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.

The Call

The man called asking about his dad. I took the call from the hostess. He hadn't talked to a nurse in about a week. My first question is usually tell me what you know, so I know how to fill in the blanks. He couldn't understand why dad wasn't getting better. It's a safe bet in my unit to discuss heart failure and fluid in the lungs. I educated, read the pet scan results, went through the mans history (and in a unit aren't they all the same??), looked up CT results. I explained about the surgery on Monday (lung biopsy). He still wasn't getting it why dad isn't any better. I'm finally going "look, he's 83 years old, the parts wear out!" "No he's not, he's 72." I'm sure of this one, after all, I can read, "He's 83, right here on the chart." Then I reinterate about the family meeting and how Jim Bob, Sue Bob and his mom were talking with the doctors when he goes, "Who's Jim Bob?" Duh, I say, "Your brother!" Thinking how bad is this connection (in my defense, the phone had been breaking up). "No, my brother is Mark Bob!" Sadly, 47 minutes and 30 seconds into this call I ask, "Who is your family?" It's the Symthe family, I had been telling him about the Smuth family......

You must understand, I had been tired, hungry, and the last part of the talk a little exasperated. My staff is now rolling on the floor as I tell one of them that this call is actually for them...... Could they please talk to the man who surely (and maybe rightfully) thinks I'm an idiot. Needless to say the HIPPA police will probably take me away when I go back......

Naked Patients

First might I say, why is the only patients that want to be naked are the ones we don't want to look at??? *sudder*

Overheard: "Now Mr. Smith, why do you keep taking your clothes off?" said the cute young nurse.

"Because I breathe better naked!" was the hasty reply.

Why

Yet again the patient didn't make it. I don't know the details, I wasn't there, but I got to clean up the emotions after. He was only a few years older than me with a preteen child. My staff was upset, they weren't expecting it. Yes, he was on a balloon pump, but geez, we see a lot of people recover after that. So why are we so surprized that this one didn't make it? Because we do our job well. He talked, laughed and joked up until he coded.

Why do we walk away from these cases saying, "what did I miss" "could I have done something different". Because we are exactly what a nurse should be. We care. This was OUR patient, he deserved the best and we gave it to him. We tried. Fifty years ago he wouldn't have had this chance, actually more like 15 years ago. We give good care. And because of that, we cry, we have bad dreams, we analyze every move we made. And I hope we never stop.

I hope if I ever do become the patient my nurse cares enough to cry at times, that she or he would think of each move they make. This time it's a healthy cry. We lost, but with the process of reviewing what we did, we also gain a respect of the fact that our patients, even when the laugh and joke, are very sick. And they need us, to be there for them.

Amazing Grace

We all left home tonight, three seperate vehicles. I only anticipated seeing one child at the concert, instead all of us were there. How strange that we, having children of this age (early twenties, teenager) should all end up at a choral concert at a church that none of us attends on a Friday night. The music was beautiful, this choir and orchastra will be leaving next week to travel to England to sing at the church where John Newton wrote most of his hymns.

It is Amazing Grace

Jellybeans

I like them, a lot. I'm type II diabetic, had a drug rep dinner tonight with dessert. I have a bag of jellybeans in my room. I want them, yet I know I should not.

Blast the evel (can't remember what movie that is a quote from) nurse that recently gave me jellybeans and reminded me how much I love them. The evil little things, so full of favor. So tempting....

Know what makes me do better control..... looking at patients. I don't want to be one. I constantly am reminded that I must exercise, eat better, so that I'm not a patient and that I can live to see my grandchildren grow up and marry. This would be the grandchildren that are not only not on the way but of the children that aren't married (only one is dating currently).

Anyway, maybe one jellybean...... maybe not.

Spring

This time of year is when I always wish I lived on a farm or ranch. I'm smart enough to know there's a ton of work to it, but the rewards are there as well. I have a friend who's parents raise sheep. I want to go in the next few weeks and see the lambs. There's just something about babies, lambs, basically innocence that we need more of in our lives.

There are many spiritual points I could make at this time, but I will leave them to you to point out. I had another favorite patient (actually more the family was a favorite, never really knew the pt) die, on Easter actually. Just as there are many other photo's I could post to hint at spring (oh, it's been a cold snap here as well, doesn't even feel like spring) we all know about the seasons and God's timing. However, my head hurts, I need to clean, and you can just think about lambs and Easter.......

Promised Photos

This is the obit written by the child in seminary. I have great hope for the future with this child as a spiritual leader. The eldest child has written a song, the youngest is in mourning. I wonder if, since he died so close to Easter, if Fat Tuesday will rise again....


On April 5th 2007 at 7:30 p.m. a dear friend and family member was murdered in a crime of passion by a toy-obsessed, energetic, addict, puppy. The dog is now in custody but the loss will be great.

Known to some as the one you hope you don’t pick up in the claw machine, Fat Tuesday turned out to be a diamond in the rough. He was a photogenic icon for many people. To some he might have represented a very important religious time. However, his family knew that religion wasn’t what Fat Tuesday was all about. You see to Phat it wasn’t about trivial events or even very good hair upkeep. What Phat cared about was peace, love, and ironically he loved animals. It was that love that ultimately led to his demise. He was warm and cuddly all the way down to his soft cottony insides.

