Tuesday, June 29, 2010
the best gift
i had the pleasure of delivering potentially life-saving stem cells to a patient today. he was alone in his room when i barged in with 2 other nurses and a secretary to sing happy birthday. it's a tradition that some of us nurses carry on. and although none of us has a particularly good singing voice, it's a nice way to celebrate a new birth of sorts. my patient was very thankful and excited, disappointed that his wife missed the commotion, but excited nonetheless. thankfully, his wife and sister arrived within a few minutes - before i began to transfuse the cells into his body. we took the obligatory photos! my patient's sister is the donor; she donated her cells yesterday and was able to hold her bag of cells and actually hand them to her brother. as she did this and we documented it on film, i said, "i bet that's the best gift you ever gave!" there were huge hugs and giant tears from all. and i left feeling thankful that some days my job is full of happiness and hope, wishes and dreams.
Monday, June 21, 2010
a good night's sleep
a 12.5 hour day is always long. when it's a busy day, 12.5 hours of busy-ness is exhausting. and when it is slow, 12.5 hours of watching the clock tick is agonizing. a good night's sleep can make all the difference. so imagine, work on very little sleep can be quite miserable! last night, i got less than 5.5 hours of sleep. but when the reason for insomnia is fun and exciting, 12.5 hours isn't so bad. i had a date last night with a boy and without spilling any details (of which none are THAT juicy), it was a very nice evening.
today was unusual though... i must say. at times it was slow, but never too dull. i had two non-transplant patients. the first patient had prostate cancer and had been admitted for sepsis (a systemic blood infection); he was to be discharged with a foley catheter and required teaching. the second was a substance abuse user post liver resection and hernia repair with severe abdominal pain, distention, and constipation. despite my disinterest in either gentleman, somehow, i found my way into both men's nether regions. not my idea of fun at work.
let's suffice it to say i had to change a foley catheter (and for those of you that don't know what that is - imagine a tube in a man's most private of parts, used to drain urine, and stabilized by a balloon inflated in the bladder - ow!) and give a suppository (you do know what this is, right? a wax bullet shoved into the other most private of parts with plenty of lubricant).
my job is so strange! i never cease to be amused by nursing tasks... thankfully these two chores did not require much concentration, just professionalism and humility (which i can fake on 5.5 hours of sleep).
today was unusual though... i must say. at times it was slow, but never too dull. i had two non-transplant patients. the first patient had prostate cancer and had been admitted for sepsis (a systemic blood infection); he was to be discharged with a foley catheter and required teaching. the second was a substance abuse user post liver resection and hernia repair with severe abdominal pain, distention, and constipation. despite my disinterest in either gentleman, somehow, i found my way into both men's nether regions. not my idea of fun at work.
let's suffice it to say i had to change a foley catheter (and for those of you that don't know what that is - imagine a tube in a man's most private of parts, used to drain urine, and stabilized by a balloon inflated in the bladder - ow!) and give a suppository (you do know what this is, right? a wax bullet shoved into the other most private of parts with plenty of lubricant).
my job is so strange! i never cease to be amused by nursing tasks... thankfully these two chores did not require much concentration, just professionalism and humility (which i can fake on 5.5 hours of sleep).
Friday, June 11, 2010
read at own risk: a few gross descriptions
i graduated from nursing school four years ago! and i can hardly believe it. i've been working on the stem cell transplant unit for 3 years and 8 months. i will admit, it took me a VERY long time to feel comfortable as a nurse. hell, i didn't feel safe for over a year. but it has finally begun to feel natural.
i can handle most situations that are thrown at me - related to transplant that is. i can treat the most severe cases of mucositis; i've seen people vomit the lining of their esophagus. i am not bothered by 4 liters of diarrhea on a 12 hour shift. and i can administer 8 blood products to three different patients before lunch time. but throw something new at me, something i don't see very often, if ever, and i regress.
this morning, in report, i learned that my patient had two holes of which i am unfamiliar. perhaps that's an inappropriate or strange description. but let me explain. my patient had both a PEG tube (a hole on the belly that leads directly to the stomach for feeding) and a tracheostomy (a hole in the neck that leads to the airway to allow for breathing). these are two "holes" that i have very little experience with and instantly, i noted my anxiety and blood pressure quickly increasing. in fact, i voiced my discomfort during report, in front of the entire staff, perhaps in an attempt to ask for help... but maybe, just maybe, to see if someone else was up for the challenge!
