The Restaurant

Thanks to the drug company I was allowed in one of the better restaurants in my town. And let me say, I do thank them. The thing is, the owner of the restaurant grows the greens for his salads. What I don't understand is, why do we now leave the stems on the ends of the green things? And why am I eating stuff that reminds me of what I used to throw away out of the garden and eat out of the yard (haven't mentioned my fixation on imitating the horse, have I??) It was rather embarassing having the green stems hang out of my mouth while sipping on the very fine wine. And I wonder why my boss rarely takes me anywhere!!

It was fun, I appreciated learning the differences between cardene and nipride, both of which I am very comfortable with. But remember, I'm the one that thrives on adrenaline. I do enjoy these dinners the speaker though made one false statement that all the ICU nurses corrected him on: patients can live forever in the ICU, we all know the stories.

On that note, my "friend" that I also precepted in the unit was delighting the aides today with stories of my disasters. I had forgotten some of them, but it was fun hearing her perspective on those things. Okay, a quickie: one of her first days in the unit, code was called, doc was in the room with our pt (we hadn't even seen the pt yet - first thing in the morning), we go to the code...... as we are bringing the code pt down to the unit they call a code in our unit. I walk in, it's MY patient. Seems the doc let him get up to go to the bathroom and he suddenly didn't feel well, they got him back in bed and that was pretty much all hey could do. The family had all gone home, they had been there all night and he was fine. Rather awkward moment explaining that one.

Another day tomorrow.........

Ode to Movie Popcorn

Disclaimer: I am NOT a poet, my favourite poet is Ogden Nash. Please lower your expectations here.

Ode to Movie Popcorn

How I love you,
dare I say, let me count the ways.
You bid to me as I dream of the movie
You call out to me as none at home can do.

You are drenched in petroleum products
called "butter"
You harden my arteries as you encircle
my circulatory system.

Yet I cannot resist,
at times I flock to the cinema
only for you do I seek.
Nay, not the flick.

You say, why oh why do you partake?
Heck if I know, but I must.
Even now, I am not sated (hope this is the right use of the word??)
You call, you call, you call.


*this is probably going to be revisited, but I had to start somewhere.

Friday the 13th

Okay, anyone that works in an ER or area like that knows that we are a superstitous lot. You never erase the last name on the board, you NEVER say "it's quite in here", in fact we get worried and call it the "q" word, lots of things like that. In my unit, in fact lots of people at this hospital (we have around 700 beds) they know me as the"angel". I have never done anything to cause it, it's just there are some people that seem to be the one that is there when things go badly. I'm always cautious about it lest people misunderstand.

Today, I was charge. We have a 20 bed unit, I had two patients (our normal load per nurse). The charge nurse is also lead on the code team for the hospital. Everything was somewhat decent this morning, I even got LUNCH!! Then, well, CODE BLUE so I ran to it. Took awhile to deal with it, transferred the pt to another unit, went back to mine. While I was out they filled my empty bed with a "great charge nurse patient." Pt in their 30's had some heart valve issues, just here to be watched a little closer. You know, just in case. While I was gone they even bathed her (my unit is awesome - I will brag on them anytime, anyplace). So anyway..... my perfect charge nurse patient didn't understand the rules, my rules...... she came down on 1.5 liters O2, decompensated over about 30-45 minutes, was intubated, PEA (ran a code), we placed an art line, neo, dopamine, NS bolus, then the big one, a balloon pump!

I'm still in shock. One of the nurses today is an instructor, she and I reviewed what had happened. Had I missed something? Should I have intubated sooner? We intubated before she gave out, I had drugs being mixed from pharmacy before I had orders so when the doc called back I could be ready right then, I was trying to beat the bad stuff..... I even had the crash cart next to her room to ward off the evil spirits..... No one felt like I missed anything and I really don't either. It's just reviewing how fast our patients can go bad. Had she remained on the floor I really think she would have died. Those nurses are good, but it happened too fast for them to be able to do everything we did. Again, and none of them will read this, well one will, the nurses around me were doing all the work, I was directing some and pacing a lot (phone calls to docs), running and fetching, scribbling notes so I could remember what in the heck happened.

I left work at 8:50, I was supposed to be off at 7p. The patient was stable when I left, the other code patient was alive as well. Maybe it wasn't a bad day after all.