He is survived by the xxxx family, including Aaron his primary caregiver and best friend.

A graveside service will be held on Friday April the 6th at 5:30ish for family and close friends (or anyone else) at the family's backyard.

Tentative Speakers include:

Stephen
John Michael
Jonathan
Aaron

And tentatively:
Pastor John Piper (Bethlehem Baptist Church)
Coach Stan Heath (SFU Basketball Coach)
Benedict XVI (Pope)
Matt Redman (British)
Bill Cosby (Fat Albert)
Kenan Thompson (Fat Albert)
Mike Huckabee (Future President of the United Stated)

A special musical tribute is also expected by Nick Cannon (hilarious) but if not Jonathan will do it.

100 Posts

This is my 101st post. Can't believe, I know, what an amazing feat. And for all two of you that read me you wonder how I filled the pages with such, well, whatever.

Todays note is hopefully a you tube event my son sent me.



Lets try......

What Have I Created?

I'm having trouble with the photo here, will work on that. The boys announced tonight that Fat Tuesday was dead. The dog killed it. Fat Tuesday is the doll, oops action figure won out of a claw machine at the movies. Fat Tuesday has had quite a ride, literally actually... front seat of jeep, trip to the zoo, no telling where else.

Since Fat Tuesday is dead, they are now in the kitchen painting him the proper colour cyanotic, including having a cap on his head to keep from discolouring his hair. The obit is being written.... What if they had applied this much work to their school.

Tomorrow I shall get permission to download a proper picture (I had planned on doing that anyway about the trip to the zoo) and possibly the obit. *shakes her head in wonder*

Winding Roads

Even wonder what would have happened had some event in your life had been different? In my case, what if my parents hadn't moved here when I was 6? What if they moved to a different state? Would I have married someone totally different? Would I still have become a nurse? What all would be different?

Another thought: Ever look at people you pass and wonder what they are thinking? What is their life like? What do they think of you? In doing patient care sometimes I wonder how I come accross to them, do they see that I care? Do they know that sometimes I cry when their loved ones die? I think of some families even now several years after I cared for them. Do my co-workers know I really mean the stuff when I say how much I enjoy them? Am I always bitchy and whiny (today was bad, I was a bitch)? I mistook a pt's family member the other day, he doesn't know how horrible I felt about it.... my brain is really bad on stuff like that.

I'm overall content with my life, sometimes I wonder, but not to change it as much as to think. Would I change it? A few things yes, but mostly no. I wouldn't be who I am without it (then again, maybe that would be good). Maybe I'm tired and need some sleep.... yep, that is true.

Must See You-Tube

I'm still laughing and I needed it so. And free psych help to boot.

http://psychiatrist-blog.blogspot.com

Go to the April Fools You-Tube stuff and watch the dead deer.

Please note, I'm prone to switching to Spanish at work when my name is called to often. Phrases I know:
No hables ingles
Mi gusta mucho Eyeore
No en casa

The Storm

I'm not afraid to admit I'm afraid of storms, always have been, can't imagine it changing now. Last night though, was an awesome storm. Now that it's over, I can admit, it scared the pee out of me and from what I hear from others, them too.

Set up: I took my son to karate at the church (yeah, it is weird) and decided I would just wait on him. I had a book to read, I'm happy. The storm started while we were there, I could hear hail bouncing off the roof, on checking it was pea to marble sized. But I was safe, it was good. After the lesson we were running out to the truck when I realized I was going to have to run through the rain (I had on crocs, bad choice) with the lightening so frequent you couldn't out run it. I ran..

So now we're driving down the road, all good, when it really began to hail. Now, I can't reproduce the sound, but it was BAM, BAM, BAM BAAM.... lightening POW POW POW, I'm sure somewhere in there I might have been screaming... but then I'm not sure. The amazing part was where, again, I'm driving like 45 mph down the road and the lights in the businesses and the street lights start going out in progression as we are driving. NOT MAKING THIS UP!! It was bizarre. I would have pulled over but frankly there wasn't anywhere that seemed safe and I was almost home.

Today I found out that we passed a substation that had a fire. But stranger, my husband works for an electric utility, people that were in for a meeting were staying at a hotel close and saw lightening hit a pole in a fireball, travel down the line to a gas station, come back towards them and headed in the direction of the substation. Even talking about it now brings back the stark raving fear I felt.

Today, in remembering all this, I also thought of the scripture where Elijah was in the cave and God passed by. Several things happened, but one was a storm. It was only in the quiet, still voice that Elijah heard God. My thought was even if God was talking if it was a storm like that I don't think Elijah could have heard him over the hail. Now now, God doesn't mind if we project our little thoughts like this. With it all over I can say, I was impressed. Think of all we do to make electric light shows and fireworks, what God does with a little warm / cold front is really impressive.

I teased the boys that stayed here this weekend that they would have to sleep with the dogs, we did last night, they were as scared as I was. The smaller border collie slept between us and didn't move all night except to cuddle closer. Very similar to when the kids used to crawl in bed with us.......

The Wedding

It was a small wedding, not fancy, but very sweet. One of my co-workers that I have been blessed to have as a friend, her daughter was getting married. Now, I must confess I look at most situations I find myself in for the humour that I might pull out. So I was seeking a good time.

