New Things

Well, the Eagles said it best, they would reunite when Hell freezes over, hence the name of the return alblum. So we said about being part of a church that was just starting up, never again!! Yet, you feel a breeze here??? The church we had been attending fell apart earlier this year. There are still some people attending but it will never be the same. There are many things that could be said about it, but I've said a lot previously and there are people there that I still care about and I don't want to hurt them with anything that I might say that would offend them.

But the new thing, it's been fun. What!! Church fun! Yes, it's not all gnashing of teeth and naysaying. When you have a heart to love one another, to build up one another, it can be fun. Sure there will come a day when fun things aren't done, but for now we are enjoying one another and rejoicing in the freedom of Christ. It's a mix of people (a very small group - had it been a church split we would have more people) which I find encouraging.

So I hope this is a good thing. I hope we have as good of reception in this town as the Eagles did when they returned. Alas, I shan't hold my breath on that one, but you can always hope. I have hope again that I can look forward to going to church and survive. If this folds at some point, I can honestly say that I gave my all to it and trust that God is looking out for me.

Socially Acceptable

You ever watch a little kid that sucks their thumb and holds a blanket? Don't they look peaceful? Methinks I would very much right now like a blankey (or Eeyore with a detachable tail), lay on my tummy with my butt up in the air, and do the thumb thing. It was a horrible day and I don't want to go back.... ever would be fine.

Methinks it's not okay to tell the family that "if you really think I'm giving *&%$$# care then maybe you should come up here and check on it yourself!"

And I'm really trying to work on not using bad language, but when I was giving report to the floor today it just oozed out, not about the pt, it was that the "pink sheet" only I didn't say sheet, I replaced the double ee's with an i. A couple of nurses almost fell out laughing. Then walking across the floor my crocs did the normal tripping me thing.......

The day went downhill from there. I can't describe it all. Okay, maybe a little more for your consideration. I took my pt up to the floor, while tucking her in the bed I heard the staff in the room across the hall start yelling for help. Maybe I should mention that I'm on the code team when I'm charge, anyway, at least I didn't have to run. I was there, start to finish. Anyway, the woman didn't do too bad, we intubated and sent her to a unit. The timing was great.

Have I mentioned that I don't, do not, want to go back tomorrow. Maybe they will let me work in the ER. I'll die of overwork, but at least they won't yell at me like my staff did today. Wait, no complaining. Off to bed, maybe watching Monk will help. Night.

Encouraging Words

Our census is low. Very Low. Staff was worried.

"They will come, they will come
The snot will flow and they will come."

or when asked where all our patients were....

"they are at home resting up for their heart attacks
and distress"

If we are patient, they will come and be our patients.......

Us or Them

We've had a pt in the unit for several months now, he has been a good patient, however as it sometimes happens, we can't fix everything. The wife reminded me today, I was there the day he came in, that he shouldn't have survived the first day. That he has made it this long is either a testament to stubborness or tenancity. I'm not sure if it was good or bad.

He died at shift change.

The family was going to let him go tomorow, but sometimes God allows us to not make the decision. I really don't know that his wife could have handled it. I'm thankful that she doesn't have to walk down that road. Funny, we were going to call her and tell her that we were worried when she wasn't there today, and she walked in as the nurse was calling her cell phone. We all hugged her, we knew the time was coming, just not sure when. The nurses were at the bedside, day shift and night shift together to bid him farewell and to go on. We all knew that it would be better for him, all that met this man knew he was a special person. I'm proud to have cared for him and the family.

As the wife hugged me, it hit me: are we comforting them, or they us?

"I Used To Do Drugs, I Still Do, But I Used To Too"

However, these days the drugs are Maalox, Crestor, and Metformin. Mitch Hedberg is one of the funniest comics I've ever heard. Sadly, he died a few months ago, heart condition. Mitch is not for the ones with virgin ears, he comes out of the drug culture, similar to how I feel about Cheech and Chong.

Last weekend I watch a bunch of stuff on TV about rock culture and the drug years of the 60's and 70's. I found that it brought back memories and feelings that I would rather not be reminded of. At my advanced age, I probably dwell to much on what might have been. Sometimes I feel like I'm two different people. There are days I would love to sit in a dark room, drink Crown and listen to Pink Floyd or Clapton doing the blues. Then there are the days that I am devoted to reading the Bible and music that is along that genre. Can the two co-habitate? Methinks yes, but then I feel guilty about that. But then, by the time I went and bought the crown and found the CD the mood would probably pass, and finding a quite place in the house is almost nonexistant. Oh well. I could eat Ben and Jerry's and stare at the fish......... Almost the same effect and about the same level of sin for me. (not the fish, the ice cream)

Thinking of the fish, maybe I'm like my neons, one of them is always away from the others... did they push him away, is he thinking, does he want to be friends with the angel tetras? So many things to wonder.

