...

Woke up to this headline this morning: Bhutto Assassinated in Attack on Rally.
Admittedly, I didn't even click on it right away because in my blurry coffee-deprived eyes I thought it said something about another attempt. But this time they did succeed. She was the daughter of a prime minister of Pakistan and twice prime minister herself, one of the first to be democratically elected in an Islamic country. But you can read her obituary here for yourself.

While upsetting and sad, I am nearly as disturbed by the fact that this story ranks number 10 on the NYTimes "most emailed" stories list this morning...just below "100 Simple Appetizers in 20 Minutes or Less." No, I'm not worried or appalled at American's knowledge of world events or priorities. I am currently investigating which countries will accept my application for political asylum. On the grounds that if I have to remain in the USA I will be clinically "annoyed to death."

Ok, back to nursing content. Later.

*sniffle*

I'm sick. I've spent the past several days on the couch, making sure that my tissue box, tissue disposal system (brown paper bag), TV remote, computer, and phone are all in a lovely semicircle arms-reach. This is chiefly because once the dogs settle in on me under the brown not-real-fur pimpin' cool blanket, it is very difficult to shuffle and shift them around simply to reach the phone or throw away a tissue. And also because I'm a little bit tired and lazy. Although I prefer the term 'efficient.' So I won't bore with you a litany of complaints or a disgusting barrage of my symptoms, because I just have a cold. A bad one, but a cold. So the chances are pretty good that you either have it, have just had it, or know someone who's had it. And the only thing worse than being sick is hearing someone complain about being sick, or list the details of their illness for you. So I'm sparing you. Before you get all worried and ask, "Wait, aren't you supposed to be a nurse? Don't you listen to sick people for a living?" Yeah, yeah, yeah. I am, and I do, and I actually enjoy it. But unless I am wearing scrubs, have a stethoscope around my neck, and am getting paid hourly (plus night differential!) I don't want to hear about your post-nasal drip or hang nail. I like to think of it like I'm a sort of super-hero. At night I put on scrubs, go out into the dark, minister to the sick, clean up their vomit and their bottoms, hold their hands, dry their tears, keep them breathing till the sun comes up. Then during the day, I put on a fleece jacket and comfy tracky bottoms with an elastic waist, curl up on my couch, think snarky mean thoughts about my neighbors, shout obscenities at women drivers who don't use turn signals, and generally practice being lazy and self-indulgent and somewhat bitter.

Whatever. I'm sick, indulge me.

Oh! The whole point of this post wast to highlight the difference between my old job, at the Place I Would Rather Chew My Own Foot off Than EVER Return to, and my current job, The Place Where I Learn Theres-no-place-like-home... So when I used to call in sick to the old job, here's how it went:
Me: Hello, is this the charge nurse?
Charge Nurse: Yeah.
Me: Hi, this is Rosebuttons. I'm not feeling well, I'm calling in sick for my shift tonight.
CN: *Sigh*. Uhm, ok. Fine.
Me: Uhm, ok, well, thanks....bye?
CN: *click*

Here's how it went when I called in to my current job:
CN: Hi Rosebuttons! Are you calling in sick?
Me: Yeah, I'm still not feeling much better yet...
CN: Aw, I'm sorry. You don't sound great, I'd probably send you home anyway if you tried to come in to work! Now listen, you stay home and rest, just take care of yourself. Hope you're feeling better soon!
Me: Aw, thanks, Charge Nurse! Hope to see you soon.

Granted, these different conversations could be attributed to either a.) differing personalities of the charge nurses, or b.) the fact that the first hospital does not have a resource pool or agency nurses they can pull from to cover absences, but I would like to attribute it to the fact the unit at the second hospital actually cares about their nurses, their well-being, and values their contribution to the unit as a whole. And therefore this attitude and culture carries over into individual interactions between staff, and greatly affects their attitudes towards work. Anyway. Carry on with your gift-wrapping or cookie-baking or whatever you people do around this time of year. I've got cable TV and knitting waiting for me.

Note to self

Personal reminder to Rosebuttons:

Reality just called, it wanted me to tell you that...you are a nurse.

Contrary to evidence of recent activities, you are not actually a member of the jet-set idle-rich who have nothing better to do than jet around the world, hang out in world-class cities, wander aimlessly through museums, and take three-hour lunches with copious amounts of wine or ridiculously named cocktails.

Starting tonight, you actually have to go to *work*...you know, that place where you attempt to earn a laughable piece of paper some call a paycheck? Because traveling is not actually free, as much as you may be certain that it should be, as it is definitely one of your inalienable rights as a human being and apparently as necessary to you as air, water, and caffeine.

And also, at this place called *work* you actually have to do stuff, like show up at a certain time, and stay for a prescribed number of hours, and complete eleventy-bazillion tasks. But wait, here comes the scary part...you also have actual responsibilities. Like monitoring invasive lines and equipment with the purpose of keeping a human being alive. And delivering important medications, and assessing problems, and communicating with other people (whether you want to or not). It is wise to note that these responsibilities and tasks are a bit harder and more important than the tasks that you've most recently been doing, such as trying to decide between the chicken or the fish, or if you should nap before or after dinner, or if you should hop on the metro or just walk through the streets of Paris to get some falafel. Because no one probably died if missed the metro train or if you accidentally napped for two hours instead of one.

