It's the homestretch of my life at U8; tonight marked shift 10 in my countdown. I'm thrilled to be moving on and immersing myself in school but terrified at the idea of being unemployed for four years and intimidated by how hard medical school is going to be. What if I'm not disciplined enough?
In wonderful circular serendipity, one of my all time favorite patients, a friendly inspirational and endearing character is back for my last weeks. I worked with him at the start of my time here and now I get to say goodbye. It's the perfect end to my clinical interactions and a great memory to tide me over until I get back to the floors in two years.
I decided to go to the big city medical school (BCMS). I was vacillating between the two for months and had decided on small-town nearby because I convinced myself that my quality of life would be better there. (family pressure may have been a factor)
Then BCMS offered me an amazing scholarship thus giving me the freedom to acknowledge that I would be happier in the program and in the city. It was enough to topple even the strongest objections to the choice. Hooray!!
I'm going to the city next month to look for an apartment. I'm so excited for this summer!
Showing posts with label work. Show all posts
Showing posts with label work. Show all posts
Friday, May 4, 2012
Wednesday, March 14, 2012
Quality of Life
We have a patient on the floor, a social admit. Adorable. She’s completely independent, mobility-wise, and wanders the floor constantly, asking that her ever-present Styrofoam cup of prune juice to be reheated. She flirts with all the men, telling them they’re the spitting image of Clark Gable, sugar lips and all.
From the desk, I see her make her revolution around the unit. She pauses next to the room with the moaning confused man with a hip fracture. I see her raise her hand to the doorframe. She makes no move to go in or even peek. But her hand trembles and she’s obviously affected.
She continues on to the end of the hall, looks out the window at the pitiful view, then returns to the desk and asks me to heat up her prune juice. As far as I can tell, she doesn’t actually drink the stuff but promise her a new fresh cup and she beams.
She makes several rounds, pausing outside noisy rooms and staring out the windows at the end of the corridor. This time of year, the trees are naked and the sky is grumpy. She’s riveted though. She always comes back to the desk and chats with me. It’s the same short conversation throughout the night. She doesn’t feel like doing the dishes. Can they wait until the morning? She’s tired and wants to go to bed.
Despite her fatigue, she makes another rotation. Whenever one of our staff passes in her in the hall, they call out her name with a bright hello. She beams and tells them that they’re the spitting image of someone famous. I look like Ann Margaret. Preeti looks like Pocohantas and Aimee’s Linda Blair.
We talk about patients and quality of their life. This lovely special little old lady has been able to affect the quality of life of everyone on this unit. Talk about giving back. We’re blessed to be a way station on her journey.
From the desk, I see her make her revolution around the unit. She pauses next to the room with the moaning confused man with a hip fracture. I see her raise her hand to the doorframe. She makes no move to go in or even peek. But her hand trembles and she’s obviously affected.
She continues on to the end of the hall, looks out the window at the pitiful view, then returns to the desk and asks me to heat up her prune juice. As far as I can tell, she doesn’t actually drink the stuff but promise her a new fresh cup and she beams.
She makes several rounds, pausing outside noisy rooms and staring out the windows at the end of the corridor. This time of year, the trees are naked and the sky is grumpy. She’s riveted though. She always comes back to the desk and chats with me. It’s the same short conversation throughout the night. She doesn’t feel like doing the dishes. Can they wait until the morning? She’s tired and wants to go to bed.
Despite her fatigue, she makes another rotation. Whenever one of our staff passes in her in the hall, they call out her name with a bright hello. She beams and tells them that they’re the spitting image of someone famous. I look like Ann Margaret. Preeti looks like Pocohantas and Aimee’s Linda Blair.
We talk about patients and quality of their life. This lovely special little old lady has been able to affect the quality of life of everyone on this unit. Talk about giving back. We’re blessed to be a way station on her journey.
Tuesday, March 13, 2012
Hovering
So my nurse manager has been present on the unit later than usual these last few days. He’s interviewing graduate nurses for our summer influx. Between his interviews, he hovers around the desk. I think it makes the nurses nervous, but I used to work for an honest-to-god narcissistic personality disorder with an impulse control problem. Mauro used to chase us down the restaurant screaming and spitting in front of the guests, just to make sure we dropped a check in a timely manner. He was CRAZY. Hovering Nurse Manager (HNM) is easy-peasy in comparison.
