i feel like i've been working a lot lately. and i think i've mentioned, i've taken on some new responsibilities. being in charge is one of them. i think nurses jobs are underestimated always. tv shows show doctors doing our jobs (seriously, what doctor even knows how to use a blood pressure cuff these days or walks a patient in the hallway). and they show nurses with bedpans. but they don't show us administering 39 different medications in a 12 hour shift. or hanging units of blood, chemotherapy, nutrition, antibiotics, hydration, and morphine all at the same time. even nurses underestimate their jobs sometimes - not realizing how important of a role we play and how much responsibility we have. but who even knows what a charge nurse does? or why s/he is important? let's just say, i didn't understand and i've been a nurse for almost 10 years.
so, this new role. it's hard. in a 12 hour shift, i have NO patients that i am directly responsible for. i don't administer medications or hang blood products. i am indirectly responsible for 21 patients AND my staff of 10 nurses. and i am the liaison for the attending, physicians, physicians assistants, nurse practitioners, nursing assistants, dietitians, pharmacists, the secretary. i sit at the front desk and help field phone calls and family members. i answer questions all day long and get interrupted during every task that i try to complete. when patients decompensate, i am the second set of hands. when new nurses have questions about how to safely care for patients, i have or find the answers. i direct nurses and physicians to our policies and procedures. i call other units to double check protocols. and i attend flow meetings throughout the day to help determine where patients in the hospital land. for instance, which oncology unit does a patient with breast cancer go to? not mine. solid organ cancers go to 7SE. if they're full, then maybe they go to 8SA. when they're full, perhaps they come to my unit. but not if i have a need for transplant patients to come and go. it's a juggling act. and i feel like i have to barter with other charge nurses and the flow supervisor not to give me every patient who is sitting in the ER. a hospital bed is a precious commodity, who knew!
but, one of the most important roles as charge is to assist in emergent situations. to respond to code lights. so when i heard the frantic code bell at shift change on monday night, my heart started racing. i knew the patient was getting dialysis - which means he was hooked up to a machine that filters his blood. two lines connect the patient - one taking all of the "dirty" blood out of his body, and the other returning the cleansed blood back. being disconnected from these lines accidentally is a potentially fatal disaster. and is just one of the risks of needing dialysis. hence, imagine my shock when i found the patient on his head with his feet in the air... almost like a yogi headstand. it will go down as one of the weirdest things i have ever seen. the dialysis nurse was crazed, trying to protect her lines from being disconnected and exsanguinating our patient. and within a minute or two, we had at least 20 people and 40 hands trying to assist us. the patient had felt chest pressure during his dialysis run and as he sat up to cough, he must have passed out and coughed himself onto the floor. somehow, his 6 foot 5 inch body twirled, ever so gracefully i am sure, onto the floor landing on his head with his feet in the air, almost resting on the bed.
thankfully what initially seemed like a disaster turned into just a good story. the patient was fine. his head scans showed no bleeding. he was disconnected from his dialysis machine with ease and without losing any blood. and his nurse survived to tell the tale. but let's just say, being in charge, i had no idea that this is how i might end my shifts - with patients attempting headstands.
namaste!
Wednesday, April 13, 2016
Sunday, March 13, 2016
mine
this was a long week. i lived at UW. not just because of work, but because my dad was in the hospital.
ugh.
his health is so complicated. it's so volatile. like he lives on a teeter totter, and only if perfectly balanced, does he feel ok. never great, but okay.
so, after 16 hours of work on sunday, and what was supposed to be a 12 hour shift on monday, my work day got cut short so i could meet my parents in the ER at 4:30 PM. dad had had some shortness of breath on his typical morning walk and neck pain that i didn't like the sound of. so, after a mini mental breakdown in my manager's office, i left my unit in a heartbeat (something that is intrinsic and so easy for me, and yet requires medications, effort, and that fine balance for my dad) and spent the rest of my day in the company of my family.
i could write pages and pages about my dad's health. about the dumb residents who suck at their job and ask questions like, "if you died right now would you want us to pound on your chest?" (these were her words, seriously!?! they don't teach hard conversations well in med school, apparently). or about the doctors that don't like to believe a patient's daughter, especially when she is in hospital scrubs, even though i was right about his heart rhythm without even seeing the EKG that they struggled to read. i won't talk about the anxiety and the fear we all have that one day this won't end well.
