well, i've been back in the US of A for a bit less than two weeks. i've already worked five 12 hour shifts. and let me tell you, there's no easing in to nursing. nope. i'm back with a bang.
first day back at work: my somewhat confused 62 year old man moaned all day long, "i'm dying, my heart is dying..."
second day back at work: i answer an emergency light. a 32 year old lady is having a seizure. three minutes later, she codes. mayhem ensues. dozens of people storm her room. there is blood everywhere. she dies.
third day back at work: same patient from first day begs me to kill him.
nothing like a light-hearted job!
Monday, November 19, 2012
Friday, November 16, 2012
nepali vacation
life before and after vacations is always... stressful, crazy, mayham?!? on october 3rd, i left the country for 35 days. there had been lots of preparation involved - many discussions, much packing, and too many to-do's to cross off the many lists. one to-do was writing a blogpost pre-trip that described my plans for my upcoming adventure. but it never happened. so here i am - post-trip.
nepal was AMAZING. it's truly too hard to express in words. photos do a little bit better a job. but still, they do not depict the true experience. the feelings i had. the lessons i learned. the ways in which i have grown. you'll just have to believe me. nepal was amazing.
nepal was AMAZING. it's truly too hard to express in words. photos do a little bit better a job. but still, they do not depict the true experience. the feelings i had. the lessons i learned. the ways in which i have grown. you'll just have to believe me. nepal was amazing.
vanna white displays her handiwork with cow dung.
two new neighbors admire their new homes through suku's new window.
funyuns on fingers are pretty funny.
ganesh accompanied me on my nepali adventures since my boyfriend, cole, couldn't come. not a very good substitute.
but he did bring good luck.
prayer flags hung on top of kang la pass (over 17,000 feet) in honor and memory of my patients.
a celebratory jump at lake tilicho.
local woman winnowing grain in the village of nar.
me, just chilling, with the saddhus. om!
Monday, September 24, 2012
laundry detergent
anyway, i was assigned a patient who is extremely sensitive to smells. one look at her allergy list had me almost chuckling. seriously, who is allergic to prednisone? or benadryl? both medications used to treat allergic reactions.
i guess i've been a nurse for too long. because instead of being sensitive and accommodating, i kind of laughed, called the patient a freak, and decided to lie. it may not be one of my finer moments. but seriously, WHO on my unit doesn't wear deoderant? i think there's one girl (and she smells horribly) but that doesn't qualify her as the best nurse for this crazy patient. nope. somehow it qualified ME! even though i use kirkland brand detergent. and decided to LIE!
when i walked into her room, before i could even introduce myself, i got a "stop right there. before you get any closer. put your hands up!" well, i didn't get the "put your hands up" part. but the rest of it i got. "what detergent do you use?" to which i replied, "some organic brand i cannot recall the name of." BINGO! "oh, i think we'll get along fine then."
and we did. my kirkland brand detergent didn't make my patient cough or sneeze. nor did my dove deoderant. or my cheap tresemme hairspray. in fact, my patient was discharged today. and i got a hug! she got close enough to smell my lunch (which she interrupted) and didn't complain about my garlic breathe or my detergent!
Tuesday, September 18, 2012
prayers
i said something today at work that i haven't said in a VERY long time. maybe ever. i told a patient that i would pray for her. i haven't prayed in years (despite 15+ years of catholic school). but i found myself saying, "i will pray for you tonight, that your body makes new cells and that your pain goes away." the words slipped out of my mouth before i could process what they meant or why they came out. but as i left her room and reflected, i thought to myself, "if i would pray for anyone, i would pray for V."
V has been my patient for the last three days. my first day with her, i wasn't a good nurse. V speaks little bits of english; her first language is spanish. and for some reason, i felt intimidated. maybe lazy. i don't know. but without communication, nursing is challenging. and i didn't do a good enough job. yesterday though, i worked harder. i wanted to go home proud of the work i had done. and so, i got us an interpreter. i scheduled a meeting with her german speaking physician (too many esl people in the same room can be a riot!). we discussed pain management and made changes to all of her medications. V felt a little better at the end of my shift, and so did i. but today was the best of all. i thought of all the little things. the prescription chapstick for her dry lips. the wet wipes for her sore hiney. i ordered her a commode chair. and delivered attends (AKA adult diapers). when we spoke, i squatted at the edge of her bed so our faces were eye to eye. and eventually, i wound up sitting in her bed, hand on her back, soothing her as she vomited. when i said goodbye this evening, V put her hand on my head (as if in blessing). and without words, she acknowledged my hard work and thanked me for my presence. what a special moment!
V is 51 years old. she is here from puerto rico to receive treatment. she is an educated woman. a minister in her church. but more important than the details, she is human. and she is suffering. and she is kind. and deserving of love. and prayers.
V has been my patient for the last three days. my first day with her, i wasn't a good nurse. V speaks little bits of english; her first language is spanish. and for some reason, i felt intimidated. maybe lazy. i don't know. but without communication, nursing is challenging. and i didn't do a good enough job. yesterday though, i worked harder. i wanted to go home proud of the work i had done. and so, i got us an interpreter. i scheduled a meeting with her german speaking physician (too many esl people in the same room can be a riot!). we discussed pain management and made changes to all of her medications. V felt a little better at the end of my shift, and so did i. but today was the best of all. i thought of all the little things. the prescription chapstick for her dry lips. the wet wipes for her sore hiney. i ordered her a commode chair. and delivered attends (AKA adult diapers). when we spoke, i squatted at the edge of her bed so our faces were eye to eye. and eventually, i wound up sitting in her bed, hand on her back, soothing her as she vomited. when i said goodbye this evening, V put her hand on my head (as if in blessing). and without words, she acknowledged my hard work and thanked me for my presence. what a special moment!
V is 51 years old. she is here from puerto rico to receive treatment. she is an educated woman. a minister in her church. but more important than the details, she is human. and she is suffering. and she is kind. and deserving of love. and prayers.
Monday, September 10, 2012
flabbergasted
i'm a bit flabbergasted.
i got called into the principal's office today. well, not really. the manager's office. but i felt like i was getting in trouble. and i don't like it one bit!
in the last year, two nurses have been investigated on our unit for possible narcotic diversion. and neither works on our unit now. interestingly enough, the rumor mill tells me that both nurses who were investigated and asked to leave were in fact innocent. rumor has it their urine and hair samples came back negative. but drugs have definitely gone missing.
in fact...
there have been more than 87 incidences with oxycodone in the last year. there are inappropriate removals of the common street drug from 33 different nurses on our unit (that's more than 1/3 of or staff). and to my horror and dismay, i am one of those nurses. some person on my unit has stolen medications under my name.
this is how it works. i log into pyxis (where all of our medications are dispensed) with my fingerprint. when i am done, i press exit. however, if i forget to press exit, my login remains open for 60 seconds. in those 60 seconds (before i am logged out), any person can remove medications under what looks like my bio-id. we have access to all the patients on the floor and to their entire medication profile. so, even though i am taking care of patient A and patient B, i can remove medication for patient Z.
last november, under my bio-id, SEVEN doses of oxycodone were taken. they were removed from three different patients, none of whom were my patients that day. there was never a discrepancy noted in the narcotic count, because whoever stole the medications "counted" them accurately. they simply never gave the doses. somehow, this has been happening for almost a year. and just NOW, our unit is sleuthing and attempting to find the thief.
the thought of me pilfering narcotics almost made me laugh. i had to tell my manager in all seriousness that there is NO WAY i would take oxycodone. i don't even drink. i won't take benadryl. and i think caffeine is a mood altering drug (one i indulge in frequently...). but nonetheless, i wouldn't handle oxycodone well!
i got called into the principal's office today. well, not really. the manager's office. but i felt like i was getting in trouble. and i don't like it one bit!
in the last year, two nurses have been investigated on our unit for possible narcotic diversion. and neither works on our unit now. interestingly enough, the rumor mill tells me that both nurses who were investigated and asked to leave were in fact innocent. rumor has it their urine and hair samples came back negative. but drugs have definitely gone missing.
in fact...
there have been more than 87 incidences with oxycodone in the last year. there are inappropriate removals of the common street drug from 33 different nurses on our unit (that's more than 1/3 of or staff). and to my horror and dismay, i am one of those nurses. some person on my unit has stolen medications under my name.
this is how it works. i log into pyxis (where all of our medications are dispensed) with my fingerprint. when i am done, i press exit. however, if i forget to press exit, my login remains open for 60 seconds. in those 60 seconds (before i am logged out), any person can remove medications under what looks like my bio-id. we have access to all the patients on the floor and to their entire medication profile. so, even though i am taking care of patient A and patient B, i can remove medication for patient Z.
last november, under my bio-id, SEVEN doses of oxycodone were taken. they were removed from three different patients, none of whom were my patients that day. there was never a discrepancy noted in the narcotic count, because whoever stole the medications "counted" them accurately. they simply never gave the doses. somehow, this has been happening for almost a year. and just NOW, our unit is sleuthing and attempting to find the thief.
the thought of me pilfering narcotics almost made me laugh. i had to tell my manager in all seriousness that there is NO WAY i would take oxycodone. i don't even drink. i won't take benadryl. and i think caffeine is a mood altering drug (one i indulge in frequently...). but nonetheless, i wouldn't handle oxycodone well!
