so, i'm precepting yet another new nurse. this one is a bit older than the wee-ones i've been teaching, just out of college, barely old enough to drink. nursing is this lady's second career. and i'm nervous she will need a third.
i've prepepted MANY nurses. i wanna say at least 20. maybe more. and all of them have turned out decent. a few, exceptional. but this one leaves me concerned. and i feel horrible about it.
new nurses (even experienced nurses) get six weeks of one on one training with me (or another preceptor on our unit). over the course of these six weeks, i do my best to impart my nursing wisdom and teach not just the policies and procedures on "how" we do things, but the "why" behind the things we do too. our goal is that after orientation, we have shaped, molded, and created a SAFE nurse - one who is not only capable of caring for a patient's complex needs but also, one willing and aware of when to ask for help if she/he is in over her/his head. some people feel nervous to ask for help, as if needing assistance is a kind of failure. but the scarier person is the one who doesn't know that help is needed.
i've been worried about this new nurse since the beginning. on our third week together, i started to voice my concerns to our assistant nurse manager. by week four, i spoke with the head honcho. and now, at the end of six weeks and with two more 12 hour shifts added to extend orientation as a continued trial, i feel in over my head. as if i have nothing left to teach. that perhaps this woman is just incapable of learning. that she is too nervous, forgetful, or dumb to be a good nurse. at the end of tomorrow's shift, i'm supposed to meet with our manager and help decide if our unit is just "not a good fit." that's what she's calling it. but basically, she means we might fire her. and i will have played a HUGE role in that decision.
typically more than one person precepts a new employee. but after three shifts with another preceptor, this new nurse expressed that she and i had a better relationship. that my teaching methods worked better for her. that her other preceptor added stress instead of relieving it. so here i am, her only teacher, with only hours left to teach... and i don't want to go to work tomorrow.
wish us luck. it's sink or swim time tomorrow...
Monday, December 8, 2014
Friday, November 7, 2014
two firsts
i had really wanted to write about this incident when it happened, when all of my feelings were raw and fresh... but it happened the week before i left for asia. and i was busy working TOO much, packing, and scrambling to see family, friends, and a baby being born!
there are certain milestones in a nursing career. i'm guessing they're different for each type of nursing. but for an oncology nurse some of them might include - first admit, first mistake, first death, first code. i've been a nurse for more than EIGHT years now; hence, i don't experience firsts very often anymore. but on september 26th, i had a first. i did CPR on a patient. now, i have had my patients transfer to the ICU (when they are VERY sick). and i've had patients die, more than once while i was in the room - sometimes with family present and a few times with just me in the room, witnessing the last breath. i've even had my own patient code - two different times. but each time, other people responded. the first time, i was still a brand new nurse and was in such shock, i'm not sure i could have stated my own name. and the second time, another nurse walked into the situation (a blue patient) and started the rapid response that led to CPR and intubation and eventually, days later, to death.
but this time, i did the CPR.
(WARNING: this is not for the faint of heart - which means, i probably shouldn't read it either)
it was such a strange day. i was precepting a new nurse (as i do frequently these days). she was on her last few weeks of orientation so she was mostly doing all of the work. she's a rockstar newbie (because i trained her as a nursing student!). but anyway, i left the unit that morning to complete my annual CPR training. in front of an evaluator, i had to demonstrate that i know how to do CPR. i did two minutes of compressions on a dummy and was given my gold star. i passed. and just a few hours later, at about 1PM, there was a code on my unit. a young patient flatlined. dozens of people filled the room. and i assumed my normal position - delivery supplies, finding chairs, kleenex, and water bottles for family and loved ones who are hysterical in the hall. but i did not do CPR. i wasn't needed at that time. there were plenty of nurses in the room. and to be honest, i'm scared of CPR. i don't even know if i think CPR is ethical... on my unit that is. even when our patients survive codes, the likelihood of them surviving long term is miniscule. and CPR breaks ribs. it's violent.
but in the afternoon, i sat with other nurses discussing codes and CPR. and i admitted out loud that i've been a nurse for a long time and have never done it. in my head, i started to regret not volunteering during the code. i thought that perhaps it's something i should be able to say i have done.
