Turning the corner

I think I may (knock on wood!) have turned the corner, in that at least I don't feel as bad as I did yesterday, so maybe I'm on the upswing. I seem to have developed a nasty-get-that-girl-into-viral-isolation hacking couch, and my tissue box and bag are my constant companions, and I'm still needing an hour's nap for every hour I'm awake, but I'm rather pleased that I don't feel any worse. I even perked up a bit at the thought of maybe going to Costco with Jodi, but it didn't take long for me to realize a.) it's Saturday of a holiday weekend, are you inSANE? and b.) the ten-minute phone conversation exhausted me and wore out my croaky voice enough.

I'm more well-equipped now too. I have many boxes of soft poofy tissues, many gallons of beverages in the fridge, some gorgeous raspberry sorbet, and MTV is re-running a marathon of the Road Rules/Real World Challenge. Dude. The only thing better than an MTV reality marathon is being sick enough to justify watching it since your brain is already mush. And I've got the funniest movie evAH, Wedding Crashers, starring one of my boyfriends, Vince Vaughn, and the Sims for amusement. So, call the sick line, I'm not going to work anymore and I'm calling in sick from life. At least for the weekend. Because come Monday morning, I think I'll be handed my discharge papers from the Sick Couch. I guess I'd better be ready to get ready to leave the country. The country, the continent, the time zone, yaddy yaddah desertcakes.

And now, it's dinner time at the Last Meal in the Country Cafe. Tonight's special: Velveeta shells and cheese. Dude.

Low Bentham

I feel guilty not having any photos posted lately, because I know, dear reader, that sometimes you just feel like looking at the pretty pictures instead of reading someone's droll words. I'm still figuring out this whole mac thing, and iPhoto, and so I haven't been able to upload any new pics. Or rather, the photos are all on the computer, I'm just having trouble organizing and finding them. So, for now, you can look at this photo of the village of Low Bentham in Lancashire, northwest England. It's where my parents lived for six months in 1996, while I was living an hour south in Lancaster. My dad recently put this photo on his flickr site, and I haven't ever seen it before. It gave me a twinge of homesickness.

Speaking of sick, yes, I am, thank you for asking. As a BMT and PICU nurse, I take care of some very sick people. People in varying degrees of organ failure, people with their mouths and esophagus ulcerated and bleeding, people with blistered skin falling off their bodies, people requiring constant infusions of pain medication, people with cancer, people who are dying. Therefore, sometimes I find it hard to complain about or even mention being sick, since I am obviously pretty well off compared to my patients. But jeeeeezus christ I feel like ass. Like a shitsickle warmed up and refrozen. My throat is scratchy and sore, my neck aches from swollen glands, my nose is blocked up and intermittently, my eyes are red and itchy and teary, my entire head is throbbing like it's caught in a vice, and my tummy is rumbling and nauseous. Today I felt a lot worse than the day before, so I'm hoping today was the low point and I can only get better from here.

I'm glad I'm single and I live alone, so I don't have to brush my hair or worry about how grody I sound when I cough. But being single kind of sucks because even though I'm a walking Sicky McFugliness, and I've called in sick from life, I still have to empty my own dishwasher and walk the dogs and go buy my own tissues with lotion and A & D ointment (for my raw, chapped nose. Don't laugh. I'm single and I can have a shiny red nose if I want. See the vicious cycle here?) Sure, a few well-meaning friends ask how I am and if they can bring me anything, but I can't really ask them to do the things I really want, like empty my dishwasher, or put the kettle on for the hot water bottle while you're up, can I? Plus I can hear the audible relief in their voices when I tell them I don't need anything, but thank you, and they are so relieved they don't have to venture over to the Sick House, risking their own health and eyesight upon glimpsing red-nosed-messy-haired-hacking Rosebuttons. I know how it is.

In other headlines from the Sick Couch, my fancy-ass graphite grey T-Mobile moto razr phone thinks its too good to accept text messages from Verizon phones. I can send and receive calls, and send texts, I just can't receive any. This may prove to be a bit of a problem considering my two friends have Verizon phones. And also considering I much prefer texting to speaking on the phone as a method of communication. Ugh.

The darling Matrix is back from the dealer's, although they were too busy to wash her inside and out so they "owe" me a wash. So, $165 later, she's happy and running great, but still a dirty lil' mofo.

I think I may still be covered under my previous health insurance, so instead of crying and beating myself up for not realizing this sooner, and instead of being pissed off that it's a freakin' holiday weekend and everything is shut (didn't we just have a freakin' holiday weekend? Get back to work, lazy America!), I shall take a deep breath and plan to get my headache meds filled as a three-month supply next week. Cross your fingers on that one.

Ok, my whining and complaining is done for now. Carry on as you were.

Shniffle

Ugh...still sick, reporting from the couch. Yesterday I got a brief and sudden spurt of time in which I wanted to clean and organize around 4pm, I'm hoping that hits again today. Until then, I want to do nothing more than lay on the couch, watch bad TV, and not stray too far from my tissue box.

I thought I had more to say. But I don't. Time for a nap.

Any chimp can play human for a day...

Just a cool line from Rilo Kiley, my latest favoritest album.

So the days count down, until I leave the country. I've done a few things, but I feel like the time is ticking by and nothing will get done.
Here's what I've accomplished so far:

• bought a new mobile phone (quadband, GSM)

• cancelled my previous mobile phone contract, because I couldn't use that phone outside of the US or Canada
• made an appointment to get my hair cut and my eyebrows waxed
• made a doctor's appointment
  

• suspended my cable TV and internet service (I'm using my neighbor's wireless service, and the cable won't be officially suspended until the day I leave. Live without my DVR? Are you kidding?)
• bought a converter/adapter kit for electrical thingies
• Saw Night at the Museum (okay, not exactly necessary for going abroad, but definitely necessary for my sanity)
• made an appointment for an oil change and check-up because my car's "check engine" light came on this morning
• balanced my checkbook and realized I can't afford the oil change, hair cut, brow wax, or new clothes until I get my paycheck advance from my foreign employers
• found out I probably don't have health insurance coverage after this month
• found out that I won't get my paycheck advance until I get to London
• bought lots of tiny travel things and generic OTC meds for my first aid kit to take with me
• Had to use some of the Airborne and zinc lozenges and cold medicine already for the runny nose and itchy sore throat that I have now

But anyway, somehow I guess everything will get done. Somehow I'll pay for what I need to pay for. And somehow I'll get to London.

Happy Boxing Day to all!

This is Ted and Stinky Duck, looking on sadly as I ignore him while I play with my new favorite toy, my wee Macbook. Photo taken by macbook itself. That's my leg on the left, you might recognize me by my polar fleece uniform that I am wearing in order to couch surf in the utmost style. And yep, I lists and lists of things to do before I leave the country in two (eek!) weeks but today I am being lazy and recovering from my 60 hour work week. I might nap now, then shower and go to Target and then the Verizon store in order to investigate the possibility of buying a cell phone that I can use in London and SA. Wish me luck. On the phone search, that is. Not so much on the napping or Target shopping, I do pretty good with those activities :)

Happy Christmas!

Happy and merry Christmas to you and all you love!

Oh. My. God. I just worked. 60 hours this week, five days in a row. Three days in the PICU, two in the hem-onc ICU. Today, at the eleventh hour (actually, the 57th hour, but who's counting?) my patient turned his stable, perfusing sinus rhythm into an atrial flutter, two-to-one conduction. Which means that his atrium squeezed about 300 beats per minute, and the ventricles squeezed 150 times per minute. That's pretty fast if you're my 100 kilogram 62-year-old male, and not my 5 kilogram 9-month female patient. An EKG was done, cardiology was called in, and excitedly decided to cardiovert the patient. They were super excited because he was already anticoagulated thanks to coumadin treatment for an aortic valve replacement ten years ago. It's not advisable to cardiovert the heart of a patient who may have been in this unstable atrial rhythm for a while without anticoagulation, because there's a risk they may have formed a clot in the atrium which would then be sent elsewhere in the body, plugging up important spaces in the lungs or brains or whatnot. Anyhoo, we sedated the patient, shocked him, and finally started an amiodarone drip which actually converted him. What I'm trying to say is that the last few hours of my excessively long stretch of working were filled with much too much activity and business and now I am so freakin' tired. And I have no idea why I'm telling you all about cardioversion instead of sitting back and watching the BBC and letting my brain melt away.

Santa decided I was a good girl this year, because a shiny white Macbook showed up two days ago on my doorstep! It is just so cute that I invited it inside and I think I'll keep it.

More later, as I recover. So, to sum up, in case you're wondering, working five twelve-hour days in a row sucks a lot.

Main Street, Yemen

If you know where this line is from, you are awesome: "When we get to Yemen, can I stay with you?"