instead, i want to talk about how special my family is. how much i love their company. even in the hospital. actually, especially in the hospital. as crazy as it sounds, it's the only time the four gadola's hang out - just my mom, dad, corina, and i. typically, we have a cohen or emerson in the mix, or my goofy brother-in-law, and sometimes, to really spice things up, joanie joins us on family gatherings. but it's rarely just US. and WE are good. my mom thinks that corina and i don't get along. she worries that one day we won't support each other in times of need. but we prove her wrong every time we do this UW cardiology thing. every hospital stay, we unite. we eat grilled cheese sandwiches in the cafeteria. we sit by dad's hospital bed and make all of the white coats laugh during rounds. we put bobby pins in each other hair and pick blackheads (this is true love).
we gadola's we're pretty special.
my dad got out of the hospital on wednesday night (i worked thursday and friday). after his "tune up," he feels a little better. and i am so thankful. but i'm also thankful for time to be with the ones we love. for family. for mine.
ugh.
his health is so complicated. it's so volatile. like he lives on a teeter totter, and only if perfectly balanced, does he feel ok. never great, but okay.
so, after 16 hours of work on sunday, and what was supposed to be a 12 hour shift on monday, my work day got cut short so i could meet my parents in the ER at 4:30 PM. dad had had some shortness of breath on his typical morning walk and neck pain that i didn't like the sound of. so, after a mini mental breakdown in my manager's office, i left my unit in a heartbeat (something that is intrinsic and so easy for me, and yet requires medications, effort, and that fine balance for my dad) and spent the rest of my day in the company of my family.
i could write pages and pages about my dad's health. about the dumb residents who suck at their job and ask questions like, "if you died right now would you want us to pound on your chest?" (these were her words, seriously!?! they don't teach hard conversations well in med school, apparently). or about the doctors that don't like to believe a patient's daughter, especially when she is in hospital scrubs, even though i was right about his heart rhythm without even seeing the EKG that they struggled to read. i won't talk about the anxiety and the fear we all have that one day this won't end well.
instead, i want to talk about how special my family is. how much i love their company. even in the hospital. actually, especially in the hospital. as crazy as it sounds, it's the only time the four gadola's hang out - just my mom, dad, corina, and i. typically, we have a cohen or emerson in the mix, or my goofy brother-in-law, and sometimes, to really spice things up, joanie joins us on family gatherings. but it's rarely just US. and WE are good. my mom thinks that corina and i don't get along. she worries that one day we won't support each other in times of need. but we prove her wrong every time we do this UW cardiology thing. every hospital stay, we unite. we eat grilled cheese sandwiches in the cafeteria. we sit by dad's hospital bed and make all of the white coats laugh during rounds. we put bobby pins in each other hair and pick blackheads (this is true love).
we gadola's we're pretty special.
my dad got out of the hospital on wednesday night (i worked thursday and friday). after his "tune up," he feels a little better. and i am so thankful. but i'm also thankful for time to be with the ones we love. for family. for mine.
Saturday, March 5, 2016
Dear Jakie
today i was sorting through old paperwork and files of cards that i keep, mostly from my mom and friends (you'd think emma and i were lovers. i save all of her cards because they are the best, kindest, most encouraging sentiments). and i came across an entire file of lovely reminders of the people i have cared for in my lifetime. some from even before i became a nurse.
a picture of one of my favorite campers (carol, the most special of women with downs syndrome) whose kiss would brighten anyone's day.
helen lahey's obituary - my church grandma, who befriended me when i was a kid. she sat in the pew in front of us and loved me as if i were her own.
a photo of dick brunell from room 21. he's flipping off the camera. he was one of my favorite's at Bailey Boushay. He pretended to dislike everyone. But he liked me. I was so young then I hardly recognize myself.
but the little scrap of paper that made me cry the most, that touches me every time i find it... a note to jakie. i don't remember jakie. he must have died while i was a nursing assistant. even then, it was my job to do post mortem care. to clean dead bodies and prepare them for the morgue. this note was left by his side (and i couldn't bare to throw it away). i share it only because i know you will honor it and cherish the words as much as i do.
dated march 19th, 2004
Dear Jakie,
What can I say? Jakie, I don't want you to die! Already, I feel as if an arm or a leg has been cut from my body. After being married for 55 years, it is hard to imagine continuing life without you by my side - but I will try to muddle on.
