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  1. blackvans1234

    When you actually ''save'' a life

    About 4 or 5 months ago I (the PCT, the hired help, that young guy, the guy that looks like he's new, the Per Diem staff) was floated to the Cardiac Care Unit (CCU) for half of a shift. About 3 hours into the shift, the Nurse went into a patient's room to find the pt in cardiac arrest. He came to the doorway and exclaimed ''we're calling a code here people!" I was directly across the hall and was second in the room as the nurse started the first few compressions. I said "I got compressions", and he moved over and went to grab code cart. This person was alive just minutes ago. It was surreal. For a few seconds it was just me and this Patient. Alone. I'm doing chest compressions,her ribs weren't cracking or grinding. Everyone tells you that you can feel ribs breaking. At that moment it was just me pushing down with my hands together on the center of this woman's chest. Her body slightly jerking with each compression. This person was alive just minutes ago. It was surreal. The patient was on a ventilator so we only had to do chest compressions, the breathing was taken care of. In what seemed like ten seconds, there was seven or eight of people in the room. I see the hand of a nurse sneaking up to place the two electrodes on the patients chest. I remember my CPR instructor telling us, "DO NOT STOP COMPRESSIONS- Let them work around you" so I just kept going, I remember the nurse going to push epinephrine. After two electrical shocks, her heart was now beating again. She had a second chance. About 20 minutes later I was re-floated back to my normal unit (physical rehab) and finished my shift. I didn't work again for two weeks, during that time I had dreams about this patient, the code, and doing chest compressions. I knew that we had saved the patient at that time, but after I finished my shift, I had no idea what happened to the patient. This patient may have died the next morning, and I had no way of knowing. It is fairly common that when someone goes into cardiac arrest once, they are likely to arrest again, and again until their body has nothing left, and then they have died. The next time I worked, I was on the Progressive Care Unit (PCU), which happens to be right down the hall from CCU. I did a little snooping around to see if this patient was still in the hospital (alive). I got wind from a CCU nurse that the patient was on PCU (where I was floated to!), so I probed some of the nurses and found out which room the Pt was in. I looked into the room and the patient was in the bed, still on a mechanical ventilator, but skinny as a rail. The patient I remember was big (swollen with fluid). This Patient was in restraints and wasn't coherent. If she patient didn't have a very unique condition / wound wouldn't have believed it was really her. I thought ''Oh well''. I finished my shift. I have seen countless people on ventilators that will likely never be themselves again, out doing what they love with those they love. It's a part of our profession. Five months pass and the memory of this patient is gone, sent off to my brain's filing department to be entered into the "Patient's I'll never forget Folder". My life continues as normal. Last Monday I'm back on my Physical Rehab unit and am looking through my 4 or 5 Patients' Charts and I see a patient's history with this same unique diagnosis / wound! I'm thinking ''no Freaking way" I go into the room and see my Patient, months later is doing well (alive is better than dead right?). The tracheotomy is healed up, the wound has healed, that one amputated toe is still....amputated... The Patient has no idea who I am, but I know all to much about her. I considered telling her about our history, but I chose not to. Everyday Nurses help people feel better, get better, deal with their biggest fears and how their life may never be the same. This becomes routine. At the end of the day we know that we have helped people, but we don't FEEL like we've helped people It wasn't until I saw this patient's progression from being on the cusp of death, to the edge of moving on with her life, that I really understood how we can really make a difference. And she'll never even know who I am. I don't want special recognition, I don't want hero status or an award. I know in my heart that what we did matters, and that's all a part of nursing.
  2. lprutean

    Alzheimer's Disease

    According to the National Institute of Aging, the Alzheimer's Disease is " an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually even the ability to carry out the simplest tasks of daily living. In most people with Alzheimer's, symptoms first appear after age 60. Alzheimer's disease is the most common cause of dementia among older people." (National Institute on Aging) How many Americans have Alzheimer's disease? "Estimates vary, but experts suggest that as many as 5 million Americans age 65 and older have Alzheimer's disease. Unless the disease can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. That's because the risk of Alzheimer's increases with age, and the U.S. population is aging. The number of people with Alzheimer's doubles for every 5-year interval beyond age 65." (nia.nih.gov) During nursing school and later during my nursing career, I had learned about AD, aging process, brain function deterioration and signs and symptoms of the disease. Occasionally, I was assigned to take care of patients affected by AD. But in the last ten years, as a pediatric nurse, I did not have many chances to be exposed to such patients. So, in my practice, over the years, my knowledge about AD faded, especially due to lack of exposure and lack of continued education classes in the geriatric field. Taking care of pediatric patients, my awareness about AD remained dormant. The only older people I was very close to, were my parents, getting older, but still independent in most aspects of their lives. Our close daily relationship, either over the phone or visits, stopped me from noticing the slow, but progressing change in personality and in ability to perform daily activities. Once in a while, my mother complained about not remembering things, having difficulties performing house work. I attributed all of them to normal aging process, and I did not take it seriously. I did not see the early stage of AD. "Memory problems, are typically one of the first signs of Alzheimer's disease." I reassured her that we all forget sometimes and that is OK. My father brought to my attention that mom became lately very slow , and spent more and more time getting dressed, or getting ready for an appointment, at the point of being late all the time. He expressed his frustrations, but day by day he started to take away some of her house chores and tried to balance their lives at his best abilities. One of the changes that startled me, was the changes in my mom's vocabulary. She started to use in a regular daily conversation words from her native language, archaic words that she never used before. When I asked her what does that word mean, she looked at me very surprised. Sometimes during our conversation she did not remember facts and tried to change the subject, tried to make up an answer, or to admit very embarrassed that she did not remember. At that time, caught in a busy life, between work and school, I did not see the gravity of her condition. Every day she lost some of her abilities to take care of others and herself. One day she flooded the bathroom because she forgot the water was running, or forgot to turn off the stove and burned the food. Than I stepped in and I started to realize that she needs more help, and I was happy to spend more time with her and do laundry, cook or take her shopping. And I did still considered that her age was number one in her decline. These were already signs of mild Alzheimer,s disease as per National Institute on Aging One winter, at Christmas time, my son came home and spent time with his grandparents. He noticed that something was wrong with grandmother, and asked me about it. He had not seen her in a few months, and was scared to see how much she changed. Mother was always a very nice, calm person with a lot of patience. Now, she started to have episodes when she became very agitated and aggressive. I was very surprised and my son suggested to take her to a neurologist. At her first visit she was able to answered all the questions , but still, after examining her the doctor diagnosed her with initial symptoms of AD. He prescribed medications to keep her calm and also to increase her cognitive functions. Every three months we followed up and I was able to see the changes compared to the last visit. I became more and more aware about the worsening of her symptoms. On a daily basis I did not see a lot of changes. Mom, like other patients with AD, was trying to hide her symptoms and inability to function from friends and family. She was able to keep the appearances and hide her forgetfulness, memory loss, inability to perform her daily routine. After reading books, articles and other specialty literature, I was able to see clearly more and more signs and symptoms of AD, the pattern of the disease and the decline of her health. As the symptoms worsened, mom stopped recognizing one by one the family members, her home, her husband. She had days when she packed her clothes and some food to go "home to her kids". Her ability to perform the daily tasks was less and less and she needed more help every day. I was happy to help, but, at the same time, very sad about her deterioration. Today my mother continues to live a life, what I call "happy and comfortable". She does not recognize any of her children, but she knows we are the people taking care of her. It keeps me happy to see her smiling when I come home from work, to see her pleased after a watching cartoons, or resting. It is very hard for me to accept her condition and her limitations. I do not know how much she remembers, or her thoughts, since sometimes she cannot express herself, or find the right words. But it is very rewarding when she gives me a kiss or a hug, or thanks me for caring for her. "People with severe Alzheimer's Disease cannot communicate and are completely dependent on others for their care." The AD had built a wall between her and the reality; she is trapped in her own limited world, but sometimes a window opens and she reconnects with me. There are days when I stand in front of that window ready to interact with her, when she can, with a bath, a massage, a good meal that she still enjoys. She spends her days playing with toys. The day is a very happy for both of us, when she calls my name.
  3. Once again, I will be working on this upcoming Thanksgiving holiday. However, I do not object to working on Thanksgiving like so many others. First of all, I am a single female with no husband or kids, so I come home to an empty house anyway. Secondly, although I have extended family members, they live halfway across the country and I am not that close to them. So even though I do not plan to celebrate this holiday in the customary style that involves food, feasting and fun in a house full of loved ones, I remain cognizant that I am thankful for many things as a nurse on Thanksgiving. I am thankful for a nursing license that enables me to earn decent pay. During my early and middle childhood years I watched as my parents struggled financially. Cheap, low-quality foods such as ramen noodles, hot dogs and Kool-Aid were the norm during my growing-up years. Sometimes the cupboards and refrigerator were empty. This might sound petty and inconsequential, but I am thankful for having a nursing license that allows me to earn an upper five-figure income. I can eat what I want, shop when I want, live comfortably, travel, and not worry about prickly bill collectors calling me well into the evening. I have never had to use a payday loan, pawn shop, or other nebulous financial instrument because I do not live from paycheck to paycheck. So I give thanks for not having to deal with the sobering financial problems and hand-to-mouth existences with which so many hard-working people constantly grapple. I am thankful for flexible scheduling. I give thanks because I am not obligated to work a regular five day work week with weekends off that seem to disappear too quickly. One of the beautiful aspects of nursing is the variety in scheduling. People who enjoy 8-hour shifts can manage to find a facility that offers a five-day a week schedule. Those of us who prefer longer shifts can continue to work three 12-hour shifts to receive four days off every week. If one wants five days off per week, he or she can work two grueling 16-hour double shifts. So, I am thankful that my position as a bedside nurse allows me to have the ultimate amount of flexibility in scheduling. I am thankful because nursing allows me to touch peoples' lives. I work in acute rehabilitation, a specialty that assists debilitated patients in seeing some restoration to their level of function through basic nursing care, specific modalities and various therapies (physical therapy, occupational therapy and speech therapy). It feels mightily invigorating to see a patient finally go home with the capacity to speak fluidly and ambulate on his own when, only a few weeks ago, the same man had been rendered totally unable to walk, talk or swallow due to a major CVA. Nothing can be more wondrous than the words of the patient when he utters, "Thank you for everything you've done for me." I have many more reasons to give thanks on this Thanksgiving holiday.
  4. Blueorchid