Also, in Things That I Think Are Funny: While in B'ham this week, my dad told me about a news story involving a holiday display on someone's yard with a nativity scene. Someone stole the baby Jesus out of the manger, as often happens. Those baby Jesi must have a high black market value. Anyway, the family replaced the baby and it was stolen yet again. So, the family replaced the baby one more time. And yet again, it was stolen. However, this time, they found a note in its place. The note read: "IOU two baby jeez"

London calling, part two: The electric bugaloo

My dilly-dallying from a few days ago about "do I keep the apartment / do I put it all in storage" has been solved, by powers beyond my control (thank you, "Dangerous Liaisons," for my all-time favorite excuse). Turns out, THEY would like me to come to London on January 8th. Okay, fine, sort of short notice, but I can do it. However, I cannot (and will not!) pack up my apartment and move it all to a storage unit in about 20 days, while working and trying to tie up every other loose end in my life. MAYBE it's possible but I sure don't wanna do it, so I'm not gonna. Anyway, tomorrow I'm going to buy a ticket to London. From there I will eventually make my way to Saudi Arabia, and I will be chillin' in the desert for a few months...maybe until May. July, at the LATEST. But it all depends. On you know, trying to live in 120 degree heat, wearing an abaya and a niqab, eating rice and lamb, all that stuff. And over the next 20 days, I must buy an airline ticket (yes, I will be reimbursed!), a laptop, new clothes (on the more modest side), cancel my utilities, change my address (to where?! I don't know yet...), make copies of my passport, organize and file my papers, visit my doctor, load up on my prescriptions, buy oodles of dog food...sheesh, there's way more stuff. Oh yeah, tell my boss I'm leaving. That's a biggie. On top of all that stuff, say good-bye to my family and friends and my wee precious niece and my dogs and try really hard not to cry every minute of the day because it would really hinder my plans of getting all this stuff done. Each time I picture saying goodbye to the dogs, I well up. I'm going to be a mess.

The weirdest? Thinking that I won't be wearing pants or driving a car for so long. I have so much more to say about this bizarre adventure I'm about to embark on...I think in the near future I will start another blog devoted to it...and I think I will call it Arabian Nightshifts.

Now, back to knitting tiny things. Distraction is a wonderful stress reliever.

A very Buttons holiday

Greetings from my favorite holiday getaway, Bellingham! Since my actual xmas weekend will consist of 60 hours of taking care of sickies, I'm spending a few days up here with my wee family. Not wee as in Roloff wee (dude, I love those guys!), but wee as in just me, mum, and dad. Well, and three small dogs. But anyway. So far it's been lovely, and we are "celebrating" in true Buttons family fashion. There is a wee tree, Norfolk pine, with a few wee gifts underneath. Our holiday meal tonight was Japanese, following by a driving Tour of Lights with appropriate "ooohs" and "ahhhhs" and lots of excitement over the dancing Santa. The slowly moving electric light-up reindeer, also appropriately creepy for the holidays, were our second favorites. Then we all curled up under blankets with a couch and a dog apiece, and watched Sense and Sensibility while mum did her crossword, I knit, and dad read the latest New Yorker. With our cups of tea and biscuits, of course. Tomorrow perhaps we will open some gifts and then head off to a matinee. Ahh, good times.

I promise to show you photos of this years' woolie gifts and the warm and toasty recipients, as soon as pressies are opened tomorrow!

Blow me away

So last night it was a bit windy here in Seattle. If you were actually in the Puget Sound area last night, you'll know that statement is the understatement of the year. I was having trouble sleeping anyway, probably because a.) it was night time, and I'm noctornal, and b.) my afternoon nap was too late in the afternoon. For some reason, the wind was way noisier in my bedroom than the living room, so I ended up on the couch with the doggies, sort of half-sleeping, and developing a headache. So I called in sick for my shift today and went back to sleep until 10am. When I re-awoke then, I was dismayed to find my cable TV and internet were down, although I fortunately did have electricity, which is apparently more than a lot of Seattle could claim. I spent a very lonely and quiet day watching movies and reading and knitting. To be completely honest, it's fairly close to how I usually spend my days off, except for the fact that since I couldn't watch cable TV or check my email or pretend to shop online, I was itching with boredom. But now the cable is back, and lo, there is nothing on worth watching. And no emails of any interest, and surfing the internet sounds boring. I'm such a brat.

I have a bit of a housing dilemma. I have to move out of my place when I go...well, over there. So naturally I'll have to give up the apartment, although I adore it, and it's perfect for me and my wienie kids, and I don't want to rent anywhere else. I have to move all my stuff into storage, then when I get back, I have to stay with my parents or friends until I a.) buy a house and move into it, or b.) find an apartment and move my stuff into it only to re-move again in a few months when I finally buy a house. This plan sort of sounds reasonable on first glance. But it is complicated by two very important points: I hate moving. I hate packing, cleaning, moving, everything. I don't so much hate the unpacking part of it but that's not really the point. And in this plan, I have to move twice. Maybe three times. And secondly, I can't stand living with other people. No matter who they are, I hate sharing my space. I wish I could just return from...over there and go house shopping, pick a place I like, and move into it, all within a week. The only other alternative to this plan is to keep my apartment, keep paying rent on it and not move my stuff out, and it will be here, waiting for me when I get back, then when I find a place to buy, I'll move then. Unfortunately, that lovely plan is a bit more expensive than renting a storage locker and sucking it up living with friends or family. Ugh. Did I mention how much I cringe at the thought of having to put on pants to go to the bathroom? Or not being able to watch what I want on TV all the time? I know, I'm a brat.

What I learned today

1. Baby-sitters are allowed to break some rules. Despite what so-called child-rearing experts say about making the baby fall asleep on their own in their little cribs, sometimes a sleepy warm baby on your chest is enough to make you fall asleep yourself, and share a lovely nap with the baby. I had the best of intentions of getting up to put the blinky-eye-rubby baby into her crib to sleep, but well....

2. Saudi Arabia is a particularly frightening, corrupt, and fundamentalist part of the world.

3. Headache pills are worth more than their weight in gold, not only to me. When I opened my new box of pills and found only half the amount that was supposed to be there, I cried. A lot. Then cried some more because I was so befuddled by my own crying over headache pills. And then I cried some more because I was so sad that the difference between having headache pills and not having headache pills makes such a huge difference to my quality of life. As in, a life that I would like to have apart from laying prostrate on the couch in the dark trying not to breathe too hard because even breathing hurts. So I am either taking them in my sleep or there is a stupid or corrupt pharmacist out there who has my precious pills in his pocket. I'm going to call the pharmacy tomorrow to talk to a manager but I'm not sure I'll be able to do it without crying.

4. Using the deposit function on an ATM machine delays the posting of your check to your account by several precious days, causing annoying "insufficient funds" charges to be posted to your account in the meantime. Next time, walk inside the bank.

Urgh. I'm hungry. And I'm really freakin' sick of having a headache.

Back and forth and back again....

The past week I haven't really been able to see straight since when I close my eyes all I see are lists of pros and cons scrolling past. It is, of course, the age-old classic question: Should I stay or should I go? More exactly, should I stay here and continue along in my fairly comfortable if vaguely unexciting life, OR should I take off for three-ish months (depending on whether you use the lunar or the julian calendar), live on the Red Sea in Saudi Arabia working as a private nurse for a foreign dignitary? Complicating the matter are the issues that I've just started a new job which I love, I would have to give up my apartment and find someone to take care of my dogs, but I would be making nearly a year's salary in those three months time. Then throw into the mix other random worries which creep into my mind...how will I get my prescription headache medicine? Will I have to eat lamb? Am I really okay with the government keeping my passport and visa while I am there, having to where a niqaab and abaya, and not laughing in public? My boss turned out to be super supportive, and said that I should go, and I'd always have a job here when I got back. Phew. My friend S offered to take care of my doggies for me, and nobody except me loves them as much as her, so double phew. My friend J offered to help me sit down and literally make lists of lists in order to prepare to go, so phew again. Then my family said uh-uh. Don't go. And other assorted things related to public beheadings and misogynistic theocracies. *screeeech.* (those are the brakes.) My family has never ever asked me NOT to do something. Well, not since I was four and I was told never to cut the cat's whiskers off again. But they've otherwise been very supportive of everything that I wanted to do, whether or not they truly agreed with me, they stood behind me. So now I'm all a-fluster and rattled again.

I'll admit, the money, whether it be blood/oil money or not, is really tempting. The carrot dangling in front of my face, promising paid-off credit cards, student loans gone, a down-payment on my very own house, a pony, is almost more than I can resist. Then there's just the whole experience of it all, the opportunity to see a part of the world and a culture that I would never otherwise be able to.

I need more headache medicine, these lists are making my head hurt.

Bah humbug

Nothing like trying to do some routine errands on an otherwise uneventful random Tuesday afternoon in December to bring out my holiday spirit. However, in my case, "holiday spirit" refers to growing amounts of frustration and increasing periods of shouting at other drivers, giving people the finger, and loudly reminding people in the post office that the line started back there and they just cut in front of me. Yes, I'm that person, the person who hates the Blue Angels, and grumbles throughout the holiday season. I'm the big wet blanket, the wet weekend in Bournemouth, whichever expression you choose. Because you should have been telling those people who you are buying unnecessary, overpriced, underused gifts for that you think they're swell throughout the year, but you waited until December because Hallmark and the Temples of Consumer Greed (i.e. malls) tell you to.

Anyway, I'm a scosh on the crabby side today, something that I hope a jacket potato with tuna and corn, a movie about crossword puzzles, and some knitting will sort out. I think I'm just a bit down over the death of Elizabeth I. Okay, so I know it was in 1603, but I just watched Helen Mirren's portrayal of it last night, and it was terribly moving and well-done, so I'm just a bit down.

And also, nothing like some holiday traffic and stupid drivers to make me feel like throwing on an abaya and checking out of Western society for several months. Did I mention my latest job opportunity? I'm sort of keeping it mum until things become more certain, but I'm sure I'm already at the top of several government lists for my recent google searches alone. Stay tuned.