so, when we had another code in the evening, this time with a different patient (the previous patient survived the code and the day), i decided it was my time. perhaps it wasn't that conscious of a decision. i had been in the room, handing nurses syringes and priming tubing when someone started to round up a few folks to do 2 minute rounds of compressions. there weren't many volunteers. so, i jumped in. my anxiety was present - me and my little sidekick. i announced to the physician running the code and to the respiratory therapists that this was my first time. that if i was doing it wrong they should let me know. but in we went. and before i even knew what i was doing, i was thumping on a man's chest. his lifeless body jumped with each compression. and blood spewed from his orifices. all codes are different. but this one, it was particularly messy. he must have been bleeding internally so with every compression, a fountain of body fluids sprayed in the air. the respiratory therapists at the head of the bed tried to contain the fluids, as they were bagging the patient (breathing for them). but it was to no avail. there was HIV positive blood everywhere.
the code did not end well. the patient expired (i hate that word). and because i had chemo to hang and another patient needing things, i left in a rush, sweating profusely without time to think or process. it was about 6:30 PM at that time, and the day was coming to a close. i gave report and headed home. cole picked me up. and i'm guessing i was still a bit stunned. but i shared the news - and the scary fact that the patient had AIDS. and that there was blood everywhere. but we discussed it. and decided, i was not at RISK. i was wearing gloves while doing the CPR. i couldn't remember, but i think i was wearing a mask for all of the rounds of CPR i completed (isn't it crazy that i can't remember? adrenaline is a funny thing). nothing splashed on me that i know of. so when we got home, cole inspected my scrubs. there were no traces of blood on my clothed or naked body. i took a shower. headed to bed. and went back to work in the morning...
only to find that those involved in the code, many of them had gone to the ER that night due to risk of blood exposure during CPR. people involved to the very same extent as me had been treated and were now taking anti-retrovirals to prevent them from contracting HIV. i was flabbergasted. a bit frantic. and worried. i called cole. i called cassie. i even called my mom (the infamous worrier). and i discussed what to do with those involved the day prior. so, to appease my concern, i went to the ER to get blood drawn and to see what they had to say. it's interesting. medicine is so not standard; it varies from physician to physician, even for patients in the very same situation. the physician i saw had a completely different reaction than the physician my friends had seen the night before. she decided my risk was SO small that it wasn't worth being on anti-retrovirals for ONE MONTH! plus, anti-retrovirals make people feel like crap. and of course, i was headed out of the country.
turns out. i'm happy with my decision. i thought about my risk of contracting HIV - they say with a KNOWN needle stick exposure (which i did not have) the risk is less than 0.3%. and on my trip, i maybe had a few fleeting thoughts. but i was not distracted or scared. i wouldn't even say worried. my initial blood work came back negative - not surprisingly. and i'll follow up again soon.
so, i guess i had two firsts. my first experience with CPR. and my first potential HIV exposure.
phew. sorry this turned out to be SO long.
there are certain milestones in a nursing career. i'm guessing they're different for each type of nursing. but for an oncology nurse some of them might include - first admit, first mistake, first death, first code. i've been a nurse for more than EIGHT years now; hence, i don't experience firsts very often anymore. but on september 26th, i had a first. i did CPR on a patient. now, i have had my patients transfer to the ICU (when they are VERY sick). and i've had patients die, more than once while i was in the room - sometimes with family present and a few times with just me in the room, witnessing the last breath. i've even had my own patient code - two different times. but each time, other people responded. the first time, i was still a brand new nurse and was in such shock, i'm not sure i could have stated my own name. and the second time, another nurse walked into the situation (a blue patient) and started the rapid response that led to CPR and intubation and eventually, days later, to death.
but this time, i did the CPR.
