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spotangel MSN, RN

ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds

Content by spotangel

  1. spotangel

    HELP ELLA! THEN ME!

    Thank you! You are balm to my battered soul! I never go into work thinking I am going to convert anyone. I just do my best as if today is my last day. I am not a saint and fall all the time on my face! The one thing you can't fault me is for not trying my hardest to help you. I have no intention of being a hero as I am far from perfect.
  2. spotangel

    HELP ELLA! THEN ME!

    Thank you for sharing what was concerning you about my post. Most of the time I write in one sitting and hit the the send button.What sticks more in my mind is what I write in detail. So many a time although the gaps are filled in my mind, they are open in the readers mind. Safety of the patient is a given for me and so I did not write that part in. I will keep this in mind when I write again. We live and learn.
  3. spotangel

    HELP ELLA! THEN ME!

    Wow! Some of the comments from the "caring profession" are unreal ----! First of all, peace to all! Few clarifications. Safety- The patient was in a contained area with 2 RNs at all times. When I left the room, I informed the primary RN of what was happening and she could see the patient very clearly through the glass door that could not be locked while awaiting social work. Follow through- The social worker worked alongside the team as she was medically cleared and followed our protocols of notification to Psychiatry, state, ACS and the police dept. The advocacy center that is affiliated to our hospital works specifically with survivors of sexual abuse and the contact person spoke to the patient while she was in the ED. Medications- This was discussed with the attending physician, hospital chief pharmacist , ED management team and PD .Since it was a mixed bag of pills and it had not been used and was not needed as "evidence", the plan was to flush it down the toilet. Confiding- Why did she confide in me? I honestly don't know. She had been collecting the pills as her way out but once her child got involved and she could not stop her being abused the second plan hatched. Spirituality- To date, I have not had one patient complain when I have spiritually uplifted them with words of comfort and hope while I tended to their physical and medical needs. I have been an RN for 28 years. I am very comfortable talking about God's love and mercy as I have experienced it firsthand. I have always felt that all my experience as a nurse and as a human being can be used to help someone in physical or mental distress. I am still like a child filled with wonder and awe when I see how people who are strangers one minute connect to us nurses and we are able to help them at a deeper level than they anticipated. To the judges-Don't be so quick to judge. There is always more to the story than you think or that has been written. I may not be your cookie cutter type of nurse and am no saint, but I am not this uncaring "Godzilla" that is smoking spiritual pot constantly! Just a human being trying to survive this no so friendly world like the rest of us!
  4. What do you say Mark, after viewing the numbing devastation. God bless all that helped and are still helping. Stay Texan Strong! This too shall pass. The true colors of the "united" States are seen in these trying times. One day at a time and God bless America!
  5. spotangel

    SHE COMES FIRST!

