedstories]

Hello! I love your blog very much. I too am a second degree nurse. I just graduated from an ABSN program and I'm struggling to get my foot in the door anywhere despite good grades + honor society membership + in state license already secured. I live in NYC and the nursing shortage here is CRAZY but for some reason no one wants to talk to me. Would you recommend home health nursing for someone in my situation? I did my preceptorship in the ED and that's 100% where I belong, but the bills are really piling up and I have no prospects. How long did you do home health before you went bedside? Thank you for any advice you have!

(Disclaimer though for all this, I'm across the country from you and have no idea the landscape of nursing jobs in NYC.)

I worked in home health for 18 months. If my goal was to get to the hospital as quick as possible, I didn't need to be there that long. I wasn't in any particular rush to move on. Plenty of people worked less than that and got hired at a hospital, I think something like a year was the average. I know the different between sending out my new grad resume and sending out my home health nurse resume was night and day. As in: literally anyone wanted to interview me.

I'd encourage you to at least apply and see if you can interview. You get to interview the company right back, and that'll let you know the kinds of work they expect from you. There are two main types of home health: the kind where you visit a lot of patients in a day and the kind where you're with one patient for the entire shift. The first kind is doing stuff like dressing changes, medication management, or periodic assessment. The second kind is more like general caregiving with nursing related requirements. I mostly did the second one, and worked night shift. So I fed a patient dinner, I gave them a bath, I got them dressed for bed, then tucked them in and stuck around until morning for their needs in the night. But within that was trach management, seizures, G tubes, medications, central lines, ongoing assessment, all that stuff that got this person nursing hours. I'm not gonna lie--it was often very very boring. I read a lot of books.

(btw west coast disclaimer again, but if you're willing to work nights, you'll get hired more easily. Everyone everywhere in the world doesn't have enough night shift coverage. also, oops! this got long and became an essay on home health!)

For downsides, in home health you can get limited training and orientation before you're alone, responsible for a patient. And then it's all on you. I had some gut-dropping moments early on where I encountered something I didn't know how to handle and didn't know how urgent it was. There's supposed someone you can call at all times, but multiple times when I did call, no one picked up. It can be super stressful and frankly dangerous as an inexperienced nurse. Luckily, many times you have the patient's family as a resource. It's likely they've been doing this years longer than you have. Though it's worst thing in the world when you wake someone up at 3 am because you're unsure and concerned, and then have that person explain in a really supportive tone of voice that these frequent, very brief seizures were probably just hiccups. Hypothetically speaking.

You can get too entwined with the patient and family's lives. It's hard to call out sick because you know no one can cover you. It's easy to cross emotional boundaries. Imagine spending 40 hours a week with someone and their family. They'll occupy a spot in your brain.

And I don't think it's a great place for a new nurse to stay for years and years, just for like professional development reasons. You won't get exposure to a variety of patients (unless you work that other type of home health in which case enjoy seeing eight different patients a day, hope traffic doesn't suck), so it's easy to forget stuff you just learned. I never had to think about transfusion reactions until I started at the hospital and shit now it's relevant all the time. I had to completely relearn how to hang an IV piggyback. Plus, since you work alone, you don't get the chance to see how other nurses work. It's hard to figure out a profession when you practice in complete isolation. It's easy to learn bad habits and have no one ever correct you.

But there's a lot I like about home health. You really do have a perspective on patients and patient care that is unique to home health and long-term care. In the hospital, you don't always get that long-term perspective. If you work with someone for a while, you can track how they progress or decline. Why do some clients stay at home for years and others keep going back to the hospital? What's different about their conditions and cares? You see all the work it can take to keep them steady. That's perspective that easy to lose. It helps you put the patient on a timeline that extends beyond the hospital. If you click with a patient and/or family and work with them for a while, it can be very satisfying working with them because you see so clearly the impact you're having.

Also! I read so many fucking books! I listened to so many podcasts (played so so softly). I knitted and learned sudoku and practiced yoga, looked up vacation spots, put in my grocery orders, and organized my playlists. I also could research and research and research. I had time to look up everything about every condition my patient had, and once I felt more comfortable with those, I moved on to looking up whatever other disease process and patient experience seemed interesting. I'd make myself a little curriculum and, after my patient was tucked in, and be like "tonight's class is vlogs about having a trach."

There were plenty of shifts where I bustled all fuckin night, and sometimes those shifts seemed to be in one endless hellish row, but often I had a lot of time to myself that I could spend however I wanted, as long as I was still in the room with the patient, able to meaningfully hear and see them, and keeping up with the night routine. I fucked around a lot and got paid for it because the job is to be available when needed, and you're not always needed. (I'm not saying slack off! I'm just saying even colicky babies sleep peacefully now and then.)

