I will probably never know why, but at 5 o' clock all hell breaks loose. Suddenly patients IV's all infiltrate, and when asked if it has been bothering them, look down at their stay-puft marshmallow arm dumbly, and say, "yeah, it has been hurting for a while." Which of course infuriates every nurse, or at least me, because they have been keeping their arm under the blanket the whole day because it is cold in the room and refuse to let the nurse, or anyone else for that matter, turn up the heat in their room.
Suddenly at 5 o'clock any NG tube will miraculously disolve any tape adhesives and slip directly out of their respective nose and land on the floor, still sucking away. Of course, this patient will not let the nurse know because they are reveling in the fact that they don't have a tube hanging out of their nose.
If anyone had even an inkling of coding, their breathing will most definately become suddenly very labored, and will quit, or somehow their heart will decide to try out a new rhythm right at the stroke of 5. Maybe V-fib would be more exciting! Everyone loves a 5 o' clock code!
Anyone who has not told anyone they are nauseated will vomit at 5, and it will, of course be all over the bed, which will require ALL the linens to be changed. Then they will say they feel fine, and no they don't want to take anything for the nausea, because the nausea is gone now. Once the linens are changed, and we have all sat down to give report, they will promptly vomit again, missing the basin, again.
At 5 o' clock, people who have not had a fever all day, will suddenly spike a fever, requiring blood cultures to be drawn from every central line lumen, as well as requiring a peripheral "stick," which whoever tries will be completely unsuccessful, regardless of skill. Or we will be out of blood culture tubes. Or the line will rebelliously decide not to give any blood this time.
If there is an admit who you expected to arrive at 9:00 a.m. or so, he or she will be sure to not show up until 5, right after you had breathed your sigh of relief for not having to get that admit. And the doctor will be sure to write a ton of STAT orders, but not until slightly after 6.
Today is one of those rare days that I can sit and write, and all my patients are actually quite wonderful. I jump up to switch one bag of FFP (fresh frozen plasma) to another, and sit down again after I have washed my hands for the thousandth time today. My patients are nicely grouped in rooms along the wall I face: 357, 359, 360. Nice. It is a great day. Of course, at 6, my admit has not shown up, and I've got my fingers crossed that he or she won't. One hour to go. Then comes report....
(P.S. Mom- I tried the spell check. I think I spelled everything right, or else it is not working. ;-) )
Wednesday, November 29, 2006
Wednesday, November 22, 2006
Thanksgiving Eve
The day before Thanksgiving, or any other holiday for that matter, is never a good time to be admitted into the hospital. I joke that they have to pay me to be here. I can not imagine being a patient, stuck in a tiny room away from family, on a completely family oriented holiday. To make matters worse, also not being able to eat a traditional meal. Hospitals do their best to make a holiday hospitalized better. They make a turkey dinner for the patients and the staff too. It does not compare to home cooked food. The turkey is inevitably cold and entirely dry. The mashed potatoes are watery, being from flakes. The best part is usually the rolls that are decent when warmed in the microwave , and it is a real treat when you can find some butter to put on them.
Someone usually brings in decorations, and by christmas there is usually a bit of tinsel or greenery. We usually bring in wrapping paper and cover each of the pictures, adding bows if we get really creative. Sometimes there are even christmas lights on the unit. The long term facility floors, like the skilled nursing facility and the oncology floors usually will even have a tree. A local elementary school usually donates paper ornaments made by the kids as a project, and we ask the patients to help decorate. Most of them are too sick, though, and their ornament gets taped either on their bed rail or onto the wall so they can look at it. The "lucky" patients also have cards and pictures up on the walls, sometimes even a drawing scribbled on the dry erase board, which as a nurse, makes writing our own name up on a challenge at times. But we would never dream of erasing the "art," it's a nice tie to the real world.