    "Annie, I need your help!" My usually unflappable ED charge nurse Nilda look frazzled "What's going on?" "I just spend 20 minutes with that guy in room 14, Mr. Uptown. His heart rate is 186; he's dizzy and refusing treatment. He wants to go home." "OK, Nilda, I am on it. Thanks!" I quickly scanned his EMR. HTN and 76 years of age, rarely was in the hospital, no allergies. I went in. Mr. Uptown was thin and frail looking, hooked up to the monitor. He was tachycardia and hypotensive. He was on IV fluids. I introduced myself as evening manager of the ED and asked him how I could help him. "Get me out of here! I want to go home." "Why did you come to the ED then if you did not want help?" "I thought my pressure was up and they would give me something and send me home. I don't want to stay!" "Who do you live with at home?" "My daughter Celine. She is 55 years old." "What about your wife?" "She died 12 years ago. I have been taking care of my daughter Celine." "What do you mean? Why are you taking care of your daughter?" I was puzzled. "She cannot take care of herself. She is mentally retarded (his words) and cannot get out of bed herself. I feed her, bath her, clean her and do everything for her." "I see. Do you have any help?" "No. I cannot leave her by herself. I only run to the store and then come back. I have to go. She is alone for 4 hours now and is probably peed and pooped on herself." He was tearing up. "Is there anyone that can watch her when you are in the hospital?" "No! She is my only child and I don't have anybody that could stay with her. She comes first! I have to go. Please help me Nurse Annie!" The tears were falling down those worn cheeks. I knew we could not let him go as he was unstable and symptomatic with dizziness. My mind went into overdrive. "Mr. Uptown, you came for help and we will help you. Do you live nearby?" "20 minutes by cab". "If I can get your daughter to you, will you stay?" "Yes! I want help but I am worried about her. I cannot leave her alone." "I understand completely. I am a mother and would want my child to be safe too. Will you trust me with your house keys? Give them to me. I will speak to the social worker; we will call the police, go to your house, pick up your daughter and bring her to the ED in an ambulance. How does that sound?" "Can you really do that?" "I will try my best and keep you updated ok?" I said as he handed me a bunch of keys and showed me the keys to the front door. I went out the room, discussed the situation with Pamela the social worker who was all for it! I called the local police precinct and ambulance service (EMS).The cops were there in 5 minutes and EMS promised to meet us at Mr. Uptown's house. I went back to room 14 and informed the patient who consented to treatment. I informed his team and they swung into action trying to stabilize him. Meanwhile Pam and I took a ride with our friendly cops (sirens on request!) sitting in the backseat of a cop car, our knees touching the front seat, the windows barred on the sides and in the front! Definitely cramped and not a luxury ride! I met Sasha and Kim, EMS staff, at the front door, after a 7 minute high speed ride! I unlocked the door and we stepped in, the cops in the front with their guns ready just in case. We rounded into the dining room of the silent house and stood with our mouths open. A rooster was walking around the dining room table and 2 cats sunning themselves at the window sill. Outside in the backyard, I counted six hens and a few chickens. The rooster ignored us as Sasha grinned and said "Dinner, anyone?!" Past the dining room was Celine's room as Mr. Uptown had told me. I entered first and saw her lying on the bed, staring at me, frightened. The others waited outside the room. I slowly approached her and knelt by her bed. I spoke to her softly. "Hi Celine! I am Annie. I am a nurse. Your dad sent me to get you to him. He is in the hospital." She did not reply as she was nonverbal and made only few sounds but no words. She smelt of urine and feces. "I am going to get Shasha and Kim my friends to help you get ready." I smiled at her as Shasha and Kim slowly came into the room. The cops kept out of sight, to keep her calm. We quickly put on gloves, gown and cleaned her thoroughly and got her ready. Her back was soaked with urine and so were her sheets. I was in awe as her skin was intact, soft and healthy looking. The house was clean and well kept. I admired Mr. Uptown for doing this all on his own, day after day. Within 15 minutes we had her ready and in the ambulance. The cops left after I carefully locked the front door on our way out. "Maybe we can come back for fresh chicken!" Shasha said with a smile. "Not on my watch!" I laughed as I patted the keys, safe in my pocket. We took off in the ambulance sirens blaring. When we reached the ED, I had Nilda triage her and get a set of vitals. I went to room 14 and checked in on Mr. Uptown whose condition was stable. He was admitted to Telemetry. I gave him an update, his keys and he was very grateful. A little later, we got their stretchers side by side and Celine smiled when she saw her dad. We admitted for 'weakness" workup. I coordinated with admissions and expedited beds for them and got them out of the ED. I high fived Nilda and left for the day, happy. They were not on the same floor. We got her a sitter who took care of her and dad was allowed to visit her. Social work got involved and helped dad find placement near his house as he could clearly not take care of her at this point. The day before she was placed in a nursing home, I spoke to the Nursing supervisor of the hospital and got them in the same room to spend their last night together as family. She was placed in the nursing home close for him to visit, once discharged. I saw him twice after that in the ED for cardiac issues. His daughter was safe, secure and he was at peace although he missed her and was lonely. I always wondered what happened to him and Celine. Since then, I have seen many older parents with disabled adults and they confide their worries and lack of support or help. I always hook them up with the social worker to get them started with services and planning for the future. As nurses we are in this unique position where patients confide their inner fears once you gain their confidence. What we do with that information can go beyond the physical complaint they come for and address what is truly important to them.
  6. spotangel

