sometimes, as a nurse, i get sick of taking care of people. i don't just care for people at work, i care for people in all aspects of my life. caring is in my genes. it just happens - almost naturally, compulsively, intuitively (even when i try to care less or stop caring at all). but then, every now and then, when i've cared too much, i crack; and then, i need someone to take care of me. please.
these last three days at work have been hard. to be brief.
on wednesday, i cared for a 46 year old nigerian man. throughout my 12 hour shift, he lost his ability to speak in english. he lost his mobility and could no longer transfer from his chair to the bed. he had unmanaged pain. and was nearing death.
today (friday), i wrapped his body in plastic and zipped him up in a body bag. his three brothers watched us perform our last "caring" techniques (which feels more like lack of caring - plastic? body bags? ugh - inhumane). the brothers (and i) cried.
my other two patients are 24 and 34 years old. the 24 year old is pre-transplant. he is hopeful and anxious. he's getting sicker before we make him better. the 34 year old has had two transplants; the first one his body did not accept and sadly, he's relapsed after the second. his leg is gangrenous and he needs a walker. he has two kids and a wife at home.
my other patient is not my patient at all. he's family; he's my dad. my dad has congestive heart failure and is seen in the out-patient cardiology clinic in my hospital. the days he has appointments while i am at work, i usually con my charge nurse to allow me to leave the floor to escort my dad. he's lived in the US for more than 30 years (from switzerland originally), but he still needs an interpreter. not literally. but he does need an advocate and someone to force him to report accurately. so, we went together today to see why he's been more fatigued and why he is retaining fluid despite the diuretics. bottom line. it's hard to care for a parent. to watch them age and get sicker.
anyway, sometimes i care too much. if you catch my drift. i worry about my "patients." i feel sad when they have aches and pains. i want for them to get better instead of sicker. i want my caring to be curing. and it's often not.
when this realization comes, that i cannot care for everyone and that i certainly cannot cure anyone, i get overwhelmed. sometimes i cry. sometimes i eat chocolate. today, i just need someone to take care of me for a change. please.
Friday, December 17, 2010
Tuesday, November 30, 2010
my job is so weird...
a patient died last night.
i watched a techn from lifecenter northwest cut his corneas out right at the bedside.
they will be donated to someone to restore sight.
an amazing gift!
but, eyes give me the willies.
especially eyes with no corneas.
now i know.
i watched a techn from lifecenter northwest cut his corneas out right at the bedside.
they will be donated to someone to restore sight.
an amazing gift!
but, eyes give me the willies.
especially eyes with no corneas.
now i know.
Thursday, November 25, 2010
rejuvenated
i took a six week vacation. and it might have been the best thing i have done for my career. ever. i came back (not wanting to go back to work, but) feeling rejuvenated and ready for the challenges that a nursing career presents. and since i have been back in the country for 2 weeks and back at work for six shifts, i have had a more positive attitude and many positive - dare i say 'special' - moments.
my first week back, i took care of an older bulgarian gentleman who had had a transplant 2 weeks prior. unfortunately, he did not speak english. and hence, caring for him was difficult. so much of assessing our patients come from conversation. an interpreter appeared every morning at 10 am - which was great and helpful. but inevitably, at 10:31, after the interpreter left, i would discover one more thing i needed help translating. can you imagine not fully understanding what was happening to you in a hospital? transplant is one of the most complicated medical phenomenons and this poor gentleman couldn't ask questions whenever he pleased, simply because of a language barrier. anyway, my joy came when, on my second day of caring for this man, i used a phone interpreter for the first time. within 1 or 2 minutes and the touch of a few buttons, i was able to get a bulgarian interpreter on speaker phone. my patient and i could talk whenever we wanted now. we could talk about intractible nausea and persistent diarrhea or we could talk about the weather. the ease and freedom that this phone brought to my patient and his wife was indescribable. after having a long translated conversation, i hung up and was cheered and celebrated as if i was a celebrity. my patient held my hand in the air, like a boxing champ. his wife said, "nurse christa good." we all had tears in our eyes. it was a strangely special moment - to give someone a voice. after three weeks in the hospital, i think my patient finally felt heard.