So anyway, I know you haven't really forgotten that you are a nurse, but sometimes it is much more pleasant to avoid reality for a while. Sorry. Hey, wait, where are you going? I'm talking to you, Rosebuttons. What are you doing on that computer? Is that the British Airways site you're looking at? Are those little numbers and letters flight times and dates? Seriously, Rosebuttons. Wait, how much? Seriously? Well, London is wonderful this time of year...

Wanderlust

As if I need a reason, I'm leaving town. I'm going so far away from the MICU that rectal tubes and being kicked at and poo-covered will be distant memories.

But don't worry! You won't miss me too much, I'll be right over here for a little while :)

Seriously.

Seriously. Are you tired of my whining, I-hate-my-job, my-job-is-sucking-the-life-from-my-weary-bones posts? Because, seriously. Last. Night. Sucked.

I don't even know where to start, except to make sure emphasize the fact that I am sick and tired of trying to take care of ETOH-w/d GIB with ESLD, encephalopathy, confusion, and of course nutso. And because that alone is not fun enough, the doctors like the write orders for me to give them either lactulose or Golytely because nothing makes a nurse happy like cleaning up liters and liters of liquid poo. So yeah, that was my night, times two, since I had two patients, in the same situation.

To save you time, I'll sum up the highlights:
- Wondering why his oxygen levels dropped a bit on the monitors, I checked in on Loony #1, only to find him and his bed covered in feces. Patient had a feces-covered washcloth in his mouth, shoved into his mouth, and refused to part with it when I tried to take it out. A brief struggle ensued. Not pretty. And also, my internal nursey filter for How to Speak Therapeutically and with Empathy to Patients at all Times has officially gone south. I now find myself saying things like, "You cannot have poop in your mouth! Open up!" I believe I also heard myself utter, "Seriously. Because it's just gross."
- Wondering why Loony # 2 was not mumbling for a few moments, I checked in to find him attempted to pull out his IV lines and any other tube he could find. When I tried to thwart his efforts, he grabbed at the IV line and pulled the entire IV pump and pole into his bed. Then, since I'm such a party-crasher, he got really pissed off and tried to push me away and wave his arms and hit me.
- When I called out for help to restrain Loony #2, the other nurses ran into Loony #1's room, assuming that's where I was. I'm all, "No, I'm in the OTHER crazy room!"
- During restraint process, involving 5 RNS and a boatload of Ativan, Loony #2 creatively called us all every obscenity he could find. It turns out he's quite an angry misogynist, as he declared that we were all dykes. Big nasty dykes. My neuro assessment was further complicated by his answers to my questions..."Do you know where you are, Mr. Loony?"
"Yeah, I'm at Dyke Central!"
"Do you know what day it is, Mr. Loony?"
"Yeah, it's the Day of Dykes on Trikes!"
There is no checkbox for those responses on the CIWA protocol (alcohol withdrawal) flowsheet, however.
- Loony #1 exercised his lungs for at least two hours by constantly yelling, "Help me!" then claiming that he would be telling his lawyer all about this.
- Later on, Loony #2 earned himself ankle restraints after I dodged several feet and leg kicks aimed at my head. And that internal nursey filter? It didn't stop me from telling him, "Seriously. Just stop talking. Stop talking now." But I could honestly think of no empathetic, therapeutic way to get him to stop spewing every nasty word for women's private parts along with a description of them.

So seriously. At least I feel completely justified when I say, "I need a vacation."

Word.

With apologies to Head Nurse, what she says explains a lot...

Nurses believe in God, I think, primarily to have somebody to blame. All I can say is, when God and I meet up at the end of my life, we are gonna have one Hell of a Come-to-Jesus meeting.

Things that are funny...

There are certain things that seem hilarious at four in the morning, that sort of lose something during the "real day" when normal people are awake and the sun is shining.

Last night at work the palm of my hand kept stinging every time I put alcohol gel on it. I noticed I had a tiny divet in my palm, the shape of a fingernail, I must have been clenching my fists while sleeping again. So the following conversation took place:

Me: This little cut on my hand is killing me! Stupid alcohol gel...
RN Friend: Weird. What's it from?
Me: (examining hand closer) Not sure...strange place for a cut...must be stigmata.
RN Friend: Cool. You should use that as an excuse to call in sick.
Me: Ooh! Good idea! 'Hi, Charge Nurse? Yeah, this is Rosebuttons RN. I'm calling in sick for my night shift tonight, maybe the next few nights too...yeah, I've got the stigmata.'
RN Friend: Perfect. They can't argue with that, you know you can't come to work if you can't control your secretions.
Me: Total infection risk.
RN Friend: I gotta get some of that stigmata.

So on my handy List of Excuses for Calling in Sick, I shall add Stigmata right after Scurvy and right before Pink Eye.

Again, apologies for insulting any more religious groups, as I probably did in my previous post as well. But what good is an organized religion if they can't laugh at themselves too?