    THE VISITORS

    Sammy's eyes were wide, her hands nervously locked together. "Umm! Annie, I am not comfortable with this". "This", being her dying patient on her first day off orientation on our telemetry unit. "You'll be fine", I encouraged her but she grabbed my hands! I gently removed my hands from her tight grasp. "C'mon! Let's go see the patient". We walked over to room 680. Mrs. Grant looked thin and frail and lost among the white sheets. Her breaths labored, her face pinched in pain. Her systems were shutting down as the cancer had spread all over and there was no other treatment left to try. She was a Do Not Resuscitate (DNR) on palliative care and was dying. I recalled her conversation with me from last week when we spoke of dying as I gently turned and repositioned her. "Annie! I am afraid!" "You are afraid? What are you afraid of? " "Dying alone" she whispered feebly. I washed my hands, pulled up a chair and sat closer to her and held her hands. "Talk to me Ms. Grant. Tell me more". "I just don't want to die alone. I am scared". "It's ok to be scared of something new but you don't have to be afraid". "Why?" her eyes clung to me desperately seeking reassurance. "Ms. Grant. When you die, you never leave this earth alone. Your guardian angel and your family who have died before you come to accompany you." "Is that true?" "It is true. I know. My dad came for my mom. He died three years before she did and she saw him and told me just before she died in my arms in the hospital". "Oh!" Hope flared in her eyes. "Ms. Grant, would you like me to pray with you? God will give you strength". "Yes, please!" I prayed The Lord's Prayer (Our father, Hail Mary and Glory be to the father) with her and especially asked Mother Mary (who I adopted as my mum as a 15 year old when my mother died) to especially watch out for her. "Ms. Grant, Mother Mary's got you. Don't worry." "I am not anxious any more. Thank you Annie." Now, as I looked her pain filled face even though she was on a morphine drip, I hoped that her anxiety about dying was gone. I silently reminded Mother Mary not to forget her at her hour of death. Seeing that Sammy was clearly overwhelmed, I told her that I would take over care for Ms. Grant and she could continue with her other patients and call me if she needed me. Her relief was palpable as she quickly left the room. I checked Ms. Grant's vitals, checked the telemetry box and wires attached to her and took a morning 12 lead EKG. Her heart rate was 44, normal sinus rhythm. Her skin was intact, diaper clean. She was unresponsive and actively dying. I upped the morphine as per the protocol and left her attached to the 12 lead EKG machine. I gently turned and positioned her as I prayed the Lord's Prayer over her and left the room. As charge Nurse, I checked the assignments, made the breaks for the staff, checked the unit and rounded on the patients. I also called Nannette the telemetry tech in their room across the hall and told her that Ms. Grant was actively dying and that she was a DNR/DNI.I requested her to call me once the heart rate dipped in the 30's. She promised me that she would. I then called the two sons and informed them that this was a good time to come visit mum. One of them, Clark, lived far away and could not come. The other one, Little Jimmy as his mum fondly called him told me that he was on his way. I told him to drive carefully and that I had a feeling mum would wait for him. Little Jimmy turned out to be 6'5'', 300 lbs. and was clearly distraught. I took him to her room and he helplessly asked me, "What should I do?" I pulled up a chair for him to sit by mum. "Just sit by her and hold her hand. Talk to her as the last sense to leave is hearing. Tell her whatever is in your heart. She can definitely hear you." Little Jimmy sat with tears dripping down his shirt, clutching his mum's hand sobbing as he talked to her. I patted his back, told him to ring the bell if he needed me, assured him that I would be back and left the room. In a half hour, I checked on him and now he had his face resting at her waist and his arms gently cradling her as he poured his heart out. Half an hour later, Nannette paged me to call the telemetry room. The heart rate was 36.I walked towards the room and stopped by the door. The scent of roses filled my nostrils as I looked into the empty room devoid of flowers. The scent was sweet, clean and powerful. I also sensed that the room was crowded even though I didn't see a soul other than the son. I felt like I was entering a packed room. "Blessed Mother, You came with your angels. Thank you!" I silently said, my heart full. I stood by Little Jimmy, one hand on his shoulder, the other on Ms. Grant's knee. The 12 lead EKG rhythm showed a pulse of 28 on the monitor. The room smelt as if there were hundreds of roses in the room. "It's time Jimmy. She will be leaving soon". He nodded his eyes red from weeping. Ms. Grant's face suddenly changed. Her eyes opened and she looked up in wonderment at the ceiling like a little child. A peace stole across her face and her face took the glow of a happy bride and she stopped breathing. The EKG machine showed a flat line. We stood silently awash in the peace of the moment. In five minutes the room lost the scent of roses and suddenly felt bare. "She is gone Jimmy but she didn't go alone". Little Jimmy looked at me and said, "I know, I felt them too". My mother had come to take her home. You can always count on her to keep her promises no matter what!
  7. spotangel

    THE VISITORS

    Hugs! I am so sorry to hear about your mom. Sometimes I have seen pts wait till everyone is gone and then pass.
  8. spotangel

