garden hoses

WARNING: this is crass and hilarious!

on monday, i answered the call light of a patient i have never met. i was trying to be helpful. but when you answer another nurse's call light, you never know what you're gonna get. when i was a brand new nurse, i never wanted to answer call lights. i was always so nervous that i wouldn't be able to handle the situation i walked into or answer the questions asked. but seven years later, i feel like i can manage most things. or at least know when i am in over my head.

this time, i walked in on an overweight gentleman profusely sweating. he was pacing around the room and looked pretty uncomfortable. i noticed that his IV pole had many bags of fluid hanging - some of which were actually connected to his foley catheter. just by assessing his IV pole, i knew that the man was receiving bladder irrigation. i know that people who require bladder irrigation for blood clots that form in their bladder and thus clot their urethra need LARGE foley catheters, not unequal to a garden hose. i would recognize the waddle from miles away (imagine walking with a garden hose coming out of your urethra. yup, OUCH!). but i didn't really expect the answer i got to my question: "what can i do for you? you look uncomfortable."

the patient said in an angry, serious voice, "of course i am uncomfortable. i have a forty pound dick!"

as a new nurse, i would have blushed and scurried about the room. trying to help him get situated. offering to call his nurse or physician.

but now, i laughed and said, "i don't think any man wants one that big, huh?"

oh come all ye faithful

today i cared for a woman on comfort care. she had been transitioned to comfort care yesterday because her prognosis is poor. but strangely, the team of medical professionals doesn't know EXACTLY what's going on with her. they cannot REALLY explain her decline. yes she has HHV6 in her cerebrospinal fluid. and yes her scans show substantial changes to her gray and white matter in her brain. but we cannot explain away WHY this happened.

but the WHY plays no part in how i care for my patient. and so, i did my very best this morning to make her comfortable and ensure her safety. i had been told that she was fairly unresponsive; that sometimes she says yes or no. but that her responses were not reliable. but i continued to talk, to explain what i was doing. and when i was done with her bedbath, i decided to tidy her room. now that our goals of treatment had shifted, there were things i could remove. and ALWAYS, ALWAYS there are things to straighten, dispose of, recycle, and organize. which the OCD in me enjoys. so i indulged...

my tidying revealed a CD player and christmas CDs. i decided to put one in. the first one was VERY peppy and almost felt inappropriate for the situation. so i changed it instantly to something more appropriate. christian christmas carols. the very first song to come on was "oh come all ye faithful." and although i haven't been to church in years and christmas has lost some of its meaning for me in the spiritual sense, i knew every word. and to my surprise, so did my patient. my dying, very sick, confused and nearly unresponsive patient began to sing. i felt flabbergasted. and amazed. touched. and saddened. and so, i sat with my patient, held her hand, and despite having a not-so-beautiful singing voice, sang every word to the entire song with her, for her, and to her.

visits at work

i don't know about other people's jobs. but mine is pretty inflexible. if i have a doctor's appointment, even if it's at 7:45 in the morning, i have to call in sick for a 12 hour day. or, if i need to pick up a friend at the airport, i have to make them take a taxi. i'm not aloud to come and go on a work day. i can't have a lunch break and go grab a bite at a local place. it's kind of a bummer. and makes work isolating and a bit inconvenient at times.

that's why when people visit me, it makes my ENTIRE day! it breaks up the 12 hours and makes work feel manageable. visits happen infrequently. but boy when they do, i LOVE it! sometimes my dad pops his head around the corner after he's gotten a blood draw. and to make the visit last longer, if i'm not busy, i walk him to the parking garage. fun, huh? it might not sound exciting, but it's the BEST. i feel so loved.

this sunday, a friend called and offered not only to stop by for a visit, but also, to deliver me my favorite coffee from my favorite coffee shop. what a friend! she even knows my drink by heart. and to avoid embarrassing myself, let's just say, it's not a simple drink. THAT is a good friend. seeing emma at the front desk made me smile. and having the opportunity to sit and chat with her for AN HOUR was the icing on the cake (not to mention, i got paid to hang out with one of my favorite people.... shhhh!).

it didn't even matter that the last two hours of my shift were crazy. i was caffeinated. and i felt loved...

thank you emma!

heart ache

today is the first of four days off. i slept in until 7:45 - even though my body naturally awoke at 5:45 (the brutal time i slip out of bed to prepare for my 12.5 hour day). and i've already started laundry, made a foot long to-do list, and am at my coffee shop sipping on a triple shot sugar free vanilla latte (they accidentally made me my drink with an extra shot - eek!). it feels grand.

work has been hard for me lately. i could blame the mistake(s) i've made. say that my confidence is shaken. my spirits are down. and perhaps that's part of it. but i also just want to say - my job is HARD. even the easy days - they're HARD.

this week, i cared for a 29 year old man/boy. in april he noticed a lesion on his tongue. he thought it was a canker sore and waited for it to go away. then he went to the dentist, and they were worried about it. but he waited for it to go away. and it never did. now, i don't know all of the details. but it wasn't until september that he was actually diagnosed - with stage IV tongue and neck cancer. and although further testing and more scans were ordered, still... he waited for it to go away.

today, the man/boy (who is really a scared and angry kid coping poorly in an adult body) will get a tube placed in his abdomen in order to feed himself. he can no longer swallow. he can't even open his mouth wide enough to brush his teeth. his tumor is the size of a softball and it has erupted through his cheek and jaw. he is hugely disfigured. and the tumor, once hiding under his skin, has stretched and pulled and finally broke through - leaving a bleeding, oozing mess. it's AWFUL. he won't talk - not just because it's hard and painful, but because he's mad. he is 29. when i was talking to our 60+ year old crass secretary about my patient he said this - "he's a kid. he should be out getting laid. and instead, he's stuck in the fucking hospital with attractive women taking care of him. he's pissed. and dying." it's true. he won't make it. his cancer is too advanced. it's inoperable.

and you know what? seeing ALL of this sadness weighs on my soul. i'm a fit, strong woman. i'm muscular and can run and squat and climb. i can carry lots of weight. lots of burden. (and for this, i am thankful. i don't take my health for granted. not after seeing so many people without it). but eventually, after seven plus years of this... after seeing more dead bodies than i can count. after hearing so many heartbreaking stories and comforting too many distraught patients and loved ones... your legs weaken. your shoulders hurt and hunch over. your muscles quiver. and your heart aches.

coffee break mid week

i find myself in coupeville, washington again. i was here just two weeks ago while on bereavement leave. but today, i squeezed in one more visit to my man friend as he completes his last week of clinicals here, working with one of the few town's physicians. it's peaceful here. sitting in a quaint little coffee shop - all of the locals chatting and catching up on the morning's gossip.