Saturday, September 8, 2012
F*%#! off
last saturday was one of the weirdest shifts i have ever worked. i wish i had written about it then. my blood was boiling. but after working 12.5 hours, i went to bumbershoot until 11:30PM, stayed up until 12:45AM, and went back to work on sunday at 7AM. the remainder of the week has flown by. so here i am, home alone on a saturday night, ready to re-hash just a small part of the drama.
are you ready for this?
on friday, saturday, and sunday of last week, i was precepting a new grad. she was completing her last three shifts of a six week orientation. and although some new nurses still requires lots of hand holding and are, what i would consider, scary nurses, this new nurse ROCKS! she is timely, can multi-task, asks appropriate questions, and time manages well. she was a dream to precept. hence, my three shifts with her were a piece of cake for me. i did NOTHING. literally. i played on the internet, made lists, did some personal planning and made phone calls.
until 4:45PM on saturday when i had to step in and stand up to my assistant nurse manager who wanted to give my new orientee a FIFTH patient.
i feel like, unless you are a nurse on my unit, most people wouldn't understand the ridiculousness of this suggestion. there are too many reasons to list why this is a horrible idea. i will note just a few:
- no nurse on my unit EVER cares for five patients in one day
- the assistant nurse manager was not in charge on saturday and had NO clue what was going on
- my orientee had already discharged two patients in the day and still had two others
- new orientees NEVER have more than two patients per shift (unless your preceptor thinks you're a rockstar and asks for a harder assignment - but NOT five patients)
when asked if she could handle it, the new grad looked at me, and said rather hesitantly, "i guess so." but she doesn't understand how the floor works. she doesn't know that five patients in one day is inappropriate, especially for a new nurse. she didn't know that there were other nurses on the floor who were less busy and had only had 2 patients ALL day long. she didn't know (or feel comfortable) standing up for herself and saying she would rather NOT get an admit at 5:30PM.
so i did. i told the assistant nurse manager that new grad girl would not take an admit. that she couldn't. that she was asking too much of her. that as her preceptor, i was looking out for her. but the nurse manager wouldn't listen to me. she kept saying, "christa, i didn't ask you. i asked a_ _ _ _ _ ." she spoke to me in a condescending tone. and despite my rebuttals, kept demanding that new grad girl take the admit. after awkward discussion in the hall, the nurse manager left me fuming and headed to tell the charge nurse that my new orientee would indeed take a FIFTH patient.
i can't describe how disrespected i felt. how demeaned. and belittled. and i couldn't stand for it. so, i resumed the conversation at the nurse's station, in front of the secretary, the charge nurse, and my colleagues. we started duking it out, in public, until it was suggested that we take our "conversation" elsewhere, to somewhere more private.
i won't describe the 20 minute conversation we had. but suffice it to say, i stood up for myself and what i believe in with all my strength. i am stubborn ALWAYS; but when i know i am right, i won't budge. and i didn't.
my assistance nurse manager knew i was angry, upset, frustrated, irate... and so, for some weird reason, she asked me if i wanted to tell her to F&%# off! i am not joking. my assistance nurse manager, an elder, and person in leadership on my unit, asked if i would feel better if i told her to F&@! off. she was trying to bully me, to get me to act unprofessional, because up until then, i hadn't. but instead of caving and doing what she wanted me to do (so she could get me in trouble), i laughed at her. told her i had some professionalism. and would never do such a thing. at work. or in my person life. i may swear. but i don't tell people to F?%! off.
period.
end of story.
are you ready for this?
on friday, saturday, and sunday of last week, i was precepting a new grad. she was completing her last three shifts of a six week orientation. and although some new nurses still requires lots of hand holding and are, what i would consider, scary nurses, this new nurse ROCKS! she is timely, can multi-task, asks appropriate questions, and time manages well. she was a dream to precept. hence, my three shifts with her were a piece of cake for me. i did NOTHING. literally. i played on the internet, made lists, did some personal planning and made phone calls.
until 4:45PM on saturday when i had to step in and stand up to my assistant nurse manager who wanted to give my new orientee a FIFTH patient.
i feel like, unless you are a nurse on my unit, most people wouldn't understand the ridiculousness of this suggestion. there are too many reasons to list why this is a horrible idea. i will note just a few:
- no nurse on my unit EVER cares for five patients in one day
- the assistant nurse manager was not in charge on saturday and had NO clue what was going on
- my orientee had already discharged two patients in the day and still had two others
- new orientees NEVER have more than two patients per shift (unless your preceptor thinks you're a rockstar and asks for a harder assignment - but NOT five patients)
when asked if she could handle it, the new grad looked at me, and said rather hesitantly, "i guess so." but she doesn't understand how the floor works. she doesn't know that five patients in one day is inappropriate, especially for a new nurse. she didn't know that there were other nurses on the floor who were less busy and had only had 2 patients ALL day long. she didn't know (or feel comfortable) standing up for herself and saying she would rather NOT get an admit at 5:30PM.
so i did. i told the assistant nurse manager that new grad girl would not take an admit. that she couldn't. that she was asking too much of her. that as her preceptor, i was looking out for her. but the nurse manager wouldn't listen to me. she kept saying, "christa, i didn't ask you. i asked a_ _ _ _ _ ." she spoke to me in a condescending tone. and despite my rebuttals, kept demanding that new grad girl take the admit. after awkward discussion in the hall, the nurse manager left me fuming and headed to tell the charge nurse that my new orientee would indeed take a FIFTH patient.
i can't describe how disrespected i felt. how demeaned. and belittled. and i couldn't stand for it. so, i resumed the conversation at the nurse's station, in front of the secretary, the charge nurse, and my colleagues. we started duking it out, in public, until it was suggested that we take our "conversation" elsewhere, to somewhere more private.
i won't describe the 20 minute conversation we had. but suffice it to say, i stood up for myself and what i believe in with all my strength. i am stubborn ALWAYS; but when i know i am right, i won't budge. and i didn't.
my assistance nurse manager knew i was angry, upset, frustrated, irate... and so, for some weird reason, she asked me if i wanted to tell her to F&%# off! i am not joking. my assistance nurse manager, an elder, and person in leadership on my unit, asked if i would feel better if i told her to F&@! off. she was trying to bully me, to get me to act unprofessional, because up until then, i hadn't. but instead of caving and doing what she wanted me to do (so she could get me in trouble), i laughed at her. told her i had some professionalism. and would never do such a thing. at work. or in my person life. i may swear. but i don't tell people to F?%! off.
period.
end of story.
Wednesday, August 29, 2012
nurse AND girlfriend
last week i had the pleasure of going to kauai with the new man in my life. it was a rather spontaneous trip. i don't typically do spontaneous well, but this man helped me to relax and enjoy.
while i worked as a nurse at a camp for developmentally disabled adults for one week, surfer boy (one of his many nicknames) made ALL of our plans. our tickets were purchased, cars were rented, resort stays scheduled, and everything one could think of for camping was prepared (down to the ever crucial rolls of toilet paper). C did a fantastic job. and despite my return from camp at 5PM on a friday night and our departure at 9:45 AM on saturday morning, i barely felt crazy. just a bit!
all in all, kauai was a delightful trip. surfer boy and i got to know one another better. in fact, we got to know one another on a very intimate level. one that is safe to discuss on a public blog that my mother reads. in fact, it's more than appropriate for a nursing related blog because it has to do with yet another ER visit and hospital stay! i am proud to say, i remained healthy in kauai - even after our strenuous hike and more bug bites than i can count!
tuesday and wednesday, C and hiked the napali coast. it's an infamous hike, on the top 10 most dangerous hiking list (which also includes mount rainier). we trekked 11 miles along the coast line, switchback after switchback, up and down cliff sides in crazy hot, very humid weather. one misstep could have wound us stranded hundreds of feet below, dead, or in shark-infested tumultuous waters. the 7 hour journey was grueling. and sleeping in a tent that night was equally as challenging - we were SO hot, there was NO breeze, and any idea of romance i had created in my mind vanished!
wednesday morning, we decided to pack up and hike out. neither C nor I is very good at relaxing and although the beach on the coast was beautiful, we couldn't imagine an ENTIRE day with nothing to do (it's not recommended to swim there because of the currents). so, at about 11AM, we began the hike back to our car. the return trek might have been harder than the approach; we knew what we were in for...
but thursday, friday, and saturday brought about the most challenging part of our trip. thursday AM, C woke up with right lower quadrant pain. as a nurse and with C in school to become a physician's assistant, we both worried about his appendix. did he have rebound tenderness? was he nauseated? did he have a fever?
C is an amazing man for numerous reasons. not only is he very intelligent (which makes his sexy), but also, he is very fit. both mentally and physically, C is one tough man. he waited out thursday, coping with periods of nausea and sharp pains. we discussed getting checked out, but with our "expertise," C felt comfortable waiting to see if things got worse. which, of course, they did. on friday at 3 in the morning! C was smart enough to check which hospitals in kauai have CT scanners. and so, we headed to wilcox memorial hospital. should your appendix ever misbehave while in kauai, go there!
this could be a very long story. it already is. i'm a blabbermouth. but suffice it to say, C did indeed have a potential appendicitis. his CT scan showed an enlarged appendix. but chronic gastrointestinal issues complicated diagnosis and treatment. C ended up being admitted for surveillance. the surgeon wanted to keep an eye on him. our departure flights were cancelled. and we set up shop in room #300. C did his best to be a decent patient. and i did my best to keep him in line!
C has never been a patient in a hospital. and i have never been a nurse to a significant other. it was a new experience. a new kind of relationship. and although we both survived the experience and are doing well, back at home in seattle, i think we would both choose to remain healthy in our futures. it feels weird to be a nurse AND a girlfriend. just as i imagine it would feel weird for C to be a physician's assistant AND a boyfriend.
while i worked as a nurse at a camp for developmentally disabled adults for one week, surfer boy (one of his many nicknames) made ALL of our plans. our tickets were purchased, cars were rented, resort stays scheduled, and everything one could think of for camping was prepared (down to the ever crucial rolls of toilet paper). C did a fantastic job. and despite my return from camp at 5PM on a friday night and our departure at 9:45 AM on saturday morning, i barely felt crazy. just a bit!
all in all, kauai was a delightful trip. surfer boy and i got to know one another better. in fact, we got to know one another on a very intimate level. one that is safe to discuss on a public blog that my mother reads. in fact, it's more than appropriate for a nursing related blog because it has to do with yet another ER visit and hospital stay! i am proud to say, i remained healthy in kauai - even after our strenuous hike and more bug bites than i can count!
tuesday and wednesday, C and hiked the napali coast. it's an infamous hike, on the top 10 most dangerous hiking list (which also includes mount rainier). we trekked 11 miles along the coast line, switchback after switchback, up and down cliff sides in crazy hot, very humid weather. one misstep could have wound us stranded hundreds of feet below, dead, or in shark-infested tumultuous waters. the 7 hour journey was grueling. and sleeping in a tent that night was equally as challenging - we were SO hot, there was NO breeze, and any idea of romance i had created in my mind vanished!
wednesday morning, we decided to pack up and hike out. neither C nor I is very good at relaxing and although the beach on the coast was beautiful, we couldn't imagine an ENTIRE day with nothing to do (it's not recommended to swim there because of the currents). so, at about 11AM, we began the hike back to our car. the return trek might have been harder than the approach; we knew what we were in for...
but thursday, friday, and saturday brought about the most challenging part of our trip. thursday AM, C woke up with right lower quadrant pain. as a nurse and with C in school to become a physician's assistant, we both worried about his appendix. did he have rebound tenderness? was he nauseated? did he have a fever?