    THE HEALER

    The day was not going as planned. I was covering another nurse on her break. One of my patients had to be rushed to surgery and she was profusely bleeding, another needed emergency dialysis as she was short of breath, a third one is dying alone in her hospital bed from cancer which has spread and I had to call her family. In the middle of this craziness I had to make sure the two other nurses, patients were okay as I was covering them for their lunch break. As I rounded on all the patients, I noticed that one of the nursing attendants was struggling with getting a patient on a stretcher. The nursing attendant Joy had only one functional arm as she had cerebral palsy and the other arm was nonfunctional. The patient needed a stat x-ray and have refused to go for an x-ray. She had a psychiatric history and was refusing to move over onto the stretcher. I tried to persuade her and she started flailing her arms at me. I move beyond reach and told her, "Hey! Watch that I have a little one here". I patted my belly as I was five months pregnant. I had just learned that I was going to have a boy, at my ultrasound appointment, a week before. She finally consented and I helped Joy put her on the stretcher. Without warning, she lashed out and kicked me in the belly saying "You are pregnant! Take this you ******-******! I felt a glancing blow on my belly as she kicked and I jumped back. Joy took her to the x-ray department I went back and sat on the desk, shaken. I did not go down to the ER to get checked out or fill in an incident report. My patients had me busy. I reported off to the other nurse when she returned and told her what her patient had done. She told me to go to the ER but I wanted to be with my patient who is dying alone. And I didn't feel any pain so did not feel the need to get checked out. The next week, I went to my doctor to get my official sonogram results. As usual, the doctor used the portable sonogram to check for a heartbeat. There was none. She tried many times and could not find a heartbeat. She asked me if anything had happened after the sonogram and I told her about the crazy patient and what she did. I had no pain, no bleeding. "I don't like this. I can't find a heartbeat. I want you to go back right now to the sonogram place I sent you two weeks ago and get an official sonogram. After the sonogram, have them call me right away," she said, her face worried. I left the office in a numb haze. I remember sitting in the car trying to remember my home phone number to call my husband. I could not remember it. It began crying in the car hoping that the doctor was wrong. I finally remembered the number and called home. My husband who had to pick up our other two children from school was shocked. He could not leave the house since he was waiting for two school buses to come. He told me how to get to the sonogram place and I drove there. The Ultrasound tech remembered me from two weeks ago. When she read the doctor's referral, she was shocked. "Please let me know if you hear or don't hear the heartbeat. I know you are not allowed to give results, but I can infer from what you say," I pleaded with her. "I can't stand not to know". She nodded her head and checked me for half an hour. Finally, she shook her head and said, "No, I am so sorry! I can't hear a heartbeat or see the baby move on the screen". The baby was exactly 21 weeks old. He died when he was kicked. My heart broke! I had been carrying my precious child dead in my belly for a week and did not know it. Anger and rage filled me. I wanted to hurt that patient. In my rational mind, I knew that I was not going to beat up a 75-year-old psych patient no matter how wicked she had been. I finally made it home. My husband and I clung to each other crying. I met with my doctor the next day. She told me that I had to get the baby out under general anesthesia. I had to go to Planned Parenthood where they would induce and take the baby out. I was horrified as a staunch Catholic to go there but my baby was dead and if I left him in, I would get sick. Since Planned Parenthood has a lot of protesters in front of their sites and children were not allowed, my nurse friend took me in her car. I sat with her in a room full of mothers that had come to abort their living child for whatever reason. If only I could exchange and get my live baby back but that was not to be. Maybe the last sonogram at Planned Parenthood would give me a new result that the baby was alive, I hoped, but that did not happen either. So I ended up getting the baby taken out and coming home after the anesthesia wore off. My friend, Sue, gave me a porcelain angel and told me that was my son's angel! I wept and wept and went to sleep. The next night, my uncle (mom's brother) came to the house. He was planning to go for a night healing mass where the Blessed Sacrament would be exposed all night in church. He wanted to know if I would want to come with him. He did not know about what happened. I did not tell him but went to the healing mass with him. I knelt before Jesus in his hidden form in the holy sacrament. I wept and asked him to take away my anger and hatred for that lady and pray for her. His peace flooded me throughout the night. When morning came I was at peace. I felt no pain. I had given my child to Jesus. God blessed us with a wonderful daughter a year later. We named her after God's angels. Jesus had healed me. Christ is my King! I have used this experience to help countless people who go through miscarriages, stillbirths or abortions. The pain, anger, and hurt inside needs the healing touch of God. It does not matter what faith you are, you are still a child of God and his arms are always open to comfort you regardless how you lost your child. He does not judge you but is always ready to be your Healer!
  9. spotangel

    I love my pediatric patients!

    Love it! Eloquently put and so true! God bless you! I still visit my ped pt that aged out but wad moved to a faculty for adults near my house .Tom was born blind with vestigial hands and feet, hydrocephalus , non verbal and looks like Humpty Dumpty ! I have never seen a happier kid. His smile is like sunshine esp when I sing his fav song. He was dropped at 2 months of age, given 6 months to live and is 27 years old now ! His skin is intact and he uplifts my spirit every time I visit.
  10. spotangel

    I Broke Rule # 1

    Brings back memories! I got my vent pts in/out of CT like a military op.The planning always helped. Had a couple of dislodged tubes and R main stem intubations that we had to fix! Our CT team always had a couple of "big brothers"that you could count on if the pts were very disoriented but like you said, communication was key!
  11. spotangel

