Regret
I don’t spend a lot of time regretting the things I’ve done. it’s not to say I didn’t learn from them, but I don’t think it’s good to dwell on what could have been. Because it isn’t.
But occasionally something does come up that stays on my mind for a while. When i was working as a nurse on the floor, I had a patient. With Cancer. I know you knew that, but in case you didn’t. He was a very kind man. He has a little OCD about him but I don’t mind. I can manage that in a patient.
We transplanted him. He relapsed.
After that I was doing that job I didn’t get, as a coordinator. I saw him more. He came by my office. We talked on the phone. He brought me cookies. Peanut butter. I printed him test results. He was always very thankful. I always told him it was no big deal. I would take all of his phone calls. I even let him call my cell phone. I read those test results. It was the least I could do.
A couple weeks ago, I was walking past patient rooms on the floor looking for someone to give something to…I was in my new job. As educator. My mind, these days, is filled with to do lists, projects and plans and meetings. Upcoming lectures, forms to make, policies to write. I have been very busy. I passed a room and out of the corner of my eye I saw him lying in a bed. I stopped and waved. He was facing me but didn’t wave back. Then I thought, maybe that wasn’t him. I was in a hurry so I continued on.
The other day I found out that he died last week.
I wish I had stopped to talk.
I. Am. Awesome.
It’s my blog so I get to say that. And even though I am sick, this post can read like I am totally peppy. Which I am not. In fact I am typing each letter extremely slow because I used all my energy to buy OJ, soup and tea at the store. In the rain. While sick. You can see why that took so much energy.
I realized that you don’t see me mouth breathing, like those poor cashiers, and you don’t have to cringe at all the nose blowing I do and then worry about what I have touched. You can just enjoy my awesomeness.
Because that’s what I am.
Why? Why am I awesome? Well if you have to ask, I guess I can fill you in. Although I did not get the superfantablulous job, I have gotten a lot of really nice words. And potential other jobs. They offered me the girl who got the job’s job and I turned it down. I know, who turns down jobs in this economy? Me.
But in the week since I turned it down I have had conversations with Doctors, managers, co-workers all saying awesome things like:
“I have been watching you do this job and you are really good at it.”
“I wanted to make sure you didn’t take that other job. I think it’s not right for you. You would do better working with me.”
“Dr. So and So thinks you should be an educator for the staff.”
“How about being the manager, have you ever considered that?” (Yes I have. And the answer is No thanks.)
I spoke with (the nursing director of the hospital) about an education job and she should be calling you soon.”
“How are you doing? Have you ever thought about management?”
“When (girl who got the job) worked with us, she never got things done. You always get back to me so quick. Why did they pick her?”
I know, that last one irks you. Me too. But what are you going to do. Unions and seniority and crap. She isn’t even planning on staying. But whatever, I have been enjoying all the appreciation I have gotten. At my last hospital, appreciation wasn’t plentiful. But complaints were.
I don’t know if someone is going to call me soon. I don’t know what will happen. But I did get called for an interview to teach Nursing at a community college. And I went. In the rain. Yesterday. We will see what happens. Either way. I am awesome.
Life Support
I haven’t talked about work much because of the busy-ness…but hey, it’s Tuesday. Cancer it is.
The last few weeks have been challenging at work. The kinds of challenges I have been thinking about are the monotony of doing the same thing every day, and how sick all of my patients have been. It seems like every day I do pretty repetitive stuff. Blood transfusions, antibiotics, chemo, go home, come back and do it all over again. But last week I got a patient I had taken care of in January. A family man with a wife, grown kids and grandchildren. He was a total OC republican, fox news watching, Sarah Palin lovin guy. And I respectfully disagreed with him. We got along great despite our differences and h was a fan of me. He even tried to tell me I should be a doctor, because I am so smart. I explained to him smart nurses are pretty important. Some people don’t get that nursing is it’s own unique science. You can get a doctorate in Nursing. We joked, we talked, and I lectured (kindly) on how he should take good care of himself at home.
I didn’t see him again until two weeks ago.
I am no good with names. I’ll be honest. The number of patients I have seen over 6 years, I don’t recall all of their names. I am better with faces and unique personality features. Tell me they’re the one who only took pills with chocolate milk. Or that he was the kid who wanted to be a magician. Those are the things that stick in my head. When I got report, I didn’t remember him. There was that vague, this name is kind of familiar feeling. But it wasn’t a very unique name, so I didn’t think much of it.
