so, i'm precepting yet another new nurse. this one is a bit older than the wee-ones i've been teaching, just out of college, barely old enough to drink. nursing is this lady's second career. and i'm nervous she will need a third.
i've prepepted MANY nurses. i wanna say at least 20. maybe more. and all of them have turned out decent. a few, exceptional. but this one leaves me concerned. and i feel horrible about it.
new nurses (even experienced nurses) get six weeks of one on one training with me (or another preceptor on our unit). over the course of these six weeks, i do my best to impart my nursing wisdom and teach not just the policies and procedures on "how" we do things, but the "why" behind the things we do too. our goal is that after orientation, we have shaped, molded, and created a SAFE nurse - one who is not only capable of caring for a patient's complex needs but also, one willing and aware of when to ask for help if she/he is in over her/his head. some people feel nervous to ask for help, as if needing assistance is a kind of failure. but the scarier person is the one who doesn't know that help is needed.
i've been worried about this new nurse since the beginning. on our third week together, i started to voice my concerns to our assistant nurse manager. by week four, i spoke with the head honcho. and now, at the end of six weeks and with two more 12 hour shifts added to extend orientation as a continued trial, i feel in over my head. as if i have nothing left to teach. that perhaps this woman is just incapable of learning. that she is too nervous, forgetful, or dumb to be a good nurse. at the end of tomorrow's shift, i'm supposed to meet with our manager and help decide if our unit is just "not a good fit." that's what she's calling it. but basically, she means we might fire her. and i will have played a HUGE role in that decision.
typically more than one person precepts a new employee. but after three shifts with another preceptor, this new nurse expressed that she and i had a better relationship. that my teaching methods worked better for her. that her other preceptor added stress instead of relieving it. so here i am, her only teacher, with only hours left to teach... and i don't want to go to work tomorrow.
wish us luck. it's sink or swim time tomorrow...
Monday, December 8, 2014
Friday, November 7, 2014
two firsts
i had really wanted to write about this incident when it happened, when all of my feelings were raw and fresh... but it happened the week before i left for asia. and i was busy working TOO much, packing, and scrambling to see family, friends, and a baby being born!
there are certain milestones in a nursing career. i'm guessing they're different for each type of nursing. but for an oncology nurse some of them might include - first admit, first mistake, first death, first code. i've been a nurse for more than EIGHT years now; hence, i don't experience firsts very often anymore. but on september 26th, i had a first. i did CPR on a patient. now, i have had my patients transfer to the ICU (when they are VERY sick). and i've had patients die, more than once while i was in the room - sometimes with family present and a few times with just me in the room, witnessing the last breath. i've even had my own patient code - two different times. but each time, other people responded. the first time, i was still a brand new nurse and was in such shock, i'm not sure i could have stated my own name. and the second time, another nurse walked into the situation (a blue patient) and started the rapid response that led to CPR and intubation and eventually, days later, to death.
but this time, i did the CPR.
(WARNING: this is not for the faint of heart - which means, i probably shouldn't read it either)
it was such a strange day. i was precepting a new nurse (as i do frequently these days). she was on her last few weeks of orientation so she was mostly doing all of the work. she's a rockstar newbie (because i trained her as a nursing student!). but anyway, i left the unit that morning to complete my annual CPR training. in front of an evaluator, i had to demonstrate that i know how to do CPR. i did two minutes of compressions on a dummy and was given my gold star. i passed. and just a few hours later, at about 1PM, there was a code on my unit. a young patient flatlined. dozens of people filled the room. and i assumed my normal position - delivery supplies, finding chairs, kleenex, and water bottles for family and loved ones who are hysterical in the hall. but i did not do CPR. i wasn't needed at that time. there were plenty of nurses in the room. and to be honest, i'm scared of CPR. i don't even know if i think CPR is ethical... on my unit that is. even when our patients survive codes, the likelihood of them surviving long term is miniscule. and CPR breaks ribs. it's violent.
but in the afternoon, i sat with other nurses discussing codes and CPR. and i admitted out loud that i've been a nurse for a long time and have never done it. in my head, i started to regret not volunteering during the code. i thought that perhaps it's something i should be able to say i have done.
so, when we had another code in the evening, this time with a different patient (the previous patient survived the code and the day), i decided it was my time. perhaps it wasn't that conscious of a decision. i had been in the room, handing nurses syringes and priming tubing when someone started to round up a few folks to do 2 minute rounds of compressions. there weren't many volunteers. so, i jumped in. my anxiety was present - me and my little sidekick. i announced to the physician running the code and to the respiratory therapists that this was my first time. that if i was doing it wrong they should let me know. but in we went. and before i even knew what i was doing, i was thumping on a man's chest. his lifeless body jumped with each compression. and blood spewed from his orifices. all codes are different. but this one, it was particularly messy. he must have been bleeding internally so with every compression, a fountain of body fluids sprayed in the air. the respiratory therapists at the head of the bed tried to contain the fluids, as they were bagging the patient (breathing for them). but it was to no avail. there was HIV positive blood everywhere.
the code did not end well. the patient expired (i hate that word). and because i had chemo to hang and another patient needing things, i left in a rush, sweating profusely without time to think or process. it was about 6:30 PM at that time, and the day was coming to a close. i gave report and headed home. cole picked me up. and i'm guessing i was still a bit stunned. but i shared the news - and the scary fact that the patient had AIDS. and that there was blood everywhere. but we discussed it. and decided, i was not at RISK. i was wearing gloves while doing the CPR. i couldn't remember, but i think i was wearing a mask for all of the rounds of CPR i completed (isn't it crazy that i can't remember? adrenaline is a funny thing). nothing splashed on me that i know of. so when we got home, cole inspected my scrubs. there were no traces of blood on my clothed or naked body. i took a shower. headed to bed. and went back to work in the morning...
only to find that those involved in the code, many of them had gone to the ER that night due to risk of blood exposure during CPR. people involved to the very same extent as me had been treated and were now taking anti-retrovirals to prevent them from contracting HIV. i was flabbergasted. a bit frantic. and worried. i called cole. i called cassie. i even called my mom (the infamous worrier). and i discussed what to do with those involved the day prior. so, to appease my concern, i went to the ER to get blood drawn and to see what they had to say. it's interesting. medicine is so not standard; it varies from physician to physician, even for patients in the very same situation. the physician i saw had a completely different reaction than the physician my friends had seen the night before. she decided my risk was SO small that it wasn't worth being on anti-retrovirals for ONE MONTH! plus, anti-retrovirals make people feel like crap. and of course, i was headed out of the country.
turns out. i'm happy with my decision. i thought about my risk of contracting HIV - they say with a KNOWN needle stick exposure (which i did not have) the risk is less than 0.3%. and on my trip, i maybe had a few fleeting thoughts. but i was not distracted or scared. i wouldn't even say worried. my initial blood work came back negative - not surprisingly. and i'll follow up again soon.
so, i guess i had two firsts. my first experience with CPR. and my first potential HIV exposure.
phew. sorry this turned out to be SO long.
there are certain milestones in a nursing career. i'm guessing they're different for each type of nursing. but for an oncology nurse some of them might include - first admit, first mistake, first death, first code. i've been a nurse for more than EIGHT years now; hence, i don't experience firsts very often anymore. but on september 26th, i had a first. i did CPR on a patient. now, i have had my patients transfer to the ICU (when they are VERY sick). and i've had patients die, more than once while i was in the room - sometimes with family present and a few times with just me in the room, witnessing the last breath. i've even had my own patient code - two different times. but each time, other people responded. the first time, i was still a brand new nurse and was in such shock, i'm not sure i could have stated my own name. and the second time, another nurse walked into the situation (a blue patient) and started the rapid response that led to CPR and intubation and eventually, days later, to death.
but this time, i did the CPR.
(WARNING: this is not for the faint of heart - which means, i probably shouldn't read it either)
it was such a strange day. i was precepting a new nurse (as i do frequently these days). she was on her last few weeks of orientation so she was mostly doing all of the work. she's a rockstar newbie (because i trained her as a nursing student!). but anyway, i left the unit that morning to complete my annual CPR training. in front of an evaluator, i had to demonstrate that i know how to do CPR. i did two minutes of compressions on a dummy and was given my gold star. i passed. and just a few hours later, at about 1PM, there was a code on my unit. a young patient flatlined. dozens of people filled the room. and i assumed my normal position - delivery supplies, finding chairs, kleenex, and water bottles for family and loved ones who are hysterical in the hall. but i did not do CPR. i wasn't needed at that time. there were plenty of nurses in the room. and to be honest, i'm scared of CPR. i don't even know if i think CPR is ethical... on my unit that is. even when our patients survive codes, the likelihood of them surviving long term is miniscule. and CPR breaks ribs. it's violent.
but in the afternoon, i sat with other nurses discussing codes and CPR. and i admitted out loud that i've been a nurse for a long time and have never done it. in my head, i started to regret not volunteering during the code. i thought that perhaps it's something i should be able to say i have done.
so, when we had another code in the evening, this time with a different patient (the previous patient survived the code and the day), i decided it was my time. perhaps it wasn't that conscious of a decision. i had been in the room, handing nurses syringes and priming tubing when someone started to round up a few folks to do 2 minute rounds of compressions. there weren't many volunteers. so, i jumped in. my anxiety was present - me and my little sidekick. i announced to the physician running the code and to the respiratory therapists that this was my first time. that if i was doing it wrong they should let me know. but in we went. and before i even knew what i was doing, i was thumping on a man's chest. his lifeless body jumped with each compression. and blood spewed from his orifices. all codes are different. but this one, it was particularly messy. he must have been bleeding internally so with every compression, a fountain of body fluids sprayed in the air. the respiratory therapists at the head of the bed tried to contain the fluids, as they were bagging the patient (breathing for them). but it was to no avail. there was HIV positive blood everywhere.