another funny experience... i had the opportunity to care for a sweet, sweet 29 year old female on our floor. she wasn't the warm and fuzzy kind of sweet. she was the rough and tough, shaved her chemo hair into a mohawk, kind of sweet. her cousins sat at her bedside playing wi-bowling, eating chips and salsa. it was almost a party in her room. but one day, she was alone and sullen. we talked, girl to girl, 29 to 30 year old, heart to heart. i acknowledged how unfair it is for someone our age to be sick, with CANCER. i asked some questions - how long has she had the C word, how was she diagnosed. and she relayed the story. she had gone to her gynecologist with what she thought was herpes. after many tests, all of which came back negative for for HSV, she discovered she had AML (leukemia) instead. her joke was, "i think i'm glad i have leukemia - at least there's a cure." true enough. transplant is a possible cure; herpes has none. let's hope her cure works!
the same gal, after i had cared for her for three days in a row, requested that i be her nurse every time that i worked. what an honor and compliment!
my first week back, i took care of an older bulgarian gentleman who had had a transplant 2 weeks prior. unfortunately, he did not speak english. and hence, caring for him was difficult. so much of assessing our patients come from conversation. an interpreter appeared every morning at 10 am - which was great and helpful. but inevitably, at 10:31, after the interpreter left, i would discover one more thing i needed help translating. can you imagine not fully understanding what was happening to you in a hospital? transplant is one of the most complicated medical phenomenons and this poor gentleman couldn't ask questions whenever he pleased, simply because of a language barrier. anyway, my joy came when, on my second day of caring for this man, i used a phone interpreter for the first time. within 1 or 2 minutes and the touch of a few buttons, i was able to get a bulgarian interpreter on speaker phone. my patient and i could talk whenever we wanted now. we could talk about intractible nausea and persistent diarrhea or we could talk about the weather. the ease and freedom that this phone brought to my patient and his wife was indescribable. after having a long translated conversation, i hung up and was cheered and celebrated as if i was a celebrity. my patient held my hand in the air, like a boxing champ. his wife said, "nurse christa good." we all had tears in our eyes. it was a strangely special moment - to give someone a voice. after three weeks in the hospital, i think my patient finally felt heard.
another funny experience... i had the opportunity to care for a sweet, sweet 29 year old female on our floor. she wasn't the warm and fuzzy kind of sweet. she was the rough and tough, shaved her chemo hair into a mohawk, kind of sweet. her cousins sat at her bedside playing wi-bowling, eating chips and salsa. it was almost a party in her room. but one day, she was alone and sullen. we talked, girl to girl, 29 to 30 year old, heart to heart. i acknowledged how unfair it is for someone our age to be sick, with CANCER. i asked some questions - how long has she had the C word, how was she diagnosed. and she relayed the story. she had gone to her gynecologist with what she thought was herpes. after many tests, all of which came back negative for for HSV, she discovered she had AML (leukemia) instead. her joke was, "i think i'm glad i have leukemia - at least there's a cure." true enough. transplant is a possible cure; herpes has none. let's hope her cure works!
the same gal, after i had cared for her for three days in a row, requested that i be her nurse every time that i worked. what an honor and compliment!
Thursday, September 16, 2010
final breaths
that patient that i mentioned a few days ago, the one with the fungal infection in his brain... well, i've been keeping tabs on him lately. i've not been his nurse, but i've visited, spoken with his wife, and caught up on his condition with his nurses. he seemed to be in the clear. he was doing remarkably well for how sick he had been and for having just had massively invasive brain surgery. his team of neurosurgeons and oncologists were optimistic for a full recovery.
today, i got to work and looked at the six intensive care beds on our unit. someone had been admitted overnight. his name was W - the same name as the above mentioned patient with whom i feel so connected. and there was a butterfly by his name - gasp! the butterfly is the symbol we use on a patient's door to signify that we have put them on comfort care (translation - that we have finally acknowledged the imminence of death, and instead of fighting it with all of our artillery, are welcoming it with open arms). what had happened?