THIS is the kind of respite i need between each shift. i'm a ferry ride away from the real world. and yet, i feel like i'm on vacation. there is NOTHING to do here. i arrived at about 6:45 last night and i will leave by 6:45 tonight (because i worked a half day yesterday and i work tomorrow). i will do nothing but eat phad see ew noodles from the ONE thai restaurant, sleep tight in a warm bed, and drink coffee.

i wish i could come here after every shift. i worked 4 hours on sunday, 12 hours on monday, 5 hours yesterday, and i work thursday, friday, monday and tuesday (all 12 hour shifts). and i don't want to. i want vacation. sometimes it's hard being a grown up, with a stressful job that requires so much brain and too much heart. it's really hard to motivate myself to work so much, with such sick people.

for now, i'm gonna get back to sipping coffee...

bereavement vacation

i wanted to post an update. about my patient. the one i wrote about last. the patient i made "extra" comfortable with morphine (i'd like to see it as that, instead of as me making the biggest error of my nursing career). i worked with him last on sunday. and i learned that my patient passed away peacefully on tuesday surrounded by family, friends, and members of his church.

i'm still on bereavement leave. my schedule is such that taking off these three shifts for bereavement means i don't work until tuesday. and although EIGHT entire days off is a nice mini-vacation, it's still not enough to heal one's heart from the loss of a grandmother, the loss of a patient, and all of the past and future losses in my career as a nurse on my unit.

i NEVER want to take bereavement again; i do not want to suffer any more losses. but i will say, this bereavement vacation is doing me well.

BIG mistake

yesterday, i made a BIG mistake at work. i've made mistakes before.

but this, this was the BIGGEST mistake i've ever made. there were potentially lethal side effects. and i cried like i've never cried before. in fact, i freaked out once i realized what had happened. and i fessed up immediately to the prescribing nurse practitioner and to the attending so that we could rectify the mistake, if it was deemed necessary.

i want to describe every last detail. all of the events that led up to hanging the write medication at the wrong concentration, hence overdosing my patient on morphine. but there are TOO many details. it's never one thing that leads to mistakes. it's a string of little things that typically leads to a disaster. and unfortunately, i'm the last link - at the bedside, closest to the patient, with the most potential to do harm even while trying to help. i want to explain away how it happened. to prove that i did ALMOST everything right. that i had THE very best intention in mind - to provide pain relief to my dying patient who was gasping for breath and whose wife was finally ready and willing to accept comfort care. but i hope that YOU (whoever YOU are) know that i am a safe nurse. that i don't practice carelessly. that i respect medicine and nursing and all of the potential mistakes that could be made. but i don't want to type a novel. i already did that in my documentation of the error yesterday.

suffice it to say, i gave my dying patient more morphine than was ordered. and although i had a second nurse double check my hanging of the potent medication minutes after i hung it, it was not until 6 hours later that the error was caught. and by this time, my patient had had more than 60mg of morphine. for those of you who know medications and dying, this is NOT an unreasonable amount of morphine to keep a patient with air hunger comfortable. Ten mg of morphine per hour is however, a VERY large dose to START a continuous morphine drip. i should have hung the morphine at 2mg/hr and instead, due to hanging a 5:1 concentration bag instead of a 1:1 concentration bag, my patient received FIVE TIMES more than was ordered.

here's the good news. i made this mistake on a patient who was VERY uncomfortable. he was in multi-system organ failure and his death was imminent, whether or not i made an error. his response to the LARGE dose of morphine suggests that his body "needed" the relief. he tolerated the morphine well; morphine causes respiratory depression and even with LOTS of morphine in his system, his respiratory rate was within normal limits. and without ALL of that morphine, my patient might have continued to be VERY uncomfortable.

here's the other good news. the nurse practitioner and the attending were VERY nice. they actually played a part in allowing this error to happen. and while i was sobbing and pouring my heart out (saying, "this is my forte. i'm good at dying. i'm so mad that i made this mistake because it's something that i am so passionate about"), they complimented me on my nursing skill. on my ease at discussing difficult subjects with very vulnerable people. on anticipating orders and advocating for my patient.

here's the best news. my patient was okay (as "okay" as a dying man can be). once the mistake was revealed, it was decided to leave the medication at the current rate of 10mg/hr. the patient was comfortable. his wife (and the other TWENTY family members and friends) was content with her decision to stop curative treatment and start comfort measures. she was at peace, seeing her husband calm. and although my shift was over before he passed, i know that i played a part in helping someone to die peacefully - which was my aim all along.

it's kind of ironic. i should be at work today. i am scheduled to be there. but my grandmother passed away on saturday in switzerland. and i'm taking bereavement. i get my next three shifts off. and you know what, i need a break. i need to grieve the loss of this patient, whom i had cared for numerous times. and i need a bit of time to heal my conscience of this mistake.

ice cream scooper?

sometimes i feel like my work days are too lame to write about on a blog. like they're just pills and IV antibiotics. vomiting and diarrhea. who would want to hear about that?

and then, i have days that are so newsworthy and so dramatic i can barely muster the energy to re-hash them here on this little blog. they're too hard to contemplate again. and i'd rather pretend they didn't happen at all, so that i could move on with my life in blissful ignorance of all the pain and suffering in the world.

on wednesday, my 35 year old patient whom i have cared for off and on since january during his numerous hospital admissions, had the courage to admit he was having suicidal thoughts and requested to see psychiatry. we take suicidal ideation pretty seriously in the hospital. or at least i do. because i understand depression pretty well. and this man has every right to be feeling like his life is miserable and that perhaps, he would truly be better off if he were dead (isn't that sad? i care for people whose quality of life is sometimes so low that i too wish for them to die).

i notified my patient's doctor. and we went in and sat in our patient's bed - together. all three of us in our 30s. two of us very healthy and privileged. and one of us teetering between life and death. one of us wanting to control his destiny by overdosing on the same narcotics that are supposed to treat his pain. my patient sat there are bawled. i HATE seeing grown men cry. and i HATE when other grown men, physicians, don't know what to say or how to handle hard situations. i facilitated the talking. i told him he is brave. that he is doing the right thing seeking help.