(WARNING: this is not for the faint of heart - which means, i probably shouldn't read it either)
it was such a strange day. i was precepting a new nurse (as i do frequently these days). she was on her last few weeks of orientation so she was mostly doing all of the work. she's a rockstar newbie (because i trained her as a nursing student!). but anyway, i left the unit that morning to complete my annual CPR training. in front of an evaluator, i had to demonstrate that i know how to do CPR. i did two minutes of compressions on a dummy and was given my gold star. i passed. and just a few hours later, at about 1PM, there was a code on my unit. a young patient flatlined. dozens of people filled the room. and i assumed my normal position - delivery supplies, finding chairs, kleenex, and water bottles for family and loved ones who are hysterical in the hall. but i did not do CPR. i wasn't needed at that time. there were plenty of nurses in the room. and to be honest, i'm scared of CPR. i don't even know if i think CPR is ethical... on my unit that is. even when our patients survive codes, the likelihood of them surviving long term is miniscule. and CPR breaks ribs. it's violent.
but in the afternoon, i sat with other nurses discussing codes and CPR. and i admitted out loud that i've been a nurse for a long time and have never done it. in my head, i started to regret not volunteering during the code. i thought that perhaps it's something i should be able to say i have done.
so, when we had another code in the evening, this time with a different patient (the previous patient survived the code and the day), i decided it was my time. perhaps it wasn't that conscious of a decision. i had been in the room, handing nurses syringes and priming tubing when someone started to round up a few folks to do 2 minute rounds of compressions. there weren't many volunteers. so, i jumped in. my anxiety was present - me and my little sidekick. i announced to the physician running the code and to the respiratory therapists that this was my first time. that if i was doing it wrong they should let me know. but in we went. and before i even knew what i was doing, i was thumping on a man's chest. his lifeless body jumped with each compression. and blood spewed from his orifices. all codes are different. but this one, it was particularly messy. he must have been bleeding internally so with every compression, a fountain of body fluids sprayed in the air. the respiratory therapists at the head of the bed tried to contain the fluids, as they were bagging the patient (breathing for them). but it was to no avail. there was HIV positive blood everywhere.
the code did not end well. the patient expired (i hate that word). and because i had chemo to hang and another patient needing things, i left in a rush, sweating profusely without time to think or process. it was about 6:30 PM at that time, and the day was coming to a close. i gave report and headed home. cole picked me up. and i'm guessing i was still a bit stunned. but i shared the news - and the scary fact that the patient had AIDS. and that there was blood everywhere. but we discussed it. and decided, i was not at RISK. i was wearing gloves while doing the CPR. i couldn't remember, but i think i was wearing a mask for all of the rounds of CPR i completed (isn't it crazy that i can't remember? adrenaline is a funny thing). nothing splashed on me that i know of. so when we got home, cole inspected my scrubs. there were no traces of blood on my clothed or naked body. i took a shower. headed to bed. and went back to work in the morning...
only to find that those involved in the code, many of them had gone to the ER that night due to risk of blood exposure during CPR. people involved to the very same extent as me had been treated and were now taking anti-retrovirals to prevent them from contracting HIV. i was flabbergasted. a bit frantic. and worried. i called cole. i called cassie. i even called my mom (the infamous worrier). and i discussed what to do with those involved the day prior. so, to appease my concern, i went to the ER to get blood drawn and to see what they had to say. it's interesting. medicine is so not standard; it varies from physician to physician, even for patients in the very same situation. the physician i saw had a completely different reaction than the physician my friends had seen the night before. she decided my risk was SO small that it wasn't worth being on anti-retrovirals for ONE MONTH! plus, anti-retrovirals make people feel like crap. and of course, i was headed out of the country.
turns out. i'm happy with my decision. i thought about my risk of contracting HIV - they say with a KNOWN needle stick exposure (which i did not have) the risk is less than 0.3%. and on my trip, i maybe had a few fleeting thoughts. but i was not distracted or scared. i wouldn't even say worried. my initial blood work came back negative - not surprisingly. and i'll follow up again soon.
so, i guess i had two firsts. my first experience with CPR. and my first potential HIV exposure.
phew. sorry this turned out to be SO long.