C is an amazing man for numerous reasons. not only is he very intelligent (which makes his sexy), but also, he is very fit. both mentally and physically, C is one tough man. he waited out thursday, coping with periods of nausea and sharp pains. we discussed getting checked out, but with our "expertise," C felt comfortable waiting to see if things got worse. which, of course, they did. on friday at 3 in the morning! C was smart enough to check which hospitals in kauai have CT scanners. and so, we headed to wilcox memorial hospital. should your appendix ever misbehave while in kauai, go there!
this could be a very long story. it already is. i'm a blabbermouth. but suffice it to say, C did indeed have a potential appendicitis. his CT scan showed an enlarged appendix. but chronic gastrointestinal issues complicated diagnosis and treatment. C ended up being admitted for surveillance. the surgeon wanted to keep an eye on him. our departure flights were cancelled. and we set up shop in room #300. C did his best to be a decent patient. and i did my best to keep him in line!
C has never been a patient in a hospital. and i have never been a nurse to a significant other. it was a new experience. a new kind of relationship. and although we both survived the experience and are doing well, back at home in seattle, i think we would both choose to remain healthy in our futures. it feels weird to be a nurse AND a girlfriend. just as i imagine it would feel weird for C to be a physician's assistant AND a boyfriend.
Friday, August 10, 2012
comfort care
i've mentioned this before, but did you know? nursing is a strange profession!
on wednesday, i arrived at work. my patient assignment included a 43 year old, heavily tattooed man whom i had admitted on monday. and a 69 year old woman on comfort care, dying of pancreatic cancer.
to top it off, i also had a nursing student assigned to work with me; she is sweet and religious and competent, but in a shy, nervous way. she lost her dad in 2006 to cancer at my hospital (which likely prompted her interest in nursing). and wednesday was her last day on my unit, her last day of clinicals while in nursing school; in fact, she graduates TODAY! it would have been nice to help her end her nursing student career in a FUN, HAPPY, POSITIVE way. but instead, i anticipated and warned her that we would likely see a woman die on our shift, that we would complete post-mortem care, and zip a once-living-loving woman in a body bag...
i haven't cared for someone on comfort care in a LONG while. which, in some way, is too bad considering i think i'd still like to be a hospice nurse some day (and could use the experience). and considering how many people die on my unit, you'd think more people would be on comfort care. but sadly, people die suddenly on our unit, with codes, and CPR, and everything but peace and quiet.
anyhoo, i was not surprised to hear that my patient was on a morphine drip; but i was surprised to hear that she was on 40mg an hour. that is a HUGE dose. enough to sedate, if not kill, a large elephant. not surprisingly, when i assessed her in the AM, her respiratory rate was 4 breaths per minute. my nursing judgement told me from that and from her cool, mottled skin that she was nearing death.
BUT... the plan of the day shifted when her team of physicians approached me and asked in a rather gruff, concerned way, "how did we get to 40mg of morphine per hour from the 2mg we started on just yesterday afternoon?" let me explain. nurses have the authority, based on an algorithm, to titrate drip rates to patients' comfort. if a patient is in pain, nurses can give a bolus and increase the drip rate at increments. but there had been NO documentation of the patient's pain; in fact the previous nurse charted that the patient was calm and comfortable. it seemed that the nurse prior to me increased the drip rate rather willy-nilly, perhaps expediting the patient's death - which is ILLEGAL.
so, for the first time (and hopefully the last) in my nursing career, i was asked to decrease the rate of the morphine drip. in essence, to reverse the comfort care orders. to possibly wake a woman peacefully dying and perhaps cause her pain.
i hated the idea. and told the team this. i agreed that perhaps the way in which her morphine drip was handled the day before was inappropriate. but the fact of the matter is, it hadn't killed her. and now, she was comfortable. and i didn't want to play any part in changing that.
after much discussion with one of my managers, and further discussion with her provider, i turned the drip down. i monitored my patient more closely, with peace of mind, knowing full well that if my patient showed the slightest bit of discomfort, i had the authority, based on MD orders, to bolus the patient with morphine and increase her continuous pain medication. thankfully, the patient remained calm. comatose. obtunded. and to my surprise, almost horror, the patient survived my entire 12 hour shift.
and yesterday's.
it's strange to want a person to die. to hope that the two breaths i counted in one minute were someone's very last two breaths. but at the same time, it's hard to see a woman, barely clinging to life, hang on.
on wednesday, i arrived at work. my patient assignment included a 43 year old, heavily tattooed man whom i had admitted on monday. and a 69 year old woman on comfort care, dying of pancreatic cancer.
to top it off, i also had a nursing student assigned to work with me; she is sweet and religious and competent, but in a shy, nervous way. she lost her dad in 2006 to cancer at my hospital (which likely prompted her interest in nursing). and wednesday was her last day on my unit, her last day of clinicals while in nursing school; in fact, she graduates TODAY! it would have been nice to help her end her nursing student career in a FUN, HAPPY, POSITIVE way. but instead, i anticipated and warned her that we would likely see a woman die on our shift, that we would complete post-mortem care, and zip a once-living-loving woman in a body bag...
i haven't cared for someone on comfort care in a LONG while. which, in some way, is too bad considering i think i'd still like to be a hospice nurse some day (and could use the experience). and considering how many people die on my unit, you'd think more people would be on comfort care. but sadly, people die suddenly on our unit, with codes, and CPR, and everything but peace and quiet.
anyhoo, i was not surprised to hear that my patient was on a morphine drip; but i was surprised to hear that she was on 40mg an hour. that is a HUGE dose. enough to sedate, if not kill, a large elephant. not surprisingly, when i assessed her in the AM, her respiratory rate was 4 breaths per minute. my nursing judgement told me from that and from her cool, mottled skin that she was nearing death.
BUT... the plan of the day shifted when her team of physicians approached me and asked in a rather gruff, concerned way, "how did we get to 40mg of morphine per hour from the 2mg we started on just yesterday afternoon?" let me explain. nurses have the authority, based on an algorithm, to titrate drip rates to patients' comfort. if a patient is in pain, nurses can give a bolus and increase the drip rate at increments. but there had been NO documentation of the patient's pain; in fact the previous nurse charted that the patient was calm and comfortable. it seemed that the nurse prior to me increased the drip rate rather willy-nilly, perhaps expediting the patient's death - which is ILLEGAL.
so, for the first time (and hopefully the last) in my nursing career, i was asked to decrease the rate of the morphine drip. in essence, to reverse the comfort care orders. to possibly wake a woman peacefully dying and perhaps cause her pain.
i hated the idea. and told the team this. i agreed that perhaps the way in which her morphine drip was handled the day before was inappropriate. but the fact of the matter is, it hadn't killed her. and now, she was comfortable. and i didn't want to play any part in changing that.
after much discussion with one of my managers, and further discussion with her provider, i turned the drip down. i monitored my patient more closely, with peace of mind, knowing full well that if my patient showed the slightest bit of discomfort, i had the authority, based on MD orders, to bolus the patient with morphine and increase her continuous pain medication. thankfully, the patient remained calm. comatose. obtunded. and to my surprise, almost horror, the patient survived my entire 12 hour shift.
and yesterday's.
it's strange to want a person to die. to hope that the two breaths i counted in one minute were someone's very last two breaths. but at the same time, it's hard to see a woman, barely clinging to life, hang on.
Tuesday, August 7, 2012
divorced
mount rainier and i have a love/hate relationship. i've decided, we're getting divorced!
as stated in my last post, i climbed mount rainier last week - for a second time. and for the second time, i wound up in the ER.
reminder: almost two summers ago, i had signed up to climb mount rainier with a guide company. in preparation, i joined crossfit and got into crazy shape! however, 100 push-ups, 100 pull-ups, and 100 squats sent me to the ER with severe muscle breakdown in my arms leading to rhabdomyelisis. i could have permanently damaged my kidneys. but thankfully, after 5 days in the hospital, and a month or so of recovery, i was fine. i am fine. but i did not get to climb rainier.
last summer, the mountain and i got along, fairly well. it must have been the therapy i attended between summers to mend our broken relationship! i summited mount rainier last summer. we seemed to respect one another on my climb. and although i felt extremely proud of my accomplishment, i vowed to only visit the mountain's lower-lands in the future.
rewind to last week. as previously mentioned, for some crazy reason, i decided to test our tumultuous relationship. i went on a 3 day date with rainier. and have since decided, we're broken up. forever. i descended the mountain on friday morning. it was fast, sliding thousands of feet on my poor little behind. i hate glissading. but i made it safely, in one piece, to the parking lot. with only a few itchy bug bites and incredibly sore quadricep muscles.
fast forward. to friday night. a bug bite on my hand began to swell. it was itchy. most bug bites are, right? but by night time, i started to worry. i was losing definition of my hand. my skin grew taut and uncomfortable. my handsome boyfriend, a PA student, decided i should probably go to the ER. not wanting to make a big deal of nothing, i decided to sleep on it. if it was worse in the AM, sure, i would go! 4:30 in the morning came quickly. and with that, came the realization that something was seriously wrong. my hand had doubled in size. i had an infection of some sort. and since i've seen too many cases of flesh eating bacteria (necrotizing fasciatis) leading to amputations, i decided not to mess around. my eager to learn boyfriend and i went to the ER at my place of employment. i was treated quickly and efficiently (maybe because it was serious, maybe because i'm an employee). i got an IV dose of serious antibiotics and was started on four times daily oral antibiotics.
cellulitis. of course, i got cellulitis on my hand from a bug bite on mount rainier! cellulitis is a skin infection. but i felt like it's an STD from my sketchy date with mount rainier! we're over. i'm getting a restraining order.