My role was to be the person that did "whatever needs to be done" or otherwise unassigned tasks. It was a good fit for me. I made myself available for the day prior to the wedding, and of course the big day.

I've had this running joke with this girl over the church she attends, so I had the priviledge of actually stepping foot inside it. (she does the same with me, don't feel sorry for her). I looked around, and said, "so this is what a **name of the denomination**** church looks like." Then called another friend that attends a similar church and announced to her, "guess where I'm at???"

Silly folks, they let me help decorate and then do errands with her. It went well. I was beginning to feel like the next day was doable.....

Day of wedding.... we pick up the cake. I was not expecting sooooo many boxes, then the terror of the car ride out to the curch. What if I dropped the CAKE!!! The PRESSURE!!! Spouse and #1 son were doing the video and the pictures so they had lots on their plates as well.

Next point of interest. Did you know that you are supposed to make the sherbert punch early? I didn't. I was told to not make it until after the wedding but I got adventurous and started right before the ceremony. Thank goodness I did!!! The stuff is supposed to melt and blend. I didn't know that. I can save your life but I know nothing about punch. Needless to say, the start of the reception was rough. However, some very kind folks stepped up to the plate and helped me.

I also enjoy watching people. Like the ones that came in and looked at the snacks we set out (no real meal was announced - it was just snacks, cake and punch) and started asking, "wheres the real food?" I felt like praying and asking Jesus to do another wedding thing. I mean come on, this is a simple wedding, no one has tons of money here, you weren't promised a meal. Also noticing the people that enjoy helping verses the people that are helpless.

All in all, a good time was had by those that wanted it. I learned a few things, her next wedding (she has 3 daughters) I will be happy to help again. Because when all is said and done, you help your friends. And I have 3 sons and will need help when it's my turn........

Internet gods

We are currently trying to be kind and gentle to the internet gods that have decided to play with our heads. One of us is in a foul temper about it, actually several of us since the boys are having to leave the nest at home to do homework at a local business. We are offering refuge to a repairman from the cable company tomorrow between the hours of 2p -5p for him to come appease the beast. We hope this one is wise and compassionate. :) We do not like to not have our internet. Any known appropriate sacrifices (please note - the children have willingly offered the kats.... but I can't see the internet gods liking kats either).

Dust Bowl

This is Lake Overholser in 1935 or my living room. Take your pick. I don't know what my mom did that angered God but she certainly didn't get the daughter she asked for. I believe she wanted one that would clean the house, bake, raise flowers, did I mention clean the house???? *also please note I inherited her house*

Dust is one of those things that overall just doesn't bother me. I figure, I don't bother it, it won't bother me. Then again, if I go and dust it, more just like it appears. Best I can tell there is a never ending supply of dust, but only a limited supply of me (now that's another topic).

But alas, sometimes the dust must be rearranged, today was one of those days. A couple of BOYS my sons age will be here Thursday - Saturday. Note, I said boys, they will not notice (at least none of the ones I've met) however on the off chance their parents enter my home, I have stirred the dust so new dust can appear.

We shall see. I really thought by the time I made the salary I make I could afford to hire someone to come do these tasks for me. Fair trade, I nurse people back to health (or something along that line) and I encourage the economy by getting my house clean. Alas, those people that live in my house demand to be fed, clothed, and have the lifestyle they are accustomed to.

Just another day

Not a bad day, for me that is. Funny thing though, I had to call a family member of my patient that is also an ICU nurse. I guess, maybe, I probably shouldn't have implied that his relative was an "interesting" case. Never a good sign to be told that your loved one is interesting to the nurses.

Cardiogenic shock, temporary pacer, balloon pump, ventalator, and the assorted medications that go along with that. Me, the one with the attention span of a gnat, was interested all day. Intriqued even. Again, not a good sign.

So far, so good. We will watch this one closely. They are very sick, but they have very good doctors. Now all he needs is a good heart.

The Order

You must understand, I rarely defy authority. I understand it's place and my place in the universe. I also understand the delicate role I as a nurse play in the unit compared to the physicians I work with. There are always those that we would not use ourselves and might I add are on the list of those that shan't touch me, but I still respect what they order for their patients. Until......

He's been in the unit for some time, I have never taken care of him but as charge I have kept up with his progress, actually, the lack of progress. We knew in our guts this man would not make it out of the unit, but we still tried to make it so. A week or so ago I began talking to the wife, I saw her daily in there and at some point either as a human or worse as a corporate slave I began to check on her each time I was there. Yet I knew where this was going and I'm not sure she did.

So the man is dying, all systems are shutting down, his body is visibly showing signs of breakdown. The sons had come in the day before at our request because we thought he would die that day. I had been shocked to find him still with us on my return. A doc that is covering for another decides we should get a test that will require us to leave the unit, be off the vent and bag, and jostle him around. When the nurse caring for him tells me about this order I was dumbfounded. I had looked at his labs earlier in the day, and this would blow his kidney function. He had been too unstable for dialysis for days and we were eeking by as it was. I can't defy the order, but in good conscious I couldn't do the order.