Proof of snow

This was the view from my parent's living room window in Bellingham, as it dawned on me that I would not be driving back to Seattle that day. I did eventually make it home, obviously, after knitting several more hats and hot water bottle cozies.

I worked two days of 'per diem' at my old job this week. The first day wasn't too bad, just had one intubated patient, fairly smooth going. The second day sucked ass, and the unit was crazy as well, but I was kind of glad. It was a nice reminder as to why I left, and that I made the right decision for myself. And so as to not interrupt my two-year stretch of not letting my patients die on my shift, I left at 3:30 when my shift ended although the patient's withdrawal of life support was going to start within the hour. Also, kudos to Dr W, who was the most direct that I've heard any doctor be with family on our unit. "Your wife is going to die. If we allow things to continue as they are now, she will die within the week. Probably closer to 48 hrs. Maybe sooner. Her disease has already made that decision for her. But you have the decision to make about how she will die." Sounds harsh, but he somehow conveyed the utmost compassion, empathy, and wisdom in that statement. And, cancer scores again.

Today I went into work then found out I wasn't supposed to be there. Oops. My surprise day off was lovely though, I managed a trip to Target and two naps.

Snow day

So yesterday I was supposed to drive back home from Bellingham, but sometime in the afternoon it seemed like a better idea just to take a little nap on the couch and relax with my knitting for the evening and just drive home this morning. However, the snow storm that came in overnight sort of changed those plans and now I'm stuck. Funny how yesterday, I was reluctant to leave but today I'm desparate for my own house, and gray, mean rainy Seattle. I miss my dishwasher, clean clothes, and fast internet connection. The doggies are missing going outside and not being buried in snow. The "storm" isn't very bad, it's still quite warm outside, and about 6 inches have fallen so far. Nothing compared to Wisconsin standards. However, the lack of a snow plow or salt or sand trucks makes it suck a million times worse than a Wisconsin storm. Not to mention the other drivers on the road, who I won't even get started with. Let me just note however, that contrary to popular belief, "four-wheel-drive" does not actually mean, "Magic ability to drive in any weather condition without adjusting your driving." Because nursing license or not, if I see you driving like an idiot in your SUV and swerving to a stop into a telephone pole because you thought 4-wheel-drive meant "don't bother increasing your braking distance," I'm not getting out of my warm car to help you. Ok, I might get out because of ethics/shmetics, but as soon as I grab your empty head and hold your neck in traction, while I'm looking at you and assessing how much you're bleeding, I'm going to remind you that you're an awful driver and maybe next time you'll actually assess road conditions and use a little of the common sense you probably just bled out. Anyway. Maybe I'm crabby. But unless you grew up in the midwest, get your ass off the roads. Unless you are driving the ONE snow plow that Bellingham might own. I think I'm being overly optimistic on that one though. Now look, I got all worked up about other drivers.

Change of venue

First of week of new job, which I guess soon will just be "job," is done. So far, it's pretty good. It's still early days, of course, but I think I will like it there.

I used to work at a place I affectionately and bitterly called the "Last Chance Motel." Because it was. People came there for the last-ditch treatment option, after failing several other treatments. They are supposedly aware of the risks of the treatment, but are willing to risk it in order to buy themselves a few months or even years of more time with their loved ones. Or they come because they just can't "give up" or they are incurably optimistic or only believe that complications and side effects happen to other people. Whatever their reasons, they showed up, bald, smiling bravely, with sad worried eyes. Anyway, I always felt a cloud of resignation hanging over my head, over everything we did. It sounds horrible, but when every one of my patients had the same outcome, regardless of what we did, how hard we fought, it's hard not to get resigned to it. When a blood culture came back positive for gram negative rods, we sighed our collective sigh, our shoulders drooped, and we reflexively ordered the appropriate antibiotics. In the back of my head I would think that I wasn't surprised, it was only a matter of time, and wondered if this would be the straw that would help our patient to the inevitable end just a little bit faster. Because it was the Last Chance Motel. We tried really hard, and we kept hoping, believing that sometime, some patient has to be the one who makes it. But really, we were waiting for the families to realize what we all already knew.

At the new job, I think I'm going to call it the Not Fair Club. Not because anyone anywhere ever deserves to get cancer or to get sick, but because kids are supposed to be playing outside and wrestling with their siblings and whining for more candy and laughing, and when you're a kid life is supposed to be simple and easy and most arguments can be countered with a big ol' "But it's not fair!" Because when you're a kid life is supposed to be fair. So lying in a hospital bed with tubes in every orifice and sutures across your belly and almost nearly dying because the tumor they just took out of you weighed almost as much as you really isn't fair. So we aren't resigned to any outcomes here, the only acceptable outcome is getting that kid out of that bed and home again so he can pull his brother's hair and smear peas on his face and make his mom laugh again. So when his blood cultures come back positive for gram negative rods our hearts drop and we stamp our feet and pout, "Damn it! It's not fair!" and we order those antibiotics and we check and double check that they are the best ones possible and we didn't miss anything.

Hrm. It's hard to talk about the old job without sounding heartless and dead inside, but I just can't really phrase it right I think.

Anyway, happy thanksgiving to those of you choosing to celebrate genocide and barbaric empiricism with gluttony and excess. Heh. I like the way that sounds. Don't worry, it's not like I would ever turn down a day off of work or a large tasty feast. I'm going to eat Greek food and see a matinee and hang out with my family in Bellingham.

Home again

Yes, I'm back safe and sound. Yes, I have hundreds of photos to pick through and upload and share with you. Yes, it was totally worth it and the best trip ever and I'm so super glad that I went. Yes, I nearly stayed. It was much closer than you think. Job offers from foreign dignitaries involving obscene amounts of cash can make one seriously rethink one's career direction. I'd love to tell you more but then I'd have to kill you. Besides, negotiations are still open. Never say never, especially if you can get a pony out of the deal.

But I will tell you more about the trip. And the "real" job that I started yesterday. Once I catch up on sleep, get un-jet-lagged (I'm not really jetlagged, I don't think I actually get jet-lagged, but it's a glamorous excuse for not having cleaned my apartment, caught up on emails or the blog, and yawning a lot at work.)

In the meantime, here's a preview of trip highlights:

Day One: Land at Heathrow (early!), take the tube to the hotel where I'm staying, and notice that this is the view from my window. Spend the rest of the day exploring London via Hyde Park, Oxford Street, and end the evening with the East End and Jack the Ripper.

Day Two: Revel more in the history of London, starting with the Tower, ending somewhere around Trafalgar Square with some famous portraits in between.

Day Three: Continue meeting my old Tudor buddies, at Hampton Court, after cruising high above London to check out some awesome views.

There is much more, including a train ride to York (complete with a train station baguette and a copy of OK magazine! Anyone else get how fun that is?!), driving on the other side of the road, finding the East Coast of England, an abbey built in a triple-digit year, the most beautiful church ever, and 49 hours with one of my dearest friends. But, as I already mentioned, I'm jet lagged. So I'm off to bed. I promise, photos tomorrow.

The great outerwear crisis

You guessed it, there was bowling going on last night. A fabulous birthday party for my fabulous friend, complete with cupcakes, bowling, and a Tom Collins drink special. Good times.


It was but a brief respite from the Great Outerwear Crisis (GOC) and the overall Getting Ready for London hoopla, although I am handling it fairly well. I have Outerwear #1, a black 3-in-1 parka, waterproof, rainproof, with a cozy fleece liner that I am taking. Both for dark and rainy London but moreso for the days out on the Yorkshire moors. BUT yesterday my new fabulous raincoat/trenchcoat arrived from England. Here is a photo that looks uncannily just like me modeling it:

I know I know, the resemblace is creepy. But I digress. So this coat, Outerwear #2, is waterproof but, in spite of the removable quilted liner, not quite as warm at Outerwear #1. However, it is infinitely more stylish and just plain CUTER and this is LONDON folks. Park Lane, to be exact. And now I am thinking that the a good compromise would a wool peacoat...and the awareness of the Nordstrom Half-Yearly sale in the back of my mind...

So now I must go back to more immediate concerns, since I leave TOMORROW (can I put any more words in CAPS in this post?!) such as cleaning the house (hate coming home to a week-old mess! Plus, it's just sort of polite for the person who has to stay here with the wee doggies), packing (bringing us right back to the GOC!), and possibly finding time to go to Nordstrom. Oh! And finalizing my itinerary. So far, here's the plan:

Monday: Arrive in London. Ignore fatigue and jetlag. Breakfast with my friends, walk across Hyde Park to the Victoria and Albert Museum.

Tuesday: Train to Hampton Court. Tate Britain in late afternoon, if time? Jack the Ripper tour at night.

Wednesday: Tower of London in the morning, National Gallery and Portrait Gallery in afternoon. V & A is open late that night in case I didn't make it on Monday.

Thursday: Walk across St James Park, Cabinet War Rooms, take a picture of 10 Downing Street? Train to York in afternoon. Pick up rental car, meet E, eat takeaway and stay up till all hours giggling over Dawson's Creek.

Friday: Tour the Yorkshire moors, including Robin Hood's Bay, Rievaulx Abbey, and Whitby. Maybe ghost walk at night?

Saturday: Depending on the weather, drive up to Alnwick and maybe even Bamburgh. OR bop around York, the minster, the York wheel, yarn shops, the ghost walk.