    THE SCENT OF DEATH

    I froze by room 650 as I wheeled the med cart. The scent hit me. The overpowering scent of flowers candles and incense. The smell, I associated with death. This was a very familiar smell to me. I had lost both parents as a teenager and this was the smell in the viewing room that was filled with flowers, wreaths, candles and incense. I hated it with all my heart. Two decades later, the smell was hitting me right outside Ms. Watson and Ms. Grey's hospital room. I parked my locked cart and went in to investigate. The smell was not around Ms. Grey's bed but around Ms. Watson's bed. Ms. Watson lay sleeping peacefully, the early morning sun gently glowing on her face like a mother's caress. The scent was overpowering and I slowly backed out of the room. I went to the nurse's station and sat down, my mind whirling. What should I do? This was not the first time; I had smelt death on this telemetry unit. The first time was a few months ago when I was taking care of a very sick septic patient John Perkins. I smelt it around his bed and was puzzled. I did not connect the dots and thought I was being overly sensitive. I thought I imagined the smell and ignored it. He was a full code and coded two hours later. He did not make it. I began getting the smell more and more frequently before patients coded. Some made it, some didn't. I cursed this "gift" of sensing the angel of death. I tried very hard to ignore it. I dared not speak up about it as I did not want to have a Salem witch hunt or my coworkers look strangely at me. I wanted to be part of the crowd and blend in and not create waves. My conscience started pricking me. Maybe, if I had told someone else, we could have been better prepared. Maybe, I could have setup the suction machine on the wall, ready to go; maybe I could have asked the telemetry monitor room to observe that pt's rhythm more closely. I beat myself up every which way without relief. One night I sat pondering about this wondering aloud about why I, who was so uncomfortable with death and dead bodies, was given this gift. I argued loudly with God as my kids were sleeping soundly and my husband was at work. I got tired eventually and went to sleep. The next day, I resolved to do things differently. I decided to be proactive. I went in to work with a plan but of course did not smell anything for almost a week! God had his own plan--! On a Friday, I smelt death outside a single room. The smell was overpowering in the room. There was not a single flower in sight, so I was sure of what I smelled. I quietly checked the suction (which was not set up in readiness---my pet peeve) and set it up ready for any emergency. I then went to the nurses' station and rolled the emergency cart to outside that room. The patient crashed within the hour. We successfully resuscitated her and transferred her to the CICU. She was forty five years old and the mother of three. Later, when the patient's primary nurse asked me how I knew to get the equipment in readiness, I told her that I had a" feeling". She believed me as us nurses are famous for our feelings and intuition. The team noticed me doing this before unexpected codes and started joking during report at shift change. They would finish report and then ask "Annie, any feelings?" and snicker! I took it in stride .There was an older wise nurse from the "Islands" who suspected that there was more stuff going on that I was letting on and once gently asked me. I told her not to label me a witch and told her. She told me simply, "Annie, don't fight it. It's a gift not a curse. Use it to help others". I still was not sure as patients still died, so what was the point of the gift. I did not realize why I got this gift until Ms. Watson room took on the now familiar smell of death. Ms. Watson was a walkie talkie with three daughters that she always talked about. I had met one of them Beth, who came every day after work. I enjoyed watching the mother daughter interaction as they teased each other and joked about the hospital food and planned for the upcoming summer. Ms. Watson was a renal patient waiting on her shunt to mature and had come in with hyperkalemia with tented T waves on her EKG and chest pain. Her pain had subsided and she was waiting for a cardiac catheterization as her Echo had shown some possible issues in her heart. She was chest pain free but there was a possibility that her Potassium would go up again, hence the wait and monitoring. Her other daughters lived out of state but called every day in the evening without fail. Beth was walking out of the room and saw me park the emergency cart outside her mother's room. Ms.Grey had been discharged and was waiting for her son to pick her up. Puzzled Beth asked me, "Who is that for Nurse Annie?" I attempted to give her a vague answer but I could never lie convincingly! She saw something in my face and persisted with her questions. I told her that I was being extra cautious. She bought it for the time being. Later she asked me seriously, "Annie there is something you are not telling me. Please, tell me." I did not want to freak her out so I kept it simple. "You know Beth how nurses are very intuitive. I just feel we should be extra careful with your mother and monitor her more closely." She read between the lines, looked me straight in the eye and asked me, "What should I do?" "Get your sisters to come and stay with mum for the next few days." She nodded her eyes filling. The next day she called me from work. "Annie, I took a couple of days off to stay with mum. My sisters are flying in. The three musketeers will be there in the evening! Don't tell mum". That evening I spoke to the nursing supervisor and got permission for the family to stay in the visitors lounge at night past visiting time for the next few days. Thankfully telemetry was slow and her roommate bed remained empty which was surprising as those beds filled like hotcakes. I told Beth about getting them permission to stay. She was very grateful and introduced me to her sisters. I left for my weekend off with their laughter ringing in my ears as they surrounded their mom who was ecstatic that they girls had surprised her! I came back on Tuesday to find an empty bed. I was surprised as she was supposed to have her cardiac catheterization that day. I asked around but no one knew as the weekend crew was off. I took the admission discharge log and checked it. My heart leaped to my throat when I saw the Monday 3 am entry. Ms. Watson had died. I was in shock. I pulled Beth's number from the paper chart that was still there. Drawing a deep breath as she picked up, I carefully said, "Beth, this is Nurse Annie from the hospital. Can you talk?" I heard her crying and then she told me what had happened. Ms. Watson was fine all weekend and insisted that the girls go home but they all refused. So they kept watch at the bedside, talking softly in between with mom when she woke up. At around 2.00 am, Ms. Watson had a massive heart attack and arrested. She was coded for almost an hour and declared dead at 3 am. Beth told me, "Nurse Annie! I do not know how to thank you. Mom's last three days on earth were her best and she never looked happier. The memories in this last three days with our mother will comfort us. We have these memories thanks to you. Bless you for giving us that chance to be with mum. I think she is at peace and so are we." I was too choked up to speak. A month later, I received a bouquet of flowers with a thank you card that said, "Mum thanks you from heaven! We thank you too!-Beth, Pam and Sara". I treasure that card more than a paycheck! Once I moved from acute care, I did not get that scent again. I hope I don't either! Since Ms. Watson's death, I realized that my gift was to be used to help the patient, family or staff to get prepared. I never knew what the outcome would be but I knew now that every patient got a fighting chance to live or die in peace. As a nursing supervisor covering that same unit, I still see some of the nurses I worked with, who remind me that before we had a rapid response team or a cardiac arrest team we had Annie's ESP!
  12. spotangel

    THE HEALER

    Thank you.
  13. spotangel

    THE SCENT OF DEATH

    That's reassuring! Never heard of intimations of death before. I hope you don't get admitted and stay in good health and happiness! I am also plugging my nose cause I don't want to smell "the scent"! It is a gift that I very reluctantly accepted but I haven't smelled it for a few years now. I have noticed however that I have got very intuitive and tell people things that make perfect sense to them and have no idea where the thoughts come from. Now plants---I am still working on them!
  14. spotangel

    What Called Me to Nursing.