Thursday, November 6, 2014
the gal who was afraid of saline
pardon my blogging hiatus...
i stepped away from nursing for a while! and i try (sort of) to keep this blog about my job.
as mentioned in my last post, i went to morocco in september. and then, just a week ago, i returned from thailand, bhutan, and cambodia - a most wonderful vacation and 31 days away from oncology nursing.
but i'm back. in full swing. that's how it always feels after vacation - like i never left. people are still sick. in fact, some of the same people who were in the hospital a month ago are still in the hospital now. some have discharged. and a few have died. sadly, one of my very favorite patients - nelson. on a side note, i did get to raise a prayer flag in his honor while trekking. and coincidentally, i learned when i was back to civilization, nelson died the day i honored him. i had no idea. his flag is blowing in the winds, close to the heavens, continually sending prayers.
now, on to some positive news, for once (i feel like negatively nelly, i'm always so pessimistic). i was charting at the computers yesterday when at the front desk, out of the corner of my eye, i saw a beautiful young woman that i recognized - but not quite. you see, this woman was healthy. she had a head full of curly hair. and she wore make-up. she looked only a bit like the patient i cared for long ago - the gal who was afraid of saline. anyway, i screamed, "what are you doing here?" and she screamed back, "i came to visit you CHRISTA!" she remembered my name. she came to visit ME. she didn't remember any other nurses - just me and the physical therapist (a young man who made her get out of bed every day even though she barely could, even though she didn't want to. and sometimes, they shook their booties in the hall, because that's how spicy she was and continues to be).
i cant' tell you how elated i felt seeing my patient pal, the one who offered to take me out on the town a year and a half ago. she wanted to buy me a beer on capitol hill - even though i don't drink. she said she'd show me a good time. she asked about my life. if i was still dating "that PA guy." and i asked how she was doing. if she was in remission (YES she is, yay). if she was still on immunosuppressants and steroids (yes she is, BUMMER). here's the good part, she's "healthy," for a three time transplant survivor. and best of all, she's HAPPY!
and i helped get her there. don't get to see that everyday.
i stepped away from nursing for a while! and i try (sort of) to keep this blog about my job.
as mentioned in my last post, i went to morocco in september. and then, just a week ago, i returned from thailand, bhutan, and cambodia - a most wonderful vacation and 31 days away from oncology nursing.
but i'm back. in full swing. that's how it always feels after vacation - like i never left. people are still sick. in fact, some of the same people who were in the hospital a month ago are still in the hospital now. some have discharged. and a few have died. sadly, one of my very favorite patients - nelson. on a side note, i did get to raise a prayer flag in his honor while trekking. and coincidentally, i learned when i was back to civilization, nelson died the day i honored him. i had no idea. his flag is blowing in the winds, close to the heavens, continually sending prayers.
now, on to some positive news, for once (i feel like negatively nelly, i'm always so pessimistic). i was charting at the computers yesterday when at the front desk, out of the corner of my eye, i saw a beautiful young woman that i recognized - but not quite. you see, this woman was healthy. she had a head full of curly hair. and she wore make-up. she looked only a bit like the patient i cared for long ago - the gal who was afraid of saline. anyway, i screamed, "what are you doing here?" and she screamed back, "i came to visit you CHRISTA!" she remembered my name. she came to visit ME. she didn't remember any other nurses - just me and the physical therapist (a young man who made her get out of bed every day even though she barely could, even though she didn't want to. and sometimes, they shook their booties in the hall, because that's how spicy she was and continues to be).
i cant' tell you how elated i felt seeing my patient pal, the one who offered to take me out on the town a year and a half ago. she wanted to buy me a beer on capitol hill - even though i don't drink. she said she'd show me a good time. she asked about my life. if i was still dating "that PA guy." and i asked how she was doing. if she was in remission (YES she is, yay). if she was still on immunosuppressants and steroids (yes she is, BUMMER). here's the good part, she's "healthy," for a three time transplant survivor. and best of all, she's HAPPY!
and i helped get her there. don't get to see that everyday.
Monday, September 8, 2014
"mini" vacation coming up!
i've taken a break from blog posts lately, mainly because it's been a crazy month, jam-packed with exciting and not-so-exciting things. just a quick run down...