Sunday: Get up wayyyy to early, drive down to London Heathrow, catch my flight home. Cry a bit.

There, sounds doable doesn't it? Your suggestions, either for solving the GOC or for the intinerary, are welcome. Get ready for many many many photos upon my return!!

London calling

Tonight is my last real shift on my unit. I'm pretty much in some kind of denial over it, since I've signed on to work there per diem (filling in for a minimum of a shift per month) so I keep telling myself that I'll be back, it won't be that different. But of course it will: I won't be spending around 40 hours per week there, with the same people, doing the same things, anymore. I will miss everyone but I'm hoping that the people I will truly miss are the people I see outside of work anyway, so we will just make more concerted efforts to make plans and see each other. I will miss our patients and their families, but I will meet new ones. Mostly I'm sure I will miss it the most once I start at the new place...I will miss the sense of familiarity with a place, the consistency, the comfort. But familiarity, consistency, and comfort are also words for complacency and boredom, so I still know that I am doing the right thing.

And I'm a bit distracted anyway....did I mention that I'm going to London on Sunday?! Yes, this Sunday!! I'm so so so so excited. I'm bursting. Simply bursting. I'm picturing myself on a big jumbo jet taking off over across the pond with my iPod (eek! Must update the iPod!) on and my knitting in my lap (eek! Which project shall I bring with me? Are knitting needles okay on the plane?! What IS okay to bring on the plane!?) and an Elizabeth George mystery, or perhaps a book on the War of the Roses, on my lap and my bucky pillow around my neck and I get all smily and fluttery and happy. My Must-See in London List keeps growing, but the Tate Modern, the V & A, the Tate Britain (and the Tate-toTate Ferry! Do you love that?!) top it, the Tower of London is of course a MUST, I'd like to get on the London Eye if I can, walk through Hampstead Heath and Hyde Park, down Oxford Street....oh! And there's an entire museum about Florence Nightingale!! Oh! And the National Gallery and National Portrait Gallery. And must consider if I can make it to Hampstead Court as well. Eek. After three days in London, I'll head up to York to see the fabulous E, where we'll rent some mini-micro-impossibly-wee car and toodle about the Yorkshire moors and hopefully even Northumberland, stopping only for sheep crossings and to eat cheese sarnies and drink tea and poke about in castles (Bolton Castle, Castle Howard, and Alnwick top that list) and ramble down narrow cobblestoned streets (Durham, Whitby and Richmond top that list) and take countless photos. However, lists aside, if nothing at all gets done off the lists but I simply spend six days sitting in pubs, drinking cider and sometimes a Guiness with black currant, eating pub food and reading the Guardian, it will all be okay. It will be wonderful. I only lived in England for six months (ten years ago!) and have only been back twice to visit since then, yet all this planning and anticipation still feels like a homecoming...instead of saying "I'm going to England," I keep feeling, "I'm going back to England."

Small things

Last night, I arrived at work and chatted for a bit with the day shift RN about my orange hat (which she recognized from the Stitch N Bitch book!) and glimpsed my patient's wife and daughter in his room. I didn't get a chance to say hello, but thought I'd see them once my shift started. When I came back for report, the day nurse told me they had gone home. "Once they found out you were his nurse again, they felt comfortable enough to leave and get some sleep tonight," she said. Aw. Jeez.

Later, Dr. McAwesome put an arterial line into my patient (a beautiful one! A work of art! Pardon the really really bad pun). He joked that the patient didn't really need one but he was looking for an excuse to spend more time with me on our last night together. Then he stopped by in a bit to check on things. "Everything ok, Rose?"
"Yep, he's fine, the line works great, his pressure is normal," I said.
"No, with you, how are YOU?" he joked.
"Oh, I'm great. A bit hungry, I would love a sandwich, but overall, I'm feeling great!"
He laughed and continued on down the hall.

A bit later, a huge tray of sandwiches appeared in our break room. Dr. McAwesome truly lives up to his name.

Early in the morning, Charge Nurse, Nurse J, and I were chatting about the frustrating inability of certain medical teams to make decisions. "Seriously, they need to shit or get off the pot," I added. Suddenly J looked alarmed and jumped up. "That reminds me, I left my patient on the bedpan!" and she darted down the hall.

Ok, this was valuable time I could have spent eating Easy Mac, yet I chose to share those little pearls from my night with you. Aww.

Gotta run. Hope no one floats aware in this flooding rain. But seriously, in the rain's defence, at least this is hard-core, sheets of rain, lakes of water kind of rain. None of that pissy spitty rain we usually get. Bring it.

Just playing around

I've updated my avatar, to the left, to show me at work. Yup, there's Nurse Rose, diligently taking care of her critically ill patient, wondering if anyone else has noticed that gorilla in the room named Death.

I'll probably change it tomorrow because that's kind of grim and macabre, even for me. But some days, like the gray days that it rains nonstop and I've only had 24 hours off to recover from work but must go back tonight, those days it's hard to find a lighter side.

Three nights left!

All in a day's....

Today started out not to good but at least it ended well...

I woke up around 9 with a horrible migraine, after dreaming that I was having a headache for probably a few hours. So I took my magic little pill, which chased away the headache but left me sleepy and drugged when I finally woke up around noon. I spent the next few hours on the phone with credit union people and bill people, getting increasingly frustrating answers and no helpful information. I battled homecoming traffic to the hospital to have my TB test read (good news: I don't have TB!) then I battled Friday afternoon grocery store moms (but found a sale on diet Coke!) then battled more homecoming traffic back home. By then I was so hungry, frustrated, and annoyed, that I took a nap. I'm a good napper.

But then I woke up, showered, and went to go hear Bill Bryson talk. And he was funny and amusing and I'm so glad I went. Then I met a fellow, J, for a drink on Capitol Hill. He turned out to be a red-headed Jewish PhD candidate from Pittsburgh. He was taller than me and didn't have girly hands. He was funny in that self-deprecating academic way that only Jews and academics can be. In case you don't me at all, those are all very very good things, on my list of "People I want to spend time with."

So, I am now a happier girl than when I woke up. I am going to knit, watch Big Love, then read another chapter in the Biography of Elizabeth. Ahhh, life is good. Well, it's not so bad.

Things that are sweet

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Originally uploaded by rosebuttons.

Although of course this entire little baby is the sweetest, cutest thing, and there isn't anything about her that isn't adorable, I love this photo because it highlights that perfect smooshable cheek, that tiny kissable ear, and those wee little fingers....my favorite bits.

outdated!

That's me, I'm out-dated. I've dated too much this week. Ugh. I don't even have the energy to update you on each of the fellows...I used it all up straightening my hair and smiling a lot. Tonight I took the night off to knit and watch Big Love and eat gnocchi in vodka sauce and of course I drank some more Argentinian wine. I have a magnet on my fridge that says, "Sorry I can't go on a date with you, I need to stay home and knit." Oh, so true.

Is it true that Lexus makes a car that can parallel park itself? Because I saw it on a commercial, so it has to be true. And I am truly disgusted. Us true parallel parkers (doing it the old-fashioned way, with my hands on the steering wheel...I know, CRAZY!) must refuse to be replace by a machine. Parallel parking is a skill, a true art-form if you will. And I will. Yep, in two moves, that's right, and I'm proud of my skills. So I thumb my nose at you, Lexus, and you lazy Lexus-drivers. If you can't parallel park your own car, then a.) Stay off the road, Soccer Mom, or b.) Find yourself a cozy little parking garage and pull that sucker in head first. Ugh. I hope your parallel-parking computer in your fancy-ass Lexus breaks and there you will be, double-parked, wondering why everyone who actually knows how to drive also knows how to use their horn. Does the Lexus beep at other drivers for you too, when they cut you off? Then make you a latte? Can you hear that noise? Listen closely. That's me gagging. On your Lexus exhaust.

Size matters

It's no secret that I love tiny things, miniature things, diminuitive things....you get the picture. And it's probably no secret that I love England, Great Britain, London, all things from the UK.... so it follows (I loved doing corrollaries in geometry) that I LOVE this. Love it.

You just keep me hangin' on...

Mr. F passed away yesterday. He had a soft-tissue infection just over his left hip bone, the result of an infected bone marrow biopsy site. After a couple of I & Ds in the OR and many many surgeons poking, debriding, cauterizing, stitching...and many many RNs packing, re-dressing, lavaging, infusing platelets, cursing surgeons...anyway, the infection was about the size of a melon. Well, the amount of flesh missing was would have been the size of a melon. It was horrible but fascinating. Poor fellow.

Anyway, the topic of this post was my musing that despite the fact that about 95% of my patients die within a few weeks of their time with me, and although I've been an RN for nearly two years, and although I've wrapped countless post-mortem bodies and handed countless boxes of tissue to family members and silently hugged grieving spouses/children/siblings/friends, never has MY patient expired on MY shift. Ok, wait, one did...a young women who we withdrew care on during my orientation in the ICU. They always wait till I go home...at least a few hours, sometimes a whole shift, then they go. Weird.

Tomorrow I'm off to my favorite little city, Portland. I've got some new CDs for the car ride (the new Beck and Portland's own, The Decemberists), a list of "needs" from Powell's, and my fleece. Really, I don't need anything more.

Of course I will miss this little face:







But he will be in good hands, getting lots of little doggie snacks and belly rubs and play time with his stinky duck. Now, I must be off to bed, I have to get through my biography of Elizabeth I before I move onto the story of Mary Stuart and the "mysterious" murder of her asshole husband, Lord Darnley. This stuff is better than soap operas!