    You will marisa.m, help people because you have been in those shoes. Maybe someday you will inspire someone else to be a great nurse by your compassion and critical thinking skills. Best of luck with school! Go for it!
  15. spotangel

    THE HEALER

    I don't begrudge anybody any services that they need from any place including planned parenthood. I also know very well that planned parenthood offer other services as I interned with them. Yet, it is hard to stomach the lack of respect or choice that an unborn child has while preaching about a woman's choices. To me that is self righteousness. This is not just a "good article", this is something that happened to me and is deeply personal. Sitting there listening to people laughing and talking about abortion was hard for me who lost a son while helping a nurse's aide and now was waiting to go to the preop area. I appreciate and respect your views like you should mine. We do not have to necessarily agree on them. I am very well aware of how touchy people are about their views on prolife and prochoice. What I shared was my experience and what I felt at that time.Peace!
  16. spotangel

    THE HEALER

    I did not inform them right away. I was out for 2 weeks after the procedure.I then went to back to my regular job. This was my perdiem job. I went back months later but did not tell anyone as I was put in different units daily. My husband and I decided not to sue the hospital. We lost our son who money could not replace. Many years later I met the Chief Nursing Officer and we discussed this and she was shocked. I never stopped praying for others that have been touched by violence and always ask for protection for all. In terms of Planned Parenthood, on that day people sitting next to me were discussing abortion freely and it was painful to listen to when I was desperately hoping that by some miracle my son was alive. I also had done an internship at Planned Parenthood during my NP studies as I wanted to see the other side and hear their perspective and not be judgmental. In all honesty most women that I saw came to abort used Planned Parenthood like contraception. Some freely told me that they didn't like condoms. Others told me that they could not afford to be pregnant, the condom broke, it would affect their figure etc. The worst one was a woman who tried to become pregnant for 8 years, got fertility treatment and finally got pregnant. At 5 months she decided this was not for her and drove 200 miles to this clinic so that she could abort and then claim a miscarriage to her gullible husband who was clueless.So their choice was to take away the choice of their child. I had all this in mind when I sat at that clinic hoping to trade my dead child for a live one at least in theory----
  17. spotangel

    While You Wait

    dpgRN, you are so spot on! Thank you for everything you do on a daily basis! The other side of the ER door is controlled chaos and only staff that have worked the ED know that. I have had staff asking me to expedite them since they work in the same hospital when I worked as an ED nurse and as a hospital supervisor. Sometimes you can, but most of the days when the ED is bursting at it seams, you get a bunch of disgruntled staff commenting about the "madhouse"! The only good thing is that most of them leave with a better appreciation of what an ED nurse does. When pushing for beds for ED pts, I tell the nurses on the floor, "Remember you can say no once you have maxed out on your census, they can't. Their doors are open 24/7, so let us work together as nurses to help each other and our patients!"
  18. spotangel

    Thank God for nurses!

