june is going to be better

the last couple of weeks at work have been hard. i'm proud to say, i've not missed a day. i've even done two 4.5 hour overtime shifts (because i keep spending money - retail therapy). but gee is it hard to care for others when you feel sick yourself. when your life is in shambles. when everything is unknown.

this weekend, i actually fell asleep at my computer while charting. the twenty minute nap saved me from more breakdowns during the remainder of my shift. i had already cried a few times in patient rooms. once especially hard when a male, nurse friend of mine asked point blank, "what's going on with you?" i couldn't help but spill the beans. "cole is struggling in our relationship. he's terrified. and i'm not sure this is going to end well." justin said in a kind, sympathetic tone - "don't let this break you christa." i said, "oh, you mean, don't feel pathetic and worthless and unloveable." and he said, "exactly." we were washing an intubated, mildly sedated man as tears rolled down my cheeks.

in other news, i've had some crazy shifts lately. two weekends ago i got floated to another unit. i was completely out of my element. and of course, the day was a shit show. i had a quadriplegic patient with blood pressures in the 210/110s (for those of you that don't know, this is an emergency). and another one of my patients returned from a smoke break outside without the IV pole that he had previously been attached to, bleeding hepatitis B AND C blood all throughout the hospital because he had pulled out his IV and the heparin gtt attached to him (a medicine that was helping to save his life from a potentially lethal blood clot in his lungs). once the mess was cleaned up, the same patient decided he hated me and threw a tantrum at the front desk, asking to be transferred to another hospital where the care was better and the staff listened to patients' needs. the bright side, i made 1.50 more per hour because i was floated. note my sarcasm. NOT ENOUGH.

i'm hoping june is better. i'm working less. i have two 8 hour class days where instead of caring for humans, i will be sitting on my rump, learning about death and dying. sounds depressing, but this is right up my alley. i'm also running my first half marathon. and i plan to fill my time with life-affirming things and amazing friends. june, here i come.

cancer is a reminder

there's nothing like CANCER to remind you that your own life ain't so bad.

i've been having a really rough time these last few weeks. the relationship that i have put my whole heart into for two years is dissolving before my eyes. my future looks different. bleak. sad. and lonely. and although i don't know what's going to happen in the long run ("there is no crystal ball," my partner says to me), i feel scared and devastated.

but then, there's work. life must go on, right? so, i force myself out of bed in the morning. and i show up, faking bright eyed and bushy tailed as best as i can at 7AM with swollen eyes and a broken heart. i do my best hollywood impression of a cheerful, kind nurse and take care of a woman my age. a mother of two. she had a transplant almost one year ago and is now facing the effects of skin graft versus host disease and long term steroid use. her once healthy body now looks old. haggard. her skin is beat red, like that of a burn victim. she is peeling everywhere. her hands are shedding what looks like gloves of skin.

mostly she lies in bed all day. sometimes crying. sometimes angry. but when she asked to take a shower (one of my least favorite things to help someone with), i decided to give it my all. we carefully readied her for a shower. i placed a towel on the bench seat. we warmed up the bathroom with steamy water and the heat lamp. and i left her alone, hoping she could wash away some of the hurt.

but a few minutes later, as i was just a few feet away from her, making her bed, i heard a sob. nervous that she had fallen or hurt herself, i busted into the bathroom to find a woman, curled in a ball, crying because she is so weak that she cannot even hold the shower nozzle. "it's okay, we'll do this together," i said. as if it is no bid deal. as if lots of 30 something year olds can't shower on their own. what proceeded was a very intricate ritual. scrubs with cetaphil. then shampoo. coconut oil. and burts bees lotion. baby powder in creases. and lace panties. all the intimate details we carried out together, because she is vulnerable. because likely, she is dying.

by the end of the 45 minute ordeal, i was sweatier than if i had run a marathon. in my plastic gown, glove, and masks, rivulets of sweat dripped down my healthy body. my broken heart ached, but instead of aching for myself, it ached for her. for pain. for illness. for families torn apart by tragedy.

