NIghts
I had a rough week of nights with may sick patients. The first few nights i was able to get some sleep but the next few nights were tough and I was unable to get any sleep. The nights are mostly consumed monetary telemetry as I have two patients with heart rates going up to the 180s at 2 o'clock in the morning. The first patient was being treated for pyelonephritis with ceftriaxone. Uncharacteristically, she did not appear to be responding to the antibiotic as she was still spiking fevers, still looked in significant discomfort and continue to have chills. As her heart rate increase I grew increasingly concerned that she may be going into complete septic shock. Multiple fluid boluses were ordered and an additional dose of gentamicin was ordered. After two nights of no response to the ceftriaxone and another night of me requiring a sporadic dose of gentamicin with fluent boldness and supplemental oxygen, and abdominal ultrasound was performed sh...