Bittter Sweet

We had a 7year old Labrador brought in with end stage heart failure and end stage pregnancy. Mum had less than a week to go and the pups should survive although it was doubtful if she would.
The idea was to stabilise her and then see about a caesarian the vet gave the owners very low to negative odds of her surviving. She was placed on oxygen and given medication.

The theatre was set up for an emergency caesarian and l also set up the medical prep for an emergency “cut and grab” if the bitch crashed. If she crashed before the operation then there would be no attempt at saving her she would not come off the table alive all efforts would go to saving the puppies the correct assumption being to save her they would die in the time it took to revive her and the odds of her pulling through revival attempts with pups in her were non existent, they placed to much stress on her body.

After about 1.5 hours there was no visible signs of improvement and her stats, were slightly worse. The vet called me over and said that when he finished his present consult we would go ahead. He would give her propofol(to induce anaesthesia)and l would tube her (a tube placed into the trachea to maintain the airway and provide 02 and anesthetic gas and remove said used). We would place her straight onto her back no clipping or cleaning just go straight in and get the pups out and she may survive via crash kit and luck.

I was giving a last check to see that everything was right in theatre. Kit open, crash kit open and ready, tube to hand all plugged in ready to roll when the auxiliary called the bitch had crashed in her kennel.
We shot through. The other vn and l grabbed her and placed her upside down on the medical prep table. She was starting to chain stoke which is dying gasps. We did not tube her the vet gave a “now” and l put the propofol into her. If she was still alive she would feel nothing.

The vet made a long slice midline and pulled open her abdomen. Blood flowed out as arteries and veins were left unclamped pooled then ran and dripped off the table. The vets hands gripped and rolled out the slippery uterus and he sliced through horn one. Fluid now joined the blood the table and floor became a red green slippery pool and the golden body of the mum became red green merging with the table.
The vet pulled out neonate pup’s and started to shove them into waiting hands. I pulled up a syringe full of euthatol. A long slice through horn 2 and those neonates pulled out and passed over.
By now the prep area was awash with blood and fluid. Apart from the pool on and under the table it was up the walls from flip back pulling out the neonates, and feet were walking through the pool to and from table 2 where neonates were taken a few paces for reviving, cleaning, drying and checking (cleft palette and anus present) table 2 also had discarded placentas thrown onto the floor mingling with dirty towels from drying the neonates.
As the vet was about to get the last one l was told get ready and as he pulled the last pup out l injected the euthatol. Mum had probably already gone by this stage but we were not taking any chances.
It had only taken minutes for the procedure; from the original “crash” call to euthatol was about 5minutes.

There was 6 live pups all strong and screaming no deaths there. The vet went back to his interrupted consult and the other vn sewed up the mums abdomen while l did a quick tidy up of the area. As soon as mum was sewn up l placed the pups back onto her dead body to try and see if they could get any colostrum out of her. They got some out but as usual with newborns it took time for the idea of suckling to sink into their little brains and the time meant that it was drying up fast within their dead mum.

An hour later the pups went home, it was a bitter sweet moment we saved 6 lost 1. By the time the pups left the building medical prep was shining and clean. No signs of the life gained and lost that had happened such a short time before.

Ego meets VN

Well l have surfaced after my 8 nights. I did a few short comments and some twitters but nights just takes the enthusiasm out of doing much l get to tired.

The following happened last year we had a day vet covering nights he was a good vet in “knowing his stuff” he was a lousy ego driven people dealer though for those he considers beneath him.

We had a bloat (GDV) case in and l went to set it up. Over the year’s l have set up for a lot probably a a couple of hundred or more of these op’s so l know what we use. There were a couple of auxiliaries on as it was only about midnight and they popped in to help setup.

The dog was prepped and transferred and the operation was about to start. I heard a bellowing coming from the op theatre so went through and was approached by a screaming vet about where the F**King hell was his suction.
I looked at him totally blankly as we do not use suction on bloats. One of the night vets tried it once a few years back, it didn’t work so we never use it.
The screaming continued as l was saying this and was told “l put it on the note of what l wanted set up and other things l wanted are not here” This was screamed along with a lot of other expletives.
Blank look from me what note? The attack unfurled and l won’t take this sort of thing so attacked back. I refused to scream but made sure he heard me and I gave back what was thrown at me soon we had a full scale war going on.

I stormed off came back with the suction and set it up and the other bits he wanted then went to look for the note. I found it eventually the idiot vet had written it on the back of an anaesthetic form and left it with the pile of said forms on the prep table. One of the aux. clearing up had moved them to the side out of the way.
I got a grudging apology from the vet for his behaviour and gave a grudging one back for all l had called him in return, 2 insincere apologies to smooth things over.

Later on the anaesthetic nurse said to me that she had seen many men angry but had never seen one go so berserk, she had been worried he would hit me and was not sure what to do she had been genuinely terrified.
I told her “That would have been his biggest mistake” and not to worry as l certainly wasn't, as had been obvious at the time.
Apparently afterwards he said he would appreciate it if she never mentioned him loosing his temper or what happened. I told her the entire night staff had heard it and already knew so he was a bit late for that.