On our floor, the patients sometimes get to know each other as they do thier laps around the unit, iv poles in tow. They talk about what cancer they got, they joke about racing each other, and how the gowns never quite cover everything. Sometimes they compare nurses, who is good, who is not. It's nice to see them bonding. During the holidays, most of the healthier ones have been sent home to be with thier families. It's the really sick ones who have to stay. We get to know their families, and kind of adopt them. Especially when the family has small kids. This year we are adopting a family that has a 4 year old daughter who also loves the little mermaid, and so we are all chipping in to buy her a little mermaid bike and bedroom set. It makes us all feel a little better that we can make her happy during this time. She does not know that this may very well be the last Christmas she has with him. I can't imagine how hard it must be for his wife too. Christmas shopping is not exactly a priority when your husband is fighting for his life in a hospital bed somewhere. (Justin says, :"hi")
We do what we can. Even though it is not really much. We don't count giving chemo, changing bedsheets and drawing labs as "something." That' s just work. We can see their future, even though we are not always right, in the end we usually are. It's tough with the family can't see where it is going. They think another bag of chemo, or another type of chemo is going to fix them. Sometimes it does, but most often it doesn't. It only makes the last days more dramatic. Especially with transplants. Even though sometimes the cancer is gone, our patients die ugly deaths. I don't think there is a way to show people what they may become. They don't know thier skin may turn to leather, that thier stomach may look like they are expecting twins, that thier feet will feel like lead and swell to 4 times what they once were. They do not know they won't even be able to take a sip of water and keep it down, even though the doctors tell them they may have nausea. How do you explain "gvhd" to someone? Your insides will slough off just does not compute. Mouthsores do not translate clearly enough to be understood as swallowing and breathing will be torture, like swallowing a mouthful of needles. It does not make sence that you will need 2 or more units of blood every day, even though you are not bleeding from anywhere. It is hard to understand why you have to take your iv pole with you into the shower. Or that the idea of just showering may as well take as much energy as planning a back packing trip to europe.
It's disheartening learning that, even after all that, the cancer has come back. I am thankful that I am not the one to have to tell them, but it does grip your stomach when you know the test results are not in thier favor, that the cancer has spread, that the chemo never worked, or that there is nothing else we can do. Holding that information back, waiting for the doctors to come in to break the news, acting is part of our job.
So we do what we can. Accentuate the positive. Nurses love giving the good news. Or at least I do. And, most importantly, it reminds us of how valuable our lives are, and how lucky we are to be able to eat that salad and sushi, to hop up out of our chairs when a patient needs us, and that we can walk out those doors to go home at the end of our shift.
Someone usually brings in decorations, and by christmas there is usually a bit of tinsel or greenery. We usually bring in wrapping paper and cover each of the pictures, adding bows if we get really creative. Sometimes there are even christmas lights on the unit. The long term facility floors, like the skilled nursing facility and the oncology floors usually will even have a tree. A local elementary school usually donates paper ornaments made by the kids as a project, and we ask the patients to help decorate. Most of them are too sick, though, and their ornament gets taped either on their bed rail or onto the wall so they can look at it. The "lucky" patients also have cards and pictures up on the walls, sometimes even a drawing scribbled on the dry erase board, which as a nurse, makes writing our own name up on a challenge at times. But we would never dream of erasing the "art," it's a nice tie to the real world.
On our floor, the patients sometimes get to know each other as they do thier laps around the unit, iv poles in tow. They talk about what cancer they got, they joke about racing each other, and how the gowns never quite cover everything. Sometimes they compare nurses, who is good, who is not. It's nice to see them bonding. During the holidays, most of the healthier ones have been sent home to be with thier families. It's the really sick ones who have to stay. We get to know their families, and kind of adopt them. Especially when the family has small kids. This year we are adopting a family that has a 4 year old daughter who also loves the little mermaid, and so we are all chipping in to buy her a little mermaid bike and bedroom set. It makes us all feel a little better that we can make her happy during this time. She does not know that this may very well be the last Christmas she has with him. I can't imagine how hard it must be for his wife too. Christmas shopping is not exactly a priority when your husband is fighting for his life in a hospital bed somewhere. (Justin says, :"hi")
We do what we can. Even though it is not really much. We don't count giving chemo, changing bedsheets and drawing labs as "something." That' s just work. We can see their future, even though we are not always right, in the end we usually are. It's tough with the family can't see where it is going. They think another bag of chemo, or another type of chemo is going to fix them. Sometimes it does, but most often it doesn't. It only makes the last days more dramatic. Especially with transplants. Even though sometimes the cancer is gone, our patients die ugly deaths. I don't think there is a way to show people what they may become. They don't know thier skin may turn to leather, that thier stomach may look like they are expecting twins, that thier feet will feel like lead and swell to 4 times what they once were. They do not know they won't even be able to take a sip of water and keep it down, even though the doctors tell them they may have nausea. How do you explain "gvhd" to someone? Your insides will slough off just does not compute. Mouthsores do not translate clearly enough to be understood as swallowing and breathing will be torture, like swallowing a mouthful of needles. It does not make sence that you will need 2 or more units of blood every day, even though you are not bleeding from anywhere. It is hard to understand why you have to take your iv pole with you into the shower. Or that the idea of just showering may as well take as much energy as planning a back packing trip to europe.
