First impressions...?
I don't know if I could be a Home Health nurse -- although I admire these people greatly. I consider them angels walking on earth after today. It may be too early to decide, since today was only my first experience with it, but this is how I feel so far. I spent the day in the hood, going in and out of rundown row houses, next to condemned buildings on either side, and in and out of the projects. This may be influencing my decision not to enter the home health side of nursing, or...
It could be because of what happened last night.
(If you are at all skittish about bugs, don't read any further. I know I wouldn't...)
My dorm room has a history. It has been known to have more complaints than average because of cockroaches. (Because I am right across the hall from the bathroom, the Environmental Services people tell me the bugs sometimes crawl out of the drain in the floor, where they have been poisoned, and then wander into my room to die a slow death.) I may have scrapped the Nursing School Idea if I had known this from the start. I had a couple run-ins last year. Last night topped those.
I was just getting off the phone, lounging on my bed and thinking about my big day ahead. Then, in my peripheral vision I noticed something dark and moving by my leg. Luckily my legs had jeans on them, because my brain stem registered it was a 2-inch long cockroach and had me flying out of bed before that thought even reached my conscious mind. I literally teleported myself into the hallway. (This probably would have happened whether I was wearing clothes or not. I was not in control of my body.)
Whenever I panic about a giant bug in my room, I have trained myself to keep my eyes on it even as I exit the premises, because the worst thing would be Not To Know Where It Is. That would make the place INHABITABLE. It must be vanquished before the place can be occupied once more. So as I was airborne I saw it run up my mattress and disappear behind the head of my bed into the darkness. Vanished. (I think it saw me freak out, and then it freaked out.)
Giant Cockroach = 1...Me = Zero.
I stood in the hall staring into the room already spending the $150 on a hotel for the night because there was NO WAY I would be able to share the room with him. A savvy RA dialed my buddy who lives on the men's floor downstairs and he came rushing to the rescue. The bug crawled out from under my door and there was a loud and noisy battle with a number of large objects used as weapons. It took a long time (probably just seconds) and there was much squealing (mine). The bug said nothing, but me and the girls made a big ruckus.
Giant Cockroach = Zero...Me = a million.
After this ordeal, I wasn't quite ready to re-enter my room and went downstairs to make a call. By now it was the middle of the night. An hour later I skittishly came back up. Wouldn't you know it, there was ANOTHER ROACH lying dead in the middle of the floor! After the initial shock, I squinted at him and just knew he was faking it. Playing possum. I stormed out to get the broom and sweep him out, and when I began -- he revived and began zig zagging around. I WAS READY FOR HIM. I got him out in the hall, and like an NHL player -- I made a big slap-shot and sent him flying to the end of the hall. He immediately flipped over onto his back again and resumed dying. (That had been his big finale.) He remained dead in the hall until another less squeamish student came home and killed him again...just to be sure.
2nd Cockroach = Zero. My nerves = Zero.
I calculated the odds of seeing more bugs in my room as being unlikely (since I only saw 3 of them all last year). I know that logic was faulty, but my brain was enacting protective measures, since I needed to sleep somehow. I decided to take a sleeping pill and consoled myself that at least I'd be unconscious if they decided to crawl all over me in my sleep. Somehow this worked and I got 4 hours sleep last night before clinicals today. (It was an effing miracle.)
(What I really should have done is set a match to this room and let it burn.)
Wouldn't you know it? Today my nurse's territory was in the slums! The odds of running into roaches and other vermin were high...as I was very aware. Some of the places were so skeevy I wanted to douse myself in clorhexidine upon exiting. The patients were all so sweet and my heart broke that they were alone in these awful places. The home health nurse is sometimes the only soul they see for days, so they love to chat. I sat, nodding politely to their ramblings, clutching my bag (since I was warned to Set Nothing on the Floor) and checked the surfaces for roaches -- which I imagined were everywhere. (Clearly I had developed PTSD from last night's events.) I was like a deep-cover CIA agent scanning the room for potential terrorists.
There was one old guy whose home smelled strongly of urine. (Turns out he pees in a bucket in the kitchen so he doesn't have to attempt the stairs to the bathroom). Regardless, he was the nicest fellow ever, and very chatty. I was on high alert in his place (for bugs) because of the condition of the place. I wanted to weep for him. Well into our visit, I had been lulled into some comfort, since my initial checks said there were no bugs in my immediate presence, and I was falling in love with this patient. Then out of nowhere he yelled and pointed at the coffee table! The nurse kind of glanced at him (she has known him for months) -- but me...? I jumped out of my skin thinking "ROACH" and my feet flew up off the ground, my hands kind of covered my head, like someone had yelled "BOMB!" (I am happy to report I did not squeal.) Turns out the guy had just forgotten to point out some paperwork the nurse needed to see, and that's how he decided to communicate.
In the meantime I developed an arrhythmia.
I told my nurse all about the roach incident the night before, and she laughed and laughed and then told me all sorts of horror stories about the big ones she's seen in the homes. This did nothing to comfort me as we continued our visits for the day I can tell you.
Otherwise...I enjoyed my day. And, I'm going back in tomorrow. I only wish I could bring my broom with me.
Tuesday, November 13, 2012
Saturday, November 10, 2012
T-Boned
There’s that time in any action movie when things are going along nicely for our characters and then, in slow motion, a car crashes in on them from the side. Classic T-bone. Nursing school is hard enough without your personal life exploding in your face like mine did this fall.
Before my crisis happened I had seen examples of them in the lives of other nursing students around me. I had shaken my head, wondering how they were pulling through a tough program despite the challenges they faced— some just temporary bumps in the road, and others, life changing events. Maybe the unifying theme I’m uncovering is this: nurses are a gritty, determined lot. I think of nursing often in terms of warfare: bombs are going off all around, and there’s this soldier ignoring all of that to bandage a wound and make their patient safe for transport. Maybe the same person who can do that, can take a hit from life and still finish a nursing program.
At least that’s what I’ve observed so far.
Exhibit A: Vomiting up a Lung. It takes days to prepare to write a nursing exam, but of course the day before the exam is usually the most intensive. A friend of mine was missing from our study group that day, so I went looking for her. As I approached her room, the smell of vomit wafted through the hall. Turns out she had thrown up a dozen times that day and was dozing in between spells. No way she’d be able to study for the exam! Of course she could call in sick and the school would allow her to make it up the following week...but there was already an exam scheduled for that week too. Writing 2 exams in one week would be unthinkable. I didn’t see any other way, but clearly she did. She continued to be sick all night. Woke up in the morning. Threw up. Dragged herself to the exam. Passed it. And then ran and threw up some more.
I was astonished.
Exhibit B: That Baseball Knocked The Sense Right Outta You. Another exam, another study buddy came in with an impressive shiner. Into the evening he was falling asleep on his books and admitted he had been feeling nauseous and sleepy since a fastball connected with his eye socket. (Clearly he had a concussion.) The mother in me was alarmed...and I immediately offered to walk him across to the the emergency room and study with him there all night if he would just GO and get LOOKED AT. The tough bastard declined and with brute force he made it to the exam the next day.