    Warm Fuzzies Story

    Your story isn't unlike many others I've read, carefully reading the printed handwriting on your flow sheet as the night shift nurse gives me a detailed list of your injuries. You're young, I don't need to see your birth date to know that as I glance up from the cubby outside your room to look at your face, only nineteen years old and your first trip to a level one trauma center. You were the driver in the accident, I'll later see pictures of your car wrapped around a telephone pole on the local news station. It was pretty bad, you weren't breathing on the scene so the first responders got to you ASAP. Your 15 year old friend in the passenger seat was taken to a different hospital and discharged a few days later but you, the sickest, you came to see us. And your tox screen was pristine. The accident was in no way your fault. But it left you with a laundry list of injuries: a broken pelvis, long bone fractures in your leg now placed in traction, and a sneaking suspicion of mine that your head cracked the windshield when you so abruptly stopped. I'll tell your mother who is dutifully keeping watch in the back of the room that we needed to fix the things that would kill you within the first few hours before going back to fix your leg. Its hard to believe that when a traction set up is the first thing that hits you when you come into the room but at one point and time you were that sick. You're still on a ventilator that first morning of three when I'm your nurse. You have a nasogastric tube and a central line with a pretty basic list of medications, pain meds, sedation, and fluids. and your vent settings are low enough that I know your lungs didn't take a beating through all of this. Its a good sign, they might even be able to extubate you soon if only you would start following commands. So I start my day like any other, gathering information from the computerized charting, the list of systems. and any concerns given to me by the night shift nurse. Its time to wake you up, coaxing you slowly out of the propofol haze so I can try and get you to put your thumbs up when I ask, wiggle your toes, stick your tongue out- anything so I know you're hearing me in there and can understand me. I encourage your mom to help when I wake you up, sometimes I think hearing that familiar voice helps keep you calm when you can't talk and are breathing through a soda straw as multiple people scream at you. We know its not a good idea to yell at someone rapidly coming out of sedation but sometimes we do it anyways... You respond little by little, the slight shift of a foot, you even crack an eye open at your mom's voice. I go slowly, remembering the previous shift's warning that "he wakes up like a bear." That adds to my suspicion you might have a head injury. Not breathing after the crash, lacerations to your head, and that snap- like turning on a light switch from a groggy propofol daze to "WHAT'S GOING ON?" in 0-6 seconds...yeah, its not confirmed just yet but we nurses don't give someone the term "head-ey" without doing out research. Fortunately the "bear" doesn't rear his ugly head and I get enough of a response that I'll consider that almost following commands- for now. Unfortunately it doesn't get any better than that for me, I can't give you the highest neurological assessment every time I pause the sedation, but every once in a while I do. And I can lower your sedation to give you the best chance to respond without the risk of you yanking your breathing tube out. Your vent settings come down even further. Things aren't so easy that night. Apparently you have a few episodes where you thrash around and try to self-extubate- a four letter word in any ICU. It scares your mom because the night nurse who comes in to tackle you back down to the bed doesn't have anyone else behind her, so there she is, pinning one arm down as the nurse takes the other and puts you back to sleep. The cavalry it seems, is either busy at those moments, or they can't hear her. You happen to be one of the lucky patients in a corner room which makes things even more difficult. Your mom starts to feel obligated to stay and the sedation goes back up, you follow commands sporadically when its safe enough to pause the sedation but fortunately your vent settings stay low. Family members come and go on day two because your mom looks exhausted and your family all agree she needs sleep. But the second day I have the same success, I start to bring your sedation back down. Your friends even come in, your buddy from the accident is in a wheelchair but he's doing okay. I later text my boyfriend (who I learned was at the wreck and transported your friend) that your buddy looks well. And then the tipping point happens where I think we might actually be able to take that tube out. Your sedation is low enough that when the trauma team rounds on you in the mid afternoon the second day I hear their attending ask why you aren't extubated. "He isn't following commands, we're working on it though," I say, representing the critical care side in the ICU. There goes the trauma attending, a tall and imposing military man who scrubs with hand sanitizer, walks in the room, puts his hands on your traction frame and barks out in his best drill sergeant voice "open your eyes!" Oh...well hello there. Caught between thoughts of men...and you little... I watch as you wiggle your toes, put your thumb up, and stick out your tongue. Okay...you're one of those guys. The night nurse and myself were women, so is your mom (obviously)...maybe you just need us to be mean...or men. And note that neither myself, nor the previous nurse, nor your mother are soft spoken...you apparently just like to listen to guys instead of us. Your mom and I share a satisfied glance and she starts to tear up and hug the doctor...its a sign you're getting better. And I could tell you plenty more stories. When you actually were extubated neither the Drill Sergeant Attending nor the nurses could get you to say anything although without the propofol you did follow commands. In fact the only word I got out of you was "broccoli?" immediately after you were extubated and started spewing green florets everywhere (where were you packing that by the way? I had your NG tube on suction for a full hour before we took the tube out). Or the time where you, acting head-ish, (which we would later learn was because you were sporting a DAI...) wiggled all of your 6 foot 2 frame to the edge of the bed while in 30 pounds of traction and tried to flip over on your stomach. Oh yeah you were strong...strong enough that when I called a nurse in to help fix the sheets you nearly picked me up off the ground as we turned you on your side and you somehow got your arm around my waist. Frankly I'm not sure how it happened either, but by the end of the third day your mom was asking where she could leave a comment card about my care. And in the week after she always took time to say hello to me in the hallways, as did your brother and your aunt. I even remember one night where I helped your brother who was panicking because he saw your arterial line go flat (you were flapping your wrist around) and I kept your arm still as he helped me re-zero the line. You came in once for a follow-up visit too. You were talking then, all the lines and tubes out of your body, and a knee immobilizer on your leg. Your voice was still soft and quiet as your mom introduced me. You didn't remember me specifically but I have a feeling you knew you had spent some time there. It was okay, I had the biggest smile on my face. You're only the second patient I've seen that came back to the floor and recognized me in some form or another, even if it was your family. It felt good. What feels even better is seeing the segment of you after I saw pictures from the accident, 8 months later, where you and your friend are standing tall. There's not an ounce of hesitation or softness in your voice, just a little hitch in your step as the camera pans out. We fixed you up and in return you're hosting a blood drive to give back to the community. I keep staring at the screen as I watch and notice my eyes getting a little misty. You can bet I'll be there. I can't tell you how it feels to see someone I've cared for look like he blends right into the crowd. Oh I know things aren't the same, and this experience will probably shape you for the rest of your life. But I'll look back on that day and when the shift is rough and things are going to hell in a handbasket I'll be able to say this is why I do what I do and know that every once in a while, I do make a difference.
  5. When I'm ironing the wrinkles out of my nursing scrubs before going to work, I often think of them. When I'm performing a procedural nursing skill at the bedside, I often think of them. When I'm explaining the purpose of a medication to a curious patient, communicating with a nervous family, or using the SBAR format to report a change in condition to a physician, I often think of them. Who am I thinking about? I often think about the nursing instructors and professors I had while I was a student. I regularly think about the seasoned nurses who oriented me and patiently transferred their nuggets of expertise to me. During the course of our days at work, we carry out procedures, perform skills, and engage in a certain way of thinking. While all of these things might appear clear-cut and routine on the surface, the majority of what we do calls for skills and knowledge that various people have transmitted to us. The most successful teacher that has certainly touched all of our professional and personal lives is direct experience. However, our professional experiences are rooted somewhere, and it is mostly from the formal nursing education we received as students and during our years of accumulating informal education at our places of employment. As we drift through our hectic days at work, some of us go into autopilot and might not always remember that our specialized skill set and fund of knowledge were introduced to us by some of the most special people in existence. Critical To Nursing Profession Nursing instructors, professors, preceptors, and seasoned nurses are critical to the nursing profession, because without them, no one would be around to transmit vital knowledge and skills to the next generation of nurses. In spite of this, the healthcare community does not always place a high value on the contributions made by nurses who educate. This is evidenced by the meager salaries that colleges, universities, and trade schools offer their nursing faculty members. After all, a nurse who has earned a master of science degree in nursing (MSN) or doctorate (PhD) can earn significantly more money by securing employment somewhere other than a school setting. The low value that the healthcare community places on nursing education is also demonstrated by the numerous hospitals, nursing homes, clinics, and other settings that fail to pay preceptors additional money for the arduous job of orienting brand new nurses to the floor or unit. I admit that I disliked a couple of my nursing instructors. However, I still appreciate them to this very day. Keep in mind the advantages that nurse educators bestowed upon you, and then return the favor by transmitting some of your expertise to a new nurse. The future generations of nurses are the lifeblood of our profession. The foundation of every competent nurse in existence today was formed by nursing instructors and built upon by experienced preceptors. Without people willing to educate, the nursing profession would cease to exist. I am expressing my deepest gratitude to the nurse educators who have selflessly passed the torch of knowledge and skills to the future cohort of new nurses because, without you, we would be lost. Thank you from the bottom of my heart. You rock!
  6. MusicalCoffee

