"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?"
Tuesday, March 27, 2012
Sunday, March 18, 2012
|Jewelry, Jersey Shore Style|
|Rides aren't open yet...I love shots of empty parks...|
|Everything in the universe has a pattern, A purpose.|
|Describes me pretty well.|
Saturday, March 17, 2012
- We help people. We both take an oath to always serve and protect, to do no harm.
- we both work really long, grueling, weird, crazy timed shifts
- We both know what each others job is like- We are both in the position to be professionals- to be calm and stern and not punch someone in the face when they really deserve it.
- We both know how to lay down the law and stand up for whats moral.
- We both deal exceedingly high amounts of bullshit on a daily basis. And still come back to work the next day.
It's been said that a sort of unwritten rule exists between nurses and cops that when we cross paths in an unfortunate situation (a nurse gets pulled over in her scrubs, or a cop ends up as a patient) we always "look out for each other", or help each other out more so than the average joe. Even so, that doesn't give nurses the free pass to do 100mph down the highway!
Anyway, the other night at work I received an admission- the patient was from the county jail, and whenever we get a patient from a jail- they are accompanied at all times by a police officer. This means the police officer has to stay in the room at all times with the patient. In the bathroom. At the bedside.
That being said, this patient happened to come up with two police officers, both young and muscular. So even though we have known to be "Sister professions", we can be ever so brotherly. Me and the ER aide have to transfer the patient from the stretcher to the bed, and we're both rather tiny. And who's watching, but the two cops, leaning against the heating unit? I totally called them out on it and threw gloves at them and they got my drift.
So I go through with my entire patient system assessment. The patient was admitted with a small bowel obstruction, and had an NGT tube (this means bile/food/poop is being drained out of his stomach through a tube and going to a little container). So I explained to the police officer what that was and how important it was that the patient didn't touch it. Then I noticed he started getting a little pale (the cop, not the patient). I smiled and continued on.
Then, when rolling the patient on his side- he (unexpectedly) let out the biggest, longest, wettest, loudest set of multiple bouts of "flatulence" ( to say it nicely). It was at this point that the police officer lost it and left the room.
He came back with "smell begone" spray, lol.
The whole situation oddly tickled my funny bone. :-)
Friday, March 16, 2012
In addition, we also placed this patient on something called "hospice care". This differs from a DNR based on the fact that a DNR says we won't do anything if he were to die, the term "hospice" means that we are going to stop all treatment to stop disease progression, and purely focus on helping him have no pain, until the moment he does die. Which, being that we stop fighting his disease (cancer), will be soon.
Now this case is common and yet all too unique (but isnt every patient?). This gentleman was diagnosed with cancer long ago and has spent years fighting this battle, as many have. He's had years to come to terms with his diagnosis, what he is doing...his life, his death. But just recently did they decide to change him to hospice...does this mean he gave up on life? No. It means he's done, he's done fighting. He's ready to face whats next.
Now, whats incredible, is the following: As an RN, all of the patients I've had under my care that have died- it was always unexpected. Sometimes I knew they may have been dying but didn't realize it was so close, other times it took me by complete surprise. Shock. They were supposed to have pulled through. I always thought, Oh my god- I was just holding their hand only two days ago. I was just taking care of them. Did I do everything I could have? If Only I had known they were going to die in days....would I have changed my care? WOuld I have stayed to sit with them longer? Would I have that "I'm sorry" look in my eye? Would that make it worse?
So, this is the first time (as an RN) that I have had someone under my direct care that knew, he accepted, the fact that death was upon his doorstep. Tomorrow, next week, next month, maybe.
It may seem strange, morbid even- to imagine this if you have never had the opportunity. Anyone who ever has had the opportunity and it was a loved one, I'm so sorry. To talk with someone, to take care of someone that could not be on this earth the next day and everyone knows it. Its not unexpected. To take care of someone, knowing you may see their obituary in the paper that week. To hold someones hand.
And, to answer my own questions- Yes. It did change my way of practice. Whether that be a good thing or a bad, I don't know exactly. Yes, we did have a small euphemistic conversation about his illness, about passing on. Yes, he was a little depressed and I sat with him a little longer. Yes, I didn't know what to say and it was obvious. Yes, I did have the empathetic look in my eye.
Yes, I did turn around after I said goodbye this morning, Yes- I did go back and give him another hand squeeze, to tell him it really was a pleasure taking care of him. He is probably going to be transferred today, so I told him it was a pleasure taking care of him, in case I wouldn't see him again. On the surface I was talking about if he got transferred before I got back. But we both knew what I was really talking about.