Bloodless

Last night I took care of a patient who had recently undergone chemotherapy and radiation, and was admitted to the MICU with severe anemia. Specifically, his hematocrit on admission was 14. Then the next day it was 13, then 12, then 11. That's what we call Super Low (or critical, whatever) since the average male should have a hct of at least 45% and we would nearly always transfuse for hct of less than 25%. But this particular patient, due to his personal religious beliefs, refused any transfusion of any type of blood products. He was not confused, and quite oriented, and understood that he could die without a blood transfusion. His cancer is still treatable, but he could not have any more chemo or radiation until his blood counts were back into a safe range. I think I am usually very nonjudgemental of my patients lifestyles, religions, or personal beliefs, but I am having a lot of trouble with this one.

His wife stayed overnight in the room with him, despite it being against our unit policy. But other nurses had previously allowed her to, and once the precedent has been set I hate being the bitch who suddenly enforces the rules. So I agreed to it, but with the warning that if her presence interfered at all with nursing care, I would have to ask her to leave. She put his side rail down and pushed the chair-bed right next to his bed, but I constantly had to wake her up and push the chair aside in order to be able to access my patient. Since he had just received four liters of Golytely and required very frequent cleaning up, I needed to make her move quite a lot. Freakin' Golytely. At one point, upon seeing the entire bed transformed into a lake of dark brown foul-smelling liquid, she sighed and said, "Wow. Awww. Wow. I'm just so surprised, he's only had one little Ensure shake in the past few days." Umm...four liters of Golytely go in, four liters of Golytely must come back out. And then some. I wondered if dayshift had silently administered the Golytely into his feeding tube without explaining the outcome? And she hovered around while I cleaned him, at one point even patting me soothingly on the shoulder and saying, "Aww. Wow, you poor thing. Wow." I bristled. Good thing the lights were dim in the room, or she may have noticed me narrow my eyes and the little hairs on the back on my neck stand up. I'm a nurse, a highly trained and well-educated ICU nurse, this is my job, this is what I do, I'm being paid for it and I chose to be here. Don't pat me on the shoulder.

The patient was pale as a ghost, lethargic and very weak. I didn't draw labs on him since the docs didn't order any, and they want to minimize blood draws as much as possible, for obvious reasons, so I don't know what his hct was this morning. The charge nurse and I discussed possible transfer out of ICU to the medical floor...after all, what could we do for him? Yes, he was full code status, but we could not transfuse. We cannot treat his life-threatening anemia, except with epo shots and iron supplements. He is not a surgical candidate. He is not intubated and his other vital signs and pressures are stable. So it sort of makes sense, he doesn't need to be in the ICU. But it struck me that his status would be downgraded, to a different level of care, essentially because of his religious beliefs. Is that weird?

I'm still thinking about this one. I'm still having trouble with it, because it doesn't make sense to me and I have trouble accepting it. Sure, a lot of religious convictions and beliefs don't make sense to me, but usually I can accept the differences in belief and move on from there. But this just doesn't sit well with me. I can't wrap my little secular head around it. Why does that one specific thing in the bible, regarding blood, get translated and adhered to so literally? Why do they accept all of our other medical advice and interventions without investigation or comparison to scripture?

And I'm confused by myself...I left the same t-shirt (his garments?) on a Mormon patient in the ICU for days and days and worked around it, I carefully wrapped and re-wrapped a head scarf around a young Muslim woman each time before a male physician entered her room, I timed certain medications around prayer times so a Muslim patient could pray, I made fifteen-minute checks on a my Hasidic Jewish patient because after sundown on a Friday she could not use the call light, I've bent the unit policy and allowed more than the requisite number of visitors into a patient's room so they can pray together, and not one bit of any of these actions bothered me. Rather, I consider it to be a crucial part of a nurse's job, since I am caring for the whole patient. But at the same time, I guess none of those things ever compromised a patient's care or well-being, either.

So anyway. This is just a big old can of worms I might be opening. Perhaps this is a controversial topic, maybe I seem callous or judgmental. I sort of feel that way. But I just don't get it.

Overheard at work...

Chipper Dayshift Charge Nurse: Good morning, Susie!* How was your vacation?
Dayshift Nurse: It was wonderful, I had a great time. Until I had to come back to this hellhole.
Chipper Dayshift Charge Nurse: (nervous giggle) Oh, haha, it isn't that bad, now is it?
Dayshift Nurse: (without a trace of irony) Yes, it is.

I promise, the above conversation was overheard at work, and I also promise, it wasn't me. Not yet anyway. I suspect that I will actually have to return from my Grand Adventures, however. So stay tuned.

To anyone out there who is not a nurse, or a travel nurse, or in a job or field where it may be difficult to find jobs, and if you hate your job, and every cell of your body cringes at the thought of starting yet another 12 (or 8) hour shift, I heartily sympathize with you. Because just this morning I realized that if I didn't have just a few weeks left at this hospital assignment, and if I didn't have a bazillion other nursing job options to pick and choose from, I would be even more morose and depressed and whingey than I already am. And that's saying a lot.

I've had four days off of work, and it felt absolutely sinful and delicious. I slept late every morning (I love you, Mr. Melatonin and your little buddy Benji Benadryl), I cleaned my house (even the bathroom floors!), I cleaned out my closet (must make room for Paris shopping!), went to the grocery store, and dropped off the clothes at Goodwill. I also made it to the pharmacy because unhappy stressed ICU nurses must NEVER run out of migraine medicine.