- my umpteenth year of camp parkview nursing
- cole's completion of his year of rotations and his second and final year of PA school
- his return HOME to our lovely place in northgate (he's been living in random locales, wherever his clinicals have been)
- cole's graduation and a medical themed bbq celebration
- a day of bumbershoot
- too many work shifts and the rollout of barcode scanning all of our medications
- meeting two new babies in my friends' lives (tiny maggie and baby bennett)
- planning the adventure of a lifetime with cole in october
- doctors appointments (dentists, gynecologists, dad's cardiologist, etc, etc)
but here's the best news of all. i have ONE shift left before a mini-vacation. i say "mini" only because it is shorter than my vacation planned in october. but by no sense is it MINI. it's BIG. HUGE. and oh so exciting. after one 12 hour shift tomorrow, i leave wednesday for morocco! AFRICA! yippee. i feel like the luckiest girl alive. i get to meet one of my very best friends, cassie, and adventure in marrakech, morocco. it's kind of like a dream come true. cassie and i traveled together after we graduated from nursing school. we went to thailand, india, and nepal. it was how we became such great friends. and ever since then, EIGHT years ago, we've dreamed and planned and dreamed some more about creating new traveling memories. buying more random souvenirs. and eating questionable food that will either go down as the best meal we've ever had or the tastiest meal that made us the most sick in our lives!!!
may twelve hours tomorrow pass ever so quickly... so i can get to morocco ASAP.
- my umpteenth year of camp parkview nursing
- cole's completion of his year of rotations and his second and final year of PA school
- his return HOME to our lovely place in northgate (he's been living in random locales, wherever his clinicals have been)
- cole's graduation and a medical themed bbq celebration
- a day of bumbershoot
- too many work shifts and the rollout of barcode scanning all of our medications
- meeting two new babies in my friends' lives (tiny maggie and baby bennett)
- planning the adventure of a lifetime with cole in october
- doctors appointments (dentists, gynecologists, dad's cardiologist, etc, etc)
but here's the best news of all. i have ONE shift left before a mini-vacation. i say "mini" only because it is shorter than my vacation planned in october. but by no sense is it MINI. it's BIG. HUGE. and oh so exciting. after one 12 hour shift tomorrow, i leave wednesday for morocco! AFRICA! yippee. i feel like the luckiest girl alive. i get to meet one of my very best friends, cassie, and adventure in marrakech, morocco. it's kind of like a dream come true. cassie and i traveled together after we graduated from nursing school. we went to thailand, india, and nepal. it was how we became such great friends. and ever since then, EIGHT years ago, we've dreamed and planned and dreamed some more about creating new traveling memories. buying more random souvenirs. and eating questionable food that will either go down as the best meal we've ever had or the tastiest meal that made us the most sick in our lives!!!
may twelve hours tomorrow pass ever so quickly... so i can get to morocco ASAP.
Wednesday, July 30, 2014
life and death
i'm so glad i didn't have to go to work today. i don't think i could have done it. my heart broke a little more yesterday (i say "more" because it breaks at work frequently)... and i needed today to nurture my soul. aside from a dentist appointment at 8 o'clock (i HATE the dentist, especially at 8 o'clock), i've been really good to myself. coffee in my glass mug while surfing the internet and eating a croissant from my favorite bakery - bakery nouveau. some organizing in my kitchen. taking out the garbage, recycling, and compost (while these chores are not fun, they do leave my space smelling and looking better). i think i might go rock climbing this afternoon to sweat out some of my demons (or ya yas as my friend cassie would say). and tonight, i have a massage at 7:30. i'm hoping to relax, to get to that dream la-la-land state, and let the tension in my muscles and brain leave my body.
yesterday, i stood in the room of my 31 year old patient, with her mom, stepdad, sister, and friends. there were four nurses, one social worker, and a priest. and we watched, as a respiratory therapist disconnected a sweet, spunky soul from the ventilator. sometimes the human body has an incredible reserve. and sometimes, it is only medicine keeping a body alive. abigail took her last assisted breath as tears filled the room. the monitor screeched. her ekg flat-lined. what moments before looked like a pink, glowing soul, turned mottled, blue, and waxy right before my eyes. (cole and i spoke about life last night. when is it that the soul leaves the body? does it leave right away? or does it linger, trying to figure out where to go next and what just happened). i'd like to think that a little bit of abby's soul seeped into each of us in that room. that each of is better, stronger, and braver because we knew her and because we were there, holding her hands and touching her body during her final moments.
i was right, a few weeks ago, when i helped my patient escape from the hospital to feel normal, just for a few hours. it would be her last hours outside. the last time sunlight kissed her face. the last time oxygen made from trees would fill her lungs.