CANCER is a good, horrible reminder.

hospital birthdays

my patient celebrated her second birthday at UWMC. to be born there is okay. lots of people celebrate their first birthday in a hospital. but a second, well... that's just a bummer. and when i say a second birthday, i don't mean a regular birthday. i mean a second "birth" day. like a re-birth. a second chance at life with a hematopoeitic stem cell transplant because otherwise you will surely die of cancer.

i gave a 30 year old two tiny bags of umbilical cord stem cells yesterday. and when my colleagues and i sang happy birthday to her, she and her mom cried. a few minutes later, my patient's mother said to me, "you know, she is my miracle, million dollar baby. she was not only born here. she was saved here. she was born at 25 weeks and spent her first days, weeks, months in the NICU. now, we are hoping you will save her here again."

psych nurse?!?

yesterday, a 39 year old woman died on our unit. she was diagnosed with AML (acute myelogenous leukemia) on friday night after an admission to the ER for SOB (shortness of breath, not son-of-a-bitch). i've seen this before. it's not something that should surprise me. cancer can sometimes be acute, instead of chronic. and sadly, it can kill people very suddenly. but i can't help but continue to be AMAZED that this woman, this mother of four, was "fine" last wednesday and today, she's dead. her children are motherless. her teenage children will be raised by her sisters and her 6 month old was taken into CPS when the aunties said they were unable to take in a baby.

i talked to cole last night on the phone (he's living in puyallup now for the next 4 months, ugh) and shared the story. and i reminded him (and myself) that it makes sense that i have irrational thoughts sometimes. that when i have cramps, i think i have ovarian cancer. or when i feel exhausted for a few days, it must be mono. my coughs turn into tuberculosis. and my bruises must be a sign of leukemia. i see these things happen. on a regular basis. to young, previously healthy people. my norm at work is to see the worst of the worst.

then, sometimes, every now and then, i get to care for a wacko! and i laugh. at the same place i sometimes find myself crying. yesterday, i transferred the same whack job from my last post to the psych unit. finally, they were willing and able to take her. and although she threw her feces at someone in the morning, she and i laughed some more in the afternoon. she tried to work her "magic" over on me, refusing to wear pants or get into a wheelchair. saying she would pee on herself if i didn't hurry the elevator. and telling me that once in a vegas hospital, she had a queen sized bed. i got her to laugh when i asked if she could gamble there too and i told her she must be mistaking the "hospital" with the hilton.

when i left her in a place much better suited to handle her needs, i almost longed to be a psych nurse. there is no cancer there. and although people are sad, there is less dying. and maybe, just maybe, more laughing.

whack jobs

spring is springing. birds are chirping. and light is seeping in through my windows. i am enjoying a lazy sunday morning on my couch - reading a new book (more like trying to stay awake), internet surfing/shopping for little girls in my life (emerson's birthday is coming up), and trying to motivate myself to get to the gym (i don't know why, but despite this beautiful weather, i'd rather run on the treadmill - something is not right with me).

i feel like i've been working a lot lately. perhaps because i did a 4.5 hour stint of overtime this week. or because my twelve hours shifts have been split up instead of in a row (which gives me bigger chunks of time off). but even though i've been spending lots of time nursing, i don't feel the same kind of burn out or exhaustion that i do a lot of the time. i work tomorrow. and i don't really want to go. but i have this refreshing sense of peace that whatever is thrown at me, i might handle with grace (i've probably jinxed myself).

i've taken care of some very sick patients recently. and although i don't always enjoy the intensity, it feels good to know that a job is well done. that my patients are safe under my care.

this week, i had the "pleasure" of caring for a psych patient. she had a transplants YEARS ago and because of that wound up on our floor. but her needs are not transplant related. they are most definitely psych related. and although i am not equipped or trained to help her psych needs, i sure had fun trying. is that bad? i don't mean to make light of a sad and difficult situation. and certainly, i don't mean to be disrespectful of mental health needs and complexities; god knows, i have my own issues. but this woman was REALLY crazy. she's in her 60s, but throws tantrums like the most stubborn of two year olds. she has a stuffed bear named "woof, woof." and when i fed her her pills in ice cream, it was never firm enough. i couldn't help but play along with some of her neuroses. "oh, you want your covers pulled up higher for the 107th time, okay?" as i pulled them up over her face. "oh, this ice cream is not hard enough. well, sorry, we don't have ice cream rocks!"