Diversity

Went to a Hispanic grocery store today. Methinks I was the only caucasian in the place. It was most interesting, beautiful layout, the various rows of peppers, vegatables, bins of beans. It was very interesting. As I walked the aisles I remembered once when my youngest was a newborn. I had signed my other boys up for swimming lessons at the only place I could really afford at the time. It was at an inner city YMCA. We were the only white people there and all the little girls would come up to the baby and want to touch him. It was really sweet. Once I asked the three year old if he noticed anything different about his instructor (I was actually inquiring about his name "Boo") but I was pleased that his answer was that Boo's swimming suit was green.

Alas, I didn't buy much there. I realized (yeah, it was my inner blond coming out) that I wasn't finding what I wanted to cook for my stirfry at the hispanic store. I just chalked this one up to exploration, but I know where to find the best peppers in town.

Duh

Prior to giving a shot to a twenty year old: You gonna stab me with that!!!!!

Dumb look on my face: Yeah.

Aren't you gonna push it in slow???

Flat expression: I can, but it will hurt a whole lot more.

I.... I ..... I guess let me look away before you stab me.

Sadly enough, I did stab her (so to speak) and she basically didn't feel it. It was only a tetnus shot, nothing like an antibiotic that actually would hurt. Good Grief, get out of my ER.

Joy

Thanks Fat Doctor for sharing this. After a hard day at work (or whereever) this is good.

The Waiting Room

Had to go to the breast surgeon today. The year after my mother died I had my baseline mammogram which showed a lump. This was properly disposed of a month later (Christmas holidays were rough that year) with a laser procedure. I now have yearly checkups with him. The funny thing with this doc is the routine: hug, grope, grope, hug. Now the grope is a very professional grope, he is well respected but if you have my sense of humour, well, what can I say. (All was well, by the well, same time next year).

I watch people: the waiting room had a mix of folks: those like me, by themselves, confident everything is fine; those with several support people that you know are not calm about this visit, and those kinda in between - scared but alone or not alone but maybe doing okay.

Waiting rooms are tense places, when I walk through the waiting room early in the morning to say hello to the guest reps the families look up but pay no mind. They know with my backpack on that I'm just another person. Later, should I walk out there, all eyes are on me. They look afraid: who will she pick? is it bad? Reminds me of the herd of animals with the lion picking one out. The other animals are running, no one stands by the one picked out. You feel the eyes on you, they all watch, even if they know they have never seen me in the unit they are in, they all watch.

I've forgotten about it before and gone out to see someone I knew, but not well. They were afraid when I came out and I forgot to ease the tension (family had no idea) until a few minutes passed. I felt bad. Anyway, interesting to watch.

The Party

Went to a surprise party tonight, the guy was actually surprised! It was a lot of the people from the church, whatever our church is now. One of my favourite things is watching people, and watching the other people watchers in the group. Example, the host of the group watches from across the room, and I loved watching his reactions to the folks. It was quite a mix of folks, and they know about the blog so this could be interesting.

The seniors that aren't that senior. Agewise, maybe, but I don't really see a seperation in us. They have more life experience, and when the karoke machine came out they went with a different group of songs (Beautiful Doll, When the Saints Go Marching In). But they sang early on and laughed at it and at us. The church had really been blessed with an awesome group of older folks, some of the ones I knew better have gone on to be with Jesus, and I wonder often had some of them been here if the church would have had some of the problems it does. I don't think so. Anyway, this is a fun lot that can teach us a lot.

The mids: I think that's me and a few others. One is particuarly interesting to me: she is surrounded by males, and she looks like she should have had girls to be on her side. At times she seems frail yet she keeps them in line. I actually came to know her more because her father, like mine, died in the unit I work in. I forget that at times when I laugh about being the angel of death, or at some of the things, but I think I did her right when her dad was a patient. This group has people that are serious about following the Lord and about doing things right. Yet they can have fun in a good way.

This group, including the ones that weren't there tonight, has come together out of necessity. They have quickly merged into people of action. I'm interested to see how this will work out. I hope that the relationships will last though.

Kids!!!

Don't ya love them??? Continuing sources of entertainment. My guys are 23, 20, and 17. All boys, all boy. I have found that if I just stay around them, hanging, I learn more about my kids than I could any other way. Picture this, one border collie being held facing forward by one boy, another tossing the ball to the dog for her to catch. Another is discussing why they should get a penguin as opposed to a weasel. I'm in shock at this point. Then they talk about how they could put a shark in my new aquarium to eat my tetras...... oh yeah, just kidding mom.

I'm talking about painting the house, they don't care what colour I paint their rooms, one just points at the colour chart while not looking! I don't get it..... They just want it done quickly so I'm not in their way.

I also was listening to them describe homeschool to someone. Basically they focused on how the youngest one always has one of the animals in his possession during school. The dog "answers" the questions the cat is usually forced to dance around. Could explain why the cat is so unhappy during the school year.

And yet I know I will miss them when they move out.

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????