"When you get those rare moments of clarity, those flashes when the universe makes sense, you try desperately to hold on to them. They are the life boats for the darker times, when the vastness of it all, the incomprehensible nature of life is completely illusive. So the question becomes, or should have been all a long... What would you do if you knew you only had one day, or one week, or one month to live. What life boat would you grab on to? What secret would you tell? What band would you see? What person would you declare your love to? What wish would you fulfill? What exotic locale would you fly to for coffee? What book would you write?"
Monday, December 26, 2011
A Christmas Nurse
Life has been....interesting? Confusing? Good? Different?
I think the "holiday season" is like that for everyone, and for a lot of people, the holiday season is different for everyone each year.
This year I've been feeling a little anti- Christmas-y and I'm not even sure why exactly. I just keep feeling that time is flying so fast, and why let myself get attached to the christmas season when it's over so fast? I think it has to do with the "I'm 23 phase and life is really starting to fly", which is, sad, because I know that feeling will only get worse with time... I also think I'm going through a phase where I'm trying to commit to things that will last...I get Christmas gets the short end of that stick this year? Next year will be different, I know it will.
Also, this Christmas was entirely different from the rest because it was my first Christmas on the job...being night shift, I worked Christmas eve into Christmas. I wasn't sure what to expect, but i sure learned a lot.
Nursing is a whole other ball game on the holidays. Like a complete idiot, I was assuming that our Christmas eve would be pleasant on the floor, as not many people like to be patients on the holidays, and not many doctors like to be doctors on the holidays.
So yes, we did have a low census. I had three patients, one admission. But the type of patients was different, in a big way.
Over the holidays, I find there are two types of main patients. At least two types I've encountered thus far.
Type one: being that no one likes to be a patient on Christmas when they should be home with their family, and no doctor wants to be rounding in the hospital when they could be home with their family, doctors I've found usually try and make an effort to discharge as many patients as they can, even if it's christmas eve, 4 pm. (my section discharged four on christmas eve!)
So, that being, the patients that re left, are the ones of high acuity status and cannot be sent home because they are just that sick. We, as nurses, don't treat these patients any different or fear their acuity status, because on a "normal" day we're used to having those patients in addition to five more.
Type two patient:
This Is where I learned the saddest lesson of all in nursing. Well, maybe not the saddest, but pretty high up there. Turns out, it's pretty common for stressed out caregivers of intense family members to "drop off" their family members in the ER a day or two before christmas, and say "they have been acting funny." This, in a way, forces the ER doctor to admit an elderly patient who has "been acting funny", to run some tests. When most of the time, the family member really just wanted a "break" for Christmas and enjoyed some alone time without being a caregiver, and there's nothing wrong with this patient.
Now we have a confused elderly lady with severe Alzheimer's, she's out of her usual habitat, and we're forced to run her through expensive tests and bolus her with IV fluids.
Now this all would be fun except this patient needs constant reorientation. She wants to pull her IV out ( that I successfully put in! YAY!!), and she is looking for her baby and thinks her mon and dad are upstairs looking for her. Awesome. Let me tell you now that when reading the ER admission assessment, it read, "family member reports patient was throwing remotes at people." Also, awesome.
The first night i had her, she was reorient-able, but she forgot everything we said within five minutes. By the time I came in for christmas eve, she was an official 1:1 visual observation, and she was not reorientable.
My shift starts at 7pm and by 9pm she was (literally) pushing my nurse aide doing the 1:1. She wanted to put the eggs from the store into the fridge. She wanted check on Jimmy. She wanted to go lock the front door, she wanted to go run to work and finish up.
I feel sorry for her, really, I do. But seriously? I tried reorienting her, i did that's what we're supposed to do. But by hour 5 of repeating myself and her behavior worsening, I tried a new rote of playing along. Yes, I locked the door. Well take care of the eggs in the morning. I checked on jimmy, he is all right. Your parents are okay, they said its time to go to bed. I did the dishes already. Work can wait til tomorrow. Is that so wrong to leave them under their illusion?
So I can't really say I blame her for wanting a break over christmas. She's a lot to take care of. But that's not the way to handle it. She needs to be in an Alzheimer's unit or nursing home, or have a 24/7 aide hired. Not an expensive hospital stay for no reason.
So, overall it was a fun night. Definitely not an "easy" night as I was so foolishly expecting. But, that's part of nursing.
So, lesson learned: never anticipate an easy night in nursing. Everrrrrr.
This next week I'll be quiet- I work three nights then flying out of town and won't have much blogging time. But I hope to post for new years. :-)
Goodnight all! ~ WNB