Kindness

Funny, I just read what I wrote about the ER, how nervous I was. It went fine by the way. But it has brought to mind how much culture difference between ER and the unit I work in. I hope that it's more the whole rest of the hospital, but anyway, you'll see what I mean.

Monday was a very rainy day.... accidents happen. A family was traveling through our town from out of state, no family here. They were involved in an accident, I don't know who's fault, I heard hydroplaning, but it's not important to the story. There were four people in the car: dad, mom, two kids. Dad was seriously injured, difficult extracation, head injury, at some point was intubated. Mom and kids were brought out my hospital, dad to another. For those that don't work in ER, the decision was based this way: dad needed serious care, we could provide that but we could only take so many victims at once. Mom and kids needed to be seen, there was great potential for serious injury. Normally kids would have gone to the local childrens hospital, but mom couldn't be treated there and they didn't want to split mom and kids up. The place dad was taken would have probably sent kids to children's, so mom and kids to us, we can do care for all.

Now, mom and kids turned out fine. Picture yourself in mom's place. One kid, the youngest was placed in the same bay as mom, the older taken to a different room. She knew spouse was hurt, but not with us. She couldn't see older kid. She was stressed. It was difficult. We were able to work them through at a decent time (even with me being slow).

I called the other hospital to see how dad was, it wasn't good: that was when I got the story about head injiury, nonresponsive, on vent with chest tubes, broken bones, etc. I went to mom, told her that he was in good hands, but very serious. I called the chaplain and had him come. We arranged for cabfare to the other hospital and chaplain called over to their chaplain for follow up. So far, not bad. Here's the rub.

Mom had glass all over her, mom had all the luggage. She asked if there was a place where she could shower. There was in the main part of the hospital. The ER charge nurse had a fit about me wanting to let her do it, even though I could "free" up the room she was in and it would require nothing of staff. We allow families to use these facilities for people that have to stay in the critical care waiting areas. I was horrified by the reaction I got. I had no idea if mom could do that at the other place, I don't know what they offer. I have no clue what kind of finances they had.

Maybe it's the thought, "what if it were me?" This is beginning to be a real source of action for me. Today I was trying to catch up on stuff, people needed me here and there. A call light was going off and the pt kept saying, "nurse, nurse, something is wrong here." I wanted to blow it off so bad, find HER nurse and let them deal with it. Finally I went in, and her IV had horribly infiltrated and the meds were burning her skin. I felt maybe an inch tall, I know that hurt her. What if I was the one needing the pain medicine or the drink or whatever..... I fail so often, yet when I want something I want others to do it NOW.

So I listen to others (and myself too often) joke and carry on, or make fun of things, or say: they really don't need that. Then I wonder, what if it were me in there.... I hope I don't get paid back for all the stuff I've done. I really hope that I become the person that responds rightly to others. But then too often I'm more like today when I suggested if only we could get the guy in the room with a fly (yes, a fly) to think he was hallucinating the fly, then he would shut up.......

Isn't it interesting what your children think of you. The other night my oldest called me as I was about to leave work. A 12 year old son of someone from the church had been skateboarding down a hill, fell and was coming to the ER at my hospital. Could I go check on him?

Got to the ER, they were just checking in, dad, kid and another teen that drove them. Kid looked bad, no kidding. My thoughts had been I would go down there, kid would have a "pumpknot" and overreacting parents. Kid was pale, had been combative, said over and over he couldn't see, bucket in lap (he was about to barf) and again, he looked bad.

I went to the back, asked the charge nurse if they were going to get him back soon, that he didn't look good (please note, I work some in this ER, I know them and knew he would be upfront with me). Seems they had just gotten multiple ambulances in and there were no open rooms. I offered that maybe we should take kid to the children's hospital that was about 10 minutes away, charge nurse thought that would be a good idea.

Normally I would not like this, kid is here, needs to be seen soon. However our children's hospital is top notch and I felt like he would be more appropriately treated there (more than likely in hindsight - my hospital would have diagnosed him and transferred to the kid's hospital anyway). I rode with the kid to the other hospital, I was quite worried about him and hoped that if something happened maybe I could be useful.