W had become unresponsive last night. a ct scan of his brain showed an enormous head bleed. death was inevitable. with grace and bravery, his family accepted the news and continues to wait at his bedside.
this job is so hard. i so badly wanted to go into W's room, to console his family, to say goodbye and make peace within my own heart. but at the same time, i didn't want to walk in their at all. what do you say to a wife who is losing her husband? to children, close to my age, who are losing their dad? i almost had to force myself into the room... but i am so glad that i visited. when i went in to offer my support, W's wife, son, and daughter were all laying their heads in W's bed; they were holding his hands, loving him, and nurturing him as he takes his final breaths. it is a beautiful scene. one family. together. for one final time.
i say it is beautiful only because it is not mine. i am so sad for W.
today, i got to work and looked at the six intensive care beds on our unit. someone had been admitted overnight. his name was W - the same name as the above mentioned patient with whom i feel so connected. and there was a butterfly by his name - gasp! the butterfly is the symbol we use on a patient's door to signify that we have put them on comfort care (translation - that we have finally acknowledged the imminence of death, and instead of fighting it with all of our artillery, are welcoming it with open arms). what had happened?
W had become unresponsive last night. a ct scan of his brain showed an enormous head bleed. death was inevitable. with grace and bravery, his family accepted the news and continues to wait at his bedside.
this job is so hard. i so badly wanted to go into W's room, to console his family, to say goodbye and make peace within my own heart. but at the same time, i didn't want to walk in their at all. what do you say to a wife who is losing her husband? to children, close to my age, who are losing their dad? i almost had to force myself into the room... but i am so glad that i visited. when i went in to offer my support, W's wife, son, and daughter were all laying their heads in W's bed; they were holding his hands, loving him, and nurturing him as he takes his final breaths. it is a beautiful scene. one family. together. for one final time.
i say it is beautiful only because it is not mine. i am so sad for W.
Tuesday, September 14, 2010
FYI
both my patients are 27 today. that's too young to be in the hospital, too young to be sick, and definitely too young to have cancer.
Saturday, September 11, 2010
hope vs no hope
yesterday there was a glimmer of hope in my day. a patient that i had taken care of a month or so ago had been re-admitted with a horrible fungal infection located deep within his brain. he needed a massively invasive surgery to remove the infection and pieces of decayed brain matter. this is not the good news. the bright side came when i walked into the patient's room and met his 20 year old son. he was kind and talkative; he introduced himself to me and thanked our hospital and staff for taking such good care of his dad and for supporting his mom. then, he proceeded to place smiley face stickers all over his dad's gauzy bandaged head.
sadly, today there was no hope. on a telemetry monitor located above the computer at which i was charting, i watched a 36 year old man's heart rate go from a very sick and rapid rate of 150 to zero. and i listened to his laotian wife wail ghastly cries in the hallway. as comfortable as i feel with death, it never feels normal to watch someone slip away... or to hear someone's shrieking anguish and pain.
sadly, today there was no hope. on a telemetry monitor located above the computer at which i was charting, i watched a 36 year old man's heart rate go from a very sick and rapid rate of 150 to zero. and i listened to his laotian wife wail ghastly cries in the hallway. as comfortable as i feel with death, it never feels normal to watch someone slip away... or to hear someone's shrieking anguish and pain.
Friday, September 3, 2010
role reversal
i've spent the last four months training to climb mount rainier. in fact, i've even blogged about it in an entry or two. it's been my main focus this summer. and likely one of a few reasons i haven't blogged much at work about work. i've been determined, excited, and unbeatable... until last week.
this last week, i got beat. and i got beaten badly!
let me describe the days prior to my hospital admission. on friday and saturday (almost two weeks ago), i did a trial run of an altitude sickness medication called diomox. the reason for the trial was that i am allergic to a cousin of the drug and wanted to assure that if i had a reaction, i was in seattle, at sea level, and near a hospital. so, i took my first two doses while working a 12 hour shift. and i was fine. perhaps a little dizzy (but it's a mild diuretic, so it made sense). the next day was a long training hike - a 14 mile loop with a 35 pound backpack. and i took two more doses. i was tired, but the training hike went well on the medication.
sunday was a day off from exercise. and monday i was at work. tuesday, i developed a respiratory infection that i feared would hinder my climb. so, i went to the doctor in search of antibiotics. instead, i was told i likely had a viral infection and would have to wait it out. blah!!! the exercise continued, as last week was supposed to be my most intense week of training. despite a fever, weakness, and general malaise, i went to hot yoga on tuesday evening and crossfit the rest of the week (not to mention 52 minutes on an escalator-like machine at a fast pace). two of the three days at crossfit were upperbody exercises. and although i have relatively buff arms (if i may say so myself), i did TOO much. advice: never do 100 pull-ups followed by 100 push ups the day after you've done push presses at your maximum weight.