the code did not end well. the patient expired (i hate that word). and because i had chemo to hang and another patient needing things, i left in a rush, sweating profusely without time to think or process. it was about 6:30 PM at that time, and the day was coming to a close. i gave report and headed home. cole picked me up. and i'm guessing i was still a bit stunned. but i shared the news - and the scary fact that the patient had AIDS. and that there was blood everywhere. but we discussed it. and decided, i was not at RISK. i was wearing gloves while doing the CPR. i couldn't remember, but i think i was wearing a mask for all of the rounds of CPR i completed (isn't it crazy that i can't remember? adrenaline is a funny thing). nothing splashed on me that i know of. so when we got home, cole inspected my scrubs. there were no traces of blood on my clothed or naked body. i took a shower. headed to bed. and went back to work in the morning...
only to find that those involved in the code, many of them had gone to the ER that night due to risk of blood exposure during CPR. people involved to the very same extent as me had been treated and were now taking anti-retrovirals to prevent them from contracting HIV. i was flabbergasted. a bit frantic. and worried. i called cole. i called cassie. i even called my mom (the infamous worrier). and i discussed what to do with those involved the day prior. so, to appease my concern, i went to the ER to get blood drawn and to see what they had to say. it's interesting. medicine is so not standard; it varies from physician to physician, even for patients in the very same situation. the physician i saw had a completely different reaction than the physician my friends had seen the night before. she decided my risk was SO small that it wasn't worth being on anti-retrovirals for ONE MONTH! plus, anti-retrovirals make people feel like crap. and of course, i was headed out of the country.
turns out. i'm happy with my decision. i thought about my risk of contracting HIV - they say with a KNOWN needle stick exposure (which i did not have) the risk is less than 0.3%. and on my trip, i maybe had a few fleeting thoughts. but i was not distracted or scared. i wouldn't even say worried. my initial blood work came back negative - not surprisingly. and i'll follow up again soon.
so, i guess i had two firsts. my first experience with CPR. and my first potential HIV exposure.
phew. sorry this turned out to be SO long.
Thursday, November 6, 2014
the gal who was afraid of saline
pardon my blogging hiatus...
i stepped away from nursing for a while! and i try (sort of) to keep this blog about my job.
as mentioned in my last post, i went to morocco in september. and then, just a week ago, i returned from thailand, bhutan, and cambodia - a most wonderful vacation and 31 days away from oncology nursing.
but i'm back. in full swing. that's how it always feels after vacation - like i never left. people are still sick. in fact, some of the same people who were in the hospital a month ago are still in the hospital now. some have discharged. and a few have died. sadly, one of my very favorite patients - nelson. on a side note, i did get to raise a prayer flag in his honor while trekking. and coincidentally, i learned when i was back to civilization, nelson died the day i honored him. i had no idea. his flag is blowing in the winds, close to the heavens, continually sending prayers.
now, on to some positive news, for once (i feel like negatively nelly, i'm always so pessimistic). i was charting at the computers yesterday when at the front desk, out of the corner of my eye, i saw a beautiful young woman that i recognized - but not quite. you see, this woman was healthy. she had a head full of curly hair. and she wore make-up. she looked only a bit like the patient i cared for long ago - the gal who was afraid of saline. anyway, i screamed, "what are you doing here?" and she screamed back, "i came to visit you CHRISTA!" she remembered my name. she came to visit ME. she didn't remember any other nurses - just me and the physical therapist (a young man who made her get out of bed every day even though she barely could, even though she didn't want to. and sometimes, they shook their booties in the hall, because that's how spicy she was and continues to be).
i cant' tell you how elated i felt seeing my patient pal, the one who offered to take me out on the town a year and a half ago. she wanted to buy me a beer on capitol hill - even though i don't drink. she said she'd show me a good time. she asked about my life. if i was still dating "that PA guy." and i asked how she was doing. if she was in remission (YES she is, yay). if she was still on immunosuppressants and steroids (yes she is, BUMMER). here's the good part, she's "healthy," for a three time transplant survivor. and best of all, she's HAPPY!
and i helped get her there. don't get to see that everyday.
i stepped away from nursing for a while! and i try (sort of) to keep this blog about my job.
as mentioned in my last post, i went to morocco in september. and then, just a week ago, i returned from thailand, bhutan, and cambodia - a most wonderful vacation and 31 days away from oncology nursing.
but i'm back. in full swing. that's how it always feels after vacation - like i never left. people are still sick. in fact, some of the same people who were in the hospital a month ago are still in the hospital now. some have discharged. and a few have died. sadly, one of my very favorite patients - nelson. on a side note, i did get to raise a prayer flag in his honor while trekking. and coincidentally, i learned when i was back to civilization, nelson died the day i honored him. i had no idea. his flag is blowing in the winds, close to the heavens, continually sending prayers.
now, on to some positive news, for once (i feel like negatively nelly, i'm always so pessimistic). i was charting at the computers yesterday when at the front desk, out of the corner of my eye, i saw a beautiful young woman that i recognized - but not quite. you see, this woman was healthy. she had a head full of curly hair. and she wore make-up. she looked only a bit like the patient i cared for long ago - the gal who was afraid of saline. anyway, i screamed, "what are you doing here?" and she screamed back, "i came to visit you CHRISTA!" she remembered my name. she came to visit ME. she didn't remember any other nurses - just me and the physical therapist (a young man who made her get out of bed every day even though she barely could, even though she didn't want to. and sometimes, they shook their booties in the hall, because that's how spicy she was and continues to be).
i cant' tell you how elated i felt seeing my patient pal, the one who offered to take me out on the town a year and a half ago. she wanted to buy me a beer on capitol hill - even though i don't drink. she said she'd show me a good time. she asked about my life. if i was still dating "that PA guy." and i asked how she was doing. if she was in remission (YES she is, yay). if she was still on immunosuppressants and steroids (yes she is, BUMMER). here's the good part, she's "healthy," for a three time transplant survivor. and best of all, she's HAPPY!
and i helped get her there. don't get to see that everyday.
Monday, September 8, 2014
"mini" vacation coming up!
i've taken a break from blog posts lately, mainly because it's been a crazy month, jam-packed with exciting and not-so-exciting things. just a quick run down...
- my umpteenth year of camp parkview nursing
- cole's completion of his year of rotations and his second and final year of PA school
- his return HOME to our lovely place in northgate (he's been living in random locales, wherever his clinicals have been)
- cole's graduation and a medical themed bbq celebration
- a day of bumbershoot
- too many work shifts and the rollout of barcode scanning all of our medications
- meeting two new babies in my friends' lives (tiny maggie and baby bennett)
- planning the adventure of a lifetime with cole in october
- doctors appointments (dentists, gynecologists, dad's cardiologist, etc, etc)
but here's the best news of all. i have ONE shift left before a mini-vacation. i say "mini" only because it is shorter than my vacation planned in october. but by no sense is it MINI. it's BIG. HUGE. and oh so exciting. after one 12 hour shift tomorrow, i leave wednesday for morocco! AFRICA! yippee. i feel like the luckiest girl alive. i get to meet one of my very best friends, cassie, and adventure in marrakech, morocco. it's kind of like a dream come true. cassie and i traveled together after we graduated from nursing school. we went to thailand, india, and nepal. it was how we became such great friends. and ever since then, EIGHT years ago, we've dreamed and planned and dreamed some more about creating new traveling memories. buying more random souvenirs. and eating questionable food that will either go down as the best meal we've ever had or the tastiest meal that made us the most sick in our lives!!!
may twelve hours tomorrow pass ever so quickly... so i can get to morocco ASAP.
- my umpteenth year of camp parkview nursing
- cole's completion of his year of rotations and his second and final year of PA school
- his return HOME to our lovely place in northgate (he's been living in random locales, wherever his clinicals have been)
- cole's graduation and a medical themed bbq celebration
- a day of bumbershoot
- too many work shifts and the rollout of barcode scanning all of our medications
- meeting two new babies in my friends' lives (tiny maggie and baby bennett)
- planning the adventure of a lifetime with cole in october
- doctors appointments (dentists, gynecologists, dad's cardiologist, etc, etc)
but here's the best news of all. i have ONE shift left before a mini-vacation. i say "mini" only because it is shorter than my vacation planned in october. but by no sense is it MINI. it's BIG. HUGE. and oh so exciting. after one 12 hour shift tomorrow, i leave wednesday for morocco! AFRICA! yippee. i feel like the luckiest girl alive. i get to meet one of my very best friends, cassie, and adventure in marrakech, morocco. it's kind of like a dream come true. cassie and i traveled together after we graduated from nursing school. we went to thailand, india, and nepal. it was how we became such great friends. and ever since then, EIGHT years ago, we've dreamed and planned and dreamed some more about creating new traveling memories. buying more random souvenirs. and eating questionable food that will either go down as the best meal we've ever had or the tastiest meal that made us the most sick in our lives!!!
may twelve hours tomorrow pass ever so quickly... so i can get to morocco ASAP.
