Just a few things..

Had an overall decent weekend at work. Got to go home early (1130pm) today, it was nice. I got back my patients from Saturday and Sunday and the two biggest pains in my ASS were transferred to other floors (hell YEAH baby!) And I got left with a cute 98 year old lady, an adorable 95 year old lady, a new stroke on a 84 year old lady and a PITA 55 year old lady who takes more meds than the other 3 women I mentioned COMBINED.

PITA #1 was a dude with Hep C and a bleeding disorder and he constantly had fresh, bright red blood in his mouth coming out of his gums. Plus his liver was shot so his ammonia levels were sky high and affecting his cognition and sense of balance. His gown was covered in blood, his room was a sty, he was forever pissing all over the floor and if I sound a little harsh talking about him it might be because the motherfucker HIT me in the arm when I gave him a shot of insulin in addition to calling ME a pain in the ass and looking at me with absolute venom every time I entered the room. Then he proceeded to call me a bitch every chance he had. At one point I walked into his room to give him some scheduled meds and he started saying "OH GOD, what do you want NOW!?  Jesus!" then I said, "Look, I don't want to be in here any more than you want me in here, so just let me do my job and I promise I will be getting away from you as quickly as I possibly can."  And then I hummed this song every time I was in his room:

A good patient I had was a 98 year old lady whose grandson was visiting and noticed her speech was getting slurred and she wasn't walking straight.  He called 911 and the ambulance came right away.  Upon arrival to my hospital, she was administered the clot busting medication TPA.  Within a few hours, all her stroke symptoms resolved. She was coherent, bright eyed and quite spunky when I got her.  I met her Grandson and thanked him for acting so quickly- he saved his Grandmother from an end in life that I see all too often.  She was really cute, too.  She said the state sent her a driver's license when she was 96 but she decided not to drive anymore.. not because she thought she couldn't, but because she said, "God forbid if someone ever hit me, the first thing everyone would say would be 'what was a 96 year old doing driving?!' and then I'd end up getting blamed for it.  So it was my choice to stop driving."  This little lady had more brains and sense than most 40 somethings I care for. Anyway, what I learned from her was firsthand how important it is to be able to catch a stroke in its early stages-- it's truly a medical MIRACLE what tpa can do.  I think we've all heard how critical timing is with catching and treating strokes.. but until you see it firsthand?? Just wow. Amazing.

Okay, God. I get it. :)

Look what just came in the mail today.

When the world says, "Give up,"
Hope whispers, "Try it one more time."
~Author Unknown


There are no mistakes, no coincidences. All events are blessings given to us to learn from. ~ Elisabeth Kubler-Ross

I LOVE MY JOB I LOVE MY JOB I LOVE MY JOB I LOVE MY JOB

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.

One year down... ;)

As of 2/16/2011 I have been an RN for one full year! What a wild ride it has been (and continues to be). In spite of all the stress and emotional turmoil I can now say unequivocally that I love being a nurse. I still get that astonished "I really get to do this?! :)" feeling every time I work, as well as the "you're for ME? I get to take care of you? YAY!" feeling pretty regularly as well. I'm not scared of calling Drs. or even suggesting meds or treatments to them, and my confidence level continues to grow. There's no way I would have been able to deal with all the emotional ups and downs without the love and support I have gotten from family and friends so thank you to all of you who have endured my tears and ranting and for sharing in my joy when things have gone wonderfully well. ♥

Driving Away on Christmas Day

http://www.youtube.com/watch?v=ulr7MPyhPaY&feature=related

I’ve never had to work on Christmas Day before, especially as a mother. My children are 7 and 9 and I am acutely aware that this could be the last Christmas where they both believe in Santa. I can’t believe how quickly the years have gone by already, and being the sentimental person I am; well, this was an exceptionally difficult holiday season for me.

Christmas morning I got up at 0430, showered, got dressed, ate breakfast and at 0530 woke up the kids and watched them open their presents. I was incredibly glad I got to do that with them, at least. (even though I would have traded that for being able to spend the whole day with them) I got into my car and each mile I drove away from my kids tightened the knot in my throat and stomach further and further. By the time I got onto Route 22, I was uncontrollably sobbing. I thought I had accepted that I wasn’t going to spend Christmas with my family, I really had, but the cold, hard reality of speeding down an empty highway on the one day of the year I used to enjoy the most was too much to bear. Then I started thinking about all the soldiers overseas right now who never even got Christmas morning with their families or have even seen them in months and months, so that made it all a little easier for me- but then, of course, I started to feel really badly for them.

I got in to work, fought back a few more tears as I swiped my badge, clocked in and immediately heard the news no nurse EVER likes to hear:

THE COMPUTER SYSTEM IS DOWN.

Knowing what I know about our IT department, I knew we would not be regaining computers anytime soon. 1. they are not fast to begin with 2. they are never around on regular weekends, let alone holiday weekends, and 3. the hospital would have to pay them some ridiculous triple extra super duper overtime for working on Christmas so how much do you want to bet the administrators said, “aw fuck it, we have a back up protocol, no big rush fixing that”. One of the Docs was fit to be tied when she heard the comps were down. She went off about how she has privileges at another local hospital and this would NEVER happen there (the comps were already down for 10 hours by the time I got there Christmas morning) and that it was inexcusable to not have computers for that amount of time. While I do agree that computers should never be down for that long of a time, I feel compelled to defend my workplace at this point by saying my hospital is the best place I have ever worked from retail to the corporate world, to school districts.. there is a culture at my hospital that is really hard to describe. I knew after my first day as a nurses’ aide 4 years ago that I was “home”. We send and receive cute and funny notes to different departments in the pneumatic tubes system on occasion. I’ve gone out to my car to find someone cleaned it off for me after it snowed during a shift, I’ve eaten lunch in the security office after being attacked by a drunk in the emergency dept. (evidently, once you’ve been mauled by an inebriated person, you become “one of the security guys” so they gave me some of their pizza lol), I’ve seen best friends of 50 years walk up to a hospital room only to discover their friend passed away just minutes before.. and because of the warm culture of the hospital and knowing that warmth is encouraged, it’s nothing for me to grab a chair for that person and sit with them and assure them the friend passed peacefully and offer a consoling ear and a kind smile. I guess the best explanation I have for what I see in most of the people and patients at work is that I see God in a lot of places. Many people hate hospitals. Maybe they equate them with loss and death, or possibly just fear of bad news. I see my hospital as God’s Workshop.. so I guess if you are going to be anywhere on Christmas day, if you can’t be with family you may as well hang out with the Big Guy in his work room.

“I believe that man will not merely endure. He will prevail. He is immortal, not because he alone among creatures has an inexhaustible voice, but because he has a soul, a spirit capable of compassion and sacrifice and endurance.”
William Faulkner