(this picture doesn't quite do the swelling justice. not to mention, it got bigger throughout the day on saturday. currently, i think i am cured.)
as stated in my last post, i climbed mount rainier last week - for a second time. and for the second time, i wound up in the ER.
reminder: almost two summers ago, i had signed up to climb mount rainier with a guide company. in preparation, i joined crossfit and got into crazy shape! however, 100 push-ups, 100 pull-ups, and 100 squats sent me to the ER with severe muscle breakdown in my arms leading to rhabdomyelisis. i could have permanently damaged my kidneys. but thankfully, after 5 days in the hospital, and a month or so of recovery, i was fine. i am fine. but i did not get to climb rainier.
last summer, the mountain and i got along, fairly well. it must have been the therapy i attended between summers to mend our broken relationship! i summited mount rainier last summer. we seemed to respect one another on my climb. and although i felt extremely proud of my accomplishment, i vowed to only visit the mountain's lower-lands in the future.
rewind to last week. as previously mentioned, for some crazy reason, i decided to test our tumultuous relationship. i went on a 3 day date with rainier. and have since decided, we're broken up. forever. i descended the mountain on friday morning. it was fast, sliding thousands of feet on my poor little behind. i hate glissading. but i made it safely, in one piece, to the parking lot. with only a few itchy bug bites and incredibly sore quadricep muscles.
fast forward. to friday night. a bug bite on my hand began to swell. it was itchy. most bug bites are, right? but by night time, i started to worry. i was losing definition of my hand. my skin grew taut and uncomfortable. my handsome boyfriend, a PA student, decided i should probably go to the ER. not wanting to make a big deal of nothing, i decided to sleep on it. if it was worse in the AM, sure, i would go! 4:30 in the morning came quickly. and with that, came the realization that something was seriously wrong. my hand had doubled in size. i had an infection of some sort. and since i've seen too many cases of flesh eating bacteria (necrotizing fasciatis) leading to amputations, i decided not to mess around. my eager to learn boyfriend and i went to the ER at my place of employment. i was treated quickly and efficiently (maybe because it was serious, maybe because i'm an employee). i got an IV dose of serious antibiotics and was started on four times daily oral antibiotics.
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Sunday, August 5, 2012
mount rainier
i accidentally climbed mount rainier this week.
and to my surprise, i summited a second time. the photo above is on august 2nd, 2012. the photo below is july 2nd, 2011 - just 13 months earlier. i've since acquired better climbing clothes!
anyhoo, this climb was not planned. in fact, last year, i had promised myself that i would NEVER climb mount rainier again. it was the HARDEST physical thing i have ever done, without a doubt. and i felt that i never needed the challenge again.
but on monday, when the invitation was sent by some friends in my mountaineers course, i almost couldn't pass up the opportunity. in order to pass my basic climbing course, i have to complete one glacier climb this summer. there are numerous climbs i could have done - easier climbs, less intense, less risky (on mountains in washington people have never heard of). but every attempt i made previously this summer had been cancelled due to weather. so, i felt like this was my only chance to pass my class AND to do so with people i trust and enjoy.
in what may be the MOST spontaneous thing i have ever done, i signed up on monday at 9AM while at work and within 48 hours, i began the grueling ascent of the mountain i have come to respect and admire.
i cannot say i enjoyed the entire experience. climbing mount rainier is hard. i did it in three days this time, instead of four. and we took a different route, because last year's route was too melted and riddled with impassable crevasses. the winthrop glacier, that we took instead, turned out to be more challenging than i ever expected. at times we crawled on all fours, using our ice axes to slither across snow bridges and crevasses. no joke - at one point, i had to JUMP over a crevasse so big i would have been swallowed up by ice had i not successfully crossed.
my anxiety, my stamina, my determination - all were tested on this mountain. i cannot say that i was positive the entire time. i cannot promise that i didn't want to turn back. i cannot tell you that i did not cry. but i can say, i am crazy proud of my second summit. i am amazed by my spontaneity. and i am impressed by the changes i have made within myself in one year. i am still the same height, but i think i may have stood a bit taller on top of rainier this year compared to last.
Saturday, July 28, 2012
slavery
i've never thought of nursing as slavery. but in a way, depending on how patients treat us, it could be considered a form of it.
i cared for a psychologist the last two days. at first, i thought he was nice. we had a thing or two in common. he's a hiker and climber, a member of the mountaineers. but after spending just a short amount of time with him, i realized this man is a control freak. i am too. i appreciate straight lines and tidy hand-writing. if given the choice, i prefer doing things MY way. but i don't believe i mistreat people because i am particular. i know i respect other folks who do things for me. i say thank you in a genuine tone when someone makes me my coffee or bags my groceries.
that was not the case yesterday.
this man HAD been very sick. he was admitted for acute renal and liver failure related to a new diagnosis of lymphoma. he had nearly died just a few weeks ago, hooked up to machines, getting dialysis. in the blink of an eye, he lost his independence. but just as quickly, he began to improve. by the time i met him on thursday, he was just using a walker to ambulate. but otherwise, he had regained most of his strength. i do not know what his baseline personality was like, but his current personality is royally F%&**$#d up.
just some examples:
he asked me to tie his shoes. so i did. then he proceeded to say, "you know, normally i tie the loops a little bit tighter." i asked if the shoes were too loose, if he felt like he would trip. he said, "no, i just tie the loops in a tighter knot, so they don't untie." WTF? i really wanted to say, "you know, i've been tying my own shoes since i was four; i think i've got this covered!"
when he asked me for assistance in the shower, i agreed to walk him to the shower bench and to take off his compression hose. they are a challenge. but i was not about to help an independent 60 year old man bathe. sorry. i draw the line. i agreed to standby, in his room, tidying his linens, so that i could help him dry his feet off (a task he may actually not be able to do independently). but when he called for me and i entered the bathroom, he was sitting naked, with a washcloth on his junk. once again, WTF? his hands work. why the hell didn't he put on his own gown? gross!!!
just another example, i'd get him all situated in bed, call light in reach, water bottle in hand. then i'd ask if he needs anything else and he would say "no, you're such a good nurse. i have everything i need." within 7 minutes, he'd call again and say, in a gross, commanding, dominating voice, "could you increase the heat, just the slightest bit!" i would do that. and leave ASAP. but without fail, he'd call again, in less than 15 minutes for another irritating chore. i swear to god, he just wanted me in his room all day, waiting on him hand and foot. i don't get paid enough for that!
i'm embarrassed to admit it. but i am reading fifty shades of grey. it's a horrible book, promoting the concept of women as submissive to men (and sadly, i can't put it down, despite being a staunch feminist). i couldn't help but feel like my patient was attempting to dominate me, like he thought i was his slave, his submissive. only, there was nothing sexy about it! i was irritated and grossed out ALL day.
i cared for a psychologist the last two days. at first, i thought he was nice. we had a thing or two in common. he's a hiker and climber, a member of the mountaineers. but after spending just a short amount of time with him, i realized this man is a control freak. i am too. i appreciate straight lines and tidy hand-writing. if given the choice, i prefer doing things MY way. but i don't believe i mistreat people because i am particular. i know i respect other folks who do things for me. i say thank you in a genuine tone when someone makes me my coffee or bags my groceries.
that was not the case yesterday.
this man HAD been very sick. he was admitted for acute renal and liver failure related to a new diagnosis of lymphoma. he had nearly died just a few weeks ago, hooked up to machines, getting dialysis. in the blink of an eye, he lost his independence. but just as quickly, he began to improve. by the time i met him on thursday, he was just using a walker to ambulate. but otherwise, he had regained most of his strength. i do not know what his baseline personality was like, but his current personality is royally F%&**$#d up.
just some examples:
he asked me to tie his shoes. so i did. then he proceeded to say, "you know, normally i tie the loops a little bit tighter." i asked if the shoes were too loose, if he felt like he would trip. he said, "no, i just tie the loops in a tighter knot, so they don't untie." WTF? i really wanted to say, "you know, i've been tying my own shoes since i was four; i think i've got this covered!"
when he asked me for assistance in the shower, i agreed to walk him to the shower bench and to take off his compression hose. they are a challenge. but i was not about to help an independent 60 year old man bathe. sorry. i draw the line. i agreed to standby, in his room, tidying his linens, so that i could help him dry his feet off (a task he may actually not be able to do independently). but when he called for me and i entered the bathroom, he was sitting naked, with a washcloth on his junk. once again, WTF? his hands work. why the hell didn't he put on his own gown? gross!!!
just another example, i'd get him all situated in bed, call light in reach, water bottle in hand. then i'd ask if he needs anything else and he would say "no, you're such a good nurse. i have everything i need." within 7 minutes, he'd call again and say, in a gross, commanding, dominating voice, "could you increase the heat, just the slightest bit!" i would do that. and leave ASAP. but without fail, he'd call again, in less than 15 minutes for another irritating chore. i swear to god, he just wanted me in his room all day, waiting on him hand and foot. i don't get paid enough for that!
i'm embarrassed to admit it. but i am reading fifty shades of grey. it's a horrible book, promoting the concept of women as submissive to men (and sadly, i can't put it down, despite being a staunch feminist). i couldn't help but feel like my patient was attempting to dominate me, like he thought i was his slave, his submissive. only, there was nothing sexy about it! i was irritated and grossed out ALL day.