Oh Jakie, I am going to miss you so much!
All my love forever and ever.
Dear Sweet
a picture of one of my favorite campers (carol, the most special of women with downs syndrome) whose kiss would brighten anyone's day.
helen lahey's obituary - my church grandma, who befriended me when i was a kid. she sat in the pew in front of us and loved me as if i were her own.
a photo of dick brunell from room 21. he's flipping off the camera. he was one of my favorite's at Bailey Boushay. He pretended to dislike everyone. But he liked me. I was so young then I hardly recognize myself.
but the little scrap of paper that made me cry the most, that touches me every time i find it... a note to jakie. i don't remember jakie. he must have died while i was a nursing assistant. even then, it was my job to do post mortem care. to clean dead bodies and prepare them for the morgue. this note was left by his side (and i couldn't bare to throw it away). i share it only because i know you will honor it and cherish the words as much as i do.
dated march 19th, 2004
Dear Jakie,
What can I say? Jakie, I don't want you to die! Already, I feel as if an arm or a leg has been cut from my body. After being married for 55 years, it is hard to imagine continuing life without you by my side - but I will try to muddle on.
Oh Jakie, I am going to miss you so much!
All my love forever and ever.
Dear Sweet
Wednesday, February 24, 2016
a list of things
there is always so much to say about my job. and if i was better at this blog thing, i would say one thing each day that i work. one thing that exasperated me. one thing that made me cry. one thing that i found particularly interesting. or one thing that i learned. but instead, i let time go by. and the impact of these things that feel really BIG when they happen, lessen just a little bit. so instead of one powerful story, here's a list of some things about my job.
- i've been in charge now just three times. and each day, every patient on my floor survived. and only a few nurses hated me because of my assignment! i'm excited about this new role. it makes me feel important. my manager always says that being in charge is an extension of management. and in a way, i get it now. i make decisions on an hourly basis that effect our unit's budget. whether i send a nurse home or call one in on overtime, i not only impact the unit's budget, but also, the staffing, safety, and patient and staff satisfaction.
- i took care of one patient MANY shifts in a row. and on the day of his transplant, of course his cells arrived 5 minutes before shift change. instead of being annoyed that it would take extra time on my part to receive the cells and quadruple check them, i felt excited to deliver this gift to someone whom i had grown to really enjoy. i gathered a bunch of other nurses, who also had just worked 12 hours and wanted to go home, and we sang happy birthday to him (since transplant is a birthday of sorts - another chance at life thanks to a kind donor!). as soon as the first words came out of our mouths, my male patient lost it. he sobbed like a baby in his hospital bed, curled up to next to his adorable wife. and i cried too. i couldn't help it. it was a lovely way to end my day.
- i had the first of my teaching sessions last week. and i'd like to say, it was a BIG success. my two new nurses who had already spent a few weeks on the floor totally appreciated my welcome and the chance to go over material more in-depth without having to complete patient care at the same time. we have another session next week. what's really nice is i've received feedback from management and they are impressed too! thanks goes a long way at work. it's really motivating to hear you're doing a good job.
that's it for now.
oh. one more thing. i'm working on my non-resolutions. i have a cleaning lady coming on saturday (overtime money put to good use).
- i've been in charge now just three times. and each day, every patient on my floor survived. and only a few nurses hated me because of my assignment! i'm excited about this new role. it makes me feel important. my manager always says that being in charge is an extension of management. and in a way, i get it now. i make decisions on an hourly basis that effect our unit's budget. whether i send a nurse home or call one in on overtime, i not only impact the unit's budget, but also, the staffing, safety, and patient and staff satisfaction.
- i took care of one patient MANY shifts in a row. and on the day of his transplant, of course his cells arrived 5 minutes before shift change. instead of being annoyed that it would take extra time on my part to receive the cells and quadruple check them, i felt excited to deliver this gift to someone whom i had grown to really enjoy. i gathered a bunch of other nurses, who also had just worked 12 hours and wanted to go home, and we sang happy birthday to him (since transplant is a birthday of sorts - another chance at life thanks to a kind donor!). as soon as the first words came out of our mouths, my male patient lost it. he sobbed like a baby in his hospital bed, curled up to next to his adorable wife. and i cried too. i couldn't help it. it was a lovely way to end my day.