I quickly asked God for wisdom, as I didn't know what else to do. We decided to call the kidney doctor to "inform" him of this order. He called the "offending
doc then called us and said it was fine with him for the pt to go for the test as long as the family understood this would knock out the kidneys and he would have to have dialysis at this point. I talked to the family twice, explaining that while I would never defy an order, my concern was that their dad would die in process and I had to live with myself over the benefit of the test verses the consequenses. We were questioning whether or not we could do this but I needed direction from them. In answering questions they came to understand there would be little benefit from the test: we might find out why he was suddenly worse but we couldn't treat him and he would lose the kidney function he had. In the end, they decided not to do the test. The man died during the night.

In explaining to the family why this order was written I tried to protect the physician. They couldn't understand why he would order a test that might kill their father in process and for sure wipe out the kidneys with no real benefit. I explained that for many people they had to understand why. I never made this doctor look bad in my effort (I think) but tried to explain what I really couldn't.

But I was left with the feeling of here's the doctor coming in for 5 minutes ordering something that I will have to do and then I'm left with a grieving family when he dies during the test. I was angry! I support you and at the same time I have to wiggle around to try to be a patient advocate. It is about the patient, not why? Then I have to remember, I can't show the anger, I must comfort the family even when I have little to offer them.

As I left that night, they were each saying goodbye to the husband of 50+ years, the father that was special (they told me this, but I knew from meeting the family the kind of man he was), the grandfather that taught him how to be a man, and a man who endured much from my staff.

I stood up for my patient, I have nothing to hang my head about. I did more than my job, I helped my nurse through this situation, and God gave me wisdom to do all without compromising my self.

Isn't It Interesting....

So I worked ER yesterday, it's been awhile. I find it interesting that two patients I treated had the same thing that I sent my son to a doctors office for. My favorite of the day.... "but I'm allergic to everything but demerol...." to which the doc said he would not give. He asked her where she got that drug, she said her pain doctor. ER doc says, "go to him then."" She promised to complain when she got the patient satisfaction survery. I took her information to the director of the ER, he will be aware that she was seeking drugs. Oh, don't worry about her pain, she asked me for water, took a prescription bottle out of her purse and took some meds.

I love ER, the human species never fails to amaze me. You have wonderful patients, then you have the people that demand all while knowing they will never pay the bill. And they want it all fast!! The ones that won't pay, they know the buttons to push "chest pain" for sniffles, kidney stone for drugs, I even had a drug seeker try to fake an MI for the morphine. But then comes the sweet family that will never put you out even for a blanket as they are shivering.

No great stories from yesterday, I don't get many of those cases. But it's okay, it makes me appreciate those I see in the unit, that really need to be in the hospital and have something I can treat. Maybe some days I need to see that.

I Wonder

Some things have happened at my work, but I see them everywhere that have had me thinking. Do you believe what goes around comes around? Do you think when your boss, or their boss, or whoever, does wrong to a co-worker that it will come back to them?

I personally do. Sadly, many times I suspect they don't recognize what they are doing nor see when it happens to them. Of one I've heard the remark "she isn't happy unless she is beating on someone."

What a horrible way to live your life. I can't imagine being so unhappy that you have to treat your fellow man so. Makes me wonder....... The sad part is, most of these people claim to be Christians, yet you find no fruit in them.

Am I any better? I hope so, but then, I've come to realize I've treated one physician badly and must find a way to apologize that he would accept and in a way that would glorify my creator. I want to do it quietly, but I write this just to say that we need to be aware of our ownselves so that we don't become like these others. I don't want to be a bitter person that must belittle those around me. I really do want to be kind, gentle, exhibiting love and peace to all. What a calling.

I have devised a method of dividing people into classes that is slightly different based on an incident at work. There was a physician that I'm less than fond of. He walked into someone's office as I was sitting there and grabbed a piece of candy. Unfortunately he began choking on it (he survived, don't worry). The interesting thing here is that a) I didn't move, b) neither did the person sitting in the office with me.

Please note, I am a kind and gentle person. Known for my caring and loving attitude. I'm sure that had he not recoved BOTH of us would have saved him. However it was quite thought provoking.

The three types of people in the world:
1. The ones you would save
2. The ones you would save with enthusiasm
3. The ones you shut the door on.

Me and My Boss

Yeah, didn't do so good in friendly class, or kindgergarden.

Oops

I Can't Help It

I'm just stupid this way. I love the cartoon and they are better shared.

Cheers!!

(double click to read text)

I can't help it, just reminds me of people I know. I need a laugh, here's to you!!

Tired

I worked four days in a row, normally only three. I don't know what it is about me being charge that seems to bring out the forces of chaos that it does. The image I would like to project is one of quite harmony in the midst of madness... I'm not there yet.

Strange things happen when I'm charge, let me cite a few cases..... end of shift (18 bed unit) young woman comes in on a balloon pump as two other pts arrive that we had been waiting hours one. Balloon pump pt then needs to be turned completely over (pronation) to help her lungs. Madness!!!

Both my pts transferred out. I wait and wait on the two pts coming to me. First one: heart rate in 20's, being externally paced. No big deal. Which is good, #2 pt is young, the dreaded words "flu like symptoms", brought down to one of the units to prevent coding, now intubated but they decide to put in a balloon pump, after that he comes to me, after I get him they decide to do emergency surgery. This amounts to 40 minutes of hell while we get him, family, docs, lab, chaplain, paperwork ready. Oh, they brought #1 pt in right before this one hit my door, and oops, he's intubated but not sedated yet so there are a few issues that we need to deal with RIGHT NOW. Funny aside: one of the nurses that was tripled up kept saying as bad as his day was, at least he wasn't me!!