I wanted to wring. his. stubborn. neck!
(You may have learned by now that nursing students would rather lose a LIMB than postpone an exam.)
It was my turn this fall when my personal life came crashing down around me. Suddenly I was on a plane home, missing school and our first exam to tend to a crisis. I won’t go into the sordid details because they are private, but I will say this is something I wouldn’t wish on anyone. Also, it had a ripple effect which followed me back to school and required hours of my attention and mental resources to help keep things on track. I failed the next 3 exams. Going into the final, I was only passing the class by 1 point. People around me and back home were praying along with me that I would somehow pull a high enough grade on the final to pass the course...which I was able to do.
It was a real nail-biter.
The emotional toll was high and I was reminded that there is NO WAY I could be doing this thing alone. Back in the wartime analogy, I felt like I had been shot and was bleeding out on the beach. Instead of letting me perish, my buddies came back at great risk to themselves and dragged me to safety.
God places people strategically around us and I have never believed that more than I do now.
And while I would never invite crisis, it did teach me something. How to ask for help. I have always liked to be the one to rally around someone and be the helper. I’m good in a jam and that’s probably why I am drawn to nursing. I’m not good at having the situation reversed. Being helpless. Powerless. Admitting that to others is so humbling. But letting people you love in, and trusting them to care for you is special too. My relationships are being redefined and reexamined because of what happened. I am thankful for that.
Its such a cliche but now its time to Pay It Forward. I got back to school after break and already there are opportunities to serve others all around me. Its so energizing to take the focus off of myself and do what I can for someone else. I look forward once again to seeing my patients. I miss them during every break.
Going into the new term I have a new theme! Recently, a friend posted a clip from a Rocky movie on Facebook and stated he recognized God in it. Ordinarily I would have cruised right past that but I was intrigued by his claim and had to watch it. I think my friend was right. What do you think?
“The world will beat you to your knees and keep you there permanently if you let it...Nobody is gonna hit as hard as life. It ain’t about how hard you hit, its about how hard you can get hit and keep moving forward. That’s how WINNING is done!”
I was never much for Stallone, but these words hit me right where I live right now.
So its a new term and a new beginning. I have fresh optimism and renewed energy for the fight. Only two more 10-week academic terms, followed by my preceptorship. I see the finish line and that keeps me going.
Who are we kidding? God is carrying me along. He has been the whole time.
Before my crisis happened I had seen examples of them in the lives of other nursing students around me. I had shaken my head, wondering how they were pulling through a tough program despite the challenges they faced— some just temporary bumps in the road, and others, life changing events. Maybe the unifying theme I’m uncovering is this: nurses are a gritty, determined lot. I think of nursing often in terms of warfare: bombs are going off all around, and there’s this soldier ignoring all of that to bandage a wound and make their patient safe for transport. Maybe the same person who can do that, can take a hit from life and still finish a nursing program.
At least that’s what I’ve observed so far.
Exhibit A: Vomiting up a Lung. It takes days to prepare to write a nursing exam, but of course the day before the exam is usually the most intensive. A friend of mine was missing from our study group that day, so I went looking for her. As I approached her room, the smell of vomit wafted through the hall. Turns out she had thrown up a dozen times that day and was dozing in between spells. No way she’d be able to study for the exam! Of course she could call in sick and the school would allow her to make it up the following week...but there was already an exam scheduled for that week too. Writing 2 exams in one week would be unthinkable. I didn’t see any other way, but clearly she did. She continued to be sick all night. Woke up in the morning. Threw up. Dragged herself to the exam. Passed it. And then ran and threw up some more.
I was astonished.
Exhibit B: That Baseball Knocked The Sense Right Outta You. Another exam, another study buddy came in with an impressive shiner. Into the evening he was falling asleep on his books and admitted he had been feeling nauseous and sleepy since a fastball connected with his eye socket. (Clearly he had a concussion.) The mother in me was alarmed...and I immediately offered to walk him across to the the emergency room and study with him there all night if he would just GO and get LOOKED AT. The tough bastard declined and with brute force he made it to the exam the next day.
I wanted to wring. his. stubborn. neck!
(You may have learned by now that nursing students would rather lose a LIMB than postpone an exam.)
It was my turn this fall when my personal life came crashing down around me. Suddenly I was on a plane home, missing school and our first exam to tend to a crisis. I won’t go into the sordid details because they are private, but I will say this is something I wouldn’t wish on anyone. Also, it had a ripple effect which followed me back to school and required hours of my attention and mental resources to help keep things on track. I failed the next 3 exams. Going into the final, I was only passing the class by 1 point. People around me and back home were praying along with me that I would somehow pull a high enough grade on the final to pass the course...which I was able to do.
It was a real nail-biter.
The emotional toll was high and I was reminded that there is NO WAY I could be doing this thing alone. Back in the wartime analogy, I felt like I had been shot and was bleeding out on the beach. Instead of letting me perish, my buddies came back at great risk to themselves and dragged me to safety.
God places people strategically around us and I have never believed that more than I do now.
And while I would never invite crisis, it did teach me something. How to ask for help. I have always liked to be the one to rally around someone and be the helper. I’m good in a jam and that’s probably why I am drawn to nursing. I’m not good at having the situation reversed. Being helpless. Powerless. Admitting that to others is so humbling. But letting people you love in, and trusting them to care for you is special too. My relationships are being redefined and reexamined because of what happened. I am thankful for that.
Its such a cliche but now its time to Pay It Forward. I got back to school after break and already there are opportunities to serve others all around me. Its so energizing to take the focus off of myself and do what I can for someone else. I look forward once again to seeing my patients. I miss them during every break.
Going into the new term I have a new theme! Recently, a friend posted a clip from a Rocky movie on Facebook and stated he recognized God in it. Ordinarily I would have cruised right past that but I was intrigued by his claim and had to watch it. I think my friend was right. What do you think?
“The world will beat you to your knees and keep you there permanently if you let it...Nobody is gonna hit as hard as life. It ain’t about how hard you hit, its about how hard you can get hit and keep moving forward. That’s how WINNING is done!”
I was never much for Stallone, but these words hit me right where I live right now.
So its a new term and a new beginning. I have fresh optimism and renewed energy for the fight. Only two more 10-week academic terms, followed by my preceptorship. I see the finish line and that keeps me going.
Who are we kidding? God is carrying me along. He has been the whole time.
Sunday, October 14, 2012
First Week in the ER
First off...they call it the ED now. I wonder if they will rename the television show...?
Emergency personnel are my heroes. Hands down. Talk about a group of steely-eyed professionals. I was in a the emergency department big city hospital with a Level 1 shock trauma center and it has been such a great leap for me in terms of advancing my clinical skills. It was also terrifying to realize how on top of everything these nurses need to be and the enormous gap I have yet to traverse to get there. If there was ever a profession that epitomizes multi-tasking, it must be ER nursing.
Every student's experience on a given day will be different -- some of us will hop from patient to patient fairly quickly and see a good number of them during our shift. My first day, I really only saw 2 but that was because I was in the two rooms right next to the trauma bays and we had a couple of patients that needed a lot of care, and took a lot of time.