It's disheartening learning that, even after all that, the cancer has come back. I am thankful that I am not the one to have to tell them, but it does grip your stomach when you know the test results are not in thier favor, that the cancer has spread, that the chemo never worked, or that there is nothing else we can do. Holding that information back, waiting for the doctors to come in to break the news, acting is part of our job.
So we do what we can. Accentuate the positive. Nurses love giving the good news. Or at least I do. And, most importantly, it reminds us of how valuable our lives are, and how lucky we are to be able to eat that salad and sushi, to hop up out of our chairs when a patient needs us, and that we can walk out those doors to go home at the end of our shift.
Thursday, November 02, 2006
No plot, so what!
I, like my mother, am indulging myself with the challenge of creating a fabulous romance novel in 30 days. I use the term fabulous very loosely, but the saying the truth is more interesting than fiction, in this case, is entirely lost on me. Romance has not been in the air for quite some time. Only ashes from recent forest fires. Not the same as smoldering passions. In my novel, I will be adding dashes from excerpts of my own life, with a splash from family and friends just for good measure. Sometimes the reality you create is more endearing and pleasant than the one you find yourself surrounded by. For example, sitting here at a nurses station, while construction is being done to upgrade the rooms, and the doctors are mumbling about themselves, and the social workers are socializing, and the call lights are calling, and the rattling of iv poles being pushed around the unit in endless circles, well, it is nice to retreat to a place where an alterego is unknowingly about to chance upon her knight in shining armour.
It does help, too, to have the influences of nyquil enticing my thoughts.
I do stop and peak into my patients rooms to ensure their safety, and can't help but wish I had their "prison sentence" of having to remain confined to a room, with nothing but a phone, a tv and my bed for entertainment. Ah, bed. To sleep, perchance to dream. But alas, another set of rounds...safety first!
It does help, too, to have the influences of nyquil enticing my thoughts.
I do stop and peak into my patients rooms to ensure their safety, and can't help but wish I had their "prison sentence" of having to remain confined to a room, with nothing but a phone, a tv and my bed for entertainment. Ah, bed. To sleep, perchance to dream. But alas, another set of rounds...safety first!
Tuesday, October 31, 2006
OK, here I go!
It's funny how you have so many thing to say, but once you get a blank screen, everything else goes blank. Then what do you do? You blog. Whatever that means. What does blog mean? Does it stand for something? Blatant La-la-la On Google? Bold Liturgies On Gab? I'm sure someone knows, and I could easily ask my research librarian mother, she pretty much does have all the right answers, but sometimes I think it best to just not know for sure and give way to the imagination.
With this blog (big lougies of gold?) I hope to make my readers laugh, wonder and speculate. I hope to help others gain some insight into the solemnity, as well as humor that life daily, if not hourly, dishes up. My patients routinely remind me how lucky I am, I will try to pass on this awareness. Because it really is good to be me!
With this blog (big lougies of gold?) I hope to make my readers laugh, wonder and speculate. I hope to help others gain some insight into the solemnity, as well as humor that life daily, if not hourly, dishes up. My patients routinely remind me how lucky I am, I will try to pass on this awareness. Because it really is good to be me!
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