It’s actually been great. I think he’s finally seeing how busy our shift can get. Yesterday, the phone was ringing nonstop, the call bells dinging and two of our surgeons were piling their charts haphazardly across half-wall of the nurses’ station. BAM! Two of the charts fell and exploded like ticker tape flutter across the floor.
The nicer of the surgeons picked up the mess and brought it to me to reorganize. The other surgeon complained to his PA about the cheap folders the hospital uses for charts. HNM whispers to me that maybe he should call another nurse in. I snorted and said that it was calm compared to the previous day and he turned new eyes toward the scene.
The resident, interrupted by her pager and a call from the covering attending, swore during her dictation. As she rushed to the PACU (something about p-waves), she called out a verbal orthopedic consult request to Mean Surgeon. He turned to Lackey PA and snidely commented that she was going to save a life. HNM turned to me and asked if I had heard her swear. I mentioned my childhood with brothers and an acutely developed selective hearing. People swear. There are bigger things to worry about.
As I shuffled through the disordered progress notes, we chatted. I mentioned my love of Nick Drake and the new discovery of Damien Rice’s music and HNM said he totally digs him! How awesome is that? I am a little resentful though that so many people have known about this great musician for so long and didn’t share the riches (Yes, I’m talking to you, Solitary Diner ☺).
I notice that the admission orders for one of the charts being reassembled demands that the patient (admitted last week) be under cardiac monitoring. OOPS. I point it out to Nurse Manager then page Cursing Resident. She calls from, ironically, the telemetry unit. I hear in the background: “GI Bleed-rapid response”. I hand the phone to HNM who takes a telephone order to discontinue cardiac monitoring.
I update the Kardex, manage a new flurry of phone calls and flag down HNM to record a critical labs result. I admit it is nice having an RN at the desk. Normally our charge takes a group and so I’m left responsible for all the mechanics of unit flow. Though I like having my finger on the pulse of the action, it sucks that there’s such limitation to my scope: I can’t take telephone orders, record critical lab results, verify medication orders or ‘waste’ narcotics (verify the use of only a partial dose) for the nurses. I sit helplessly waiting for someone certified to have time to step in.
I often stay late to finish up everything I’m allowed to (checking diets and labs, stuffing charts etc) but it sucks when there are dozens of charts to be checked (hours of work) and I’m on the elevator waving goodbye at the bleak faces of nurses with a longer night ahead of them.
This week, I hope that HNM realizes how much work gets delayed because he doesn’t schedule a nurse to run the desk after 1500. I really think that if the powers that be break it down, it would be much cheaper to eliminate my job and add a nurse to the roll call. Having a nurse at the desk would likely eliminate at least 6 hours overtime every night. That combined with my income minus said nurse’s wage would amount to more than $45,000 saved for the institution every year.
It’s actually been great. I think he’s finally seeing how busy our shift can get. Yesterday, the phone was ringing nonstop, the call bells dinging and two of our surgeons were piling their charts haphazardly across half-wall of the nurses’ station. BAM! Two of the charts fell and exploded like ticker tape flutter across the floor.
The nicer of the surgeons picked up the mess and brought it to me to reorganize. The other surgeon complained to his PA about the cheap folders the hospital uses for charts. HNM whispers to me that maybe he should call another nurse in. I snorted and said that it was calm compared to the previous day and he turned new eyes toward the scene.
The resident, interrupted by her pager and a call from the covering attending, swore during her dictation. As she rushed to the PACU (something about p-waves), she called out a verbal orthopedic consult request to Mean Surgeon. He turned to Lackey PA and snidely commented that she was going to save a life. HNM turned to me and asked if I had heard her swear. I mentioned my childhood with brothers and an acutely developed selective hearing. People swear. There are bigger things to worry about.
As I shuffled through the disordered progress notes, we chatted. I mentioned my love of Nick Drake and the new discovery of Damien Rice’s music and HNM said he totally digs him! How awesome is that? I am a little resentful though that so many people have known about this great musician for so long and didn’t share the riches (Yes, I’m talking to you, Solitary Diner ☺).
I notice that the admission orders for one of the charts being reassembled demands that the patient (admitted last week) be under cardiac monitoring. OOPS. I point it out to Nurse Manager then page Cursing Resident. She calls from, ironically, the telemetry unit. I hear in the background: “GI Bleed-rapid response”. I hand the phone to HNM who takes a telephone order to discontinue cardiac monitoring.