- i had the first of my teaching sessions last week. and i'd like to say, it was a BIG success. my two new nurses who had already spent a few weeks on the floor totally appreciated my welcome and the chance to go over material more in-depth without having to complete patient care at the same time. we have another session next week. what's really nice is i've received feedback from management and they are impressed too! thanks goes a long way at work. it's really motivating to hear you're doing a good job.
that's it for now.
oh. one more thing. i'm working on my non-resolutions. i have a cleaning lady coming on saturday (overtime money put to good use).
Friday, January 15, 2016
2016 non-resolutions
well, it's 2016...
i've never been one to make resolutions. especially because it's mid january, and if i was to make resolutions, i feel like i'm behind. and that i've already failed. in fact, that's why i don't make resolutions. i don't like to look back on a year and feel like i did something wrong. like i didn't succeed, complete, or perfect my goals.
but this year, i'm making a list. of suggestions (NOT resolutions). just ideas. far out dreams. plans. wishes. hopes. i'm putting them out into the universe (thanks to emma) to see what happens.
here's a few things:
- take on new challenges at work
- explore new things, near and far
- continue going to yoga
(turns out, the whole breathing thing is really good for me)
- read more books (start AND finish them)
- find a husband
- win the lotto
- organize my bills, papers, and documents
- decorate more of my white walls
- look into adoption
- inquire about school
- write in a journal, at least once per month
(it's good to set attainable goals)
- hire a cleaning lady every now and then
(let's face it, i'm a bad housewife even to myself)
- be less self conscious and more confident
- cook more
- be amazing
what do you think? attainable? certainly a list of things i can work on. daily.
my work life looks interesting this year. i'm already working on goal number one! i'm gonna be a charge nurse soon. should be interesting, taking on this leadership role. and, i've asked to teach more too. we need to hire 18 new nurses on my unit (it's complicated, but we're losing 23 nurses as our ICU beds move to another unit). and although i already precept A LOT, our orientation process for new nurses is less than perfect. i feel like some preceptors struggle with teaching. so, i've offered to teach two four hour classes to every new hire during their six week orientation. i've yet to develop a curriculum, but i'm excited. i'm passionate about teaching. and about helping a new nurse feel confident and prepared to be independent. i'm excited to impart some of my expertise and some of my wisdom, not just on how to care safely for patients, but also, on how to care for yourself as a new nurse. it such a hard job! one that i continue to love (for the most part).
i've never been one to make resolutions. especially because it's mid january, and if i was to make resolutions, i feel like i'm behind. and that i've already failed. in fact, that's why i don't make resolutions. i don't like to look back on a year and feel like i did something wrong. like i didn't succeed, complete, or perfect my goals.
but this year, i'm making a list. of suggestions (NOT resolutions). just ideas. far out dreams. plans. wishes. hopes. i'm putting them out into the universe (thanks to emma) to see what happens.
here's a few things:
- take on new challenges at work
- explore new things, near and far
- continue going to yoga
(turns out, the whole breathing thing is really good for me)
- read more books (start AND finish them)
- find a husband
- win the lotto
- organize my bills, papers, and documents
- decorate more of my white walls
- look into adoption
- inquire about school
- write in a journal, at least once per month
(it's good to set attainable goals)
- hire a cleaning lady every now and then
(let's face it, i'm a bad housewife even to myself)
- be less self conscious and more confident
- cook more
- be amazing
what do you think? attainable? certainly a list of things i can work on. daily.
my work life looks interesting this year. i'm already working on goal number one! i'm gonna be a charge nurse soon. should be interesting, taking on this leadership role. and, i've asked to teach more too. we need to hire 18 new nurses on my unit (it's complicated, but we're losing 23 nurses as our ICU beds move to another unit). and although i already precept A LOT, our orientation process for new nurses is less than perfect. i feel like some preceptors struggle with teaching. so, i've offered to teach two four hour classes to every new hire during their six week orientation. i've yet to develop a curriculum, but i'm excited. i'm passionate about teaching. and about helping a new nurse feel confident and prepared to be independent. i'm excited to impart some of my expertise and some of my wisdom, not just on how to care safely for patients, but also, on how to care for yourself as a new nurse. it such a hard job! one that i continue to love (for the most part).
Tuesday, July 28, 2015
a pat on the back
a letter sent to my manager...
I hope this note finds you well.
I’m writing today to share a comment from one of our transplant donor coordinators, Leah. This week, two of your nurses worked with us on a potential cornea donation and they made an impression on her.