We got to the ER, kid started vomiting as soon as we rolled in. You look at lay people in these situations and how they react and how we react. Dad had kid in the men's bathroom before I could stop him, he suddenly ran out and told me kid was barfing...... okay, I ran in and was like, get him in the wheelchair. Dad told me we needed to clean up the mess, I went out and told security that I needed towels, methinks dad probably couldn't carry kid over it without falling. I thew towels down, kid in wheelchair and got out of there.

While they were triaging kid, dad kept getting flustered and I would answer.... I noticed then that there were several notations "mom states...." I figured it was easier to let it go than to clarify. The staff there was wonderful, I was quite proud of them.

As it turns out, kid fractured his skull and was admitted to ICU. This was Thursday, today I heard he is still in the hospital, having trouble keeping food down.

I told my son that I appreciated him calling me, I think they would have stayed at my hospital until seen and it was better that I pushed to move him. While there were downsides to moving him (again, normally I would not do that) it was better for this situation. My son also went to the hospital to see them and be available if needed to help. It's interesting to see how compassionate he is towards others. I wish I could say that my hospital is always the best, but I do so appreciate knowing that they will tell me when I need other help. Oh, and I work in that ER Monday.

Irony

Even "funnier (so to speak)..... I got a ticket last week. Yes, I moaned about it to both guys while admitting I deserved the ticket I did gripe that there was no probation offered by that judge. This is while we were traveling to another part of the state. Yes, I was speeding. Yes, I deserved it..... but rats, I was trying to get away from a group of trucks. Makes no difference, I'm sure they get sick of hearing excuses so I basically didn't offer one when I was stopped. It just reminds me of when patients hit their call light to get you to come into the room when they can see you looking at them and they could just wave you in (yeah, a lady came out to the desk today - the glassed ICU room was facing me, the pt told her to come back in he would just hit the call light even though she was at my desk asking me a question I would need the chart for the answer). Sorry, I digress...... Anyway, whining should only be for fun, never serious.

Anyway..... I loved the irony and I enjoyed the patients.

Time

I haven't blogged in awhile, life has been getting in the way. Nothing special, just stuff. Maybe it's being out of the daily routine, not doing school with the kid. Maybe it's just being tired.

Had to take spouse to a larger city for a checkup on his eye. He has, this is what the doc calls it, a mole on the edge of the cornea. We go once a year to make sure that it doesn't grow. This particular day spouse was not feeling well so I drove. Unfortnately we had to make an unscheduled stop to met one of our fine state troopers. Unstead of pointing to the specimen in the back seat and saying I was on my way to a specialist (he looked dead) I just made no excuse at all. I figure these guys are as sick of whiners as I get. It will cost me $130, some pride, oh, and the judge doesn't offer probation, nor do they take personal checks. So it goes on my beautiful record.

Lately I've been pondering my life and what if I had been raised here or there or done this or that. I'm late 40's, I think this is natural. I'm not unhappy with my life, just wonder. Then I wonder if when we are in heaven if we get to enjoy things maybe we didn't here. Unending Ben and Jerry's without weight gain, riding horses across the prairie, just stuff....... Is it foolish to consider these things? I mean, I'm all for unending praise of Jesus around the throne, don't get me wrong, and I suppose we won't even think about such things, but I wonder. Oh foolish me. Oh well. Off to met more state troopers, #3 son needs his drivers license and we must go to their hidey hole. Yesterday they were pissed off, maybe today will be better.

Reports of My Death Are Only Hopeful

Okay, I'm not dead. I'm tired. I haven't been reading any blogs much, I haven't had energy to think about what is going on around me. I had hoped today to play catch up, but alas, life caught up. I probably should have done this last night when I wasn't sleeping, but I was too busy focusing on stuff that I can't control. So, needless to say nothing has been writen.

I will say, I am still stunned from hearing a patients father tell me (and administration when he complained about me) that he didn't care what we (oh, said this to the doctor that told him we wanted his daughter sedated) that if he "wanted to wake her up he would, and it didn't matter if it was not in her best interest!" I was also instructed in new tattoo care.

When you get in situations, you have to seperate the patient from the family. I liked the patient, of course, I like most people when they are properly sedated with ativan, versed, haldol, or geodon.

I'm going to now carry my anemic blood, my ear with the effusion (oh, I had a checkup today), and my tired booty to bed. I have to work tomorrow and I expect someone will expect me to actually earn my money. I will have a lot to say when I finally sit down and sort it out.