Anyway, that was fun. I shall work on my auora and see if that can improve things in the atmosphere. If not, maybe pray over a bag of NS and squirt it around the unit. :)

Irony

I had coffee the other day with the associate Pastor of our church. He's a nice guy, we rescued he and his family from the northern US to the south. I had some kind of response I was going to send him from work so I whipped out an email to his address at the church. His name is Chris..... I made a typo...... this is the response my server gave back......

christ@yourlocalchurch.org> no such user here

Another quickie: one of the docs I work with told me they had a guy helping them part time, he wasn't working out. One of the partners sent out an email telling about the problems and wrote "what a bozo." Unfortunately he sent it to the guy... needless to say they are looking for a new parttimer.

PETA

(to see in full size double click)

I love animals, I have many running around the inside of my house. However, I was moved to write today when I read the Pearls Before Swine cartoon for the day. It is not the one above, but I couldn't find it.

PETA, we all know the group.... People that Eat Tasty Animals..... they prowl around my house and wear down my resolve.

ENOUGH I say!!!! Okay, I can't even type this with a straight face...... I love to eat the animals, cows are my favorites, chickens are high up there.... I only wish I knew the creator of this strip, he is truly twisted.

Cats In Sinks

Found this site, after the last post, you probably need it.

catsinsinks.com

The Patient

Funny, he came in today, I don't know these people, but for some reason when the wife was giving the history to the doc something clicked in my brain. Now I've been doing this for several years and there's always some level that you connect with folks, but this was different.

Prior to the doc going in the room he told me there was only one thing more they could really do for this man. That would be to place a pacemaker in his heart. But basically that was it. The wife began telling the doc that only the top part of his heart worked, the back and the bottom were damaged severly in an earlier heart attack. He was being admitted because he was having V-tach (not a good sign for those that have no clue what I'm talking about - the pacer can shock him out of it).

So what, this happens all the time. I guess that's my point. It was almost like I could see me or my spouse or someone I love standing there matter of factly stating the facts. And the doc replied in kind. He was quite and gentle, but responded as she had with the facts. The facts in this case were basically "this is it, all we can do."

Why does it bother me? I don't know. Maybe it's two young ones that died, maybe it's the ones that "almost came to the unit" (a pediactric code today, a young mother - about a week after having her baby - that died, the ones I read about), maybe it's years of death, I don't know. Am I over the recent deaths, I would have to say no. What can make it better....... I don't know. I've talked until I'm sick of talking. I'm frustrated. Why did they die? Or maybe it was that I thought the one was going to make it and she didn't. Or maybe it's the fear that this man will code on me before we get the pacer and I will be inadequate to stop it. I think that may be it..... fear of being inadequate. I know I'm not in control, as I often say, these forces were in play long before we come onto the scence. Just as I am setting myself up for my health in 20 years, so were they. IT's that element of surprise - boom!! you're dead, hope I can save you! that is beginning to get to me now and then. Will I give the right drug, do the compressions right, etc that I wonder about. Will I see the signs before they code???? So much to do.

Sorry, this is way too long. This may be too much truth.

Working on the Photo Thang

Kid shot this the day we went on the field trip. He made one of the small local papers in the process.

More working on Photo's

Again working on the photo's...... son shot these as well.

Duh!!

Okay, I like the picture..... it's from Photobucket, I don't know the kid. I will one day figure out how to get more of my pictures on here so I don't feel like I'm robbing strangers.

I've had a headache, one of the nasty ones this morning. I wrote a couple of emails...... Those things should not happen together. Fortunately I didn't talk on the phone, no telling what I would have said. Just thought I would share........

My poor associate pastor, he should one day change his email address. Seems like when I have a headache I am more "truthful" or shall we say, less tactful, than other times. I checked the email, I think it was okay, but I did share more honestly in this request than I normally would have. What you say, shut up and go to the zoo....... take more drugs??? Good idea, later.

Babies

Some days things make sense, most days it doesn't. My work is so important to me, in some ways I've found that yes, it does define who I am. But some days I find that it leaves me without answers.

In the last two weeks there have been several young mothers die in our hospital. Two were in our unit, one as I was taking care of her. Then another died in another area. There were also several that got into trouble with their pregnancies but were able to resolve those issues.

Our hospital is large, and we are one of the best in the area. These deaths are not because they weren't getting good care, but because situationally these women were probably the "one in x number" that stuff happens to. This sentence sounds so flat though when you see it.

We are left with families that now have a baby with no momma. I didn't know all the dynamics to all the cases for the families and from my standpoint that's probablly a good thing. My imagination can fill in the blanks on that. I'm just dumbfounded that so much has happened.

Yes, I'm used to patients dying, it happens often. But they are usually people that have lived into their 60's or more. Now that I'm in my late 40's that doesn't sound old, but it's older than these women. It's different, and I'm not the only one that is having trouble with this. I find myself thinking about it a lot, what could we have done? Why did such normal illness go so bad in the pregnancy? Why ...fill in the blank? So what about the rest of the staff, is it just me? But I know it's not. We still talk about it. They feel the same thing.