the rest of the day was a series of check-ins. check-ins with my patient (to assure his safety). with charge nurses (on my unit and on psych - to see if we were doing the right thing). with the psychiatry team of residents and doctors. with his oncology team of doctors. with his pharmacist. with the discharge nurse (as he was going to be DCd to home that evening).

and although i truly believe that i did everything right, i went home feeling anxious. what if my very sick patient did attempt suicide? what if he succeeded? what if he ended his misery? would i feel glad that he was pain-free and done with his transplant battle? or would i feel partly to blame? like i should have done something better or differently?

i won't mention the rest of the week. it's too long. and too sad. but suffice it to say, i don't have good weeks when my family is potentially ill. and i don't like for my patient's to be a shade of grey-blue while struggling to breathe. and i don't like seeing wives in the hallway, pacing while their husbands are "crashing" - as one of them put it. (note the plural. wive(S). we had two codes yesterday).

working at molly moon's, scooping ice cream, working on my biceps and eating samples all day, is sounding better and better.

miracle man

this week, after a long 12 hour shift, as i walked down the mile long corridor towards the garage and couldn't find my key card to get past some doorway, a nice nurse came up behind me and let me through. we ended up walking to our cars together and chatted the whole way. turns out, i know this woman. not SUPER well. but enough. and she knows me. what my family has been through. she was one of my dad's primary nurses when he was a patient at my hospital more than 14 years ago for five weeks.

at first we just talked about our respective jobs. about oncology versus cardiac patients. about the number of our patients who die. we talked about the "heroic" and sometimes not so heroic measures we institute to keep people alive. and about how sometimes what we do in medicine feels inhumane and morally wrong. then, for a brief second we talked about how i was supposed to work on her unit. how i got a job as a cardiac ICU nurse and quit about 10 days before i was supposed to start via email from kolkata, india.

and then, she asked. a question i assume she was hesitant to ask. because after 14 years of being a cardiac patient, sometimes the outcome is not so good. but she asked anyway. "how is your dad doing?" i beamed with pleasure. my answer was "good. great actually. he just returned from almost a month in europe, visiting his home country. and earlier this year, he and my mom went to china. they retired more than a year ago and it's been so good for him. for them." the nurse remembered by dad's deli. he had only owned it for more than a year when he fell so ill.

it was nice to talk about my dad. people often ask me about him. because they know how important he is to me. how much i love him. care about him. and worry. then the nurse said, "you know, it's amazing how much i remember about your dad. i remember you and your sister and your mom so well." i replied with, "well, we were there a long time." but LOTS of her patients stay a long time. lots of patients have heartbreaking stories and supportive families. she said, "i guess you remember the miracles!"

happy birthday to my favorite miracle! my dad turns 68 years young today. and i love him!

she's back!

my lovely friend and new mama, marian, took 8 months off for maternity leave. she deserved every minute. but i'd be lying if i didn't admit, i totally missed her. thankfully, we made efforts to see each other on days off. i couldn't help but crave visits with her completely adorable daughter. and we started to run together to train for a 10k race that we completed in august. and i do believe, we're actually better friends than in january when she left for her two days of bedrest and then the more than 7 week early arrival of ada.

but, she's back!

i've been lucky enough to work with her several days already since her return (and mine from vacation). and it makes work such a different place. to carpool to work with a friend (because we now live so close). to work alongside a fantastic nurse who offers help when needed (and when not needed). to sit down during breaks (of the opportunity arrives) and share super personal stories, dreams, and hopes while hiding from patients, colleagues, and managers.

this week, we worked together on sunday and monday. yesterday, i spent the majority of the morning with her and her little sidekick - enjoying coffee, running, and going to costco. and today, i'm ALONE (more on that in some other blog post - but cole is in yakima for the next month). so i miss her (and him). but we're back at it tomorrow - work on thursday or friday. and although i'd much prefer more time off, it sure feels nice knowing that i'm working with my friend.

hemorrhoids

it's always hard to come back from vacation. going from breakfasts of croissants and brisk hikes in mountain air to rushed microwaved soy patties and the stale hospital air that my job provides is - well, to say the least - rough. but it's especially hard when you're thrown in (because the higher ups trust you and give you hard assignments). on tuesday, i had three patients - two of whom were off service and discharged at the very exact same moment. wednesday i was doused in trach juices by a very lovely woman my dad's age; she has tongue cancer and required the placement of a tracheostomy to breathe. and to be honest, i have NO idea when it comes to trach care. that afternoon, i was asked to do conscious sedation for a patient other than my own - a transplant patient who has been doing more than $100.00 a day of marijauna. needless to say, the bronchoscopy was very chill - he didn't squirm, he didn't care, and thankfully, he kept breathing. but yesterday, yesterday was the hardest.

i cared for a gal just three months younger than myself. she and her husband have been married for 9 years. they have two children. and they are from WAY out of state. and the reason she showed up in seattle is because we were the only cancer center willing to offer her a shot. she's sick. refractory to chemo (meaning she cannot get into remission, even for a bit). and to top off this glorious deal, she has a super scary hemorrhoid! you couldn't imagine how much trouble a hemorrhoid can cause. she can't sit. she can't go to the bathroom. she can't sleep. she's miserable. and yet, she has the best attitude.

i told her that i dislike caring for patients my age. it just doesn't seem fair. and she said, "He has a plan." i'm not much of a believer, but i said, "it better be a good one." i want this woman to survive; she is kind (and the good ones always seem to die). and she said, "somehow, it always is - whatever it is." ahhhh... to be at such peace. what a brave lady!

in the afternoon, her equally as kind husband asked if i would teach him how to care for his wife's "wound." and so, i raised the bed to his height. making sure he wasn't too squeamish. and he kindly and carefully watched my hands do what his would be doing in the future. i told him he was brave, that nursing isn't for everyone. and he said, "i made a commitment - and i know she would do it for me." it sounds simple. i quick re-living of vows. an acknowledgement of love and kindness. in sickness and in health.

but it was so special to witness. so touching. i left. and i think they cried. and typing this, i want to too.

very expensive babysitter

today i am a very expensive babysitter... i am sitting outside the room of a patient, watching, waiting for him to impulsively jump out of bed without regard to his many IV lines attached to his chest. at which time, i too will jump, don my yellow gown, mask, and gloves, and assist him to his commode chair (hopefully before he has had an accident). my patient is a grown man, slightly confused. when asked this morning where he is, he responded in all seriousness with "the parliament building." and because he is currently slightly unsafe on his feet and unaware in his mind, i am his right hand woman. and i am BORED. it could be worse. but seriously, i just want to be on vacation.