I update the Kardex, manage a new flurry of phone calls and flag down HNM to record a critical labs result. I admit it is nice having an RN at the desk. Normally our charge takes a group and so I’m left responsible for all the mechanics of unit flow. Though I like having my finger on the pulse of the action, it sucks that there’s such limitation to my scope: I can’t take telephone orders, record critical lab results, verify medication orders or ‘waste’ narcotics (verify the use of only a partial dose) for the nurses. I sit helplessly waiting for someone certified to have time to step in.
I often stay late to finish up everything I’m allowed to (checking diets and labs, stuffing charts etc) but it sucks when there are dozens of charts to be checked (hours of work) and I’m on the elevator waving goodbye at the bleak faces of nurses with a longer night ahead of them.
This week, I hope that HNM realizes how much work gets delayed because he doesn’t schedule a nurse to run the desk after 1500. I really think that if the powers that be break it down, it would be much cheaper to eliminate my job and add a nurse to the roll call. Having a nurse at the desk would likely eliminate at least 6 hours overtime every night. That combined with my income minus said nurse’s wage would amount to more than $45,000 saved for the institution every year.
Saturday, March 10, 2012
Laundry Pieces and Admission Oppositions
Laundry had piled up. It had overflowed from my hamper in the bathroom sprawling into the hall. Plus, I was completely out of clean underwear, even the old granny panties formerly buried deep in the bureau. So I spent the morning, and two rolls of quarters, at the Laundromat, armed with two months of un-listened to news and politics blurbs on my Ipod. I am now caught up, sort-of, in a dilettantish way, on world mechanics.
I was listening to the NPR weekend edition podcast “In Today's Economy, How Far Can A GED Take You?” from 2/19 and the closing music was the instrumental of Dar Williams’ “February”. It’s my least favorite song on that album; I prefer “Southern California Wants To Be Western New York”- mostly because I was once (still am?) a mousy SUNY student composting in long underwear and the idea of being lusted after… a lovely novelty. Still… I love NPR ☺
Also fruit flies that drink alcohol are protected from parasitic wasps who can’t hold their liquor. It’s self-medication of an awesome sort. Courtesy of “Cheers! Fruit Flies Drink To Their Health, Literally” from weekend update 2/22.
I went head to head with admissions last night. Our unit was one patient away from its limit. Our nurses are not supposed to have more than 7 patients (which, in my opinion, are still way too many, particularly with the acuity we often have on our med-surg floor. It’s dangerous). Anyway, we had been slammed with 6 admissions/add-on post-ops, all within an hour when we got the call for the final one: 50yo man 400lbs AMS and oozing cellulitis, combative, infected with everything that you can think of, bacterial and viral. Bah.
I studied the census board and then called down. We’ll need to move these ladies together, transfer that dude to that room and then we’ll put Conan into this bed.
Admissions response? “Just put Conan into bed 36A.” I could hear her eyes rolling through the receiver.
“We can’t put Conan there. The roommate just had a major surgery. You don’t put infected patients in with surgical. Besides he needs to be closer to the nurse’s station. We don’t have enough staff for a sitter.”
She argued.
Jeez. Did she think I was just looking to occupy my time? We were crazy busy on the floor and who would be doing the actual physical transfer of the patients and all of their belongings and update all the computer records, charts, assignment sheets, ADT book and kardexes? ME. All she had to do was enter in a few keystrokes.
More arguing.
I called the nursing supervisor. She came up, glanced at the census and then called down to the admissions office.
She !!still!! argued but, eventually, the lady in admissions acquiesced and plotted the patients.
Seriously.
I was listening to the NPR weekend edition podcast “In Today's Economy, How Far Can A GED Take You?” from 2/19 and the closing music was the instrumental of Dar Williams’ “February”. It’s my least favorite song on that album; I prefer “Southern California Wants To Be Western New York”- mostly because I was once (still am?
Also fruit flies that drink alcohol are protected from parasitic wasps who can’t hold their liquor. It’s self-medication of an awesome sort. Courtesy of “Cheers! Fruit Flies Drink To Their Health, Literally” from weekend update 2/22.
