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.

So I hear it's your birthday...

Thank you Jerry, and yes, it was yesterday! I'm officially an old lady, the big three-oh. It's a good thing, because now my knitting and sewing and old-lady name and wiener dogs all make a lot more sense. Plus, it feels kind of cool not being stuck slogging through my 20s anymore. I'm so over the 20s. The 20s were all about going to class and figuring things out and deciding what to be and what to do and what not to do. Not that I've got anything much more figured out, but I have learned things like not to keep drinking after you've thrown up (age 19), not to keep calling the boy if he stops returning your calls (age 20), how to read as little of possible but still ace the test (age 21), and how to get a real job that pays the bills (age 28). So now that I've got that stuff out of the way, I can be 30 and fabulous. And I'm going to try all sorts of new things. Already, I've been to Jack in the Box for the first time and eaten my first mussels (two different events, obviously). And it's only going to keep getting better from here!

I'm not going to tell you how hot it is here, nor am I going to complain about the weather. Contrary to popular belief (based upon the amount of people who do it), whining about the weather does not actually change it. Apparently, there are plenty of other blogs out there doing that if that's what you want to read. But I am going to mention that if you have absolutely nothing important that you need to be doing or anywhere you should be going, if you can get away with wearing nearly nothing, if you enjoy bad reality TV, and if you surround yourself with icy cold beverages, sprawl on the couch and point all the fans at you, this weather suits me fine.

I am also pondering why my neighbor, the Laundry Slut, continues to have at least eleventy billions loads of laundry to do EVERY weekend despite the fact that from April till October he NEVER wears a shirt. Tessa is currently barking up a storm at him because he's out in the yard, and even Tessa understands that public nudity is a privilege, not a right. A right specifically reserved for Colin Farrell and the Italian soccer team. And last I checked, furry Laundry Sluts were not members of that team.

Oof, I've left my post. Back to the couch, I don't think I've seen this particular episode of Kathy Griffin: My Life on the D-List.

I'm still here...

I haven't posted anything in a while, so I thought I'd drop in to say hey, I'm still around. Been working a lot lately, taking care of W. for a few weeks now. She's sometimes a tough patient, but I keep requesting her now, for whatever reason. Maybe because it gets easier to more experience you have with a patient, the whole "the devil you know..." thing. Maybe because the more you invest in taking care of someone, the more you have to be there for them. Last night her daughter asked me, "Is she going to wake back up? Is my mom ever going to be my mom again?" I don't know. Nobody knows. Maybe, or maybe not. There's such a super-fine tightrope we walk at work, giving realistic expectations but not extinguishing hope. Never extinguish hope, that's all some of these people have. You've got to hope for the best, because, really, what choice to do we have? Our chaplain told me once (someone else probably said this first, so I apologize for not giving credit where due), "Always hope for a miracle but never expect one."

Someone died this week. He was a cool guy. I want to link you to his obituary in the New York Times so you can read about his life and everything he did, but I'm too paranoid about HIPAA. He taught me that regardless of political affiliation, some people are just good people. He was warm, curious, funny, and open. He wanted to hear what you thought just because you thought it, not because you supported a particular party or 'side.' He wanted you to know more about politics, but he would give you a book or literature and encourage you to learn something through your own eyes then come back to discuss it with him. He found humor wherever he could. The love and compassion he inspired in his family members, evident from the way they looked at him and laughed with him was moving. He was genuine in a disarming way. When you strip away preconceived ideas and deal with people just as human beings, you are often surprised but always rewarded. It's unfortunate that sometimes it takes illness and suffering, or just putting someone in a neutralizing hospital gown, to approach that situation. So thank you sir, I feel lucky just to have met you.

I'm on stand-by tonight for work but I just received an 'ominous' call from my charge nurse, so I might be putting those scrubs on after all...

