i've recently been noticing that nursing seeps its way into all aspects of life. nursing is not just a profession; it's a mindset. we nurse everywhere we go. we take care of those around us, whether or not they are our patients. and sometimes, nursing rears its ugly head at the strangest and most inopportune of times.
i work with this fantastic nurse. she recently acknowledged that she needed a break; not a long one, but a good one. we've had numerous deaths recently on our unit. and it just becomes overwhelming sometimes. so, on a whim, she decided to fly to cabo san lucas. she and her husband spent 6 days sunning themselves without a care in the world. it's just the kind of break from nursing one needs. self-care is important.
but then, just when you least expect it...
A and her husband were on a boat. they were spending their last afternoon on the water. then, all of a sudden, in the distance, people were in the water, waving for help, signaling distress. turns out, a couple walking/wading on the beach were carried out to sea by an undertoe. with help from locals, the female drowning victim was pulled into A's boat and A did CPR. the woman was cold and blue. her pupils were fixed and dilated (not a good sign). but as a nurse, you do your best. you try to save lives. whether you're in the hospital or on vacation, once a nurse, always a nurse.
once on shore, the mexican paramedics took over. and within minutes, A left the beach and headed to the airport - not knowing the outcome of her heroic works.
so much for a relaxing vacation.
both the female and male drowning victims died. see this article for more information. oh, and by the way, never go swimming on divorce beach. the name says it all...
http://www.calgarysun.com/news/alberta/2011/02/05/17170151.html
Sunday, February 6, 2011
Friday, February 4, 2011
control freaks
as a nurse, i'm a caretaker. i like to take control of a situation and make things better. it's very hard for me to take a backseat. i'd hate to admit that i'm conceited or arrogant, but as a control freak, one often thinks that she can do things better. and in this situation, i want to take control and make things better.
(i know i can't. and even if i tried, the final result would be the same. i am no better equipped to handle the situation than the people in charge. but i'm bad at being a spectator.)
we have a family friend, let's call him C. he is one of the kindest men i've known. he is only a few years older than i am. he's the father of two boys - A is 16 and D is 12. his wife has a 19 year old daughter and he takes his parenting role very seriously, even with her. he works hard all week, working two jobs, to support his family, so that on the weekends, he can spend quality time with his children. they go to church. they play an active role in their hispanic community. C wants to give his children more than he had growing up. he wants them to be educated, upstanding citizens.
but sadly, all of their lives changed this week when A pulled a gun on D and shot him in the mouth. i wish i could say it was an accident. but bottom line is, the boys were rough-housing and A got out a gun and pulled a trigger. certainly A did not mean to kill D; and thank god, he didn't. D is in serious condition and will hopefully recover with minimal side effects (once the reconstructive surgeries, physical therapy, and possibly speech therapy is complete). but the fact of the matter is, A had a gun. it was purchased illegally. it has been discovered he is a part of a gang. and now he is in jail. he is being tried as an adult. and will forever be haunted by the fact that he shot his own brother over a video game.
because C is so devastated and in such a state of shock, i'm worried that he won't know how to navigate the medical and judicial system. he doesn't have the money to pay for high quality lawyers; and he's not in the right state of mind to research law offices who take pro-bono cases. i'm worried he won't demand the best care at the hospital. what if he doesn't know that you can request interpreters, certain nurses, social workers, and special treatment. i hate to admit that the system works in this way, but i truly believe that unless you demand high quality care, you often get just mediocre care.
and so, because i can't just sit and watch, my dad and i went to visit C and D in the hospital yesterday. it was a strange site to see; i've only seen one other child intubated and in serious condition (it was my sister when i was just 12 years old and she was 16). anyway, D looked peaceful and amazingly, in one piece after a GSW (gun shot wound - those of you who watched ER or Gray's Anatomy should know the abbreviation). he is well taken care of. his nurse was doing a fine job, likely her best. and in the brief time i was there, a social worker showed up to provide assistance.
it was good for me to see that D is getting good care. that the system is working to support C. many people are working hard to save this little boy, to give him the most normal life possible after being shot by his brother.
and it's sometimes okay for me to watch others do their job. sometimes it's okay for a nurse to just be a person. to just hug C and offer him human support instead of nursing support. it's okay to not be in control. very infrequently do my attempts at control work out anyway!