i feel honored to have been a part of both of those days - both abby's living and her dying. her life. and her death.
may her soul live on.
yesterday, i stood in the room of my 31 year old patient, with her mom, stepdad, sister, and friends. there were four nurses, one social worker, and a priest. and we watched, as a respiratory therapist disconnected a sweet, spunky soul from the ventilator. sometimes the human body has an incredible reserve. and sometimes, it is only medicine keeping a body alive. abigail took her last assisted breath as tears filled the room. the monitor screeched. her ekg flat-lined. what moments before looked like a pink, glowing soul, turned mottled, blue, and waxy right before my eyes. (cole and i spoke about life last night. when is it that the soul leaves the body? does it leave right away? or does it linger, trying to figure out where to go next and what just happened). i'd like to think that a little bit of abby's soul seeped into each of us in that room. that each of is better, stronger, and braver because we knew her and because we were there, holding her hands and touching her body during her final moments.
i was right, a few weeks ago, when i helped my patient escape from the hospital to feel normal, just for a few hours. it would be her last hours outside. the last time sunlight kissed her face. the last time oxygen made from trees would fill her lungs.
i feel honored to have been a part of both of those days - both abby's living and her dying. her life. and her death.
may her soul live on.
Thursday, July 17, 2014
a wedding at work
yesterday was supposed to be an ordinary day. i had a four hour class in the morning for work. nothing special, just learning our new method of medication administration using a scanning "gun" to prevent medication errors. it was lame. but after class, i went up to my unit to see two of my colleagues who were having their very last days on 8NE. my co-workers are dropping like flies, leaving the in-patient nursing world for lives in the out-patient world - all because what we do on 8ne is heavy. challenging. heart-breaking. overwhelming. and sometimes, AMAZING. like so amazing, that it's hard to deal with. hard to hear. and hard to be a part of.
anyway, when discovering that my unit was short a secretary, i decided to stay on for over-time only if guaranteed to NOT work with patients. isn't that horrible? i had it in me to answer phones, but not to do patient care. so, i stayed for 4 hours in my flip-flops. and it turned out to be one of my most jaw-dropping, heart-warming days at work i've had in 8 years.
are you ready for this story. get the kleenex.
there is a 25 year old woman in our ICU. last week she went to the ER with abdominal pain only to find that she has a terminal, metastatic cancer and has days to weeks to live. crazy, right? to be healthy one week and dying the next. at 25. at about 2:50, my charge nurse said to me, "christa, i need your help. we're planning a wedding. the 25 year old patient wants to marry her boyfriend before she dies in the next 24 hours."
what transpired in the next 2-3 hours is unbelievable. it's the perfect example of teamwork. how one person's vision and efforts can make a difference in a BIG way. and how 20 people, working together, can make a life-changing things happen.
one nurse started making flowers petals out of red construction paper to throw during the "ceremony."
another called a bridal store to donate a veil and gloves (the bride was too sick to stand and/or wear a wedding dress),
the nurse practitioner in charge of the patient's care called friends and colleagues who donated their money and time. i saw her at the edge of the bed, whispering to the patient, "how have you envisioned this day? what can we do to make it special?"
a pulmonary attending brought her photographer husband to the hospital to take wedding photos. on the way, they stopped at a store and bought a wedding cake.
i called a local florist, explained the situation, and within 2 hours the owner of the store personally delivered a bouquet, a boutineer, and lavender rose petals.
my friend c called her husband and said "i need you to bring the pink champagne from our fridge to the hospital ASAP. we have a patient getting married; she's going to die soon." within minutes, c's husband was standing on our unit, champagne and glasses in hand.
the patient's pastor from her church arrived to carry out the ceremony. our hospital chaplain attended and brought candles and bibles and more flowers.
the patient's nurse washed her hair, de-hospitalized the room, and not only turned up machines to help her breathe and turned down machines to stop beeping and squeezing and chirping, but also, helped to make everything look special and appear calm.
there were numerous family members and friends. hospital staff. parents of the bride. parents of the groom.