today is my last shift before more than two weeks off. cole and i leave for switzerland on monday for a quick rendezvous in the mountains. after a few solo days, we will meet up with my parents to tour my dad's home town of disentis. should be quite relaxing - drinking coffee and eating cheese fondue, going on walks on tiny trails behind the most beautiful and melodic cows (the bells, not the moos). in some ways, this is a celebration of sorts. cole has finished his didactic year of PA school. we have survived our first year together. as of august 18th, we have lived together for one month and lived to tell the tale. and in some ways this is a brace-yourself-for-the-next-year trip. cole starts rotations all over the state when we return and i head back to the grind. what a summer it has been!



i haven't written here much. i'm not sure if it's been because i was unmotivated or too busy. perhaps uninspired by my patients and or experiences here. my favorite patient, the saline gal, well... i have good news about her. i sent her home about three weeks ago. i walked her out to the garage myself. the first breath of fresh air was shocking and tearful. and my very biggest hope is that she only gets better each day!

moving day!

yesterday was a strange work day in the very best way...

i got standby at 9:30!  the charge nurse, who is a friend of mine, decided we were overstaffed and that if i wanted, i could leave work, be on-call, and then return at 3:00 when we would become understaffed.  of course, i would have to pick up different patients at 3 (which meant losing my favorite 27 year old gal).  but it was worth it for me.  her response, "you can't go" said with a wine.  and then a "good luck with the move christa."

cole was going to do the walk-thru and get our keys to our very first place together ALONE.  and of course, i was sad about it.  but in all this moving debacle, i am learning, going with the flow is often best.  i am not good at going with the flow.  it is most definitely something i need to work on.  and today especially, as i have movers heaving my most precious belongings and wheeling greasy handtrucks on my beige carpet, i must breathe in and out.  and let go of all control.

getting the keys together to our place was perfect.  our new space, minus all of our belongings, looks very nice and peaceful (in a few hours, it's going to look like a disaster zone).  and cole and i shared fun conversations and kisses.

and at 3, it was back to work.  i cared for two grumpy men who were uninterested in seeing me.  which was perfect.  because i was too tired and hyper (at the same time, if you can believe that) to be my best nurse self.  the shittiest part of a pretty decent day...

when i went to say goodnight to my favorite patient, i discovered, she's sicker.  she has an infection in her lungs.  she's getting a bronchoscopy today - as i type.  and i know i'm attached when i would almost rather be at work caring for her than taking a day off.

do people die?

my 27 year old patient - the one who is afraid of saline and who i have grown much to attached to - asked me point blank this morning, "do people die here?"

considering we have the most deaths in the entire hospital and considering i frequently (well, certainly more than most people i know) wrap up bodies in plastic body bags, i didn't quite know how to respond.  sometimes i speak before i think...

this time i said, "well, this is a hospital.  of course people die here."  and then i quickly followed it up with, "but people i like don't get to think about dying.  they have to stay positive and do well."

suddenly, i felt unsupportive.  like maybe i had shut up my patient, just when she needed me the most.  so i sat down and asked, "why are you asking me?"

what proceeded was a very candid conversation followed by some tears.

and now, i only like her more.

more stress

i just need to vent a little...

i worked last tuesday, wednesday, and thursday.  and this week, i work monday, tuesday, and wednesday.  that's more than 72 hours in 9 days.

on friday, saturday, and sunday, i spent the majority of each day packing up the cumulation of my life, the condo where i have lived for more than 7 years (by myself).

and on thursday morning, at 9 AM, movers will arrive at my door.  thank god for them by the way.

but good god, this is stressful.

summer = stress

summer.

summer in seattle is beautiful.  for the few weeks that it lasts, i enjoy being outside and soaking up some sunshine.  i know it's good for my mind and my vitamin d levels.

but this summer.  i feel like i barely have time to breathe.

it doesn't help that this summer i am moving.  renting out my condo space.  volunteering one week of my time at a camp for developmentally disabled folks.  attending my first gay wedding (for a couple who has been together for more than 30+ years).  training for a 10k.  seeing every doctor i know for every body part that can get examined (why do i make doctor appointments for summer?).  and planning a trip to switzerland with cole to visit my dad's hometown.  oh, all the while working full time as a nurse.

not to mention, i am also supporting/loving a man who is moving.  who is sharing a living space with me (what is he thinking?!?).  who remains in school full time and is writing a thesis. who is planning a trip to switzerland.  who will be attending his first same-sex wedding.  and who, starting september, will have month long clinical rotations all over the state of washington.  first stop - yakima.  then - coupeville.  and finally - bellingham.  

this summer = stress.

one crane

this week i cared for a woman more than 100 days post her transplant.  she should have been on her way home, with her baby-but-new immune system.  but instead, she was flying home with her cancer in relapse, to die amidst palm trees and sunshine instead of in a strange city where it rains, even in summer.  my patient's niece was keeping my patient company when i walked into her room in the afternoon; she was meticulously folding paper cranes.  it's been a few years since i worked on my 1000 for our unit.  but as soon as i saw the tiny square paper, i HAD to fold one.  so i sat down with my new lady "friends" and folded a paper crane.  just 1 out of 1000.  i know it won't bring the luck my patient needs.  but i do hope it helps to bring some peace and a good death.

the C word

i've discussed my dad being a patient.  i claimed he was my very favorite.  although, i don't like taking care of him.  because i don't like to admit that he is sick.  and i hate to witness his steady decline.  his aging.  and his heart pooping out.

but i like it just as little when my mom is the patient.  in the last few months, my mom has been a patient.  not the heart kind.  thank god.  a different kind.  that could be equally as dangerous.  and just as scary.  it's just a different organ.  did you know that skin is an organ?  one of the most vital.  if we didn't have it - imagine, the rest of our stuff would fall out!

anyway, my mom went to a dermatologist to get a tiny skin tag removed.  it was on her neck.  but thankfully, the dermatologist asked her to get NAKED - even though they'd never met.  the naked part served to be crucial.  as he did a total body scan of all of my mom's moles, sure enough, he found some suspicious ones.  and sure enough, after the biopsies, one came back as melanoma - the big daddy of all skin cancers.  the bad one.  the one that can metastasize.

so, we went back together.  to get the margins removed (especially with melanoma, you want to be sure you've removed ALL of the cancer).  and i watched as they sliced a nice chunk out of my mom's back. i asked questions.  lots of them.  like the nurse daughter that i am.  and hoped to never seen the man again.