Wednesday, July 25, 2012
smell
our senses are amazing. all five of them. but every now and then, i'm taken aback by one of them.
on monday, i cared for a 74 year old man. he looked a bit more frail than his 74 years, hunched over a walker, pale and disheveled in hospital pajamas. but he smelled dignified. and in an instant, i was reminded of my grandfather. who died more than 12 years ago.
i feel bad admitting this, but i don't think of poo (his nickname) that often. and if so, it's more of a fleeting thought than a realistic, tangible memory complete with longing and ache.
as i left my patient's room and passed by his sink, i saw a familiar green bottle adorned with a gold cap and the signature polo emblem. my grandpa used to wear so much polo cologne it was almost as if he bathed in it. the "collector" that he was, his bathroom always had numerous green bottles. it was the obvious, standard father's day, birthday, and christmas gift. and i realized why my head was flooded with thoughts, taken back a decade in time.
all because of my sense of smell.
on monday, i cared for a 74 year old man. he looked a bit more frail than his 74 years, hunched over a walker, pale and disheveled in hospital pajamas. but he smelled dignified. and in an instant, i was reminded of my grandfather. who died more than 12 years ago.
i feel bad admitting this, but i don't think of poo (his nickname) that often. and if so, it's more of a fleeting thought than a realistic, tangible memory complete with longing and ache.
as i left my patient's room and passed by his sink, i saw a familiar green bottle adorned with a gold cap and the signature polo emblem. my grandpa used to wear so much polo cologne it was almost as if he bathed in it. the "collector" that he was, his bathroom always had numerous green bottles. it was the obvious, standard father's day, birthday, and christmas gift. and i realized why my head was flooded with thoughts, taken back a decade in time.
all because of my sense of smell.
Sunday, July 15, 2012
ACLS
i passed my ACLS class on friday. we had a mock-code that i led and my patient survived after numerous shocks and the administration of many, many medications. but i must say, i would still prefer that my patients not code on my watch. mainly because my instinct is to let someone die. but also, because codes are chaotic and stressful. here's to never needing to use my ACLS skills!
Thursday, July 12, 2012
gummy bears
there have been too many hospital dates to count as of late! this new man who is courting me (in and out of the hospital) is very nice. and according to all of the ladies i work with, who have caught glimpses of him in the hallway, very attractive to boot. hence, i am one lucky nurse.
but yesterday's hospital date was over the top.
last friday included a hand-delivered, made-perfectly-to-order coffee and a well-deserved break outside in the sun. there are always smooches snuck in stairwells or hallways. and typically one very giddy and cheery nurse returns to her unit, due past her allowed 15 minute break. that's hard to beat!
but yesterday, yesterday was special.
the hospital man not only visited and brought ME treats, but also, he brought treats to my friend. do men know that's the way to win over women? to know and care for their friends? hospital man brought me tootsie rolls and for my friend, M, he brought a small pack of gummy bears. "cute," you say! but it's more than cute. it's special. here's why:
M, is one of my bestest friends. she's a nurse on my unit. and crazily enough, she's had cancer and has had two stem cell transplants. thank the good lord, she had a better outcome than the majority of my patients. and she is now more than 7+ years out and in complete remission. but her treatment left her in menopause and hence, infertile.
medicine is miraculous though. and with the help of an egg donor (her sister) and lots of hormonal injections self-administered into her buttocks, IVF has made M pregnant. two fertilized eggs were placed in her uterus in the hopes of implanting six weeks plus two days ago. and TOMORROW! she will find out if she is pregnant with one or two "gummy bears." you see, that's what M has called them - her potential children. they're gummy bears. and hospital man (who until yesterday hadn't even met M) knew about M and the gummy bears and was thoughtful enough to bring her a treat (and not just tootsie rolls - GUMMY BEARS!). how freakin' cute is that?!?
keep M in your thoughts tomorrow. and pray for the gummy bears. 1 or 2. red, yellow, orange, green, or clear. as long as they're healthy!
but yesterday's hospital date was over the top.
last friday included a hand-delivered, made-perfectly-to-order coffee and a well-deserved break outside in the sun. there are always smooches snuck in stairwells or hallways. and typically one very giddy and cheery nurse returns to her unit, due past her allowed 15 minute break. that's hard to beat!
but yesterday, yesterday was special.
the hospital man not only visited and brought ME treats, but also, he brought treats to my friend. do men know that's the way to win over women? to know and care for their friends? hospital man brought me tootsie rolls and for my friend, M, he brought a small pack of gummy bears. "cute," you say! but it's more than cute. it's special. here's why:
M, is one of my bestest friends. she's a nurse on my unit. and crazily enough, she's had cancer and has had two stem cell transplants. thank the good lord, she had a better outcome than the majority of my patients. and she is now more than 7+ years out and in complete remission. but her treatment left her in menopause and hence, infertile.
medicine is miraculous though. and with the help of an egg donor (her sister) and lots of hormonal injections self-administered into her buttocks, IVF has made M pregnant. two fertilized eggs were placed in her uterus in the hopes of implanting six weeks plus two days ago. and TOMORROW! she will find out if she is pregnant with one or two "gummy bears." you see, that's what M has called them - her potential children. they're gummy bears. and hospital man (who until yesterday hadn't even met M) knew about M and the gummy bears and was thoughtful enough to bring her a treat (and not just tootsie rolls - GUMMY BEARS!). how freakin' cute is that?!?
keep M in your thoughts tomorrow. and pray for the gummy bears. 1 or 2. red, yellow, orange, green, or clear. as long as they're healthy!
Friday, July 6, 2012
unhealthy lady parts
i had a mostly shitty day. and it ended even worse than shitty. i think i might have killed a baby raccoon. i don't like animals that much; but i've never wanted to kill one. and it didn't help that i was giving a ride home to a friend of mine and when i screeched on my brakes, she literally started wailing. i didn't know humans could cry so instantaneously. it was ridiculous.
anyhoo, back to nursing. i started my day with three patients today, all of whom were in their early 30s. none of them were transplant patients. they all had some sort of gynecologic cancer.
33 yrs old - cervical cancer with metastases to the lungs and abdomen. i sent her home on hospice at 10:45. i had never met her or her family. but i had to discharge her, say goodbye, and wish her "peace." i mean, seriously, what was i supposed to say.
31 yrs old - newly diagnosed ovarian cancer status post L ovary removal (in addition to an 18 pound mass that was removed from her abdomen) with an open abdominal incision draining lots of fluid
34 yrs old - breast cancer post op day +1 status post a L mastectomy with 2 bulb drains
i'm NOT a gynecology oncology nurse. nor am i a post op nurse. i was in over my head today. and in over my heart. i dislike caring for folks my age, especially women with gynecological cancer issues. does it get worse than that? could a woman be any more vulnerable? i helped a 34 year old woman try on a bra for the first time since her entire left breast was removed; we looked at her scars together. it made me sad. and grateful for my health.
at 5:45 tonight, i admitted another patient. a 39 year old male. he's getting a transplant in 6 days. he's too young too. but at least i understand transplant patients. and at least he doesn't have any unhealthy lady parts.
anyhoo, back to nursing. i started my day with three patients today, all of whom were in their early 30s. none of them were transplant patients. they all had some sort of gynecologic cancer.
33 yrs old - cervical cancer with metastases to the lungs and abdomen. i sent her home on hospice at 10:45. i had never met her or her family. but i had to discharge her, say goodbye, and wish her "peace." i mean, seriously, what was i supposed to say.
31 yrs old - newly diagnosed ovarian cancer status post L ovary removal (in addition to an 18 pound mass that was removed from her abdomen) with an open abdominal incision draining lots of fluid
34 yrs old - breast cancer post op day +1 status post a L mastectomy with 2 bulb drains
i'm NOT a gynecology oncology nurse. nor am i a post op nurse. i was in over my head today. and in over my heart. i dislike caring for folks my age, especially women with gynecological cancer issues. does it get worse than that? could a woman be any more vulnerable? i helped a 34 year old woman try on a bra for the first time since her entire left breast was removed; we looked at her scars together. it made me sad. and grateful for my health.
at 5:45 tonight, i admitted another patient. a 39 year old male. he's getting a transplant in 6 days. he's too young too. but at least i understand transplant patients. and at least he doesn't have any unhealthy lady parts.
Thursday, July 5, 2012
holiday code
around 4:30 yesterday evening, there was a code on my unit. i was hanging blood in a patient's room when i heard the irritating alarm sound. it goes off frequently. but more often than not, it's an accident. so we don't always take it seriously. but when it kept sounding, i excused myself from my patient's room to check out what was happening.
sure enough, someone was grabbing the code cart and running down the hallway. when i got to room 12, i saw one of our patients looking gray and still; a woman whose room i had been in only hours before to help give a bedbath at which time she was alert and oriented, chatting with her children. she was a bariatric patient (meaning she was large in size and required a ceiling lift to get her from a bed to a stretcher). and apparently she coded during this transfer (i believe they were trying to get her downstairs for a CT of some sort). the room was crowded by a cot (for her two daughters to sleep on), an oversized bed, AND a stretcher. there was hardly any room for people, let alone a code cart. CPR started. commands were being yelled. and in the midst of a code, i recognized a school friend of mine shouting orders (we went to high school together and she is now a fellow at UW, doing a rotation with heme onc); we made eye contact and she waved.
there wasn't much for me to do in the way of helping. there are usually TOO many people in a code situation. lots of gawking and curiosity. i like to make myself useful. so when i saw her 21 and 22 year old daughters crying in the hallway, i got them folding chairs and kleenex (small gestures). and brought liters of fluids be administered. and saline flushes to push drugs. i grabbed the doppler machine to find pulses (that never became present). and chatted with a brand new nurse who had a dear-in-the-headlights look about her, as if she will never be the same after having worked this particular shift and having witnessed this situation.
is it appropriate to say a code ended well, even if the patient died? apparently, as CPR was being performed and life-sustaining efforts were being made, the family discussed that their mother would not want to be on life-support. her longterm prognosis was poor. and her quality of life had already not been good. so with courage and great sadness, they gave permission to stop. with the nod of a head and the words, "time of death..." a woman passed. there were tears in the hall. amongst family. and one nurse. the patient's nurse. mine welled in my eyes, but never dripped down my cheeks.
as a side-note to this already sad story, i couldn't help but be aware of the fact that the patient's nurse (who might i add carried herself very professionally) must be suffering in a big way. it's always terrible to lose a patient; to have cared for someone so intimately and then to witness their death - especially when it is such a gruesome end. but this nurse holds a special place in my heart. i mentioned her earlier this year. at eight months pregnant, she went into labor and delivered a dead child. she held her tiny one in her arms, breathless and heartbeat-less, just a few months prior. and as i assisted the nurse in post-mortem care, wrapping a lifeless body in plastic and sealing a human life in a body bag, i couldn't help but worry that the nurse would not be okay. that she would go home and crumble. that even though she is courageous, she may not be able to return to work. because who can function after such great loss.
my fourth of july was nice, up until the code. and it ended in a nice way, after work. but for a few hours, it sucked. codes on the fourth of july are not good.