Anyway jesus christ that got away from me, but like please know that I was in your exact place, and I know how much it sucks and how crazy it makes you feel because I THOUGHT WE WERE SHORT ON NURSES DON'T ANY OF YOU FUCKERS NEED A NURSE, and know that all the other job hunts after this should and will be easier than this.

[skyloftian-nutcase]

With your Lu in healthcare au I have a question (or more 😬) about Wind! What’s been his worst and best experiences with working at the hospital? Were the others able to provide emotional support when he needed it?

Best is seeing people pull through when they seem like they’re not gonna make it. Worst is, well, uh, the opposite 😅 One of his worst experiences was a traumatic airway insertion - the patient’s airway was full of blood and already swelling, Wind couldn’t visualize the airway to intubate and they had to trach the person instead (ie they had to make a surgical airway). I wrote a snippet about it, I’ll have to hunt it down later to reblog!

[serpenttailedangel]

This bugs me so much

Why does he have a nasograstric tube?

Why did they give a nasogastric tube to a patient on a ventilator? He's in a perma coma. Did the place where he got treated just not, like, stock PEGs or something? Is getting a PEG in there once for a perma coma patient with a trach really less effort than keeping any NG tube in? With a trach!? They still have the NG tube in him in the not-flashback years later you're really telling me they kept to NG tubes in a perma coma trach patient for years!?

Are you trying to not cut holes in his body and that's why you used the stupider long term tube? Cause he already has a hole in his neck, doc!

[enkisstories]

The trial of General Hux - Part 2 of 2 (Chapter 10 of Mutiny on the Steadfast)

Part 1

In the infirmary things went by a different pace than in the outside world. None of  the hectic and confusion had a place here, but never mind that, people of course brought their memories and grievances with them. Those who had gotten seriously wounded during the mutiny or the subsequent rebel takeover were resting, sorted by their specific injuries instead of their allegiance. It remained to be seen if that was still manageable when the first First Order members would have recovered enough to start trouble. A trio of only lightly wounded members of the Resistance’ boarding party was sitting around a table, absorbed in a card game. They were waiting for the doctors to make their next round that would most likely clear them to leave and resume duties appropriate to their condition in the base.

Commander Trach woke up on his back. He had been briefly awake before, after arriving on the planet, and then passed out again while the medics had changed his blood-soaked bandages. How long he had slept the man didn’t know. He only felt a sting in his left arm, where an infusion needle had stuck not so long ago. So at minimum he’d been out for the time it had needed for the medicine to trickle into his body.

The first thing he beheld when he looked around were his tropical fish swimming around their tank. Trach blinked. This really was his own fish tank, that had gotten placed so prominently in the room, he realized. The sea anemones and corals were all in the specific places he had arranged them in. Someone must have had rescued the aquarium from the Steadfast - not the worst prize Trach could imagine to take from an enemy ship.

Having spent most of his life in space, Masir Trach had never developed a taste of planetbound life. He just knew that someone would open a window sooner or later to let the “good, fresh air” in. That would introduce all kinds of overwhelming sounds and scents to the room, rendering the protection a four-walled shelter offered moot. And over the course of the day the temperature would change drastically, perhaps the one aspect of planet life that irritated the man the most. There’d be wind or even rain and the air pressure would change hours before the onset of the downpour already, giving any sensible person a headache. Not to mention the gradual change in lighting from sunrise to sunset. The heck, scratch “gradual”, a single cloud could cause havoc with that! Normally Trach could deal with all of this when he was on a mission, even find it entertaining during shore leaves. But getting tossed into a natural environment without warning and against his will caused the officer to give himself over to his aversion to life in an ecosphere to the fullest degree. Everything about nature sucked, weather was not species-appropriate for the most advanced people in the galaxy and he didn’t want it, end of story!

Someone approached the patient. It was Poe Dameron and his intention seemed to be to hand Trach a pot filled with hot, steaming tea. Next to the rebel rolled his droid, the infamous BB-8. That one’s intention Trach couldn’t guess. Assisted by a medical droid, the man sat up and accepted the cup. Without taking his eyes off Dameron, and as appalled as if staring a Dianoga into its eye, Trach took a sip. What could his visitor want? He looked like Dameron, but Trach thought to know better. His General was dead; this here was once again a smelly, unpredictable rebel-scum.

“Trach? I never knew. Never knew that so many of you really believed in your propaganda. I thought… I mean, Finn told me about the stormtroopers, how they got brainwashed from their early childhood. But I believed all you officers to be in this for the power. Now it seems that you, too, are victims. If there’s a way to make you see… to wake as many as possible up, I’d do it. In an instant.”

All of a sudden the weather wasn’t the most irritating thing anymore. Dameron still spoke in the same manner as he had done on the Steadfast: brash in battle, but warm and encouraging in private. How could that be?

