Guess

 Guess who got floated off of the oncology floor to take care of COVID patients?

THIS GIRL!

Tired now, off to bed.

TTYL.

I'm in California!

 I never planned on coming here. It's expensive and it's crowded, at least in the Bay Area where I'm working right now.

But it's also really, really beautiful here, the weather is generally fantastic, and everyone at the hospital I'm working at has been very nice and helpful.

I'll keep you posted on any fun activities I do and/or craziness I see (or perpetrate, lol). Since I've been here, I've been so overwhelmed with orientation at work and all that goes with it, that I've just been taking long walks around the neighborhood.

I'm renting a house with another nurse who I befriended a couple years ago when she was a traveler at my old hospital in New Hampshire. Unfortunately, she had to delay her arrival because her car's engine shit the bed in Colorado! She should arrive by this Friday, fingers crossed!

That's another reason I haven't explored much. Exploring and adventuring can get expensive, and since my buddy isn't here yet, I've been paying the entire rent on this place myself, ugh. Speaking of expensive, HOLY SHIT, housing is expensive here!

Ahem.

The unit I'm working on is Medical/Surgical Oncology, which again is a slightly different discipline than I'm used to, but it's so awesome that I'm learning new things with a new patient population!

Let's see, most of my experience is inpatient Hematology/Oncology in NH. Then I did inpatient nursing on a dedicated Bone Marrow Transplant Unit in TX. My last gig was at an outpatient chemotherapy/biotherapy infusion center in Minneapolis! Now med/surg onc in California. We see a lot of post-op urological and gynecological cancer patients.

Obviously, the core of my job is still the same, and my goals are always the same: take the best care of my patients that I can!

I'll keep y'all posted.

Oooookay...?

I pull back the curtain of one of my three infusion rooms and greet my patient. He's going to have an hour-long immunotherapy infusion. 

I have all my supplies set up to access his implanted port. 

I ask him to show me his port site, so I can visualize and palpate it prior to accessing. And he whips off his shirt. Completely.

He's sitting there in his slightly grubby jeans, smelling like cigarette smoke, just looking at me, as if daring me to question him or comment on his action.

I stare at him thoughtfully for a moment, then I say,

"Oooookay...as long as you keep your pants on!"

He didn't give me a lick of trouble after that, though he didn't put his shirt back on until he was ready to leave, either!

So...this happened.

 I guess I haven't checked in for quite some time. Like, my entire contract in AUSTIN, TEXAS.

I worked on a Bone Marrow Transplant unit, nights. It was quite the educational experience for me, and I learned a lot. I learned a lot about myself, too! I learned that it is NOT OK for me to take too much time off with no plans or anything to do. I turned into a depressed sloth. No, a SLUG. It was absolutely disgusting and it made me realized that if I'm not working, I still need something the fuck to do!

I give myself permission to do absolutely nothing at least one day a week, though. I'm an extroverted introvert, so, since I'm around people all day long, interacting and taking care of them, I need my alone (*cough*hermit*cough*) time to decompress. So, in my jammies I stay, allllll day long!

Anyway. Austin happened. It was fine. Considering that it was only the second hospital I've worked in since I became licensed, it was a great learning experience. Some of the practices made me raise my eyebrows. Some made me shake my head. But I knew going into this travel nursing gig that I would encounter sometimes big differences in the way things are done from place to place, organization to organization, facility to facility. I've bitten my tongue, but also pointed out some questionable things. I figure, as long as my patients are safe and I'm not doing anything that could cost me my nursing license, I'm ok with whatever.

Now I'm in Minneapolis, and have been since the end of June. I'm close to wrapping up my assignment here, too. My last day is October 1st, and I already have a contract signed for another night-shift hospital gig in the Bay Area starting October 18th, medical oncology this time.

The interesting thing about my job here in Minnesota is that it is an Outpatient Infusion Clinic! I have never done outpatient anything before, so this is an incredible opportunity. I'm learning so much about chemotherapy regimens that we just don't give in the hospital. I'm also getting very good at some important nursing skills that they just don't teach in nursing school anymore, and which we weren't even allowed to do at my "home" hospital in NH, like STARTING PERIPHERAL IVs!!! Something so basic, the average person on the street just assumes every nurse will know how to do it. Nope. But now I do, and it makes me sooooo happy.