Leah writes, “RN Christa and RN Lauren were both very proactive and pro-donation. (They) Wanted to support the family the best they could. They were great, despite their patient being a MRO d/t lymphoma”.
The decedent’s family was very interested in transplant donation but due to the patients illness, it was not possible. Christa and Lauren did everything they could to make donation happen.
It’s interactions with champions like Christa and Lauren that keep us excited about donation and happy to be working so closely with hospital staff, like yours. We can’t do it without you.
Please feel free to share this note of gratitude as widely as appropriate. They both deserve a pat on the back.
this was a nice thank you for just some of the hard work i put in last week.
I hope this note finds you well.
I’m writing today to share a comment from one of our transplant donor coordinators, Leah. This week, two of your nurses worked with us on a potential cornea donation and they made an impression on her.
Leah writes, “RN Christa and RN Lauren were both very proactive and pro-donation. (They) Wanted to support the family the best they could. They were great, despite their patient being a MRO d/t lymphoma”.
The decedent’s family was very interested in transplant donation but due to the patients illness, it was not possible. Christa and Lauren did everything they could to make donation happen.
It’s interactions with champions like Christa and Lauren that keep us excited about donation and happy to be working so closely with hospital staff, like yours. We can’t do it without you.
Please feel free to share this note of gratitude as widely as appropriate. They both deserve a pat on the back.
this was a nice thank you for just some of the hard work i put in last week.
Monday, July 27, 2015
he sails on
it's been a long time dear blog...
i could make excuses. but in reality, i've been avoiding this space on purpose. i haven't wanted to process work life or real life (and now more than ever, the two feel very connected). it feels too hard. so i've just been letting things mull over in my mind, wreck havoc on my soul. some days i show up at work, just because i have to. and some days, i do my best. my very best.
the last week i had more amazing moments that i can count. more than i could ever share in writing. how lucky am i? when i contemplate job changes and career goals, i feel blessed to have been a part of amazing nursing moments. life moments. that remind me why i do what i do. why i was meant to be a nurse.
on wednesday of last week, after a fantastic birthday celebration that included 30 miles of backpacking in two days, i arrived at work to find one of my favorite patients on comfort care. strangely enough, i cared for david for the first time exactly one year prior.
comfort care is a blessing and a curse. i love taking care of people on comfort care. for some reason, i feel at ease with people when they are dying. i enjoy participating in families biggest, hardest, sometimes most beautiful moments. but of course, comfort care is sad. there are usually tears. shared memories and the best of stories. there is noisy breathing. and morphine. endless questions with difficult answers. often of which i do not have the answer to. but i'm good at saying i don't know. i'm good at answering the questions i can. and my calmest and kindest self appears. and it feels nice (especially when lately i've been a grouch).
i spent much of my 12 hour day in david's room. his wife, daughter, and son-in-law were present. there were visits from social workers, palliative care physicians, and friends. and there were snuggles (i love when loved one snuggle with their family members as they are dying; it's the most beautiful intimate moment to witness). there were stories - boy were there stories. david had spent many a year on a sailboat. in fact, he and his wife raised their daughter on a sailboat i believe. they were adventurers. kind and giving people. the kind i would like to be when i grow up. seriously. i'd be ecstatic if i could impart just a little bit of david and a whole lot of barbara in my life.
david's wife is the epitome of an angel. i can't imagine a better wife. she lived and breathed for david. his every pain was hers, and his every success was celebrated (i will never forget one time i was caring for david and he successfully pooped in a bedpain; barb celebrated as if he had won a gold medal in the olympics. and david, in his most cynical, dry voice said, "barbara, anyone can take a shit?!? but to her, it was noteworthy. celebratory. if she had had balloons, they would have been blown up. if there was cake, she would have lit a candle). barbara told me that over the course of the last year, david had been in the hospital 173 days. and while he was out-patient, there had been 150 clinic appointments. she was there for every one. every day. she never left his side.
david died peacefully in his sleep the evening after i cared for him. he and his family have touched me. deeply. if they are able to carry on with such grace, so too must i.
i could make excuses. but in reality, i've been avoiding this space on purpose. i haven't wanted to process work life or real life (and now more than ever, the two feel very connected). it feels too hard. so i've just been letting things mull over in my mind, wreck havoc on my soul. some days i show up at work, just because i have to. and some days, i do my best. my very best.
