Tuesday, August 29, 2006

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:

Sunday, August 27, 2006


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.

Wednesday, August 23, 2006

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.

Tuesday, August 15, 2006

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.

Thursday, August 10, 2006

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...

Monday, August 07, 2006

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.

Sunday, August 06, 2006

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.

Thursday, August 03, 2006

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.

Wednesday, August 02, 2006

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...

Tuesday, August 01, 2006

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.