friday evening, after crossfit, i literally could not lift my own water bottle to my lips. i had dinner with a friend and had to excuse my poor table manners and clutsiness. saturday i hiked, figuring i did not need my arms for a 9 mile hike with a 40+ pound pack on my back. but i certainly was sore beyond belief, unable to flex or extend my arms. i iced things and took ibuprofen to hasten my recovery. but it was to no avail.
on monday morning, i woke up still sore and feeling "fat." really, my muscles were just inflamed and incredibly angry at me. however, my right arm was larger than the left. and being a nurse, i worried that i may have developed a blood clot. because i had to work that day, i iced and medicated while working for 12.5 hours. but my worry grew throughout the day as others noticed and commented on the size of my arm and the possible diagnoses. blood clots, a torn bicep, cancer, elephantiasis - it could have been anything!!! by evening, i had a physician's assistant look at it and he told me to get it checked out immediately. so began my hospital stay...
i became a patient at swedish medical center, first in the emergency room and then on a medical unit in room 906. and for the first time in my life, i was a patient and not a nurse. the role reversal was strange and the experience was incredibly humbling.
essentially, the combination of my intense exercise, possible dehydration, and overuse of my arms had caused rhabdomyelisis - a severe breakdown of muscle tissue which results in the build up of waste products and toxins that damage your kidneys. i was admitted to prevent acute renal failure and put on a sodium bicarbonate drip. within minutes of my ultrasound to rule out clots in my arms and assessment of my lab results, i was given an IV in the lesser of swollen of arms and pumped full of cold intravenous fluids.
as a nurse, i was on high alert. the ER nurse never offered me a warm blanket. i had no nurse call light to ask for help. there was no bathroom in my curtained room. when a transporter came to wheel me up to my new room, i was on a gurney, looking up at the ceiling, getting nauseated from the bumps in the floor and the sharp turns; oh my goodness, how do my permamently nauseated oncology patients tolerate being wheeled to chest x-rays and procedures? my first night "sleep" was interrupted at least 4 times between midnight and 6 AM - doctors visiting, an admission history to complete, vital sign checks, blood draw in the wee hours of the day. with incredibly swollen arms, my veins were hiding deep below the surface and i had to get poked at least three times, just the first day! i grew increasingly impatient with my lack of control and the great unknown. nobody could tell me i would be okay; nobody knew my lab results for hours (even though i knew they were completed and in the computer); nobody could make the doctors appear when i wanted to talk to them. i was stuck, confined, totally at the mercy of others. my only role was to WAIT - to wait patiently for others to tell me news.
for a complete and total control freak, it was a challenge - to say the least- to be in the hospital. because i was so weak and my arms so damaged, i couldn't shower myself or put on my own clothes. hence, it was a good lessen in humility to have to ask for help and such a great reminder of how lucky i am to have family and amazing friends. my dear friend emma saved me from having to ask my nurse, a total stranger, to help me wash my hair. she kindly helped me to get undressed, wash, and get redressed without feeling the least bit embarrassed. the next day, my mom even shaved my armpits! all this may sound silly, but being clean was important to my happiness... and since i couldn't do it on my own, i felt blessed to have support. aside from tuesday, wednesday, and thursday nights, i was never alone in the hospital for more than 1 hour. people brought me flowers, meals, magazines, chocolate peanut butter malted milk balls - the supply of kindness was endless.
i am thankful to be out of the hospital. of course, i am crushed that my dream of climbing mount rainier is shattered... at the very least, postponed til next season. but, when i return to work this friday, i will return with a greater understanding of my job and the role of patient. i've always known that being patient as a patient must be challenging, but i have a new appreciation of the vulnerability that my patients feel. may i be a better nurse from here on out!
this last week, i got beat. and i got beaten badly!
let me describe the days prior to my hospital admission. on friday and saturday (almost two weeks ago), i did a trial run of an altitude sickness medication called diomox. the reason for the trial was that i am allergic to a cousin of the drug and wanted to assure that if i had a reaction, i was in seattle, at sea level, and near a hospital. so, i took my first two doses while working a 12 hour shift. and i was fine. perhaps a little dizzy (but it's a mild diuretic, so it made sense). the next day was a long training hike - a 14 mile loop with a 35 pound backpack. and i took two more doses. i was tired, but the training hike went well on the medication.