And oh! The best part. HBO and Showtime On Demand. My thoughts so far? The Tudors: Showtime should probably have left the period piece to BBC or A & E. But I will continue to watch it. Because it's Jonathan Rhys Meyers. I'm obsessed with all things Tudor-history, as geeky as that may be. Weeds: Love it, but maybe a bit too much cops/gangsta drama this season. Californication: So far, funny funny. And pretty well-written. And David Duchovny? Yes. Just...yes. I have loved him ever since the days when I would have given my right pinky finger just to be the Agent Scully to his Mulder, and he rocks in this show, as a drunk and drugged-out bitter divorced misplaced New York writer bitching about living in LA.

So that's what I've been up to lately. Sorry, not much nursing content in this post. Mostly because I've had a few days off, but also because I hate my job. Which makes me sad, because I used to love being a nurse, and I've even had jobs where I would truly look forward to starting a shift. I want to love nursing again. I miss you, nurseywork.

On skin windows and flying patients...

Last night was a gorgeous, huge, glowing full moon yet all I can think to write about are pressure ulcer dressings and modes of moving fatty boombalatty patients who would otherwise kill your back. I'll never be a poet at this rate, topics like that just don't translate very eloquently.

Last night I lifted my 110 kilogram patient with just one finger! No, I'm not freakishly strong or even gifted with special powers, although it's understandable if those are the first conclusions you reach. It turns out the PUH MICU has installed these overhead lifts in each patient room, so if you put the special sling under your patient, you simply attach the straps of the sling to the arms of the lift, use the handy-dandy push button controls, and lifto-shifto, you can boost that patient up in bed! In mere seconds! Your old-beyond-its-years nursing back thanks you profusely, as do your colleagues who are too busy to put on gloves and risk their own backs just to help you get your patient straightened up in bed. The sling thingy even tilts a little sideways so you can put some pillows underneath and turn your patient with ease. You know, to prevent nasty pressure ulcers...which brings me to my next point...

Maybe this is already a universally known technique, (and by universal, I mean widely known to the huge population of people who are RNs and deal with skin care issues...perhaps not yet material for Good Morning America, but of growing importance to a wee minority...) but a colleague at PUH has introduced me to duoderm windows! It's a stroke of genius, an inspiration of brilliance. So...you know when you have those nasty tunneled oozing pressure ulcers, and of course by their very nature they are in the most inconveniently dirty places, such as the on the very underside of your patient, a mere centimeter (sometimes not even!) south of the a*us? So of course keeping a dressing over such an ulcer, nonetheless keeping it clean and dry, becomes a seemingly insurmountable problem. Then if you do manage to put a dressing over it, each time you have to change it, you are just bothering and irritating the already-sensitive skin by peeling stickies off it? Well...get ready for this...my brill-ee-unt colleague crafts a window out of duoderm, places it over the offending sore, then packs it, and covers it with gauze and finally a piece of tegaderm which adheres to the duoderm, but not the patient's skin! SO, the duoderm stays in place and each time the site is soiled you do not need to rip off a piece of duoderm, plus you can change the tegaderm as much as you might need to without hurting the adjacent tissue!

Oh my goodness. I think this has turned into one of those, "You know you spend too much time in hospitals when these things get you you excited..." posts. So sorry. Soon I will be in Europe and perhaps I will be excited by things like world-class art, ancient monuments, and legendary pain au chocolat. I certainly hope so. I just have to survive 168 more hours of work before I leave....I know, I know, could I have thought of a more depressing way to say, "I leave for Paris in less than three weeks!"??


*This is an example of the patient sling I am in love with.
*Disclaimer: The people in this photo are not me and my patient, nor do they even remotely resemble me or my patients. For example, notice the cheery smiles on their faces and the sunlight streaming in through the window...and that's just to start with...

Just checking in...

In case anyone is wondering, I'm still here, and I'm still alive. Somehow. Even though throughout the month of September I've only got seven whole days off. In response to Clean Dry and Intact's comment, I'm not sure I have very good advice on how to survive five shifts in a row...when I had the time, I tried to clean my whole house, do every piece of laundry, and run every little errand that I had, so there'd be nothing to worry about or stress over during my long stretch at work. But now, since I've only got little onesie or twosie days off, I just try to rest and sleep as much as possible on my days off. Then I try to schedule to get just one little thing done before I go to work each night...even if it's as little as taking out the garbage. In the meantime, I'm considering the pros and cons of hiring an errand boy. Can I get an au pair even if I don't have kids?


NurseSF asked why I use acronyms for the hospitals I work at, and whether it's better to do that or to be honest about where you work, etc. I'm not really sure what's best, but for myself, I'm just paranoid about HIPAA. I always change any details about my patients that I write about in order to protect their identity, even their genders or ages. I guess I'm just worried that if someone recognized me or the hospital I write about, they might think I'm revealing private patient information. I don't really mind if people I work with read this, but I just wouldn't want it to get back to the managers or anything. I suppose there's a slim chance of that, but just to be safe...