Tales from the Last Chance Motel

Last week at work, I took care of J., the woman who was in withdrawal and suffering from extremely altered mental status, although she was coming around a bit. I also took care of W., an engaging southern politician who said things like, "I have a five-pound appetite but a three-ounce stomach." He was a genuinely nice guy, the kind of person who, when he asks you how you are, asks you because he actually wants to know. I admitted him one night then got him ready for discharge him the next. So I came back to work this week and was guilitily pleased that J. had been transferred to another unit the day before. Then I found out that she had died that morning, a victim of her aggressive stage-four gastric cancer. And although I had discharged W., he had been re-admitted the next day but was currently on his way back home, via air ambulance, as he had relapsed and suddenly gotten sicker, so he wanted to be home to die. That night my another patient on my unit died, and I helped her nurse wrap up her body. My patient is also awaiting a celestial discharge, but remains full-code status and continues to undergo all treatments, such as mechanical ventilation, kidney dialysis, and a levophed drip (cardiac medication to keep her blood pressure up). She has gained over 80 lbs in less than three weeks, and when I move her or touch her she cries. Her tears are bloody and leave permamently stained rivers down her cheeks. Last night one side of her neck started swelling up like a baseball and we found a strange (fungal?) rash/spots across her chest. Yesterday another patient that I'd had a few weeks ago received her stem cell transplant but shortly thereafter went into respiratory distress, acute renal failure, and suffered a huge MI (heart attack). She was intubated and dialysed but her blood pH had been around 6.1 for nearly four hours. That's real BAD. So...yeah. I don't know why I'm typing all this, except that its what I mean when you ask me, "How was work?" and I say, "It was okay."

Wakey wakey

Although not a great photo, this is a view of the sunrise as seen from many of our patient rooms. After spending a darkened night making sure patients are breathing, whispering around sleeping family members, using a flashlight to check name bands, and ruminating over the horrors and unfairness of cancer, its always a comforting yet bittersweet surprise when the sun starts to come up, and the world outside starts to brighten. As if to say, "Things won't always be this bad."

My patient this week was going through probable benzodiazepine withdrawal, which presents somewhat similarly to alcohol withdrawal. Which is not a pretty picture. She may have taken up to 90 clonazepam tablets over six days, which is about 5 times the maximum recommended dose. She was delirious, narcoleptic, agitated, anxious, noncommunicative, impulsive...well, all that and a bag of chips. Oof. I'm drained from those three days of making sure she didn't pull out her central line, reaccessing her implanted port when she did pull it out, keeping her hands away from her foley catheter, listening to her cry, and hoping she didn't have any more seizures. Also, three deaths over the past three days on our unit, although all during day shift.

Then this morning I couldn't fall asleep because I was having this strange shooting and intense lower back pain each time I tried to lay down, which was rather bothersome. I couldn't remember hurting myself while bending or turning or lifting a patient, although it's certainly possible. All I could think of was, "Pt c/o lumbosacral pain, rated 7/10, nonradiating, sudden onset. Relieved with ibuprofen 800mg PO and diphenhydramine 25 mg PO. Reassess pt comfort q8hrs."

It's July!

Happy July 1st everyone! I hope you all enjoy this lovely sunny summer month, the barbecues, the swimming, the sunshine. Ahh. Just, please, whatever you do, do not get sick or injured. Buckle your seatbelts, wear your helmets, cook your meat thoroughly, remember that "beer before liquor..." Do whatever you must do to avoid having to go a hospital at all costs. Because July 1, all across the country, is the first day of being a doctor for all new doctors. Don't get me wrong, the first-year residents are, for the most part, a group of highly trained, motivated, caring professionals. Ready to save lives. Just as soon as they figure out the appropriate dose of tylenol and make panicked calls to their attendings. I worked with an R1 last night was only five days old (awww!), still wet behind her cute doctor ears. So fresh and new, actually, that she was still getting ice packs for patients herself. And bless her, she was sooo sweet and caring, and trying so hard. But her comment to another nurse last night sums it all up: "You have no idea how many patients we'd kill if it weren't for you guys." (meaning us nurses! Like me! Hah! Yep, now you should be scared!)

