i feel too grown up! i'm 30 years old and already, i'm taking care of my parents!
don't get me wrong. i love being there for them; it's a privilege really. after all the parenting and support they've given to me, it's certainly time for me to give back. but at the same time, sometimes i wish this wasn't happening until i was 50 and they were 80.
my poor little dad somehow developed a cyst on his knee. of course, it's on the leg that has no veins (because they used them for his 7 grafts during his bypass surgery 13 years ago); hence, he's extra swollen. and he's in excruciating pain. i found him hobbling around the house this morning and had to help him put his socks on his feet and his pants around his ankles. of course, he thinks he's "healthy" and "fit" enough to go to work today. so he's gonna hobble, hop, skip, and jump around the kitchen at his restaurant. what a crazy fool!
this morning is a bit different than the typical "escort" i provide. instead of bringing my dad to some cardiologist or wacky procedure, i'm with my mom. she's having a colonscopy. ugh. poor little thing. without need for description, we all know what that is and where they go. makes me cringe and clench just thinking about it. i'm her designated driver for after the procedure when she's all drugged up on fentanyl and versed. should be an entertaining morning!
just another day in the life of christa... nurses, doctors, waiting rooms, procedure suites, gowns, gernies, drugs, IVs, blood, gas, and a whole lot of poop!
Wednesday, June 29, 2011
Thursday, June 16, 2011
a week of chaos
i didn't write last week because it was just too CRAZY!
now that the events have come and gone and i am more rested, i don't feel like "reflecting" on the chaos. i'm trying to get over it, not delve deeper. but i will share the "highlights."
monday of last week, i had to make that scary phone call to the mother of a 21 year old. it overwhelmed me in some way and i really didn't like being the bearer of bad news.
that afternoon, i also admitted a patient with low blood pressures - 80s/40s. She was unable to get in and out of bed on her own due to hypotension and new-onset bilateral lower extremity weakness. try safely getting a hefty woman with limp legs to the toilet after a failed attempt at a bedpan.
tuesday and wednesday i had off from work. and to be honest, i don't remember much of what transpired. but i know it involved a few tears, a visit to my therapist, and trying to get out of a date with a foreigner that reminded me of my father (poor english, balding, and black socks).
thursday of last week was the most intense. my dear, dear friend's uncle had had surgery prior in the week. and sadly, to our shock and dismay, he coded early that morning due to a swollen airway. cassie called me while i was at work to share the news. uncle john had been emergently intubated and placed in the ICU. but it didn't look good.
just by chance, my mother also had a good friend in the ICU. i know her well - when i was little, she drove my carpool and her kids and i played together making gymnastic routines in the lawn and swimming in the lake. she had donated a kidney to her sister-in-law. so while visiting and supporting cassie, i decided to visit my mom's friend also - just to check in. she was doing satisfactorily. so imagine my disbelief when i heard a code blue called in her room just hours later. could i really know two people teetering on the brink of life or death in the same unit of the same hospital just rooms away? yup. as i was running down there to offer support to her family, i ran into my mom's friend's husband. he was clueless as to what was happening. so, of course, i had to take it upon myself to share the news and walk him into the scene. 15 doctors, code cart, chaos. to make a long story short, turns out, she's okay.
that same evening though, while still working my 12 hour shift , just to keep things exciting, my fourth patient of the day "decided" to fall at 6 PM. a STAT head CT and incident report ensued. and my day ended in a blur. if i were a drinker, i would have kicked back a few!
friday brought sadness. it was determined that cassie's uncle had no brain activity. so in the morning, his courageous family decided to withdraw care and allow him to pass. an adventurous, inspirational, and beloved man died that day. a family lost their father, brother, uncle, and friend - and the world will never be the same.
because someone/something had decided that i was superwoman and could handle more...
to end my work week, one of my three patients on friday evening began to suffer from chest pain. so instead of lazily charting, spacing out at a computer screen, and taking the time to say goodnight to each of my patients, i ran around the unit like a chicken with my head cut off. there were numerous emergency meds, STAT orders, tests, and blood draws. it's a strange thing to watch someone in pain, perhaps having a heart attack in front of your very eyes, and to be unable to stop it. and it's even weirder to go home before the conclusion, not knowing how the story ends.
saturday morning, i went hiking. ALONE. i spent 4 hours outside in misty rain and clouds. i had brought music to listen to, in case i needed "company." but truly, the noise was too stimulating. i needed silence. i needed to breathe in fresh air and blow out a week of chaos.