the last week i had more amazing moments that i can count. more than i could ever share in writing. how lucky am i? when i contemplate job changes and career goals, i feel blessed to have been a part of amazing nursing moments. life moments. that remind me why i do what i do. why i was meant to be a nurse.
on wednesday of last week, after a fantastic birthday celebration that included 30 miles of backpacking in two days, i arrived at work to find one of my favorite patients on comfort care. strangely enough, i cared for david for the first time exactly one year prior.
comfort care is a blessing and a curse. i love taking care of people on comfort care. for some reason, i feel at ease with people when they are dying. i enjoy participating in families biggest, hardest, sometimes most beautiful moments. but of course, comfort care is sad. there are usually tears. shared memories and the best of stories. there is noisy breathing. and morphine. endless questions with difficult answers. often of which i do not have the answer to. but i'm good at saying i don't know. i'm good at answering the questions i can. and my calmest and kindest self appears. and it feels nice (especially when lately i've been a grouch).
i spent much of my 12 hour day in david's room. his wife, daughter, and son-in-law were present. there were visits from social workers, palliative care physicians, and friends. and there were snuggles (i love when loved one snuggle with their family members as they are dying; it's the most beautiful intimate moment to witness). there were stories - boy were there stories. david had spent many a year on a sailboat. in fact, he and his wife raised their daughter on a sailboat i believe. they were adventurers. kind and giving people. the kind i would like to be when i grow up. seriously. i'd be ecstatic if i could impart just a little bit of david and a whole lot of barbara in my life.
david's wife is the epitome of an angel. i can't imagine a better wife. she lived and breathed for david. his every pain was hers, and his every success was celebrated (i will never forget one time i was caring for david and he successfully pooped in a bedpain; barb celebrated as if he had won a gold medal in the olympics. and david, in his most cynical, dry voice said, "barbara, anyone can take a shit?!? but to her, it was noteworthy. celebratory. if she had had balloons, they would have been blown up. if there was cake, she would have lit a candle). barbara told me that over the course of the last year, david had been in the hospital 173 days. and while he was out-patient, there had been 150 clinic appointments. she was there for every one. every day. she never left his side.
david died peacefully in his sleep the evening after i cared for him. he and his family have touched me. deeply. if they are able to carry on with such grace, so too must i.
Monday, January 26, 2015
the BIG stuff
i participated in a beautiful thing today.
most of my patients are bald. it doesn't even phase me anymore. i don't expect to see hair. when i have patients with full heads of hair, i think it's weird - like something is wrong with them.
but every now and then, i am asked to shave someone's head. maybe she had some hair; short hair that has grown since her last round of chemotherapy. or stubble that seems to itch as it too falls out. but rarely, maybe never, have i shaved someone's head who has NEVER lost their hair. never have i shaved someone's head and made them cry.
and today i did. my patient is a sweet, very sick woman. and her husband loves her like nobody else. he came to me today and said, "i think today's the day. can you shave Ts head?" i responded with an of course. and then he surprised me. he said, "when you're done with her, will you shave mine?" i chuckled a bit, awkwardly, because i've never shaved anyone's head who doesn't have cancer. but why not? what a loving, kind thing to do for your wife - to show solidarity in the hardest of situations.
we took selfie's before. and my patient cried. and as the buzzer buzzed, she closed her eyes. her shoulders heaved. and her sobs were audible. it took me a while to complete the task. she had beautiful, thick hair. and to my surprise, i killed the batteries in not one, but two of our automatic razors. which meant, i couldn't complete Ts husband's head. which was okay. because he left for an hour and got a barber to do a better job that i ever could have done.
but the best part was the reveal. my patient stood up and faced the mirror with courage. she held her husband's hand and she looked and touched her fuzz. and she cried again. i watched as she and her husband cried together. and i cried too. for getting to witness such love. for being a part of peoples' lives during such BIG stuff.
most of my patients are bald. it doesn't even phase me anymore. i don't expect to see hair. when i have patients with full heads of hair, i think it's weird - like something is wrong with them.
but every now and then, i am asked to shave someone's head. maybe she had some hair; short hair that has grown since her last round of chemotherapy. or stubble that seems to itch as it too falls out. but rarely, maybe never, have i shaved someone's head who has NEVER lost their hair. never have i shaved someone's head and made them cry.