    "It's everyone's responsibility. I don't want any explanation as to why you didn't know!" Tom, the administrator's voice was clearly frustrated as he spoke to the outgoing Night Nursing Supervisors. He was talking about a patient that was admitted who was waiting for a bed for almost 40 hours in the ED. The patient was an elderly 87 year old that was vented. "Imagine that poor patient on a hard stretcher for all those hours. You should have intervened!" The supervisors were silent. The administrator was on the phone getting morning report about the hospital from the outgoing Supervisors. I always came at least 15 minutes before my shift as the morning Nursing supervisor and was listening in to the report. Tom then asked, "Who is coming on this morning?" One of them answered, "Annie and Gwen". I piped up, "Good Morning Tom!" "Good Morning Annie. Can you please follow up on this?" "Will do, Tom", I quietly answered. After he hung up, I asked the outgoing supervisor that covered the ED what kind of bed the patient was waiting for and was told that the patient was waiting for a critical care bed. After report, when they left, I checked my units on EMR, got the patient's name and checked the admission status for this patient who did not need a critical care bed as I was told in report but a regular medical floor vent room! I called admitting and asked them to prioritize her admission. I then went over staffing with Gwen, the other supervisor and the staffer. Now it was time for rounds. I started off at the admitting office and reviewed with Chris the admitting clerk all the vent rooms in the hospital. This was a four day holiday weekend. All rooms were occupied. The chance of a discharge/ transfer from those rooms was very slim. This meant that the patient might end up waiting another day for a bed. I went to the ED and asked where that patient was located. I then went to the patient cubicle and saw 2 family members there. I introduced myself and was told that they were the grand daughter and great granddaughter of the patient. They were not happy. The granddaughter was upset that the patient was vented even though there was a clear DNR/DNI in the chart. "They waited till her son had left and then tubed her", she fumed. "My grandmother never wanted a tube down her throat and they still put it. Once I get her in a room, I am taking this up!" I did not comment as I wanted to check my facts. "This must be really hard on all of you. Do you know what the plan is for her? ", I asked her. "She is admitted and waiting for a room. When she goes up they are going to pull out the tube in the room". She had been admitted under pulmonology and had got a palliative care consult in the ED after being vented. I thanked the granddaughter for being patient and told her the bed situation. I asked her who the health care proxy was. She told me that it was the patient's daughter, her aunt Veronica. I went and spoke to the attending physician and nurse of the patient both who concurred that the patient was vented before their shift and they were not sure why as the patient was a DNR/DNI. I also heard about a panicky family member who had been at the bedside in the ED, and insisted that the patient be tubed after Bipap had failed, although that person was not the health care proxy and that the doctor "gave in". I checked the records and found a recent DNR/DNI in the EMR. It made no sense to hold a vented patient for the next 15 hours waiting on a bed on a four day weekend, and extubate the patient once she reached her room upstairs. The family was very clear on the wishes of the patient. They were fighting for what she wanted. "Can we do this extubation in the ED and honor the patient's wishes"? I asked the attending as the ED was slow and we did have a few empty private rooms. He was comfortable with extubating as long as we followed all protocols. So, I initiated a call to palliative care who then walked us through what to do. I then sat down with the family and told them of this option. I requested them to discuss this as a family and asked them to also call the health care proxy. She called back and was in full agreement and said she would be there in the next hour or so. The patient was moved to a private room in the ED. The entire family arrived. Lot of tears and hugs and goodbyes were initiated. The patient was already on a fentanyl drip. The proxy confirmed the DNR/DNI with the attending. The tube was withdrawn and she kept breathing. The family had been prepared by the staff for this scenario and used the time wisely by staying by her. An hour and half later, the patient's son walked through the door and the monitors went crazy! Ten minutes later, she was gone peacefully. I walked right in as the son walked out crying and the granddaughter looked at me with tears in her eyes and I just knew. I introduced myself to the rest of the family and they told me, "She just passed after her son came. She was waiting for him." They wanted to put her dentures and asked me for permission and I said" Absolutely!" and assisted them. One of them introduced herself as the patient's daughter's friend. She told me that the patient was mother to many of them who were not related by blood. They all called her "Ma"! I told them that she sounded like an awesome Ma and she went in peace surrounded by those who loved her and those she loved. They thanked me for my help and one of them ferverently said as I walked out," This is why I like nurses! Thank God for nurses!" I informed the attending that the patient had died and he went in and pronounced her. Later on at night, I gave Tom, my boss, a quick rundown of the facts and he was appreciative. I went home feeling that my shift was worth it. It felt good providing closure and advocacy for this patient and family. I thanked the ED team before I left especially the new attending that had taken over the case and agreed to the extubation after initially having qualms that quietened when I told him, "Let us do right by this patient even though we did not create this mess or situation". He came back to me and told me that he had completed all the paperwork (death Certificate), calls (Medical Examiner) and notes. The nurse had called the organ donation network as per our protocol. We left the family to grieve and celebrate her life. Driving home, I thought of this patient that I never once spoke to and hoped that she would now advocate for us, in the nursing profession, from above and be our Ma!
  19. You gotta wait your turn 'cause I am trying out this year's Nurses day gift!
  20. After the day I had, I needed a timeout from the kids!
  21. spotangel

    Why did she do this to me?

    Thank you Paul. Keep up the good work and writing that you do! I know that your children are very lucky to have a father like you! God bless you for everything you do! You are an inspiration to many parents.
  22. spotangel

    Why did she do this to me?