Overheard

Picture this: Intensive Care Unit. Patient in bed...... screaming:

CODE BLUE!!!

CODE BLUE!!!
CODE BLUE!!!
CODE BLUE!!!
CODE BLUE!!!

Over and Over.......

Families think we don't care as we call out to her: "Stop!! You're upsetting the other patients!!"

Have I mentioned I love Haldol and Geodon????

Celebration

The fact is, our boys are growing up. The oldest son's best friend got married this weekend. Graduated college, and now married. It won't be long until the groom is one of mine. ***sigh***

The bride was delightful, family was awesome. We had to go out of town for the wedding and were able to stay onsight at the colleg campus. The grooms family has had a tough year and friends came to show support and celebrate. It was great!!

Isn't it wonderful when we come together, love one another and rejoice!! This family has been close to us since the oldest boys were toddlers. They have celebrated everything together and I'm so excited that we were able to partake.

The Funeral

I got a message from a friend last week, her mother had become ill suddenly and passed away. I was stunned, the first I heard of it and it was over. I initially thought that I had missed everything, but then began to realize that the funeral had not happened. The morning of the funeral I realized that as I was typing a letter to her about how hard it was for me when my dad died, and how lonely you feel in the midst of the people, that I could tell her this in person.

The thing is, you couldn't just up and go, this place was a couple of hours away. But when I thought about completing the letter about how I understood what she was going though, I realized I could hug her instead. The drive was good, I had time to reflect on many things. It was one of those where you drive like crazy on the interstate, then you get to drive in the country. This state, in late spring, is beautiful. Yeah, what a sacrifice: I got to be away from town, alone.

One thing people don't know how to do is to just be. It's a helping word: be. Sometimes there are no words, you just are there. I had no great thoughts for my friend, I'm not "puffing" myself up. I remembered the pain when my parents died, and I came. If there was wisdom to impart, others did it. I just wanted to be there for her.

This woman died in the house she was born in, she decorated the cemetry before she died. She raised wonderful children and was keeping her grandson while her son was in Iraq. She had a faithful old dog that will be lost without her. Moments of wandering around, there is a river that flows behind her home, one that is popular with canoeist. It was a simple funeral, yet it spoke volumes. I never met her, but I would have been honoured to call her a friend. I wish I could effectively describe what I felt, but words limit me. There was a certain amount of mourning, because she will be missed, but it was a celebration of a life that was not wasted.

Maybe that's it...... a life that was not wasted. How much time do we waste, but what is wasted time? Is it a waste to sit and read, to enjoy just "being" with someone and not doing? Is it a waste if you don't solve the worlds problems, but you are faithful to the people around you? Is it a waste to live a simple life, one that surely Hollywood would make fun of, yet you have a simple faith that God is eternal and we are not?

I envy those that can do that. Can realize we are not to waste what God has given us. To enjoy the time together, to enrich our minds and souls, to give to others as we have been given. To be forgiven, to forgive, to love, to be loved.

I suspect this kind lady is in heaven, enjoying the presence of God and seeing the tears wept in her honour. She probably wonders why they cry for her, but she has surely shed tears as they do.

Rest now my friend, this is your legacy. And I thank you that you allowed me to come and see this part of your life. Don't hide what and who you are. I know you were surprised by my presence, but you would have surely come for me. You were taught by your mom friendship, and this is who you are. Friends love each other, they can just "be" there, and when you need to safely cry, now or in a year, I'll be there if you need me. Funny thing, you accepted me at a time when I was weak and loved me, and should you need me, I'll be there for you. Go sit at the river, think eternal, and know you are loved.

Pearls.......

I'm putting the following link here, what I'm requesting is that you pick the character from Pearls that best suits you, BUT that you also pick the character that best suits me.

http://www.comics.com/comics/pearls/html/cast_PearlSwine.html

I can't wait.........

Drama

This last week has been interesting. Work was, well, fascinating. We weren't that busy for once, and well, the nurses and staff had spring fever. I wear a stuffed figure of a character on my stetoscope, they keep stealing it. They were hilarious. We actually got to destress. Nice, probably won't happen again in a long time. Even the docs were pulling jokes on each other.

Okay, I must tell. Once there was a surgeon that was asked to help do a trach. I won't say at what level training he was to protect his innocence. So the pulmonologist, the RT and the surgeon are at the bedside ready to start when the surgeon whips out instructions. Well, see one, do one, teach one........