Codes don't happen in real life like they happen on TV or in the movies. Heck...probably because of this, I didn't even realize I was in one, until my instructor asked me about it later! All I knew, was we had about 15 people in our room for about an hour. Then somehow things turned and poof! -- it was back to just me and my nurse and our very sick patient. During the Code, people were hopping, but somehow it seemed like controlled chaos, this team knew all the dance steps and stayed out of each other's way as they all performed their own tasks. The doctor was so relaxed and no one was shouting, just quietly going about their business. Amazing.
Since I could do hardly anything but just stay out of their way, I had time to notice random things. Since my nurse and I had personally inspected the room and gone through every drawer with an inventory checklist -- I knew we were ready. And I could see why he took this step VERY seriously. As the Code ran it's course...the floor just got filled with debris. All the packaging for every supply was on the ground and they ran through supplies in a shockingly fast clip. I began to think about how, not having one critical item and that crucial moment could just make it or break it for my guy on the table, fighting for his life.
Then there was a whole nurse just standing off to one side documenting everything that happened, every drug given, dose and time. Every order. Procedure. She was like the court reporter. And...its because of today's law-suit happy society that we have her.
All of the "right ways" we learned to do things in class...many fall by the way-side when there is no luxury of time. And that's not a criticism.
Then I saw symptoms occurring in my patient that I wondered if I would ever see. It's called "Decorticate Posturing" and it's sad that I got to see this in real life, because it's never a good sign when the arms go really stiff and flex outward. But I saw it.
I also noticed veteran nurses who have done it a million times struggle with things that I would struggle with now, and that kind of comforted me. After a patient is given an artificial airway, they often need to get a tube down to decompress the stomach. Getting that tube down can be tricky. Even for the pros.
So we got through the Code and after a few hours, our patient was transferred up to the floor and we turned our attention to the next patient. She was thrashing around and confused, so when it came time to give her an IV, I had to wrestle to keep her arm still so my nurse could get a line. After a few failed attempts she had so much blood running down her arm and onto her hand that it looked much worse than it had to be. But she managed to work her arm free at one point and grab my white sleeve with her bloody hand and I looked like I had been finger-painted. It reminded me of old episodes of MASH and how Hawkeye was always awash in gore.
For this lady I got to apply restraints. Something I haven't really had to do before. She was a really sweet little old lady who just needed a little help to keep her safe.
The next day was more excitement and I saw many more patients and got to do more things. Sunk my first IV, a nice big 16 gauge needle, which was awesome. There's this thrill when you see the flash of blood return in the catheter and know you got it I just can't really describe. I'm sure they would discourage cheering, but that's what I wanted to do.
One patient stands out and will likely change how I worry about people who live alone. She had gone down in her home for a week before she was found. She was in a very bad state by the time we got her, and she smelled wretched from having laid in her own filth for that long. Soooooo sad! My eyes would water any time I approached her room. The other nursing students hadn't gone in, but I finally wanted to help and went in and offered. It was just so great to take care of her and make her comfortable. I figured if the whole floor could smell her, surely she could too! We made it better and that's when the nurse I was helping looked up at me, laying across her and holding her arm in position for him to try and get a vein, and said, "Now there's a REAL nurse!" Meaning me! I asked him why he said that and he replied, "You see any other people in here offering to help? We're not that busy..." I floated on that compliment the rest of the day.
I do want to be a REAL nurse.
:)
Emergency personnel are my heroes. Hands down. Talk about a group of steely-eyed professionals. I was in a the emergency department big city hospital with a Level 1 shock trauma center and it has been such a great leap for me in terms of advancing my clinical skills. It was also terrifying to realize how on top of everything these nurses need to be and the enormous gap I have yet to traverse to get there. If there was ever a profession that epitomizes multi-tasking, it must be ER nursing.
Every student's experience on a given day will be different -- some of us will hop from patient to patient fairly quickly and see a good number of them during our shift. My first day, I really only saw 2 but that was because I was in the two rooms right next to the trauma bays and we had a couple of patients that needed a lot of care, and took a lot of time.
Codes don't happen in real life like they happen on TV or in the movies. Heck...probably because of this, I didn't even realize I was in one, until my instructor asked me about it later! All I knew, was we had about 15 people in our room for about an hour. Then somehow things turned and poof! -- it was back to just me and my nurse and our very sick patient. During the Code, people were hopping, but somehow it seemed like controlled chaos, this team knew all the dance steps and stayed out of each other's way as they all performed their own tasks. The doctor was so relaxed and no one was shouting, just quietly going about their business. Amazing.
Since I could do hardly anything but just stay out of their way, I had time to notice random things. Since my nurse and I had personally inspected the room and gone through every drawer with an inventory checklist -- I knew we were ready. And I could see why he took this step VERY seriously. As the Code ran it's course...the floor just got filled with debris. All the packaging for every supply was on the ground and they ran through supplies in a shockingly fast clip. I began to think about how, not having one critical item and that crucial moment could just make it or break it for my guy on the table, fighting for his life.
Then there was a whole nurse just standing off to one side documenting everything that happened, every drug given, dose and time. Every order. Procedure. She was like the court reporter. And...its because of today's law-suit happy society that we have her.
All of the "right ways" we learned to do things in class...many fall by the way-side when there is no luxury of time. And that's not a criticism.
Then I saw symptoms occurring in my patient that I wondered if I would ever see. It's called "Decorticate Posturing" and it's sad that I got to see this in real life, because it's never a good sign when the arms go really stiff and flex outward. But I saw it.
I also noticed veteran nurses who have done it a million times struggle with things that I would struggle with now, and that kind of comforted me. After a patient is given an artificial airway, they often need to get a tube down to decompress the stomach. Getting that tube down can be tricky. Even for the pros.
So we got through the Code and after a few hours, our patient was transferred up to the floor and we turned our attention to the next patient. She was thrashing around and confused, so when it came time to give her an IV, I had to wrestle to keep her arm still so my nurse could get a line. After a few failed attempts she had so much blood running down her arm and onto her hand that it looked much worse than it had to be. But she managed to work her arm free at one point and grab my white sleeve with her bloody hand and I looked like I had been finger-painted. It reminded me of old episodes of MASH and how Hawkeye was always awash in gore.
For this lady I got to apply restraints. Something I haven't really had to do before. She was a really sweet little old lady who just needed a little help to keep her safe.
The next day was more excitement and I saw many more patients and got to do more things. Sunk my first IV, a nice big 16 gauge needle, which was awesome. There's this thrill when you see the flash of blood return in the catheter and know you got it I just can't really describe. I'm sure they would discourage cheering, but that's what I wanted to do.
One patient stands out and will likely change how I worry about people who live alone. She had gone down in her home for a week before she was found. She was in a very bad state by the time we got her, and she smelled wretched from having laid in her own filth for that long. Soooooo sad! My eyes would water any time I approached her room. The other nursing students hadn't gone in, but I finally wanted to help and went in and offered. It was just so great to take care of her and make her comfortable. I figured if the whole floor could smell her, surely she could too! We made it better and that's when the nurse I was helping looked up at me, laying across her and holding her arm in position for him to try and get a vein, and said, "Now there's a REAL nurse!" Meaning me! I asked him why he said that and he replied, "You see any other people in here offering to help? We're not that busy..." I floated on that compliment the rest of the day.