    The Nursing Niche

    "To do what nobody else will do, a way that nobody else can do, in spite of all we go through, is to be a nurse". - Rawsi Williams There are some people who knew nursing was for them from the get-go. Then there are those who realized it a bit later in life. Whether you found it by accident or were born with it, you know it's where you belong, and you can't see yourself doing anything else. It might be all sorts of stressful, all kinds of crazy, and decisively depressing most of the time, but it's your place. At the end of a lengthy and sometimes crushing day, you may feel defeated and drained, both mentally and physically, but that's how it goes. You win some, you lose some, you have good days and bad days. It comes with the profession. When someone asks who you are, you reply, "A nurse". It's not what you do, it's who you are. I was one of the late bloomers. I never knew exactly what I wanted to do with my life career wise, but I knew I wanted to help people. In grammar school, I thought I'd be a teacher or maybe an EMT. When I got to high school I decided on psychologist because, hey, I had plenty of experience with mental illness, some would say too much, and it was something that fascinated me quite a bit. However, like everything else, it just didn't feel right. I wasn't completely committed to the point I could see myself doing it for the rest of my life. I needed more. I really wanted to make a difference in the world, or at least a small part of it. My friend is a nurse in a long term care facility, and she started telling me about the profession, what she does, the pros, the cons, and just like that I was hooked. I delved into my own research after that and the more I learned, the better I felt. This was it. What I've been looking for all this time. Hallelujah, I've finally found it! Some people, like myself, have felt so lost that they believed there was no point to their life. The age-old philosophical question of, "Why am I here"? haunts your thoughts night and day. You go through the motions, wondering if you'll ever find that something everyone else seems to have. You watch all of your friends and family graduate, knowing what they want, and you just continue to float aimlessly. Sure you have a job...one that you hate more than when they run out of your favorite flavor of pie after you've been looking forward to it all day, but it's a paycheck. Then the day arrives when a little light comes on, for whatever reason. You discover what you were meant to do, and once you find your niche, it's one of the best feelings in the world. After all, everyone wants to belong to something. Everyone wants to matter to someone, somewhere. As a nurse, you see people at their worst, you help them to get back to their best, you quiet their fears, you hold their hand, you listen, you laugh, you cry, you're there. Now, that doesn't necessarily mean you'll be treated in a way that reflects as such all the time, but you can rest assured you did your best.
  7. I am told that this Thursday, today as it were, is a day to surround ourselves by people that we both adore and cannot stand and are a source of endless joy and drama (AKA Family...whether work or genetic, does it really matter which?), to overdose on Tryptophan, beach ourselves firmly in the well worn embrace of the couch and, between bouts of reflux, to give thanks. Now, I'm not saying that such a thought is wrong...but I am respectfully stating that it could--wait, strike that--should be every day--well, the giving thanks part anyway. But sometimes it is easy to get caught up and to forget to note the things that cause gratitude, no matter how fleeting, no matter how misguided, no matter how seemingly insignificant. Perhaps this point is more freshly drilled home after finishing a failed resuscitation effort (yes, I am one of the health care soldiers dutifully standing guard this holiday). I find myself chilled, soul-weary, and pensive. It is easy to get caught up in the dregs of life, to feel down, sorry for ourselves even and somehow bamboozled into thinking that we having nothing, not one little thing, for which we need to feel grateful. And, on this day, in this moment, still wrapped in the shroud of self-doubt, a touch of defeat and smeared with a strange relief at my own mortality, I choose to pause and offer up words of thanks. Dear Universe, Gremlins, World, Higher Power, Human Race et. al, Things for which I am thankful The Diet Sunkist sale earlier this week which allowed me to purchase five cases for the price of two. Armed with the tang of sweet citrusy carbonation of Ka-Boom! I am now unstoppable. The ever reassuring Thwip!Thwip!Thwip! of the chopper blades as they beat the air on the helipad, heralding the presence of help. For calling home the last survivor of a tragic wreck--for he may now open his eyes to discover he is truly not alone. The power of the team to fight. The strength of the team to stop. The allowance and forgiveness of the team to grieve. Bolt-cutters. Chocolate cake shakes. For music. Any music. All music. The four walls around me and the roof over my head. For running water. For electricity. For heat. Creativity in all it's forms. Even the lost art of spaghetti sculpting. For stilling the caffeine and hyper-exhaustive jitters when starting that IV the other week on a child terrified of needles. For the blood return. For remembering/being old enough to know what life was like before video games. For surviving my childhood foray vs. Lawn Darts. Seriously. How did any of us survive our childhoods? I know that the playground by my house had concrete beneath it. Concrete. For occasionally having too much time on my hands. For helping me find my pants each and every morning. For the eyes, though weathered with time and poor genetics, which see. For the ears, though battered with too much unprotected exposure to machinery, which hear. For the mouth, though well trained in waspish comments and scowls, which remembers how to smile. For the voice that laughs. For the lungs which power my marathon yodeling sessions and hour long Aretha Franklin impersonations while dancing in my kitchen. Dry socks. For the moments when it all just suddenly :clicks: For Veterans everywhere. For Servicemen and women. For POW MIA's. You are remembered. You are not forgotten. You do what you do so I can continue doing what I do. And I, for one, am so humbly grateful. Remember that time when I broke my foot in an Emergency Heart? I'm grateful for that, too, as sometimes it is through suffering we are reminded of humility. The technology which allowed the replacement of a valve in a grandmother who would not have seen her granddaughter's first dance recital without it. Lint rollers. Two inch silk tape. For impervious, read: patent leather, Danskos. For those same Danskos to come in my size. For those same Danskos to be patent leather, in my size and orange striped like the wrapper of Fruit Stripe gum from the eighties. The eighties. For Aquanet. My sweet baby, Kid, who is trying to steal the cat's bacon. Mmmmm....bacon. Everything is better with bacon. Seriously. Remember that chopper? What if, once you were brought on board and secured.... There was bacon. Single greatest day of your life, right? For Denny's because they invented a sundae that has @#$% bacon on it. For Coronary Artery Bypass Grafting. Underwear that does not attempt to cut off circulation or forage into places best left unknown. For Nursing Students who ask questions and remind us where we started. The crystal clear night when I could actually see the stars, trace the constellations and feel my long past grandfather's rumbling voice near my ear, guiding my outstretched, pointing hand as it had so many years ago over the shield of Orion. Crisp, tumbling fall leaves which make that oh so delicious cRuNcH under foot. Moments of silence. For waking up each day to a life which has quality. You. Just you. I may not know you. I may have never laid eyes upon you. But I am confident that you bring something to this world that no other may contribute. You are important, unique and precious. Remember that, even on your bad days, that somewhere in this world, there is a crazy woman that is grateful you exist. Kindest regards and a Merry Holiday to all from Your Friendly Neighborhood Sociopath, ~~CheesePotato~~
  8. sweetpealuvr

    My Oncology Patients are ROCKSTARS

    I was one of those lucky people who knew from an early age what I wanted to be. As long as I can remember I've always wanted to be a nurse. I had no family members who were nurses, no personal experiences with being in a hospital - it was just something I always knew. So here I am, 30 years of being a nurse and I still get a big thrill going to work each day. I've been in Oncology Nursing for over 20 years and truly have found my passion. I love my patients! I get to share in their joy when they receive good news and I also get to share in their sorrow when they hear the sad news. My clinic day is full of the most extreme roller coaster of emotions that you can imagine and I wouldn't want it any other way. As an Oncology Nurse, being a cheerleader is part of my job description. When someone has gotten bad news or they are feeling like crap (sorry but that's how they feel), it's my responsibility to help them see how amazing they are and what a great job they are doing- fighting their battle with cancer. I always tell my patients they are ROCKSTARS. I know of no other area of nursing where patients have so many people cheering for them on a daily basis. In my clinic when a patient has completed their last chemotherapy treatment, we hand them a huge Captain's Bell to ring out in victory while the staff, their family members and other patients applaud. It gets me all teary-eyed for them every time I get to share in the ringing of the bell. The sense of accomplishment they experience when completing their last treatment and the look in their eyes is priceless. They have fought a long and overwhelming battle against their cancer and have won. Each one of them deserves to be celebrated with people cheering and clapping with the occasional WOOP WOOP being yelled out! Currently, I am involved in an event where they will be having a Survivor's Slideshow. So I have set about gathering photos of my ROCKSTAR patients to be included in the presentation. I was actually quite surprised how enthusiastic they were over the slideshow. Several of them went out and had their pictures professionally taken for the event. Some took their pictures with their hair and some without it - they were all beautiful. While gathering up the pictures I would remind them that they were ROCKSTARS, but this time their pictures would be up on a diamond vision screen, just like Van Halen, Rolling Stones, The Beatles, etc... I would stand next to them and put my arms in the air with my hands making the sign language sign for I love you, my mouth open sticking out my tongue, like a rockstar. They would laugh and copy what I was doing. Their giggles sounding like beautiful music to my ears. One particular day in clinic, I was again in my cheerleader role because someone needed cheering up. I had 5 ladies all of different ages and ethnic backgrounds, in chairs. I told them we needed to practice our ROCKSTAR face and they just laughed knowing what was coming next. So imagine if you can 5 ladies all hooked up to their IV's, with their arms in the air, hands making the I love you sign language sign, mouths open, tongues sticking out and belly laughing as they looked around the room at each other and this crazy nurse standing in front of them. I will never forget this moment as long as I live. And I know in my heart that my patients truly are ROCKSTARS! God I love my job. ❤️
  9. jadelpn