I went head to head with admissions last night. Our unit was one patient away from its limit. Our nurses are not supposed to have more than 7 patients (which, in my opinion, are still way too many, particularly with the acuity we often have on our med-surg floor. It’s dangerous). Anyway, we had been slammed with 6 admissions/add-on post-ops, all within an hour when we got the call for the final one: 50yo man 400lbs AMS and oozing cellulitis, combative, infected with everything that you can think of, bacterial and viral. Bah.
I studied the census board and then called down. We’ll need to move these ladies together, transfer that dude to that room and then we’ll put Conan into this bed.
Admissions response? “Just put Conan into bed 36A.” I could hear her eyes rolling through the receiver.
“We can’t put Conan there. The roommate just had a major surgery. You don’t put infected patients in with surgical. Besides he needs to be closer to the nurse’s station. We don’t have enough staff for a sitter.”
She argued.
Jeez. Did she think I was just looking to occupy my time? We were crazy busy on the floor and who would be doing the actual physical transfer of the patients and all of their belongings and update all the computer records, charts, assignment sheets, ADT book and kardexes? ME. All she had to do was enter in a few keystrokes.
More arguing.
I called the nursing supervisor. She came up, glanced at the census and then called down to the admissions office.
She !!still!! argued but, eventually, the lady in admissions acquiesced and plotted the patients.
Seriously.
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....
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.
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.
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!
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.
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.
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.
Wednesday, December 14, 2011
Names
I like words and letters. I like how shuffling them around can result in endless meanings.
When I was a little girl, one of my favorite activities was playing boggle by myself. I would shake the dice and then find as many words as I could in two minutes. After the buzzer, I would scrutinize the board, writing down all the words that I hadn't found during the time limit.
If I found more before the buzzer than after, I won.
On the bus, I rearrange advertisement script in my mind, coming up with as many new sentences as I can. Or I try to just change character spaces. (shoestore up the stairs = shoes tore up the stairs)
When I study the unit census for staffing purposes, I automatically pick out the names with alternate meanings and make up sentences. I don't even really think about it, it just happens.
When I see the last names: Armstrong, Cox, Foster, Good, Paynes, I am going to chuckle. When the next two admissions are named Burns and Seaman. I will start to laugh uncontrollably.
Then I'll be embarrassed when my coworkers ask me what's so funny.
Sigh.
When I was a little girl, one of my favorite activities was playing boggle by myself. I would shake the dice and then find as many words as I could in two minutes. After the buzzer, I would scrutinize the board, writing down all the words that I hadn't found during the time limit.
If I found more before the buzzer than after, I won.
On the bus, I rearrange advertisement script in my mind, coming up with as many new sentences as I can. Or I try to just change character spaces. (shoestore up the stairs = shoes tore up the stairs)
When I study the unit census for staffing purposes, I automatically pick out the names with alternate meanings and make up sentences. I don't even really think about it, it just happens.
When I see the last names: Armstrong, Cox, Foster, Good, Paynes, I am going to chuckle. When the next two admissions are named Burns and Seaman. I will start to laugh uncontrollably.
Then I'll be embarrassed when my coworkers ask me what's so funny.
Sigh.
Monday, December 5, 2011
Manly Food
One of my patients last night was eating voraciously. In addition to an enormous meal from the hospital kitchen, he devoured 3 TV dinners, 1 PB&J sandwich and two pieces of toast and jelly.
Around 0200, he called out for another snack. After discussing it with his nurse, I brought him a couple of saltine packets.
A tirade spewed forth.
"I'm a MAN. I've traveled the world and have a MAN's appetite. I'm not a little boy and don't want no little boy snacks!"
He threw the crackers at me and said he wanted a MAN's snack.
I asked him what he wanted and he told me:
"a chocolate sundae."
I wonder how he feels about quiche.
Around 0200, he called out for another snack. After discussing it with his nurse, I brought him a couple of saltine packets.
A tirade spewed forth.
"I'm a MAN. I've traveled the world and have a MAN's appetite. I'm not a little boy and don't want no little boy snacks!"
He threw the crackers at me and said he wanted a MAN's snack.
I asked him what he wanted and he told me:
"a chocolate sundae."
I wonder how he feels about quiche.