Oh, no word from my new boss on the possibility of changing my start date. Looks like Europe may have to wait....

So sorry!

Have you missed me? I am a horribly neglectful bloggie friend.

First, it's official, I've given notice at Old Job and accepted New Job. So good-bye oncology ICU, hello pediatric ICU! I'm so super excited and scared to death and a bit sad and a lot nervous. But overall, it feels like the right thing and the right time to be doing this.

I have ten shifts left at Old Job, and suddenly last night decided it might be nice to hop over to Europe in between jobs, to treat myself and rest and rejuvenate my spirit, etc. So I'm attempting to get my start date moved back by a week, which would give me 12 days off. I'm leaning towards a brief but juicy tour of Budapest and Prague, although Amsterdam and Paris is a close second. But I've always wanted to go to Glasgow and tour the art and architecture of Charles Rennie Mackintosh. Plus the Scots are just awesome people. Then there's always the idea of just flying into London or Manchester, renting a car, and spending a week touring cold drafty castles during the day and sitting in warm toasty pubs with E at night, eating a lot of fish and chips and laughing our arses off at Dawson's Creek. Any ideas/suggestions? Of course this is all dependent on getting my start date moved and scraping together a small pile of cash...

Boys and dates in general, super lame. I'm tired of all the weirdos. And metrosexuals? You all need your own dating website. Or least you must identify yourself as such on your profiles. Because nothing makes me want to flee the restaurant faster then seeing you and the hair-with-product in it and your casual-yet-expensive jacket and your twitchy too-small hands. Somehow, not attractive. Give me mismatched flannel and endearingly out of place hair, along with big man hands, any day.

Change of Shift

It's up, it's official, the new Change of Shift over at Emergiblog. Head on over to read bits and bobs from the inner workings of nurse's minds, it's not for the faint of heart, but it is truly engrossing :) And of course, there's a little something from yours truly...

OH! I got to go to the morgue last night! These next 16 shifts will be filled with "I've always wanted to...". When the guy (totally blanking on his job title) came to pick up the body in room 34 (who was also a daddy, a son, a husband, a victim of a horrible disease, but mostly a really awesome guy, but I'm sure HIPAA prefers I just call him the body...) I helped him roll the black-shrouded 'mystery' cart downstairs. Then I helped him attach chains to sling under the white-plastic zipped up body-shaped parcel, attach the chains to the hydradaulic lift, raise the body off the cart, drop it down onto another stainless steel 'stretcher' and roll on into the refridgerated compartment. He then slammed the door shut, taped a stamped name-sticker to the door, and that was that. Full circle.

randomity

That's my new made up word.

Last week I went out with J, a night nurse, and we apparently had a wonderful time. We had Vietnamese food, then continued on for coffee and cheesecake, then even walked in the park a bit. We stayed up until 1:00am, and the next day I was all happy and giddy and couldn't wait to see him again. Three days pass, and now I no longer want to see him again. We exchanged a few emails, the usual, "I had a great time, hope we can do it again." So that's not the problem. I have no idea what happened inside my head, except that the happy giddy feeling has been replaced and now I just feel weird about him, not entirely comfortable, and am remembering the not-so-good things rather than the "aww" things about the date. Nothing in particular was "not-so-good," so I'm having a really hard time explaining this. Except that now it's bothering me that he never asked the names of my dogs, and I think he was kind of pushy and cocky. Last night he called a couple of times, but didn't leave a message. In case I haven't mentioned this before, I'm really big on a few little things, like phone etiquette. Like, I obviously KNOW that you called (twice!) so a normal, polite thing to do would be to leave a simple message and I will call you back when I can. Do you think that if you call more than once, I will eventually be fooled into wondering what that funny beepy sound is, coming from this small piece of gray plastic, and press the start button?! Anyway, I'm confused by myself on this one. I just don't want to see him again. So there.

Last night little Ted was very ill, it was very heartbreaking. The vomiting and diarrhea are no fun of course, but it's even sadder to see him so lethargic and depressed. I ordered a pizza, and he slept in the other room the whole time I was eating! He was too sickies to even scratch his butt. This morning he seemed a bit peppier, although rather annoyed that all he got for breakfast was rice. I may go get him some boiled chicken (can I buy it pre-boiled? I don't want to touch it raw. And how does one boil chicken? Should I just cut it up, then throw it into boiling water?!) and cottage cheese for his dinner, maybe that will be more appetizing while remaining bland enough for his upset tummy. I also want to give him pedialyte for dehydration and metronidazole for a tummy bug and draw his electrolytes, but I must just be a doggy-mom first and a nurse second. Sigh.

In exciting news, this week I discovered these. Go look! NOW! And now I must look to my left in order to see myself, because I am absolutely BESIDE MYSELF in the cuteness that these things are. Can you even STAND it?! Can you IMAGINE the lambs?! ARGH! So I am well chuffed (and British, for a moment, apparently) that my dream farm, of miniature animals, will truly be complete. The pygmy goats, mini horses, and wee piggies will be pleased to have some wooly friends.

I have a job interview this week (shhhhh). I am super excited and nervous, not so much over the interview itself, but that if I get this new job, of the transition I will have to make. And it's a strange thing to reconcile in my mind, because I love my current job. I love the unit, and my co-workers, and my patients and their families. I love the work we do, the teaching and research environment, the support of the whole medical team, and the sunrises. But I don't love the medically futile things that we do, when I stop doing things FOR the patient and do things TO him, when people aren't afforded the dignity of dying peacefully and when they are ready. I don't love taking care of someone for weeks and weeks and always losing them in the end. I feel like a weenie because there are many wonderful nurses in our ICU who have been doing this for years and continue to do this, and I wonder what they're made of that I'm missing, because I can't do it anymore. But I also became a nurse there, I started as a wee nurse technician, only two quarters into nursing school, scared of someone else's vomit and fumbling my way around a glucometer, and I grew up into an emesis-bucket holding IV-starting ICU nurse. And now I guess I just want to see what else is out there.

Dating updating!

Gosh, I've been neglectful...are you all gasping for details on my coffee date with R?! Probably not, but you get them anyway. No juicy details to impart, but I will say that I was pleasantly surprised (comment from J: "Why are you always so surprised when a date goes well? Are you expectations that low?!") Uhm, I guess they are. But seriously, considering my past history, I think I'm still entitled to be surprised when someone shows up in clean, unripped clothing and buys me a cup of coffee. Anyway, R was pretty cute, funny, and smart. And also had a sweet sensitive side, since he wants to be a writer and loves reading. Aww. We even made plans to try to get together soon for dinner, so he's either a good liar and says that to all his dates or he actually maybe liked me a little, at least enough to want to see me again.

Tonight I went out to sushi with C, who I almost didn't go out with because he works in sales and lives on the east side and tried to get me to come over there for dinner. BUT I held out, convinced him to come to this side of the water, and gave him a chance. It was a not-unpleasant evening, but nothing memorable.

Tomorrow may be dinner or drinks with J, who happens to be a night shift nurse. Maybe we'll stay up all night trading stories about mucous plugs or nectrotizing fasciitis. I can't wait!

Oh, when I got home from sushi with C, I went to go comb my hair and a live spider fell out of it. Heh. If C doesn't call again, I guess I know why!

Also, I'm contemplating changing hospitals and units. Not that I don't love my unit and my coworkers and patients, but my interest has been sparked in something else. And I feel like I need to move on before I completely burn out, at least emotionally. My SuperNurse facade may be fooling you (and me) but in reality each of these patients and family members who get to me, then leave me, take a little bit of me with them. I don't want to give away any more information about my future plans until they're more concrete, but I'm already re-reading chapters in my nursing texts and checking the mileage from my house to New Hospital, so maybe I'm really ready. Stay tuned...

Smitten

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Originally uploaded by rosebuttons.

Who doesn't love Jon Stewart? Not this little girl! Only three months old, and already showing good taste. She's hoping that his sons are available when she turns 40, and is ready to start dating.

Death of a squirrel

This is the story of a hapless wee squirrel. A stuffed wee squirrel, bought for Ted while on vacation down AT the shore (the AT in that phrase carries a significance only you right coasters will understand), in an attempt to provide him with one more toy than the single stinky duck that he singularly loves. So, once Tessa fell asleep on the couch (I didn't actually have to wait very long for this to happen) I brought out the squirrel and presented it to Ted. Tessa just KNEW something was up, and the rest is history.


What do you have there? A new creature? A squeaky creature? I'll have that, thankyouverymuch. I must make sure it's dead.






Hey! She took my squ-- Hm, my butt itches.










I will soon rid the house of the squeaking creature! Resistance is futile.







Sigh. When are the snacks?







Don't worry. Ted may look quite pitiful in that last picture but I assure you that he got over the theft of his squirrel within three seconds and is much happier scratching his butt and looking for snacks than de-squeakifying small woodland creatures. He leaves that to Tessa. And yes, the fun never does end around here.