I do want to be a REAL nurse.
:)
Wednesday, September 26, 2012
Exorcisms and Lunatics
A report from this term studying Acute Care nursing, which includes time in the ICU, ER and the Psych unit. We are starting the last half of this term and it has been quite a ride both here at school and in my personal life. Since this blog is about nursing school, I'll focus on that.
First, the med-surg update, wherein I spent the first half of my clinical time taking care of VERY sick and dying patients in the step down critical care floors. I would describe this part of clinical as being thrown right into the deep end of the pool. Where previously I'd have the occasional challenge of more than one IV bag/ pump to deal with, the odd Foley bag or maybe an exciting deep wound dressing to change, usually it was just one of these things at a time to focus on. By contrast, with THESE patients, it was like the Nursing Gods said, "I'll SEE your bag of poop, your purulent wound, your bags of fluids....and I'll RAISE you a feeding tube, PLUS, three more pumps, AND a trach, a vent, heart monitor, an ART line, dialysis, and a couple of amputated limbs!"
The question was more like, "What WASN'T going on with my patient....?"
Like adrenalin? ...Become a critical care nurse.
You might recall my lingering fear of patients who have an artificial airway and the phlegm that is associated with it. Yeah...I'm pretty much over that. Each patient I had this term had this going on...sometimes to an alarming degree. My gag-o-meter did blip a couple times as I initially learned to suction, and I by no means relish this task, but because I did it so often, I became desensitized. I did have my nursing instructor's haunting words running through my mind as I dealt with the holes in the necks of my patients and tried to keep a reasonable distance from that opening. He said, "Make sure you keep your mouth closed when you suction...because a patient coughs and it will shoot straight in your mouth! So no talking!" I pray this never happens, and yet I can see how easy that foul outcome could occur. These folks generate a LOT of goop. Nuff said.
You might be wondering why I refer to exorcism in the title of this post. [Queasy people will want to skip ahead.]
Sadly, I was about to call a priest to fight the demons I thought must be inhabiting my poor patient one day. It was straight out of the movie. She needed just a crazy amount of medications that we needed to give into her feeding tube. It was a staggering number and I just kept thinking, any healthy person would feel sick after all this. [Foreshadowing.] There was also a decompression tube sticking out of her belly that emptied into a bag on the side of the bed filled with both stomach and bowel contents. It was a sick dark forest green / brown and I had to fight from walking in a circle around it just because I feared bumping it and somehow spilling the mess on the floor. The night nurse had changed it and had reported it was the most foul-smelling brew she had ever encountered. That was enough for me...and I was just grateful that the bag was not even close to full, meaning I wouldn't have to change it!
She also had a trach, so she breathed out of a tube in her neck. After a student and I had done our morning care, flipping her this way and that, tidying her bed up, we began raising the head of the bed back up and that became our exorcism nightmare. Suddenly noxious green-brown goop started gushing out of her mouth and down her chin! Terrified it was going to leak right into her trach airway and she would inhale it...I jammed my (gloved) hands under chin and began catching the stuff and my partner quickly tried to suction out her mouth! That's. When. The. SMELL. Came. And my eyes instantly began to water and my own stomach threatened to heave. Nothing could touch this...not a pus-filled necrotic wound, not poop, not vomit. This stuff made me want to run from the room and never return. And just as we would catch up with the suctioning, more would gurgle and froth from her mouth making me wonder just when her head going to start spinning around and she would levitate from the bed!
We eventually got her cleaned up and settled and I sent the trash far FAR from the room so the smell would fade. As much as I hated this, I just kept thinking how bad was it for HER?? This girl had so many things wrong with her I couldn't fit it all on my clinical paperwork, she couldn't talk, felt sick and then something as nasty as that had to happen. And she was MY age!!
Acute care has taught me that when things go wrong...sometimes they go very, very wrong.
So far I got to see and do so many things in the first half of the term, that it was very exciting and terrifying. I am now in my psych rotation and that is like moving from one planet to another. I'll end my term with 2 weeks in the ER, which could get really interesting.
I'm back from my day with the crazies.
Actually, my 2nd day. A few weeks of psych lecture and all of the conditions and their lists of signs and symptoms began to merge together. Depression, bi-polar, schizophrenia, severe anxiety. And we haven't even covered them all. Then I got to go to the floor and saw the real stories and the real people whose lives are utterly destroyed by these conditions. Many of them will never be okay and lead a normal life. But they are not just a list of symptoms to me anymore.
I observed an advanced case of schizophrenia in a relatively young woman. She sat and rocked, carrying on conversations with people who weren't there. I thought to myself how strange to live in this age when if I saw her walking down the street talking out loud like that, I wouldn't even wonder. I'd just think she had a hands-free bluetooth device in her ear and I'd walk on by. In decades past, that behavior would stand right out.
I interviewed another schizophrenic, a pleasant enough guy who was happy to talk to me. I got through a number of questions when he casually mentioned he'd done time for killing a couple of people, like he was commenting on the fine weather we were having.
Another young guy looked like he should have his whole life in front of him is debilitated with bi-polar disorder and completely isolated from society. He was smart and funny, and didn't mind that I whooped his butt in a game of chess. Then I read his file and saw the downward spiral he has been on and I grieve for his future unless medications can help correct his condition.
So many psych patients isolated from society for something they can't help. I'm profoundly sad about this and my experience with these patients has given me a lot more understanding of just how derailed and lost they are. I know for sure I'll never want to be a psych nurse because the hands-on care is part of the job I really like and I'm not sure I have the mental stamina to deal with what psych nursing entails, but I also know that I'm looking at the whole issue in an entirely new light.
First, the med-surg update, wherein I spent the first half of my clinical time taking care of VERY sick and dying patients in the step down critical care floors. I would describe this part of clinical as being thrown right into the deep end of the pool. Where previously I'd have the occasional challenge of more than one IV bag/ pump to deal with, the odd Foley bag or maybe an exciting deep wound dressing to change, usually it was just one of these things at a time to focus on. By contrast, with THESE patients, it was like the Nursing Gods said, "I'll SEE your bag of poop, your purulent wound, your bags of fluids....and I'll RAISE you a feeding tube, PLUS, three more pumps, AND a trach, a vent, heart monitor, an ART line, dialysis, and a couple of amputated limbs!"
The question was more like, "What WASN'T going on with my patient....?"
Like adrenalin? ...Become a critical care nurse.
You might recall my lingering fear of patients who have an artificial airway and the phlegm that is associated with it. Yeah...I'm pretty much over that. Each patient I had this term had this going on...sometimes to an alarming degree. My gag-o-meter did blip a couple times as I initially learned to suction, and I by no means relish this task, but because I did it so often, I became desensitized. I did have my nursing instructor's haunting words running through my mind as I dealt with the holes in the necks of my patients and tried to keep a reasonable distance from that opening. He said, "Make sure you keep your mouth closed when you suction...because a patient coughs and it will shoot straight in your mouth! So no talking!" I pray this never happens, and yet I can see how easy that foul outcome could occur. These folks generate a LOT of goop. Nuff said.