sunday was a day off from exercise. and monday i was at work. tuesday, i developed a respiratory infection that i feared would hinder my climb. so, i went to the doctor in search of antibiotics. instead, i was told i likely had a viral infection and would have to wait it out. blah!!! the exercise continued, as last week was supposed to be my most intense week of training. despite a fever, weakness, and general malaise, i went to hot yoga on tuesday evening and crossfit the rest of the week (not to mention 52 minutes on an escalator-like machine at a fast pace). two of the three days at crossfit were upperbody exercises. and although i have relatively buff arms (if i may say so myself), i did TOO much. advice: never do 100 pull-ups followed by 100 push ups the day after you've done push presses at your maximum weight.
friday evening, after crossfit, i literally could not lift my own water bottle to my lips. i had dinner with a friend and had to excuse my poor table manners and clutsiness. saturday i hiked, figuring i did not need my arms for a 9 mile hike with a 40+ pound pack on my back. but i certainly was sore beyond belief, unable to flex or extend my arms. i iced things and took ibuprofen to hasten my recovery. but it was to no avail.
on monday morning, i woke up still sore and feeling "fat." really, my muscles were just inflamed and incredibly angry at me. however, my right arm was larger than the left. and being a nurse, i worried that i may have developed a blood clot. because i had to work that day, i iced and medicated while working for 12.5 hours. but my worry grew throughout the day as others noticed and commented on the size of my arm and the possible diagnoses. blood clots, a torn bicep, cancer, elephantiasis - it could have been anything!!! by evening, i had a physician's assistant look at it and he told me to get it checked out immediately. so began my hospital stay...
i became a patient at swedish medical center, first in the emergency room and then on a medical unit in room 906. and for the first time in my life, i was a patient and not a nurse. the role reversal was strange and the experience was incredibly humbling.
essentially, the combination of my intense exercise, possible dehydration, and overuse of my arms had caused rhabdomyelisis - a severe breakdown of muscle tissue which results in the build up of waste products and toxins that damage your kidneys. i was admitted to prevent acute renal failure and put on a sodium bicarbonate drip. within minutes of my ultrasound to rule out clots in my arms and assessment of my lab results, i was given an IV in the lesser of swollen of arms and pumped full of cold intravenous fluids.
as a nurse, i was on high alert. the ER nurse never offered me a warm blanket. i had no nurse call light to ask for help. there was no bathroom in my curtained room. when a transporter came to wheel me up to my new room, i was on a gurney, looking up at the ceiling, getting nauseated from the bumps in the floor and the sharp turns; oh my goodness, how do my permamently nauseated oncology patients tolerate being wheeled to chest x-rays and procedures? my first night "sleep" was interrupted at least 4 times between midnight and 6 AM - doctors visiting, an admission history to complete, vital sign checks, blood draw in the wee hours of the day. with incredibly swollen arms, my veins were hiding deep below the surface and i had to get poked at least three times, just the first day! i grew increasingly impatient with my lack of control and the great unknown. nobody could tell me i would be okay; nobody knew my lab results for hours (even though i knew they were completed and in the computer); nobody could make the doctors appear when i wanted to talk to them. i was stuck, confined, totally at the mercy of others. my only role was to WAIT - to wait patiently for others to tell me news.
for a complete and total control freak, it was a challenge - to say the least- to be in the hospital. because i was so weak and my arms so damaged, i couldn't shower myself or put on my own clothes. hence, it was a good lessen in humility to have to ask for help and such a great reminder of how lucky i am to have family and amazing friends. my dear friend emma saved me from having to ask my nurse, a total stranger, to help me wash my hair. she kindly helped me to get undressed, wash, and get redressed without feeling the least bit embarrassed. the next day, my mom even shaved my armpits! all this may sound silly, but being clean was important to my happiness... and since i couldn't do it on my own, i felt blessed to have support. aside from tuesday, wednesday, and thursday nights, i was never alone in the hospital for more than 1 hour. people brought me flowers, meals, magazines, chocolate peanut butter malted milk balls - the supply of kindness was endless.
i am thankful to be out of the hospital. of course, i am crushed that my dream of climbing mount rainier is shattered... at the very least, postponed til next season. but, when i return to work this friday, i will return with a greater understanding of my job and the role of patient. i've always known that being patient as a patient must be challenging, but i have a new appreciation of the vulnerability that my patients feel. may i be a better nurse from here on out!
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