The 65 year spread

What an interesting bunch of patients over the weekend. A 20 yr old male with Wolff-Parkinson-White Syndrome (and cardiac conduction disorder), an 85 year old male with uncontrolled hypertension and ridiculously low heart rates at night (omg, cute as a frickin button! scheduled for a pacer placement), another 85 year old male scheduled for open heart surgery (CABG (coronary artery bypass graft) one of the 'youngest' 85s I have ever seen, a very pleasant 52 year old male with a tracheostomy who miraculously survived v-fib turned cardiac arrest (also had PEG tube in for bolus feeds and crushed meds), a sweet little blind 72 year old woman also with uncontrolled hypertension (had her on a nicardipine drip until her BPs dropped to the 90/50s from 200/100s.. drip was d/c ed once it dropped and ber BPs steadily rose THANK GOD), and a delightful Jamaican woman in with vertigo who I admitted yesterday was able to discharge today; she actually got up and gave ME a hug, not the other way around. (I'm usually the one to initiate hugs. :) )

The 20 year old was doing schoolwork on his laptop and he had an open book next to him.. in one glance I knew it was an engineering book (being married to an engineer made me very familiar with those types of oddly formatted, diagram-filled formula laden mumbo jumbo pages). I ask him what type of engineering he's studying and he says "civil engineering". He goes to a local university NOTORIOUS for drunk kids getting dragged into the emergency dept.. so I said, "Wow, it's really nice having a _____ student here without a dangerously high blood alcohol level!" He started to laugh but I could tell I he was really nervous; so I went back to the engineering talk and mentioned my husband is an electrical engineer.. now that kind of grabbed the kid's interest. We talked a bit about where my husband worked and for how long, how I met him, how long we dated... the discussion got very specific to my situation and I don't generally like telling too much about myself but sometimes that's the only way to establish rapport with someone, so I figured it was okay. Got home that night and told my spouse the story and my husband was like, "You do realize that thanks to you, that kid is pretty sure he's going to land a Victoria's Secret model once he graduates with his big fancy engineering degree, don't you?"

well, DUH


I was thinking a lot about where I want my career to go and I am still 99% sure I am destined to become a hospice nurse. The weekend program hospital money is nice but I don't think I can keep doing cardiac post op med surg for years and years. I really love the cardiac population but I never feel like I have enough time to really get to know them and support them. I do my best and a lot of pts. are very grateful for what I do give to them, but I want my job to be more patient/patient family focused. I just know I would be great at it. I think there is SO MUCH to be learned from the dying, and I think death can be a beautiful, serene experience. It's a part of life and our society keeps so quiet about it as if it doesn't exist. Honestly, the hardest part of my job is when someone dies unexpectedly.. there's no closure for the dying or their families and the patient is surrounded by total strangers usually. When the Dr's leave the room it looks like a friggin hurricane went through. Syringes everywhere, papers all over, plastic wrappers from this or that. No family ever should have to see their expired loved one surrounded by a mess like that.. so I immediately clean up the room then perform post mortem care. When the family arrives, I tell them about what the last moments were like for the patient, I relay any last words they may have spoken, then I offer to sit with the family if they wish.(they usually refuse if there's more than 1 person.) Then I pull the curtain and let them say their goodbyes.
Death is sad and final and causes such loneliness and despair for the people who are left behind, but it's also poetic and beautiful. It's the closing of an exquisite leather book cover. The reading of the story is over, but bits and pieces of it stay with those who took the time to read it. ...and bits and pieces of our loved ones stay with us because we took the time to love them.