You might be wondering why I refer to exorcism in the title of this post. [Queasy people will want to skip ahead.]
Sadly, I was about to call a priest to fight the demons I thought must be inhabiting my poor patient one day. It was straight out of the movie. She needed just a crazy amount of medications that we needed to give into her feeding tube. It was a staggering number and I just kept thinking, any healthy person would feel sick after all this. [Foreshadowing.] There was also a decompression tube sticking out of her belly that emptied into a bag on the side of the bed filled with both stomach and bowel contents. It was a sick dark forest green / brown and I had to fight from walking in a circle around it just because I feared bumping it and somehow spilling the mess on the floor. The night nurse had changed it and had reported it was the most foul-smelling brew she had ever encountered. That was enough for me...and I was just grateful that the bag was not even close to full, meaning I wouldn't have to change it!
She also had a trach, so she breathed out of a tube in her neck. After a student and I had done our morning care, flipping her this way and that, tidying her bed up, we began raising the head of the bed back up and that became our exorcism nightmare. Suddenly noxious green-brown goop started gushing out of her mouth and down her chin! Terrified it was going to leak right into her trach airway and she would inhale it...I jammed my (gloved) hands under chin and began catching the stuff and my partner quickly tried to suction out her mouth! That's. When. The. SMELL. Came. And my eyes instantly began to water and my own stomach threatened to heave. Nothing could touch this...not a pus-filled necrotic wound, not poop, not vomit. This stuff made me want to run from the room and never return. And just as we would catch up with the suctioning, more would gurgle and froth from her mouth making me wonder just when her head going to start spinning around and she would levitate from the bed!
We eventually got her cleaned up and settled and I sent the trash far FAR from the room so the smell would fade. As much as I hated this, I just kept thinking how bad was it for HER?? This girl had so many things wrong with her I couldn't fit it all on my clinical paperwork, she couldn't talk, felt sick and then something as nasty as that had to happen. And she was MY age!!
Acute care has taught me that when things go wrong...sometimes they go very, very wrong.
So far I got to see and do so many things in the first half of the term, that it was very exciting and terrifying. I am now in my psych rotation and that is like moving from one planet to another. I'll end my term with 2 weeks in the ER, which could get really interesting.
I'm back from my day with the crazies.
Actually, my 2nd day. A few weeks of psych lecture and all of the conditions and their lists of signs and symptoms began to merge together. Depression, bi-polar, schizophrenia, severe anxiety. And we haven't even covered them all. Then I got to go to the floor and saw the real stories and the real people whose lives are utterly destroyed by these conditions. Many of them will never be okay and lead a normal life. But they are not just a list of symptoms to me anymore.
I observed an advanced case of schizophrenia in a relatively young woman. She sat and rocked, carrying on conversations with people who weren't there. I thought to myself how strange to live in this age when if I saw her walking down the street talking out loud like that, I wouldn't even wonder. I'd just think she had a hands-free bluetooth device in her ear and I'd walk on by. In decades past, that behavior would stand right out.
I interviewed another schizophrenic, a pleasant enough guy who was happy to talk to me. I got through a number of questions when he casually mentioned he'd done time for killing a couple of people, like he was commenting on the fine weather we were having.
Another young guy looked like he should have his whole life in front of him is debilitated with bi-polar disorder and completely isolated from society. He was smart and funny, and didn't mind that I whooped his butt in a game of chess. Then I read his file and saw the downward spiral he has been on and I grieve for his future unless medications can help correct his condition.
So many psych patients isolated from society for something they can't help. I'm profoundly sad about this and my experience with these patients has given me a lot more understanding of just how derailed and lost they are. I know for sure I'll never want to be a psych nurse because the hands-on care is part of the job I really like and I'm not sure I have the mental stamina to deal with what psych nursing entails, but I also know that I'm looking at the whole issue in an entirely new light.
Tuesday, July 10, 2012
Old-Timers
Or...Alzheimers.
We spent time studying dementia this term. I have to say, I never really thought much about this patient population before then, which is weird because both grandmothers succumbed to it. And because of it, I have often joked that I'd rather go out in a fiery ball of flames while still in my prime than lose my mind slowly. When I saw on our clinical rotations for the term that we'd be spending time at an Alzheimer's facility, I quietly freaked a little bit.
Old people scared me as a kid. I thought they smelled off. They shook. They pinched my cheeks too hard. They cough and hack up big loogies. (During my childhood, a loogie expelled by an elderly person in our front seat unfortunately stuck to the inside of our windshield during some drive...and I was the only one to notice it there, dangling and suspended for the duration of the trip. This memory has unfortunately stuck with me...and launched my fear of both old people...and phlegm in a single incident.)
I grew out of that, and now I really enjoy the company of our older generation. But I do admit that sick, old people still kind of unsettled me prior to entering this profession. I don't like to see suffering of any kind, but I think seeing older folks sick in bed touches something primal in me which says, "that'll be you someday" -- and I'd spook.
Armed with our new knowledge of the disease process and nursing care associated with Alzheimer's, we began our time at the facility -- no ordinary home, the place is dedicated to this type of patient, and one whose family can afford the six grand a month it costs to live there. It was outside of the city in a very affluent community and I already wondered where they house the ones who can't afford to live there.
I don't know what I was worried about...because I can now say I enjoyed my time with these patients so much, I had a hard time leaving them. The place was as homey as it was possible to make it, the staff were loving and very skilled at communicating with patients in various stages of the disease. Our biggest objective wasn't to provide nursing care to these folks -- it was to learn how to communicate with them effectively. So we went there primarily just to observe and interact.
What did I do?
I fed a lady who was becoming too advanced, she was close to needing to be moved into a full-time nursing facility, because she was entering the final stage. She was non verbal, unable even to eat by herself, and wandered around vacantly the rest of the time. I would occasionally redirect her, or bring her to meal times. She also fell (so common) and I was first to her side, trying to keep her from attempting to get up until a staff member could be sure she was un-hurt. Other than a nasty goose-egg, she was okay. Still, during those minutes trying to keep her still, I saw shear terror and pain in her eyes, and it was all I could do to keep her from panicking. She nearly wrenched my arm off trying to rise -- which reminds me that caring for these folks can be very physical.
I danced. When the singer came to entertain everyone, we were encouraged to act as a pep-squad; handing out tambourines, bells and other instruments for audience participation. We clapped and sang along and I was amazed how even some of the more advanced patients could recall every word to the oldies! There were a few gentlemen who were willing to get up and once they did, still remembered how to lead me in a fox-trot. It's true that long-term memory can linger when short term memory is completely shot.
I took orders. Some of these patients are quite un-patient-like. They could be mistaken for staff. One younger lady was so convincing, she started ordering us around to tidy up. "Get these chairs put away!" "This place is a mess!" Thinking she worked there...I helped stack some chairs! Doh!...she was a resident. [This was amusing to the staff, and to my instructor.] Patients wear clothing, not gowns -- and because of "white coat syndrome" (a fear of medical professionals), the staff also wear street clothes. So, for a newcomer, it can be tough to tell them apart!