So underneath my bitter, tired, overworked facade, I'm truly super-duper excited about my upcoming trip to Paris. I'm just a little too worn out from working to open my guide books and focus on the teeny French words on the pages at the moment. Thank goodness I have three weeks left till I leave. Wait, only three weeks?! Damn.

On second thought...

There are some things which can be defended with the age-old excuse: "It seemed like a good idea at the time." But even I have to admit that there are some things to which I have to say, "No, it never seemed like a good idea. But maybe later, down the road, I'll look back and say, 'it was sort of a good idea,' " Case in point, somehow scheduling myself to work 12 out of 14 consecutive night shifts. Yes, 12-hour night shifts. Yes, I realize that's 144 hours, or a couple of 72-hour work weeks. But I'm hoping that as I'm sitting at a sidewalk cafe in Paris, ordering another bottle of wine, or browsing the little boutiques in Le Marais district and contemplating an adorable pair of red shoes, I tell myself, "Self, I'm really glad you worked some extra hours because it's making my adventure in Paris so much more better," except with better grammar of course. And in French.

I'm working at both hospitals now, PUH, and per diem on my old unit... the hospital that is like an old boyfriend to me. You know, comfy, I have good memories from our time together, I miss it there, and time and other hospitals only serve to help me forget the reasons why I left in the first place. But anyway. I'm sort of hoping that by splitting up my shifts, some at each hospital, it won't make a 5-night stretch feel like five nights. Heh. Stop snickering at my faulty logic. Paris! Red Shoes!

Oh! And now for some nursing content....things that are also NOT a good a idea: (Ahem..residents, listen up...) No matter how "unresponsive" you think your intubated patient is, always always always always ALWAYS write PRN sedation orders for him. Always. Because when said patient is an angry sweaty confused 400-pound man, and he suddenly wakes up with a tube in every orifice, and you're a little too slow returning his nurses's pages, there really isn't too much said nurse could have done prevent him from contorting his massive body in such a way to pull the ET from his throat. Wrist restraints be damned. Additional things that suck about this little vignette: Patient was already requiring 100% ventilator support, meaning that when he removed the ET tube from his throat, I had to call a code to get lots of people in that room STAT to re-intubate him. And sedate him. And also, you know how night shift nurses kind of work like a big team, and really step in to back each other up? Yeah, not so much. Apparently this is not universally true. The two other travellers on the unit really stepped up, one of them watching my patient for a couple of brief intervals to let me take brief breaks off the unit, and also helping me change a foley and insert an NG then lavage until clear. The other helped me turn and clean the verylargesweatypatient then even offered to take my other patient from me once she realized how swamped I was with verylargesweatypatient. To be fair, later in the shift the charge nurse stepped up and helped me set up my arterial line and drew labs for me when the three sets I had drawn hemolyzed.

Another little piece of advice to residents: When the patient's hematocrit drops from 48 to 32, please notify the nurse and ask her to re-draw the blood sample before you order a GI consult, and order four units of blood on the patient. Which I would have done, had I noticed the lab value before the residents did. But I didn't, because I was too busy titrating drips, inserting a foley and an NG, and various other little tasky things.

Anyway. I'm done ranting now. Back to work tonight, at the Old Boyfriend Unit (OBU). Kind of looking forward to it. But in the meantime, there are guidebooks to tab.

I am highly trained professional

And occasionally I get poop in my hair at work. And no, it's not my own poop. Although, as the astute Jodi pointed out, "I think this is one of those cases where even if it was your own poop, it wouldn't be any less gross." I love that Jodi thinks like me, by acknowledging that indeed there are situations where the fact that the poop is your own versus someone else's DOES make it less gross. Yes indeed, I am a well-educated and highly trained professional. I spent lots of money and went to years of schooling in order to be paid to where your poop, on my head. How did the poop get on my head? Seriously, do you really want to know? Are you thinking to yourself, "Wow, that sounds gross. I'd better take steps to avoid that happening to me." Yeah, I doubt it. You're thinking, I will never complain about the papercut I got at work again. And to nurses out there...I bet you really don't want to know how it happened either, because I know you're all chuckling to yourself but thinking, "At least it wasn't me....this time." And FYI...try not to fling sheets off the bed, no matter how carefully you think you checked it.

So...contrary to the above anecdote, I really am liking my job at PUH. I'm back on night shift now, and so far everyone is pretty cool to work with and I think I'm getting into the swing of things fairly quickly. For some reason, I've been feeling braver as a nurse lately. Like last week I did three peripheral blood draws. No big deal, right? Right, except that's more than I've done in three years as an oncology nurse ("What? You mean some people don't automatically have central lines placed upon hospital admission?! That's crazy talk.") My usual response to an order requiring a peripheral stick is to call the phlebotomist, or look at the patient's arms myself, and failing to see a huge neon sign with an arrow saying, "Right here! Even a blind monkey couldn't miss it!" I sweetly ask another nurse to help me. No, I'm not proud. I was a blood draw weenie. Finally I sort of realized that I couldn't avoid peripheral sticks for the rest of my nursing career, and maybe it would be fun to have one more skill. Next up: IVs. Uff.