Yesterday I skipped church, went to the nursery. I just wanted to be with babies. There were only two there, and I didn't get to fill my need totally, but I did have some relief. I need to cry. I recognize that need, but I have trained myself to not cry easily. One small tear ecked out with the baby, but someone came in and that stopped it. My fear, it will happen and I won't be able to control it. I will go off when I'm tired or mad and then it will come out and not be healing.

I was in nursing school when my dad died. One day in peds I was assigned a baby that was intolerate of food and his mother had returned to their home to care for other kids. The instructor wanted someone who would just hold and rock the baby. It was for both of us a good day. The only time I sat that baby down was for diaper changes. My instructor was a wise woman, she had clued me in before the others so I could get that assignment. Thanks!!

Babies are healing..... God gave them to us for hope. Hope for ourselves, hope for man, hope for the future. They smell good, and they respond to us. They are cute, cuddly and they need us. Touching them makes people smile. Holding them filles our hearts. And where is one when I need it.......

Dodge Ball

I've never seen the movie, but real life is interesting. Yesterday the males in the youth at church challenged the young married males to a round (or two) of dodge ball. I went to take pictures.

Males are interesting, yes I've known that for a long time but they still continue to fascinate me. Give them a ball and a challenge and they totally change. At work the day before one of the guys was explaining la crosse to me, I've never really seen a game but he used to play. It was interesting, the history of the game more than anything.

Dodge ball as I remembered was nothing like this. There was not only skill, but they set up traps. The youth were pretty well slaughtered, I think they anticipated an easy knock off, but it was not to be. Several of the guys were quite into it, I saw a lot of diving, jumping, etc. Oh, yes, I got hit. It was close several times, but one of the youth threw and I never saw that one. Seems the laws of physics don't bend because I'm female and not playing.

My son, oh my son. He is sooooooo one of them. If only he could move like that when he's here. I was quite impressed. I always knew he could smell like them, but seems he can blend with them well.

Of course what would be a gathering of males without the proverbial stuffing of one of them into the trash can. Actually they used some brotherly love because they didn't get this one too far in. However, sweat was applied to his face. At our church they call this bonding of males "NGL" or "non-gay love". The term was started by my #2 son at some male bonding experience. Actually this group is really good, and even though some of the guys have left the church they still maintain their relationships. All in all, it was great fun.

Time Out

As I said in my last post, I took the kid and we went to a local "mountain" and shot some photo's. This is a huge field filled with daffodils, about 3-4 acres I think. It was great fun, we both had cameras, both ended up on the ground shooting different angles. His photo's (and camera) are much better than mine, but the sunshine and just being free were great.

We then went to a boat dock and shot pictures of boats, water reflections and spider webs. Actually I just watched, my job was more to hold the lenses and make sure he didn't fall in.

It was peaceful....... okay except for the music. My general tendancy is to let him play his music when we are out. Christian rap isn't too bad, and I've almost stopped twitching......

Tomorrow is back to work, I love my job but we will be understaffed again. I went in to help for a few hours today and it was wild. The next three will be tough, but then again, I'm not the patient. I'll try Fat Doctors trick, see if pretending they are Jesus will help, but I suspect that will have it's own trauma.

Planning

Isn't planning a wonderful thing? The 2nd graders this week in my Sunday School class will learn how God planned the world. I made some plans this week..... they were good plans. I was going to take Patient X and Y so that I could work with my preceptee and spend quality time with her. Patient X was very sick, and with stuff we don't usually deal with. Pt Y was boring and no problem.

Any guesses what happened? Pt X resolved overnight many of the issues that would have made that case great. Pt Y on the other hand developed new and frantic issues. We had to go to CT, emergency surgery and another test. Guess which Pt the preceptee had...... guess how much time I got to spend with her...... guess how frustrated I was.

I probably should have changed her assignment, but Pt X was still interesting and there was no time to really teach on Pt Y. Besides, the surgeon was, well, how can I say it, "doesn't give warm fuzzies to nurses" and I really didn't want to run off my preceptee. Actually for him he was pretty nice, either he was still half asleep or feeling good about the case (as he should, perforated bowel got caught early, no real mess).

As bad of a time as we are having being short staffed and beat over the head about budget, and as sick as our pts are, we are actually doing pretty good. Our chaplain (chaplain the kid) is very close to us and usually picks up on who needs some extra support. I'm glad that the hospital has allowed us the support that we get from them, I can't imagine doing this without it.

That being said, the kid that I torture at home and I are going on a field trip today. Where? I don't care, I need a day away to renew my soul.

Too Young

She died today, early twenties, just had her first baby. She got to hold it, but doesn't know it. The baby will see pictures of her with the mom, but never know her. The family wasn't even functional enough to be classified dysfuntional. Live for today must have been the lifestyle, but I can't stand in judgement of her because she has paid for it. And now the baby will.

My unit is not a area where we see much of this, but as she died another rolled in, pregnant and on the vent. We pray for a better outcome. There's always hope, but always reality is too close.

****the baby in this picture is NOT the real baby...... this baby is from photobucket.com.....

Beam Me Up Scottie

So today at work one of the nurses walked around all day talking about how she just needed two weeks away at the beach. ALL DAY...... At times she didn't seem like she was even aware of us.