I rocked a baby. Another very advanced lady carried around a doll who had a name, and who was very real to her. (This is actually quite common...to bond with a favorite item.) In any case, during the music session, I watched her point to the singer and whisper things in her baby's ear. She would rock and mother her, and bring her everywhere. When it was time to get this lady into the bathroom, she was very unwilling to put the baby down in order to go do her business. The staff member saw me nearby and offered my help to "hold the baby" while she went. I swear this patient pinned me with her eye contact as if to silently warn me that this was a Big Deal, and handed the doll over. I effusively reassured her that I took this task seriously, as any mother would, and reflexively began bouncing and rocking the baby! Then...since toileting can take a while, the staff member went to a nearby counter and began folding laundry and asked if I'd like to help. I nervously glanced back and forth between her and the bathroom door -- what was I supposed to do with the baby?! I'd made this promise to look after her! I laid the baby down on the counter, kept one eye on the door, and helped out. The SECOND I saw that door handle jiggling, I swooped up the baby, resumed my stance and surrendered the it to my nervous mother when she emerged. She snatched her back and all was again right in her world.
I passed out snacks. We all rolled a cart around and became very popular as we handed out ice cream, asking vanilla or chocolate, and serving it up. Many times when we returned to our customers...they had forgotten what they ordered, but were still happy to see us. Then, when we had made one pass around the place, we still had many ice cream cups left -- as many patients had declined. One student asked me..."Shoot, what do we do now that we have so much left?" I said, "Let's go around again, they won't remember us being there the first time!" And it was true. Many that had declined before, took us up on it the second time around. And it is so important for these patients to keep weight on, or even to gain weight, that we didn't want to waste an opportunity.
I took a walk. One lady appeared quite standoffish, and was even referred to as snobby. She had this old-world, old-money feeling to her. Considering the zip-code, she very likely was! She kind of glared down her nose at everyone, and mostly wandered the hallways, looking at the driveway, as if expecting her chauffeur to arrive at any moment. None of the students had engaged her yet, so finally I mustered up courage to ignore her glares and offered to take her for a walk. One of the things we learned is that in those patients who were raised in higher social circles where manners and "social graces" were expected -- they can cover the onset of their disease in the early stages with meaningless pleasantries. In fact, on our walk, I relied on that and she graciously answered my remarks about our fine weather, these lovely roses, and other generally acceptable social ice-breakers with the expected replies. Anyone listening in on our conversation wouldn't really guess she had Alzheimers. This is because I didn't ask her any questions that required recall. However the answers were robotic, and yet allowed her some feeling of normalcy as we strolled.
When it was time to go, I had bonded with so many of these folks, and with the amazing people who cared for them, that I was a little sad to leave. On my way out, I approached the lady that I had fed, the one who was non-verbal. I said good-bye expecting no response and instead she reached out and hugged me and then, plain as day said, "Thank you. Good to see you." And all of the nursing students, and our instructor just stood amazed, grinning. They were the only words we ever heard her say!
Okay, I got a lump in my throat after that.
I have a whole new outlook on the subject of Alzheimer's now...and consider my time with these folks a gift. So many of them will end up in my hospital, and because they will be out of their environment, in crisis, and away from the caregivers who know them and their particular needs so well -- they will be frightened.
I'm so glad I got to practice how to reach them.
We spent time studying dementia this term. I have to say, I never really thought much about this patient population before then, which is weird because both grandmothers succumbed to it. And because of it, I have often joked that I'd rather go out in a fiery ball of flames while still in my prime than lose my mind slowly. When I saw on our clinical rotations for the term that we'd be spending time at an Alzheimer's facility, I quietly freaked a little bit.
Old people scared me as a kid. I thought they smelled off. They shook. They pinched my cheeks too hard. They cough and hack up big loogies. (During my childhood, a loogie expelled by an elderly person in our front seat unfortunately stuck to the inside of our windshield during some drive...and I was the only one to notice it there, dangling and suspended for the duration of the trip. This memory has unfortunately stuck with me...and launched my fear of both old people...and phlegm in a single incident.)
I grew out of that, and now I really enjoy the company of our older generation. But I do admit that sick, old people still kind of unsettled me prior to entering this profession. I don't like to see suffering of any kind, but I think seeing older folks sick in bed touches something primal in me which says, "that'll be you someday" -- and I'd spook.
Armed with our new knowledge of the disease process and nursing care associated with Alzheimer's, we began our time at the facility -- no ordinary home, the place is dedicated to this type of patient, and one whose family can afford the six grand a month it costs to live there. It was outside of the city in a very affluent community and I already wondered where they house the ones who can't afford to live there.
I don't know what I was worried about...because I can now say I enjoyed my time with these patients so much, I had a hard time leaving them. The place was as homey as it was possible to make it, the staff were loving and very skilled at communicating with patients in various stages of the disease. Our biggest objective wasn't to provide nursing care to these folks -- it was to learn how to communicate with them effectively. So we went there primarily just to observe and interact.
What did I do?
I fed a lady who was becoming too advanced, she was close to needing to be moved into a full-time nursing facility, because she was entering the final stage. She was non verbal, unable even to eat by herself, and wandered around vacantly the rest of the time. I would occasionally redirect her, or bring her to meal times. She also fell (so common) and I was first to her side, trying to keep her from attempting to get up until a staff member could be sure she was un-hurt. Other than a nasty goose-egg, she was okay. Still, during those minutes trying to keep her still, I saw shear terror and pain in her eyes, and it was all I could do to keep her from panicking. She nearly wrenched my arm off trying to rise -- which reminds me that caring for these folks can be very physical.
I danced. When the singer came to entertain everyone, we were encouraged to act as a pep-squad; handing out tambourines, bells and other instruments for audience participation. We clapped and sang along and I was amazed how even some of the more advanced patients could recall every word to the oldies! There were a few gentlemen who were willing to get up and once they did, still remembered how to lead me in a fox-trot. It's true that long-term memory can linger when short term memory is completely shot.
I took orders. Some of these patients are quite un-patient-like. They could be mistaken for staff. One younger lady was so convincing, she started ordering us around to tidy up. "Get these chairs put away!" "This place is a mess!" Thinking she worked there...I helped stack some chairs! Doh!...she was a resident. [This was amusing to the staff, and to my instructor.] Patients wear clothing, not gowns -- and because of "white coat syndrome" (a fear of medical professionals), the staff also wear street clothes. So, for a newcomer, it can be tough to tell them apart!
I rocked a baby. Another very advanced lady carried around a doll who had a name, and who was very real to her. (This is actually quite common...to bond with a favorite item.) In any case, during the music session, I watched her point to the singer and whisper things in her baby's ear. She would rock and mother her, and bring her everywhere. When it was time to get this lady into the bathroom, she was very unwilling to put the baby down in order to go do her business. The staff member saw me nearby and offered my help to "hold the baby" while she went. I swear this patient pinned me with her eye contact as if to silently warn me that this was a Big Deal, and handed the doll over. I effusively reassured her that I took this task seriously, as any mother would, and reflexively began bouncing and rocking the baby! Then...since toileting can take a while, the staff member went to a nearby counter and began folding laundry and asked if I'd like to help. I nervously glanced back and forth between her and the bathroom door -- what was I supposed to do with the baby?! I'd made this promise to look after her! I laid the baby down on the counter, kept one eye on the door, and helped out. The SECOND I saw that door handle jiggling, I swooped up the baby, resumed my stance and surrendered the it to my nervous mother when she emerged. She snatched her back and all was again right in her world.