now that the events have come and gone and i am more rested, i don't feel like "reflecting" on the chaos. i'm trying to get over it, not delve deeper. but i will share the "highlights."
monday of last week, i had to make that scary phone call to the mother of a 21 year old. it overwhelmed me in some way and i really didn't like being the bearer of bad news.
that afternoon, i also admitted a patient with low blood pressures - 80s/40s. She was unable to get in and out of bed on her own due to hypotension and new-onset bilateral lower extremity weakness. try safely getting a hefty woman with limp legs to the toilet after a failed attempt at a bedpan.
tuesday and wednesday i had off from work. and to be honest, i don't remember much of what transpired. but i know it involved a few tears, a visit to my therapist, and trying to get out of a date with a foreigner that reminded me of my father (poor english, balding, and black socks).
thursday of last week was the most intense. my dear, dear friend's uncle had had surgery prior in the week. and sadly, to our shock and dismay, he coded early that morning due to a swollen airway. cassie called me while i was at work to share the news. uncle john had been emergently intubated and placed in the ICU. but it didn't look good.
just by chance, my mother also had a good friend in the ICU. i know her well - when i was little, she drove my carpool and her kids and i played together making gymnastic routines in the lawn and swimming in the lake. she had donated a kidney to her sister-in-law. so while visiting and supporting cassie, i decided to visit my mom's friend also - just to check in. she was doing satisfactorily. so imagine my disbelief when i heard a code blue called in her room just hours later. could i really know two people teetering on the brink of life or death in the same unit of the same hospital just rooms away? yup. as i was running down there to offer support to her family, i ran into my mom's friend's husband. he was clueless as to what was happening. so, of course, i had to take it upon myself to share the news and walk him into the scene. 15 doctors, code cart, chaos. to make a long story short, turns out, she's okay.
that same evening though, while still working my 12 hour shift , just to keep things exciting, my fourth patient of the day "decided" to fall at 6 PM. a STAT head CT and incident report ensued. and my day ended in a blur. if i were a drinker, i would have kicked back a few!
friday brought sadness. it was determined that cassie's uncle had no brain activity. so in the morning, his courageous family decided to withdraw care and allow him to pass. an adventurous, inspirational, and beloved man died that day. a family lost their father, brother, uncle, and friend - and the world will never be the same.
because someone/something had decided that i was superwoman and could handle more...
to end my work week, one of my three patients on friday evening began to suffer from chest pain. so instead of lazily charting, spacing out at a computer screen, and taking the time to say goodnight to each of my patients, i ran around the unit like a chicken with my head cut off. there were numerous emergency meds, STAT orders, tests, and blood draws. it's a strange thing to watch someone in pain, perhaps having a heart attack in front of your very eyes, and to be unable to stop it. and it's even weirder to go home before the conclusion, not knowing how the story ends.
saturday morning, i went hiking. ALONE. i spent 4 hours outside in misty rain and clouds. i had brought music to listen to, in case i needed "company." but truly, the noise was too stimulating. i needed silence. i needed to breathe in fresh air and blow out a week of chaos.
Thursday, June 9, 2011
dreaded phone calls
i'm not a parent, but i know about every parent's worst nightmare - that something has happened to their child, that they are ill or in danger, or god forbid, dead. i know about dreaded phone calls because when i was 12, my mom got one. it was harborview (the best hospital for the worst cases - trauma) and they called to have my mom come and identify her daughter. it was a friday night. my mom and i had been watching the miss america pageant. my sister was headed to her high school's soccer game. sadly, she and her three friends never made it there. two teenagers died that night; thankfully, my sister survived (she was intubated at the scene of the accident and had brain swelling). and although it was over 18 years ago, i will never forget that phone call. and neither will my mom.
this week, i made that phone call. and it sure felt horrible.
a 21 year old patient on my unit was in the midst of his transplant. well actually, he had been transplanted 6 days prior. but he was in the midst of the worst part. the previous days of chemotherapy and radiation were catching up to him. without an immune system, his body could not heal any of the damaged and dying cells. the lining of his entire GI tract - from his mouth to his anus (that's how i always describe it to patients) - was raw with mucositis (inflammation, ulcerations, and pain that is difficult to treat). and for some unknown reason, he began to have difficulty breathing. it's likely that his airway was so swollen that he could not safely or easily pass oxygen. and within minutes, he was in a very dangerous situation.