but, three months later (now my mom needs every 3 month total body scans), he found more suspicious moles.  and he did 3 more biopsies.  and one more returned positive for melanoma.  another - basal cell.  neither is good.  no one wants misbehaving cells on his or her body.  and i don't like it ONE BIT.

perhaps i'm not the nicest of daughters . . . but as my mom worries about my dad's health and always talks as if he is going to die so soon and she will be left alone, i remind her that she could die first.  i mean, right?  she could be hit by a bus.  or have a heart attack.  or get skin cancer.  it's not like i want that.  but i'm a pessimist.  and sometimes a realist.  and perhaps i just don't like the idea of my dad dying ever or of leaving my mom alone.

but when the C word hits your family.  and it hits your mom.  one of your very best friends.  your biggest supporter and cheerleader.  your sidekick.  your telephone buddy and shopping companion.  your - "i came from you, and you raised me, and i'm so much like you." it can seem too much to handle.  i'm a C word nurse.  nobody i know is allowed to get the C word.  especially my mom.  i need her.  forever.

end of story.

diet coke and tootsie rolls

despite having a third patient added to my assignment late this morning, i had a good start to my shift.  in one hour and fifteen minutes, i saw all three patients, got their vitals, completed their assessments, delivered tons of scheduled medications, buckets of ice, and extra anti-emetics for those feeling particularly pukey.  my orthodontist patient gave me a full, free consultation, complete with pulling down my lips, assessing my gums, and quoting a cost for invisiline - the perfect alternative to braces.  the best part though was when my manager delivered to me a diet coke and ten tootsie rolls for talking to the joint commission yesterday and helping to make our unit and staff look good (i had told him yesterday that he owed me a drink and when asked, "what's your poison,"i responded with "a diet coke and tootsie rolls" - i mean, it's the best the gift shop can offer).

anxiety

this week, i cared for the same patient that called me the "vagina whisperer."  i like her.  she's young and feisty.  and when i admitted her, she warned, "i call the shots."  if i was a patient, i'd be bossy too.  so i was okay with it.  as long as her demands weren't too crazy.  and they weren't.  really.

although, my patient does have a phobia/allergy to saline.  which in the grand scheme of things is kind of a big deal.  saline is like sterile salt water.  i didn't ask, but i wonder, is she allergic to the ocean?  we use saline ALL the time in the hospital, especially with our patients who are getting multiple medications, multiple blood draws, and have central lines for constant intravenous access.  every time i use a central line, i flush with 10mL of saline - before and after blood draw, before and after administration of medications, blah, blah, blah.  i use saline ALL the time.  getting through transplant without saline is literally impossible.  there is NO alternative.  because NO ONE is really allergic to saline.

my sweet patient has had two transplants prior to this one.  she has spent more days than she can count in the hospital.  and i don't doubt that she's been nauseated, has thrown up, and been miserable numerous times.  and often, patients report that they can "taste" the saline flush (even though we flush it into a VEIN - nowhere near the mouth or stomach or GI tract).  anyhoo.  being the nice nurse that i am and having a case of anxiety myself, i was sensitive.  i went along with her gum-chewing routine pre and post saline flush.  and i went slow, like she commanded.  and i told her every last detail about what i was doing.  so that she would trust me.  and it worked out nicely.  there was very little nausea.  and no throwing up.

at one point, my patient asked me what would happen if she refused to get flushed with saline.  if she refused the IV medications that require saline before and after.  and opted for needles to get her blood instead of her IV access that serves as a faucet for blood.  i was kind of flabbergasted.  this saline thing is a TRUE phobia.  it's anxiety at its extreme.  and so, i point blank told her, she has to get over it.  it sounds insensitive.  but she needs saline.  she won't survive transplant without it.  and i told her that.  i also shared, "dear, i have anxiety too.  only, i haven't figured out my gum chewing routine to get me through it.  you have a solution.  and it works.  you're doing great.  you have to keep going.  and you have to do well."

third time's a charm, right?  i hope this third transplant works.  

feedback

i'd say this is pretty decent feedback regarding my care and the unit i work on...

"christa treated me so well. i never felt rushed or a burden and i was always well informed and included. in fact, everyone was wonderful on __unit. Even walking the hallways, i felt like i was accepted and part of a community. as if just being on the floor and being smiled at could help you heal faster. people walking by would stop to chat if they had time. i've never met a staff so friendly. i'll tell you, __unit has set a high standard for this guy. if i ever have one of my friends or family get sick in seattle, i'm telling you, i'm hopping in a cab and coming straight to you guys. in my opinion, there isn't any better care anywhere."

new nickname

nurses get called lots of things.  and often they are not nice things.  thankfully, my patient population is fairly kind.  and rarely do i get called something not nice.  but the other day, i was called something i've never been called before.  and not something i ever thought i would find complimentary.  seeing as i am a heterosexual female.  but i'm gonna take this is as a compliment.  from a 26 year old female patient - terrified about getting a foley catheter inserted into her urethra (pee hole) - i got called "the vagina whisperer."  we laughed.  awkwardly.  and i felt proud.

what now

i'm about to get really cranky and opinionated.  so if you're going to be offended, don't read further. 

i am currently being paid time and a half (happy memorial day) to sit in my patient's room (while she sleeps) and make sure that she is safe (ie. doesn't attempt to kill herself with IV tubing or slippers or her spoon).  don't get me wrong.  i feel for patient's with psychiatric disorders.  anyone that tries to kill herself more than 100 times is obviously not normal.

BUT...

i'm angry at the system.  why is my psych patient on an oncology unit?  our beds are the most expensive in the house.  why is she 26 years old and nobody has been able to help her?  how is she able to manipulate so many people into getting what she wants?  why can someone like this have children and people that i know and love who want children more than anything cannot?  what should our state do with people with mental disorders?

i feel kind of angry.  and helpless really.  i'm certainly not equipped to help this woman.  and so many people before me (who are) have failed.  so, what now? 