Wednesday, November 16, 2011
The Catheter Interrogation
First thing this morning, a urologist came to place a supra pubic catheter bedside. The patient had been retaining crazy amounts of urine and neither his nurses nor his orthopedic surgeon could place a foley in him. So urology was consulted.
The doctor had called in a list of supplies that he'd need bedside by 0530. Apparently he was rather rude to the evening secretary about it, saying 'everything better be ready", in a 'you people always mess up' sort of way. But I know the evening secretary is something of a sensitive whiner, so I took her report with a grain of salt.
He arrived examined the patient and then decided to try his hand at placing the foley first, giving me and the patient's nurse a new list of supplies. We have coude catheters in different sizes and foley kits stocked on the floor so much of his list was immediately manageable. But he wanted Urojet (lidocaine) syringes too. We don't have them in our McKessen so it was a short process to get them up to the floor. He needed to write an order, I faxed it to pharmacy and then immediately ran down to pick them up.
He was NOT HAPPY.
Though it took 10 minutes tops to get them (5 of which were taken by him arguing about writing the stupid order), he was incredibly put out. I heard about how ridiculous we were, how he doesn't have time for this stupid delay.. etc, eye rolls and disdain galore.
Fortunately for the patient, he was able to successfully place the foley. Whew.
A few minutes later, I stopped in the room to check on the patient and I noticed that his collection bag had over a 1200 cc in it.
I remembered reading somewhere that draining the bladder too quickly can cause the patient major discomfort so I pointed it out to his nurse. She was busy doing her end of shift med pass and instructed me to ask the urologist if she should clamp the catheter.
So I did.
I thought he would attack me.
He completely lost his temper and flayed into me.
"That's the stupidest thing I've ever heard! Why do you think to clamp the catheter? Why?" and then he waited. It took me a moment to realize that it wasn't a rhetorical questions but that he actually wanted a response.
I tried told him that I had read somewhere that it could hurt the patient if the bladder emptied too quickly but as soon as I started talking he restarted his rampage.
I was mortified. I tried to explain that I was just an aide and the messenger for the nurse but he kept at me. I can't remember everything that he said; I was flustered and just trying to escape. I remember him saying that they don't teach nurses to be doctors and thrusting a new order at me, written in block letters as though I were in grade school, DO NOT CLAMP CATHETER. It was the only completely legible order he'd written thus far.
He ended up staying to yell at me for longer than it took him to place the foley.
So much for his valuable time....
I'm totally re-writing one of my evil book characters in his honor and he's (the character) is going to suffer.
.
The doctor had called in a list of supplies that he'd need bedside by 0530. Apparently he was rather rude to the evening secretary about it, saying 'everything better be ready", in a 'you people always mess up' sort of way. But I know the evening secretary is something of a sensitive whiner, so I took her report with a grain of salt.
He arrived examined the patient and then decided to try his hand at placing the foley first, giving me and the patient's nurse a new list of supplies. We have coude catheters in different sizes and foley kits stocked on the floor so much of his list was immediately manageable. But he wanted Urojet (lidocaine) syringes too. We don't have them in our McKessen so it was a short process to get them up to the floor. He needed to write an order, I faxed it to pharmacy and then immediately ran down to pick them up.
He was NOT HAPPY.
Though it took 10 minutes tops to get them (5 of which were taken by him arguing about writing the stupid order), he was incredibly put out. I heard about how ridiculous we were, how he doesn't have time for this stupid delay.. etc, eye rolls and disdain galore.
Fortunately for the patient, he was able to successfully place the foley. Whew.
A few minutes later, I stopped in the room to check on the patient and I noticed that his collection bag had over a 1200 cc in it.
I remembered reading somewhere that draining the bladder too quickly can cause the patient major discomfort so I pointed it out to his nurse. She was busy doing her end of shift med pass and instructed me to ask the urologist if she should clamp the catheter.
So I did.
I thought he would attack me.
He completely lost his temper and flayed into me.
"That's the stupidest thing I've ever heard! Why do you think to clamp the catheter? Why?" and then he waited. It took me a moment to realize that it wasn't a rhetorical questions but that he actually wanted a response.
I tried told him that I had read somewhere that it could hurt the patient if the bladder emptied too quickly but as soon as I started talking he restarted his rampage.
