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.