DANGER

i have a lot to say about my job.  about everything really.

for instance...

today i cared for a 26 year old woman with multiple psychiatric disorders.  she has attempted suicide more than 100 times.  and has procreated twice.  her children will never know her.  they are probably better off for that.  

and...

last thursday, my patient died at 9:03 in the morning.  her daughter-in-law requested a hug from me even though we just met.  and she said, "i don't know how you do what you do.  it must be so hard."  

it is...

but all i feel like saying at the moment is, my colleague got poop IN HIS EYE yesterday.  

nursing is dangerous.  

heartstrings

certain things tug at heartstrings.  for some people, it's animals.  for others, it's hallmark commercials.  kids tend to hug at my heartstrings and i'm not even a mother yet.

i worked on monday and tuesday.

on monday, a patient on our unit was getting her second stem cell transplant.  soon after her first one, she relapsed.  and hence, needed a second one to cure her disease and give her the best chance at living life with her darling family.  she was not my patient.  but her nurse asked some of us to join him in singing happy birthday to his patient.  sometimes we do this.  sometimes i do this.  especially when i like my patient and they are positive and kind and i think they might get a kick out of a dozen or so nurses singing a horrible rendition of happy birthday while they are getting their transplant.  so we sang.  and the patient smiled.  her 3 year old son snuggled up beside her in bed.  beaming with pride.  singing along.  what is it about kids and happy birthday?  they LOVE it.

and i cried.  i couldn't help but be touched.  by the child's innocence.  his love.  his momma's love.  and her fear - that this might not work.  that she might be celebrating her last "birthday" with her son.

on tuesday, my day was a whirlwind.  i played nurse, tour guide, and secretary.  nurses wear many hats.  and just by chance, i happened to be answering phone calls when the same patient from the day before walked up with her little son.  grandma was taking him home.  maybe for a nap.  but he didn't want to go.  he wanted to hold his mom's hand.  and so she walked him to the elevator.  gave him kisses.  told him that grandma would take good care of him.  i'm sure her heart was breaking inside too. of course she wanted to go with them.  ditch her IV pole of life saving medications.  and get the hell out of her scary situation.  but instead, she left her mother and son at the elevator.  moments later, he broke free from his grandmother's hand and ran to my desk - right in front of me.  he looked at his mom down the long white hospital hallway.  and he waved.  a sweet wave.  a perpetual wave.  he wouldn't stop.  and his lower lip trembled.  and his eyes teared.  god he loves his momma.  it was so clear.  he knows something is up.  he turned back to the elevator, to grandma.  then returned to my desk.  and he waved again.  and the lip pouted.  i watched this dance for what felt like several minutes.  back to grandma at the elevator. then back to the hallway, to see his momma and wave.  on his final trip from the elevator to the hall, instead of waving, he held up his tiny fingers and made the sign for i love you in sign language.  

it seemed like a routine they have done before.  but there was desperation in it.  a mature desperation.  there were no tantrums.  just resignation.  acceptance.  that momma belongs in the hospital.  and the tiny little 3 year old most move forward, without her, strong and brave.  ready to face the world.

heartstrings.

anniversary

it's been one whole year since nurse patient died. 

i think about her frequently. 

and i think of her husband. 

and her two daughters. 

best "work" day ever

i had a personal chauffeur this morning - my mom.

we went to a french bakery for coffee and pastries before she dropped me off for my second day of jury duty.

from 9:00 until about 10:00, i sat in the quiet room at the municipal court on my laptop, catching up on emails, reading blogs, and pinning things on pinterest.

and right around 10:00, i got called off of duty.

and headed home.  once again, using my free bus tickets.

i was supposed to be working today, an entire 12 hour shift.

and get this, i got paid for the ENTIRE day.

plus my $10.00 jury duty payment.

working for the state and serving the state kind of rules.

here's to jury duty every year!

"rough" day

i'm downtown serving my civic duty today.

i woke up around 6:57 - much later than a normal work day.

and i leisurely walked a few blocks to get a coffee.

next, i hopped on the #12 down to madison and 5th avenue.

and i sat for a few hours until my name was called.

then, along with 15 other folks, i got quizzed on the law, on "innocent until proven guilty," and on my attitudes towards drinking and driving.

and i was kindly let go.

i think i'm too conservative when it comes to drinking.

for lunch i spent all but 1 of the dollars i am making today.

and now i am sipping on free tea while using wi-fi.

soon, i will be taking the bus home with my free bus tickets.

and my day will end hours before the end of a nurse shift.

"rough" day.

support

for the past few days, i've been working with a 45 year old woman struggling with breast cancer.  she's had breast cancer since 2001 - that means she was only 33 years old when she was diagnosed.  she was a new mom then.  now, she has a high school age daughter and an 18 year old son.  and although i don't know much about her life, i witnessed her support system.  she is circled by friends and caring and prayer.  and it's a huge honor to witness such love.

at this point in her disease, she has metastases to her bones and lymph nodes.  and as of late (like in the last week), she has had mental status changes that suggest she has brain mets also.  her responses to questions are slow.  and she has difficulty finding the correct words to explain herself.  she gets confused whether it is day or night.  and although she doesn't have much choice, she allows medical professionals to poke and prod her over and over.

last night, i knelt in front of her, held her shoulders that were slumped over her bedside table, and rested my head near hers (to keep her still), while two physicians sliced through ribs and drained almost one liter of fluid from her lungs.  i felt like we were taking a nap together.  she was calm.  and i was tired.  while we were "hugging," the world was still.  i felt good.  and i hope she felt safe.  that i would protect her from the resident who had never done a thoracentesis and was doing it for the first time with a fellow guiding his every move.  that i would talk her through their actions - since they sometimes forget they are working on humans.  that i would find her support system once the doctors left so that she would never be alone.

my job is incredible sometimes.  i witness such love.  and such devotion.  sometimes IT (whatever IT is) is so palpable that i am left speechless.

 in awe.  crying while charting at my computer.

did i mention that my patient's two main caregivers are her ex-husband and her best friend from mississippi who flew in to be with her for this indefinite amount of time before she passes?  some people are blessed with good support.  good friends.  and love.

i am too.      

see something new every day

today, i did something i've never done before.  i touched a penile implant.  in a penis. 

nursing is SO weird.

jury duty

you know your life is lame when you look forward to jury duty.  i got called.  for the third time.  on may 7th.  and sadly, i am not scheduled to work as a nurse on the 7th.  if i was, my employer has to pay me for my civil duties.  but i am scheduled to work on the 8th and the 9th.  if they put me on some trial that lasts days and days, perhaps i will get a little respite from nursing.  oh and they give you a whopping ten dollars per day as a juror.  woohooo!!!  i just worked 60+ hours in the last 7 days.  i need a break.  one that jury duty might provide.

compliments

a new nurse gave me a compliment yesterday that i really appreciated.  she said this - "i've been watching you precept that student and i'm really sad that i didn't get a chance in my orientation to be precepted by you.  you seem really smart and calm.  like i would have learned a lot from you."  it was nice.  i enjoy teaching.  and i think i am decent at it.  but to have someone recognize it.  to compliment me.  well, compliments always feel nice.