words can't describe what it felt like on our unit. in some ways, it felt frantic - what takes most brides months to pull off happened in a few hours. and in other ways, it felt magical. there were tears. there was shock. our new manager assisted and turned her eye to the real flowers (that are not allowed on our unit), the real candles, and the champagne. we wrote thank you notes. and patted each other on the back for jobs well done.
this 25 year old will never live to see 26. she will not get to fulfill her dream of becoming a nurse. she will never get to be a parent. she won't grow old with her husband. but she will die knowing that she is united with the love of her life. that people she doesn't even know worked hard to make one of her dreams come true. that sometimes miracles happen - in different ways than you hope - and they are beautiful!
anyway, when discovering that my unit was short a secretary, i decided to stay on for over-time only if guaranteed to NOT work with patients. isn't that horrible? i had it in me to answer phones, but not to do patient care. so, i stayed for 4 hours in my flip-flops. and it turned out to be one of my most jaw-dropping, heart-warming days at work i've had in 8 years.
are you ready for this story. get the kleenex.
there is a 25 year old woman in our ICU. last week she went to the ER with abdominal pain only to find that she has a terminal, metastatic cancer and has days to weeks to live. crazy, right? to be healthy one week and dying the next. at 25. at about 2:50, my charge nurse said to me, "christa, i need your help. we're planning a wedding. the 25 year old patient wants to marry her boyfriend before she dies in the next 24 hours."
what transpired in the next 2-3 hours is unbelievable. it's the perfect example of teamwork. how one person's vision and efforts can make a difference in a BIG way. and how 20 people, working together, can make a life-changing things happen.
one nurse started making flowers petals out of red construction paper to throw during the "ceremony."
another called a bridal store to donate a veil and gloves (the bride was too sick to stand and/or wear a wedding dress),
the nurse practitioner in charge of the patient's care called friends and colleagues who donated their money and time. i saw her at the edge of the bed, whispering to the patient, "how have you envisioned this day? what can we do to make it special?"
a pulmonary attending brought her photographer husband to the hospital to take wedding photos. on the way, they stopped at a store and bought a wedding cake.
i called a local florist, explained the situation, and within 2 hours the owner of the store personally delivered a bouquet, a boutineer, and lavender rose petals.
my friend c called her husband and said "i need you to bring the pink champagne from our fridge to the hospital ASAP. we have a patient getting married; she's going to die soon." within minutes, c's husband was standing on our unit, champagne and glasses in hand.
the patient's pastor from her church arrived to carry out the ceremony. our hospital chaplain attended and brought candles and bibles and more flowers.
the patient's nurse washed her hair, de-hospitalized the room, and not only turned up machines to help her breathe and turned down machines to stop beeping and squeezing and chirping, but also, helped to make everything look special and appear calm.
there were numerous family members and friends. hospital staff. parents of the bride. parents of the groom.
words can't describe what it felt like on our unit. in some ways, it felt frantic - what takes most brides months to pull off happened in a few hours. and in other ways, it felt magical. there were tears. there was shock. our new manager assisted and turned her eye to the real flowers (that are not allowed on our unit), the real candles, and the champagne. we wrote thank you notes. and patted each other on the back for jobs well done.
this 25 year old will never live to see 26. she will not get to fulfill her dream of becoming a nurse. she will never get to be a parent. she won't grow old with her husband. but she will die knowing that she is united with the love of her life. that people she doesn't even know worked hard to make one of her dreams come true. that sometimes miracles happen - in different ways than you hope - and they are beautiful!
Thursday, July 10, 2014
my patient "escaped"
i helped to plan an escape for a patient of mine this week. perhaps it's because i too once escaped from the hospital while i was a patient and still attached to my IV pole or maybe it's just because this gal is cool (and so am i?!?) that i relate so well. she's 31. younger than me. and she's been dating a man for maybe two years total (just like cole and me). they're unmarried. and in love. or once in love. and i can't help but to put myself in her shoes (TOMS) and wonder what it would be like. how would i feel. what would happen to my relationship. and my future (if i made it to the future).
this gal has had a rough go. or as one of my other super young patients put it, she's won the "anti-lottery." like the shittiest prize ever. not only cancer - lymphoma. but lymphoma with brain tumors. debilitating brain tumors. WTF? why should a 31 year girl get that? when she's in school. and hoping to do something amazing with her life. and feeling excited about love and marriage and family.
