Tuesday, January 24, 2012

Drink of Choice

It was a very busy day at work tonight. The hospitals in the area are at red alert; maximum census. We traded and juggled patients within our unit and with other floors to maximize bed usage. I'm the one responsible for making sure that, in these situations, the patient's television and meal services follow him/her.

We have different bed models and I have to make sure that the model bed in the room is suitable for the particular patient. Some beds can support the trapezes used by the orthopedic patients, others can't. Some beds can be lowered closer to the floor for the lols and loms who have trouble getting up. With a dozen discharges and admits/transfers, it can get fairly hectic.

All in all, there were dozens of little tasks that needed to be balanced throughout the night. Charge and I, deflected some of the stress fantasizing about paradise. It didn't include 72 virgins but rather several handsome men (we decided that we didn't need as many as 72), tropical beaches and endless backrubs and beverages.

Anyhoo, I mentioned that I don't care for most liquor but that an occasional scotch is divine.

One of the nurse's came back to the desk as I was describing my drink of choice: a rich, peaty scotch with hints of wood, straight up.

It wasn't until she laughed that I realized that it sounded like I was mixing my fantasies up. And so a new euphemism 'sipping the scotch' was born into our unit vernacular, joining, among others: "nasonexing the gift" -another sexual reference whose etymology is convoluted and traces back to the behavior of one of our frequent flyer patients.

Oh the things we come up with....

Wednesday, January 18, 2012

Tantrums at Work

One of our exclusively elective surgeons is on vacation and so our unit census is low. When this occurs, our scheduled staff rotates either floating to another unit or gets called off.

This nurse
arrived, saw that a coworker was floated and proceeded, behind the closed door of the breakroom but perfectly audible down the hall, to shout, slam things around and basically throw a ten minute tantrum worthy of an ambitious two year old.

Why?

Apparently, it was her turn to be called off and she's so sick of other units 'taking advantage of our low census' and 'stealing' our staff.

Wow.

Monday, January 16, 2012

Sheepishness


After my last 'oh woe is me..' post, I've actually had a good time at work and made plans to share some vino and conversation with one of the new nurses.

We've discovered a mutual appreciation for Bollywood movies and the absolute awesomeness of SRK.



She's new to the area and I think that she's lonely too.

I've got an interview in Chicago next month for school. I'm excited. I love Chicago!

Friday, January 13, 2012

Laziness and Loneliness

I'm lonely.

When I moved back from the west coast to my itty-bitty industrial town, my life changed completely. During the subsequent two years when my time was consumed with caring for my mother, my smart, stimulating and worldly friends across the continent dropped away. I just hadn't the time to nurture our relationships.

I'm trying to create new stimulating relationships but apparently I'm weird.

My nursing coworkers, the pinnacle of education in this working class town, are consumed entirely with creating and raising families, getting married or engaged. We're friendly enough at work but I so miss talking with people about things beyond our immediate sphere of family and work.

Those who read, read Twilight and the Hunger Games. They tease (not maliciously) me about the books that I bring in and I can't find any interest in the antics of Belle or Edward.

Growing up here, I was the lonely little girl in the tree with a book fantasizing about evading the trolls below. When I left at eighteen, I discovered a wonderful world full of fascinating curious people who read, traveled, explored cultures, food and art, fought for environmental preservation and human rights. They celebrated their own uniqueness and seemed to appreciate mine. I swore that I'd never return to this area.

Then dad got sick and mom got sick and I again was tethered.

I know that the end is in sight; I'll be leaving in a few months and re-entering a world of more curious people.

This last year has been brutal though. Those who have applied to medical school probably remember how demoralizing the process is. You basically rip your life and history apart, present the pieces to anonymous adcoms and wait for them to decide that you're lacking. With the deaths of my parents and my relocation thousands of miles and several time zones away from my friends, I lost all of my social and emotional support.

Every time that someone I work with asked why my applications were failing, I withered away a little more. Trying to explain the immense competition involved came across as just defensive and it showed in their expressions.

Emotionally, I'm hibernating now. The acceptance that I received validated me in a way that I could have never predicted. My intellectual loneliness isn't so severe now that I know that it's finite.

I don't feel defensive anymore when people insinuate that I'm lazy because I don't plan on working through medical school. I can just wait a few short, yet impossibly long, months and I'll be with folks who'll understand that I'm not lazy.

I'm grinning now in anticipation. I know that I'm leaving an intellectual desert to conquer an ocean of knowledge. It'll be hard, I know, but it'll never be as hard as the last few years of dehydration. It can't be.

Tuesday, January 10, 2012

Directions

One of the new attendings came up to me today and asked for directions. She was new to the area and not sure on how to get home. She lives next to a major landmark and the drive is pretty straight forward from the hospital, a two-turn trip.

Because she seemed so dubious about my verbal directions, I drew a little map.

Still hesitant, she gratefully watched as I pulled up the google maps version.

Aha!

As she was walking away, I called out: "do you want the map?"

"Oh no, I'll just GPS it. Thanks."

We all laughed about it the rest of the night. So ridiculous!


BTW: Interview invitation Numero Dos esta noche!! ole!

Sunday, January 8, 2012

Outrage

It was a busy crazy day at work. I’m usually the only one on the desk on evening shifts; the charge nurse takes a group of patients. This week, the patient who will not be named was here again so I worked with Charge in that room and managed the desk.

We’re implementing a new rounding system next month and so I was also responsible for logging all patient call bell requests in preparation for the new protocol.

There was a water line rupture in the unit next to ours and the shut-off affected some of our patient rooms, public bathrooms and other facilities. I needed to contact Engineering, itemize the affected plumbing, and make other arrangements for patients and staff.