I passed out snacks. We all rolled a cart around and became very popular as we handed out ice cream, asking vanilla or chocolate, and serving it up. Many times when we returned to our customers...they had forgotten what they ordered, but were still happy to see us. Then, when we had made one pass around the place, we still had many ice cream cups left -- as many patients had declined. One student asked me..."Shoot, what do we do now that we have so much left?" I said, "Let's go around again, they won't remember us being there the first time!" And it was true. Many that had declined before, took us up on it the second time around. And it is so important for these patients to keep weight on, or even to gain weight, that we didn't want to waste an opportunity.
I took a walk. One lady appeared quite standoffish, and was even referred to as snobby. She had this old-world, old-money feeling to her. Considering the zip-code, she very likely was! She kind of glared down her nose at everyone, and mostly wandered the hallways, looking at the driveway, as if expecting her chauffeur to arrive at any moment. None of the students had engaged her yet, so finally I mustered up courage to ignore her glares and offered to take her for a walk. One of the things we learned is that in those patients who were raised in higher social circles where manners and "social graces" were expected -- they can cover the onset of their disease in the early stages with meaningless pleasantries. In fact, on our walk, I relied on that and she graciously answered my remarks about our fine weather, these lovely roses, and other generally acceptable social ice-breakers with the expected replies. Anyone listening in on our conversation wouldn't really guess she had Alzheimers. This is because I didn't ask her any questions that required recall. However the answers were robotic, and yet allowed her some feeling of normalcy as we strolled.
When it was time to go, I had bonded with so many of these folks, and with the amazing people who cared for them, that I was a little sad to leave. On my way out, I approached the lady that I had fed, the one who was non-verbal. I said good-bye expecting no response and instead she reached out and hugged me and then, plain as day said, "Thank you. Good to see you." And all of the nursing students, and our instructor just stood amazed, grinning. They were the only words we ever heard her say!
Okay, I got a lump in my throat after that.
I have a whole new outlook on the subject of Alzheimer's now...and consider my time with these folks a gift. So many of them will end up in my hospital, and because they will be out of their environment, in crisis, and away from the caregivers who know them and their particular needs so well -- they will be frightened.
I'm so glad I got to practice how to reach them.
Friday, July 6, 2012
Shock of Re-Entry -- Summer Break
I've been so busy, I neglected to blog the whole last term! And now I've been home for three days. Time to catch up.
It would be too much to try to cover all of my impressions and experiences I had during this term in one blog post. I'll make it a summer project to reflect on all of that. Tonight I'll focus on current events.
Friday, on 48 hours with little to no sleep I wrote my final. My study group and I had to literally pull each other across the finish line because individually we had all hit our respective walls. Among us we had chain-smoking, endless fits of crying, incoherent babbling and fits of rage. Pure adrenalin pulled me through and then I clenched for the "rest of the story" -- because as much as we all wanted to celebrate in our usual fashion (corner bar at 11:00 am over beers), we knew we'd be saying goodbye to students who found out they failed out of the program. So far I know of 7 good people who won't be with us in the fall. It makes me profoundly sad to see some of them go. So the last day of any term is bittersweet.
On top of that we said goodbye to our graduating seniors that night. So after a couple of beers, I went back to the dorm for two hours of precious sleep, before rousing to attend the graduation ceremony. So...more tears, albeit happy ones. Still-- I'll be missing some of the good friends I made this year. The seniors did provide some great insights and encouragement in terms of getting through this first year. I can't wait to hear how they all do writing their boards this summer and landing their first jobs. They must know They Are Being Watched!
During finals week, students were succumbing to illness all around me, and I smugly boarded the plane home thinking I had avoided it for once. Don't know what I was thinking. I got sick my first day back and I may be getting sicker by the day. Bronchitis, rhinitis, laryngitis and otitis. You know another -itis? -- I probably have that too! This may be the universe's idea of a joke, because I was going to be without health insurance for only about a week and a half before I start back at work next Tuesday. So, of course, I'll probably get pneumonia the way this is going.
I feel out of sorts being back home.
At school, we literally have bars around us when we go out on the porches (to keep us from jumping off??) Of course, it feels like prison. Many jokes are made about this, and...like prisoners, we fondly start off many conversations during middle of the night with, "When I get outta here, I'm gonna...." (Fill in the blank.)
So now I'm out. I'm free!! At least for about 6 weeks. Maybe its the time zone change, maybe its illness, or...more likely, its Post Traumatic Stress Disorder -- but being on the outside feels very strange. Like I've forgotten something. Or I should be doing something. I just don't know quite what to do with myself. Reconnecting with friends and family is lovely, and I'd be enjoying that more if I wasn't coughing up a lung and without a voice. But, there's this nagging feeling, it's almost surreal. I walked down the steps to my home, for the first time since I left for nursing school last summer, and I thought..."Did I just wake up from a bad dream?" It all felt quasi-normal: heading back down to the cabin on the beach, walking the same steps, trailing behind my son who was carrying all the heavy stuff as usual. But this is only a brief interlude at the mid-point of this journey called nursing school. The friends and family here can't really know what it's like doing this...and my "fellow prisoners" are all enjoying their brief parole back east.
I think it's time for self-care just now. I better bite the bullet and go in for a throat culture before this pestilence in my throat turns into full-blown pneumonia -- which will waste too much of my precious time. In a few more days, and with the help of some really good drugs, I'll finally ease into my summer and enjoy it!
It would be too much to try to cover all of my impressions and experiences I had during this term in one blog post. I'll make it a summer project to reflect on all of that. Tonight I'll focus on current events.
Friday, on 48 hours with little to no sleep I wrote my final. My study group and I had to literally pull each other across the finish line because individually we had all hit our respective walls. Among us we had chain-smoking, endless fits of crying, incoherent babbling and fits of rage. Pure adrenalin pulled me through and then I clenched for the "rest of the story" -- because as much as we all wanted to celebrate in our usual fashion (corner bar at 11:00 am over beers), we knew we'd be saying goodbye to students who found out they failed out of the program. So far I know of 7 good people who won't be with us in the fall. It makes me profoundly sad to see some of them go. So the last day of any term is bittersweet.
On top of that we said goodbye to our graduating seniors that night. So after a couple of beers, I went back to the dorm for two hours of precious sleep, before rousing to attend the graduation ceremony. So...more tears, albeit happy ones. Still-- I'll be missing some of the good friends I made this year. The seniors did provide some great insights and encouragement in terms of getting through this first year. I can't wait to hear how they all do writing their boards this summer and landing their first jobs. They must know They Are Being Watched!
