Where I've been

I've finally been broken.

I've had a lot of professional successes and a lot of personal turmoil the past few months.  Had a patient whose wife had recently died of cancer and he needed to have open heart surgery.  Admitted himself several times and each time signed out AMA, deciding he would rather just die than try to add unwanted years to his life.  Enter Dr. T.  He's an incredibly compassionate cardiac surgeon who's been with the network for many years.  He took a personal interest in this man's story and was quite determined to do everything in his power to persuade this man to have the surgery.(Dr. T has an incredible bedside manner, brings treats for the staff whenever he comes in.. he's the embodiment of everything a Dr. should be.) One admission on a Saturday, I once again admitted the patient and I took it upon myself to call Dr. T at home to see if he can talk to him about having the surgery one more time.  Dr. T came to the hospital in his sweatpants to talk to this patient.  Long story short... the patient finally had the surgery, and I even got to be his discharging RN. It was so wonderful to be able to hug him and send him on his way with his brand new lease on life.  I hope he will go on to find the good in life and find reasons to continue to take care of himself.

Not a week after all this took place, an email arrived in my email box saying Dr. T will no longer be with the network. My immediate thought was "aw I'm so sad he's retiring :("
Only he WASN'T retiring.  Turns out the hospital is pushing him out for political reasons (paying him too much? Maybe other surgeons feeling he was stealing their thunder..? I don't know).   I am hurt, angry and saddened by the news of his leaving and I feel the hospital is losing a HUGE piece of its culture and soul by cutting him loose.  I actually nominated him for a special hospital award as a final way to stick it to the hospital for being complete ASSHOLES.

On the heels of that nonsense, they decided to close the Neuroscience/Stroke Unit and combine the stroke population with our cardiothoracic post op surgical floor and up our nurse to patient ratios.  So now, instead of 5 patients, I have a 6 patient assignment- and MORE WORK, more patients that are "completes" (meaning immobile, diapered, and unable to feed themselves most of the time), and we get new stroke admissions which means hourly neurochecks and vital signs for the first 8 hours of their admission then every 4 hour neuro checks in addition to dysphagia assessments prior to pts being allowed to eat and stat MRIs not to mention caring for pts with chest tubes, PEG tubes, Amiodarone/Dobutamine/Heparin/Nitroglycerin/Cardizem/Insulin drips post cardiac caths, CABGs, ablations, and cardioversions.  And for SOME mysterious reason every single patient assignment I have had has had at least 2 terminal cancer patients.


I'm not sleeping well, I feel fatigued on my days off and I am just generally not myself, so.. yeah.. That's why I've been quiet.  On the upside, none of my patients has any clue I'm under all this pressure and I hear many times a day what a wonderful nurse I am, so that is nice, at least.  I just wish my kids didn't have to catch me crying every once in a while.