Monday, July 2, 2012
cancer lessons
The Things I Wish I Were Told When I Was
Diagnosed With Cancer
- by Jeff Tomczek, a 28 year old freelance writer who was diagnosed with leukemia at the age of 27. He now has no trace of leukemia.
Your relationships are about to change. All of them. Some will get stronger. They will probably not be with the people you would expect. The people you want to handle this well might not be able to for a variety of reasons. Some of the reasons will be selfish. Some of them will be entirely innocent and circumstantial. All of them will be forgivable because no one plans for cancer. Carrying bitterness or anger won't help your recovery. Fighting for anyone to stick with you won't cure you. Those who can, will.
You will be determined to have more energy than you do. You will convince yourself that you are thinking straight, are able to handle all of this and do not need anyone. You will run out fuel. Your body will change first and your mind will follow. You won't lose your mind, memories or sensibility. It will all come back. But, you will be different. You will never have the same sense of self. You should embrace this. Your old self was probably really great. Your transformed self will be even better. Give into what is happening and trust it.
You are going to feel fear. Even if you are normally stubborn, confident and seemingly invincible you will finally find yourself admitting that you are scared of something. Cancer is scary and incredibly confusing. The unknowing will eat at you worse than the disease itself. You'll need distractions. Music and sleep will probably be the ones you resort to most. Reading will become difficult. So will watching TV or movies, having conversations, writing and basically everything else. They call it "chemo brain" for a reason. You will feel normal eventually. Just a new kind of normal. When you feel afraid let yourself lean on those around you. Cry. Be vulnerable. You are vulnerable. There will be time for strength, but never admitting weakness will cause anxiety to mount and your condition to worsen. Let it all out. Yell if you need to. Sing when you feel up to it. Sob uncontrollably. Apologize for your mood swings. Treatments and prescriptions will often be the cause of them. The people that love you will understand.
The people that love you will be just as scared as you are. Probably more. They will be worrying even when they are smiling. They will assume you are in more pain than you are. They will be thinking about you dying and preparing for life without you. They will go through a process that you will never understand just like they will never understand the process you are going through. Let them process. Forgive them when they don't understand. Exercise patience when you can. Know that those that were built for this will be there when you get to the other side and you will all be able to laugh together again. You'll cry together too. Then you'll get to a place where you will just live in the world again together and that is when you know that you have beaten this.
The sooner you recognize that you are mortal, the sooner you can create the mentality for survival. There is a chance you might not make it. Just like there is a chance that you will. Don't look at statistics. You are unique and what is happening inside you is unique. Your fight is yours alone and there are too many factors to compare yourself to others that have had your condition. No one will want you to think about death, but you won't have a choice. You will think about it from the moment you are given your diagnosis. Come to terms with it. Calmly accept it. Then, shift every thought you have into believing that you won't die. You are going to beat this. Your mental focus on that fact will be more powerful than any treatment you receive.
Your doctors and nurses will become your source of comfort. You will feel safe with them. If you do not feel safe with them you need to change your care provider immediately. There is no time to waste. This shouldn't be a game played on anyone's terms but yours. When you find the right caretakers you will know immediately. Do not let insurance, money or red tape prevent you from getting the treatment you deserve. This is your only shot. There is always a way. Find those hands that you trust your life in and willingly give it to them. They will quickly bring you a sense of calm. They will spend time answering your questions. There will be no stupid questions to them. They won't do anything besides make you feel like you are the most important life that exists. They will never make you feel like they don't have things in control. They will be honest and accessible at all times. They might even become your friends. You might celebrate with them over drinks months or years after they have cured you. They deserve your gratitude, respect and appreciation daily. If you get upset at them during treatment know that they'll forgive you. They get that you're going through something they can't imagine- but they understand better than anyone. They see it every day and they choose to be there because they want to make the worst experience of your life more tolerable.
You will need to find balance after treatment. Start by seeking balance during treatment. Eat well. Sleep well. Listen to your body. Explore meditation. Experiment with new forms of exercise that aren't so demanding. Embrace massage and other body therapies. Go to therapy. A therapist will be able to guide you through your journey in ways you could never fathom. Do not be too proud to speak to someone. You cannot afford to store up the intensity of the emotion that comes with fighting a life-threatening illness. Let it out for yourself. You will begin to hear your voice changing. That voice is who you are becoming in the face of mortality. Listen to that voice. It will be the purest, most authentic version of you that you have ever known. Bring that person into the world -- strengths and vulnerabilities and everything between. Be that person forever.
You will inspire others. It will feel weird. People you haven't spoken to since grade school will be in touch. Ex-girlfriends, former colleagues... even people you felt never wanted to talk to you again. The influx of interest in your seemingly fading life will be greater than any living moment you have ever experienced. That support is what will shift a fading life into a surviving one. Be grateful for every message. Be appreciative of each gift and each visit. There will be moments where all of this attention will make you feel lonelier than you have ever felt in your life. In a hospital room full of people with messages stuffing your inbox, voicemail and mailbox you will find yourself feeling completely alone. This is when you will realize that you could afford to have a stronger relationship with yourself. That only you walk this earth with 100% investment in you. Make the investment and use this as an opportunity to reexamine your self-worth. Love yourself more than ever and recognize how much love there is for you in the world. Then start sharing that love. You will come to see that even when you are the neediest person you know you can still be giving. Giving will make you feel better than taking.
When you get to the other side you won't believe it. They will tell you the disease is gone. Everyone you know will rejoice and return back to their lives. You'll constantly wonder if it is coming back. Slowly this feeling will fade, but cancer will always be a part of you. It will define how you see the world moving forward. You're going to feel like the future is a funny thing to think about because the present is going to suddenly seem incredibly important. Keep moving. You'll be more productive. You'll understand who truly loves you because they will still be there. You'll want to meet new people that connect to the newly evolved version of your old self. You'll want to let go of those that don't "get" who you are now. You'll feel a little guilty doing it. Then, you'll move on. You don't have time to waste. The greatest gift you've been given is that you now understand that and you're going to make the most of every second. You're going to be the most passionate person you know going forward. Translate that passion to a greater purpose. Be fearless again.
You will be determined to have more energy than you do. You will convince yourself that you are thinking straight, are able to handle all of this and do not need anyone. You will run out fuel. Your body will change first and your mind will follow. You won't lose your mind, memories or sensibility. It will all come back. But, you will be different. You will never have the same sense of self. You should embrace this. Your old self was probably really great. Your transformed self will be even better. Give into what is happening and trust it.
You are going to feel fear. Even if you are normally stubborn, confident and seemingly invincible you will finally find yourself admitting that you are scared of something. Cancer is scary and incredibly confusing. The unknowing will eat at you worse than the disease itself. You'll need distractions. Music and sleep will probably be the ones you resort to most. Reading will become difficult. So will watching TV or movies, having conversations, writing and basically everything else. They call it "chemo brain" for a reason. You will feel normal eventually. Just a new kind of normal. When you feel afraid let yourself lean on those around you. Cry. Be vulnerable. You are vulnerable. There will be time for strength, but never admitting weakness will cause anxiety to mount and your condition to worsen. Let it all out. Yell if you need to. Sing when you feel up to it. Sob uncontrollably. Apologize for your mood swings. Treatments and prescriptions will often be the cause of them. The people that love you will understand.
The people that love you will be just as scared as you are. Probably more. They will be worrying even when they are smiling. They will assume you are in more pain than you are. They will be thinking about you dying and preparing for life without you. They will go through a process that you will never understand just like they will never understand the process you are going through. Let them process. Forgive them when they don't understand. Exercise patience when you can. Know that those that were built for this will be there when you get to the other side and you will all be able to laugh together again. You'll cry together too. Then you'll get to a place where you will just live in the world again together and that is when you know that you have beaten this.
The sooner you recognize that you are mortal, the sooner you can create the mentality for survival. There is a chance you might not make it. Just like there is a chance that you will. Don't look at statistics. You are unique and what is happening inside you is unique. Your fight is yours alone and there are too many factors to compare yourself to others that have had your condition. No one will want you to think about death, but you won't have a choice. You will think about it from the moment you are given your diagnosis. Come to terms with it. Calmly accept it. Then, shift every thought you have into believing that you won't die. You are going to beat this. Your mental focus on that fact will be more powerful than any treatment you receive.
Your doctors and nurses will become your source of comfort. You will feel safe with them. If you do not feel safe with them you need to change your care provider immediately. There is no time to waste. This shouldn't be a game played on anyone's terms but yours. When you find the right caretakers you will know immediately. Do not let insurance, money or red tape prevent you from getting the treatment you deserve. This is your only shot. There is always a way. Find those hands that you trust your life in and willingly give it to them. They will quickly bring you a sense of calm. They will spend time answering your questions. There will be no stupid questions to them. They won't do anything besides make you feel like you are the most important life that exists. They will never make you feel like they don't have things in control. They will be honest and accessible at all times. They might even become your friends. You might celebrate with them over drinks months or years after they have cured you. They deserve your gratitude, respect and appreciation daily. If you get upset at them during treatment know that they'll forgive you. They get that you're going through something they can't imagine- but they understand better than anyone. They see it every day and they choose to be there because they want to make the worst experience of your life more tolerable.
You will need to find balance after treatment. Start by seeking balance during treatment. Eat well. Sleep well. Listen to your body. Explore meditation. Experiment with new forms of exercise that aren't so demanding. Embrace massage and other body therapies. Go to therapy. A therapist will be able to guide you through your journey in ways you could never fathom. Do not be too proud to speak to someone. You cannot afford to store up the intensity of the emotion that comes with fighting a life-threatening illness. Let it out for yourself. You will begin to hear your voice changing. That voice is who you are becoming in the face of mortality. Listen to that voice. It will be the purest, most authentic version of you that you have ever known. Bring that person into the world -- strengths and vulnerabilities and everything between. Be that person forever.