Rest now, my friend

He was 55 years old, I'll call him Sam. He'd once said that he was afraid of dying because "there will be a lot of empty pages in my book." I'd taken care of him nearly all of my shifts for the past six weeks, throughout his stay in the ICU. For the first few weeks, he was intubated and sedated. His son and daughter told me that he was slightly hard of hearing, but would prefer to have the television on in the background. The Learning Channel or Discovery, if possible. So all night long, I kept the channel on one of those, switching only to avoid infomercials. In the quiet of the beeping pumps and whooshing ventilator, I would fill the silence by talking to him about what was on TV as I drew his blood, changed his dressings, gave him his bath. Together we learned about the black plague and Emperor Caligula. Some nights were rougher than others...but we got through cold sepsis and some other hypotensive crises and looked like maybe we'd made it through the weeds. Weeks passed and eventually he was extubated (breathing tube was removed). He was slow to wake up, but each day became a bit more interactive. He could indicate if he had pain or not, nod and smile, he even had the good grace to smirk at my bad jokes. My nurse friend, J, and I got him onto the cardiac chair and wheeled him around the unit as the sun rose, to say hello to everyone and check out the views. He smiled more, and preferred to sit in front of the window when possible. He couldn't speak very well yet, but I got pretty good at carrying on a conversation with him my interpreting his nods, smiles, shoulder shrugs, and eyebrow lifts. I remember the morning we watched the rain come down, and lamented that somehow, we'd missed the end of summer.

One night I came on shift to find that he'd been reintubated two days before, and was worsening overall. Liver failure, possible GI bleed, counts dropping, unknown infection. The next night, he had a little blue sticker next to his name card on the door: Do Not Rescusitate. I continued to administer his medications, check his blood sugars, draw his labs, record urine output, turn him side to side, keep his mouth and eyes clean. I watched as his blood pressure dropped lower and lower. I called his daughter, who came in at 4am to spend the night. I said goodbye at the end of my shift, knowing it was the last time I'd see him. But in my mind, the last time I really saw him was the morning we'd watched the rain come down, and lamented that we'd missed the end of summer.

Those pages in your book, Sam? They're not empty.

So I am sad now. The same small sadness that I don't feel quite entitled to, since I know his children and his family are truly grieving, and compared to them, I barely knew him. It doesn't get any easier, because now when I feel sad, it just adds on to the sadness that I had for Billy, and for W., and the guy with my dog's name, and and and...

It was inevitable...

There they are, the Wiener Twins. It was about time, really. I've had at least one dachshund for over ten years now, and the hot dog costumes were bound to happen eventually. And they are worth it. There you have it.

Update on Love and Other Catastrophes: Mr.Lovesmelovesmenot finally fades completely into the background, after a performance of asshole proportions, impressive even by his own previously-set asshole standards. I think I still hear the fire trucks, something about some bridges burning. Ah well. So, my tears are wiped, the drinks are drunk, and I'm moving on. I'm jumping right back onto that dating train, if only for a bit of distraction and a reminder that maybe there are decent guys out there, ones who will pay for dinner, tell you that you look nice, and call when they say they will. I am meeting Bachelor # 1, R*, tomorrow for coffee. He told me a funny story about something he heard on NPR in an email, so I guess I'm a sucker for NPR-quoting microserfs. Stay tuned!

I have no good stories involving blood, mucous, or toenails, as I haven't worked in nearly ten days. Ahhhhhhhhhhh.

Here are some of my favorite things: Malbec, Dreyer's fat-free vanilla frozen yogurt, and sour gummi worms. Not all together, silly. That would be gross. Now, if you'll excuse me, I have big plans to cuddle with my little doggies, sip my wine, and watch Nip/Tuck.

Big walkies!

Today was the big 5K PAWS walk at Magnuson Park. Despite the typical Seattle September weather, we were there, along with over 1000 other Seattle doggies.

We signed in, then got the doggies properly attired in their stylish PAWS bandanas. Unfortunately they did not have Weenie Size and Tessa occasionally got her paw stuck in hers, and Ted's dragged through a few puddles.

While we were waiting for the walk to start, Ted wandered off and we had to convince him that he was not part of Team Terrier.

Then, we were off! Following the signs...

And five kilometers and two very wet bellies later, we were done, to much applause. Which the Wonder Weenies took in stride of course, because really, why shouldn't there be much applause for them all the time?

You know you're a dog person when...

This week in the ICU... two other nurses and I were just finishing bathing a patient, and stuffing pillows into pillow cases. K comments, "It was time that toenail came off anyway. I mean, did you see the tissue around it? It's necrotic. That nail was..." she glances at the sedated pt, then back at us, "that nail was D-E-A-D."

Me: "You're right, the nailbed isn't even bleeding. It's a good thing we removed it -- " then J cuts me off, "What?! Just because she's sedated and intubated she can't spell?" and suddenly K and I realize what she had just done, and bust up laughing.

Also, on a related note, we've discovered what really makes seasoned ICU nurses squirm. Nurses who have suctioned rivers of poo, poked and prodded open, oozing wounds, had skin blisters pop all over them, dealt with tenacious mucous plugs...show them a toenail which has fallen off, and they get a little weak at the knees. A whole toenail.

Well, tomorrow is the big PAWS walk! The dogs are currently resting up, after carbo-loaded and stretching. Okay, so they'd be 'resting up' anyway, but you get the picture.

Walking for Wildlife!

Me and my chubby couch potatoes are going to get off our butts on Saturday and do the PAWS Walk! It will be a challenge...for me, because I have to be awake around 8:00am, and for them, because, well, they're looking a little sausage-like lately. BUT it's only 5K, and I'm fairly confident we can all do it. Will try to get some cute pics but in the mass doggy confusion it might be hard! Anyway, if you're at all inclined, head over to my webpage to learn more about it, and what PAWS does in our community. And of course donations are greatly appreciated, you will get wet doggy kisses via email :)

In other news, I'm leaving town next week! Well, only for one night. But sometimes, that's all you need. Me and the my fearless travelling companions, the Wonder Weenies, and S, are all heading south to the ocean. We will learn about fruit that grows in bogs, eat pizza, run (two-legged creatures will be walking) on the beach, take lotsa photos, and enjoy our peaceful cabin in the woods. Ah. It will be lovely.

And now, your Ted for Today:

Today's Ted

Too-close shot of little Ted's head, just because. I think everyone needs a daily dose of Ted, so here is yours.

And now I am going to make a little pizza with little mozzerrella balls, because it's a little kind of day. I'm also going to clean the bathroom later. Maybe a little.

Hello? Reality calling. Please pick up line 6.

I am a terrible terrible person but I spend much of time of at work feeling quite frustrated by family members of my patients. Okay, that's an exagerration, it's not that much time. But proportionately, the amount of frustration I feel towards them is much more than I should (like never) since their loved ones are super sick, dying, in pain, all of the above.

So last night my fellow RN/friend fielded an early-morning phone call from a family member, and from listening to her end of the twenty-minute phone call, and watching the expressions on her face, I knew it was the exact type of phone call we've both taken many many times before. A concerned family member/friend calls, in our night-shifty case, early in the morning, and wants to be updated on their friend's condition. And here is where the Great Divide in understanding and information begins, from health care provider to family member.

ConcernedFamilyMember ["Connie"]: So, how is my sister? ["Susie"]? Any changes over night?

Nurse: (after verifying through several means and fingerprints and a hair sample that this person is who she says is and can be privy to Susie's super-secret-private health care information). She's doing okay, there were no major changes to her condition over night.

Connie: Oh good, so she's doing better then?

Nurse: Well, she's staying about the same. But she didn't make any changes for the worse, so that's a good thing.

Connie: Well that's good! Is she awake?

Nurse: Not exactly. She's on a lot of sedation and pain medication right now.

Connie: Oh. But shouldn't we wake her up? Is it bad that she's so sedated?

Nurse: No, it's actually a good thing. If her sedation levels are decreased, she tries to pull out her breathing tube and she grimaces like she's in pain, so we're trying to keep her very comfortable.

Connie: Well, if she's more awake, maybe she'll breath better on her own? And come out of the ICU sooner?
Here's where Nurse quietly takes a deep breath, closes her eyes, and starts to continue this conversation privately in her head, not saying what she actually wants to...

Nurse: No, she's not ready to breathe on her own yet, we do breathing trials everyday to determine that. But thanks for your opinion, even though you are not a medical professional, we really need people like you to do our jobs because otherwise we never would have considering your very educated point. Where do you work? Can I come and watch you, and tell you how I think you should do your job? I bet I don't need any special training either.

Connie: So how much longer then? A few days? A week?

Nurse: There's no way to say that at this point, as she's still dependent on dialysis since her kidneys aren't working yet, and she's on several heart and blood pressure medications...

Connie: Are those medications something she'll be able to take when she goes home?

Nurse: No, those medications are currently only in IV form, and they have to be running continuously... Or she'll die. Do you get that? She's super sick and has a high chance of dying. She's on life support and the ventilator and drips are the only things keeping her alive, minute to minute. If we could give her a pill and let her go home, believe me, we would have done it.

Connie: Because my Uncle Harry...he was on dialysis, but he got to go just a few times a week, and he was fine. And he was on this medication that made him make more urine. Have the doctors tried that? Since Susie's not peeing?

Nurse: Every case is very different. The doctors are doing everything they can to support Susie until her system starts to be able to recover on it's own. And again, thanks for your expert opinion. I'll pass it on to the docs, since they're really not actually doing anything, and your idea is probably the best they've heard all day.

Connie: Okay. Also, I noticed her toenails are looking kind of yellow, when I was there yesterday. She usually puts some cream on them for fungus or something. Does she still have that? Because she needs that twice a day.