The boss handled it well. Took her a cup of water with a packet of salt in it and a picture of a family at the beach.

I gave her a candy bar.... Milky Way...... so she could dream of being on the beach at night and looking up at the stars...... We help each other that way.....

Myself, I've always wanted a holideck like they had in Star Trek. I'm not sure what I would want the most, this way I could use it often. Today would have been a nice day to use it. My top choices: riding horses through the day; fishing in a quiet area; the beach is good, like that one. So many choices, so little funds.

Tuckered Out

Have you ever been so tired you don't feel like talking, eating, or so tired you can't sleep. I worked last Thursday, Friday, and Saturday and have felt that way pretty much since. Saturday I went to see some friends that came in from out of town, I finally had to leave early. I usually am one of the last ones to go, not this time.

I'm fighting a cold, but also I think I'm just getting beat down. You know, you give, you give, and you give and it's never enough. We had a pt come down from the floor that had coded, no family could be found, when we finally did they wanted everything done. But then they weren't understanding that there was nothing we could really do. She was a very large woman, way over the classification for bariatric. It didn't change the way we cared for her, but it did frustrate our efforts to care for her.

I need renewal. I need to believe I'm making a difference somewhere. And the sad thing is, I'm one of the positive ones.

Why I Love My Job

Just another day in the unit. All was well, actually that's not true. We had a patient in one room that was there because he was seeing things we weren't. Another was having some wonderful family issues that administration had to be called for. One of my families told me all about the family issues the other family was having, only she wasn't getting much of the real story. And we had a couple of patients that were sicker than snot.

So we get a young one transferred in (young in our case is anything under 50). You got to watch the young ones, they go bad in a hurry. So she's in for one thing, doing kinda okay. But then she suddenly started hemorrhaging like crazy. Funny, she calls us in because she was "bleeding a little after she coughed a lot." That was an understatement! She is not here for this, she's here for shortness of breath. Our staff is fairly young, most had not seen anything like this so I was interested in their reactions. Now if I had known what we were getting into we would have worn gear to protect our clothes, but this was sudden. I had blood up to my elbows, one of the new ones got a little on her pants and went and changed clothes (before the patient went to the OR). Turns out the patient had coughed out stitches from a 2 week old surgery and that was what caused the bleeding.

It's in the hussle that you see who is going to survive the long term. Some of them stayed rooted to one spot, some looked confused, some got the light in their eyes that tells me they understand. When the patient started going into shock only one or two observed that and make the appropriate decisions. This happened at shift change, the pt's nurse stayed late that night to make sure everything went well, then she called to see how she did. And she did what I did, worried about "what did I miss" and "what else could I have done." She's a good nurse, and she will be better for the experience, once she processes it.

I worry about the ones that never understood how close this was or never catch on that they missed it. Earlier in the day I was frustrated with one that only went one pace, and he never tells me when he's in trouble. I can't help you if I don't know. But all in all, they are such a good crew and they really want to be better. We'll make it, and the patients will be fine.

Eats flies. Dates a pig. Hollywood star

I pass this everyday when I take my spouse to work. I LOVE it!!!! He is now walking around saying something about "first Eeyore with a detachable tail and now Kermit, I've married a five year old." He doesn't realize I was in the mall today, Eeyore and Kermit are a lot cheaper than the jewerly I like. I have VERY good taste.

We make life so complicated, it's not. Do unto others as you would have done unto you, work hard, play hard. Even God has a sense of humour, ever read about the talking donkey? And the fact that He picks the obscure tribe of Israel to have as His own? Besides, looking at many of the people in the "church" you would have to have a sense of humour to put up with them. So there's your mini-sermon of the day. Time for the diabetic to go make brownies. :)

Me in math class

There is very little to add to this. I can't claim the original, but I will say I have frustrated many an instructor.

There was the one that actually thought she could teach me the way. I explained that I knew they just made the stuff up and agreed on the rules so they would have a job. I passed, not sure how. I think for the same reason my current boss keeps me around: entertainment value.

Adventures of the Heart

30 years ago I would have been amazed to have seen where we are now. Who would have know that so much could happen. The kids, the parents, the jobs, the dogs....... everything.

I know my parents weren't sure we should marry. We were both 18, very idealistic, and yet very confident that this was what God wanted in our lives. I still believe it. Both my parents are gone now, but they both have told spouse in different ways how glad they were to have him in the family.

I'm not sure what his parents thought. I was not like them at all. I was from "town", they were not. I'm still different, but so is their son. His dad is gone now, I did truly love him, and I do love his mom.

Why are we still together? I don't know. It isn't easy living with me, I do feel for my spouse. But he will also tell you he isn't perfect. But he is kinda cute, and his heart is so loving. I don't know why he loves me, I would have given up long ago. The years have been tough. We've never had enough money, it seems like things are a struggle, but then we had our faith (well, until that got destroyed as well). But we have been blessed so much by what God has given us, we have wonderful children, we have a home (my parents left us a great place to raise kids), we are regaining our faith, and we have dogs that love us even when no one else does. Again, why are we together when so many around us are not, I don't know. But I'm glad we are. Happy Valentines Day

It seems like I have a ton of stuff to get done today and no one wants to cooperate. The kid doesn't focus on school, the dryer doesn't want to dry, the kid that was going to help me with transporting backed out........ I'm going no where fast.