ANYway, I'm here in Minneapolis because my oldest child SystemsReady (aka Silver, or Silver the Evil Chao, way back when), lives here! I'm totally crashing in her living room on a queen-sized air mattress, lol! I took a job that honestly pays peanuts, just to spend time with her, since we hadn't seen each other in so long (THANKS, COVID). Soooo worth it. We've had a blast, and I'm going to miss her terribly once I leave.

She's doing great, BTW, thanks for asking. Kick-ass, Goth Chick, computer-programming, stick-shift driving, Manic-Pixie-Dream-Asexual-Autistic-Girl! 

So proud of her. 

She turned THIRTY this year, BTW!!! She was fifteen when I started blogging. Damn, I'm old.

And here I will stop. I have an anecdote from work to share, but I will time that particular post for a few days or maybe a week from now. I want this one to sit here for a bit. Maybe some of my loyal readers (hi, you two!) will wander back over and find it.

TTFN!

Shenanigans!

 The joy of working with youngsters...

Like when your pod partner (*cough*Tyler*cough*) writes your name on a white board in LARGE letters and places it at the foot of his dementia patient's bed where she can easily read it, and over the next few hours you really grow to hate your own name..."CHRISTINA! CHRISTINA! CHRISTINA! CHRISTINA!"

It can get really old, really fast. But, yes, it *was* funny!

Long time, no hear...

 Well hello there, Strangers! 

I'm embarking on a new adventure in a few weeks:

I'm finally going TRAVEL NURSING.

Watch this page for updates. I have signed with two agencies and two recruiters, so we'll see how it goes with contracts. I'm oncology nursing certified as well as chemotherapy and immunotherapy certified, so I'm definitely focused on heme/onc inpatient nursing and/or infusion clinics.

I'm hoping for my first assignment to be in the Dallas/Ft.Worth area, but we'll see. Anywhere in the Southwest is fine in my books, I just want to get out of the fucking COLD. And snow. And ice.

I really don't want to bust my ass in the parking lot again. Just my luck, I'd break something and be out of work for a while.

Yep, really need to pay off those nasty student loans before I hit retirement age. I'm in my fifties, after all!

Gotta think ahead. I would like to eventually own my own home and have a place to settle down to enjoy my golden years. ;)

Anyway, that's it for now. See you on the flipside!

Overheard in a Patient's Room

***while I was holding the urinal for a male patient with tremors and BPH.

"C'mon, George!"

I did NOT need to know that my patient's penis is named "George". 

That's my dad's name, and his dad's name.

My patient, btw, is NOT named George.

I'm bewildered AND slightly disgusted.

Not what I expected to hear...

from my 88-year-old patient.

I answered a call light in the middle of the night. My patient beckoned me over to her bedside and we had the following exchange:

"This is gonna be an odd request..."

"Don't worry about it, I'm here to help!"

"My snatch is itching, could you wash it for me?"

*blink blink*

So I did. 

I cannot make this shit up. Seriously. I can't.

That time when... (no pun intended!)

That time when you're working the night shift when Daylight Saving Time starts.

And your *very insistent* patient demands that you adjust the clock in her room. Right. NOW.

And the clock slips out of your hand, falls to the floor, and on the way down triggers a Code Blue.

I can't make this shit up.

Overheard on the Cancer Ward

So, after having a *ahem* firm discussion with Eeyore* over the phone about why my patient, who's likely perfed his bowel, can't come to the radiology department for STAT portable x-rays, she finally shows up, and the following conversation takes place.

Me (joking while piling on the lead-lined gear, as I'm needed to hold the plate behind the patient for a specific view of the abdomen.):

"Meh, I get more radiation flying on a plane...and I'm almost fifty, I'm done having babies!"

Eeyore (seriously):

"You could always get cancer..."

Really? You don't say?  You realize that this is the oncology unit?! And we're in a room with a patient who was just diagnosed with lymphoma, a tumor of which likely punched a hole in his bowel about an hour ago...? And I'm an oncology nurse, who handles (carefully!) chemotherapy agents almost every shift?

Ugh. Some people.



*AKA the morose overnight x-ray tech

Stop and Reflect

I roll my eyes as my ass barely hits my chair when the patient in 403 hits the call light. Again. For the millionth time this shift. I need to get my charting done!