And he smiled.
Its not something you can ever take lightly, death. When someone is that close to whats next- that close to an eternity of darkness or perhaps an eternity of bliss, they are close. They know its coming. They can mentally prepare. It will never not be weird.
I hope its an eternity of bliss.
Wednesday, March 14, 2012
I am 23, and all of my friends work full time 9-5 jobs......
I went to the beach today (Its about a 2 hour ride for us where I live). It was awesome. I invited a couple different people to go- everyone declined- they were all working. And it occured to me. We're all really growing up.
THis totally sucks!
THe funny part is, I have a full time job, too. I have a really hard, stressful, chaotic anxiety driven full time job, too. And yet I still magically get 3-4 days off per week, and can totally go to the beach all day on a wednesday, If I so desire that day when I wake up.
I think I need to find a person that has a crazy schedule too. 9-5 M-F is too.....predictable. :-\
I feel like a total five year old, complaining. Oh well.
Tuesday, March 13, 2012
I think discovering a talent, makes sense under certain circumstances. Like, discovering you are really really good at playing soccer, but you never knew this because you never played. Or you are really good at drawing but never knew before because you never drew. Makes sense, right? In this case, I'd say its possible to discover new talents you possess at any given time in your life, from age 0 to age infinity.
So, who here considers a photographic memory a talent? Part of me wants to say it is a talent, because what else is it? A skill? Not really. A character trait? Sort of. Personality? No. Its a.....what? An ability, I guess?
Regardless of what it is, its definitely something I have discovered I have.
Which is the funny part.
LET me explain.
Lately, I have noticed in myself that I have some strange ability to remember numbers. I can take vital signs on 10 people in a row and then write them all down on a board after, providing that I took note of the vital signs in the initial time of it taking place. There are other times, that I've looked at a number on a scale on a patient, took note, and then went and did other things. 4 hours later I remember I need to document the patients weight, or the aide asks me what it was, and I can somehow recall it to even the tenth. Of course, It only happens if I see the number. If someone tells me, "Her temperature is 98.7", I won't remember it like....5 minutes later. But if I see it, I can pull up that image whenever I need it. It gets harder with temperatures because I look at so many thermometers so often, and each image therefore tends to look the same. Its easier with the scale, for instance- to visualize, because its uncommon to be weighing patients at night and therefore, be using a scale.
This skill is usually completely useless in life elsewhere at all times. So what If I can remember phone numbers from 5 years ago, providing that I took note of them at the time? When I was a grocery store cashier I used to remember the barcode numbers (usually over 12 numbers) for each individual water production company (poland spring, nestle, aquafina, etc) for the large containers so that I, as the cashier, wouldn't have to pick them up. I'd see them in the cart and scan it in manually. I was right every time. So, that was cool. And useful, for like-the 2 years I was a cashier.
I also have a photographic (sort of) memory when it comes to names. I can usually attach a first name to a last, on a patient I maybe saw once. Sometimes (most times) I can't even place a face to the name, but I can remember the whole name. For some ungodly, useless reason. Even if I had the patient 5 years ago. Last night I had a patient with a rather unique last name. Somehow the name struck me so much, that it brought back the name of a mere acquaintance I haven't seen since the second grade. Yes, they ended up being related. Weird.
Anyway, this is the funny part:
Besides numbers and names, I have a HORRIBLE MEMORY.
I'm not kidding. It is truly embarassing. It makes me a horrible friend, person, girlfriend, granddaughter, neice, sister, etc.
I have spent the last like 5 years legit thinking I have early onset dementia. Oh yes. I do often walk into rooms forgetting what I came in there for. I do often forget what I was talking about MID-SENTENCE. It makes me a horrible friend because I often legit forget where we left off in your epic case of problems. And its not that I don't care, I truly truly truly do. I do care, and I am interested. But its like I am incapable of remembering the stories you've told me or havent told me, or where we left off about your boyfriend/girlfriend issues. Therefore I am left with trying to pull off every time acting like I know exactly what you're talking about. But it goes both ways, I often (most times) cannot remember where I left off with you, either. I guess its just that so much useless stuff is stuck in my brain (like the barcode number for poland spring) that it has no room for important friend stuff. :-( It sucks and I'm working on it.