The vet and l still work together every so often for a few hours on various shifts and are ultra polite to each other.

Brit Politics 2010

Had a mooch round the cartoons on the state of brit politics today here are 3 unbiased ones. Fair to say l do not like any politicians and do not think any of them are fit for purpose.

Sighs!

When l started this blog in September 2008 l couldn't think what to call it so choose veterinary nursing and life. I still can not think what to change it to. I was thinking of the Barefoot Veterinary Nurse as l dislike shoes and avoid wearing them. That limited me to just veterinary nursing, or A Barefoot View of Life and Veterinary Nursing, that's to long.
So l stick with what l have, still undecided on a name but this one seems to work and on the basis if it isn't broken don't fix it l shall stick with the "temporary" name.

Fed up just been into town to upgrade my phone to an iphone it will have to go on hold as they want £154 for the basic 3Gs. It is all to do with fact it is a mid term change, l am not primary phone on the contract (business one) and they just want to gouge us for it. And if we get it we have to agree to keeping our contract with them for another 24 months.

This is the only reason l vote Suffragette


Dry Bones

Life up to Date

Garr fighting off another bought of bad throat and high temperature. Thank goodness for throat lozanges. My idiot Dr who, after a lot of abuse from friends and family l visited about 3 weeks ago as l was getting over last 2 month session, said in one breath. "Well it could be a low grade virus you can not shake due to stress. (You don't say!) BUT as you tested negative for a hiatus hernia 10 years ago l am going to treat you for acid reflux here is a script for omipramizole (strong antacids)
I have come to the conclusion my idiot Dr thinks "If it looks like a horse, and sounds like a horse, it must be a lion eating a tomato"
I am looking for a new Dr l can not handle the total cretin l have any more. He and his partner are worse than useless.
On the subject of medicals l have the meeting re scheduled for 17th May with the local nhs over the complaint for my dads discharge in January. They cancelled the last one as some head of nursing who "Just has to be there" was ill.
We had a letter through asking if we wanted to opt out of all our data going onto the nhs computer. I thought that the computer had been cancelled? Anyhow l filled in the don't put us on it part.

I was getting excited as up to now we have had no paper work through the door about the election but nulab spoiled it yesterday when l got home. There was a "thing" through the door. All the more reason not to vote for them they spoilt my no info yet boast.
Anyway l can not see who is worth voting for they are all as corrupt and scummy as each other so l will vote because of the suffragettes, but l will spoil my paper as A) This area is so solidly labour over 3/4 of the residents who normally vote would need to fail to turn out to make a difference B) I hate all politicians as being corrupt, insipid, self serving clones made out of some spoiled dough. I was hoping that a hung parliament means 300+ politicians hanging by their throats from parliament rafters. I am assured though it doesn't mean that, still l can but dream.

I have a long stretch of nights from Friday 8x 22:00-08:00 on the trot. I am hoping that they are fairly quiet.
I did 2x 17:30-03:30 over the weekend and the nights were manic. It felt like every animal in the area seemed to decide to become ill, get hit by a car or get bitten by another one.
Had a dog in with a tracheotomy tube. What a sweetie to treat, he would sit and lift his head to have his tube cleaned and suctioned every 2hours, l wish more patients were as cooperative.
One of the regular night vets is on holiday so a day vet covered. He has a worse memory than l do which was great as l am usually the bad memory person. He is having a "Come dine with me" night with the staff l was going to go, but, l think as it will be my first night off after my 8 night marathon, l won't make it.

Have been on days yesterday and today at a different vets. One of my semi regulars. It is novel working the whole shift in daylight and ending at 19:00 like regular vet staff. Going to be busy today though as we have a load of ops, l am sole nurse from midday and apart from ops and cleaning post op (theatre, kits, general prep area)and putting away the order l also have quite a few nurse appointments to do as well as all the discharges as patients recover.
Just hope the purified water gets there this morning for the autoclave or several ops will be cancelled. Someone forgot to order any last week but l think l got the phone order through in time to the supplier. If it all goes "tits up" it won't be my problem thought. The joys of being a locum cover, we have to have some perks.

Hub has been away since thursday last week. Langer have had a big skydiving meeting. He lead the SOS (Skydivers Over Sixty) attempt on a UK record over the weekend. They managed a quick 9 way but did not declare it as no one was happy with it. For goodness sake l give up. They got a 9 way, they got a UK record, every jumper was a brit and well over 60 but nope.. they weren't happy. I think the SOS stands for Senile Old Sods or Stupid Old Sods. Later on the Saturday they tried for an 11 way but it wasn't to be.
He is home tonight to do paperwork and l have made the big decision to go into town tomorrow and get an iphone 3gs. I have been dithering since February over that or Blackberry Bold but decision made (l think)

Oh well off to work this getting up in the morning for work is a very novel feeling. I can stand it occasionally but not regular.