    Mother's Day

    When you become a nurse, you take the knowledge that you have acquired, start on a journey, apply what you learn and hope for the best outcome for a patient. When you become a mother, it is not much different. Only that when it is your child, you are personally invested in the positive outcome. When you are a nurse, you are professionally invested in the best outcome. I wish that motherhood came with evidence based practice! But with mothering, you can put whatever theory to the test as you would like, and children take on a life of their own, so the outcome is not as clear as one would like or hope for. And yet, we are invested. We want our children to be happy. To be fufilled, to be ok with their choices, and to dream. For our patients, we would want less sufferring, for our patients not to be sad, not be dysfunctional, to be whole. The outcome is not always as clear as we would like it to be, no matter the theory behind our actions. So not much different. Siblings, if you will. Nursing takes the most primative form of caring about the outcome of someone, and shapes it into a burning desire to make a difference in someone's life. Even those of you who say that nursing is not what it is cracked up to be, that you are tired, burnt, disgusted....those are often some feelings that mother's feel as well. Yet, with a renewed conviction thinks perhaps they will do it again another day if for nothing else but to make someone else's life different. Better. To make it whole. The work we all do is important. It takes the life of another and alters it. So even when feeling discouraged, know in your heart and mind that even if the outcome is not as you would have liked it to be, you made a difference. You did what you needed to do, then you got better, fought harder. You take pause in the fact that what you do, good/bad or indifferent is real. Much like a mother. On this Mother's Day, like every day, it is also important to remember that each patient that we come across has a mother. And at one time, perhaps in the moment or many years ago, for one split second, or never-ending devotion, the patient presented to you is someone's beloved child. That no matter what the circumstance from conception to now, someone mothered this child. Even in the most un-ideal circumstances, someone, somewhere brought this child into the world in a loving act. As nuses. we sometimes have to then remember that compassion, even if the patient presents in a not so ideal form. It takes courage to be a mother. It takes courage to be a nurse. Courage is measured in the things you know, but that you forge ahead and do anyways. Never doubt your worth, as well as never doubting the worth of the patient in front of you. Happy nurse's week to all of my fellow nurses. And top it off with a Happy Mother's Day to all my fellow nurses who are also Moms.
  10. "The only thing worse than an active conscience is one that's retroactive." - Harold Coffin. An active conscience is defined as an inner awareness of right and wrong, good and bad, that a person uses to constantly steer his or her conduct toward taking the ethically righteous course of action in life. Having an active conscience is extremely important, because without one, there's not much else to stop a person from perpetrating awful acts against others, perhaps except the external threat of legal punishment. Then again, people who do not possess active consciences would most likely do something bad if they felt they had a strong chance of not getting caught. Based on purely anecdotal support, I would say that the overwhelming majority of nurses have active consciences that guide them to do the right things, even when the most difficult situations arise. As an example, nurses have topped the list on Gallup surveys for many years, having been voted the 'most trusted' professionals by members of the public who respond to the poll. Nurses, who have led the rankings for 11 consecutive years, were ranked "high" or "very high" for honesty and ethics among 85% of respondents (Laidman, 2012). In other words, a large segment of the population trusts us to tell the truth, be ethical, and do right by them. Not all individuals have active consciences, which leads them to lie, cheat, steal, mislead, falsely blame, and engage in many other unsavory exploits that devastate peoples' lives. For instance, the shady insurance salesman who convinces unsuspecting people to purchase useless discount plans by deceptively claiming they are health insurance policies lacks an active conscience. This is obvious because the blatant deceit does not bother him one bit. Also, the live-in caregiver who sneakily makes unauthorized bank withdrawals from accounts belonging to her trusting elderly client lacks an active conscience because the theft does not create any inner struggles between right and wrong. Unfortunately, several of the entities that employ nurses are filled with managerial employees who seem to not have active consciences. Many nurses wonder how some hospital administrators, chief nursing officers, and unit managers are able to look the other way while understaffing, a lack of supplies, and poor working conditions negatively affect patient care. Some nurses are puzzled by the current trend of placing customer service on the highest pedestal while patient care gets placed on the back burner. Other nurses stare in disbelief as the unit manager is rushing them to transfer the deceased patient out of room 401 to make room for a new admit coming from the emergency room. How can this be happening? Is the love of monetary profit causing some peoples' consciences to become inactive? In this difficult healthcare climate, nurses should be immensely proud of themselves for continuing to act upon their active consciences to do the right thing for their patients. Without an active conscience, the world would become a frightening place with people who are incapable of feeling shame, guilt and remorse. Work-Cited / References Laidman, J. (December 6, 2012). Nurses Remain Nation’s Most Trusted Professionals. Medscape Medical News. Retrieved January 2, 2012 from http://www.medscape.com/viewarticle/775758
  11. LoveNeverDies

    How We Can Make the Difference

    I remember laying on the couch watching TV when I got the call. "It's back." was all he said. I felt ice shooting through my veins as it sunk in. My very dear friend's mother had been in remission from ovarian cancer for almost 2 years and on a scheduled PET scan they found more tumors. She decided to begin chemotherapy immediately, we knew how agonizing it was to her to have to lose her hair again. But, she couldn't imagine leaving her only child and husband behind. Being in nursing school, every new bit of information was like a knife in my heart. However, the doctor and family had a lot of hope for recovery. We all still had hope. The next information to come was that she was not responding to the chemotherapy, they would have to try something else. Eventually, it came that she had to be hospitalized. She was in constant pain all the time. She had the most wonderful nurses, always came quickly with her scheduled medications, always came to answer the call light immediately and returned with her extra doses of pain medication. Her PCTs were fabulous, always being as delicate as possible when turning her and handling her needs. One, in particular, was very personable to us and we thoroughly enjoyed when we saw her name on the board. She would sit with her whenever we needed to leave the room for a few minutes, she would stroke her arm and constantly used a swab to clean out her mouth and wet her lips. Basically, the healthcare team made themselves available whenever we needed them, but allowed us time alone when they weren't immediately needed. It seemed that they knew how very much we appreciated the privacy to talk with her and even sometimes just sit in silence. I have had my fair share of dying patients in clinical and in my job, but it just wasn't the same, being someone I have known my entire life, someone I have had many conversations with over the years. Yet, those people treated her as if she was their loved one. They continuously tried to soothe our grief at the situation and often asked about the fond memories we had. It has made a huge difference in how I will interact with my patient's families in the future. I never realized how important our role is in the families' life at this point. I always felt awkward and intruding when I came in to check on their family member. Now I realize how much healing I can do for everyone, not just the patient. Eventually, she was allowed to come home and have home health for a while until she finally passed away peacefully, and free of pain. Every single Nurse and multiple PCTs came to visit, called, or sent cards and food to the family. It was nice to know that even at her worst, she could make people love her. I sincerely would like to thank every Doctor, NP, Nurse, Aide, Student and any other healthcare provider that has assisted families in time of heartache. I would also like to remind people that most of these Nurses were not specifically Hospice and still had a lot of comforts to offer to us. Her son has decided to pursue nursing as a result of these meaningful interactions. Although it was still a horrible thing to deal with, these people made the difference in how we handled her passing.
  12. dpgRN