Wednesday, July 30, 2014
life and death
i'm so glad i didn't have to go to work today. i don't think i could have done it. my heart broke a little more yesterday (i say "more" because it breaks at work frequently)... and i needed today to nurture my soul. aside from a dentist appointment at 8 o'clock (i HATE the dentist, especially at 8 o'clock), i've been really good to myself. coffee in my glass mug while surfing the internet and eating a croissant from my favorite bakery - bakery nouveau. some organizing in my kitchen. taking out the garbage, recycling, and compost (while these chores are not fun, they do leave my space smelling and looking better). i think i might go rock climbing this afternoon to sweat out some of my demons (or ya yas as my friend cassie would say). and tonight, i have a massage at 7:30. i'm hoping to relax, to get to that dream la-la-land state, and let the tension in my muscles and brain leave my body.
yesterday, i stood in the room of my 31 year old patient, with her mom, stepdad, sister, and friends. there were four nurses, one social worker, and a priest. and we watched, as a respiratory therapist disconnected a sweet, spunky soul from the ventilator. sometimes the human body has an incredible reserve. and sometimes, it is only medicine keeping a body alive. abigail took her last assisted breath as tears filled the room. the monitor screeched. her ekg flat-lined. what moments before looked like a pink, glowing soul, turned mottled, blue, and waxy right before my eyes. (cole and i spoke about life last night. when is it that the soul leaves the body? does it leave right away? or does it linger, trying to figure out where to go next and what just happened). i'd like to think that a little bit of abby's soul seeped into each of us in that room. that each of is better, stronger, and braver because we knew her and because we were there, holding her hands and touching her body during her final moments.
i was right, a few weeks ago, when i helped my patient escape from the hospital to feel normal, just for a few hours. it would be her last hours outside. the last time sunlight kissed her face. the last time oxygen made from trees would fill her lungs.
i feel honored to have been a part of both of those days - both abby's living and her dying. her life. and her death.
may her soul live on.
yesterday, i stood in the room of my 31 year old patient, with her mom, stepdad, sister, and friends. there were four nurses, one social worker, and a priest. and we watched, as a respiratory therapist disconnected a sweet, spunky soul from the ventilator. sometimes the human body has an incredible reserve. and sometimes, it is only medicine keeping a body alive. abigail took her last assisted breath as tears filled the room. the monitor screeched. her ekg flat-lined. what moments before looked like a pink, glowing soul, turned mottled, blue, and waxy right before my eyes. (cole and i spoke about life last night. when is it that the soul leaves the body? does it leave right away? or does it linger, trying to figure out where to go next and what just happened). i'd like to think that a little bit of abby's soul seeped into each of us in that room. that each of is better, stronger, and braver because we knew her and because we were there, holding her hands and touching her body during her final moments.
i was right, a few weeks ago, when i helped my patient escape from the hospital to feel normal, just for a few hours. it would be her last hours outside. the last time sunlight kissed her face. the last time oxygen made from trees would fill her lungs.
i feel honored to have been a part of both of those days - both abby's living and her dying. her life. and her death.
may her soul live on.
Thursday, July 17, 2014
a wedding at work
yesterday was supposed to be an ordinary day. i had a four hour class in the morning for work. nothing special, just learning our new method of medication administration using a scanning "gun" to prevent medication errors. it was lame. but after class, i went up to my unit to see two of my colleagues who were having their very last days on 8NE. my co-workers are dropping like flies, leaving the in-patient nursing world for lives in the out-patient world - all because what we do on 8ne is heavy. challenging. heart-breaking. overwhelming. and sometimes, AMAZING. like so amazing, that it's hard to deal with. hard to hear. and hard to be a part of.
anyway, when discovering that my unit was short a secretary, i decided to stay on for over-time only if guaranteed to NOT work with patients. isn't that horrible? i had it in me to answer phones, but not to do patient care. so, i stayed for 4 hours in my flip-flops. and it turned out to be one of my most jaw-dropping, heart-warming days at work i've had in 8 years.
are you ready for this story. get the kleenex.
there is a 25 year old woman in our ICU. last week she went to the ER with abdominal pain only to find that she has a terminal, metastatic cancer and has days to weeks to live. crazy, right? to be healthy one week and dying the next. at 25. at about 2:50, my charge nurse said to me, "christa, i need your help. we're planning a wedding. the 25 year old patient wants to marry her boyfriend before she dies in the next 24 hours."
what transpired in the next 2-3 hours is unbelievable. it's the perfect example of teamwork. how one person's vision and efforts can make a difference in a BIG way. and how 20 people, working together, can make a life-changing things happen.
one nurse started making flowers petals out of red construction paper to throw during the "ceremony."
another called a bridal store to donate a veil and gloves (the bride was too sick to stand and/or wear a wedding dress),
the nurse practitioner in charge of the patient's care called friends and colleagues who donated their money and time. i saw her at the edge of the bed, whispering to the patient, "how have you envisioned this day? what can we do to make it special?"
a pulmonary attending brought her photographer husband to the hospital to take wedding photos. on the way, they stopped at a store and bought a wedding cake.
i called a local florist, explained the situation, and within 2 hours the owner of the store personally delivered a bouquet, a boutineer, and lavender rose petals.
my friend c called her husband and said "i need you to bring the pink champagne from our fridge to the hospital ASAP. we have a patient getting married; she's going to die soon." within minutes, c's husband was standing on our unit, champagne and glasses in hand.
the patient's pastor from her church arrived to carry out the ceremony. our hospital chaplain attended and brought candles and bibles and more flowers.
the patient's nurse washed her hair, de-hospitalized the room, and not only turned up machines to help her breathe and turned down machines to stop beeping and squeezing and chirping, but also, helped to make everything look special and appear calm.
there were numerous family members and friends. hospital staff. parents of the bride. parents of the groom.
words can't describe what it felt like on our unit. in some ways, it felt frantic - what takes most brides months to pull off happened in a few hours. and in other ways, it felt magical. there were tears. there was shock. our new manager assisted and turned her eye to the real flowers (that are not allowed on our unit), the real candles, and the champagne. we wrote thank you notes. and patted each other on the back for jobs well done.
this 25 year old will never live to see 26. she will not get to fulfill her dream of becoming a nurse. she will never get to be a parent. she won't grow old with her husband. but she will die knowing that she is united with the love of her life. that people she doesn't even know worked hard to make one of her dreams come true. that sometimes miracles happen - in different ways than you hope - and they are beautiful!
anyway, when discovering that my unit was short a secretary, i decided to stay on for over-time only if guaranteed to NOT work with patients. isn't that horrible? i had it in me to answer phones, but not to do patient care. so, i stayed for 4 hours in my flip-flops. and it turned out to be one of my most jaw-dropping, heart-warming days at work i've had in 8 years.
are you ready for this story. get the kleenex.
there is a 25 year old woman in our ICU. last week she went to the ER with abdominal pain only to find that she has a terminal, metastatic cancer and has days to weeks to live. crazy, right? to be healthy one week and dying the next. at 25. at about 2:50, my charge nurse said to me, "christa, i need your help. we're planning a wedding. the 25 year old patient wants to marry her boyfriend before she dies in the next 24 hours."
what transpired in the next 2-3 hours is unbelievable. it's the perfect example of teamwork. how one person's vision and efforts can make a difference in a BIG way. and how 20 people, working together, can make a life-changing things happen.
one nurse started making flowers petals out of red construction paper to throw during the "ceremony."
another called a bridal store to donate a veil and gloves (the bride was too sick to stand and/or wear a wedding dress),
the nurse practitioner in charge of the patient's care called friends and colleagues who donated their money and time. i saw her at the edge of the bed, whispering to the patient, "how have you envisioned this day? what can we do to make it special?"
a pulmonary attending brought her photographer husband to the hospital to take wedding photos. on the way, they stopped at a store and bought a wedding cake.
i called a local florist, explained the situation, and within 2 hours the owner of the store personally delivered a bouquet, a boutineer, and lavender rose petals.
my friend c called her husband and said "i need you to bring the pink champagne from our fridge to the hospital ASAP. we have a patient getting married; she's going to die soon." within minutes, c's husband was standing on our unit, champagne and glasses in hand.
the patient's pastor from her church arrived to carry out the ceremony. our hospital chaplain attended and brought candles and bibles and more flowers.
the patient's nurse washed her hair, de-hospitalized the room, and not only turned up machines to help her breathe and turned down machines to stop beeping and squeezing and chirping, but also, helped to make everything look special and appear calm.
there were numerous family members and friends. hospital staff. parents of the bride. parents of the groom.
words can't describe what it felt like on our unit. in some ways, it felt frantic - what takes most brides months to pull off happened in a few hours. and in other ways, it felt magical. there were tears. there was shock. our new manager assisted and turned her eye to the real flowers (that are not allowed on our unit), the real candles, and the champagne. we wrote thank you notes. and patted each other on the back for jobs well done.
this 25 year old will never live to see 26. she will not get to fulfill her dream of becoming a nurse. she will never get to be a parent. she won't grow old with her husband. but she will die knowing that she is united with the love of her life. that people she doesn't even know worked hard to make one of her dreams come true. that sometimes miracles happen - in different ways than you hope - and they are beautiful!