    The screaming echoed down the hallway followed by a string of curses and a crashing sound! My steps slowed down as I listened. The voice was familiar---too familiar. I rang the doorbell of the apartment and all sound stopped. The door slowly opened and I looked at James, the home health aide's grim face. "Is that Ted?" He nodded as I cautiously entered the apartment. "What's going on?" As James opened his mouth, one of the bedroom doors was flung open and out stormed Ted. He looked at me and screamed, "I want to kill her!!" I looked at Ted calmly and asked, "Who Ted? Who do you want to kill?" "That-----"! She robbed me!" A string of unmentionable names followed. "Ted! Sit down. Let me help you. James please get him some cold milk with a squirt of chocolate please." As he drank the milk, the story spilled out. Ted was a resident in a group home where I was the Nurse Manager. Recently Nancy (another resident) and he had broken up and Ted wanted to hook up with someone. Ted was mentally challenged but loved two things; working his day job and having sex. So on payday he was advised by a "helpful "coworker friend that on a certain street he could find a" girlfriend" for a certain price. So Ted went to the building in a nice neighborhood and found a pretty girl standing outside. He point blank asked her to have sex for money and she smiled and said yes. She then took him in to the building and took him into a nice "living room". She then asked him if he wanted a threesome and he was thrilled. She asked him her fees upfront which he promptly gave as he was very honest about money matters. She then asked him to take out his clothes and wait. She took his clothes and went to call her friend and never came back. Ted stood in the living room in his birthday suit getting colder by the minute! He then went into the next room and found a corridor with lots of doors. He knocked on the first door and an old woman came opened the door, looked, screamed and slammed the door! More doors opened, more screams and then the police arrived! He was at a senior citizen apartment complex! Ted was escorted by two grinning policemen back to his residence in a blanket. As soon as the cops left his anger and humiliation spilled over and he exploded. He started yelling, throwing things and having a meltdown screaming, "Why did she do this to me?" I calmed him down and told him that not all people were trustworthy in the world and that not all women were like her. I cautioned him about getting sick from having sex with strangers. I told him that the money lost was a good lesson for him not to give his hard earned money to strangers especially for sex. I reassured him that the cops would be hunting down the "bad woman" and let them do their job. He calmed down some. I remembered the first time I saw Ted. I was being introduced to the five residents as their new nurse. This older white guy around 60 came and hugged me tight. Being new to the country, I thought that this was a way Americans said hello! An older woman Ethel, who worked as the home health aide in the residence, came smiling and pried him loose off me and told me. "Don't let Ted hug and feel you as he loves to do that! After that I gave Ted a wide berth when he came near me-and kept him at a distance physically. Ted had a job in a company and wanted badly to be one of the boys. So when everyone talked about having girlfriends, Ted wanted one too. Two years before I joined this agency Ted asked Nancy to be his girlfriend. Their visits were supervised and Nancy was put on birth control. When I came onboard, I noticed that Nancy was very fatigued and tired. Being mentally challenged and paranoid schizophrenic, I was concerned if the psychiatric meds she was on were to blame. Two things stood out on chart review. Her periods were heavy and frequent and she was on birth control. When I questioned this, I was told of the "arrangement". I was amazed that a woman with a mental capacity of a child was in this relationship. As I gained her trust, she told me that she did not like sex as it hurt. Further questioning revealed that Ted was having anal sex with her and she did not want it as it hurt. I also was concerned as the latest CBC showed that she was very anemic and that she had fibroids and Dysfunctional Uterine Bleeding. After a meeting with the team and the state official (as she was a ward of the state), the birth control pill and the sex stopped. Nancy was happy although the bleeding continued and she ended up with a hysterectomy which was another wild story by itself. When Ted heard that his arrangement was off, he was furious and threw his TV on the sidewalk through his bedroom window on the 6th floor. Luckily no one got hurt----! Ted continued his daily job and was always on the lookout for love and checked women out thoroughly! I left the agency but always had a soft corner for my "girls and guys". I always expedited mentally challenged patients especially while working in the ED. They have dreams and hopes like all of us and experience emotional ups and downs. They need special handling, razor quick thinking and simple explanations. They notice if they are treated with respect and will remember that always. Last year, I went to a local shopping mall and parked my car. As I walked towards the entrance, I passed a van with people waiting to board. I looked at some of them with helmets on and nostalgically thought of my "guys" that I took care of 22 years ago. I suddenly stopped when I looked at their faces as they really were my guys!! With tears in my eyes, I called them by name, one by one and even "Rocking Sam" who was severely autistic, stopped and looked at me and smiled. The staff that were all new to me were startled till I told them who I was. I asked about Ted who I was told passed from a heart attack many years ago. Nancy is still there and goes to day program daily. When I think of how dependent they are on staff to advocate and take care of them, as they get older I realize how much our care can make a difference. It may not make headlines but they still remember you. Isn't that why we do what we do every day without fanfare? To be a Nurse, the best kind!
  23. spotangel

    Why did she do this to me?

    True! It's like having to let go of your child every day and pray that they make it through the day safely and come home intact. After we bolstered up his battered ego and self confidence with some "TED" talk , he kept saying"You can't con ME! I am too smart!" We would agree and tell him,"We know you are a smart cookie!" and cross our fingers behind our back! We encouraged him to role play "offers" with us and how to respond. Thank fully no other adventures followed and we encouraged him to watch sappy awwwh movies about true love! He always tried though----could not let a pretty face pass by! We loved him warts and all!
  24. spotangel

    NTI: Mastering the Art of Professional Networking

    This is so true! Great article! Keep those smartphones away and have a conversation with the person next to you or someone at the buffet table. At work, I make it a point to greet and wish the team when I see them and round in the morning. It is amazing how proactive people are at work when you say, 'How can we help this patient/family member". Sometimes they may not know but may know someone who might be able to help. Do small things with great love and the chips just align themselves!
  25. spotangel

    Why did she do this to me?

    Ted was a real character . I handled him with kid gloves because under all that bluster and bravado was the mind of a seven year old that was desperately trying to cope up with the world. He always felt that he was two steps behind no matter how hard he tried.Hence the bluster, the groping, the cursing and wanting to be one of the men.Thank you 3ringnursing. He does have a special place in my heart.
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