I just forgot the main point I was trying to make with this blog. Maybe thats my point right there...
oh! Right. Point is, aren't photographic memory people supposed to remember every single thing they come into contact with? Names, numbers, furniture placement, where they parked their car, answers to tests they took 8 years ago, friend stuff, etc.? So how, please- can I have a photographic memory useful for nothing- but not be able to remember important stuff? Its kind of not fair.
Its funny- If I see something that belongs to someone else and I want to take a further look at it by picking it up- I try really hard to take a mental picture of exactly how it was sitting previously. When I'm done looking at it like eight seconds later, can I remember that mental picture? No. Of course not. Then my unrelenting anxiety disorder comes out to play as I stress out the entire next week that you will find out I touched your....thing. Yeah.
I also remember thousands of lyrics that I memorized when I was 11, (i'm 23 now) but DO YOU THINK I can remember the Pledge of friggen Allegiance? No. If you asked me to sing the national anthem right now, a song I've sung a bajillion times in childhood, I'd fail- miserably. Ask me to sing some random song I liked when I was in middle school? Got it.
I'm telling you, my memory is clinically diagnosed (by me) as being completely useless and self-centered. Because obviously I can only retain non important things.
~A Writer in a Forgetful Nurses Body
Monday, March 12, 2012
Patient: no, not really. She had a small episode where she farted and it came out as poop.
Doctor: oh. I was going to get a stool culture for reports of diarrhea but I guess I can't culture a fart.
Lololol. A lot of things make me giggle relentlessly at 4:30 am. This was one of them.
Thursday, March 8, 2012
I happen to be one of those annoying girls that when unexpectedly confronted with a really hot/cute guy, I tend to forget who I am, what I stand for, I get all giggly. I tend to start rambling and when I realize I am totally blowing it I try and fix it with lots of more rambling. There are are lot of overzealous and unecessary hand gestures involved too. Really cool.
So lets illustrate just how really awesome I can be. This happened.
At the gym. Cute guy smiles at me, stands within 5 feet of me. stays there, smiling.
we had been doing the flirty eye thing for awhile, so i felt like I could make a small conversation..
me: Hey. So, is the gym always this crowded at 11 at night?
him: Yeah, a lot of night shifters.
Me: Oh sweet, yeah, I work night shift.
Him: Oh? What do you do?
Me: I'm a nurse.
Him: Oh, like an RN?
Him: Oh sweet, Im going to school to be a doctor.
Me: Oh, thats awesome. I know a lot about....doctor...ing.
Him: thats awesome. So what kind of nurse are you?
Me: I'm on Surgical oncology.
Him: Oh, man I bet thats hard. Look of concern/shock on his face.
Me: Oh, yeah.....you know. Yeah. It is. I mean, sometimes. Its different. I deal with a lot of......cancer......and well.....surgery.......
Look of more concern/horror on his face.
Me: I try and fix the look of concern/horror on his face.... But you know...its cool...I tend to have my patients for a pretty long time....so I get to know them pretty well and all......but then they die....sometimes....and you know, its a bummer.
Him: Total look of horror.
Me: stillllll like a flopping fish out of water, I try to fix that look on his face. "No its all cool though, really.........I come to the gym to sort of work out all the stress that builds up..........yayyyy.....happiness..........!" *awkward smile*
Him: oh...wow.....thats, really.....interesting.
I walk away. Like a boss.
Yeah. Believe it or not, I've done that more than once. Not with hot guys. Because I find a four leaf clover more often than a hot guy actually starts a conversation with me. But with lots of other people. I have that type of job that I turn into a conversation ruiner. I mean I could focus on all the awesome parts of the job..................but somehow the death in the job is always the first thing to come to mind when people ask what being a nurse on oncology is like. I guess I always think that that is what people are expecting to hear?
These are times I wish I worked OB and when people asked what I do I could tell them I get to play with babies all day and yadayada. Happiness. People expect happiness out of OB. But the conversation is already grimm when I say I work Surgical/oncology. People hear that big word, "oncology", and their face automatically shifts. But seriously, how many happy ways can you happily steer any conversation in oncology nursing? It can be a challenge.
So, yeah. That did happen. Disclaimer: Minor paraphrasing used to protect identities of hot people. But you got the idea.
Thanks to working night shift, I am unnaturally awake at an unfair hour and had to write this , but now I'm totally going back to sleep, awesome.
