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.

People are fucking disgusting...

(here was an AMAZING rant about a situation at work, but I found it impossible not to add in enough details that someone could potentially identify the patient, so I deleted it.)



Fucking motherfuckers. Pieces of shit.  (this was the end of the post).

Anyway, sorry about how click-bait-y this seems.

I've been really busy trying to finish my chemo certification. I mean, I took the class, passed the exam, and have my chemo card, but I have to get "signed off" on all different types of chemo (three times each, no less), in order to be officially certified and stuff.

Seeing as I work exclusively night shift, it has been understandably difficult. Therefore I've been sacrificing quite a few days off to go in during the day to do some chemo.

Fun times.

We're also currently seriously short-staffed on my unit, so I've been working a lot of overtime shifts. Tired. That's what I am!

For some reason, social media just isn't floating my boat recently, I have no idea why.

And I have the advent of my (dear God, PLEASE) soon-to-be-a-college-graduate daughter to look forward to, as she will be moving back home until she finds a job that nets enough that she can support herself.

Three grown women in a tiny, two-bedroom apartment...what could possibly go wrong?

Wait, don't answer that. I've already gamed out every scenario in my head!

Anyway, life's busy, there's never enough time in a day to do everything that needs to be done, etc., etc.

Basically just like every other sap out there on the planet!

Well, if you're still out there, reading my wittle blog, thanks! I'll try to make more of an effort to post more frequently than every few months (oy!).

See you on the flip side.

Generally, yes.

I had a confused patient in his 90s as part of my assignment the other night. When I had a bit of downtime, I sat with him to reorient him and keep him from pulling out his IV (AGAIN!).

We were chit-chatting about nothing in particular when he suddenly reached over and began stroking my wrist while staring at me intently and murmuring, "Do you like affection...?"

As I jerked back in surprise and sputtered a response about inappropriate behavior and professionalism, what was running through my mind was,

"NOT FROM YOU, MOTHERFUCKER!"

I called over our young, MALE nursing assistant to take over sitting and wasted no time sharing the story over a laugh with my colleagues.

A few minutes later, while checking my phone, I saw I had received a text message from one of my fellow nurses. I thought it was odd, because she was standing right there! Why would she be sending me a text when she could talk to me...?

Then I saw what she had texted...and busted out laughing.

Well played, Meg. Well played.

Patient Education

Patient education is a huge and very important part of nursing.

I had to teach each of my patients something last night.

No, you're not a "wimp" for being in pain after having MAJOR abdominal surgery. Yes, it's okay to have the ordered pain medication, that's what it's for. Yes, the nausea and dry-heaving you're suffering from could absolutely be caused by the pain, and yes, I can give you something for that, too.

And NO, you're not being a "bother". It's my job. :)

No, you can't smoke e-cigarettes in the hospital. Yes, I could smell it when I walked into the room. No, it doesn't matter how tiny the cig is, it has to go. No, I'm not mad at you. Yes, you can absolutely have a nicotine patch, and I'll go ask the doc to order one for you ASAP.

You're welcome. :)

NO, YOU CANNOT HAWK UP LOOGIES AND SPIT THEM ON THE FLOOR NEXT TO YOUR BED. Yes, I slipped in your phlegm and almost fell on my ass. Or hit my head. Yes, I'm gagging as I'm cleaning your nasty-ass sputum from the tread of my sneaker. No, I 'll never let you know how disgusted I am. Yes, I will point out the tissue box that's RIGHT THERE. And the trash can that's also RIGHT THERE, and ask you to use both in the future. No, I will not ask you if you do the same thing in your own home, because yes, I can control myself. Unlike you.

Let me get you some apple juice. You're welcome.

ZOMG!!

Happy TEN YEAR Blogiversary to meeeeeeeeee!

That's like a BILLION years in meatspace.

:D

Blogorado!

As always, I had the absolute BEST TIME EVAR at Blogorado this year.

Thanks so much to the FarmFamily (Farmmom, Farmgirl, FarmDad) for being exemplary hosts.

The food was exquisite and plentiful, the booze copious, and the conversation raunchy as fuck.

We blew up a papier-mache heart (lovingly and laboriously made by PhlegmFatale, who couldn't make it out to Colorado this year, boo!), filled with confetti and pom-poms, and covered with sequins and glitter, in honor of  our dear friend, Gay_Cynic, who passed away over Memorial Day Weekend this year. We miss you!

I shot up a good bunch of my ammo, as I want to get really comfortable with my CZ82. One of my magazines developed a burr which needs to be filed or ground away (grinded?), so I was unable to use it. I really should just stock up on magazines, anyway.