and today i did. my patient is a sweet, very sick woman. and her husband loves her like nobody else. he came to me today and said, "i think today's the day. can you shave Ts head?" i responded with an of course. and then he surprised me. he said, "when you're done with her, will you shave mine?" i chuckled a bit, awkwardly, because i've never shaved anyone's head who doesn't have cancer. but why not? what a loving, kind thing to do for your wife - to show solidarity in the hardest of situations.
we took selfie's before. and my patient cried. and as the buzzer buzzed, she closed her eyes. her shoulders heaved. and her sobs were audible. it took me a while to complete the task. she had beautiful, thick hair. and to my surprise, i killed the batteries in not one, but two of our automatic razors. which meant, i couldn't complete Ts husband's head. which was okay. because he left for an hour and got a barber to do a better job that i ever could have done.
but the best part was the reveal. my patient stood up and faced the mirror with courage. she held her husband's hand and she looked and touched her fuzz. and she cried again. i watched as she and her husband cried together. and i cried too. for getting to witness such love. for being a part of peoples' lives during such BIG stuff.
Saturday, January 10, 2015
grief and loss
i've been having a rough time lately. like really rough. and although i don't really want to discuss it, i do want to discuss how my experiences with anxiety, sadness, and depression may have benefited a family member of one of my patients.
yesterday i had the honor of caring for a 47 year old woman dying from her AML. she had had one transplant with relapse almost immediately following. despite more chemotherapy, donor lymphocyte infusions, and radiation, medicine could not cure her. even her second transplant failed to deliver a miracle.
by the time i got to work yesterday, my patient, her husband, and her mother had decided to change their goals of care from cure to comfort. what that means to me is - they made a good decision. a brave decision. the most loving and respectful decision for a very sick and tortured body and soul. by the time i met my patient, she was unable to respond. her drug-induced sleep looked peaceful and her expirations made soft sighs. as her fingers and toes turned blue, her husband sat beside her, holding her hands and whispering into her ear. it was a beautiful thing to witness. that is the beauty of my job. sometimes i am fortunate enough to watch death approach peacefully and for loved ones to grieve and cope in beautiful ways.
as the three of us watched a woman get closer and closer to her last breaths, we talked about the pain of losing a loved one. about how to cope with that loss. and her husband asked me what i do after hard experiences. it was so interesting - the timing of this patient and his questions. i am experiencing loss now. i am in the midst of BIG grief. and so i was candid. i told him to find healthy coping mechanisms. to try any and all he knows of. to be open to the love and support of friends and family, even when it feels foreign to accept it. to try therapy. massage. acupuncture. hypnotism. whatever works. can trying new things to be healthy ever be bad? try writing. exercise. support groups. church. reading.
my patient's husband and i came up with a good list. and i think we're going to use them all...
yesterday i had the honor of caring for a 47 year old woman dying from her AML. she had had one transplant with relapse almost immediately following. despite more chemotherapy, donor lymphocyte infusions, and radiation, medicine could not cure her. even her second transplant failed to deliver a miracle.
by the time i got to work yesterday, my patient, her husband, and her mother had decided to change their goals of care from cure to comfort. what that means to me is - they made a good decision. a brave decision. the most loving and respectful decision for a very sick and tortured body and soul. by the time i met my patient, she was unable to respond. her drug-induced sleep looked peaceful and her expirations made soft sighs. as her fingers and toes turned blue, her husband sat beside her, holding her hands and whispering into her ear. it was a beautiful thing to witness. that is the beauty of my job. sometimes i am fortunate enough to watch death approach peacefully and for loved ones to grieve and cope in beautiful ways.
as the three of us watched a woman get closer and closer to her last breaths, we talked about the pain of losing a loved one. about how to cope with that loss. and her husband asked me what i do after hard experiences. it was so interesting - the timing of this patient and his questions. i am experiencing loss now. i am in the midst of BIG grief. and so i was candid. i told him to find healthy coping mechanisms. to try any and all he knows of. to be open to the love and support of friends and family, even when it feels foreign to accept it. to try therapy. massage. acupuncture. hypnotism. whatever works. can trying new things to be healthy ever be bad? try writing. exercise. support groups. church. reading.
my patient's husband and i came up with a good list. and i think we're going to use them all...
Monday, December 8, 2014
sink or swim
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...
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...
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
Subscribe to:
Posts (Atom)