    To Touch A Soul

    We referred to him as Mr. Comatose. His chart had him diagnosed as mentally ill and he was mostly comatose. He was blind. He never spoke. We were unsure if he heard anything. He barely moved. He was a complete care patient. He made us wonder. What goes past such a body that neither speaks, or moves nor seems to understand? Do the medications we carefully calculate and administer have a purpose other than to just maintain a beating heart? It sometimes felt as if he were a mock patient like those we had practiced on in labs during our training; except this one had no remotes or buttons that triggered any form of communication. It was as if we were cleaning and turning a being that had skin and bones and even a beating heart, yet still lacked life. It was as if we were caring for a lifeless manikin; the life of the task, of one human to another, from a nurse to a patient, seemed to be lacking from our daily encounters with Mr. Comatose. Is this where our job is summed into a daily set of tasks and checklists to mark off? It sometimes felt as if we were turning and feeding a product on a to-do list. We wondered if the care we performed for him meant anything. We have cared for comatose patients before, but they often had families that we were able to connect to, which remotely connected us to the patient. When family was present we provided the physical care to the patient and the emotional care to the family; thus connecting the two life-forces of our nursing roles. Even when our comatose patients had no family, we knew that they heard and possibly understood us. However, Mr. Comatose had been a vegetable for years, and was mentally ill prior to his vegetative state, so and we weren't sure how much he had ever heard or even understood. We often wondered; did he feel pain? Was there anything more than a body? Did his heart feel our touches of care? Did our dedication and devotion to his needs just bounce off his rubbery skin? Did we manage to evoke some semblance of life from his rubbery body, or reach some sort of soul that was perhaps hiding in this stationary statue of skin, bones and IV tubing? The group of us nurses made conscious efforts to treat Mr. Comatose as a human being despite how our minds wondered about the perplexity of his existence, and questioned the mystery life that existed beyond his swollen skin and beating heart. When we would get into his room to change or turn him, we would chatter about in our daily banter. We would occasionally include Mr. Comatose, even ask for his silent opinion at times. We told about our dinner plans, our aches and pains, and we would tell him about the vacations we were looking forward to. Sometimes we would complain to him about our heavy workload and update him on the hours left to our shift. We would go and wish him good night before we left, and we would greet him in morning. He soon became some sort of fascinating presence on our unit in an unbeknownst way. He was somewhat an object of our fascination. His silence spoke comfort during rough days, his silence helped decide where to go on our next vacation or even which nurse he preferred to turn and clean him next. One morning we received the news, Mr. Comatose was medically stable and would be returning to his nursing home. We shared this new with him eagerly, and as expected he responded with his now very familiar tone of silence. The hours of the day floated by as we got busy with our other patients. We were startled from our work tasks with the sounds of incessant cursing emanating from one of the patient rooms; **** you, **** you. We thought an intruder or a disruptive family member was on the unit and we were about to call security. As we searched for the intruder, we traced the cursing to Mr. Comatose's room. Indeed, he was a living being. It was his last day in the hospital, and those were the only sounds we ever heard from him. Somewhere inside our large and swollen sleeping beauty was a soul crying out. That day the soul that absorbed our nurse banter and our gentle care when rolling and cleaning him, broke out of its silence in a thankful curse. His mouth broke out in a passionate **** you. This time we answered him back with a silent, gentle caress on his shoulder. He quieted down. Our touch had silenced him. Perhaps that day we had reached beyond a being with rubbery, swollen skin sheltering a beating heart. Perhaps that day we had touched a soul.
  13. ProfessorNurseRN