I was mortified. I tried to explain that I was just an aide and the messenger for the nurse but he kept at me. I can't remember everything that he said; I was flustered and just trying to escape. I remember him saying that they don't teach nurses to be doctors and thrusting a new order at me, written in block letters as though I were in grade school, DO NOT CLAMP CATHETER. It was the only completely legible order he'd written thus far.
He ended up staying to yell at me for longer than it took him to place the foley.
So much for his valuable time....
I'm totally re-writing one of my evil book characters in his honor and he's (the character) is going to suffer.
.
Friday, November 4, 2011
Monday, October 31, 2011
Settling In..
Well, I'm getting used to my new apartment. My neighbors are musicians. Yep. Alt Rock. Sigh. Toulouse is not amused.
I love it nonetheless. Here are the aforepromised photos.
There's been a delay on the house closing. Lawyers. Hopefully, we'll finally finalize it this week. In the meantime, I've been popping up there to check on it and take advantage of the laundry. Yesterday afternoon, I was vacuuming and heard "knock, knock, knock" on the door.
I opened it up and, lo and behold, there was the mayor of my small town holding a small ceramic bowl.
I invited Mr. B in and we chatted for a few minutes. Apparently, his son bought the house and the mayor was unaware of the delay in closing. He was wandering around the property last week, found my collection of wheat pennies in the garage and took them home. When he found out about the delay, he wanted to return the money. He was embarrassed. We walked through the house together and he mentioned some things that 'John-John' wanted to change and asked about the family. I had never really known him, his kids were older than me, but he was my brother's little league coach and shared booster club responsibilities with my mom and several aunts and uncles.
After he left, I burst out in laughter. I was robbed by my mayor! It struck me as incredibly ironic.
Work has been remarkably smooth. The nightmare patient that I had mentioned last time was only with us for a few days and since then, our census has been mostly comprised of easy ortho patients.
No more news on the medschool application front. I'm still 'under review' at all of the other schools. The waiting is impossible. BAH.
Wednesday, October 19, 2011
New Digs
I'm settling into my new apartment. It's a tiny studio in an old Victorian house with ceilings higher than the room is wide...
I'm using an old refurbished library study table for dining. I last rented a mother-in-law basement apartment, draped in grapevines and filled with books, that I christened the li-burrow. I haven't yet thought of a clever name for this new place. I'll post some more photos when I finally organize the living/bedroom. It's filled with boxes now and not very inspirational.
We have a patient at work. I'm not able to express the turmoil that this patient throws the hospital into when (s)he is here. I've been on the unit for over a year an this is the second visit. It's an incredibly stressful time for nursing staff, manager and hospital administration. This patient only comes to our floor for reasons that I can't go into without violating HIPAA. I can only say that they're unique and awful. I'm not experienced or clever enough to adequately change the details and still portray the magnitude of this person's effect on us. We get extra staff and the nursing supervisor relocates her center of command to our floor for the duration of the patient's stay. It doesn't help with the stress levels of the nursing staff. My manager hand selects the staff assigned to the room. Though he picks his most reliable, most patient and most experienced, it's not an honor.
The last time, the patient stayed 2 months. I'm not looking forward to another two months of complete anxiety before every shift. Bah.
I received my first med school interview offer. I'm thrilled but my loneliness yesterday was amplified in my hunt for someone to share my excitement. I mentioned it to my coworkers but they were more concerned that this means I may not be there next year. My brother disapproves of my ambition (I'm too old) and my west coast friends couldn't talk last night.
I'm still excited though!!
Sunday, October 9, 2011
Isolation
All five of our isolation rooms are sequestered in one hallway on our unit. I was walking back from helping woundvac dressing change and found myself stopping in each room to chat with the patients. I knew them all well. I chatted with Dean* (MRSA) about his kids; Ira* (VRE) shared his news about his UNOS status; Frances* (MRSA) asked me for a cigarette and we laughed together at the inside joke; and for a few minutes, Robert* (CDIFF and MRSA)and I competed to see who could get the most Jeopardy questions right. He won. Stupid "Sports Venues".
I headed back to the desk and, out of curiosity, checked to see how long my friends on the I-ward had been here. At July 7th, Ira was the newest admission. Three months. Like the others, he's settled in. He has his favorite snacks in the kitchen fridge, a mountain of pillows to burrow into, piles of linens, dressing changes and unopened Nepro spilling out of cupboards and closet. Photos of his dog are on the wall and an extension cord keeps his cellphone and nook within reach.