(i know i can't. and even if i tried, the final result would be the same. i am no better equipped to handle the situation than the people in charge. but i'm bad at being a spectator.)
we have a family friend, let's call him C. he is one of the kindest men i've known. he is only a few years older than i am. he's the father of two boys - A is 16 and D is 12. his wife has a 19 year old daughter and he takes his parenting role very seriously, even with her. he works hard all week, working two jobs, to support his family, so that on the weekends, he can spend quality time with his children. they go to church. they play an active role in their hispanic community. C wants to give his children more than he had growing up. he wants them to be educated, upstanding citizens.
but sadly, all of their lives changed this week when A pulled a gun on D and shot him in the mouth. i wish i could say it was an accident. but bottom line is, the boys were rough-housing and A got out a gun and pulled a trigger. certainly A did not mean to kill D; and thank god, he didn't. D is in serious condition and will hopefully recover with minimal side effects (once the reconstructive surgeries, physical therapy, and possibly speech therapy is complete). but the fact of the matter is, A had a gun. it was purchased illegally. it has been discovered he is a part of a gang. and now he is in jail. he is being tried as an adult. and will forever be haunted by the fact that he shot his own brother over a video game.
because C is so devastated and in such a state of shock, i'm worried that he won't know how to navigate the medical and judicial system. he doesn't have the money to pay for high quality lawyers; and he's not in the right state of mind to research law offices who take pro-bono cases. i'm worried he won't demand the best care at the hospital. what if he doesn't know that you can request interpreters, certain nurses, social workers, and special treatment. i hate to admit that the system works in this way, but i truly believe that unless you demand high quality care, you often get just mediocre care.
and so, because i can't just sit and watch, my dad and i went to visit C and D in the hospital yesterday. it was a strange site to see; i've only seen one other child intubated and in serious condition (it was my sister when i was just 12 years old and she was 16). anyway, D looked peaceful and amazingly, in one piece after a GSW (gun shot wound - those of you who watched ER or Gray's Anatomy should know the abbreviation). he is well taken care of. his nurse was doing a fine job, likely her best. and in the brief time i was there, a social worker showed up to provide assistance.
it was good for me to see that D is getting good care. that the system is working to support C. many people are working hard to save this little boy, to give him the most normal life possible after being shot by his brother.
and it's sometimes okay for me to watch others do their job. sometimes it's okay for a nurse to just be a person. to just hug C and offer him human support instead of nursing support. it's okay to not be in control. very infrequently do my attempts at control work out anyway!
Tuesday, February 1, 2011
show of force
my unit was over staffed today. so, instead of being a nurse, i got to be the secretary. it's a nice change. although, i must admit, sometimes i think being a secretary is harder. i answer phones, help doctors find orders, answer phones, fax orders, answer phones, deal with patient family members, answer phones, validate parking... the tasks are endless. and all of them seem to happen at the same time. i'm constantly being interrupted.
the most exciting part of my day today was when a nurse asked me in a hurried and frantic voice to call a show of force. it's similar to a code, in that it's announced hospital wide on the intercom. but instead of having a crashing, near-death or dead patient, it's called on a patient who is violent or crazy.
the patient on my unit was in the bathroom, yelling profanities, and refusing assistance back to bed when he was unstable on his feet. he threatened to throw a pot of urine at our charge nurse! but thankfully, within a minute or so, we had dozens of people surrounding our patient, peacefully, but intimidating-ly, "forcing" him back to bed.
nursing is kind of comical sometimes. what other profession do you have to worry about getting doused with urine?
the most exciting part of my day today was when a nurse asked me in a hurried and frantic voice to call a show of force. it's similar to a code, in that it's announced hospital wide on the intercom. but instead of having a crashing, near-death or dead patient, it's called on a patient who is violent or crazy.
the patient on my unit was in the bathroom, yelling profanities, and refusing assistance back to bed when he was unstable on his feet. he threatened to throw a pot of urine at our charge nurse! but thankfully, within a minute or so, we had dozens of people surrounding our patient, peacefully, but intimidating-ly, "forcing" him back to bed.
nursing is kind of comical sometimes. what other profession do you have to worry about getting doused with urine?