    A Phone Call

    She called my name down the hallway. To me, at the other nurses' station. Why she did that, I don't know. I had a phone next to me. She's the unit secretary. Why doesn't she know my extension? "You have a phone call. Johnson's brother. Wants to speak to his nurse" I call back (now we are just raising our voices at each other, how foolish) "Transfer the call over here." She calls back at me. "What's the number at your phone?" Again I wonder- why don't you know the number? But I don't ask her aloud. I reply "6015" The phone next to my computer rings and I answer. "Third floor, this is SarahLee, how can I help you?" I hear a voice, sounding far away and yet right in my ear. "This is George, Elizabeth Johnson's brother. I was wondering if you could tell me how she is doing?" I ask "Are you her health care proxy or power of attorney?" "No, just her brother," the voice seems frail. My HIPAA training kicks in. I search my brain and scan through the computer in front of me to see if this person is a contact. I don't see his name in the computer and the chart is at the other nurses' station. Then inspiration strikes me. "I'm sorry, can you hold on for just a moment?" I ask. I press hold on the phone and walk down the hallway. Knocking, I enter. "Elizabeth, your brother George is on the phone, wondering how you are doing. Can I give him some information?" Elizabeth looks up and smiles. "Oh yes! I have been trying to call him! Please tell him anything that he wants!" I go back to the station and the phone, press hold again and just get a dial tone. I lost him. I must have hung up on him, poor man. Another victim of my sad phone skills. Sighing, I go back down the hallway. "Elizabeth, do you have his phone number? I'm sorry but I think I lost him." She searches her brain as she is lying there on her bed: "Oh yes, it's 478, no 784, no...oh dear, I'm always forgetting it..." Suddenly, the overhead page is heard, "SarahLee, phone call front desk. SarahLee, phone call front desk." Thankful, I say "Never mind Elizabeth, that's probably him" I go straight to the unit secretary this time. No more fancy phone maneuvers for me. She tells me how to use her phone, I sit down and I answer it. Quick apology for hanging up on him "I never could run these phones." "It's ok," he laughs nervously. Then, without skipping a beat, like he was diving into a pool before he lost his nerve, he asks: "Sarah, is my sister going to die?" Stunned at the suddenness of such a request, I search through my brain about the woman I just left in the room. Respirations even, non labored, alert, talking, laughing, getting up as needed on her own, very limited pain. Speaking cautiously, I reply "No...I wouldn't say that she is going to die. I mean, of course, I can't see the future. She's going to need some time to recover, certainly, but no, right now she's not dying." Suddenly there was a silence on the other end. No talking, just deep breathing heard, in and out, in and out. I thought I had hung up on him again. Finally I say "Um..sir..are.. are you still there?" Deep breathing and then, a tearful voice, full of anguish, speaking in a rush now, "I got home and had a message from our other sister, they said she was doing terrible, not well at all, that she was dying...I tried to call her room several times and I couldn't get through...so I finally thought I should try the nurse...so I've been trying to get through at the desk...." Then I heard the sound of him blowing his nose. And there it was. That moment that comes every now and again, where I am going along doing a normal day's work and then suddenly I feel like an observer of my own life. Like I am someone who is looking through a glass at all these different people walking around and suddenly I see two people who have never met before meet at an intersection. Without warning, his day's crisis had smacked headlong into my day's routine. What was he thinking when I put him on hold to ask my patient's permission to talk to him and then subsequently hung up on him? He had thought his sister was dying. Did he think I had to find someone else to break the news to him? Did he think that he would never hear his sister's voice again? Did he think that the nurse didn't want to talk to him? When I picked up the phone, I thought that he was going to ask some general questions like "How is she doing, when can she go home, can I come and see her?" But his question was more serious. His question was his biggest fear. He didn't even know if she was dead, dying or alive. Our phone conversation continued and we talked a little more about her health. His tears and fears subsided. I could tell that relief was spreading right through him. I could almost see his smile over that phone line, if such a thing is even possible to say. At the end of our conversation (with the help of the unit secretary) I transferred his call to her room where he and his sister had a good conversation. She called me into the room later and gave me a big hug. "Thank you so much," she said. "He was so afraid" and we laughed together, as two people who knew a private joke. But the rest of that shift, I felt what must be one of the best feelings in the world. I felt like smiling, laughing, running down the halls like a fool. Because my patient wasn't dying. She was very much alive. I had put one person's mind at ease. And I got a hug and a thank you from another. What more could I ask for? So don't ever underestimate the value of the little moments in nursing, like a phone call. Small routine moments in our patient care may turn out to be one of the biggest moments in our patients' and their families' lives. And we get to be part of it. How amazing! What little moments have you been a part of?
  14. As part of our pinning ceremonies in nursing school, we all probably remember reciting the Nightingale Pledge, a modified "Hippocratic Oath" composed in 1893 by Mrs. Lystra E. Gretter and a Committee for the Farrand Training School for Nurses, Detroit, Michigan. The pledge is as follows: Since today is the birthday of Florence Nightingale, I thought it would be a good time to look back at the life of the woman considered to be the founder of modern nursing. Early Life Florence Nightingale was born on May 12, 1820 in Italy into an affluent, upper-class, well-connected British family. Although her mother, Francis, who came from a family of merchants was interested in social-climbing, Florence, the younger of two daughters, was reportedly awkward in social situations. Florence's father, William Edward Nightingale, was a wealthy landowner and provided Florence with a classical education, including studies in mathematics, German, Italian, and French. Florence, who was strong-willed, often butted heads with her overly controlling mother. Instead of socializing with the upper-class females in her mother's circle, Florence was always interested in ministering to the ill and poor people in the village which bordered her family's estate. It was clear to Florence when she was 16 that nursing was her calling. At that time, nursing was seen as menial and lowly labor - certainly not an honorable profession. Her upper-class parents wanted her to marry someone