And also...after I just revealed my generally pathetic lack of skills as a bedside ICU nurse, I've decided to take the CCRN. I know, blood draws AND certification?! Crazy talk. Oh well. No one doesn't want an extra dollar an hour, right? Plus, dorky old me, thinks maybe it will be fun to study and learn more or refresh myself on general critical care knowledge. There's something strangely enlightening about studying something that you're already doing...that super-wattage lightbulb that goes on..."So THAT'S why my patient's heart rhythm kept going into Tourssade's...."

And also...even MORE exciting that CCRN, and blood draws, and poop in the hair....(I know, settle down, already!) I'm planning a huge vacation, the biggest trip of my little 31 years. I'm going to Paris and New York City in October! Okay, maybe my trip to Saudi Arabia was bigger, but I hardly planned a bit of it. It was more like, "The private royal plane is leaving around 8am. Your driver will pick you up at 7:30. Maybe you should pack or ask a maid to pack for you." So yeah, turns out this time around I have to fly coach and arrange my own travel and even pack myself. Hah. Anyway, I've got my plane tickets, and even places to stay, but I'm totally overwhelmed and freaking out by the amount of planning I need to do. I've got mountains of guide books, but I haven't even started tabbing them yet! Uff. But it's a good kind of exciting freak-out. Enough to make me forget about buying a house or studying for the CCRN to even studying my Arabic or French. Fortunately my closest friends have left the country for a few weeks, leaving me lots of extra time for planning and hermiting with my computer.

Not so bad

I am tentatively reporting that so far, I think I really like my new job. Of course, it's very early days so far...but it really seems to fit. Beyond the goodies like computer charting, I'm just so tickled and happy to be back at a teaching hospital, I love seeing the gaggles of white-coated students and interns following their attending on rounds, looking like sleep-deprived fearful ducklings and mumbling incoherently as they step on the back of each other's shiny new Danskos when the attending stops the parade unexpectedly. I love listening in on rounds if I'm available, I love the new equipment and latest technology and the use of PEEP trials and arterial lines and how everyone actually knows what a hemoglobin A1C is, and why we should draw them. I love the air beds and water beds and sand beds. And so far, most of the nurses seem really nice, and welcoming, and helpful. The other day I volunteered to help an intern insert a foley catheter, only to discover that it was her very first one EVER, and so I actually taught her how to do it.

Maybe it's because my first job as a nursing tech was at a teaching hospital, and then my first two years as an RN were at teaching hospitals, but something about this job feels a bit like coming home. Slipping back into my comfort zone, with familiar insulin drip algorithms and other such protocols, it's nice.

Anyway, it's all good. It's very important for a lazy, homebody person like me to have a job that I actually enjoy, a place I want to go to, and I've got that again. Phew :)

They found me...

Today I started my new job. I now have an ID badge which states "U. S. Government" and all ten of my fat little fingerprints are squirreled away in the FBI and CIA databases. Grrrreat. Talk about an walking experiment in cognitive dissonance...that's me. Take the little left-wing socialist Arabic-speaking child of marxist hippies who throws up into her mouth a little at the mere sight of George Dubya slap a government badge on her.

Anyway, other than that, I'm sure the new job will fine....the usual use of my overpriced education and professional skills...life-saving, split-second decisions and critical thinking: "Is this stool liquid to justify the insertion of a rectal tube? Here comes the finger puppet!"

In space-time-continuum news, I've re-entered the 21st century, as evidenced by the fact that this hospital exclusively uses COMPUTER CHARTING for everything. It's so freakin' snazzy I might need to buy some new scrubs just to keep up.

Ack. I think I'm overtired.

Like a shark...

I am moving on, my contract at Private Suburban Community Hospital has ended, and instead of renewing I've decided to work closer to home. So tomorrow I'll be starting at Public Urban Hospital, or PUH. I ended up liking my time at PSCH, the other staff were so nice and warm and welcoming, the equipment was generally new and up-to-date, and the pace was fairly easy-going and straight-forward. But I refuse to drive over an hour each way to work in the fall, in the dark, in the rain....blah blah blah commutecakes. I was so happily and genuinely surprised that when I showed up for my last shift at PSCH, the other nurses had planned surprise potluck for me, gave me a card, some funny party gifts, and another nurse even came in on her day off to bring a cake with palm trees on it! It really was touching. Not touching enough to make me stay, because I am like sharknurse...move or die...heh. So, I keep moving on...

Bad things happen

Yesterday, a tragic event happened in Minneapolis, which happens to be sort of where I grew up, so it's especially sad and spine-tingly to watch the scenes of the collapse. The bridge collapse during rush hour must have been terrifying and the families of the the dead, injured, and the missing have my whole-hearted sympathies.

Yesterday, more tragic events happened in another part of the world. I'm not comparing numbers, or saying that the more people who are killed makes one tragedy more significant than another. And I'll readily admit that the closer something is to your home, the more personal ties you have to it, the more significant an event becomes to you. But I wonder how the four major cable news networks that are devoting hours and hours of coverage to this event fail to see the irony of their complete lack of mention of other tragic events happening in the world. Obviously we care more because this happened in the US, and probably because it was a seemingly random and senseless event.