by the end of the day, this lady and i were laughing. at each other i think. with one another hopefully. i found out her nickname when she was a child - glory-bug. and we talked about easter egg dying - which she claims she hasn't done since she was 5.

i didn't do a perfect job for this woman. she still screamed bloody murder at times throughout the day. and she told her team of doctors to "get the F*&% out of her room." but at least she never told me that. at least we got along. at least we respected one another. from one whack job to another!

unsung heroes

last week i had the ENTIRE week off. it was a spring break of sorts that i got to celebrate with my my student boyfriend, cole. we went to san francisco and walked miles and miles. and ate delicious chinese treats from non-english speaking bakeries. and like bad medical people, we allowed the sun to kiss our cheeks and chests, soaking up the surprising sun without sunscreen.

but now, i'm back. back to seattle. back to work. cole is back in school. and already burnt out of his new rotation - outpatient GI. he's ready to be done with school. and i'm ready to retire! ha.

in all seriousness though. i had a good work week. i worked 36 hours and although it was busy, it felt productive. i got things accomplished with my patients. i was a good nurse. better than my tired, burnt-out, cynical self. i could feel myself rejuvenated from days of reading books. and time spent on my couch. and it didn't hurt that i cared for two very kind men. one who wore fluorescent pink glasses (and joked that they were in support of breast cancer, but were really just an expensive mistake when he ordered prescription glasses over the phone) and the other who at 65, has lost all of his independence because of a transplant we gave him 4 years ago.

in just two 12 hour shifts (i only cared for this patient 2 of my 3 work days), i found myself falling "in love" with him. i don't mean the kind of love i feel for cole. i mean the kind of love a nurse feels for a patient. the kind of love that means, even when i'm not at work, i think constantly about them. the kind of love that means, i really want what's best for this man - whether that means he lives or dies. the kind of love that helps me appreciate my role as nurse and reminds me i am good at what i do.

this man's medical history is complex to say the least. he's had two transplants. and suffered from years of graft versus host disease. and now, although in remission from his cancer, will most likely die from his GVHD - a side effect from his treatment. i've never seen anything like it - skin so taut that his lungs can't expand enough to breathe. skin so rigid and inflexible that his arms and legs are permanently bent, contracted, inhibiting his ability to scratch his own nose, wipe his own behind, and be the independent man he longs to be.

i think what endeared me to this man was his willingness to be vulnerable. he admitted that he was afraid. he admitted his weaknesses and found the courage to ask for help. when his wife or i assisted him with the simplest of tasks, he thanked us. he spoke of the many hardships he has faced with grace. and continued on with the bravery and determination of a hero.

i think my patients are heros. super men and super women, battling life one day at a time. one precious day at a time. not wasting any moments between breaths.

handprints

you'd think after years of working on the same unit, with the same kinds of patients, i would have done most things by now. it's true. i've administered numerous kinds of chemotherapy, given drugs that i've never heard of, put my fingers in places i wish i hadn't... you get the idea. but last week, i did something i've never done before. and although it was a learning experience, i found it kind of weird. one of those moments where you want to laugh, but laughing would be inappropriate.

i helped a fellow nurse paint the hand of her patient with jet-black ink using a roller brush and made handprints on pretty paper. it was like an art project, for three year olds. only i'm not a pre-school teacher and my subject was not three. she was in her sixties. breathing with the help of a ventilator. her arms were flaccid and her fingers squeezed together tightly. her family members watched us, as if we had done this before. as if we should be good at arts and crafts with nearly dead people. and instead, we smudged paint. we had to make a few before we got any that looked like hands. and even the good ones looked like a preschooler had done it.

but to my amazement, the family loved it.

our unit is trying to get better at death and dying. thank god! this kind of improvement is right up my alley. i wish doctors and nurses were all comfortable talking about that journey. i wish we could light candles and sing. when parents of small children are dying, i wish we helped tape video messages or write letters. but instead, we're making handprints. and i guess it's a good start.

even though it felt weird to me.