Tuesday, January 25, 2011
hissy fit
i am 30 years old. but i threw a 13 year old hissy fit yesterday at work. i think it was justified. don't all 13 year old girls?
in all honesty though, it was a legitimate complaint. the charge nurse of the day was a man; he very infrequently does charge. in my opinion, he's a lousy nurse, let alone a charge nurse. and because i believe a charge nurse flavors the day with his/her unique charm, attentiveness, and help, i anticipated that yesterday might be a little chaotic or less than smooth.
sure enough, at 11:30, after a leisurely morning with relatively simple patients, the charge came to me to give me an unscheduled admission. without asking how my day has been going (which is his job) or if my patient load could be burdened by an additional patient, he gave me the patient's name and a brief synopsis of her needs. she was coming from the OR and would need chemotherapy. i begrudgingly took the admit after first asking if he had asked any other nurses on the unit if they could easily take an admit. his response was, "no, you're the first." to which i responded, "why did you choose me?"
now, know that i rarely talk back to people in positions of power. i respect my elders and most of our charge nurses. but for some reason, i was feeling obstinate. his response irritated me even more; my blood pressure rose to dangerous levels. "i think you're the only nurse qualified to give chemotherapy," was his reply. i work on an oncology unit. did he seriously think i was the only chemo certified nurse. as a charge nurse, his job is to know every one's competencies and skills. turns out, more than 4 other nurses were qualified to give chemo. i pointed out the fact and snottily asked if he had taken that into consideration; he said no.
so, by now, i was making him uncomfortable. i was questioning his skill and his role as charge nurse. i wasn't refusing to take the admission. in fact, i admittedly acknowledged that i was NOT having a busy day and that i COULD tolerate a third patient, i always can. but that wasn't my point. my point was, i ALWAYS get asked to take admissions. i often have three patients. as a capable and rather relaxed nurse, i get my job done in a timely fashion and appear calm more often that not. but it's annoying and i would argue, unfair, to give the good nurse the hard patients, the admits, and difficult families - simply because they CAN do the job and do it well. how are the other nurses - the nurses who cannot handle three patients, or the nurses who have no time management skills - ever going to learn when i pick up their slack.
fifteen minutes later (the admission hadn't arrived to the unit yet), the charge nurse called me. he said, "good news. you don't have to take the admit. another nurse is discharging her patient and will be down to just one patient." great. no admit for me. but what almost irritated me more was, if indeed he had been a good charge nurse, he would have been attuned to the patients on the floor and known from the very beginning that a discharge was taking place and that a nurse, other than myself, would have been able to take an admission.
the funny part of the day... three more patients were admitted yesterday. all of them were unplanned. i could have taken any one of them. my afternoon was slow. but, because i had stuck up for myself, or maybe because i scared him, the charge nurse didn't ask me. everyone else got admits and i enjoyed a relaxed afternoon!
in all honesty though, it was a legitimate complaint. the charge nurse of the day was a man; he very infrequently does charge. in my opinion, he's a lousy nurse, let alone a charge nurse. and because i believe a charge nurse flavors the day with his/her unique charm, attentiveness, and help, i anticipated that yesterday might be a little chaotic or less than smooth.
sure enough, at 11:30, after a leisurely morning with relatively simple patients, the charge came to me to give me an unscheduled admission. without asking how my day has been going (which is his job) or if my patient load could be burdened by an additional patient, he gave me the patient's name and a brief synopsis of her needs. she was coming from the OR and would need chemotherapy. i begrudgingly took the admit after first asking if he had asked any other nurses on the unit if they could easily take an admit. his response was, "no, you're the first." to which i responded, "why did you choose me?"
now, know that i rarely talk back to people in positions of power. i respect my elders and most of our charge nurses. but for some reason, i was feeling obstinate. his response irritated me even more; my blood pressure rose to dangerous levels. "i think you're the only nurse qualified to give chemotherapy," was his reply. i work on an oncology unit. did he seriously think i was the only chemo certified nurse. as a charge nurse, his job is to know every one's competencies and skills. turns out, more than 4 other nurses were qualified to give chemo. i pointed out the fact and snottily asked if he had taken that into consideration; he said no.
so, by now, i was making him uncomfortable. i was questioning his skill and his role as charge nurse. i wasn't refusing to take the admission. in fact, i admittedly acknowledged that i was NOT having a busy day and that i COULD tolerate a third patient, i always can. but that wasn't my point. my point was, i ALWAYS get asked to take admissions. i often have three patients. as a capable and rather relaxed nurse, i get my job done in a timely fashion and appear calm more often that not. but it's annoying and i would argue, unfair, to give the good nurse the hard patients, the admits, and difficult families - simply because they CAN do the job and do it well. how are the other nurses - the nurses who cannot handle three patients, or the nurses who have no time management skills - ever going to learn when i pick up their slack.