I walked into the room and started talking about my plan for the day. Hi, I am Lisa, I am your nurse, and so on….This patient was pretty sick. I knew my day was going to be busy from report. And right away I had to turn the patient with assistance because he was too weak to turn himself. I was thinking to my self this guy is so sick. He probably won’t do well. I know that’s a vague description, but to be specific would take up space. Let’s just say he had tube placed every place you can have it; he was weak, fragile and edematous. Lab tests were getting worse. And he wasn’t young and healthy to start with.
Just as I left the room, it dawned on me. This was the same guy I had before. I knew him. I knew him walking and talking. I knew him with no edema and more muscle. He was drastically different. It’s weird how I can take care of someone very ill with empathy and compassion but not think too hard about who they were when they were healthy. As soon as I remembered him and that healthier version came into my mind, I was sad.
I went right back in and asked if he remembered me. He did. He couldn’t talk very loud and had a tube in his nose for nutrition and medication. We talked a minute but then he had to go for a test and procedure.
While he was gone, I asked the doctors what happened to him. Why did he get so ill? And then I heard an overhead page. Code Blue. In the location of his test. It was him.
Last Thursday, when I got off work I went to the ICU. I sat with his wife and his kids as they tried to say goodbye and to end life support. They cried and made jokes and hugged. They procrastinated in doing what they had come to do, trying to have a few more moments with him. I came, because I had heard that was what they were doing. And I knew they would be doing with strangers. Nurses, who are kind and competent, but strangers nonetheless. Not the ones who had known him before. I thought his family ought to know that this moment, this very difficult moment was felt by the people who had cared for him. When I was leaving, I though about the way this family communicated and the way they supported each other in that difficult moment. They hugged, held hands and gave eachother space to say goodbye. I was so grateful to have been in a room filled with so much love and support.
Call Me A Hypocrite
Waiting for a job like you
I told my sister I had a job offer coming in the mail soon from a University Hospital. To which she replied “Are you going to be one of those job hopping people?” She meant it negatively but I thought to myself: Only in my dreams. Only in my dreams could I hop from place to place until I find somewhere I want to spend the next four years. But really, four years-hell, one year seems long. Really Long.
Sunday Bloody Sunday
OK, it was actually Saturday and NOT Sunday, but I couldn’t resist that title when it popped into my head. Saturday morning at our house was an episode straight out of CSI (a Dog Whisperer episode) at our house. Will and I woke to go about our usual morning which includes opening and closing the back door 25000 times to let the dogs out and then back in. Because our dogs have ADD. OR very very small bladders. I’d say it was BPH, but Heidi is the one who barks next to the back door the most, and she hasn’t got a prostate. Actually, I don’t even know if dogs have a prostate. Do they?
The In & Out usually starts at 6 am, but if I am home I stay in bed to avoid it. I crawl out of bed for my morning cereal (Yes, that is what we eat every morning. Except Elisabeth, who can only eat carbs in the form of toast or waffles) and join in the annoying game of DRIVE LISA AND WILL CRAZY BY OPENING THE BACK DOOR A LOT. Most days I barely notice it. I just open door on auto pilot. That is specifically related to the ability of parents to ignore their children crying and yelling. After a while all parents learn this skill, which is why they can call you and talk to you on the phone with that screechy kid in the background. All of those parenting skills easily transfer to annoying dogs with pea-sized bladders.
This Saturday, however, was thrown off course when my husband noticed blood on the laundry room cabinet. Which immediately grossed him out despite the fact that he is a nurse. He even said Eww. Gross. I know what he was thinking. He was thinking of the hell that he has come to know with two girls who menstruate plus one dog who likes to dig articles out of the trash. There has been several occasions in which we have come home to find our vampire dog, Cesar, has taken all of the trash from the bathroom and spread it across the floor. He doesn’t just spread it on the floor, he rips it into pieces. Pieces of overnight with wings that have been used. And he usually chooses the carpet to arrange his Hanibal art. Will refuses to clean those messes up. He has a close to vomiting aversion to that specific kind of mess. So when he pointed out the blood on the cabinets, I am pretty sure he was starting to retch.
But soon we discovered that there was blood ALL OVER OUR HOUSE. All on the walls, the floor, in the laundry room, the kitchen and the dinning room. All at dog level. So of course we made sure our kids were alive and not bloody. And then we examined the splatter trajectory like a forensics team investigating a crime scene. We concluded that all the blood was at dog level so it must be the dogs. Katie reported she had heard a yelp or a whine early this morning from outside. We, knowing Heidi’s nature, began searching for a dead animal.