Nurse: I'll will look into that, and make sure that's being addressed. Because that's super important. Because you know what else? Her kidneys shut down and her heart isn't sending enough blood to her toes and her medications are making them turn black and her lungs are filling with fluid and blood and she has clots throughout her liver that makes the rest of her skin look yellow and I need to change the dressings over her blistering skin and make sure her cardiac drip doesn't run out and suction her so she gets oxygen but dammit, her toes better not have fungus! I guess I am a lazy nurse because I didn't even put her toe cream on.

Connie: Yeah, because she needs that twice a day. I can bring some in if you don't have any there. And is her purple quilt in her room? Because that looks really pretty on her.

Nurse: Don't worry about it, we can get some here. And yes, the quilt is there. But it's on the chair, not on her. If it were on her it might get covered in liquid green stool, mucus, or blood. Probably all three. And also, you should be worrying about Susie's life, not Susie's toes. You should be hugging her children and thinking about how she lived her life, and how she'd want her life to end. You should be just sitting near her, if you can, and telling her how special she is, and playing her favorite music, or taking her dogs to the park and scratching them behind the ears, and not going to the pharmacy for her toe cream. Because Susie is very near death and this is going to be a terrible way for Susie to die. Do you get that?

Connie: Well, thanks for filling me in. I'll be in later in the afternoon. If you get a chance, let Susie know that I called. And that...we love her.

Then her voice cracks, and my eyes fill up, and I sigh and head into Susie's room to adjust her blood pressure drip and look for the toe cream.

Fire in the sky

This morning I woke up and my bedroom door was slightly ajar, and there was a strange light coming from the living room. I lay there, completely confused, wondering what possible light I could have left on overnight, and I was sure I'd remembered to turn them all off. After a few moments, and after I glanced at the clock, I realized it was just sunlight. I've heard that happens in the mornings, actually much of the day in fact. Hm.

I was quite pleased to see this article in the New York Times. As Tessa is always saying, it's about time more people realized they are associated with greatness.

Now I must suck down my coffee to fortify myself and perfect my Mean Voice in order to call my payroll supervisor. She f*cked up my last paycheck, and no one messes with Nurse Ratched's paycheck. No one.

In the meantime, I leave you with this thought of the day:

Belated

It was your birthday last week, so I just wanted to say welcome to your new decade, it's going to be wonderful. I have my camera with me nearly constantly but I'm kicking myself that this is the only photo I took of you on the actual day. I think that's okay though, since this is how I know you...walking along a path, with you at my side, calling for small dogs and laughing at their exploring. They were probably just at our feet in this shot. So anyway, happy birthday again, and here's to several dozen more years.

Are my eyes open? ...NO!

Bonus points if you can tell me where that title line comes from. Hint: It's from a sitcom.

My eyes are only half-open right now because I'm super tired but I think most of the super-tired that I'm feeling is actually the hazy weird feeling that I get after I take my migraine medicine. Good news: I no longer have a headache. Bad news: I feel like I'm underwater. Blurble.

Nothing much else to report. Oh, Bellingham is still there, still lovely and peaceful and relaxing. And also quieter and has cheaper more abundant parking. So there, Seattle. Pictures to come soon.

I've been taking care of S. at work for the past two weeks, the latest in my never-ending stream of post-transplant super-sick intubated patients. I read in his chart notes that he told the social worker, pre-transplant, that he hoped for the best outcome because, "...if not, my book will have a lot of empty pages." So far I've pulled S's blood pressure out of the toilet two separate nights and convinced him not to die of cold sepsis one night. But that's all fodder for another post. Right now my eyes are blinking too long and I can hear the ice cream and bad reality TV calling me from the other room.

And also, Boy still eludes me. Another weekend that he's out of town, another week to wait to see him. Ah well. At least I don't feel smothered.

The Ones

This morning a nurse friend and I had a conversation about The Ones That Get to You. These are the patients who, for undefinable reasons, just get to you. Somehow you connect with them on a different level than with your other patients. They are the patients who wander into your thoughts on your days off. Routine or mundane tasks caring for them aren't bothersome or easily put off. When they or their family members say "Thank you," and you respond, "No problem," what you are really saying is: "No, thank you. Thank you for reminding me again why I am a nurse, why it is important that I come to work, for providing me with the inspiration and energy to do my job..."

I wish I could say that all of my patients inspire me to give my whole self to my job and my tasks, but they don't. I don't slack off or not care about the other patients, but The Ones That Get to You are special. As my colleague put it, from the moment you feel that connection with these special patients, something tugs at your heart and starts to hurt a little. Because caring that much more about them means hoping that much harder. You lose just a smidge of your "professional objectivity" and you start to believe that maybe this patient is the one that fits into the "10% survival rate" category. You cling just a little bit more to the lab values that start trending positively. And you hurt a whole lot more when things don't go well, because you hoped just that little bit harder. But in exchange for the disappointment and the hurt and the loss when they lose their fight, you had that connection. You witnessed courage, strength, and in the end, peace.

The Ones That Get to You are the ones that I would much rather have met for the first time at cocktail party, or standing in line at Starbucks, or at the dog park. Because, then, in a perfect world, that would mean they didn't have cancer, and maybe we would have been friends.

Baby love

"Hey, Mum, that dishwasher is nasty. Buy me a new one. Please. T'anks verry mutch." (as said in an Irish accent. Just because that would be super cute.)






"Go ahead, mom, take your time doing your household stuff and helping Mr. Repairman. I'm very content here in Auntie Rose's lap. She's fun. She keeps telling me about the pony she's going to buy me and teach me to ride. That sounds pretty cool. Also, what's icecreamferbreakfast? She said I can eat that with her..."




This was pretty much my view for most of the day, but it doesn't get too much better than that. I even got a few smiles out of those chubby one-dimpled cheeks, and I'm mostly certain they weren't even gas. We watched HBO on-demand and drank some formula and had a couple of Code Browns (official hospital-speak for poop-in-the-pants) and even managed to put our own little fist into our mouth without missing and poking ourselves in the eye. And when you're six weeks old, that's big stuff.

I must say, after spending 48 hours this week taking care of people at the end of their lives, some slowly dying and some actively dying, and having to interact with people facing serious and debilitating and scary diseases, and needing three people to help me clean a 200-lb adult's Code Brown, hanging out with someone at the beginning of her life, who's just figuring out what she likes and doesn't like, is pretty cool. Somehow it's refreshing and comforting. Somehow it seems to restore the part of me that gets used up every time I wrap another body for the morgue cart, or hug a mother who is saying goodbye to her son.


Yes, Ted, you are still my firstest and my favoritest baby. Although you are an incredibly needy little thing...

This is my view the rest of the time...

The countdown begins...

As of this writing, I have forty-five minutes. Exactly forty-five minutes for the phone to ring and Nurse-In-Charge to tell me to come to work, for my regular shift, and earn my regular pay. BUT if the phone rings in forty-six minutes or thereafter, and the Nurse-In-Charge tells me to come to work, I will earn time-a-half plus two extra hours of pay. Let the nail-biting commence...

But also I have to admit that I don't really want the phone to ring at all, I want to stay home in elastic-waisted pants and a tank top (yes, I really am that spoiled that now I think even scrubs are 'getting dressed' and 'restrictive.' And yes, I realize that this means there will be moomoos in my future.)

So while I wait and try not to watch the clock or the phone, I have some fabulous tidbits of reading for your entertainment: First, I apparently have a very presitigious job. Go ahead, let it out, I know you're snickering too. It's a lovely sentiment and all, but apparently these people who wrote this article or voted in this poll have never actually seen nurses work, or probably ever met a nurse.
Above, nurses on a day off. Yes, we are alpacas. I do not have any photos of us discussing a fecal fat collection, wiping our patient's butts, suctioning liquid stool, gloving up to pick pills out of a basin of puke, packing a rectal abscess, taping a plastic bag over a dead patient's head, or, doing the windmill dance with our scrub pants pulled up to our armpits to the lady lumps song while pretending to spank each other at four a.m. Perhaps the term 'prestigious' in the survey was loosely interpreted to mean, "Thank god there are people weird and crazy enough out there to do that job because you couldn't pay me enough to step away from my cushy desk job which is lacking any contact with body fluids at all."

Also, Dr. Hebert has written a moving and eloquent entry on the case of the charges against the doctor and two nurses from a New Orleans hospital regarding their questionable actions in the immediate aftermath of Katrina. I've been wanting to say a bit about this lately, but he puts it into words much better than I could. It's extrememly thought-provoking, and unfortunately the case is going to get very polarized because of the hot-button issue of euthanasia. As an oncology and ICU nurse who has been a part of countless discussions and situations of end-of-life care and issues, this case seems to strike close to home. But also having seen families go through absolutely unimaginable horrors with their sick loved ones and losing people, I know that until you are actually in your own little hell, until your own unimaginable horrors are visited on you, there is no possible way to guess how you might react. Therefore, I don't think it's possible to truly understand or to judge how others react while they suffer through their little hells.

And finally, read this med student's post about his experiences in the MICU. As I read this, I kept looking over my shoulder to see if he was on my unit, and I wondered if I'd seen him at the code the night before. It's funny how I alternate between feeling like my job and my work environment and situations are so surreal and bizarre that no one else would understand, to reading a doc or a nurse's blog entry and becoming convinced that he or she has followed me through my shift and saw exactly what I saw.

CHA-CHING! It's now officially 7:00 pm.