fifteen minutes later (the admission hadn't arrived to the unit yet), the charge nurse called me. he said, "good news. you don't have to take the admit. another nurse is discharging her patient and will be down to just one patient." great. no admit for me. but what almost irritated me more was, if indeed he had been a good charge nurse, he would have been attuned to the patients on the floor and known from the very beginning that a discharge was taking place and that a nurse, other than myself, would have been able to take an admission.
the funny part of the day... three more patients were admitted yesterday. all of them were unplanned. i could have taken any one of them. my afternoon was slow. but, because i had stuck up for myself, or maybe because i scared him, the charge nurse didn't ask me. everyone else got admits and i enjoyed a relaxed afternoon!
Thursday, January 13, 2011
the life of a heart patient
my dad is a good patient!
his cardiac ablation went well yesterday. they were able to find the pathway in his heart that has been causing his a-flutter and they cauterized several bands of heart muscle cells. ha, ha - got you, you naughty random electrical currents! burn, baby burn!
my dad is also a very brave patient...
because he is on so many heart medications to keep his blood pressure low (less stress for the heart), the nurse, whose job it is to give conscious sedation (ie. the good, sleepy meds), was limited. she could not sedate my dad because his blood pressure kept dropping to dangerous levels. so, for those who care or understand, he only got 0.5mg of versed and 25mcg of fentanyl. that's NOTHING. i give that to my oncology patients without blinking. my poor little dad (and i mean little - he only weighs 140 on a good day) was awake the entire 4 hours while they were burning his insides. he tolerated it like a champ. and according to my dad, his nurse was a superstar. she talked to my dad, trying to distract him. she patted his head. and when his back ached from hours of stillness on a gurney, she rubbed his back. she even apologized, to my dad and to us, for keeping my dad so wake. she was just doing her job - keeping my dad safe! i appreciate nurses - especially cynthia in the cath lab!
so. my dad was discharged this morning. he's to take it easy now for several days. and to continue limiting his salt intake, monitoring his fluid status, and checking his vital signs. my dad teases that life is no fun anymore. he can't drink. he can't smoke. and now he can't even eat food with salt.
but a non-alcoholic, smoke, and salt free life is better than no life at all!
his cardiac ablation went well yesterday. they were able to find the pathway in his heart that has been causing his a-flutter and they cauterized several bands of heart muscle cells. ha, ha - got you, you naughty random electrical currents! burn, baby burn!
my dad is also a very brave patient...
because he is on so many heart medications to keep his blood pressure low (less stress for the heart), the nurse, whose job it is to give conscious sedation (ie. the good, sleepy meds), was limited. she could not sedate my dad because his blood pressure kept dropping to dangerous levels. so, for those who care or understand, he only got 0.5mg of versed and 25mcg of fentanyl. that's NOTHING. i give that to my oncology patients without blinking. my poor little dad (and i mean little - he only weighs 140 on a good day) was awake the entire 4 hours while they were burning his insides. he tolerated it like a champ. and according to my dad, his nurse was a superstar. she talked to my dad, trying to distract him. she patted his head. and when his back ached from hours of stillness on a gurney, she rubbed his back. she even apologized, to my dad and to us, for keeping my dad so wake. she was just doing her job - keeping my dad safe! i appreciate nurses - especially cynthia in the cath lab!
so. my dad was discharged this morning. he's to take it easy now for several days. and to continue limiting his salt intake, monitoring his fluid status, and checking his vital signs. my dad teases that life is no fun anymore. he can't drink. he can't smoke. and now he can't even eat food with salt.
but a non-alcoholic, smoke, and salt free life is better than no life at all!
