So
Movember is over
(Kind of about moustaches, really about men's health, namely the prostate).
We supported it
(see below). Check out your man parts, men. I know, we are nurses, but don't look at us, sickos.
Under the glasses I was hiding what my real expression is. My homemade, 'born this way' face. My siblings and I got a chuckle out of this e-card. It's the truth, everyone thinks I am mad and unapproachable and I feel like Lady Gaga explaining all day "I'm not upset, I was born this way."
*****************************************
But the other day... The other day I was pretty upset.
I am on a Cardiac Surgical step down unit, which is not ICU where I was. Patients have a lot of heart and vessel surgery and placement of pacemakers here. Don't get me wrong, I am refreshing and relearning the heart well enough but I do feel like I am getting more dumb as a nurse, partly because as a traveler, you are given the unpopular and otherwise difficult patients.
A usual assignment here consists of 2-3 patients, usually with 1-2 discharges to home, opening you up for an admission or assuming care for another patient who is already present. At most, you should see 3-4 patients in one day. As of late, and I don't know whose moustache-y idea this was, I have been getting 6-8 patients in one day. Not easy peasy, admit and begin care or end care and discharge. These were some pretty tough ones with nurses in the family, complicated and exclusive family visitation (since when did I become your doorman/security too?), and lots of unnecessary legal threats.
I think I already relayed the patient that I admitted for 4 hours and simultaneously while discharging her I was admitting her neighbor who arrived with crushing chest pains, only spoke Spanish, had an irregular and fast heart rate with blood pressure in the 250s. Then I swapped this one out (missed out on a real ICU like bedside procedure) and assumed care for another mess of a patient. And his family. "Can he have a lemon packet?" Really.
The other day I walked into work and should have known with the moon and the report I got from the night nurse that it was not going to be a good day. He neglected to tell me important information about one difficult patient so I walked into a poorly cared for, dominating, young, very sick and unhappy man. We had started from the top, immediately "I want to speak to a supervisor!" Oh brother.
I had to take him off the unit for a procedure that was scheduled to last several hours. Not once did he make eye contact and wasn't cooperative with any assessing of him. I let it go and thought, he will be away, readjust his attitude and in the meantime, I will fix up his room and he will be excited to be back, hopefully feeling better than our first meet up. In the meantime, my other patients kept me busy with a discharge, phone calls and transferring to another unit for a procedure at the bedside that could not be done on our floor.
Sparing some details for your boredom and his privacy, I picked him up early from the procedure because he had ended sooner than expected. Still no eye contact. C'mon guy, I can break almost anyone! As I wheeled him backwards into his room he was already shouting to his wife, "Call my family! Get them here to witness! Get my lawyer on the phone, I've been neglected!" WHAT. If anyone has ever worked with me (Erica), you can attest that I OVER care for my patients. Erica (a nurse from home) once said, "If you had two brain dead patients, you would still somehow be running late on charting because you would be in the room with them." I was so blindsided with this day.
The patient relayed to his wife that I had ignored him and neglected him (he was not on the unit long enough for me to neglect anything). He said that I didn't answer phone calls from the nurse who was caring for him. I was unable to because I was in another room with another patient and the charge nurse actually took the call and relayed the information to me. So somehow, he took that as me neglecting him. I know, he was just a mean and mad man, upset about the situation he was in and taking it out on his supposed submissive (me). When I heard his take on the day I responded by outlining my morning, reinforcing policy and patient privacy and exactly what happened with his nurse's phone call. His wife butted in and said "Please don't fight with my husband. He is very sick." WHAT. WHAT IS HAPPENING!?
I shut my mouth and just focused on tasks at this point. I collected vital sign information, reviewed the medications he was ordered and asked if he felt well enough to swallow pills. Then I asked how he liked to take them, "ice water." I told him and his wife that I would be back shortly with the medications and his water. I stepped out of the room and immediately began shaking.
Then it happened. I tried to send his blood work to the lab and one of my nurse friends asked me an unrelated question. I looked up and just started bawling. I backed my way into the copy room and my friend followed me. I just unloaded everything about this patient's unfair treatment toward me while he was demanding that he "just be treated fairly." Same here buddy, same here. I am so mad at myself for crying at work. So mad. I can usually turn a bad situation good and work my butt off to bring the unhappy patient around. Not today. Now my eyes looked like they were bleeding. The charge nurse met us in the copy room, I relayed what happened, she reinforced that it wasn't me but that he seemed to do better with male nurses. She reinforced my worth to their unit and suggested making a switch. She found a male nurse to take this patient from me. Relief.