need another vacation

time flies.  i've already been back from vacation for more than 2.5 weeks and i feel like i could already use another break.  how does that happen?  i only work 3 or 4 twelves per week and already, i want more time off.  do all adults feel this way?  is constant vacation the only way to be happy?  better not be the case because the way i see it, at almost 33 years old, i have at least 30 more years of work ahead.  good god.  that seems a bit depressing.

since i never shared any photos from my trip to guatemala, let me do that.  this trip was not health related.  i did NO volunteer work.  i didn't save any children.  or cure cancer.  i didn't even build houses.  i simply toured all the sites, went to church on palm sunday, witnessed jesus parades for easter week, and enjoyed my boyfriend.  we went to tikal to see ancient mayan ruins.  and to lake atitlan for a hippy retreat off the grid (that means they used only solar power and our shower was frigid).  we spent only one day doing nothing - sleeping in, taking naps, and eating street food.  it was divine.  all of it.  guatemala.  cole (hospital hunk).  adventure.

without further ado...

baby "priest" sleeps through parade

 jesus and the telephone pole cross

 at the cemetery

 feet on cobblestone streets of antigua

 view from hippy hotel on lake atitlan

 colorful streets of antigua

umbrella sellers

 sweaty kiss at tikal on tower four

always a nurse

yesterday, as cole and i were leaving a local coffee shop, i waited at the door for an elderly man who seemed to be wanting to come inside.  instead he asked me what time the locale was open until and if i knew whether or not they served for dinner - he was inquiring for his son he was caring for.  without questioning, the man kind of unloaded on cole and me.  somehow he mentioned the name of the place he is living (which is affiliated with scca and thus, all of my patients) and so i said, "oh, i'm a nurse.  i wonder if your son is one of my patients."  i guess i'm always a nurse.  when people look dead on a sidewalk or just when an old man needs a shoulder to lean on and ear to listen.  poor man.  he explained his story.  he (at 80 years old) is the only caregiver for his son who has had a bone marrow transplant that has seemed to fail.  he used interesting words - layman's words - like "they keep killing him with chemo."  and when i acknowledged the stress he must be under, he said with tears in his throat, "sometimes i just want to run away.  but i'm his dad.  i'm his only person."  after chatting for at least 10 minutes, cole and i found an escape.  i almost wanted to invite the man over for dinner.  but instead we wished him well.  as we parted, he thanked me for all that i do.  he was genuine.  it was kind.  and sincere.  and it wasn't but 10 steps before i burst into tears.  "everyone i'm surrounded by is so sad," i said into cole's chest.  "life is so unfair for so many people."  no father should watch his son dying.

thank god for vacation.  and trips to guatemala.

i'm out. 

coinkidinks

we live in a very small world.

yesterday, my 75 year old patient was visited by his pastor.  because i saw that he had a visitor, i chose to leave my patient alone for a while.  eventually, i decided i should complete my tasks - deliver medication and check his blood sugar.  so i interrupted.  and thus began the weirdest coincidence.

my patient's visitor, his pastor for the last 25 years, is the husband of the woman who babysat me from the time i was maybe 2 until i was 7 (when they moved from mercer island to lake forest park).  gail lived right between my pre-school and what would become my elementary school.  i was walked across the street everyday so that i could play in her sandbox with her two sons.  she helped to raise me since both my parents worked.

the man didn't recognize me.  and at first, i wasn't sure he was truly mike, gail's husband.  but when i asked if his son's nickname had been popo, i got the strangest stare.  then it clicked for him.  "i gave your sons the chicken pox!"  (his mom had me chew gum and share it with her little ones - to get it over worth).

i love coinkidinks!

oops

nurses have DARK senses of humor.  so when my friend andy was having a hard day and said something about his patient having difficulty breathing, i kinda joked and said, "well, if he just stopped breathing altogether, maybe your shift would be easier."  andy looked at me with that you didn't just say that look.  and we parted and went about our lives.  it was just ten minutes later that i responded to an emergency light.  andy's patient's oxygen saturation was 70%.  he was struggling to breathe.  and unresponsive.  we rubbed his chest.  attempted to get him to respond.  we called respiratory therapy.  and anesthesia.  they intubated him.  and sent him to the ICU.  and all i could think was, "shit, did i make this happen?"  me and my stupid sense of humor.

feeling pessimistic

the last two days i worked, i cared for the sweetest woman.  she's 49 years old.  she's a mother.  to two twenty-something girls who very much need their mom.  go figure, she got admitted to our unit because she is SICK.  everyone on my unit is SICK.  but this woman deserves capitals.  she needs some cheerleaders.  or angels.  or something.

she is 120 post her transplant.  and although she got her own cells back (which is our "easiest" kind of transplant), she struggled from the beginning.  her mouth sores got so bad after chemotherapy, she was intubated.  her lungs started to hemorrhage for no reason.  her heartbeat became erratic and required extra monitoring.  and when she left the hospital, we thought it was a miracle.  we clapped.  and felt joy in our hearts.  a passion was re-ignited - a hope - that maybe transplant works.  maybe all this hard work - witnessing people suffer - has purpose.  maybe there is life after transplant after all.

but once again, now i am not sure.  her future - if she has one - is going to be VERY hard.

as i prepare for work tomorrow, i feel a sense of apprehension and anxiety.  the kind, loving part of me that knows i am good at my job, that knows i offered the best kind of support to this patient, wants to care for her again.  tomorrow and the next day.  maybe until her discharge - to home or to the heavens (we call it a discharge to the eternal care unit or a celestial discharge).  i know she felt safe with me.  and i did a good job, juggling all of her needs - medical and emotional.  hence, there's a small part of me that wants to call my unit and request that i be her nurse tomorrow.

but somewhere inside, there's also part of me that never wants to see her tearful eyes again.  part of me wants to avoid her like the plague.  pretend like she doesn't exist and never inquire about her well-being. if i accidentally acknowledge her existence, i want to pretend that she's getting better, that when her room is empty it's because she's well, shopping with her daughters, celebrating birthdays and graduations and weddings.  but i'm not that optimistic.  never have been.  and never will.  not when it comes to cancer.  on my unit.

stagnant

i haven't written much lately.  i think i've been feeling disenchanted. burnt out. bored. depressed.  