Wednesday, January 12, 2011
ablation
the family waiting room in the cath lab sucks!
i'm a family member today, not a nurse. and i'm waiting on pins and needles.
my dad is getting an ablation to correct his irregular heart rhythms. we (my dad, mom, sister, and i) have been at the hospital since 6:30 this morning (that was 6 hours ago). and my dad is still in the cath lab getting a tune-up. my boyfriend describes the procedure like this - "they're burning and electrocuting your dad." all they're forgetting in the barbaric procedure are the leeches!
we've had one update from a nurse who was poorly informed about my dad's case (not reassuring), but apparently, my dad is talking to the nurse about switzerland as they map out the naughty electrical currents on his heart muscle. how strange, huh? my dad is awake while they have cameras and tools up a vein in his groin.
anyway, there are three children in the waiting room - 2 six year olds and 1 eight year old. their mom is having the same procedure as my dad - only she's probably in her thirties. it's strange what people have to endure. while sitting here with this family, we've learned that the two six year olds are actually triplets. they were born at 27 weeks and the oldest of the three passed away. the eight year old told his dad not to talk about his mom's health; it scares him. and now they're mom's sick! hasn't this family been through enough?!?
i'm not sure what i am rambling about. all i know is, hospitals are full of sad stories. everyones lives are full of struggles. and hopefully everyones lives are sprinkled with triumphs. i sure hope this waiting room is full of triumphant stories. the three little kiddos and their dad deserve a success story - they deserve a healthy mommy. and of course, we're rooting for my dad! my mom deserves a new and improved husband (with an obedient heart) and my sister and i deserve our ornery dad back...
i'm a family member today, not a nurse. and i'm waiting on pins and needles.
my dad is getting an ablation to correct his irregular heart rhythms. we (my dad, mom, sister, and i) have been at the hospital since 6:30 this morning (that was 6 hours ago). and my dad is still in the cath lab getting a tune-up. my boyfriend describes the procedure like this - "they're burning and electrocuting your dad." all they're forgetting in the barbaric procedure are the leeches!
we've had one update from a nurse who was poorly informed about my dad's case (not reassuring), but apparently, my dad is talking to the nurse about switzerland as they map out the naughty electrical currents on his heart muscle. how strange, huh? my dad is awake while they have cameras and tools up a vein in his groin.
anyway, there are three children in the waiting room - 2 six year olds and 1 eight year old. their mom is having the same procedure as my dad - only she's probably in her thirties. it's strange what people have to endure. while sitting here with this family, we've learned that the two six year olds are actually triplets. they were born at 27 weeks and the oldest of the three passed away. the eight year old told his dad not to talk about his mom's health; it scares him. and now they're mom's sick! hasn't this family been through enough?!?
i'm not sure what i am rambling about. all i know is, hospitals are full of sad stories. everyones lives are full of struggles. and hopefully everyones lives are sprinkled with triumphs. i sure hope this waiting room is full of triumphant stories. the three little kiddos and their dad deserve a success story - they deserve a healthy mommy. and of course, we're rooting for my dad! my mom deserves a new and improved husband (with an obedient heart) and my sister and i deserve our ornery dad back...
Thursday, January 6, 2011
it's been one year...
since i started this blog. and so far, i've enjoyed writing here. my attitude towards nursing, my particular unit, and the specialty of oncology has dramatically improved. and overall, i think i'm in a better place than 365 days ago.
i don't think i can credit the blog with this shift. it helps that my outside-of-work-life has been good. i've traveled to indonesia to "study" yoga. i trained to climb mount rainier (and although i did not summit, i did some amazing hikes and proved to myself how strong i am). i trekked in the nepali himalayas and climbed to 16,400 feet. and i met a very kind man who treats me with respect and kindness. i'd say i couldn't be much luckier.
this blog has served as an outlet for me. i like to write. there is something very cathartic about it. hammering out some words and feelings on a keyboard during or after a 12.5 hours shift helps me to let go of some of the overwhelming thoughts, worries, and emotions that nursing creates in me.
here's to another year full of nursing stories - funny, sad, and even strange ones!
i don't think i can credit the blog with this shift. it helps that my outside-of-work-life has been good. i've traveled to indonesia to "study" yoga. i trained to climb mount rainier (and although i did not summit, i did some amazing hikes and proved to myself how strong i am). i trekked in the nepali himalayas and climbed to 16,400 feet. and i met a very kind man who treats me with respect and kindness. i'd say i couldn't be much luckier.
this blog has served as an outlet for me. i like to write. there is something very cathartic about it. hammering out some words and feelings on a keyboard during or after a 12.5 hours shift helps me to let go of some of the overwhelming thoughts, worries, and emotions that nursing creates in me.
here's to another year full of nursing stories - funny, sad, and even strange ones!
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