I took over his discharge, which ended up being a little more complicated than expected but I happily worked hard for this patient to get out the door. At one point here I had zero patients and three waiting to get in. I RAN to lunch. Afterward, I got slammed back to back to back with report, admission, family request, phone call, procedure, doctor visiting at the bedside and repeat. One guy I admitted was my favorite flavor, an 80-something guy. I spent approximately three minutes in the room and went to catch my next patient coming into another room. While I was admitting a different patient, my friend went into the room to help me pass some medications since they were not available when he arrived to his room. The guy asked, "Where is that girl nurse?" "She is admitting another patient, I am helping out. Brought you some medicine." "Oh. Man, when I saw her, I thought I had died and gone to heaven! She could make a small dog break a large chain!" Thankfully this friend relayed that conversation to me. Though I was drowning and having a rough day, that made it worth it. I knew he had felt my care in the short time we spent together. Another patient I had received came from a more intense unit so everything that was helpful was just removed from his body and the timer started now. He needed a better IV, I had to make sure I watched the clock so that he peed, he needed a diet order and it was conveniently dinner time so he was hungry smelling everyone else's tray. I have learned one thing from this unit, I will never be that ICU nurse that removed everything as the patient is heading out the door for a transfer, that's just mean.
This patient's wife was at the bedside when I arrived, the delivering nurse said that she pretty much was the nurse and would let you know what he needed. She, however, needed a sleeper seat. Again, am I taking care of you or your loved one? Let me do a few things first. She asked me several times and I also reminded her that I didn't forget her request, I just had a few things higher on the list at this moment. GOSH. His other family member asked me my name again as he was walking over to me. Was he trying to shake my hand? Oh no, "NATALIE... I want to give you THIS." I looked at a piece of paper he handed me. It was a list of six names of family members that were unwelcome to visit. It said something to the effect of "Under no circumstances should these persons be allowed in or be given any information. If this request is not honored, we will take the appropriate legal action." Again!? Twice in one day. Ironically, it was the same diagnosis and procedure. Maybe I should start a study...
I thankfully finished my day and gave report to three understanding souls. I prefaced report with the following and I am sorry if it is too much information but it is where I was that day at that time:
"I am sorry to give you report on this person, whom I barely know. He was my 8th admission and I had a heck of a day. Since this morning, I laughed, I cried, I almost peed in my pants, I haven't changed my tampon all day and am going into toxic shock any minute now. I have boob sweat, back sweat, pit stains down to my waist, I smell like death and my legs are throbbing. That being said, I will tell you what I DO know."
Travelers are awesome. They don't care and are confident enough to figure it out and take control of a messy situation if need be. They don't judge other nurses for a bad day or a bad job. Echoing my last post, I am thankful to be associated with the traveler team.
I can do this. April will be here before I know it.
*****************************************
Now onto December.
There is no snow here, still. It's pretty great! I have had my balcony doors opened for a few weeks and the coolest it gets in my apartment is 69 so far. There was one whole week of rain, light and then heavy for a minute, then light again. I'm sure you heard about a storm hitting California and the north got it pretty good, flooding and some other damages. We just had slow drivers and cloudy days. My other traveler friends and I get a good giggle imagining native Californians in say, Pittsburgh or Chicago weather. Oh boy! A few drops and every highway is completely jammed with slow moving cars. It really hit me when I said at work, "It took almost twice as long to get to work today. A few drops and everyone slowed down the entire way here!" I heard a native respond, "As they should! It is so slippery out there!" Wow, really? I have yet to see a pile of wet leaves or any threat of skidding on the road. What a bunch of wimps!
So, this is happening now:
Much happier news. My parents landed on December 1st in Hawaii. My dad arranged for them to get leis as they got off the plane. Cute! Now take those sweaters off and go enjoy the weather!
Thaaaaaaaaaaaat's better. And unreal. Looks photo shopped. It's like a second honeymoon and that makes me smile.
This morning, they safely messaged once they landed from their helicopter tour of the island. I had no idea Annie Ba-nannie had it in her! I am going to rename her Dare Devil Grammy. She won't be stopped!
She went THAT high. Over ALL of that water!!
I'm just saying. Watch your mailboxes...
Speaking of mailboxes, I'd better start working on some sort of Christmas shopping and cheer. Cards and kids' gifts and secret Santa lists are in the works. Three weeks? See, April will be here before you know it.
And, Santa, if you are listening...
I've been a pretty good girl this year. I've got myself and my life into some semblance of order. I have had a great year and never wanted less in my life (other than an occasional hug and visit home to see family and friends again). My list has gotten short is what I am saying, but these items... I have been lusting after and wouldn't be upset if they arrived this year.
The dress, not the girl. A Diane Von Furstenberg dress from last summer (2011). Still loving it!
Any or all of these Michael Kors watches. I originally feel in love with the rose gold but recently moved over to the pure gold and then I saw this black face. OOOH! I need to document the time of my life in style, no?
Besides nursing school, this really is probably one of the
best better things that I have done for myself. I still miss everyone and the comfort of that "home" feeling, but I'm doing it!
It's an odd balance of money, sun and fun versus home, comfort and a
different, familiar warmth. The holidays here are going to be a
struggle but 'yinz guys' better fire up your FaceTime n'at! Show me
what you are wearing and what nonsense you are all getting into!
Cheers of the Christmas flavor!
XO