Recently same pulmonologist and RT are getting ready to do a trach, surgeon (a well trained surgeon that has a great sense of humour) pulls out instructions from his pocket. Pulmonologist screams..... "YOU!!!" at the RT who is rollong over laughing. Pulmonologist is now seeking revenge........

On another note, stress has been high at the church, but I think we are on the down side of it now. Okay, we are leaving, now sheeps without a pastor. But so much good has come from it that I believe God will redeem the day.

And I want to thank my blogging buddies here, it's nice to know that our hearts touch even when we don't know each other. I hear "Fiddler on the Roof" so I'm out of here.......

Super Villian

I took a Super Villian quiz for a friend of mine. I'm not into these things, but I did find the questions interesting. I didn't realize "motherly" would be a question. I think I can understand most of the answers. So, here it is.


You are Mr. FreezeMr. Freeze
--------------------------------------------------------------------------------
68%
The Joker
--------------------------------------------------------------------------------
67%
Dr. Doom
--------------------------------------------------------------------------------
67%
Riddler
--------------------------------------------------------------------------------
64%
Lex Luthor
--------------------------------------------------------------------------------
52%
Two-Face
--------------------------------------------------------------------------------
52%
Venom
--------------------------------------------------------------------------------
51%
Poison Ivy
--------------------------------------------------------------------------------
50%
Apocalypse
--------------------------------------------------------------------------------
46%
Juggernaut
--------------------------------------------------------------------------------
44%
Dark Phoenix
--------------------------------------------------------------------------------
44%
Magneto
--------------------------------------------------------------------------------
39%
Catwoman
--------------------------------------------------------------------------------
37%
Mystique
--------------------------------------------------------------------------------
36%
Kingpin
--------------------------------------------------------------------------------
33%
Green Goblin
--------------------------------------------------------------------------------
28%
You are cold and you think everyone else should be also, literally.

Ouch

I've been busy with real life lately and haven't written much or read much on the blogs. Much to my surprise, I went to Fat Doctor's blog today to find out that she is closed down. Seems a co-worker buster her out to the boss. The boss was fine about it, but it really bites. I guess for FD it was much like having your diary read over the loudspeaker.

So many people are amazed that we blog. What do you say? What if your boss finds out? What if a patient recognizes themselves? First of all, you would have to be more paranoid than I am to recognize yourself. Seriously, of all the people in the blogging world do you think you are special enough to make the interesting stuff you read on here? Come on.... and then you have to realize that so much is embellished to make it interesting, well, Jerry Springer has some openings.

My boss..... she wouldn't be happy, but methinks she would get over it. I think too that she recognizes creative writing. However, I don't want to push it. I do love my job.

I'm sorry FD, I really am. You have shared so much with us, we've walked down many things with you. I'm still touched by the death of one of the bloggers, I never knew her, but yet, I did. Somewhat better than some folks I see on a regular basis. Why is that? Because she opened up her thoughts for us to see, something we don't trust those close to us to do.

Alas, real life calls. I have much to do before going to throw myself before the patients and families tomorrow. See if I have any sanity left.

Patient Wisdom

I love patients, they have such "interesting" tidbits. Today I was informed that putting a rubber band in the patients hair will induce seizures.

There are days that the families help us do our jobs, they tell us how to give the meds, they tell us how to pull up the patient in the bed. They help us manage our time, because we so often sit around and do nothing (this is usually when at 5pm I'm writing my 9am assessment that I couldn't write because I was bathing the pt and giving meds, talking to the doctor about what we need or what has happened, u know.

I remember my mom was worried about me reaching over my head when I was pregnant because I might strangle the baby. But then, I freaked out when I ran into an electric fence because I was afraid I might electricute the baby. Ah, the days of going to the family doctor with the baby and asking if having the car windows down were the reason he had ear infections. He was sooooo patient with me.

We learn, we grow, we teach. Of course, we snicker behind the closed doors....

Is It Obsessive?

If you wake up at 12:45 am and call work about something you forgot to do, is that too obsessive?

That was the second phone call. Some have called me "work boundary challenged." Can I charge them for that time? Oh dear.