Thursday, July 10, 2014
my patient "escaped"
i helped to plan an escape for a patient of mine this week. perhaps it's because i too once escaped from the hospital while i was a patient and still attached to my IV pole or maybe it's just because this gal is cool (and so am i?!?) that i relate so well. she's 31. younger than me. and she's been dating a man for maybe two years total (just like cole and me). they're unmarried. and in love. or once in love. and i can't help but to put myself in her shoes (TOMS) and wonder what it would be like. how would i feel. what would happen to my relationship. and my future (if i made it to the future).
this gal has had a rough go. or as one of my other super young patients put it, she's won the "anti-lottery." like the shittiest prize ever. not only cancer - lymphoma. but lymphoma with brain tumors. debilitating brain tumors. WTF? why should a 31 year girl get that? when she's in school. and hoping to do something amazing with her life. and feeling excited about love and marriage and family.
(side note: my heart broke for her for the like 27th time as she was telling her mom about the different kinds of chemotherapy she's going to get. while describing one she said, "this is the one that destroys my ovaries." her mom cringed and not to be mean, reminded her daughter that she's already in menopause, from the other chemo she has received in the last 10 months. her mom, who also experiences hot flashes and the un-sexy-ness of dry vaginas, said to her sweet daughter, "we'll get you a baby somehow. don't you worry.")
UGH.
anyhoo. my patient will likely be in the hospital for the next month or more. and of course, i want for her to do well. but my experience tells me that she won't. that the nice ones always do poorly. and that with her disease, her prognosis is VERY BAD. like, she won't get out of the hospital E-V-E-R, bad. so, when her doctors said that it would be okay to sneak out of the hospital for a little shopping and lunch adventure, i was in full support. insurance companies don't allow patients to come and go. and of course, if something bad happened to her while she was out, her insurance would flip out, likely not cover her hospital stay, and WE would be at fault and shit up a creek. so the "escape" had to go well.
i felt like an accomplice to a crime. or like her mother. although her real mom was in on the crime also, i was the nurse. the responsible one. i had to think of everything. the wheelchair she had to steal - to prevent falls. the hat - to protect her bald, radiated head. the pain medication i had to tuck into her pocket - in case her persistent headache became too unbearable. the timing of her other medications to keep her safe.
what was supposed to be a two hour pass turned into four plus hours. and although i started to worry, i was elated when she returned. my patient was happy. she ate lunch in the sunshine. she bought make-up to fancify her face. and jewelry to adorn her cancer ridden body. she gabbed with her sister about clothes and shoes and retail. and even though she didn't say it, i think she felt normal. for a second.
instead of dying in a hospital bed while the rest of the world passes her by, she got to participate. for four short hours. and i'm so happy that i could help.
this gal has had a rough go. or as one of my other super young patients put it, she's won the "anti-lottery." like the shittiest prize ever. not only cancer - lymphoma. but lymphoma with brain tumors. debilitating brain tumors. WTF? why should a 31 year girl get that? when she's in school. and hoping to do something amazing with her life. and feeling excited about love and marriage and family.
(side note: my heart broke for her for the like 27th time as she was telling her mom about the different kinds of chemotherapy she's going to get. while describing one she said, "this is the one that destroys my ovaries." her mom cringed and not to be mean, reminded her daughter that she's already in menopause, from the other chemo she has received in the last 10 months. her mom, who also experiences hot flashes and the un-sexy-ness of dry vaginas, said to her sweet daughter, "we'll get you a baby somehow. don't you worry.")
UGH.
anyhoo. my patient will likely be in the hospital for the next month or more. and of course, i want for her to do well. but my experience tells me that she won't. that the nice ones always do poorly. and that with her disease, her prognosis is VERY BAD. like, she won't get out of the hospital E-V-E-R, bad. so, when her doctors said that it would be okay to sneak out of the hospital for a little shopping and lunch adventure, i was in full support. insurance companies don't allow patients to come and go. and of course, if something bad happened to her while she was out, her insurance would flip out, likely not cover her hospital stay, and WE would be at fault and shit up a creek. so the "escape" had to go well.
i felt like an accomplice to a crime. or like her mother. although her real mom was in on the crime also, i was the nurse. the responsible one. i had to think of everything. the wheelchair she had to steal - to prevent falls. the hat - to protect her bald, radiated head. the pain medication i had to tuck into her pocket - in case her persistent headache became too unbearable. the timing of her other medications to keep her safe.
what was supposed to be a two hour pass turned into four plus hours. and although i started to worry, i was elated when she returned. my patient was happy. she ate lunch in the sunshine. she bought make-up to fancify her face. and jewelry to adorn her cancer ridden body. she gabbed with her sister about clothes and shoes and retail. and even though she didn't say it, i think she felt normal. for a second.
instead of dying in a hospital bed while the rest of the world passes her by, she got to participate. for four short hours. and i'm so happy that i could help.
Thursday, June 26, 2014
self care
i don't have a lot to say today. but i felt like writing. i'm home. sick. sitting on the couch. recuperating from four twelve hour shifts in a row. and mentally preparing for the three more that start on saturday. ugh.
i have one friend in the hospital at 26 weeks pregnant (who is being brave and calm and amazing). and cole's dad with sudden vision loss due to unknown causes. another friend has her TWO in-laws in the hospital due to two different issues that occurred at the same time. her mother-in-law had a stroke at home, did nothing about it, and then started having seizures. and a father-in-law who suffered a heart attack at the very same time. excuse my french, but WTF?
suffering is hard to witness sometimes. there is so much of it. and only so little space in your heart to carry it all. how do you support your friends and loved ones who are hurting? or feel stressed? what can you do as a nurse and as a friend? when are you over-stepping boundaries or simply going above and beyond? is there a difference?
i'm gonna vegetate today. and maybe buy vegetables at the grocery store. i need to eat better. and drink juice with vitamin C. i need to take good care of myself so that i can continue to take good care of others.
(over the last four days, i cared for a 23 year old gal. she's beautiful. and quiet. she's in pain. and getting REALLY sick from her chemotherapy. i gave her her stem cell transplant over the last two days (3 bags on tuesday and 2 bags yesterday). and i'm REALLY hoping it works. she wants to go to school to become a pharmacy tech. and one of my other 23 year old patients who i re-admitted on monday is one year post transplant and wants to be a doctor when he's finally healthy enough to go to school. how cool is that?).
i have one friend in the hospital at 26 weeks pregnant (who is being brave and calm and amazing). and cole's dad with sudden vision loss due to unknown causes. another friend has her TWO in-laws in the hospital due to two different issues that occurred at the same time. her mother-in-law had a stroke at home, did nothing about it, and then started having seizures. and a father-in-law who suffered a heart attack at the very same time. excuse my french, but WTF?
suffering is hard to witness sometimes. there is so much of it. and only so little space in your heart to carry it all. how do you support your friends and loved ones who are hurting? or feel stressed? what can you do as a nurse and as a friend? when are you over-stepping boundaries or simply going above and beyond? is there a difference?
i'm gonna vegetate today. and maybe buy vegetables at the grocery store. i need to eat better. and drink juice with vitamin C. i need to take good care of myself so that i can continue to take good care of others.
(over the last four days, i cared for a 23 year old gal. she's beautiful. and quiet. she's in pain. and getting REALLY sick from her chemotherapy. i gave her her stem cell transplant over the last two days (3 bags on tuesday and 2 bags yesterday). and i'm REALLY hoping it works. she wants to go to school to become a pharmacy tech. and one of my other 23 year old patients who i re-admitted on monday is one year post transplant and wants to be a doctor when he's finally healthy enough to go to school. how cool is that?).
Sunday, June 22, 2014
some lessons i learned
i attended a palliative care class last friday and monday. for 16+ hours, i heard lectures on death and dying, pain management, how to communicate difficult news to mourning families, the stages of grief, etc. we shared devastating stories, some beautiful experiences with good deaths. and we even walked the journey of our own passing - imagining the losses experienced along the way: the loss of control, the inability to complete favorite tasks/hobbies/activities, the changes in our relationships, the weakening of our muscles and perhaps our spirit. and although i've heard these lectures before and completed these activities, although i constantly think of illness and dying, i learned NEW things. i appreciated the time to reflect on my job. and my life. to acknowledge the difficult work that i do. and the toll it takes on my heart.
here are a few things i learned.
first of all, i find it amazing that as a nurse, i have the opportunity to attend classes about death and dying. there are hours and hours of lessons to be learned. we just glossed over some subjects and we spent SIXTEEN hours learning. and in med school (or PA school, since i have "shared" cole's experience as a student), they spend maybe ONE hour learning these same subjects. no wonder some doctors have a difficult time with this process...
we discussed the importance of breath. scientifically, i get that we need to breathe. that there is oxygen exchange in our lungs. that every muscle in our body needs 02 to function. but what i never really think about or practice is the importance of deep breathing as a nurse, when i get anxious or have to do difficult things. one lecturer asked us what things makes us nervous as nurses. being sterile and placing foley catheters? placing IVs? walking into the room of a dying patient and talking to crying family members? when is it that we find our hearts racing, our minds whirring with fear and anxiety? when do we run on auto-pilot instead of acting as humans with caring and compassionate hearts? and what if we took intentional deep breaths during those moments to slow down our own heart rates and to allow our brain to receive the oxygen it needs to use our frontal lobe and actually THINK and ACT.
i was also reminded about attitude. they say "attitude is everything." and i actually believe that. but still, i start most of my days grumpy. not wanting to be at work. annoyed that i have a certain assignment with difficult patients, ones that call too much or are rude to staff. what if instead of starting out with a negative attitude, i spent just 60 seconds recalling why it is that i became a nurse? what if i remembered that my goal has always been to take care of vulnerable (sometimes grumpy) people and make a difference in their life? to help people along challenging illnesses that sometimes end in death and to make that road easier, to listen and share in intimate experiences? might my day be better? YES.