A few weeks back Will had found a dead lizard in the laundry room. And one time we found Heidi playing with an injured bat behind a chair. We were convinced she had done something gruesome. Just to be sure though, I had Will go outside and check the dogs while I started the cleanup process. All the blood was in splattered drops and not smears or puddles and not in large amounts. Will reported that the dogs were fine.
After cleaning the walls and floor, we did what any investigators would do. We asked ourselves what do we know? And then my husband looked out the back window and noticed that Heidi’s tail was bleeding. Which was why the blood was splattered. Because Heidi was walking through the house wagging her tail and splattering blood all over our house.
Like good nurses we cleaned her tail and saw she had a one inch long cut. We dressed it with gauze which fell of two seconds later. The we wrapped it in coban, which was heavy and made her tail drag. Which made her try to pull it off with her teeth. Finally we got the dressing right. We still don’t know what happened in the backyard that cut her, but not once has she whined while we changed her dressing and reapplied neosporin. She’s a good patient.
All of my patients smell
It’s not their fault.
Sort of. I mean…I feel guilty for saying that. I hate complaining about my patients. I hate to think of people going to the hospital and worrying about what their nurse thinks of them.
But it’s true. At the GOV’T hospital, they smell more. They have little to no money. Which can be directly correlated to poor health insurance. And quality dental care. I have had so many patients with missing teeth, rotted teeth and some SERIOUS halitosis (which is the way we nurses say bad breath). And yesterday was exceptionally bad.
I have to tell you I have super smell. I really do. And my very acute sense picks up on subtle changes before anyone else. I’ll smell something burning in the oven before other people pick up on it. I used to smell skunk through the vents at my old job (although I am highly attuned to that smell in particular because of my murderous dog) at least 5 minutes before everyone else would notice. And that is another reason why I hate close talkers, because I don’t want to smell their breath. And I will.
And yesterday my bionic smell almost made me puke in my patients room. It’s started with a trach cleaning (which..gag..I hate) and ended with me trying to hold my breath, wipe the tears from my eyes and get out without gagging in his face. And I felt so awful about it. But the thing is, cancer smells bad. Especially cancerous phlegm and bad teeth. I don’t know if you knew that, but it does.
After work I went to Trader Joe’s and I could help but wonder if everyone could smell the cancer breath on me. Because I could still smell it. Ugh. I wanted a shower but I really had to stop for stuff for dinner. And the guy at the check out said to me “You look tired.”
I told him I was. He asked me what I do, and I told him I was a nurse.
“My girlfriends doing that right now, going to nursing school. Do you like it?” he asked.
And ignoring the rotten phlegm smell I smiled and said I do. I told the rewards for helping people were worth it. He smiled back, handed me my falafel and hummus, and said have a good day.
I hope he knows I meant it.
Every Job Has Perks Right?
Work in retail, get a discount. Work in food service, get free food. People get hooked up all the time with jobs or even just knowing some one who has a particular job. We have a friend who does mortgages (sux for him now…) and we went house shopping we went to him. He kept us out of those 8-armed crazy octopus loans that would have killed us by now. We got a fixed interest rate back when it was the unpopular thing to do. It’s all about who you know.
So what’s the perk of nursing? I guess drug company sponsored dinners, free pens and canvas totes. That’s for me. And for people who know me. No perk. No hook up on discounted chemo or cheap drugs (sorry DPH). But my husband, the research nurse, he’s had all kinds of perks.
Even before he was a research nurse we got perks. He knew all the surgeons, anesthesiologists, and ER docs. When we went to the ER we never had more than a 2 hour wait. Sound like a long time, but it was usually less than one hour. And the doctors always give him this waiver of fees so we don’t have to pay the physician’s bill, just the hospital bill.
Now with research we have enjoyed dinners at places like Ruth’s Chris and free tickets to hockey and basketball games (including Lakers finals tickets). But I have been waiting. You see all the research he does is for perioperative pain medication. Pain medicine for surgery. The people in the study usually get their surgery paid for. Bunionectomies, hernia repair…and finally this summer LIPOSUCTION.
I begged him to get me in. Please, please please hook me up. These thighs are like giant logs. They need help. Turns out families of employees can’t be in the study. It’s like, unethical or something. So I can’t get lipo for free. But you may be able to in June or July. If you want to, let me know and I will give you the info.
The Medically Underserved
So I haven’t talked to you about my new job yet.