yesterday i spent all day with a girlfriend.  in the almost seven years since we finished nursing school together, cassie has had oh i don't know, three or four different jobs.  she went back to school.  she's a nurse practitioner.  she's moved at least three times.  had twelve different hair-dos.  run thousands of miles - literally.  and is currently making over her life - for the umpteenth time.  just hearing about her life is exhausting and exhilarating and exciting! 

i'm not writing about cassie because i'm jealous.  although sometimes i am.  jealousy is the worst, ugliest quality.  

i'm writing and comparing myself to others because sometimes i feel stagnant.  unlike cassie, i've lived in the same place for seven years.  my hair is always the same - long and brown.  i've had one job.  and there are only two initials after my name.  

sometimes i feel like i'm supposed to do more, be more.  try something new, and different.  like bangs.  or being the private nurse of a plastic surgeon!  

but i'm bad at change.  in fact, i sort of hate it.  so, it's back to work tomorrow.  and the next day.  and on sunday and monday too.  

here's the good news.  i have a vacation coming up - next thursday.  guatemala, here i come.  with hospital hunk.  remember him?  i love that man.  i'm excited for sunshine.  vibrant colors at boisterous markets. parading crucified jesus's during easter week in antigua.  and time away from seattle, the MEDEX PA program, and cole's never, ending homework to-do list.  

traveling remains

check out this article here

i couldn't help but smile.

the trip of a lifetime.  one last hoorah!

souls

on tuesday, i watched my patient take her last breaths.  she had no family at her bedside.  she was all alone (other than for my presence).  and so i held her hand.  and watched her for several minutes.  to see if she was going to breathe one more time.  to see if i could see her soul leave her body.  but she never breathed again.  and i didn't see her soul leave her body.  but something happened to mine.  i can't name it.  but i felt proud of myself for staying with a woman when i was afraid.  and i felt alive even though i felt so sad.

a bit numb

this week, in one twelve hour shift, my unit had three deaths.  i think there is some strange fact - one person dies every eight seconds (and two more are born).  or something.  but, i'm pretty sure my unit filled the quota for the day in a small area.  or for seattle for that matter.  it sure seemed like a lot of loss.  i don't like to think that many people are suffering all at once - especially around me.

i'm back to precepting new graduate nurses again (even though i adamantly told my bosses i wouldn't ever do it again because of a certain incident with one of my nurse managers - check this out).  but, what can i say?  i'm a pushover.  anyway, as part of a new nurse's six week orientation, if the opportunity arises, i always make her participate in post-mortem care.  most new nurses have never seen a dead body.  most shake in their danskos a bit.  and i walk them through it.  explain that i think it's an honor to participate in someone's last bath.  and if someone has to wrap a human body in a plastic body bag, then you better believe, i want to do it and i am going to do it with respect.

so, two new nurses, one seasoned male nurse (with a big heart and eyes that well up, even when he doesn't want them to), and i bathed a patient who had been on our unit for months.  he had died a few hours before, peacefully, planned, on a morphine drip.  each of us had cared for him before.  he was a nice man.  kind.  quiet.  strong.  and we completed our task with respect and dignity.

however, without thinking too much about it, i assumed it would be my only intimate experience with death that day.  i was wrong. 

a few hours later in the day, i answered the call light of a patient.  she was not my patient.  but her nurse had asked if i could help her.  the patient's pain pump was beeping and she was busy.  so, as i messed with the pump and quieted the noise, i heard the patient rattle...  the death rattle.  that's what nurses call it.  you know it when you hear it.  it doesn't sound good.  there is some struggle in it.  and surrounding loved ones usually panic.  typically you wait for another one to come.  sporadically.  not nearly as often as regular breaths.  but this time, nothing followed.  surrounded by her sister, son, and very best friend, i witnessed the last breath of a complete stranger.  there were questions and instant sobs.  "is she gone" her son wailed.  "i think so," i said quietly, holding her hand.

ironically, a chaplain had followed me into the room moments prior.  and so with her, we consoled the family.  it was gut-wrenching and amazing all at once.  her son began to panic; the 35 year old grown man began to hyperventilate.  i told him to take my place, to take his mother's hand from my hand and to be with her as she passed.  i assured him that both she and he would be okay.  "i know," he said. 

i stayed for a few minutes.  long enough to know the woman was loved.  that she was amazing.  and irreplaceable.  and the world will never be the same without her.

i came home from work that night.  a bit numb.  one more patient had passed, close to change of shift.

what does one do to recover from such a day?  i'm not a drinker.  but if i was, i just might have had a few. 

maternity leave starts today

i'm bummed.  nursing just became a little harder and a bit more dull.  my bff (marian's debut blogpost) just discovered today that she is on pseudo bedrest.  she is due march 5th; but because her little girly is measuring VERY TINY, they are suggesting she stop working as a nurse - it's not like it's the easiest, most relaxing job.  marian has worked just as diligently her entire pregnancy as she did before she got knocked up.  and she's entertained me just as "hard" (that's a word she uses - all the time).  somehow, the days i work with marian are easier and more fun.  tomorrow starts marian's SEVEN months of maternity leave.  wish her luck.  i'll need some too - just to get through the 84 twelve hour shifts without her!  

liver transplant

one day this week, i was walking in to work.  i was probably rushing, running a few minutes late.  UW has one of the longest hallways in the nation.  and by the end of it, i'm usually sweating and grumpy, not wanting to be at work at 6:54 AM.  but i couldn't help but smile and feel privileged to work in medicine when i heard a man checking in at the information desk.  he was speaking with the volunteer front desk staff (who i know is a heart transplant survivor; he wears a mask and when i was doing my clinicals at UW while in nursing school, i spoke with him).  the patient said, "i'm checking in for my liver transplant.  the man on the phone this morning told me you'd be able to direct me."  it was serendipitous that i heard this interaction.  i could have been 10 minutes earlier or 5 seconds later.  but witnessing miracles in my place of work made me feel excited to be a nurse.  excited to provide care to sick people.  excited to participate in miracles.

eat your heart out

happy new year...

welcome to 2013!

i had planned on writing some inspiring post to start the new year; to re-ignite my passion for writing and nursing.  but instead, i have to share something totally insignificant (albeit hilarious).  i may have heard the best quote of the year, and it's only january 3rd.

my 380 pound patient, after having hallucinations about kanye west, said in a funny voice - "i'd like to eat dinner off of lil kim's ass!"  i don't know exactly what she meant by that.  i don't know if she actually meant to say it in front of me.  but it was all i could to do leave the room without cackling to myself. 

eat your heart out my sweet patient!