anxiety

this week, i cared for the same patient that called me the "vagina whisperer."  i like her.  she's young and feisty.  and when i admitted her, she warned, "i call the shots."  if i was a patient, i'd be bossy too.  so i was okay with it.  as long as her demands weren't too crazy.  and they weren't.  really.

although, my patient does have a phobia/allergy to saline.  which in the grand scheme of things is kind of a big deal.  saline is like sterile salt water.  i didn't ask, but i wonder, is she allergic to the ocean?  we use saline ALL the time in the hospital, especially with our patients who are getting multiple medications, multiple blood draws, and have central lines for constant intravenous access.  every time i use a central line, i flush with 10mL of saline - before and after blood draw, before and after administration of medications, blah, blah, blah.  i use saline ALL the time.  getting through transplant without saline is literally impossible.  there is NO alternative.  because NO ONE is really allergic to saline.

my sweet patient has had two transplants prior to this one.  she has spent more days than she can count in the hospital.  and i don't doubt that she's been nauseated, has thrown up, and been miserable numerous times.  and often, patients report that they can "taste" the saline flush (even though we flush it into a VEIN - nowhere near the mouth or stomach or GI tract).  anyhoo.  being the nice nurse that i am and having a case of anxiety myself, i was sensitive.  i went along with her gum-chewing routine pre and post saline flush.  and i went slow, like she commanded.  and i told her every last detail about what i was doing.  so that she would trust me.  and it worked out nicely.  there was very little nausea.  and no throwing up.

at one point, my patient asked me what would happen if she refused to get flushed with saline.  if she refused the IV medications that require saline before and after.  and opted for needles to get her blood instead of her IV access that serves as a faucet for blood.  i was kind of flabbergasted.  this saline thing is a TRUE phobia.  it's anxiety at its extreme.  and so, i point blank told her, she has to get over it.  it sounds insensitive.  but she needs saline.  she won't survive transplant without it.  and i told her that.  i also shared, "dear, i have anxiety too.  only, i haven't figured out my gum chewing routine to get me through it.  you have a solution.  and it works.  you're doing great.  you have to keep going.  and you have to do well."

third time's a charm, right?  i hope this third transplant works.  

feedback

i'd say this is pretty decent feedback regarding my care and the unit i work on...

"christa treated me so well. i never felt rushed or a burden and i was always well informed and included. in fact, everyone was wonderful on __unit. Even walking the hallways, i felt like i was accepted and part of a community. as if just being on the floor and being smiled at could help you heal faster. people walking by would stop to chat if they had time. i've never met a staff so friendly. i'll tell you, __unit has set a high standard for this guy. if i ever have one of my friends or family get sick in seattle, i'm telling you, i'm hopping in a cab and coming straight to you guys. in my opinion, there isn't any better care anywhere."

new nickname

nurses get called lots of things.  and often they are not nice things.  thankfully, my patient population is fairly kind.  and rarely do i get called something not nice.  but the other day, i was called something i've never been called before.  and not something i ever thought i would find complimentary.  seeing as i am a heterosexual female.  but i'm gonna take this is as a compliment.  from a 26 year old female patient - terrified about getting a foley catheter inserted into her urethra (pee hole) - i got called "the vagina whisperer."  we laughed.  awkwardly.  and i felt proud.

what now

i'm about to get really cranky and opinionated.  so if you're going to be offended, don't read further. 

i am currently being paid time and a half (happy memorial day) to sit in my patient's room (while she sleeps) and make sure that she is safe (ie. doesn't attempt to kill herself with IV tubing or slippers or her spoon).  don't get me wrong.  i feel for patient's with psychiatric disorders.  anyone that tries to kill herself more than 100 times is obviously not normal.

BUT...

i'm angry at the system.  why is my psych patient on an oncology unit?  our beds are the most expensive in the house.  why is she 26 years old and nobody has been able to help her?  how is she able to manipulate so many people into getting what she wants?  why can someone like this have children and people that i know and love who want children more than anything cannot?  what should our state do with people with mental disorders?

i feel kind of angry.  and helpless really.  i'm certainly not equipped to help this woman.  and so many people before me (who are) have failed.  so, what now? 

DANGER

i have a lot to say about my job.  about everything really.

for instance...

today i cared for a 26 year old woman with multiple psychiatric disorders.  she has attempted suicide more than 100 times.  and has procreated twice.  her children will never know her.  they are probably better off for that.  

and...

last thursday, my patient died at 9:03 in the morning.  her daughter-in-law requested a hug from me even though we just met.  and she said, "i don't know how you do what you do.  it must be so hard."  

it is...

but all i feel like saying at the moment is, my colleague got poop IN HIS EYE yesterday.  

nursing is dangerous.  

heartstrings

certain things tug at heartstrings.  for some people, it's animals.  for others, it's hallmark commercials.  kids tend to hug at my heartstrings and i'm not even a mother yet.

i worked on monday and tuesday.

on monday, a patient on our unit was getting her second stem cell transplant.  soon after her first one, she relapsed.  and hence, needed a second one to cure her disease and give her the best chance at living life with her darling family.  she was not my patient.  but her nurse asked some of us to join him in singing happy birthday to his patient.  sometimes we do this.  sometimes i do this.  especially when i like my patient and they are positive and kind and i think they might get a kick out of a dozen or so nurses singing a horrible rendition of happy birthday while they are getting their transplant.  so we sang.  and the patient smiled.  her 3 year old son snuggled up beside her in bed.  beaming with pride.  singing along.  what is it about kids and happy birthday?  they LOVE it.

and i cried.  i couldn't help but be touched.  by the child's innocence.  his love.  his momma's love.  and her fear - that this might not work.  that she might be celebrating her last "birthday" with her son.

on tuesday, my day was a whirlwind.  i played nurse, tour guide, and secretary.  nurses wear many hats.  and just by chance, i happened to be answering phone calls when the same patient from the day before walked up with her little son.  grandma was taking him home.  maybe for a nap.  but he didn't want to go.  he wanted to hold his mom's hand.  and so she walked him to the elevator.  gave him kisses.  told him that grandma would take good care of him.  i'm sure her heart was breaking inside too. of course she wanted to go with them.  ditch her IV pole of life saving medications.  and get the hell out of her scary situation.  but instead, she left her mother and son at the elevator.  moments later, he broke free from his grandmother's hand and ran to my desk - right in front of me.  he looked at his mom down the long white hospital hallway.  and he waved.  a sweet wave.  a perpetual wave.  he wouldn't stop.  and his lower lip trembled.  and his eyes teared.  god he loves his momma.  it was so clear.  he knows something is up.  he turned back to the elevator, to grandma.  then returned to my desk.  and he waved again.  and the lip pouted.  i watched this dance for what felt like several minutes.  back to grandma at the elevator. then back to the hallway, to see his momma and wave.  on his final trip from the elevator to the hall, instead of waving, he held up his tiny fingers and made the sign for i love you in sign language.  

it seemed like a routine they have done before.  but there was desperation in it.  a mature desperation.  there were no tantrums.  just resignation.  acceptance.  that momma belongs in the hospital.  and the tiny little 3 year old most move forward, without her, strong and brave.  ready to face the world.

heartstrings.

anniversary

it's been one whole year since nurse patient died. 

i think about her frequently. 

and i think of her husband. 

and her two daughters.