I take a deep breath and let out a sigh. We're working without an LNA again this shift. I guess they figure things are "quiet" at night and we can manage without one. We can. Barely and sometimes poorly.

I step into 403 and say,

"Hey Steve, what can I do for you?"

And he answers,

"I just wanted to tell you what a great job you're doing! Sorry for being such a pain.."

Instantly I'm ashamed of myself. Being a patient totally sucks. Especially when you're as sick as Steve. He has no control over anything, except the call light. I get that he is lonely and wants someone to talk to.

I need to do my job, which yes, includes charting (oh, so MUCH charting), but mainly involves patient care.

Patient care isn't just pills and assessments. Patient care also means taking the time to tend to the emotional and mental well-being of the folks entrusted to us. It's a big responsibility. I need to focus on that more and on the minutiae of charting less.

It makes me a better nurse, and a better person. And all of my patients benefit.

Creepy...

That creepy/awkward moment when you realize that your fifty-something patient is calling her *husband* "Dad"...

And calls urination "tinkling".

*shudders*

That moment when...

you wake up in the very quiet, deserted, pitch-black, middle-of-the-night infusion suite and realize you accidentally forgot to actually START THE MOTHERFUCKING TIMER when you began your break (aka "nap").

And now you were off the clock and unavailable for an hour instead of 30 minutes.

Oh, well. Everybody knew where I was and nobody came looking for me.

And seeing as I haven't taken a real break in WEEKS, unit manglement *, I mean MANAGEMENT better not say a word...






*I totally stole this, but I don't remember from whom/where!

Overheard in the hospital...

Me: What would you like to drink to take your meds?

Patient: VODKA!

Me: I'm so sorry...we don't have that...

Patient: Then why did you ask?!

Incentive!

I hate running.

OK, let's be real. It's more like a slow jog. A trot, if you will. But, still. I hate it.

I'm in the middle of doing a Couch-to-5-K program. I guess my thinking is that I can run anywhere. It's an exercise I can do outside or inside on a treadmill, and get some good cardio in, in about thirty minutes.

Plus, I really want to do some 5K's for charity(ies).

The running is a recent development. I signed up at a local gym a few months ago, and it had nothing to do with New Year's Resolutions! I hadn't been getting any exercise at all. Nope, my incentive was one particular patient.

I only took care of her twice, on two different admissions, about a month or so apart.

I am an excellent nurse. I have compassion, empathy, mad skillz, all the good stuff. But even the best nurses can eventually run out of patience (no pun intended). When you have a patient who needs help, that's par for the course. But when said patient apologizes constantly, it can sometimes get annoying. It really depends on the patient. This lady has many health problems (obviously, otherwise she wouldn't be in the hospital!), most of which are directly related to her being obese. I won't go into detail here (HIPAA and all), but will say that she had very frequent, messy bowel movements and was unable to wipe herself. She would get off the toilet and, well, bend over and present. She explained that at home, she had to get in the shower every time she had a BM, because it was the only way she could clean herself. She told me how she used to love having friends over and entertaining, but she just couldn't manage it anymore. And she apologized CONSTANTLY. Incessantly. Irritatingly.

At some point in the last decade or so (she is in her fifties), she must have had the opportunity to think, "Hey, this is going in a direction I don't like! Maybe I should do something about it." But instead she has ended up in the position of needing oxygen even when at rest, and being unable to tie her shoes, cook a meal, or wipe her own butt.

Believe me, I understand being addicted to food. I have been morbidly obese. I was anorectic as a teenager. My weight has yo-yo'ed since puberty. But when I developed gestational diabetes in my late thirties, and knowing the risk of developing Type 2 diabetes increases dramatically when you've had GD, I decided to do something permanent about my weight. I had bariatric surgery, and now can actually see my toes when I look down.

I'm not saying it's the answer to everything. It's not a magic pill. But the gestational diabetes was a wake-up call. Diabetes scares the shit out of me. It affects every organ system. It can dramatically shorten your life-span, and it can lead to inch by inch amputations. Trust me, I've seen it. Scary.

Which is kind of ironic, seeing as I'm an oncology nurse! You'd think I'd mainly be scared of cancer. But nope, it's the diabeetus.