(side note: my heart broke for her for the like 27th time as she was telling her mom about the different kinds of chemotherapy she's going to get. while describing one she said, "this is the one that destroys my ovaries." her mom cringed and not to be mean, reminded her daughter that she's already in menopause, from the other chemo she has received in the last 10 months. her mom, who also experiences hot flashes and the un-sexy-ness of dry vaginas, said to her sweet daughter, "we'll get you a baby somehow. don't you worry.")
UGH.
anyhoo. my patient will likely be in the hospital for the next month or more. and of course, i want for her to do well. but my experience tells me that she won't. that the nice ones always do poorly. and that with her disease, her prognosis is VERY BAD. like, she won't get out of the hospital E-V-E-R, bad. so, when her doctors said that it would be okay to sneak out of the hospital for a little shopping and lunch adventure, i was in full support. insurance companies don't allow patients to come and go. and of course, if something bad happened to her while she was out, her insurance would flip out, likely not cover her hospital stay, and WE would be at fault and shit up a creek. so the "escape" had to go well.
i felt like an accomplice to a crime. or like her mother. although her real mom was in on the crime also, i was the nurse. the responsible one. i had to think of everything. the wheelchair she had to steal - to prevent falls. the hat - to protect her bald, radiated head. the pain medication i had to tuck into her pocket - in case her persistent headache became too unbearable. the timing of her other medications to keep her safe.
what was supposed to be a two hour pass turned into four plus hours. and although i started to worry, i was elated when she returned. my patient was happy. she ate lunch in the sunshine. she bought make-up to fancify her face. and jewelry to adorn her cancer ridden body. she gabbed with her sister about clothes and shoes and retail. and even though she didn't say it, i think she felt normal. for a second.
instead of dying in a hospital bed while the rest of the world passes her by, she got to participate. for four short hours. and i'm so happy that i could help.
this gal has had a rough go. or as one of my other super young patients put it, she's won the "anti-lottery." like the shittiest prize ever. not only cancer - lymphoma. but lymphoma with brain tumors. debilitating brain tumors. WTF? why should a 31 year girl get that? when she's in school. and hoping to do something amazing with her life. and feeling excited about love and marriage and family.
(side note: my heart broke for her for the like 27th time as she was telling her mom about the different kinds of chemotherapy she's going to get. while describing one she said, "this is the one that destroys my ovaries." her mom cringed and not to be mean, reminded her daughter that she's already in menopause, from the other chemo she has received in the last 10 months. her mom, who also experiences hot flashes and the un-sexy-ness of dry vaginas, said to her sweet daughter, "we'll get you a baby somehow. don't you worry.")
UGH.
anyhoo. my patient will likely be in the hospital for the next month or more. and of course, i want for her to do well. but my experience tells me that she won't. that the nice ones always do poorly. and that with her disease, her prognosis is VERY BAD. like, she won't get out of the hospital E-V-E-R, bad. so, when her doctors said that it would be okay to sneak out of the hospital for a little shopping and lunch adventure, i was in full support. insurance companies don't allow patients to come and go. and of course, if something bad happened to her while she was out, her insurance would flip out, likely not cover her hospital stay, and WE would be at fault and shit up a creek. so the "escape" had to go well.
i felt like an accomplice to a crime. or like her mother. although her real mom was in on the crime also, i was the nurse. the responsible one. i had to think of everything. the wheelchair she had to steal - to prevent falls. the hat - to protect her bald, radiated head. the pain medication i had to tuck into her pocket - in case her persistent headache became too unbearable. the timing of her other medications to keep her safe.
what was supposed to be a two hour pass turned into four plus hours. and although i started to worry, i was elated when she returned. my patient was happy. she ate lunch in the sunshine. she bought make-up to fancify her face. and jewelry to adorn her cancer ridden body. she gabbed with her sister about clothes and shoes and retail. and even though she didn't say it, i think she felt normal. for a second.
instead of dying in a hospital bed while the rest of the world passes her by, she got to participate. for four short hours. and i'm so happy that i could help.
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