But seriously people..."we" spend billions of dollars invading a foreign country, illegally occupying it for years, destroy its infrastructure, so what entitles us to the luxury of looking the other way as hundreds and thousands die over there day, week, and month?

Anyway. Thank god it's shark week on the Discovery Channel, so I have something else to watch on TV rather than being incensed and depressed by the TV news. But why do they stop at shark week? Why don't we get camel week, or tiger week? Or pony week? I love ponies too.

Back in the saddle

Here I am...I'm back. Back in Seattle, back at work (although a different hospital now...same poop, different county), back in my house with my wee doggies. I was thinking maybe I should start a whole new blog, since I am no longer working night shift and I'm doing doing very much knitting in the summer time, so I'm hardly knitting in the dark anymore. But how many blogs should one girl have? So for now I'll just keep this one, since I'm rather be working night shift and I'm sure I will knit more again, and I'm essentially lazy and can't be bothered at the moment to set up a new blog. Maybe next time I leave the country on another grand adventure, I'll make a new one :)

So anyway. Here I am but I don't really have much to say. And is anyone out there anymore? I have some tales from the ICU to tell...but I'll save those for later. For now, I just have an idea of what I what would do if I ran the world. Now, believe me, I rarely get these ideas, because I'm pretty much happy to let the lunatics run the world and to hole up on my desert island with my little dogs, a bottle of rum, and a Bob Dylan CD. My very own tiny version of isolationism, as enacted by the Republic of Rosebuttons. BUT I have one little request to make, to the people who are running the world: Everyone who is climbing or wants to climb Mt Everest...? Stop it. Get off the mountain. It's officially closed. Forever. First of all, people, why? Because it's there? To prove something? That's the lamest most egocentric reason of all. There are lots of things that we humans can do, or might want to do, but we shouldn't. And if you have something to prove, why don't you go to Africa and vaccinate some babies, or take over FEMA, or adopt an abandoned puppy, or just let that guy merge in front of you on the highway without giving him the finger? But I digress. As Einstein said, "Only two things are infinite: The universe and human stupidity. But I'm not certain about the universe." So if you have something inane to prove to yourself or your peeps, go ahead and do it, it's none of my business. BUT...here's where I get pissed off: When, in the course of reaching your self-centered and pointless goal, it becomes acceptable to eschew all implicit moral behaviors, to stop being human. There is an acceptable code, on the mountain, that if another climber can no longer walk, you leave him or her to die. The reasoning is rational and cold: You hardly have enough energy to walk by yourself, it would be impossible to save another person by carrying them off the mountain as well. Implicit in this code is the idea that everyone is completely on their own on that mountain, no one can save anyone else, or even help anyone else. So climbers routinely walk by dying and dead people on their quest for their 15 minutes at the top of the world. And it is ok, because that's the code, and other people do it. BUT, as it turns out, there is no pot of gold on top of that mountain, there is not even a cure for cancer, or AIDS, or the secret to peace in the Middle East. There is not even very much oxygen up there. Yeah, perhaps there is a personal accomplishment, but if you're looking for accomplishment, try undergoing and surviving cancer treatment. Or flying cross-country with a one-year-old by yourself. For fuck's sake, just learn to change a flat tire. What I'm trying to say in my roundabout way, is that I have a huge problem with a useless activity that allows people to justify foresaking their own humanity and their duty to be human towards other people. Now, I'm the first person to snark at your whinging, snotty child on an airplane, or call you some choice four-letter words if you cut me off on the highway without your turn signal, and I might even whisper something about your poor judgment in selecting spandex shorts to my equally snarky friends, because I'm the first to admit I'm not the warmest or nicest person, and in general I don't like most people. BUT, if I found you lying on the ground, and you needed help, I would stop and use my sock to tourniquet your gaping flesh would or just hold your hand so you weren't alone, not because I'm a nice person, but because I'm a human being, and that's why we're here. And maybe I didn't climb to the highest point on the planet, but if that one other person 's life was a bit better because I was where I was, then that's okay. So, you crazy Everest climbers, get off that mountain. I think you left something down here on Earth...it might be your humanity.

Heh

This is awesome news: Zoo puts humans on display.

The last line of the article sums it all up, I love it.

I'm off to see a man about a horse. In Hyde Park, that is.

'doh

Thanks for your comments guys, I'm touched when I hear people are actually reading me :) Anyway, I'm an eejit...I will definitely send you bloggy invites but turns out I need your email addresses to send the invites too, and I can't seem to figure out how to see your emails from the comments (if that's possible at all). So, I'm sorry, but can you email me instead of comment? I'm srrussso at gmail dot com.

Thanks again! I'll figger all this stuff out someday...

...on a jet plane

...don't know when I'll be back again.

I'm not sure if I'll be posting here much in the next several months, but maybe I'll pop in once in a while with a funny story or anecdote. I'm leaving for London tomorrow afternoon, with essentially a one-way ticket. From there, I'll travel on to Saudi Arabia with my employer to work as a private nurse for three to six months.