So this patient really lit a fire under me. I thought to myself, "I do NOT want to end up like that! I need to get stamina, strength, and flexibility."

Hence, the gym membership and the "running". Yep, not looking for a beach bod. Don't want to compete in any weight lifting competitions, nor run any marathons. I just want to stay healthy. I don't want to end up like her. And when I'm feeling lazy and don't want to go to the gym, I say her name in my head, it's like a mantra. And then I go. And I run.
____________________________________________________________________________
Anyway, the tl;dr version of this incredibly rambling post is: I had a patient who kicked my butt in gear when it comes to exercise, by being a cautionary tale, so to speak.

Someone please explain to me...

how it takes SEVEN people, including three hospital security guards, to get a 78-year-old, 5'6", 125 pound patient with Parkinson's disease and Lewey body dementia, back into his bed and restrained (with LOCKED restraints, I might add)...?

I was sore the next day. Time to hit the gym.

Bonus, I dodged his foot and thus didn't get kicked in the face!

Awkward.

When your patient describes with relish how he beat the shit out of his wife's boyfriend and broke said boyfriend's nose.

I mean, what do you say to that?

"Great job! Now here's that Tylenol you asked for..."

"So, how much did he bleed, exactly?"

"Pics or it didn't happen!"

Like I said, AWKWARD.

That feeling when...

your patient copiously and incredibly foul-smellingly shits the bed.

Out of spite.

Is it nerdy of me...

to be a little stoked when I'm introduced to patients and family member as "the Night Nurse?"

In my head I'm thinking, "Fuck, yeah! I'm the NIGHT NURSE, bitches! Superheroes come to ME for help!"

*ahem*

I said good-bye to a long-time patient of ours this morning. We'll see her again for in-patient chemo in a few weeks, but her discharge has been a long time coming, and she's understandably really excited about leaving the hospital.

She wasn't part of my assignment the past week or so, but when I found out last night that she was leaving in the morning, I made a point to go see her before I went home.

I almost cried when she hugged me and thanked me for "being the light in [her] nights."

*sniff*

This is why I'm a nurse. I can get past all the bullshit with charting eating up all our time, and "patient satisfaction" being the be-all, end-all of healthcare, as long as I can help my patients and their family members and make a positive impact on their experience in the hospital.

This and That

So, it's been awhile.

I quit my per diem job at the primary care clinic. My boss refused to accept my resignation, and still texts me, asking if I can do a few hours here or there.

Uh, no.

While I loved my co-workers there, I HATED the job. It was hours of tedium interspersed with moments of utter terror. Telephone triage is not for wimps! I never really felt that I got the hang of it, triage protocol book at hand or not.

Plus all the emails from the patients to the doctors, which had to go through the nurses first. Ugh.

People are fucking stupid. I've known this for quite some time, but read a few hundred patient emails and you'll feel it at a visceral level. I'm frequently amazed that humanity has survived as long as it has.

ANYWAY. Enough about that. My faith in humanity is frequently restored by my amazing inpatients.

I ran into the sister of one of my former (and likely future) patients when Thing 1 and I were shopping at a local Big Box store. I heard, "CHRISTINA!!!" and turned around to be tackle-hugged by a familiar lady. She squeezed me so hard and asked, "Do you know what a difference you made during my sister's last admission? We're so grateful to you!"

Well, I'm not ashamed to admit I got a bit teary-eyed (or maybe more than a bit...)
Enough so that Thing 1 muttered sotto voce, "Mom, get it together!"

Heh.

I'm allowed these moments, dammit!

The most amazing thing about this is that the sister happens to be a very experienced nurse, so praise coming from her...well!

In other news, I have some advice:

It behooves one to perhaps not make comments, even sarcastically or due to frustration, that imply that if one's aged, chronically ill mother had only fallen and BROKEN HER HIP, maybe her insurance company would have coughed up the cash for a bed in a rehab or skilled nursing facility by now...
Yeah, that gets you a visit from Adult Protective Services right quick!

This morning, right before shift change, I was holding a graduated cylinder for my patient to empty her colostomy into, when she, well, missed. Just a little bit. The contents splashed onto my hand and the floor.

"Oh, SHIT!" my patient whisper-shouted.

"LITERALLY!" I replied.

I made her laugh!

And this, children, is why we wear gloves.