She Knows It's Coming

Okay, I show up for work in the ICU Thursday.... my orientee is sitting in a chair. Ha you say, so..... So this gal never sits, she is usually 30 minutes early for work, has report underway, makes me look terrible all the time. So I'm thinking, what's wrong......

We start report. Now, I'm not the most observant person in the unit, but I could even tell Zippy ain't feeling so good. First clue, she can't finish a sentence without having to stop for a breath (and when the sentence is "No, I'll stay." it isn't a good sign). Second clue, I've seen pt's that have better colour than she had (you can include 1/2 dead pts in that), third, my co-workers all said she was sick.

Give her credit, Zippy was determined to work!! She refused to go the ER, she said she couldn't drive home, she was gonna work. We had a balloon pump pt and something else, nothing serious. I kept telling her that it was fine for her to stay, when she passed out we could do anything we wanted (the chaplain later told me that this statement was pivotal in her relenting to care while she could control some of it). When she was trying to give the 9am meds and couldn't get the meds down the NG tube and realized that someone would have to help with that - she thought it was stopped up, reality was she was too weak to push the meds, it flushed easily with the healthy nurse. She finally said that maybe she would go to the ER. I knew there was no way this gal was going in a wheelchair, but her audible wheezes were unnerving to me as we walked down to the ER (yeah, not very observant, I didn't hear them with all the racket in the unit, in the hallway, oh my!) And of course, she was breathing 37 times a minute.

I also work in the ER pool, so I was hoping that would speed things up for us, alas, not to be. We got back rather quickly but getting respiratory was a little slow. I went back and forth (I was charge in our unit, hated to be gone long) and Zippy was in good hands. However after her 1 hour updraft and CXR her sat on room air was 85%. I suggested maybe O2 would be in order, but didn't put it on in case they wanted gasses. Epi and steroids were given, and she ended up on 40% veni mask. Long story short(er), she got admitted to ICU for bilateral PE's (blood clots). Two days later she is doing much better, I did manage to care for HER patients without killing any of them, and she is ALMOST cooperating with her care.

I can't tell you how scared I was. We lost a blogger in the fall to this, of course I've seen pts die with it, one of our nurses mom died with one (sorry babe - I know it still hurts and I know you were very scared), and I'm quite attached to the girl. I'm hoping that Zippy will take this serious, will actually cooperate with the docs (we did hand pick them), and will heal quickly. After all, I am having to do my own work, God save the patients!!!!

Tagged - Why I Blog

Survival - I've found that my survival depends on being able to look at most situations and to see if I can make someone laugh when I retell it. I now find myself thinking during the day about how to tell this without violating HIPPA or my friends confidence.

Interaction - I live a fairly sheltered life, seriously!! I love hearing how others respond to what I say and think. There are a few of you out there that have responded so kindly to me, but I also like to challenge main stream thought (except for when I want you to come to the main stream).

Venting - 100% O2..... I try to keep myself out of trouble by changing enough that the idiots won't recognize themselves or the suits either. I have totally refrained, well, most of the time refraned from trashing someone that gives me a paycheck. But come on, there are sooooo many times I just want to scream, "you may have imprinted your image on my forehead, you may give me a paycheck, but I can't keep saying over and over that you 'really' care about my staff when you have everything you need and we don't" and we could go on from there but I suspect most of my readers know what I'm talking about.

Dreams - I finally spoke the words today to a friend, "I would really like to be a children's book reviewer." Possibly even a writer. No, that's not true. I would really love to be a writer. So this is a way for me to fulfill some of that. (I would be really good as a kids book reviewer though).

Freedom- I can talk all day in here without being interrupted once. I can tell the story, edit the story, jazz the story, but you can't stop me *giggle*. This is so freeing.

Too Bummed To Blog

I've not written anything, been busy attending to things belonging to a higher power. This is not the first time I've been involved in a church that was imploding, but this time I'm more detached. It's sad really. Why, why, why? Because we are but frail humans with a sin nature. Now, not everyone believes that, it's okay, but I've seen enough sin nature to convince me. Otherwise, how do you explain the news and what people do to each other.

Today was a new low. Everytime I try to type something about this, I can't. I think I need to leave it at that. Fortunately, this time my source isn't the church, it's the rock. And I hope and pray that I not take my eyes off the rock.

Maybe when I go back to work Thursday the patients will give me something to laugh at.