For the past several weeks, although I've been feeling better for a few days, I've had basically a persistent headache which evolves into a migraine every third day or so, and had to take excedrin or nsaids on a daily basis. Last night, I admitted a patient from another oncology floor, a young woman in her early thirties who had mental status changes and a seizure. The nurse giving me report began by saying, "So this young woman presented to the ER last night with intractable headaches but appearing otherwise normal..." By this morning she was incoherent, unable to communicate, and thrashing in bed, agitated and unconsolable. At one point in the night she was foaming blood from her mouth because she bitten down so hard on her tongue. I had to pinch her nose shut to get her to open her mouth and stop biting her own tongue. We have no idea what is wrong with her. But yeah, I have an appointment with my doctor to discuss my headaches.

Yawners

Yawners
Originally uploaded by rosebuttons.

The Famous A. has a comment on reading this blog, apparently. Everyone's a critic. Ah well.

This post contains neither nursing content nor knitting content, maybe because I've had four days off work and it just seems too hot to be knitting. But mostly because this little person is just too darn cute and far more interesting than anything I can blither about purling or the reasons why cancer sucks.

Today I went to Target and spent far far too much money because a.) Queen sheet sets were on sale, and b.) I have to buy new underwear on a weekly basis because Ted eats it. Seriously. He snoots it right out of the hamper and chews it up. Grody, I know. Then I went to happy hour where I could only have one drink because I had to drive home. So I think I need to either a.) Hire a full-time driver, b.) Use my bus pass to get to and from happy hour, or c.) Pretend my car is always in the shop and make people pick me up. I'll be pondering my options.

Oh and also...even though I have recently fallen head-over-heels for the charms of the above-mentioned tiny person (have you SEEN her?!), I still despise the rest of the world's children. Today I was leisurely enjoying a refreshing beverage at Starbucks until a hoard of blond childfreaks descended upon the bench next to me and proceeded to bang on the bench with their toys and screech loudly and constantly at the top of their lungs. Their parentard conveniently disappeared into a nearby store. Apparently, children don't grasp the concept that an evil glare means "Shutthefuckup" until they are quite a bit older. I would gladly have taught them that but I didn't have the patience today. As I was buying a snacky in Starbucks, their parentard came in to order a drink and her ineptitude at ordering an iced tea was saddening. Here's one of my pet peeves #415: When someone orders a drink but insists on using a hand signal to show what size of drink she wants, instead of using her Grown-Up Words. PEOPLE! Puh-lease! Anyway, as I was saying, apples...and trees...not that far apart.

Hello, world!

12 hours old
Originally uploaded by rosebuttons.

Today I met the most fascinating little person, little A., who just made her debut yesterday. She is modeling her very first handknit hat here, and quite adorably as well. I can't wait to get to know her better. And as her aunt, I get the fun job. I don't have to worry about whether she eats her peas or puts her socks on backwards or finishes her calculus homework before TV, I get to take her shopping and teach her to ride a pony and tell her which boys to avoid (pretty much all of them, but at least we have a while). Although I'm sure she'll have even more interesting things to teach me as time goes by.

So happy birthday, A., and welcome to the world. We're awfully glad you're here :)

...

Billy died in the early hours of Thursday morning, the night after my last night shift taking care of him. After a conference with his doctors, his family made the decision to withdraw life support and place him on comfort care measures. He was extubated and died peacefully on a morphine drip with his family at his side. He was 25. I will remember the floppy blond hair and the wry grin from the photo above his bed rather than the war-torn body he left in the ICU bed.

I am sad and feel strangely guilty that I wasn't there. I never met his mother, just spoke to her on the phone each night I was his nurse.

I haven't even cried yet but last night I had three patients who needed their nurse to crack jokes with them, sigh in empathy at their pains and complaints, and make sure they got their antiobiotics on time. And we march on...