i'm gonna put these lessons into action!
here are a few things i learned.
first of all, i find it amazing that as a nurse, i have the opportunity to attend classes about death and dying. there are hours and hours of lessons to be learned. we just glossed over some subjects and we spent SIXTEEN hours learning. and in med school (or PA school, since i have "shared" cole's experience as a student), they spend maybe ONE hour learning these same subjects. no wonder some doctors have a difficult time with this process...
we discussed the importance of breath. scientifically, i get that we need to breathe. that there is oxygen exchange in our lungs. that every muscle in our body needs 02 to function. but what i never really think about or practice is the importance of deep breathing as a nurse, when i get anxious or have to do difficult things. one lecturer asked us what things makes us nervous as nurses. being sterile and placing foley catheters? placing IVs? walking into the room of a dying patient and talking to crying family members? when is it that we find our hearts racing, our minds whirring with fear and anxiety? when do we run on auto-pilot instead of acting as humans with caring and compassionate hearts? and what if we took intentional deep breaths during those moments to slow down our own heart rates and to allow our brain to receive the oxygen it needs to use our frontal lobe and actually THINK and ACT.
i was also reminded about attitude. they say "attitude is everything." and i actually believe that. but still, i start most of my days grumpy. not wanting to be at work. annoyed that i have a certain assignment with difficult patients, ones that call too much or are rude to staff. what if instead of starting out with a negative attitude, i spent just 60 seconds recalling why it is that i became a nurse? what if i remembered that my goal has always been to take care of vulnerable (sometimes grumpy) people and make a difference in their life? to help people along challenging illnesses that sometimes end in death and to make that road easier, to listen and share in intimate experiences? might my day be better? YES.
i'm gonna put these lessons into action!
Friday, June 20, 2014
birthday twin
yesterday, as i was preparing for my day, writing out lists of medications and times for blood draws, i noticed that my patient and i were the very same age and had the very same birthday. kind of creepy, huh? someone my age with my birthday has been battling cancer for years and now is 16 days post a transplant. am i lucky or what?!?
Sunday, June 1, 2014
Tuesday, May 27, 2014
june is going to be better
the last couple of weeks at work have been hard. i'm proud to say, i've not missed a day. i've even done two 4.5 hour overtime shifts (because i keep spending money - retail therapy). but gee is it hard to care for others when you feel sick yourself. when your life is in shambles. when everything is unknown.
this weekend, i actually fell asleep at my computer while charting. the twenty minute nap saved me from more breakdowns during the remainder of my shift. i had already cried a few times in patient rooms. once especially hard when a male, nurse friend of mine asked point blank, "what's going on with you?" i couldn't help but spill the beans. "cole is struggling in our relationship. he's terrified. and i'm not sure this is going to end well." justin said in a kind, sympathetic tone - "don't let this break you christa." i said, "oh, you mean, don't feel pathetic and worthless and unloveable." and he said, "exactly." we were washing an intubated, mildly sedated man as tears rolled down my cheeks.
in other news, i've had some crazy shifts lately. two weekends ago i got floated to another unit. i was completely out of my element. and of course, the day was a shit show. i had a quadriplegic patient with blood pressures in the 210/110s (for those of you that don't know, this is an emergency). and another one of my patients returned from a smoke break outside without the IV pole that he had previously been attached to, bleeding hepatitis B AND C blood all throughout the hospital because he had pulled out his IV and the heparin gtt attached to him (a medicine that was helping to save his life from a potentially lethal blood clot in his lungs). once the mess was cleaned up, the same patient decided he hated me and threw a tantrum at the front desk, asking to be transferred to another hospital where the care was better and the staff listened to patients' needs. the bright side, i made 1.50 more per hour because i was floated. note my sarcasm. NOT ENOUGH.
i'm hoping june is better. i'm working less. i have two 8 hour class days where instead of caring for humans, i will be sitting on my rump, learning about death and dying. sounds depressing, but this is right up my alley. i'm also running my first half marathon. and i plan to fill my time with life-affirming things and amazing friends. june, here i come.
this weekend, i actually fell asleep at my computer while charting. the twenty minute nap saved me from more breakdowns during the remainder of my shift. i had already cried a few times in patient rooms. once especially hard when a male, nurse friend of mine asked point blank, "what's going on with you?" i couldn't help but spill the beans. "cole is struggling in our relationship. he's terrified. and i'm not sure this is going to end well." justin said in a kind, sympathetic tone - "don't let this break you christa." i said, "oh, you mean, don't feel pathetic and worthless and unloveable." and he said, "exactly." we were washing an intubated, mildly sedated man as tears rolled down my cheeks.
in other news, i've had some crazy shifts lately. two weekends ago i got floated to another unit. i was completely out of my element. and of course, the day was a shit show. i had a quadriplegic patient with blood pressures in the 210/110s (for those of you that don't know, this is an emergency). and another one of my patients returned from a smoke break outside without the IV pole that he had previously been attached to, bleeding hepatitis B AND C blood all throughout the hospital because he had pulled out his IV and the heparin gtt attached to him (a medicine that was helping to save his life from a potentially lethal blood clot in his lungs). once the mess was cleaned up, the same patient decided he hated me and threw a tantrum at the front desk, asking to be transferred to another hospital where the care was better and the staff listened to patients' needs. the bright side, i made 1.50 more per hour because i was floated. note my sarcasm. NOT ENOUGH.
i'm hoping june is better. i'm working less. i have two 8 hour class days where instead of caring for humans, i will be sitting on my rump, learning about death and dying. sounds depressing, but this is right up my alley. i'm also running my first half marathon. and i plan to fill my time with life-affirming things and amazing friends. june, here i come.
Saturday, May 17, 2014
cancer is a reminder
there's nothing like CANCER to remind you that your own life ain't so bad.
i've been having a really rough time these last few weeks. the relationship that i have put my whole heart into for two years is dissolving before my eyes. my future looks different. bleak. sad. and lonely. and although i don't know what's going to happen in the long run ("there is no crystal ball," my partner says to me), i feel scared and devastated.
but then, there's work. life must go on, right? so, i force myself out of bed in the morning. and i show up, faking bright eyed and bushy tailed as best as i can at 7AM with swollen eyes and a broken heart. i do my best hollywood impression of a cheerful, kind nurse and take care of a woman my age. a mother of two. she had a transplant almost one year ago and is now facing the effects of skin graft versus host disease and long term steroid use. her once healthy body now looks old. haggard. her skin is beat red, like that of a burn victim. she is peeling everywhere. her hands are shedding what looks like gloves of skin.
mostly she lies in bed all day. sometimes crying. sometimes angry. but when she asked to take a shower (one of my least favorite things to help someone with), i decided to give it my all. we carefully readied her for a shower. i placed a towel on the bench seat. we warmed up the bathroom with steamy water and the heat lamp. and i left her alone, hoping she could wash away some of the hurt.
but a few minutes later, as i was just a few feet away from her, making her bed, i heard a sob. nervous that she had fallen or hurt herself, i busted into the bathroom to find a woman, curled in a ball, crying because she is so weak that she cannot even hold the shower nozzle. "it's okay, we'll do this together," i said. as if it is no bid deal. as if lots of 30 something year olds can't shower on their own. what proceeded was a very intricate ritual. scrubs with cetaphil. then shampoo. coconut oil. and burts bees lotion. baby powder in creases. and lace panties. all the intimate details we carried out together, because she is vulnerable. because likely, she is dying.
by the end of the 45 minute ordeal, i was sweatier than if i had run a marathon. in my plastic gown, glove, and masks, rivulets of sweat dripped down my healthy body. my broken heart ached, but instead of aching for myself, it ached for her. for pain. for illness. for families torn apart by tragedy.
CANCER is a good, horrible reminder.
i've been having a really rough time these last few weeks. the relationship that i have put my whole heart into for two years is dissolving before my eyes. my future looks different. bleak. sad. and lonely. and although i don't know what's going to happen in the long run ("there is no crystal ball," my partner says to me), i feel scared and devastated.
but then, there's work. life must go on, right? so, i force myself out of bed in the morning. and i show up, faking bright eyed and bushy tailed as best as i can at 7AM with swollen eyes and a broken heart. i do my best hollywood impression of a cheerful, kind nurse and take care of a woman my age. a mother of two. she had a transplant almost one year ago and is now facing the effects of skin graft versus host disease and long term steroid use. her once healthy body now looks old. haggard. her skin is beat red, like that of a burn victim. she is peeling everywhere. her hands are shedding what looks like gloves of skin.
mostly she lies in bed all day. sometimes crying. sometimes angry. but when she asked to take a shower (one of my least favorite things to help someone with), i decided to give it my all. we carefully readied her for a shower. i placed a towel on the bench seat. we warmed up the bathroom with steamy water and the heat lamp. and i left her alone, hoping she could wash away some of the hurt.
but a few minutes later, as i was just a few feet away from her, making her bed, i heard a sob. nervous that she had fallen or hurt herself, i busted into the bathroom to find a woman, curled in a ball, crying because she is so weak that she cannot even hold the shower nozzle. "it's okay, we'll do this together," i said. as if it is no bid deal. as if lots of 30 something year olds can't shower on their own. what proceeded was a very intricate ritual. scrubs with cetaphil. then shampoo. coconut oil. and burts bees lotion. baby powder in creases. and lace panties. all the intimate details we carried out together, because she is vulnerable. because likely, she is dying.
by the end of the 45 minute ordeal, i was sweatier than if i had run a marathon. in my plastic gown, glove, and masks, rivulets of sweat dripped down my healthy body. my broken heart ached, but instead of aching for myself, it ached for her. for pain. for illness. for families torn apart by tragedy.
