where will i be...

i haven't written about work much. and i don't know why. i keep telling myself to.

things are changing on my unit. nurses are leaving. i think in the last year we've lost something like 20 nurses. many people whom i have enjoyed working with. many who have made my job a fun place to show up in the morning for a daunting 12.5 hours. they say they're leaving because they're unhappy. with our schedule. with management. with the success to loss ration.

but me. i still don't feel like leaving. it's not that i'm perfectly content at my job. but i don't like change. and i still like the remainder of my colleagues. and although 12.5 hour shifts are LONG, i have a permanent day position. and my schedule pretty much rules. and i typically take off a month per year. and i've accumulated plenty of sick and vacation time. enough to take some maternity leave if i ever get to be pregnant. and i'm comfortable there. i know what i am doing. i'm good at it. people ask me questions and i know the answers.

at the same time, i don't see myself there forever. and that scares me. where would i go? and when? will i ever be brave enough to become a home health hospice nurse? or will i do something totally uncharacteristic and try labor and delivery? (i'm fairly certain the answer is NO). ICU? would nights ever work better for me? or a clinic job? school nursing?

a lot of unknown scares me. some excites me.

i wonder where i will be a year from now.

five years from now...

ten.

maybe it will be me

yesterday was my last day working with cole on my unit. today is his last day as a student there and although i tried to work overtime today to enjoy him for just a few more hours, they didn't need me. and so here i sit, waiting for my partner to come home to me. waiting to kiss him as he walks in the door. waiting to see what happens next in our ever changing life.

working with your partner is challenging. like i mentioned earlier, i watched my parents work together. and it often seemed a struggle. but i must say, i enjoyed working with cole this last month. we never cared for the same patient. and our jobs are so different (even though we are both healthcare professionals). but we were able to wake up around the same time. get ready side by side. drive in together on the days of work we shared. gaze at each other down long hallways. flirt ever so slightly. and share work tales at the end of the day that we both understood.

at the same time, there are things i very much disliked about working together. sometimes waking up at the same time and trying to get out the door at the same time was a struggle. sometimes we fought over parking money and who gets to drive the car home and who has to take the bus (because i get off at 1930 and he gets off at 1700). sometimes i didn't want to hear about cole's work day - especially on my days off - because i get enough of cancer while i am at work (and unfortunately, think enough about it when i am not). and sometimes, although we shared the same kinds of patients with the same diseases and complications, we were interested in different parts of their stories. cole has an interest in immunology and cell lines; he wants to know the difference between CD45 cells and NK cells. i, on the other hand, care less about that and more about how much my patient misses their children. or how worried they are about their finances. or how afraid they are to die.

i am not suggesting that one interest or role is more significant than the other. both are equally important. but i found it very interesting that even when taking care of the very same population of people, cole and i are different. different is good. and sometimes it's hard.

cole very much enjoyed working with stem cell transplant patients. and over the last four weeks, we dreamed of what it would look like if he chose to work there. and a part of me thinks it would be good. i would be excited for him to start and learn and share that part of my life. and a part of me thinks it would be hard.

cole is not finished with school until august. august 28th to be exact. and he likely won't start working until late fall or early winter, due to taking his boards, getting licensed, and finding a job. but i'm excited to see what his future holds. what our future holds. where he will be working. and with whom.

maybe it will be me.

grateful

sometimes it takes a patient with MS who is completely immobile and dependent to remind you how amazingly privileged you are...

somehow we ended up talking about cuba. and i was able to say, "i've been there. i circumnavigated the globe while in college and i wound up on a university campus with 600 other college students listening to fidel castro speak to us for FIVE hours."

then, at some other point in our day, we talked about india. and i chimed in, "oh, i've been there." at that, my patient said, "i am fascinated by you. what were you doing there?" to which i replied, "oh, i worked at mother teresa's home for the destitute and dying for four months." my patient was astounded.

i guess my "history" is kind of interesting. i've had some amazing experiences and completed some pretty monumental tasks.

but what really makes me realize how lucky i am (in addition to having had the opportunity to travel the world) is when i help my patient turn his body in bed and he moans and groans. or when he has to ask me to bend his knees for him so that he can stretch his hamstrings. or when i clean his totally sore scrotum and he thanks me profusely. or when i use a ceiling lift to transfer him like cattle from bed to a chair. or when i comfort a groan man as he cries, "i can't lose my ability to walk."

i am an independent, healthy, strong woman. and THAT is something i won't take for granted - thanks to K in room 8260 for making me aware and reminding me to be grateful!

happy soul

on monday and tuesday, cole and i shared the bathroom while getting ready in the morning. i brushed my teeth as he shaved. i showered as he flossed. and after our quick, hurried morning routines, we were out the door and on our way to coffee, both decked out in the most amazing argyle socks - mine with neon yellow, his with turquoise (socks are my thing, and now, his!).

our days were busy. mine with nursing tasks. his with physician assistant work and student learning. we saw one another at a distance, down long white hospital halls. and we smiled in passing. i avoided grabbing his behind and he avoided kissing me. but somehow, we danced... flirtatiously. eyes twinkling at one another. hearts beating faster.