But you haven’t asked, so I am guessing your not so interested.
Oh well.
I am working at GOVERNMENT facility now. When I say government, that includes county hospitals, mental health facilities and clinics; VA facilities, state correctional facilities and jails. All of these places hire nurses. And all of these places have care for people who kind of have to be there. Be it insurance or lack of, being a jail or prison inmate, or being a veteran. I don’t say that because all the patients hate it, but you have to be aware of the fact that they are stuck in a system and that system comes with certain, um, frustrations.
There is a reason why people complain about bureaucracy. But it doesn’t mean it shouldn’t exist at all….but that’s a whole ‘nother Oprah. Recently DPH said I have some good stories at my new job. And she’s right, they are. But I want you to know, I tell you things because they’re people. People who need health care, no matter what their situation. And that’s what being in Nursing is about. I hope you all get the kind of nurse who remembers that when you go to the hospital.
In my first month at the GOVERNMENT Hospital:
My first day on the floor a patient coded. But it was the most organized code I ever saw.
I almost puked because my pt kept shoving a basin full of saliva and phlegm in front of me telling me to look at in Spanish. And I usually have a strong stomach at work. But it was sloshing…
I’ve drawn blood. With a needle. Something I haven’t done in 4 1/2 years. And it went well.
I had a patient yell at me to get out and never come back. And that was when I went to introduce myself at the beginning of my shift.
And just the other day I saw a patient on a 72 hour hold try to sneak out and when the special team (for psych emergencies) caught him he started yelling “I. Don’t. Need. Your. Medicine.”
Let’s say it’s never a dull moment. And it’s entirely different then the last 4 1/2 years. And 8 hours go by so fast. And sleep is great.
I’m no Nurse Ratchet.
Really I am not.
And I hated my psych rotation. For the exact same reason I loved cancer and AIDS and the complex, life changing diagnosis, I hated psych. Psych is difficult and there is no easy fix. All those theories from Freud, Maslow, Erickson…maybe you would be OK but your mom abandoned you and you never got through the trust-mistrust thing all right. Or maybe it’s the chemicals in your brain. And maybe you need medication and that could take years to find the right combination. But I am just trying to listen to you objectively and make sense of what your saying, but with your flight of ideas…I am getting lost. And now your sitting too close and I feel really uncomfortable. All I can think about is how your missing two teeth right there in front and your talking about how you learned the electric slide in sixth grade and those were the days.
A lot of people say you have to be a little crazy to be a psych nurse.
I am going to disagree. I think I recognize my limitations and the fact that my mental state isn’t strong enough for psych nursing. Because talking to those people, it’s kind of like talking to members of my family. Sure it helps me relate sometimes, but it also helps me get really impatient really quick.
Anyways, just because I am not a psych nurse doesn’t mean I don’t have to deal with psych issues. Let me remind you of the sickle cell patient who hoards. Or how about another one we had, who was an adult. Kevin. He should have been off our service and into an adult service, but he was still being seen by our doctors. We wondered if he would get lost in an adult service and end up homeless. He was six feet tall and kinda scary. Like any good psych patient. The first time I had him he was in the teen room when I came on shift. Lived from foster home to foster home. He was 18 and played the guitar. When I came into the teen room because his IV was beeping occluded (because he was playing guitar and it was kinked), he said very sharply to me I don’t like people sneaking up on me. And trust me, I couldn’t sneak up on a table. I am clumsy.
The songs Kevin wrote were all about death and destruction. And he refused to lay down. Refused. He would fall asleep sitting up. And one night he fell asleep standing up and chipped his teeth. Everyone tried so many ways to get him evaluated and treated. But he refused any psych treatment. He just wanted his days of pain meds until his crisis was over and then he would leave. I think he was kind of fond of us though. He invited us to hear him play at a coffee shop. I never went though. Because I have a fear of six foot tall psych patients. I know, your thinking I am perpetuating a stigma. I am not helping the face of mental illness. And your right. Which is why I should never be in that field.
Last time I saw him, we had to call security on him. He was in a corner room demanding more pain meds. The on call doctor said he had been told to only give him oral meds. When the nurse went to tell him his options he was furious. He started banging his head backwards onto the headboard screaming. The nurse came out pissed and said Call Security! This is a pediatric floor. This is ridiculous.
Some days with the difficult bone marrow transplant patients, the dying we remind ourselves of Kevin. And we kind of miss him.
If you are a psych nurse, way to go. Thanks for taking that job so I don’t have to.
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