i was not the boy's nurse (i say boy as if he is some little thing, but as a 30 year old, 21 now seems so young - too young for cancer). but i was helping his nurse - drawing STAT labs, finding doctors, getting emergency medications, and of course, making phone calls. with one glance at the patient, it was obvious that he was terrified. he was gasping for breath. he could not sit upright enough. he was restless and i swear the pathetic, terrified look on his face said, "i need my mom." i asked his nurse if his parents were somewhere in the hospital and she said no. so i asked if i should call them.
i didn't realize what i had offered until i left the room to go dial his parents' phone number. what would i say? what does one say to a parent as their son is on the brink of crashing, requiring intubation, and possible CPR? how do you tell a parent that their son is dying? and that he is alone? i didn't have much time to think. and likely a rehearsed conversation wouldn't sound any better than a non-rehearsed one. so i dialed and his mom picked up.
i don't remember exactly what i said. but it went something like this:
"are you Cs mom?"
yes
"hi, my name is christa. i am a nurse on the oncology unit where you son is a patient. i am not currently his nurse, so i have very limited information. and i am so sorry to be making this phone call. but i wanted you to know, that C is having difficulty breathing. we are moving him to the intensive care unit to be more closely monitored. he is surrounded by doctors and we are working very hard to keep him safe. i think you should be here. do you have someone who could drive you?"
i can drive myself; i'm on my way
it was a quick conversation - a minute, maybe two. but it was the most difficult phone call i've ever had to make. sometimes, i hate the phone.
*** for once, my story has a happy ending. well, at least it's happy so far. after many, many drugs and many, many interventions, the 21 year old boy ended up NOT getting intubated. his swollen and bleeding airway somehow managed to stay open. and he continued to breathe on his own. he is now 11 days post transplant and closer to healing, closer to recovering from transplant, and closer to remission! ***
this week, i made that phone call. and it sure felt horrible.
a 21 year old patient on my unit was in the midst of his transplant. well actually, he had been transplanted 6 days prior. but he was in the midst of the worst part. the previous days of chemotherapy and radiation were catching up to him. without an immune system, his body could not heal any of the damaged and dying cells. the lining of his entire GI tract - from his mouth to his anus (that's how i always describe it to patients) - was raw with mucositis (inflammation, ulcerations, and pain that is difficult to treat). and for some unknown reason, he began to have difficulty breathing. it's likely that his airway was so swollen that he could not safely or easily pass oxygen. and within minutes, he was in a very dangerous situation.
i was not the boy's nurse (i say boy as if he is some little thing, but as a 30 year old, 21 now seems so young - too young for cancer). but i was helping his nurse - drawing STAT labs, finding doctors, getting emergency medications, and of course, making phone calls. with one glance at the patient, it was obvious that he was terrified. he was gasping for breath. he could not sit upright enough. he was restless and i swear the pathetic, terrified look on his face said, "i need my mom." i asked his nurse if his parents were somewhere in the hospital and she said no. so i asked if i should call them.
i didn't realize what i had offered until i left the room to go dial his parents' phone number. what would i say? what does one say to a parent as their son is on the brink of crashing, requiring intubation, and possible CPR? how do you tell a parent that their son is dying? and that he is alone? i didn't have much time to think. and likely a rehearsed conversation wouldn't sound any better than a non-rehearsed one. so i dialed and his mom picked up.
i don't remember exactly what i said. but it went something like this:
"are you Cs mom?"
yes
"hi, my name is christa. i am a nurse on the oncology unit where you son is a patient. i am not currently his nurse, so i have very limited information. and i am so sorry to be making this phone call. but i wanted you to know, that C is having difficulty breathing. we are moving him to the intensive care unit to be more closely monitored. he is surrounded by doctors and we are working very hard to keep him safe. i think you should be here. do you have someone who could drive you?"
i can drive myself; i'm on my way
it was a quick conversation - a minute, maybe two. but it was the most difficult phone call i've ever had to make. sometimes, i hate the phone.
*** for once, my story has a happy ending. well, at least it's happy so far. after many, many drugs and many, many interventions, the 21 year old boy ended up NOT getting intubated. his swollen and bleeding airway somehow managed to stay open. and he continued to breathe on his own. he is now 11 days post transplant and closer to healing, closer to recovering from transplant, and closer to remission! ***
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