We also had a stroke response on one of our post-ops. I had to monitor the call, STAT orders, arrange for CT, and, afterwards, restock the crash cart. The house staff was going to send the patient to telemetry and I arranged the transfer between the units.

In the meantime, we received 2 contact precaution admissions from the ED and, with no available isolation rooms, I had to rearrange the already admitted patients, inform the nursing staff, direct the aides, contact housekeeping to clean the rooms and then admissions to confirm the computer transfers.

While the stroke response was occurring, the nursing supervisor arranged for a transfer of someone already downgraded to medical from telemetry to make room for our unfortunate patient.

It soon became apparent that our patient belonged in intensive care and not tele. I began those arrangements.

Despite the alleviation of urgency, the other unit decided to send up the transfer, walking! before we were ready. I scrambled to find somewhere for her while her room was prepared. Argh! Her meds hadn’t been hung and she was due for pain medicine so she complained the entire time while I tried to juggle everything. Her new nurse was still dealing with the stroke situation.

Finally things settled a bit and, ten minutes before shift change, the supervisor called about a non-urgent transfer from intensive care. “ICU only has two patients, can this wait until morning?” “No, this patient needs to start PT first thing in the am.” “Sigh, alright.” I HATE moving patients around at 11 pm. I think it’s hard enough for them to get sleep without the jostling and noise from rolling squeaking beds and housekeeping carts. But I took down the details, another iso-room needed! and began rearranging our patients.
The aides grumbled but they moved the patients. The call bell system erupted from all the newly awake patients. “I have to use the bathroom.” “Am I due for pain medicine?” “Will you call my family to let them know about the change?” etc..

11:10 One of the nurses from ICU called to give report. I told her that we weren’t ready yet. Our nurses were just starting report themselves.
“NO! I need to give report NOW.”
“Um. No you don’t. It’s a non-urgent transfer and I know that your shift isn’t over until 0700”
“We’re just starting an in-service. I want to give report before it starts. I won’t send the patient up for a while.” Sigh.
“Jackie would you mind taking report now? She’s insisting.” I rolled my eyes and handed the phone to an incredibly patient nurse. Jackie gets report and says that the patient’ll be up between 12 and 12:30.

11:15pm. I track down the housekeeper just before he finishes his shift and beg him to clean the room for our transfer.

11:17 ICU nurse calls with update on the transfer patient. I tell her that the nurses are in report and that Jackie will call back when she’s ready.

11:19 Housekeeping is still in the room cleaning. The elevator door opens and our patient steps off, white knuckles grasping his walker and the aide carrying his belongings. !!!!

“The room’s not ready! Why are you here!”
“Oh. I just came on. They told me to bring him up.”
“You have to go back down. We’re not ready.”
“I can’t go back down; They already stripped his bed, we don’t have anywhere to put him”

Seriously? I lead them down to the room and pull a chair out into the hall for the patient.

Following the aide back, I laid into her.
“We told you folks several times that we weren’t ready! This is inexcusable. You didn’t even bring him up in a wheelchair!”
“I’m sorry, I just came on. I’m just doing what they told me to.”
Sigh.
“I know that it’s not your fault but this is ridiculous!” Grumble Grumble.

The aide leaves and I go back to the room to get the patient settled in. When I come out, the nurse from ICU is yelling at Jackie.

“How dare you yell at my aide! Blah blah blah, miscommunication that’s all your fault.. blah blah blah..”
I could feel the hackles grow across my shoulders like the hump of a grizzly bear. I’m outraged and start to jump in but a nurse grabs my arm and I pause. Jackie diffuses the confrontation by apologizing and the ICU nurse righteously storms off.

I’m told that the ICU nurse is something of a barracuda, is always right and never lets things go. After she leaves, the nurses gather and complain about her unjustified behavior and how awful she is.

It’s now five days later and I’m still stewing over the situation. It makes me so mad when people like that ICU nurse get away with laziness, superiority, inconsideration and recklessness because people are afraid to call them on their crap.

In hindsight, I know that if I had gotten involved, the confrontation would have escalated. It wouldn’t have been fair to the night crew to spark it and then leave when my shift was over.

But I HATE that someone else gave an apology for my behavior. If my behavior calls for an apology, I want, I NEED, to be the one to offer it.

In this situation, though I cognitively recognize Jackie’s motivation to diffuse the situation, her apology stabs me viscerally. I know that I should just let it go but I’m so outraged.

Wednesday, January 4, 2012

New Year's Resolution.

It was a rough end of the year for me. I try hard not to resent the families abandon their older relatives at the emergency department... "Grandma (who is 96 and unable to walk without assistance) attacked us"... My own family, parents, grandparents, siblings has decreased to two (my brother and grandmother) over the last few years. I don't know if I'll ever share the joy of the winter seasons again like I did in years before. I hate that people can just throw the gift of family away.

My heart breaks when the holiday passes and the poor 'social admissions' wonder what they did, cry for their families or stare blankly at the wall. The families rarely seemed to visit.

I did have a lovely time reflecting on the year to come though. I'm hopeful that it will be a monumental series of experiences.

I don't normally make resolutions but I'm determined to squeeze out every bit of adventure, enjoyment, stimulation and happiness that I can. I have a tendency to be complacent; spending my time reading in my apartment and being alone. The last few years of my life have revolved around taking care of my mother, my grandmother, my brother's family and work. I hadn't made any plans because other things were more important. I fell into a deep gloomy rut.

I want to get up and go every morning, make plans and rediscover an anticipation of life that I've somehow lost. I won't wait anymore for things to just happen; I will do.

I've got months of time off saved up and I'm going to use every drop before I leave my job.

That's my New Year's Resolution.

Cheers all.