I also adopted an adorable, bottle-fed kitten and brought him home with me! I'll have to share pics of Calcifer once I get them off my phone.

And you haven't lived until you've played a game of Bards Dispense Profanity with the Atomic Nerds, Tam, ZerCool, EvylRobot (and his son), and Barron! Jeebus, I frequently laughed so hard I almost peed myself!

Every year, before it's even over, I look forward to the next year, when we all gather again. It's wonderful to spend time with one's tribe.

To all who were there (you know who you are, and I've reached my max linky-love level, dammit!), as always, it was spectacular to spend time with y'all, and to the new-to-me folks, it was lovely to meet you...see y'all next year!

*tap tap* Is this thing on?

Wow, it's been quite some time since I posted. Sheesh.

I think Facebook is becoming the slow death of blogging. Though I do filter and censor myself a lot on the Book of Face. On my blog is the only place I can just spew out whatever crazy shit crosses my mind.

For example, I had to tell a patient to simmer down and let us do our jobs. Without going into too much detail, she knew she was sick and called 911 and was brought to our ED and then admitted.

After which she proceeded to bitch and complain about EVERYthing.

"Why do you have to put the bed alarm on...I feel like I'm in a nursing home!"
"ANOTHER blood draw? I feel like a pin cushion!" (These are just a few, and you have to understand that once you went into her room, you ended up being in there for at least half an hour, if not longer. She was like a psychic vampire, draining me of my will to live.)

She battled with us over every intervention, procedure, medication...you name it and she either refused or required half and hour of education or cajoling...sometimes repeatedly about the same issue!

I totally understand that nobody wants to be in the hospital. We try to make every patient's stay as pleasant and hassle-free as we can, but it's not a hotel or resort!

After I explained for at least the fifth time why we needed to have the bed alarm on, at least at night, and why she needed to call for assistance before getting out of bed, etc., she said she had had enough, that she didn't want to be there, and she was going to leave in the morning, no matter what.

I looked at her and said, "Ms. White, YOU were the one who called 911 and came to the hospital, because you knew you were sick and that it was very serious. LET US DO OUR JOBS. The way you feel right now, the condition you're in...do you really think you're ok to take care of yourself at home?"

She replied, "That's not fair!"

You're in your sixties, and you're only figuring this out now?!

No, I didn't say anything to that effect to her! Even though I really wanted to...

Anyway, this post totally turned out different than I expected. Sorry about that...but that means I can blog more, yay!

Not really appropriate.

My pod partner, after assisting me with incontinence care and linen change for my new patient, asked me,

"So, what's her diagnosis?"

My reply?

"She's old as fuck."

I'm going to hell for that.

The vital nursing knowledge I've gleaned from my not-so-copious experience:

Common sense...isn't.

Actually...appropriate!

I felt a little uncomfortable at the chemotherapy education session at the hospital last week. I mean, it WAS my day off, so if I wanted to wear denim shorts and my Deadpool t-shirt, why not? I was also rocking my blinged-out skull and crossbone earrings.

When I arrived in the conference room and saw the other attendees, I had to hide a wince. Most were wearing business casual clothing. The others were in scrubs because they were coming off shift.

I felt like I stood out like a sore thumb. Then, as we progressed through the presentation, I came to a realization. Chemotherapy is poison. So my awesome earrings were totally appropriate. And Deadpool? Man, he became a super...hero (?) because he was dying of cancer and desperate for a cure! How perfect was my t-shirt after all!

So I stopped worrying about it and absorbed all the info. Besides, who cares what other people think, right?

A funny thing happened on the way to the medcart...

The doctor summoned me urgently to the patient's bedside. He pointed to her ileostomy bag and said,

"Please page the ostomy nurse, STAT! It looks like pieces of her intestinal tissue or stoma are sloughing off into the bag!!!"

I whispered in response, "It's watermelon...she had it for breakfast!"

He blushed and said, "Well, don't I feel silly!"

To be fair, the patient had no teeth, so she regularly had pretty big chunks of food in her collection bag!


Then there was the patient who didn't seem to be arousable. Calling his name, gentle shaking/jostling, nothing was working. So I fired up the good, ol' sternal rub and hoped it would work its magic...

nothing. I kept rubbing and rubbing, harder and harder, knowing I was surely hurting him as he was pretty damn hairy.

Without opening his eyes, he suddenly said,

"You're rubbing the wrong spot..."

Alrighty, then! Gotta love the night shift...