You will inspire others. It will feel weird. People you haven't spoken to since grade school will be in touch. Ex-girlfriends, former colleagues... even people you felt never wanted to talk to you again. The influx of interest in your seemingly fading life will be greater than any living moment you have ever experienced. That support is what will shift a fading life into a surviving one. Be grateful for every message. Be appreciative of each gift and each visit. There will be moments where all of this attention will make you feel lonelier than you have ever felt in your life. In a hospital room full of people with messages stuffing your inbox, voicemail and mailbox you will find yourself feeling completely alone. This is when you will realize that you could afford to have a stronger relationship with yourself. That only you walk this earth with 100% investment in you. Make the investment and use this as an opportunity to reexamine your self-worth. Love yourself more than ever and recognize how much love there is for you in the world. Then start sharing that love. You will come to see that even when you are the neediest person you know you can still be giving. Giving will make you feel better than taking.
When you get to the other side you won't believe it. They will tell you the disease is gone. Everyone you know will rejoice and return back to their lives. You'll constantly wonder if it is coming back. Slowly this feeling will fade, but cancer will always be a part of you. It will define how you see the world moving forward. You're going to feel like the future is a funny thing to think about because the present is going to suddenly seem incredibly important. Keep moving. You'll be more productive. You'll understand who truly loves you because they will still be there. You'll want to meet new people that connect to the newly evolved version of your old self. You'll want to let go of those that don't "get" who you are now. You'll feel a little guilty doing it. Then, you'll move on. You don't have time to waste. The greatest gift you've been given is that you now understand that and you're going to make the most of every second. You're going to be the most passionate person you know going forward. Translate that passion to a greater purpose. Be fearless again.
Tuesday, June 26, 2012
sick day
hospital dates have turned into hooky days. i called in sick yesterday because i spent the weekend away; one night in portland and the other on the coast, at manzanita beach. i highly recommend a weekend away and a sick day. it does wonders for the mind, body, and spirit!
 |
| need i say more? |
Friday, June 22, 2012
the taj
if you dig deep enough, every person has an amazing story! my patient today seemed to have MANY. the best though, the one that made me slightly jealous, took place in india. at none other than the taj mahal. when my 65 year old male patient was 19 years old, he and several buddies drove a VW van from england to india... while visiting the taj at dusk, closing time, he and his friends hid. and they spent the night in one of the world's most famous buildings! in the morning, they splashed around in the reflection pools. and although a few of his friends were caught, my patient was not. i cared for someone today who has slept in the taj mahal. can you say you know anyone that has done that?
Tuesday, June 19, 2012
bi-birthday week
i rarely wish i was at work. but today, i wish i was working so that i could be the lucky nurse to delivery my sweet 73 year old (soon to be 74, this thursday) her new stem cells. i cared for her yesterday and she expressed her disappointment that i was not working today. a friend of mine will be infusing the two bags of stem cells. she'll do a great job. but i hope she remember to sing happy birthday (my practice when giving someone a transplant). i know she'd get a kick out of it! happy birthday b - - - -!
TTP
yesterday i cared for a 45 year old woman newly diagnosed with TTP - thrombotic thrombocytopenic purpura. say that 12 times fast! it's a clotting disorder thats onset is rather sudden and if left untreated causes death - rather rapidly. micro-clots form in the blood stream raising havoc in the kidneys, heart, and brain (just a few of the vital organs!).
the most successful treatment of this disorder is called plasmapheresis (seriously, why is everything in medicine so hard to pronounce?). anyhoo, what it entails is a dialysis-like machine. yesterday, my patient had 4L of plasma "exchanged." that's FOUR LITERS of donated plasma exchanged with her crappy plasma. it's quite the ordeal. it requires a fancy kind of line (intravenous access). and takes multiple hours. any time the body loses or exchanges liters of fluid (as in dialysis or plasmapheresis), blood pressure is critical and susceptible. hers was decent, but on the low end of normal all day.
so when a nursing assistant found me and told me my patient decided to leave the unit alone to get a latte, i was a bit worried. my patients are not allowed to leave our floor. with a hematocrit of 22 (seriously low) and a platelet count of 10 (crazy low), she is at a huge risk for a fall with potential for a lethal outcome. no joke. a fall with a platelet count of 10 could cause a serious brain bleed (just read the post from last week to know what i'm talking about).
i decided the damage was done. the nursing assistant had told her not to leave. but she did anyway. she's an adult and can make her own decisions.
but i really became worried when the secretary called me and told me to get down to the cafeteria STAT with a wheelchair. my patient was dizzy, about to fall, and nauseated. apparently some physicians were at her side, waiting for my arrival.
it was quite the scene i arrived at. my patient was surrounded by not one but three physicians. there were orange juice containers and sugar packets strewn about (i guess they assumed she was diabetic and had low blood sugar; quite the contrary... when i brought her back upstairs, her blood sugar was sky high thanks to their "help"). and one of the physicians was trying to check a blood pressure. i kid you not, she seriously said out loud, "i forget how to check a blood pressure." when i offered to do it for her, i got no response. now that i think of it, they didn't really talk to me at all.
i thanked the physicians for their "help" and returned my patient to my unit safe and sound.
the most successful treatment of this disorder is called plasmapheresis (seriously, why is everything in medicine so hard to pronounce?). anyhoo, what it entails is a dialysis-like machine. yesterday, my patient had 4L of plasma "exchanged." that's FOUR LITERS of donated plasma exchanged with her crappy plasma. it's quite the ordeal. it requires a fancy kind of line (intravenous access). and takes multiple hours. any time the body loses or exchanges liters of fluid (as in dialysis or plasmapheresis), blood pressure is critical and susceptible. hers was decent, but on the low end of normal all day.
so when a nursing assistant found me and told me my patient decided to leave the unit alone to get a latte, i was a bit worried. my patients are not allowed to leave our floor. with a hematocrit of 22 (seriously low) and a platelet count of 10 (crazy low), she is at a huge risk for a fall with potential for a lethal outcome. no joke. a fall with a platelet count of 10 could cause a serious brain bleed (just read the post from last week to know what i'm talking about).
i decided the damage was done. the nursing assistant had told her not to leave. but she did anyway. she's an adult and can make her own decisions.
but i really became worried when the secretary called me and told me to get down to the cafeteria STAT with a wheelchair. my patient was dizzy, about to fall, and nauseated. apparently some physicians were at her side, waiting for my arrival.
it was quite the scene i arrived at. my patient was surrounded by not one but three physicians. there were orange juice containers and sugar packets strewn about (i guess they assumed she was diabetic and had low blood sugar; quite the contrary... when i brought her back upstairs, her blood sugar was sky high thanks to their "help"). and one of the physicians was trying to check a blood pressure. i kid you not, she seriously said out loud, "i forget how to check a blood pressure." when i offered to do it for her, i got no response. now that i think of it, they didn't really talk to me at all.
i thanked the physicians for their "help" and returned my patient to my unit safe and sound.
Friday, June 15, 2012
old folks
work was a bit nuts this week. each day had its own excitement.
TUESDAY: hospital date # 2
WEDNESDAY: fall, black eye, and head bleed
THURSDAY: line placement, MRI, delayed chemotherapy and possible extravasation
i could write about so many things. but i feel inclined just to mention the sweet patient that i admitted on tuesday morning - a 73 year old woman who has been married for 55 years. when doing her admission history, i asked about her past medical history. she said, "i'm healthy - aside from cancer." she has an attitude about her, a feistiness that will hopefully serve her well during transplant. her husband and daughter sat by her side, teasing her about reading "soft porn" on her kindle (seriously, i can't even use a kindle!). and although she's quite wobbly on her feet (due to osteoarthritis), she refuses to use a commode at her bedside; "i have just a little bit of dignity left. i will walk to the bathroom!" she called herself a troublemaker and apologized for "allowing" her central line to literally fall out of her chest, prompting stat x-rays, a delay in her chemotherapy, and causing us to scramble and reorganize her day and our plans.
i thoroughly enjoyed caring for this little woman. in some ways, i suppose she reminded me of my own grandmother who was feisty in her own right, obstinate and stubborn beyond belief (much like myself). it's strange how once you lose your grandparents, you stop hanging out with elderly folks. unless you count your parents, who are slowly aging alongside myself. older folks have so many great things to teach us... i almost can't wait to head back to work next week to see what trouble little b---- has gotten herself into! and what lesson she can impart to me to make me more optimistic and just a bit wiser!
TUESDAY: hospital date # 2
WEDNESDAY: fall, black eye, and head bleed
THURSDAY: line placement, MRI, delayed chemotherapy and possible extravasation
i could write about so many things. but i feel inclined just to mention the sweet patient that i admitted on tuesday morning - a 73 year old woman who has been married for 55 years. when doing her admission history, i asked about her past medical history. she said, "i'm healthy - aside from cancer." she has an attitude about her, a feistiness that will hopefully serve her well during transplant. her husband and daughter sat by her side, teasing her about reading "soft porn" on her kindle (seriously, i can't even use a kindle!). and although she's quite wobbly on her feet (due to osteoarthritis), she refuses to use a commode at her bedside; "i have just a little bit of dignity left. i will walk to the bathroom!" she called herself a troublemaker and apologized for "allowing" her central line to literally fall out of her chest, prompting stat x-rays, a delay in her chemotherapy, and causing us to scramble and reorganize her day and our plans.
i thoroughly enjoyed caring for this little woman. in some ways, i suppose she reminded me of my own grandmother who was feisty in her own right, obstinate and stubborn beyond belief (much like myself). it's strange how once you lose your grandparents, you stop hanging out with elderly folks. unless you count your parents, who are slowly aging alongside myself. older folks have so many great things to teach us... i almost can't wait to head back to work next week to see what trouble little b---- has gotten herself into! and what lesson she can impart to me to make me more optimistic and just a bit wiser!
hospital date #2
i went on a second hospital date this week. i could get used to dates mid-day. kissing in seattle's drizzle makes a 12 hour shift much more exciting! the york peppermint patty from the gift shop that he brought me as a "gift" was just icing on the cake...