respectable. Education At age 24, Florence defied her parents' wishes and left England to enroll as a nursing student at the Lutheran Hospital of Pastor Fliedner in Kaiserwerth, Düsseldorf Germany. Upon her return to England in the early 1850's, she took a job at a London Hospital. After her impressive work there, she was promoted to superintendent after only a year. Florence Nightingale became known as a reformer and advocator for public health due to her work at greatly improving sanitary conditions after an outbreak of cholera. Crimean War - "Lady with the Lamp" Florence became a living legend as the "Lady with the Lamp". Her work during the Crimean War from 1854 until 1856 was well-known as she led nurses who cared for thousands of soldiers. She and her team of nurses improved the unsanitary conditions at a British base hospital, reducing the death count by two-thirds, which helped save the British army from medical disaster. She was also a visionary health reformer, a brilliant campaigner, the most influential woman in Victorian Britain and its Empire, second only to Queen Victoria herself. Upon Florence Nightingale's return from the Crimean War, the Queen rewarded her work by presenting her with an engraved brooch that came to be known as the "Nightingale Jewel" and by granting her a prize of $250,000 from the British government. Achievements Florence Nightingale's greatest achievement was to make nursing a respectable profession for women. Her writings on hospital planning and organization had a profound effect in England and across the world. She published over 200 books, reports and pamphlets. Florence died at the age of 90, on 13th August 1910. She became one of the most famous and influential women of the 19th century. Her writings continue to be a resource for nurses, health managers and planners to this day. Nursing has certainly come a long way since the time of Florence Nightingale. We should not forget the courage and perseverance of the Lady with the Lamp who remains the most famous nurse in history. This inspirational figure helped to transform nursing into the highly respected profession it is today. Happy Birthday, Flo!!!!! More Fun Facts! Watch Florence Nightingale - Mini Biography... [video=youtube_share;o0FWqDlOYYs] Trivia questions for you.... How did Florence Nightingale get her nickname, "The Lady With the Lamp"? What was her sister's name? What animal did Florence Nightingale carry with her, even when doing hospital rounds? Was Florence Nightingale ever married? What is the name of the nursing school Florence Nightingale opened in 1860? How did Florence Nightingale get her name? What was the cause of death for Florence Nightingale? Where is Florence Nightingale buried? Related Topics... Whatcha Know about Flo (Florence Nightingale)? The Nightingale Pledge - Still relevant today? Florence-Nightingale-Birthday-Worlds-Famous-Nurse.pdf
  15. angiebaci

    Thank you, Eileen

    Four years ago, my father died. We were all expecting him to die since he was a terminal cancer patient, however, when his life began to end we were in complete shock. Chalk it up to denial or hope, we were completely surprised when the time actually came. If it wasn't for the bravery of one nurse, the last days of his life would have been filled with a great deal of confusion for our family. This nurse completely changed our ability to filter information and make a decision while dealing with a dying family member. She gave us strength and clarity, two things which we were severely lacking before her intervention. When my father received his stage IV cancer diagnosis, the Oncologist gave him three years to live because he was relatively young and healthy. One year into that three-year timeline, he started to deteriorate slightly. He became less happy, ate less, and experienced more pain on a daily basis. Nevertheless, he was still carrying on his life, driving about town, going to doctor's appointments and running errands. He had just returned from a road trip from San Francisco to Los Angeles to consult with another Oncologist when he started to experience extreme pain. The pain became so unbearable that he went to the hospital. He was given Morphine to ease the pain. He fell asleep and he never woke up. In between falling asleep and dying, there were a handful of days. He went to the ER on a Sunday and died on Friday. When he initially fell asleep, he would have brief periods of consciousness and be able to semi-interact with us in a coherent fashion. He made slurred requests to not let visitors see him in his current state and asked me to rearrange plans he had made with friends. Eventually, his periods of semi-consciousness turned into delirium. He would open his eyes and make eye contact with us but would speak about something that wasn't happening in the room. He was happy and jovial but not with us. Even in his delirium, he still embarrassed me in front of any and all hospital staff by telling them I was a nurse, one of his favorite things to do. My father's sudden decline in functioning left my family and I in a state of total confusion. He had doctors and staff from every department pay him a visit and they would each clear him from their standpoint. The hospitalist suggested we decrease his pain medication to bring back more lucid behavior. Infectious disease ensured us he did not have an underlying infection. The discharge planner encouraged us to decide on a local skilled nursing facility for him to be transferred to until he regained his normal level of functioning. My family and I were running in circles, both mentally and physically, trying to reconcile what the doctors and staff were telling us with the shell of a person we saw laying the bed. Even though I was a nurse, I felt useless to my family as a source of guidance. I was out of my realm and dealing with death for the first time. On Tuesday, the day shift nurse, Eileen, pulled my mother outside of the room to speak to her outside of my father's earshot. She told my mother point blank, "He is dying. I have been an Oncology nurse for many years and this is what happens. The organs shut down and the mind starts to slip away." These words were hard to hear, but they were what we needed to hear. Eileen could sense that we knew this was the reality of the situation, although we needed validation from someone. No one had even brought up the words "death" or "dying" up until this point. Her words were the most logical and easy to understand we had heard since the beginning of his cancer diagnosis. She wasn't speaking in medical jargon or down from a pedestal. She was a human, talking to another human, in a hallway. The bravery of Eileen's actions helped our family come together and get through the worst part of that week, Wednesday through Friday. We made the heart wrenching decision to pursue palliative care and he died two days later on the same day his daughter gave birth to his only granddaughter. He died two years before we were expecting and decades before we were ready to let him go, however, it was his time. Eileen led with her heart in a moment of need and the impact of her actions will never fade from our memory. From one nurse to another, thank you.
  16. morecoffeepls