“Talk to me, Commander!” Poe pleaded, but the First Order officer only glared at him as one of the barbarians who were about to plunge the galaxy into chaos.

“The hell, Trach, of all the things you could have picked up from me and Hux, it had to be our stubbornness?”

At this point of the one-sided conversation someone screamed on top of their lungs. A male voice, Poe realized, and then he recognized it: Lieutenant Dopheld Mitaka of the bridge crew. Poe followed the sound with his eyes and saw the lieutenant grasp his bed sheet, ready to pull it over his head any moment. The man’s fingers were jittery, his whole body was shivering. What could have scared him this much?

WHOMP.

Poe looked up into the direction this new sound had come from. He spotted Eightball, the spherical interrogation droid, that had just hit the ceiling that, unfortunately for the droid, had cables running along it in this section. IT-08’s currently extended syringe poked deep into one, what resulted in a weak jolt. Trying to free himself by wiggling around, Eightball only managed to get caught even tighter in that technological spider web.

“I see”, Poe murmured.

Mitaka must have seen one of the infamous imperial torture droids close in on him… and he was currently a prisoner of the enemy… What was one to think in this situation, naturally?

Only Eightball’s job was not information gathering, but delivering medication to those who needed it according to their individual schedule. He was also constantly monitoring the patients’ condition and would raise the alarm should one try to leave the infirmary or engage in otherwise suspicious activity. In other words, the droid was living the best life he could imagine. Before the scream anyway, Mitaka’s fearful wail, that in turn had scared the droid into shooting up towards the ceiling.

“I guess that’s on me”, Poe confessed. “I vouched for IT-08 to get employed here. Because Hux said they serve as paramedics…”

“Have you ever noticed that General Hux is a tad bit less on the empathic side?” Trach sputtered. “Maybe what HE thinks is acceptable is a little non-standard?”

“Er, right. You’ve got a point. - Eightball, come down!”

In beeps the droid explained what was plain to see – that he was caught in the cable salad.

“I’ll fetch someone to help you”, Poe promised.

That someone was already on his way here and his name was Finn. While Rose was following Hux’ unique search tactics with the same fascination someone shooting a wildlife documentation might feel, Finn had listened to his common sense. Distressed about having been made into a First Order follower, Poe would most likely seek out First Order personnel. Not the likes of Kandia and Kornsenf in their cells, but the pilots and officers he had worked with after he had gotten turned. Most of those were in the base’s hospital at the moment, so that’s where Finn had went.

Poe grabbed his arm, pulled the friend close, quickly pressed a kiss on his cheek, then gestured towards the captured droid.

“Ever wanted to be try out Force telekinesis?”

“Guess what”, Finn replied with a grin, “I practiced on my own in our cell! But I had to be careful not to alert the guards to the full extent of my abilities, so I didn’t get anywhere. I have the feeling telekinesis is something I might be good at, though, seeing that it complements my combat training. A push in the right moment… Well, in this case  a pull, more like it.”

The force sensitive looked up at IT-08.

“Eightball, I’m going to grab you with the Force! If that scares you, go into standby for a spell!”

Finn waited a moment. He saw the lights on the droid dim one by one, until only the “unit activated” indicator was glowing white anymore. Then, like the Jedi of old, who had also used gestures to better focus on a task at hand, Finn stretched out both his hands towards the ceiling, first the physical ones, then the spiritual extensions. With the left hand Finn steadied Eightball, with the right hand he gently tucked at the cables until the droid was freed. But Finn wasn’t trained in the use of the Force yet, so his channeling of it had been less efficient than it could have been. After entangling the droid, his hands and arms felt strained. Finn couldn’t gently levitate the droid downwards as he had planned, but he could position himself where Eightball would land and catch him before he’d smash onto the floor.

Finn was holding Eightball safe and sound, when Rose and Hux entered the room through a door opposite the one Finn had taken. They saw Poe enthusiastically congratulate Finn to some feat – apparently he had levitated Eightball with the Force? Poe was full of awe of his partner, less so of Finn’s talent, but of the way he had calmed the droid down before starting the rescue. That was husband and father material right there!

“Grabbing is what’s difficult”, Finn stated. “Establishing the connection to anything requires faith in the Force actually existing and in my connection to it being real.”

Rey having healed Hux back to full had been a pretty big indicator to the Force being real, powerful and open to get called upon by those with an open mind and heart. Finn hadn’t been present at that scene, but the living evidence of it having happened had stood right next to him on the stage afterwards.

“After I touch something, moving it around can be as easy as if I held it with my physical hands”, Finn relayed his experience.

Can be, that was the key here. Today there had been no pressure. Had Finn failed, someone else would have come with a ladder and untied the droid. To reliably produce the same effect in a crisis, or move objects around tactically in combat would require actual training, something Finn was looking forward to.

For now he handed Eightball to Poe.

