Edda’s been doing great so far this year, for this I am grateful. We are still struggling to find evening care for her. This is not surprising to me and we can manage well and are managing well, but it’s a strange spot to be in. I’ve had to subscribe to care.com and my goal is to reach out to one person a day – so far two nicely worded apologetic not interested/not available responses.

I went to the hospital for a shift yesterday – I had two easy shifts in a row last week, so I was due for a mid-week frantic one and it was. Were all my patients bleeding? I think they might have been. I gave three – almost 4 units of blood – which for me is highly unusual – each to a different patient. I haven’t given a single unit of blood in months. I don’t like bleeding patients on my unit, they tend to be unstable and cause me worry and distress. When a doctor orders blood – it’s a complicated order. It fires off little notices simultaneously to the lab (to draw type and screen labs – at least two blood draws) and subsequently to the phlebotomy team (for the two draws, it has to be two different phlebotomists), to the blood bank (to get the blood ready) and to the nurse (to administer the transfusion). I’m trying to match the order to the actual occurrence, because a doctor might have ordered 4 units for a patient and I got report that three were given – one was given in the OR, one was given night shift PACU, one was given day shift PACU (so three nurses), and then finally to me where I’m supposed to give the final and 4th one, but I can only find two units previously documented – so am I giving the 3rd one or the 4th one? Unclear. Because of the new system and everyone learning to put in orders in a different way and response to a new ordering system, all these things got misrouted or stuck in the computer, so I spent a lot of time wrestling with all these spider legs to get them to walk in a coordinated manner all while people need blood. It’s not so much fun.

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