CANCER is a good, horrible reminder.
Thursday, May 8, 2014
hospital birthdays
my patient celebrated her second birthday at UWMC. to be born there is okay. lots of people celebrate their first birthday in a hospital. but a second, well... that's just a bummer. and when i say a second birthday, i don't mean a regular birthday. i mean a second "birth" day. like a re-birth. a second chance at life with a hematopoeitic stem cell transplant because otherwise you will surely die of cancer.
i gave a 30 year old two tiny bags of umbilical cord stem cells yesterday. and when my colleagues and i sang happy birthday to her, she and her mom cried. a few minutes later, my patient's mother said to me, "you know, she is my miracle, million dollar baby. she was not only born here. she was saved here. she was born at 25 weeks and spent her first days, weeks, months in the NICU. now, we are hoping you will save her here again."
i gave a 30 year old two tiny bags of umbilical cord stem cells yesterday. and when my colleagues and i sang happy birthday to her, she and her mom cried. a few minutes later, my patient's mother said to me, "you know, she is my miracle, million dollar baby. she was not only born here. she was saved here. she was born at 25 weeks and spent her first days, weeks, months in the NICU. now, we are hoping you will save her here again."
Wednesday, April 23, 2014
psych nurse?!?
yesterday, a 39 year old woman died on our unit. she was diagnosed with AML (acute myelogenous leukemia) on friday night after an admission to the ER for SOB (shortness of breath, not son-of-a-bitch). i've seen this before. it's not something that should surprise me. cancer can sometimes be acute, instead of chronic. and sadly, it can kill people very suddenly. but i can't help but continue to be AMAZED that this woman, this mother of four, was "fine" last wednesday and today, she's dead. her children are motherless. her teenage children will be raised by her sisters and her 6 month old was taken into CPS when the aunties said they were unable to take in a baby.
i talked to cole last night on the phone (he's living in puyallup now for the next 4 months, ugh) and shared the story. and i reminded him (and myself) that it makes sense that i have irrational thoughts sometimes. that when i have cramps, i think i have ovarian cancer. or when i feel exhausted for a few days, it must be mono. my coughs turn into tuberculosis. and my bruises must be a sign of leukemia. i see these things happen. on a regular basis. to young, previously healthy people. my norm at work is to see the worst of the worst.
then, sometimes, every now and then, i get to care for a wacko! and i laugh. at the same place i sometimes find myself crying. yesterday, i transferred the same whack job from my last post to the psych unit. finally, they were willing and able to take her. and although she threw her feces at someone in the morning, she and i laughed some more in the afternoon. she tried to work her "magic" over on me, refusing to wear pants or get into a wheelchair. saying she would pee on herself if i didn't hurry the elevator. and telling me that once in a vegas hospital, she had a queen sized bed. i got her to laugh when i asked if she could gamble there too and i told her she must be mistaking the "hospital" with the hilton.
when i left her in a place much better suited to handle her needs, i almost longed to be a psych nurse. there is no cancer there. and although people are sad, there is less dying. and maybe, just maybe, more laughing.
i talked to cole last night on the phone (he's living in puyallup now for the next 4 months, ugh) and shared the story. and i reminded him (and myself) that it makes sense that i have irrational thoughts sometimes. that when i have cramps, i think i have ovarian cancer. or when i feel exhausted for a few days, it must be mono. my coughs turn into tuberculosis. and my bruises must be a sign of leukemia. i see these things happen. on a regular basis. to young, previously healthy people. my norm at work is to see the worst of the worst.
then, sometimes, every now and then, i get to care for a wacko! and i laugh. at the same place i sometimes find myself crying. yesterday, i transferred the same whack job from my last post to the psych unit. finally, they were willing and able to take her. and although she threw her feces at someone in the morning, she and i laughed some more in the afternoon. she tried to work her "magic" over on me, refusing to wear pants or get into a wheelchair. saying she would pee on herself if i didn't hurry the elevator. and telling me that once in a vegas hospital, she had a queen sized bed. i got her to laugh when i asked if she could gamble there too and i told her she must be mistaking the "hospital" with the hilton.
when i left her in a place much better suited to handle her needs, i almost longed to be a psych nurse. there is no cancer there. and although people are sad, there is less dying. and maybe, just maybe, more laughing.
Sunday, April 20, 2014
whack jobs
spring is springing. birds are chirping. and light is seeping in through my windows. i am enjoying a lazy sunday morning on my couch - reading a new book (more like trying to stay awake), internet surfing/shopping for little girls in my life (emerson's birthday is coming up), and trying to motivate myself to get to the gym (i don't know why, but despite this beautiful weather, i'd rather run on the treadmill - something is not right with me).
i feel like i've been working a lot lately. perhaps because i did a 4.5 hour stint of overtime this week. or because my twelve hours shifts have been split up instead of in a row (which gives me bigger chunks of time off). but even though i've been spending lots of time nursing, i don't feel the same kind of burn out or exhaustion that i do a lot of the time. i work tomorrow. and i don't really want to go. but i have this refreshing sense of peace that whatever is thrown at me, i might handle with grace (i've probably jinxed myself).
i've taken care of some very sick patients recently. and although i don't always enjoy the intensity, it feels good to know that a job is well done. that my patients are safe under my care.
this week, i had the "pleasure" of caring for a psych patient. she had a transplants YEARS ago and because of that wound up on our floor. but her needs are not transplant related. they are most definitely psych related. and although i am not equipped or trained to help her psych needs, i sure had fun trying. is that bad? i don't mean to make light of a sad and difficult situation. and certainly, i don't mean to be disrespectful of mental health needs and complexities; god knows, i have my own issues. but this woman was REALLY crazy. she's in her 60s, but throws tantrums like the most stubborn of two year olds. she has a stuffed bear named "woof, woof." and when i fed her her pills in ice cream, it was never firm enough. i couldn't help but play along with some of her neuroses. "oh, you want your covers pulled up higher for the 107th time, okay?" as i pulled them up over her face. "oh, this ice cream is not hard enough. well, sorry, we don't have ice cream rocks!"
by the end of the day, this lady and i were laughing. at each other i think. with one another hopefully. i found out her nickname when she was a child - glory-bug. and we talked about easter egg dying - which she claims she hasn't done since she was 5.
i didn't do a perfect job for this woman. she still screamed bloody murder at times throughout the day. and she told her team of doctors to "get the F*&% out of her room." but at least she never told me that. at least we got along. at least we respected one another. from one whack job to another!
i feel like i've been working a lot lately. perhaps because i did a 4.5 hour stint of overtime this week. or because my twelve hours shifts have been split up instead of in a row (which gives me bigger chunks of time off). but even though i've been spending lots of time nursing, i don't feel the same kind of burn out or exhaustion that i do a lot of the time. i work tomorrow. and i don't really want to go. but i have this refreshing sense of peace that whatever is thrown at me, i might handle with grace (i've probably jinxed myself).
i've taken care of some very sick patients recently. and although i don't always enjoy the intensity, it feels good to know that a job is well done. that my patients are safe under my care.
this week, i had the "pleasure" of caring for a psych patient. she had a transplants YEARS ago and because of that wound up on our floor. but her needs are not transplant related. they are most definitely psych related. and although i am not equipped or trained to help her psych needs, i sure had fun trying. is that bad? i don't mean to make light of a sad and difficult situation. and certainly, i don't mean to be disrespectful of mental health needs and complexities; god knows, i have my own issues. but this woman was REALLY crazy. she's in her 60s, but throws tantrums like the most stubborn of two year olds. she has a stuffed bear named "woof, woof." and when i fed her her pills in ice cream, it was never firm enough. i couldn't help but play along with some of her neuroses. "oh, you want your covers pulled up higher for the 107th time, okay?" as i pulled them up over her face. "oh, this ice cream is not hard enough. well, sorry, we don't have ice cream rocks!"
by the end of the day, this lady and i were laughing. at each other i think. with one another hopefully. i found out her nickname when she was a child - glory-bug. and we talked about easter egg dying - which she claims she hasn't done since she was 5.
i didn't do a perfect job for this woman. she still screamed bloody murder at times throughout the day. and she told her team of doctors to "get the F*&% out of her room." but at least she never told me that. at least we got along. at least we respected one another. from one whack job to another!