With so much awkward love,
Monday, March 5, 2012
However, the following does concern me. There is a point in every shift where your nurse supervisor should (if they are a good supervisor) get report from you. All they want is a very simple report about the most important things about your patient (diagnosis, PICC or PAC line, do they have a foley catheter, when are they going home, is anything abnormal, is this patient going to cause any predictable problems or have they, do you -as the nurse-need help?)
Well wouldn't you like to know, that by 3 am, particularly when the nurse supervisor shows up at the worst time when you're running around like crazy, they ask, "have time for a quick report?"...and they ask, as described above, "what are they here for?"
...and suddenly, you realize. You have no.friggen.clue.
At this moment of pure brain pudding syndrome, you may be able to recall -
- your patients birthday
- your patients favorite flavored ice cream
- which way your patient prefers to roll when they are getting cleaned up
- exactly what time they prefer their sleeping pill
- exactly how many times you gave them dilaudid
- the life long story about your patients cat
- what your patient will probably want when they call the call bell
- how many times is normal/expected for your patient to call the call bell
And it goes on.
But the DIAGNOSIS?
Let me tell you, there was one night I can remember where I didn't have my binder in front of me with all my patients information, and I literally sat there in front of my supervisor after she asked the epic question for at least FIVE WHOLE MINUTES. I stared at the board with my patients last name, thinking that would turn my brain from pure mush and blankness to actually something worthwhile and smart.
But no. Instead my supervisor took pity and was all like, "how about I come back?"
Yes. It was that bad. Complete blank.
Like I said, I remember the most ridiculous things. But the diagnosis? Pshh. Particularly when it's not something immediately obvious.
Sometimes it's easier to remember the patient is in with gastroenteritis when you have vomit on your shoe. Sometimes it easier to remember the patient is in with abdominal pain when you forget how many times you have pulled dilaudid out of the machine.
But something like pancytopenia? Not so much. That's all lab values. You don't see "pancytopenia" when you look at a patient. You see your patient. You remember all the things from the list above.
But that doesn't mean it's not important to always remember. It's just a demonstration of how much your brain goes to compete mush.
I hope this happens to other nurses and I'm not going into early dementia.
With mushy brain love,
Saturday, March 3, 2012
Racquetball? Honestly, I had heard of the game maybe once or twice, and only knew it was "the game you play in the box". But, obviously, its with a racquet, its free, and I thought I would give it a try.
So I went for the lesson, and I sucked. Well, I thought I did. Apparantly, I did well for never having played, but thats probably thank you to tennis experience. However, it just so happens that the director of the racquetball programs walked by as I was finishing my lesson, and asked if I would be *interested* in joining a beginners racquetball league. I thought about it....I thought, OK- It can't hurt to just put my name down to be emailed about it, right?
So sure enough, I never went back to play. I got back into working, christmas came, went on vacation, etc. Then, one day I get an email about the league. It was scheduled to be every tuesday. I emailed back with concern that I wouldn't be available on tuesdays being that my work schedule changes weekly. No problem, they said- just rearrange your match. To me- that interaction wasn't a *go ahead and put me in the tournament* interaction.
However, sure enough, a couple weeks later I get an email of the tournament schedule- and sure enough- I was on it, after only having had one lesson.
My first reaction- after my pulse racing- was NO! Absolutely not! I will nottttttttttt do this, how can I best get out of this?? But then I thought- man the whole tournament is matched- If i back out it will extraordinarishly hard to reschedule....I have to play. But I can't play. I can't. I won't. But I have to. What do I do??
So I talked to friends about it, and of course- the general concensus was- DO IT! I realized, with their help that I have to try new things and if it really sucks that bad, then it will be over soon and its not the end of the world. Great.
So next thing I did was schedule myself for another lesson, and went and bought all my supplies! Yikes!
Well, I won my first match so far! (yay!) but lost my second match (nay)- but thats not the point.
The point is, is that I'm absolutely falling in love with the sport! I can't stop thinking about it! I love it! Yes, it is a very intense workout like no other. You have to think extremely quickly and move even faster than that. But I love racquet sports. And there's just something so stress relieving about making that impact between the ball and your racquet.......ahh. The other day after work I went to play- by myself, just to hit the ball around. Its so nice being in an enclosed area where you can hit the ball as hard as you want and it comes right back to you. On a tennis court you have to go running after it all the time, bring 50 balls, etc.
So, thats my funny story of the week. I shall keep you updated on how it all pans out, but I'm pretty sure I'm a new lifelong player :)