Thursday, June 7, 2012
nurse suspended
some crazy shit went down at work yesterday (and i'm not talking about my date).
this week at work, i have continued to be the computer support person. i have not had patients to care for, only staff and charts and computers. it's been kind of strange. a bit boring. but a nice change of pace. so, when my charge nurse (and friend) asked me to pick up a patient last night at about 4:45 PM i was a bit thrown for a loop. as the computer support person, i'm not supposed to have patients. but i went with the flow; i could tell something weird was happening.
sure enough, something weird happened. all around the same time, my other friend got pulled into a room with our manager. i saw the two of them together. nosy, i wondered what was happening! but it wasn't good. our manager ended up questioning her about the narcotics she had given to her patient. what time did she give them? how many? he was not accusing her of anything. he explicitly stated, "you are not in trouble. but answer these questions honestly. and don't mention that we're having this conversation." of course, she told me. but...
i could ramble about every minute detail that transpired within a 20 minute period. or i could just cut to the chase. a nurse that i work with, the nurse that trained me on my unit almost 6 years ago, was suspended. obviously, it's a hush hush matter. i don't know definitive accusations or details. but i do know that i ended up with one of this nurse's patients for the remainder of the shift. that the nurse was sent home immediately. that while i was getting a quick report from the nurse, my manager handed the nurse being sent home a business card (probably with the hospital's lawyer or the nursing union's representative info on it).
whatever went down wasn't good. narcotics are missing on my unit. and a nurse was sent home. sounds like a big deal to me.
i left work feeling hyper, anxious, and a bit awestruck last night. i recognize that i have the potential to hurt people at my job; we handle very dangerous medications. but i forget how much trust is put in our hands. how much access we have to things people pay really good money for on the street. how mood altering and addictive some of the things i handle on an every day basis are.
i feel for this nurse. i believe that the nurse is a good person. but i am so thankful that i have zero desire to do what that nurse may have done. that i am content with a nice caffeine buzz. and the giddiness i feel after a hospital date!
this week at work, i have continued to be the computer support person. i have not had patients to care for, only staff and charts and computers. it's been kind of strange. a bit boring. but a nice change of pace. so, when my charge nurse (and friend) asked me to pick up a patient last night at about 4:45 PM i was a bit thrown for a loop. as the computer support person, i'm not supposed to have patients. but i went with the flow; i could tell something weird was happening.
sure enough, something weird happened. all around the same time, my other friend got pulled into a room with our manager. i saw the two of them together. nosy, i wondered what was happening! but it wasn't good. our manager ended up questioning her about the narcotics she had given to her patient. what time did she give them? how many? he was not accusing her of anything. he explicitly stated, "you are not in trouble. but answer these questions honestly. and don't mention that we're having this conversation." of course, she told me. but...
i could ramble about every minute detail that transpired within a 20 minute period. or i could just cut to the chase. a nurse that i work with, the nurse that trained me on my unit almost 6 years ago, was suspended. obviously, it's a hush hush matter. i don't know definitive accusations or details. but i do know that i ended up with one of this nurse's patients for the remainder of the shift. that the nurse was sent home immediately. that while i was getting a quick report from the nurse, my manager handed the nurse being sent home a business card (probably with the hospital's lawyer or the nursing union's representative info on it).
whatever went down wasn't good. narcotics are missing on my unit. and a nurse was sent home. sounds like a big deal to me.
i left work feeling hyper, anxious, and a bit awestruck last night. i recognize that i have the potential to hurt people at my job; we handle very dangerous medications. but i forget how much trust is put in our hands. how much access we have to things people pay really good money for on the street. how mood altering and addictive some of the things i handle on an every day basis are.
i feel for this nurse. i believe that the nurse is a good person. but i am so thankful that i have zero desire to do what that nurse may have done. that i am content with a nice caffeine buzz. and the giddiness i feel after a hospital date!
Wednesday, June 6, 2012
first
i'm not going to divulge much about this, but...
i had a FIRST at work today. in the midst of my 12 hour shift, i went on a date. how hilarious and fun is that? although the "date" was very much innocent, something about it felt trashy and a little grey's anatomy! me, in my scrubs, sneaking away from my unit, going on a walk along the montlake cut, soaking up the few rays of sun that shone today, and giggling with a new man.
hmmm...
i had a FIRST at work today. in the midst of my 12 hour shift, i went on a date. how hilarious and fun is that? although the "date" was very much innocent, something about it felt trashy and a little grey's anatomy! me, in my scrubs, sneaking away from my unit, going on a walk along the montlake cut, soaking up the few rays of sun that shone today, and giggling with a new man.
hmmm...
Friday, June 1, 2012
knock, knock
i took care of a 25 year old boy yesterday. he has cancer. and as part of his treatment, he got chemotherapy infused in his central nervous system (intrathecal methotrexate). sadly, a side effect of his treatment was paralysis, from the belly button down. it wasn't supposed to be a side effect; but it was. so for the last month, he has learned to be as independent as possible.
one would think that a 25 year old boy with cancer who "accidentally" became essentially paraplegic would be angry. but instead, this boy has risen to his challenge. and he is kind. and polite. and appreciative. and determined.
because life can always get worse, this poor dude also has a bad case of diarrhea. of course he does. he can't get himself to the toilet. and his nurses are all practically his age (i'm making myself almost 7 years younger!). so to avoid the embarrassment, he has learned to get himself on and off a bedpan AND to clean himself up.
so, imagine my surprise and delight when at the end of the day, this guy wanted to tell me a knock-knock joke. i wish i could tell it to you out loud. it's sort of a joke you need to HEAR. so if you don't get it, read it aloud. say it a few times. and laugh.
"knock, knock."
"who's there?"
"smell mop."
"smell mop poo?"
ha, ha, ha. i laughed hysterically. a nurse always loves a good poop joke!
get it??? smell ma poo!?!
one would think that a 25 year old boy with cancer who "accidentally" became essentially paraplegic would be angry. but instead, this boy has risen to his challenge. and he is kind. and polite. and appreciative. and determined.
because life can always get worse, this poor dude also has a bad case of diarrhea. of course he does. he can't get himself to the toilet. and his nurses are all practically his age (i'm making myself almost 7 years younger!). so to avoid the embarrassment, he has learned to get himself on and off a bedpan AND to clean himself up.
so, imagine my surprise and delight when at the end of the day, this guy wanted to tell me a knock-knock joke. i wish i could tell it to you out loud. it's sort of a joke you need to HEAR. so if you don't get it, read it aloud. say it a few times. and laugh.
"knock, knock."
"who's there?"
"smell mop."
"smell mop poo?"
ha, ha, ha. i laughed hysterically. a nurse always loves a good poop joke!
get it??? smell ma poo!?!
Wednesday, May 30, 2012
heart vaca
haven't posted much lately. not much to say.
as you might imagine, going to work after losing a patient whom i cared for for three months feels different. i feel less motivated to work hard. i kind of want to protect myself from getting close to anyone else, from losing any other amazing human beings.
timing in life is funny. on may 19th, our hospital launched a new charting system. it has changed MUCH of our practice. and is taking A LOT of getting used to. and in preparation for this change, i volunteered months ago to be an "expert," a super-user if you will. which, if you knew me would make you laugh because i SUCK at all things computer. but i took extra classes. and volunteered to assist staff in the change. so, for my last two 12 hour shifts, i've done NO patient care. instead, i walk around the unit, asking nurses and physicians if they need help charting. i re-write physician orders and serve as a liason between staff and the new computer system professionals who pace around out unit, expert in the computer system but oblivious to our unit and the way in which it functions.
in some way, sitting in front of a computer and helping healthy nurses chart (instead of caring for sick people struggling to survive) feels good. it's kind of like a mini-heart vacation. i wouldn't say i enjoy it. it's kind of boring. and lame. and i'm not even that great at it. but a heart vaca was in order.
so, thank you CPOE (computer physician order entry)!
as you might imagine, going to work after losing a patient whom i cared for for three months feels different. i feel less motivated to work hard. i kind of want to protect myself from getting close to anyone else, from losing any other amazing human beings.
timing in life is funny. on may 19th, our hospital launched a new charting system. it has changed MUCH of our practice. and is taking A LOT of getting used to. and in preparation for this change, i volunteered months ago to be an "expert," a super-user if you will. which, if you knew me would make you laugh because i SUCK at all things computer. but i took extra classes. and volunteered to assist staff in the change. so, for my last two 12 hour shifts, i've done NO patient care. instead, i walk around the unit, asking nurses and physicians if they need help charting. i re-write physician orders and serve as a liason between staff and the new computer system professionals who pace around out unit, expert in the computer system but oblivious to our unit and the way in which it functions.
in some way, sitting in front of a computer and helping healthy nurses chart (instead of caring for sick people struggling to survive) feels good. it's kind of like a mini-heart vacation. i wouldn't say i enjoy it. it's kind of boring. and lame. and i'm not even that great at it. but a heart vaca was in order.
so, thank you CPOE (computer physician order entry)!
Friday, May 25, 2012
sympathy cards
"they lived and laughed and loved and left... and the world will never be the same."
i have a favorite sympathy card. there's an empty bench with a little red bird sitting on it. it's simple. and beautiful. and expresses what i feel about loss just perfectly.
and i sent it to nurse patient's family today.
to husband, 18 year old daughter, and 13 year old daughter-
i cannot express in words how sorry i am for your loss.
i feel so fortunate to have met and cared for nurse patient over the last few months. work became a special place for me where i felt privileged to care for a much loved, respected, and brave woman. despite being so sick and confined to the hospital (which often squelches peoples' true self), i feel like i got a glimpse into nurse patient's spirit. undoubtedly, she was an amazing and courageous woman! i so admired her strength and determination. she fought with every ounce of her being. and i know, beyond a doubt, if fighting and determination were enough, she would have waltzed out of the hospital, head held high, ready to face the world with her precious family. unfortunately, health isn't solely determined by bravery, courage, and determination.
work feels different without nurse patient's presence. i will miss caring for her and being a tiny part of her world. thank you for allowing me in to your family, for trusting me to care for your wife and mom. watching you love and care for nurse patient was a beautiful, beautiful thing. witnessing a bond so strong and a love so deep is a true honor. i feel blessed and privileged to have known nurse patient and will forever remember her.
please know you are in my thoughts and in my heart - today, tomorrow, and always.
sincerely,
christa
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