Friday, March 21, 2014
unsung heroes
last week i had the ENTIRE week off. it was a spring break of sorts that i got to celebrate with my my student boyfriend, cole. we went to san francisco and walked miles and miles. and ate delicious chinese treats from non-english speaking bakeries. and like bad medical people, we allowed the sun to kiss our cheeks and chests, soaking up the surprising sun without sunscreen.
but now, i'm back. back to seattle. back to work. cole is back in school. and already burnt out of his new rotation - outpatient GI. he's ready to be done with school. and i'm ready to retire! ha.
in all seriousness though. i had a good work week. i worked 36 hours and although it was busy, it felt productive. i got things accomplished with my patients. i was a good nurse. better than my tired, burnt-out, cynical self. i could feel myself rejuvenated from days of reading books. and time spent on my couch. and it didn't hurt that i cared for two very kind men. one who wore fluorescent pink glasses (and joked that they were in support of breast cancer, but were really just an expensive mistake when he ordered prescription glasses over the phone) and the other who at 65, has lost all of his independence because of a transplant we gave him 4 years ago.
in just two 12 hour shifts (i only cared for this patient 2 of my 3 work days), i found myself falling "in love" with him. i don't mean the kind of love i feel for cole. i mean the kind of love a nurse feels for a patient. the kind of love that means, even when i'm not at work, i think constantly about them. the kind of love that means, i really want what's best for this man - whether that means he lives or dies. the kind of love that helps me appreciate my role as nurse and reminds me i am good at what i do.
this man's medical history is complex to say the least. he's had two transplants. and suffered from years of graft versus host disease. and now, although in remission from his cancer, will most likely die from his GVHD - a side effect from his treatment. i've never seen anything like it - skin so taut that his lungs can't expand enough to breathe. skin so rigid and inflexible that his arms and legs are permanently bent, contracted, inhibiting his ability to scratch his own nose, wipe his own behind, and be the independent man he longs to be.
i think what endeared me to this man was his willingness to be vulnerable. he admitted that he was afraid. he admitted his weaknesses and found the courage to ask for help. when his wife or i assisted him with the simplest of tasks, he thanked us. he spoke of the many hardships he has faced with grace. and continued on with the bravery and determination of a hero.
i think my patients are heros. super men and super women, battling life one day at a time. one precious day at a time. not wasting any moments between breaths.
but now, i'm back. back to seattle. back to work. cole is back in school. and already burnt out of his new rotation - outpatient GI. he's ready to be done with school. and i'm ready to retire! ha.
in all seriousness though. i had a good work week. i worked 36 hours and although it was busy, it felt productive. i got things accomplished with my patients. i was a good nurse. better than my tired, burnt-out, cynical self. i could feel myself rejuvenated from days of reading books. and time spent on my couch. and it didn't hurt that i cared for two very kind men. one who wore fluorescent pink glasses (and joked that they were in support of breast cancer, but were really just an expensive mistake when he ordered prescription glasses over the phone) and the other who at 65, has lost all of his independence because of a transplant we gave him 4 years ago.
in just two 12 hour shifts (i only cared for this patient 2 of my 3 work days), i found myself falling "in love" with him. i don't mean the kind of love i feel for cole. i mean the kind of love a nurse feels for a patient. the kind of love that means, even when i'm not at work, i think constantly about them. the kind of love that means, i really want what's best for this man - whether that means he lives or dies. the kind of love that helps me appreciate my role as nurse and reminds me i am good at what i do.
this man's medical history is complex to say the least. he's had two transplants. and suffered from years of graft versus host disease. and now, although in remission from his cancer, will most likely die from his GVHD - a side effect from his treatment. i've never seen anything like it - skin so taut that his lungs can't expand enough to breathe. skin so rigid and inflexible that his arms and legs are permanently bent, contracted, inhibiting his ability to scratch his own nose, wipe his own behind, and be the independent man he longs to be.
i think what endeared me to this man was his willingness to be vulnerable. he admitted that he was afraid. he admitted his weaknesses and found the courage to ask for help. when his wife or i assisted him with the simplest of tasks, he thanked us. he spoke of the many hardships he has faced with grace. and continued on with the bravery and determination of a hero.
i think my patients are heros. super men and super women, battling life one day at a time. one precious day at a time. not wasting any moments between breaths.
Sunday, March 2, 2014
handprints
you'd think after years of working on the same unit, with the same kinds of patients, i would have done most things by now. it's true. i've administered numerous kinds of chemotherapy, given drugs that i've never heard of, put my fingers in places i wish i hadn't... you get the idea. but last week, i did something i've never done before. and although it was a learning experience, i found it kind of weird. one of those moments where you want to laugh, but laughing would be inappropriate.
i helped a fellow nurse paint the hand of her patient with jet-black ink using a roller brush and made handprints on pretty paper. it was like an art project, for three year olds. only i'm not a pre-school teacher and my subject was not three. she was in her sixties. breathing with the help of a ventilator. her arms were flaccid and her fingers squeezed together tightly. her family members watched us, as if we had done this before. as if we should be good at arts and crafts with nearly dead people. and instead, we smudged paint. we had to make a few before we got any that looked like hands. and even the good ones looked like a preschooler had done it.
but to my amazement, the family loved it.
our unit is trying to get better at death and dying. thank god! this kind of improvement is right up my alley. i wish doctors and nurses were all comfortable talking about that journey. i wish we could light candles and sing. when parents of small children are dying, i wish we helped tape video messages or write letters. but instead, we're making handprints. and i guess it's a good start.
even though it felt weird to me.
i helped a fellow nurse paint the hand of her patient with jet-black ink using a roller brush and made handprints on pretty paper. it was like an art project, for three year olds. only i'm not a pre-school teacher and my subject was not three. she was in her sixties. breathing with the help of a ventilator. her arms were flaccid and her fingers squeezed together tightly. her family members watched us, as if we had done this before. as if we should be good at arts and crafts with nearly dead people. and instead, we smudged paint. we had to make a few before we got any that looked like hands. and even the good ones looked like a preschooler had done it.
but to my amazement, the family loved it.
our unit is trying to get better at death and dying. thank god! this kind of improvement is right up my alley. i wish doctors and nurses were all comfortable talking about that journey. i wish we could light candles and sing. when parents of small children are dying, i wish we helped tape video messages or write letters. but instead, we're making handprints. and i guess it's a good start.
even though it felt weird to me.
Saturday, February 22, 2014
where will i be...
i haven't written about work much. and i don't know why. i keep telling myself to.
things are changing on my unit. nurses are leaving. i think in the last year we've lost something like 20 nurses. many people whom i have enjoyed working with. many who have made my job a fun place to show up in the morning for a daunting 12.5 hours. they say they're leaving because they're unhappy. with our schedule. with management. with the success to loss ration.
but me. i still don't feel like leaving. it's not that i'm perfectly content at my job. but i don't like change. and i still like the remainder of my colleagues. and although 12.5 hour shifts are LONG, i have a permanent day position. and my schedule pretty much rules. and i typically take off a month per year. and i've accumulated plenty of sick and vacation time. enough to take some maternity leave if i ever get to be pregnant. and i'm comfortable there. i know what i am doing. i'm good at it. people ask me questions and i know the answers.
at the same time, i don't see myself there forever. and that scares me. where would i go? and when? will i ever be brave enough to become a home health hospice nurse? or will i do something totally uncharacteristic and try labor and delivery? (i'm fairly certain the answer is NO). ICU? would nights ever work better for me? or a clinic job? school nursing?
a lot of unknown scares me. some excites me.
i wonder where i will be a year from now.
five years from now...
ten.
things are changing on my unit. nurses are leaving. i think in the last year we've lost something like 20 nurses. many people whom i have enjoyed working with. many who have made my job a fun place to show up in the morning for a daunting 12.5 hours. they say they're leaving because they're unhappy. with our schedule. with management. with the success to loss ration.
but me. i still don't feel like leaving. it's not that i'm perfectly content at my job. but i don't like change. and i still like the remainder of my colleagues. and although 12.5 hour shifts are LONG, i have a permanent day position. and my schedule pretty much rules. and i typically take off a month per year. and i've accumulated plenty of sick and vacation time. enough to take some maternity leave if i ever get to be pregnant. and i'm comfortable there. i know what i am doing. i'm good at it. people ask me questions and i know the answers.
at the same time, i don't see myself there forever. and that scares me. where would i go? and when? will i ever be brave enough to become a home health hospice nurse? or will i do something totally uncharacteristic and try labor and delivery? (i'm fairly certain the answer is NO). ICU? would nights ever work better for me? or a clinic job? school nursing?
a lot of unknown scares me. some excites me.
i wonder where i will be a year from now.
five years from now...
ten.
Friday, January 31, 2014
maybe it will be me
yesterday was my last day working with cole on my unit. today is his last day as a student there and although i tried to work overtime today to enjoy him for just a few more hours, they didn't need me. and so here i sit, waiting for my partner to come home to me. waiting to kiss him as he walks in the door. waiting to see what happens next in our ever changing life.
working with your partner is challenging. like i mentioned earlier, i watched my parents work together. and it often seemed a struggle. but i must say, i enjoyed working with cole this last month. we never cared for the same patient. and our jobs are so different (even though we are both healthcare professionals). but we were able to wake up around the same time. get ready side by side. drive in together on the days of work we shared. gaze at each other down long hallways. flirt ever so slightly. and share work tales at the end of the day that we both understood.
at the same time, there are things i very much disliked about working together. sometimes waking up at the same time and trying to get out the door at the same time was a struggle. sometimes we fought over parking money and who gets to drive the car home and who has to take the bus (because i get off at 1930 and he gets off at 1700). sometimes i didn't want to hear about cole's work day - especially on my days off - because i get enough of cancer while i am at work (and unfortunately, think enough about it when i am not). and sometimes, although we shared the same kinds of patients with the same diseases and complications, we were interested in different parts of their stories. cole has an interest in immunology and cell lines; he wants to know the difference between CD45 cells and NK cells. i, on the other hand, care less about that and more about how much my patient misses their children. or how worried they are about their finances. or how afraid they are to die.
i am not suggesting that one interest or role is more significant than the other. both are equally important. but i found it very interesting that even when taking care of the very same population of people, cole and i are different. different is good. and sometimes it's hard.