“Here. He’ll probably like waking up in someone’s arms.”

“Eightball – call to arms!”

At the verbal command the droid returned from standby. He fully turned around himself once, saw the Generals Dameron and Hux as well as Rose and Finn, who weren’t strangers by a long shot, either, and synchronized his position with Poe’s shoulder. Everything was well again.

“So, P…” Hux’ lips were closing in preparation to form the P-sound, but before they could produce it, he corrected himself: “So, Dameron. I expected you to be distressed to Exegol and back, but here you are, playing with my droid.”

Poe grinned.

“It’s nice to see you, too, Armitage.”

It was nice, indeed, Poe thought to himself. Not exactly the other’s presence in itself, but standing here while feeling all calm, with no more primal urges for prisoner mistreatment.

“Shall we take this double date to the cantina?” Poe asked. “The last I had was a sticky energy drink before going out to blast rebel-scum out of space.”

Rose opened her mouth, but before she could voice whatever concerns she might harbor, Hux nodded.

“Yes, let’s. I haven’t even started telling the imbeciles in there what I think of them!”

There they walked, the First Order deserter Finn, the (technically) defector from the New Republic to the Resistance Poe, the leaker-temporarily-traitor-de-facto-leader of the First Order Armitage and Rose, who had lost her home world and family to the First Order. To their feet BB-8 was prowling and around their heads IT-08 was skimming.

As executions went, Hux thought, this one was way more pleasant than his first one. That was the whole point: He was still thinking and as long as he kept at that, there was still a chance to escape his face for a second time.

[purplefiction-ao3]

Sorry to all of you who are patiently waiting for the final chapters of my WIP. I’m in the hospital again (developed a hiatal hernia that had me rushed to the ER because of pain and low O2 sats). Now, I’m pretty drugged up rn so anything I write for “Tender is the touch” has a high likelihood of making zero sense. I’ve literally been trying to write this post since yesterday but I keep going in and out sleep and waking up to find I’ve written nonsense.

I’m still struggling to breathe and the new tracheostomy will probably happen soon in the next week or so, before I have the hernia repair surgery. The anesthesiology team are worried that my airway won’t tolerate an endotracheal tube very well, too much scar tissue.

Honestly, this all really fucking sucks. I don’t want any more surgery and I don’t want a new trach. Being in the ICU with its sounds and smells is super triggering for my medical trauma, tbh. I’m so tired and I’m so scared. But I am grateful for my sweet, angel of a nurse who has been sitting with me when she has time to help me through the extreme anxiety and panic attacks. She’s been holding my hand and giving me cool cloths for my forehead. She’s even told me stories about her little baby, and shared photos with me, since I told her I love babies. It’s helped a bit. It’s a good distraction at the very least.

Please send any good thoughts, vibes, prayers or whatever you prefer to send. I need good vibes for better seizure management (already had two tonic clonic seizures since being admitted to the hospital yesterday morning), good vibes for my heart to continue to handle the extra stress my body is under right now, and good vibes for the hernia surgery I’m going to have in the coming days.

Thank god for the cocktail of heavy meds that are keeping me comfy and calm and the extra breathing support I’m receiving now to help with the air hunger.

Hopefully I’ll be back to my writing sometime in the next week or so. I have to remind myself that these hospital stays never last forever. Thanks for all of your continued patience. 💜

(Hope this wasn’t just one big long wall of nonsense-text. lol)

[nostalgebraist-autoresponder]

The doctor wanted to give her patient a trial run without his trach. He should make a full recovery, albeit a slow one.

[mrsballlegs]

Had the stuuuuupidest situation at work last night…. This patient with stage 4 cancer has been in and out of the icu for most of the last year family refuses to trach and refuses comfort care…. They finally convinced the family to do hospice, extubated him specifically to send him home w hospice, had him in the gurney when hospice was like oh you said NG tube? We thought you said g tube, we can’t take that! And family wants him to get tube feeding while on hospice so. Back in the hospital bed, extubated with unclear goals of care 🤧 at least I got through the night without reintubating….. barely….

[that-catholic-shinobi]

Apologies if this has been a topic of discussion already but - is that a Passy-Muir speaking valve?! Is it symbolic?

It is! You’re only the second person to recognize it.

I’m a pediatric palliative care nurse and most of my patients are on trachs. Respiratory/ Palliative nursing is kinda my specialty

[gardenstateofmind]

the icu patient i was sitting with on friday was on a ventilator but not fully sedated, so he kept waking up and trying to rip everything off, and at one point he twisted around so much he was able to pop the vent tubing off of his trach collar and i'm just like HELLO?

it was easy to put back on, and it's happened to me before, but i did wish a nurse would have come in to check when the vent alarm started going off 😭

[humorofanightshiftnurse]

What my trach patient thinks when I get super bossy and won’t let him be obnoxious.