I'll be continuing to blog and write while I'm abroad, from a different blog, Arabian Nightshifts. However, it's one of those annoying invite-only blogs, as I don't feel entirely comfortable making it public, for just anyone to stumble upon. You know, employer privacy, national security, little things. But I'm not trying to shut you out, oh no! I want to share all that I can with anyone that I know. So, if you want to continue reading, and you want a fancy schmancy bloggy invite, just leave me a comment! Even if I don't "know" you, if I know your blog or we've made a vague passing acquaintance and I'm fairly sure you're not the Minister of Defense of the Kingdom of Saudi Arabia, I'll let you in. Oh, and if I know you for reals, as in, I know your birthdays and your mother's maiden name, you're getting an invite soon anyway once I get things up and running. My main motive in the "invite-only" idea is to not have it available on random search engines or to people just clicking through. Like, the muttawah (religious police) or officials in the Kingdom. Not a good place to offend anyone, if you know what I mean. Just trying to keep a low profile ;) I don't know a whole lot about innernet securty, but I figure this is fairly safe way to go. If I'm entirely off base, let me know, eh?

So yeah. I wish I could write an eloquent and concise post about how it feels to organize and pack up your whole little world, to systematically check out of This American Life for a short but indeterminate period of time, to say farewells and thank yous and love yous to all who matter to you but to keep wondering if you said it enough, but I'm sort of at a loss. I also wish I could explain how I'm still in disbelief about what I'm about to do, that I think I'm really super excited and thrilled to be embarking on this adventure, and that I hope that I remember how exciting this all is when I'm suddenly wondering what the fuck I'm doing and where the hell I am. But I can't, I'm just packing and checking things off lists, and going through the motions trying really hard not to cry, so I'm sorry I'm not doing a better job of writing about it.

Stay tuned, whether I see you over at Arabian Nightshifts, or when I'm back here, writing about returning to work at the Children's Hospital. And thanks for all the fish.

Schmoo

IMG_1889.JPG
Originally uploaded by rosebuttons.

These are my schmoos, my babies, my "pack," my favorite little creatures ever. This week and especially this weekend has been full of "lasts," which are bittersweet. Each wonderful moment with my friends or my family stings a bit as I realize that it's the last one for a long time, and I wish the moments would dilate so I can hold them longer, and imprint them on my brain to remember later.

And I can't get enough of these little guys, of their wet noses, or velvet ears, or soft naked bellies, even their wheezey, regular snores when they're sleeping cuddled next to me. Their liquid brown eyes follow me worriedly as I clean the house, drag out the suitcases, and make piles everywhere. So I stop each time I walk by then, and smoosh their faces, scritch the top of the heads, tell them they're best dogs in the world. But it just sucks, because I can't make them (or me) feel better by making sure we've got each other's emails, or promising to write and call regularly, or even by telling them when I'll be back. All they know is that something big is going on, their little world is changing, and I might be leaving. I guess that's sort of all I know, too.

And then there were three

Three days, that is. Until I leave. Eek.

This week has been filled with making lists, crossing things off lists, adding things to the lists...farewell dinners with friends, organizing bills and payments, mail forwarded, getting the car serviced and washed, getting my hair cut, my brows waxed, shopping...

But of course I still found time to lay on the couch, cuddle with the doggies, and enjoy my mindless cable TV. Thanks to Nicole, I found this: Effects of drugs and alcohol on spiders. Go ahead, just try not to laugh out loud.

Now I'd like to do some more of that laying on the couch with the dogs, but I must go and pick up my prescriptions before my insurance expires tomorrow. And then I must go to the Apple store and pick up Sims 2, because, well, why not? How else will a girl pass the time on transatlantic flights or those lonely nights in the desert? And maybe I'll pick up a pair of speakers, because as fabulous my wee macbook is, it does not seem to have great sound.

And I might be rather brave, or probably just a little stupid because it is 4:30 on Friday, and I am about to head out in the rain across the ship canal bridge, on my way to U Village. That will mean nothing to you if you're not from Seattle. And if you are from Seattle, I can hear you snickering at me.

Obligatory 2007 post

I hid on my couch and avoided any New Year's Eve celebrations this year, mostly because I was still sicky sniffly achey but also because I had decided not to succumb to the pressure of making plans, coordinating people, ensuring a good time, blah blah fish cakes. So Steph brought us some yummy pizza (with extra red sauce on the side, thank you!) and we watched Creature Comforts on the BBC, laughed at the goofy dogs, then parted well before midnight. Not a rockin' celebratory night by any stretch, but as comfortable (elastic waist pants were worn by all) and cozy as I needed. As Jodi said, it will turn into 2007 whether we celebrate it or not. And I figure that I've got a whole year of brand new exciting adventures ahead of me.

So lets see, is this where I'm supposed to make New Year's plans, or even resolutions? I think I'm going to pass on that one too. I've made enough plans (quit job, go to London, spend some months in Saudi Arabia, come home, get job back, buy a house, travel the world, buy myself a pony, etc) and resolutions only depress me because it forces me to think about what I want to change about myself instead of what I already pretty much like about myself. So, all by itself, with no lists or planning on my part, I think 2007 is going to change me and force me to look at and understand the world and myself in profoundly different ways. And hey, if I lose a few pounds in the process, that would be nice.