cole very much enjoyed working with stem cell transplant patients. and over the last four weeks, we dreamed of what it would look like if he chose to work there. and a part of me thinks it would be good. i would be excited for him to start and learn and share that part of my life. and a part of me thinks it would be hard.
cole is not finished with school until august. august 28th to be exact. and he likely won't start working until late fall or early winter, due to taking his boards, getting licensed, and finding a job. but i'm excited to see what his future holds. what our future holds. where he will be working. and with whom.
maybe it will be me.
working with your partner is challenging. like i mentioned earlier, i watched my parents work together. and it often seemed a struggle. but i must say, i enjoyed working with cole this last month. we never cared for the same patient. and our jobs are so different (even though we are both healthcare professionals). but we were able to wake up around the same time. get ready side by side. drive in together on the days of work we shared. gaze at each other down long hallways. flirt ever so slightly. and share work tales at the end of the day that we both understood.
at the same time, there are things i very much disliked about working together. sometimes waking up at the same time and trying to get out the door at the same time was a struggle. sometimes we fought over parking money and who gets to drive the car home and who has to take the bus (because i get off at 1930 and he gets off at 1700). sometimes i didn't want to hear about cole's work day - especially on my days off - because i get enough of cancer while i am at work (and unfortunately, think enough about it when i am not). and sometimes, although we shared the same kinds of patients with the same diseases and complications, we were interested in different parts of their stories. cole has an interest in immunology and cell lines; he wants to know the difference between CD45 cells and NK cells. i, on the other hand, care less about that and more about how much my patient misses their children. or how worried they are about their finances. or how afraid they are to die.
i am not suggesting that one interest or role is more significant than the other. both are equally important. but i found it very interesting that even when taking care of the very same population of people, cole and i are different. different is good. and sometimes it's hard.
cole very much enjoyed working with stem cell transplant patients. and over the last four weeks, we dreamed of what it would look like if he chose to work there. and a part of me thinks it would be good. i would be excited for him to start and learn and share that part of my life. and a part of me thinks it would be hard.
cole is not finished with school until august. august 28th to be exact. and he likely won't start working until late fall or early winter, due to taking his boards, getting licensed, and finding a job. but i'm excited to see what his future holds. what our future holds. where he will be working. and with whom.
maybe it will be me.
Tuesday, January 14, 2014
grateful
sometimes it takes a patient with MS who is completely immobile and dependent to remind you how amazingly privileged you are...
somehow we ended up talking about cuba. and i was able to say, "i've been there. i circumnavigated the globe while in college and i wound up on a university campus with 600 other college students listening to fidel castro speak to us for FIVE hours."
then, at some other point in our day, we talked about india. and i chimed in, "oh, i've been there." at that, my patient said, "i am fascinated by you. what were you doing there?" to which i replied, "oh, i worked at mother teresa's home for the destitute and dying for four months." my patient was astounded.
i guess my "history" is kind of interesting. i've had some amazing experiences and completed some pretty monumental tasks.
but what really makes me realize how lucky i am (in addition to having had the opportunity to travel the world) is when i help my patient turn his body in bed and he moans and groans. or when he has to ask me to bend his knees for him so that he can stretch his hamstrings. or when i clean his totally sore scrotum and he thanks me profusely. or when i use a ceiling lift to transfer him like cattle from bed to a chair. or when i comfort a groan man as he cries, "i can't lose my ability to walk."
i am an independent, healthy, strong woman. and THAT is something i won't take for granted - thanks to K in room 8260 for making me aware and reminding me to be grateful!
somehow we ended up talking about cuba. and i was able to say, "i've been there. i circumnavigated the globe while in college and i wound up on a university campus with 600 other college students listening to fidel castro speak to us for FIVE hours."
then, at some other point in our day, we talked about india. and i chimed in, "oh, i've been there." at that, my patient said, "i am fascinated by you. what were you doing there?" to which i replied, "oh, i worked at mother teresa's home for the destitute and dying for four months." my patient was astounded.
i guess my "history" is kind of interesting. i've had some amazing experiences and completed some pretty monumental tasks.
but what really makes me realize how lucky i am (in addition to having had the opportunity to travel the world) is when i help my patient turn his body in bed and he moans and groans. or when he has to ask me to bend his knees for him so that he can stretch his hamstrings. or when i clean his totally sore scrotum and he thanks me profusely. or when i use a ceiling lift to transfer him like cattle from bed to a chair. or when i comfort a groan man as he cries, "i can't lose my ability to walk."
i am an independent, healthy, strong woman. and THAT is something i won't take for granted - thanks to K in room 8260 for making me aware and reminding me to be grateful!
Wednesday, January 8, 2014
happy soul
on monday and tuesday, cole and i shared the bathroom while getting ready in the morning. i brushed my teeth as he shaved. i showered as he flossed. and after our quick, hurried morning routines, we were out the door and on our way to coffee, both decked out in the most amazing argyle socks - mine with neon yellow, his with turquoise (socks are my thing, and now, his!).
our days were busy. mine with nursing tasks. his with physician assistant work and student learning. we saw one another at a distance, down long white hospital halls. and we smiled in passing. i avoided grabbing his behind and he avoided kissing me. but somehow, we danced... flirtatiously. eyes twinkling at one another. hearts beating faster.
people on my unit know cole. my friends have spent time with him. my manager has met him at work functions. and because, over the last few months, i couldn't keep my excitement to myself, almost ALL of my nurse friends/colleagues have been anticipating his arrival. but it was the nutritionist's comment that made me smile the most. she is indian and although she speaks english well and with a beautiful accent, her comment came out differently than most people would say it. and i like her observation. she said this - "i see your soul happy today!"
that feels good.
our days were busy. mine with nursing tasks. his with physician assistant work and student learning. we saw one another at a distance, down long white hospital halls. and we smiled in passing. i avoided grabbing his behind and he avoided kissing me. but somehow, we danced... flirtatiously. eyes twinkling at one another. hearts beating faster.
people on my unit know cole. my friends have spent time with him. my manager has met him at work functions. and because, over the last few months, i couldn't keep my excitement to myself, almost ALL of my nurse friends/colleagues have been anticipating his arrival. but it was the nutritionist's comment that made me smile the most. she is indian and although she speaks english well and with a beautiful accent, her comment came out differently than most people would say it. and i like her observation. she said this - "i see your soul happy today!"
that feels good.
Saturday, January 4, 2014
working with your partner
in 1985, my parents went bankrupt and had to close down their motorcycle shop. they swore they would never run a business together again.
so, imagine my surprise, disappointment, and non-support, when i was in high school and they announced that they were going to buy a small swiss-german deli and run the business together - my dad cooking and my mom running the finances. i thought it was a horrible idea. i was sure they'd get divorced.
they fought. and fought some more. but in the end - they succeeded. they created a quirky little restaurant famed on mercer island for the best soups, salads, and pretzel rolls in town (thanks to my dad). and the best, friendliest service (thanks to my mom). AND they are still married.
so, get this. cole is spending the next month "working" on MY unit. he will have a one month student rotation on the bone marrow transplant service. and although i tend to think working with your partner is not the best idea, i'm totally excited about our future together as cancer providers!
i'm excited for some silly things. first, we might actually get to carpool in the mornings. it'll be nice to have someone awake with me at the butt crack of dawn. AND, i'm excited to see cole all dressed up all day long. it'll be nice to share a lunch here and there if time allows. and of course, there will be coffee breaks and tootsie roll runs (again if time permits).
but i think what is best about this opportunity is that it will allow cole to see what my job entails. i know cole thinks i am a good nurse. he has said this before. but i want him to know WHO i am nursing. i want him to meet my patients, to hear their stories, and to witness their strength, courage, and sometimes anguish and heartbreak. it's not that i want him to be sad along side me (as i often am), but i want him to know me better by knowing my work better.
cole is truly a brilliant student. he has a passion for learning and succeeding that is unrivaled by most. i know he will do well as a physician's assistant. and i would be honored to stand beside him as a nurse to his patients.
p.s. happy new year! may 2014 be great!
so, imagine my surprise, disappointment, and non-support, when i was in high school and they announced that they were going to buy a small swiss-german deli and run the business together - my dad cooking and my mom running the finances. i thought it was a horrible idea. i was sure they'd get divorced.
they fought. and fought some more. but in the end - they succeeded. they created a quirky little restaurant famed on mercer island for the best soups, salads, and pretzel rolls in town (thanks to my dad). and the best, friendliest service (thanks to my mom). AND they are still married.
so, get this. cole is spending the next month "working" on MY unit. he will have a one month student rotation on the bone marrow transplant service. and although i tend to think working with your partner is not the best idea, i'm totally excited about our future together as cancer providers!
i'm excited for some silly things. first, we might actually get to carpool in the mornings. it'll be nice to have someone awake with me at the butt crack of dawn. AND, i'm excited to see cole all dressed up all day long. it'll be nice to share a lunch here and there if time allows. and of course, there will be coffee breaks and tootsie roll runs (again if time permits).
but i think what is best about this opportunity is that it will allow cole to see what my job entails. i know cole thinks i am a good nurse. he has said this before. but i want him to know WHO i am nursing. i want him to meet my patients, to hear their stories, and to witness their strength, courage, and sometimes anguish and heartbreak. it's not that i want him to be sad along side me (as i often am), but i want him to know me better by knowing my work better.
cole is truly a brilliant student. he has a passion for learning and succeeding that is unrivaled by most. i know he will do well as a physician's assistant. and i would be honored to stand beside him as a nurse to his patients.
p.s. happy new year! may 2014 be great!
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