After her transplant, my mother lived in the hospital for 11 months. We settled her in as best we could with soft throws, poster-sized photos of family on the wall, homemade hospital gowns, radio, magazines, toys, anything that we could think of to make it more comfortable. She hated it. She had no interest in anything but getting home.
I don't see that with my I-ward friends. Both Robert and Frances have been on the verge of going home several times over the months but they got stressed, become enraged and argued with the discharge planners. Then they had relapses, Robert became septic and Frances' tissue flap reopened.
Over the weeks, I've learned bits and pieces about my patients lives. Ironically, the time they spend in the I-ward is less isolating than their home lives. They each have a different story but, without exception, they are lonely and enjoy the 'perks' of living in a hospital: constant company, all the food they can eat, any need/desire filled by just pressing a call bell button.
Over the last year, I've noticed a steady increase of 'social admissions' to our unit. I think it's due to the aging local population, the depressed economy and the cutbacks at the nearby psychiatric hospital. A lot of its inpatients have been reevaluated to outpatient status. The recent flooding also destroyed 2 nearby nursing homes and countless homes.
It's scary and sad to me, that the awfulness of being in a hospital is actually preferential to what awaits outside.
Though my mom never made it out of her hospital stay, she had something better to look forward to, to work for. We all, up until the very end, had hope and desire that she'd make it home. In that way, we were fortunate.
No news on the med school application front.
I headed back to the desk and, out of curiosity, checked to see how long my friends on the I-ward had been here. At July 7th, Ira was the newest admission. Three months. Like the others, he's settled in. He has his favorite snacks in the kitchen fridge, a mountain of pillows to burrow into, piles of linens, dressing changes and unopened Nepro spilling out of cupboards and closet. Photos of his dog are on the wall and an extension cord keeps his cellphone and nook within reach.
After her transplant, my mother lived in the hospital for 11 months. We settled her in as best we could with soft throws, poster-sized photos of family on the wall, homemade hospital gowns, radio, magazines, toys, anything that we could think of to make it more comfortable. She hated it. She had no interest in anything but getting home.
I don't see that with my I-ward friends. Both Robert and Frances have been on the verge of going home several times over the months but they got stressed, become enraged and argued with the discharge planners. Then they had relapses, Robert became septic and Frances' tissue flap reopened.
Over the weeks, I've learned bits and pieces about my patients lives. Ironically, the time they spend in the I-ward is less isolating than their home lives. They each have a different story but, without exception, they are lonely and enjoy the 'perks' of living in a hospital: constant company, all the food they can eat, any need/desire filled by just pressing a call bell button.
Over the last year, I've noticed a steady increase of 'social admissions' to our unit. I think it's due to the aging local population, the depressed economy and the cutbacks at the nearby psychiatric hospital. A lot of its inpatients have been reevaluated to outpatient status. The recent flooding also destroyed 2 nearby nursing homes and countless homes.
It's scary and sad to me, that the awfulness of being in a hospital is actually preferential to what awaits outside.
Though my mom never made it out of her hospital stay, she had something better to look forward to, to work for. We all, up until the very end, had hope and desire that she'd make it home. In that way, we were fortunate.
No news on the med school application front.
Tuesday, September 27, 2011
My Month of Scramble
I sold my mom's house last week; the buyers paid cash and are forgoing an inspection which means a fast closing. EEK. and Yay.
I'm scrambling to find new housing, storage for my parents' things that we're keeping, and all the little errands that one doesn't realize until that time of moving is upon them.
I received my second med school rejection, ironically from my #2 dream school. Bah.
Work is interesting. Last week, one of the patients developed a really weird icky crush on me. He followed me around and asked me every day to join him in a new activity. Play Scrabble? Go to the zoo? In all honesty, it was creepy because he was not mentally impaired in the slightest. Somehow it's easier to understand/think cute/tolerate a patient's romantic interest if they're elderly and demented or young and MR. I don't understand how a middle aged man could rationally think it a good idea to ask out the nurses/aides.
We had a mandatory aide meeting yesterday, a punitive grousefest. Apparently, the aides aren't doing their jobs properly, have bad attitudes and things need to change. This was all based on our recent Press Ganey scores. The nursing aides are the front line to patient care after all. Later, my manager pulled me aside, basically told me that he didn't have any problems with my work and asked me to 'keep an eye on the moods of my coworkers'. I don't really know what he meant by that but I felt manipulated nonetheless.