What I learned at work last night

• The one time you don't walk-super-fast (because you NEVER run in a hospital) to an emergency light, it will really actually be a code and not just an "Oops, did I bump that switch on the wall?"
• In a code situation, just pick something, and just do it. That way it's harder to freak out. Like, grab the ambu-bag off the wall, open the box, put it together, plug the tubing onto the oxygen, turn up the oxygen, place the mask on the patient's face, chin-lift-jaw-thrust, hold the mask in place super tight and squeeze that bag. Doesn't seem too complicated but it becomes complicated when people are yelling, "Get the doctor! Where's the doctor? I called him! Where's the CPR board? Where did his son go? Normal saline wide open now!" among many other things I probably didn't hear.
• When you're doing something, just do it, don't worry too much about doing it right. Remember, the patient is already dead. I felt a twinge of, "Aw, sorry..." as I yanked his head back and pushed my fingers under his jaw to pull it forward till my tiny rationale mind realized that when someone is doing compressions on your chest while someone else digs a needle around in your groin looking for a femoral vein, the guy had bigger problems than if I maybe bruised his chin.
• When you need something, don't just ask. It won't get done. So find someone, make eye contact, and say, "Betty Boop! [insert name here] I need a liter of saline!"
• You have to take care of each other first and foremost. When the nurse whose patient it was looks gray and shaky, don't ask her if she's okay. Just lead her to a quiet room, put a warm blanket around her shoulders, hand her a glass of water. Then let her talk, or not talk, but just sit near her. She'll be in shock, and freaked out, and questioning everything she did and didn't do. So let her say those things, but keep reminding her that she did everything she could have done, she did her best like she does every night at work, and she's going to be okay.
• In real life, there is no Foreshadowing Music of Doom. Otherwise, we would have heard it during the our conversation about the above-referenced pt's quality of life, probably life expentancy, and the nurse's comment that hopefully he should die sooner rather than later, or his suffering will simply be needlessly prolonged...cue code light. See previously mentioned chain of events.

...

So this happened.

Despite everything we do, leukemia continues to be relentless and indiscriminate.

In the Navy!

The US Navy was in town last night. Well, not all of them, I guess, but many of them in their little white outfits (I suppose it's more manly to call them uniforms?) were having a night on the town (shore leave?) in Belltown. So what's a girl, even a dirty-socialist-patriot-hating-anglophile girl, to do? Well, after three martinis, dance with them of course! Every 'civilian' guy who happened to go out in Belltown last night wore a permanent scowl as he nursed his drink against the wall, cursing himself for not joining the navy and getting to wear a shiny white outfit that draws drunk girls to him like moths to a flame. Hahah.

Oh, and...
Dear Seattle,
We hate the Blue Angels. Nobody is impressed by them, nobody thinks they're cool. We think it's a great big old waste of money to pay those overgrown toddlers to fly around in their million-dollar toys, causing unnecessary noise pollution and indescribable traffic headaches. They make our doggies quiver and pee on the floor and do nothing to improve hangover headaches. So yeah, to sum up, not impressed. Spend your money on something else. However, if they were dogfighting or having some kind of 'demolition derby' in the sky, that'd be cool.

Things that are gross

First of all, I am not one to brag about the gloriousness that is Seattle in the Summer (apart from Seafair, tourists, traffic, and bikers taking up my lane of traffic), mostly because it's already crowded enough here and Seattle has already gotten a fat little ego and behaves pretty pretentiously about its great old self (but I digress.) As I was saying, I like to keep the secrets of the green, lush, sunny, temperate, rainless summer to myself, lest hoards of *gasp* right-coasters or worse, tourists, clog up my fair city. Also, it's just not nice to remind your friends in other parts of the country who are sweating and melting and sweltering and mostly complaining like crazy that you are so damn comfortable in your AC-free house in just an old skirt and a t-shirt. Ahhh. BUT...my point was that when you log on to Weather.com to see if you need to wear a light sweatshirt over your tank top as you walk around the lake, and the headline reads "Heat wave! Dangerous record highs!" then, in little letters at the top it reads, "local weather: Seattle, 64" you can't help but snicker a little and sigh happily. And before you go poking your little Rosebuttons voodoo dolls with blistering hot needles and sending me sucky weather karma, let me remind you that I spent 12 years in the midwest, that's "America's Heartland," (those are Quotes of Sarcasm), the Flyover States, aka the land of 10-month winters with temps around minus 50 and two months of sauna-like humidity and heat and mosquitoes bigger than kittens. So yeah, nasty hot summers suck. Huge hairy balls. However, Seattle summers don't suck. But shhh. Don't tell. I think the airport closes for the summer anyway, so you can't come. So do the highways. (Seattle drivers snicker, "Tell me about it. Just in the summer?")

Yesterday I went to Target, and bought some cheap clothes that I may or may not have needed. Then I ordered some Indian food, and stopped first at another Indian restaurant along the way to buy a jar of the Best Stuff Ever, mango relish. I was tempted over to the nearby Walgreens to buy some hair dye (currently burning itself into my scalp. Gotta shower soon, T minus 6 minutes). But between the restaurant and my car I had a mild spaz attack and dropped the bag with my hair dye and mango relish, causing the top to loosen and spew oily mango relish all over...my hands, the hair dye box, etc. So I sort of wiped off my hands the best I could and proceeded to the next Indian restaurant to pick up my eggplant bharta, self-consciously aware that I smelled like mango pickle. And although he was super nice and gracious, I could tell the guy at the counter was thinking, "These silly white girls. She is nowhere near of Indian descent, and I am not fooled by her attempt to slather herself in mango pickle. No free mango lassi for her.'' *Sigh*

edited to add: The title of this post refers to smelling like mango pickle, and wondering whether my hair will smell like mango pickle forever. I just got a little sidetracked as I checked the weather...

Randomly random

This is Ted. Tell him he's a big dog, he likes it.

This is the culprit, cute as he may be. He is the reason behind my weekly trips to Target for more and more underwear. Trust me, you don't want to know the details. However, I am about to go again tonight...not buying underwear tonight, just returning some things I bought on impulse while I was there last night buying underwear. Yep. I've got a lovely date planned with myself for tonight...I'll hop up to Target, then order some Indian food and pick it up on the way home, then watch Bridezillas and Hex on DVR, and possibly Unbreakable from Netflix if I'm still awake. I know, it doesn't get any more exciting than that. I don't know how I handle it either.

Hey nurses...is anyone else out there starting to get all into (I almost said 'excited' but then realized that even I am not that dorky) the idea of going back to school to get your masters and maybe even be an NP only to be gobsmacked by this bizarro DNP thang?! Can anyone else explain to me why this is happening (I know, I know, four-year doctorate prepared patient care provider yaddy yaddy more cheap labor for the Health Care System Monster sorry personal opinion). I'm mostly tempted to say f*ck 'em, I'm gonna be a stinkin' masters-prepared NP anyway and if you want to pay me less or fire me in 2015 than fine, I'll be happy milkin' my pygmy goats and teaching kids to ride ponies. Then a little bit of me says, hey, if my current Health Care System Monster is willing to pay for nearly all of it, who am I to turn down the chance to get a doctorate and just be done with it?! Those are my thoughts, as small as they are. Discuss amongst yourselves. Opinions?

I'm thoroughly annoyed with myself because I'm In Waiting. Waiting for a boy to email/text/call, if you must know. I hate being like this, because I'm an independent grown-up who doesn't sit around waiting for boys to call and dammit, they should be lucky if I even deign to answer their call. Stop laughing, I like to tell myself that. It almost sort of works.

So anyway, thanks for tuning in. I have a date with Target and Bombay Grill and the TV, mustn't be late.

What she said

Last night I asked my colleague how her patient W was doing, since I'd taken care of her for several weeks in the ICU. W had been extubated (breathing tube removed, was breathing on her own) two weeks ago, and been moved out of the ICU to floor care last week. She was starting to nod yes/no to questions but was not very interactive and hadn't said anything at all. My colleague said W was doing okay, slowly getting better, but somewhat depressed. So I stopped by to see her, tell her who I was, and that she looked a million times better, and was making good progress. She nodded a little while I spoke and seemed aware that I was there. A few hours later, her nurse found me again. "I need you again in W's room, come with me," was all she said. I went and stood near W's bed, and her nurse said, "W, tell Rose what you just said to me." I glanced skeptically at her nurse, but took W's hand and looked at her. "I want to go home," she said simply. "You want to go home?" I replied. She nodded, looking me right in the eye. And while I'm always loath to make promises to patients, I told her, "Of course you do. And of course you're going to go home. Not tomorrow, and probably not as soon as you'd like, but that's the path you're on. Every day you get stronger, and every day we all work really hard to get you ready to go home. And you're working the hardest at it. So I can hear it in your voice now W, that you're getting better and you're going to go home."

Then I went back to my own patient's room [ed: another RN had been watching my patient and my monitors while I was in W's room], to continue titrating his levophed to maintain a blood pressure that actually perfused his organs with blood and adjusting the amount of oxygen the ventilator was giving him. He is really sick, at least as sick if not sicker than W had been. Some of them get better, and some of them don't, I don't know why. Maybe if I knew why then I wouldn't be hopeful when the situation was futile or I wouldn't distance myself when there really was hope.

There was also a code on the unit tonight, not my patient however. I was entering the room just as two young doctors ran onto the unit then stopped short in the doorway. "Shit, I hate it when we're the first doctors at a code. Have you ever run a code before?!" one said to the other.