people on my unit know cole. my friends have spent time with him. my manager has met him at work functions. and because, over the last few months, i couldn't keep my excitement to myself, almost ALL of my nurse friends/colleagues have been anticipating his arrival. but it was the nutritionist's comment that made me smile the most. she is indian and although she speaks english well and with a beautiful accent, her comment came out differently than most people would say it. and i like her observation. she said this - "i see your soul happy today!"

that feels good.

working with your partner

in 1985, my parents went bankrupt and had to close down their motorcycle shop. they swore they would never run a business together again.

so, imagine my surprise, disappointment, and non-support, when i was in high school and they announced that they were going to buy a small swiss-german deli and run the business together - my dad cooking and my mom running the finances. i thought it was a horrible idea. i was sure they'd get divorced.

they fought. and fought some more. but in the end - they succeeded. they created a quirky little restaurant famed on mercer island for the best soups, salads, and pretzel rolls in town (thanks to my dad). and the best, friendliest service (thanks to my mom). AND they are still married.

so, get this. cole is spending the next month "working" on MY unit. he will have a one month student rotation on the bone marrow transplant service. and although i tend to think working with your partner is not the best idea, i'm totally excited about our future together as cancer providers!

i'm excited for some silly things. first, we might actually get to carpool in the mornings. it'll be nice to have someone awake with me at the butt crack of dawn. AND, i'm excited to see cole all dressed up all day long. it'll be nice to share a lunch here and there if time allows. and of course, there will be coffee breaks and tootsie roll runs (again if time permits).

but i think what is best about this opportunity is that it will allow cole to see what my job entails. i know cole thinks i am a good nurse. he has said this before. but i want him to know WHO i am nursing. i want him to meet my patients, to hear their stories, and to witness their strength, courage, and sometimes anguish and heartbreak. it's not that i want him to be sad along side me (as i often am), but i want him to know me better by knowing my work better.

cole is truly a brilliant student. he has a passion for learning and succeeding that is unrivaled by most. i know he will do well as a physician's assistant. and i would be honored to stand beside him as a nurse to his patients.

p.s. happy new year! may 2014 be great!

garden hoses

WARNING: this is crass and hilarious!

on monday, i answered the call light of a patient i have never met. i was trying to be helpful. but when you answer another nurse's call light, you never know what you're gonna get. when i was a brand new nurse, i never wanted to answer call lights. i was always so nervous that i wouldn't be able to handle the situation i walked into or answer the questions asked. but seven years later, i feel like i can manage most things. or at least know when i am in over my head.

this time, i walked in on an overweight gentleman profusely sweating. he was pacing around the room and looked pretty uncomfortable. i noticed that his IV pole had many bags of fluid hanging - some of which were actually connected to his foley catheter. just by assessing his IV pole, i knew that the man was receiving bladder irrigation. i know that people who require bladder irrigation for blood clots that form in their bladder and thus clot their urethra need LARGE foley catheters, not unequal to a garden hose. i would recognize the waddle from miles away (imagine walking with a garden hose coming out of your urethra. yup, OUCH!). but i didn't really expect the answer i got to my question: "what can i do for you? you look uncomfortable."

the patient said in an angry, serious voice, "of course i am uncomfortable. i have a forty pound dick!"

as a new nurse, i would have blushed and scurried about the room. trying to help him get situated. offering to call his nurse or physician.

but now, i laughed and said, "i don't think any man wants one that big, huh?"

oh come all ye faithful

today i cared for a woman on comfort care. she had been transitioned to comfort care yesterday because her prognosis is poor. but strangely, the team of medical professionals doesn't know EXACTLY what's going on with her. they cannot REALLY explain her decline. yes she has HHV6 in her cerebrospinal fluid. and yes her scans show substantial changes to her gray and white matter in her brain. but we cannot explain away WHY this happened.

but the WHY plays no part in how i care for my patient. and so, i did my very best this morning to make her comfortable and ensure her safety. i had been told that she was fairly unresponsive; that sometimes she says yes or no. but that her responses were not reliable. but i continued to talk, to explain what i was doing. and when i was done with her bedbath, i decided to tidy her room. now that our goals of treatment had shifted, there were things i could remove. and ALWAYS, ALWAYS there are things to straighten, dispose of, recycle, and organize. which the OCD in me enjoys. so i indulged...

my tidying revealed a CD player and christmas CDs. i decided to put one in. the first one was VERY peppy and almost felt inappropriate for the situation. so i changed it instantly to something more appropriate. christian christmas carols. the very first song to come on was "oh come all ye faithful." and although i haven't been to church in years and christmas has lost some of its meaning for me in the spiritual sense, i knew every word. and to my surprise, so did my patient. my dying, very sick, confused and nearly unresponsive patient began to sing. i felt flabbergasted. and amazed. touched. and saddened. and so, i sat with my patient, held her hand, and despite having a not-so-beautiful singing voice, sang every word to the entire song with her, for her, and to her.