my 67 year old male patient has laryngeal (neck) cancer. he's had parts of his tongue removed, in addition to tumors in his neck and throat. he cannot speak. and now, he breathes through a hole in his neck that is kept open by a plastic device. all of that works fine and good when he is "healthy." but add some pneumonia to an already sick man and that airway fills up with gunk fast. i'll spare you ALL of the details, but imagine the most vile and putrid smelling substance. it was hard to even be in the same room as the man because of the stench, let alone up close, in his face, performing tasks i do not feel comfortable with to help him breathe. oh, what an interesting day.
i learned how to suction a patient. it's not that hard. it's just new. and at first, new things are scary to me. but i was reminded, once again, how vulnerable my patients are. this man, who is dying of cancer, cannot speak. he has no words to voice his thoughts, feelings, and emotions. yes, he can write with pen and paper, but imagine how exhausting, challenging, and unsatisfying that would be. i so often get caught up in my own feelings, my own fears and concerns, that i forget how brave my patients are.
i can handle most situations that are thrown at me - related to transplant that is. i can treat the most severe cases of mucositis; i've seen people vomit the lining of their esophagus. i am not bothered by 4 liters of diarrhea on a 12 hour shift. and i can administer 8 blood products to three different patients before lunch time. but throw something new at me, something i don't see very often, if ever, and i regress.
this morning, in report, i learned that my patient had two holes of which i am unfamiliar. perhaps that's an inappropriate or strange description. but let me explain. my patient had both a PEG tube (a hole on the belly that leads directly to the stomach for feeding) and a tracheostomy (a hole in the neck that leads to the airway to allow for breathing). these are two "holes" that i have very little experience with and instantly, i noted my anxiety and blood pressure quickly increasing. in fact, i voiced my discomfort during report, in front of the entire staff, perhaps in an attempt to ask for help... but maybe, just maybe, to see if someone else was up for the challenge!
my 67 year old male patient has laryngeal (neck) cancer. he's had parts of his tongue removed, in addition to tumors in his neck and throat. he cannot speak. and now, he breathes through a hole in his neck that is kept open by a plastic device. all of that works fine and good when he is "healthy." but add some pneumonia to an already sick man and that airway fills up with gunk fast. i'll spare you ALL of the details, but imagine the most vile and putrid smelling substance. it was hard to even be in the same room as the man because of the stench, let alone up close, in his face, performing tasks i do not feel comfortable with to help him breathe. oh, what an interesting day.
i learned how to suction a patient. it's not that hard. it's just new. and at first, new things are scary to me. but i was reminded, once again, how vulnerable my patients are. this man, who is dying of cancer, cannot speak. he has no words to voice his thoughts, feelings, and emotions. yes, he can write with pen and paper, but imagine how exhausting, challenging, and unsatisfying that would be. i so often get caught up in my own feelings, my own fears and concerns, that i forget how brave my patients are.
Monday, June 7, 2010
elevator
so, my last post was about the stairs. i bragged about how many "sets" i had completed in a 12 hour shift, just for fun! well, today... today was not a stair day. i don't think i took the stairs once. i was TIRED. the elevator was calling me. it called in the morning on my way to work, when i went downstairs with a friend to get a 10 cent peppermint patty, and in the evening, on my way down and out of the hospital! big mistake!
i had waited for some of my fellow nurses to finish report so that we could walk to the garage together; it's always more fun to walk with company. so at 7:45, later than i like to stay at work, six of us got on the elevator to descend from the 8th floor to the 3rd. why we didn't all traipse down the steps, i cannot say. but, as we waited for the slow elevators to ding and pick us up, we talked about how one of our colleagues had recently gotten stuck for 15 minutes. just then, we piled in the elevator, and it began to plummet; the elevator shuttered to a stop and started to vibrate. it was crazy! we all looked at one another as if the hospital was haunted. how could that happen, especially just right after we had talked about it. thankfully, none of us panicked... and thankfully, there were two bright and strong gentleman nurses who pried the doors open. or perhaps i would still be there!
i had waited for some of my fellow nurses to finish report so that we could walk to the garage together; it's always more fun to walk with company. so at 7:45, later than i like to stay at work, six of us got on the elevator to descend from the 8th floor to the 3rd. why we didn't all traipse down the steps, i cannot say. but, as we waited for the slow elevators to ding and pick us up, we talked about how one of our colleagues had recently gotten stuck for 15 minutes. just then, we piled in the elevator, and it began to plummet; the elevator shuttered to a stop and started to vibrate. it was crazy! we all looked at one another as if the hospital was haunted. how could that happen, especially just right after we had talked about it. thankfully, none of us panicked... and thankfully, there were two bright and strong gentleman nurses who pried the doors open. or perhaps i would still be there!
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