I love autumn. I drove to work today and noticed the trees preening at their reflection in the river. I can't remember seeing the leaves change last year. It's astonishing how grief and sadness can blind one to such beauty.
I'm scrambling to find new housing, storage for my parents' things that we're keeping, and all the little errands that one doesn't realize until that time of moving is upon them.
I received my second med school rejection, ironically from my #2 dream school. Bah.
Work is interesting. Last week, one of the patients developed a really weird icky crush on me. He followed me around and asked me every day to join him in a new activity. Play Scrabble? Go to the zoo? In all honesty, it was creepy because he was not mentally impaired in the slightest. Somehow it's easier to understand/think cute/tolerate a patient's romantic interest if they're elderly and demented or young and MR. I don't understand how a middle aged man could rationally think it a good idea to ask out the nurses/aides.
We had a mandatory aide meeting yesterday, a punitive grousefest. Apparently, the aides aren't doing their jobs properly, have bad attitudes and things need to change. This was all based on our recent Press Ganey scores. The nursing aides are the front line to patient care after all. Later, my manager pulled me aside, basically told me that he didn't have any problems with my work and asked me to 'keep an eye on the moods of my coworkers'. I don't really know what he meant by that but I felt manipulated nonetheless.
I love autumn. I drove to work today and noticed the trees preening at their reflection in the river. I can't remember seeing the leaves change last year. It's astonishing how grief and sadness can blind one to such beauty.
Tuesday, September 13, 2011
Nighttime Serenade
Tonight, I stayed several hours past my shift end to sit with a confused elderly patient. "George" had a psych history and a broken hip. For various reasons, he had a triple lumen catheter and an order for TPN. Just before 2nd shift he pulled out his line and offered it to his nurse like a wedding ring, asking her to marry him.
I had worked with George before. He was unfailingly cheerful and absolutely adorable in his confusion. He was definitely one of my favorite patients. Because he was tugging on his foley and newly placed peripheral line, I volunteered to stay and guard his wandering hands.
He called me his little black Jewish kitty-cat and asked to pet my fur (I'm neither black nor Jewish) but happily acknowledged that I was a cat who didn't like to be petted and sang to me instead: "Kitty-Cat I Love You" to the tune of Bull Moose Jackson's big hit.
George didn't seem to have any short term memory; he constantly asked where he was, did his parents know he was there, why we had kidnapped him, when I was going to have my baby. (I'm not pregnant). *sigh*
Despite his misinterpretation of my physical homage to all things cheese (my little potbelly), we had a great time together telling stories and tearing pictures of cats out of the stack of magazines that someone had left him.
Outwardly, he and my mother were complete opposites. He was a tall black millwright and my mom was a tiny white schoolteacher. She died young and he had reached a blessed age. But their eyes were the same: brown and slightly bulging. He and my mom were both confused but so very loving and so happy to meet new faces.
It breaks my heart that he's transferring tomorrow to a university hospital for surgery and I won't be able to follow up on him.
I had worked with George before. He was unfailingly cheerful and absolutely adorable in his confusion. He was definitely one of my favorite patients. Because he was tugging on his foley and newly placed peripheral line, I volunteered to stay and guard his wandering hands.
He called me his little black Jewish kitty-cat and asked to pet my fur (I'm neither black nor Jewish) but happily acknowledged that I was a cat who didn't like to be petted and sang to me instead: "Kitty-Cat I Love You" to the tune of Bull Moose Jackson's big hit.
George didn't seem to have any short term memory; he constantly asked where he was, did his parents know he was there, why we had kidnapped him, when I was going to have my baby. (I'm not pregnant). *sigh*
Despite his misinterpretation of my physical homage to all things cheese (my little potbelly), we had a great time together telling stories and tearing pictures of cats out of the stack of magazines that someone had left him.
Outwardly, he and my mother were complete opposites. He was a tall black millwright and my mom was a tiny white schoolteacher. She died young and he had reached a blessed age. But their eyes were the same: brown and slightly bulging. He and my mom were both confused but so very loving and so happy to meet new faces.
It breaks my heart that he's transferring tomorrow to a university hospital for surgery and I won't be able to follow up on him.
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