During finals week, students were succumbing to illness all around me, and I smugly boarded the plane home thinking I had avoided it for once. Don't know what I was thinking. I got sick my first day back and I may be getting sicker by the day. Bronchitis, rhinitis, laryngitis and otitis. You know another -itis? -- I probably have that too! This may be the universe's idea of a joke, because I was going to be without health insurance for only about a week and a half before I start back at work next Tuesday. So, of course, I'll probably get pneumonia the way this is going.
I feel out of sorts being back home.
At school, we literally have bars around us when we go out on the porches (to keep us from jumping off??) Of course, it feels like prison. Many jokes are made about this, and...like prisoners, we fondly start off many conversations during middle of the night with, "When I get outta here, I'm gonna...." (Fill in the blank.)
So now I'm out. I'm free!! At least for about 6 weeks. Maybe its the time zone change, maybe its illness, or...more likely, its Post Traumatic Stress Disorder -- but being on the outside feels very strange. Like I've forgotten something. Or I should be doing something. I just don't know quite what to do with myself. Reconnecting with friends and family is lovely, and I'd be enjoying that more if I wasn't coughing up a lung and without a voice. But, there's this nagging feeling, it's almost surreal. I walked down the steps to my home, for the first time since I left for nursing school last summer, and I thought..."Did I just wake up from a bad dream?" It all felt quasi-normal: heading back down to the cabin on the beach, walking the same steps, trailing behind my son who was carrying all the heavy stuff as usual. But this is only a brief interlude at the mid-point of this journey called nursing school. The friends and family here can't really know what it's like doing this...and my "fellow prisoners" are all enjoying their brief parole back east.
I think it's time for self-care just now. I better bite the bullet and go in for a throat culture before this pestilence in my throat turns into full-blown pneumonia -- which will waste too much of my precious time. In a few more days, and with the help of some really good drugs, I'll finally ease into my summer and enjoy it!
Tuesday, April 10, 2012
I'm Pretty Sure the O.R. Made Me Shorter
I loved my two OR experiences. LOVED them! I know for sure I don't want to work in one...at least, not right now. But the experience was so rewarding.
Last week I got to see a surgeon hunting for a bullet that had been lodged for 2 years in the guts of my dear, sweet patient. The doc hunted for that thing like an easter egg before giving up and repairing the damage it had done to his parts so he could look forward to a "normal life." I met the patient before the surgery, watched his insides get rebuilt for several hours, and then stayed with him in the PACU for a couple more hours since he had nobody there to hold his hand, except his two prison guards. We had a good talk about his hopes and dreams and I didn't leave his side until I was made to go.
Did I mention he was a prisoner?
I wish I could share how much this case touched my heart and reminded me of why I wanted to be a nurse in the first place, but...there are privacy laws. Let me just say that I hope I never forget him. The other students watched as I fed him his ice chips and stayed close so he wouldn't be afraid and declared that if they are ever in the hospital, they want ME as their nurse!
Aw...shucks.
Today was my final day in the O.R. rotation and I faced another fear. The fear of watching the gore that is an orthopedic joint surgery. Why is this my fear? Because I had four surgeries to rebuild my humpty-dumpty left arm not so long ago, and have some titanium in there to prove it. Since I'll be facing more of such surgeries in the future (for maintenance) -- I just wasn't sure I was up to seeing up and bloody close just what goes on in there!
Meh. No big deal. I was glued to the procedure the whole time. I orbited all around the table to make sure I saw every drill, wire and bolt. It was disgusting and fascinating. I loved it.
What I do NOT love about the O.R....
The fashion. Really, the only way to express oneself is by way of eye makeup. (Designers like to express themselves.) It's kind of like a Burka-Situation. The puffy blue hats are as far away from sexy as possible. And you can think some guy could be good looking under all the layers of blue...and yet be disappointed when the patient is rolled away and the guy lowers his mask.... I'm just saying.
It's a meat locker. If you are perpetually cold, like me, this environment is unacepptably frigid. Good for patients because bacteria like warm places to grow. Bad for me. The menopausal ones around me LOVE it.
The lead. If you are going to work in an orthopedic OR, they will ask you if you are wearing lead. You may think about the uncomfortable underwire bra for a second, and then say no. And then they will wrap you in an apron of lead down to your knees and you'll stagger away under its weight. They take lots of x-rays while they drill holes in bones. You will consider your pre-osteoporotic bones, and of the discs of your spine crushing in on themselves under the weight of this new torture device. You will wonder why you didn't drink more milk and if you will be two inches shorter by the end of the day. Bad enough that you will be standing on your feet for four hours in a meat locker, but now you are also shrinking.
And then the surgery will be over and you will take off the lead...
And you will float away!!!
Last week I got to see a surgeon hunting for a bullet that had been lodged for 2 years in the guts of my dear, sweet patient. The doc hunted for that thing like an easter egg before giving up and repairing the damage it had done to his parts so he could look forward to a "normal life." I met the patient before the surgery, watched his insides get rebuilt for several hours, and then stayed with him in the PACU for a couple more hours since he had nobody there to hold his hand, except his two prison guards. We had a good talk about his hopes and dreams and I didn't leave his side until I was made to go.
Did I mention he was a prisoner?
I wish I could share how much this case touched my heart and reminded me of why I wanted to be a nurse in the first place, but...there are privacy laws. Let me just say that I hope I never forget him. The other students watched as I fed him his ice chips and stayed close so he wouldn't be afraid and declared that if they are ever in the hospital, they want ME as their nurse!
Aw...shucks.
Today was my final day in the O.R. rotation and I faced another fear. The fear of watching the gore that is an orthopedic joint surgery. Why is this my fear? Because I had four surgeries to rebuild my humpty-dumpty left arm not so long ago, and have some titanium in there to prove it. Since I'll be facing more of such surgeries in the future (for maintenance) -- I just wasn't sure I was up to seeing up and bloody close just what goes on in there!
Meh. No big deal. I was glued to the procedure the whole time. I orbited all around the table to make sure I saw every drill, wire and bolt. It was disgusting and fascinating. I loved it.
What I do NOT love about the O.R....
The fashion. Really, the only way to express oneself is by way of eye makeup. (Designers like to express themselves.) It's kind of like a Burka-Situation. The puffy blue hats are as far away from sexy as possible. And you can think some guy could be good looking under all the layers of blue...and yet be disappointed when the patient is rolled away and the guy lowers his mask.... I'm just saying.
It's a meat locker. If you are perpetually cold, like me, this environment is unacepptably frigid. Good for patients because bacteria like warm places to grow. Bad for me. The menopausal ones around me LOVE it.
The lead. If you are going to work in an orthopedic OR, they will ask you if you are wearing lead. You may think about the uncomfortable underwire bra for a second, and then say no. And then they will wrap you in an apron of lead down to your knees and you'll stagger away under its weight. They take lots of x-rays while they drill holes in bones. You will consider your pre-osteoporotic bones, and of the discs of your spine crushing in on themselves under the weight of this new torture device. You will wonder why you didn't drink more milk and if you will be two inches shorter by the end of the day. Bad enough that you will be standing on your feet for four hours in a meat locker, but now you are also shrinking.
And then the surgery will be over and you will take off the lead...
And you will float away!!!
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