It's not like I need help procrastinating. But I'm teaching CPR for the first time tonight and I need to prepare. The migraine last night didn't help. Oh well.

So, we shall see. He seems to be receptive to learning now..... biology, here we come!!!!!!

Harrison Snack

Harrison is a Burmese Mountain / Border Collie dog. He LOVES bunnies...... a lot. We kept a friends bunny for Easter Break, the bunny was a bit stressed. I don't know that the bunny was ever alone. Harrison stayed by the cage the whole time just begging to "please, please let me hold the bunny, please....." However when we did let him just smell the bunny he started drooling and snapping at the neck.

One of my friends just got her kids a couple of bunnys, Harrison wants to go visit. I told her that if the bunnys were bad Harrison would be happy to help. He's always sooo wiling to be a good friend. Anyway, so should you have a bunny that needs a little stress test, let Harrison know. He lives to serve.

Princess Bride

I find it hilarious how many people really love this movie. My youngest son (16) allowed me to look at his facebook page and I realized he had joined a group that states this is the greatest movie ever. We do movie quotes at work, this is one of the most popular. I have been loaning my copy of the DVD to others to get them up to speed.

How can it be?? Duh, have you seen it?? Pirates! True love!! Danger, giants, eels, Magic Max, so many wonderful elements.

Here is my question, what is your favorite part?? Myself, I have trouble deciding. I think I have to say the final duel between the prince and Wesley. But there is so much wonderful wordplay throughout the movie it is difficult to say.

This is my first attempt at adding a pic to my website. #1 son shot this pic at a park close to our house. Methinks it is copyrighted. I think he will let me use it (okay, I did ask first).

I kinda feel this way today, I've even thought about adding this image as my "official" pic, and I still may. Those that know me well will know there is something else that actually defines me, however, as Eeyore with a detactable tail sits beside me he says that right now he's not happy with the previous photos the boys have made. Maybe the next time spouse brings home the lights and backdrop for the boys to practice with.

You say - your boys practice with professional photography lights, well yes, don't yours?? Actually my living room, small as it is, is not bad for a make do studio. The boys have a GIANT poster (think 7" x 5") with a Narnia front and black back. It works. Their facebook pages have wonderful examples, but since I would prefer not everyone know exactly who I am.......

So lets post this and see what happens. If it works, I hope to make my site much more interesting. And actually, I do like the goose.......

Codes

The hospital I work in uses the unit I'm in and one other (as back up to us) for the "code blue" team. I tend to be an adrenaline junkie, so it suits me well now and then to go. There is one rule that I wish I could get established into protocol. When you pull the code button you reach over and drop the temperature of the room. Face it, little old ladies / men that code aren't going to mind if we cool down the room. Assuming we are able to be successful in reviving them, they will be transferred anyway. It's tough doing CPR at 100 compressions a minute when sweat is pouring off of you.

Codes on the floor are nothing like things you see on TV, in fact, they are nothing alike. Things are never where you need them, so many people in the room, you never know which people will show up, you never know what is going to happen. It's like an adventure everytime. Now in saying this, it's not to say things are bad, it's just not controlled the way that they show it on TV. A code in the ER or in the unit is much more controlled, we have everything set up, we are generally more prepared for "the worse case" than the floor is. The nature of the beast and all.

The last code I went to, one of the RN's was telling me I needed to give "high dose epi". I couldn't remember that being part of the ACLS but I looked anyway. I'm a bit insecure at times, I've only been out of school 5 years, these guys have more experience, so I attempted to do what he said. Later of course, I looked and we don't do that anymore. Another code, the RN kept giving me the wrong pads for the defibulator we had on the cart. She then went and got the right defibulator (instead of giving me the pads for the one on the cart) and still couldn't get it to work. Fortunately we were just "preparing" to shock and nowhere close to needing to use the stuff. My hospital only uses two types of equipment, I'm glad. Overall though, we do good work. I've never walked away from one of our codes saying that "if only......" Our mistakes tend to be in getting ahead of ourselves and not in what we are doing.

One day I would like to work for a short time somewhere else just to see how others do it. I mean totally away from this part of the country. I've pretty much always lived here, the southern mentality is probably affecting the way things are done and how people react. I've always wondered how end of life stuff is handled at other places.

The Brunch

The brunch went rather well (topic: Women's Heart Health), got lots of positive comments. We went with the concept that most folks really know the major details (don't smoke, exercise, lose weight, be perfect) so we highlighted things that we thought might be important. One was when you call 911, unlock the door. Men wait an average of 5.5 hours before presenting to a medical facility, women 6.4, both numbers are unacceptable. Every minute you wait could be heart muscle damaged.

We also thought that we would ask some questions, toss a piece of candy at the person that got it right. Now, I should have checked to see how well my partner can toss. I mentioned that we wanted no assault charges filed, but I didn't realize how close I was to reality. This gal is a girly girl. I'm more the baseball sports kinda girl. She "tossed" the candy but I think the ladies just weren't ready for it. I hope that's why it hit them. Anyway, they loved the talk. Hopefully some of it might actually pay off one day.

Now back to Super Bowl commercials, how I love them. Enjoy the day!!!!