Thursday, November 30, 2006

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.

Sunday, November 26, 2006

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.

Wednesday, November 22, 2006

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.

Tuesday, November 21, 2006

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.

Saturday, November 11, 2006

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!!

Tuesday, November 07, 2006

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."

Saturday, November 04, 2006

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.

Friday, November 03, 2006

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!