    The Boy at the Bottom of the Stairs

    We try to teach our children how to be good. Being innocent isn't necessarily the same thing, and some day, when the sheen has worn off, becoming a virtuous person in this world will mean making hard decisions and choosing difficult paths. I was fortunate enough to have a saint for a mother, and two sisters with Down Syndrome who taught me everything I will ever know about compassion. My moral upbringing and idyllic childhood are how the world and my place in it were given meaning - and why, I believe, I was chosen to become a nurse. To be entrusted with the well-being of another human being, and to respond to this duty with competence and caring are the things that inform my practice. They are also, if I am mindful of them, what will help me try to be a deserving parent. Fortunately for them, the responsibility to raise my three sons isn't mine alone, and it's a wonder to me that each day is an opportunity for them to learn or experience something for the first time, and each person they encounter may have a lesson to offer. In turn, my kids teach me something new every day (about the world, about myself, about what's important), and I will never get over that. My oldest is six now. He is one of those kids that have no shame, and you hope never will. Anything for a laugh. Too funny, too friendly - no such thing as either, but there are times. Whereas I'm a stocky, seemingly unapproachable angry or pensive bear in appearance, my son is a lean, piano-fingered, open-faced, winsome boy. His dark brown eyes are big, like a Keane waif, and he needs to grow into his head some day. When he was two, we started calling him "The Mayor" - fearless in a crowd, among strangers, and engaging. My favorite example of his absurd social prowess is the time he crashed my sister-in-law's boss's swanky Sweet Sixteen party for his daughter. They had just popped in to drop off some paperwork, and he knew no one, but he insisted on staying for a song or two. He was working the dance floor alone for a while before he decided to pull the initially reluctant partygoers out of their seats and make some things happen. My wife told me that before long, all the girls had formed a circle around him and were chanting his name: "Go Leo! Go Leo!" She said the manager of the banquet hall approached them on their way out and thanked my son profusely for saving the party. Powermoves. He is also quick to tears, which concerns me a little, but not really. He has a soft heart. When the waterworks are appropriate and genuine, it's touching as hell. If I mention the piggy bank that "nana gave me when I was born!" and was accidently shattered last year, or Mimi, his favorite stuffed cat (it's a dog, actually), that got a haircut when my wife decided putting it in the washing machine was a good idea, he wells up and turns away. I am proud of his sensitivity, moved by its depth and authenticity. Recently, my wife and I somehow managed to watch an entire movie without interruption. It was pretty decent, primarily because of its insistent and unapologetic adherence to formula; a real tearjerker. Leo wandered into the room, barely noticed, about halfway through. Two brothers are fighting during the climax, and although one is severely injured, the other is forced to continue to punish him. When the physical and emotional anguish was coming to a head, my son burst out laughing. When we turned, his face was streaming tears and he was pointing to it: "I can't believe I'm crying so hard! This is so sad!" We all started laughing, but he broke my heart and I had to get up and walk into another room. Last year around this time, my son taught us a lesson about what the holidays should mean. We were picking up another of my wife's sisters at the train station downtown a few days before Thanksgiving. We were early, and my son wanted to walk across the street to look in the windows of the antique stores. He likes old things. The storeowners really respond to this kid. My son asks good questions, makes astute observations and clever jokes, is respectful; invariably, they quickly establish a rapport that excludes me. The guy at Salvage Alley calls me Leo's Dad, and has offered to take him on as a horologist apprentice. I think he meant it. Ever since Leo first walked into his shop, picked out an ornate, curved handle sword cane, assumed a fancy English gentleman's pose and said, "Ello Govna" to himself in a mirror, this crusty old bastard decided he and my son would be friends. "Soldiers, daddy," in a goofy baby voice because that was how he used to pronounce it; so, I hoisted him on my shoulders, and off we went. I was still explaining how someone had put a three-masted fully rigged ship inside a bottle he had spied in some dark corner of Vestige in a Bottle when we heard a girl shout. She was backing out of a doorway, and quickly covered her mouth with both hands. I let my son down, and he latched onto my arm as we approached the scene. The girl told us that she and her boyfriend were about to start walking up the stairs when an old man fell backwards from "almost all the way". As she was saying this, I noticed a few people standing over the man, and one of them was trying to get him up. I bolted over and intervened. We carefully lowered him back to the floor, and I looked up for my son. He was walking toward me, holding the shaken, top-heavy teenage girl's hand. I asked that people clear some space, but I think that only brought more attention to the situation from passers-by. I scanned the advancing crowd again for my son, and saw him saying something into his pretty new friend's ear. She promptly walked over and told everyone to make some room and that I was a nurse. Some nudging, the shuffling of feet, and in an instant, the doorway was empty. People were either looking on at a significant distance, or had simply walked away into the remainder of their otherwise uneventful night. It's an odd thing, and not the first time this has happened to me. An old woman gets dizzy at a wedding, I mention that I'm a registered nurse, and someone grabs me by the arm and clears a path. (Diagnosis: too many ouzo martinis and circle dances.) I believe as far as most of the people on the sidewalk that night were concerned, the situation was being handled. However, as I started to assess the man, I realized he was in trouble. He was struggling to sit up, but I gently redirected him. I was asking him questions, but he simply stared at me. His affect was blunted, and I noticed a very slight droop on the right side of his ashen face. I asked him to squeeze my hands, but I couldn't tell whether or not he could understand me. I had heard someone calling 911 when I first approached the scene, and now there were sirens in the distance. I could feel my son standing directly behind my shoulder, and the man's blank gaze shifted from my face to his. I looked over at my son to make sure he was all right when he simply lifted his hand and said, "Hi." When I looked back at the fallen man, his brow furrowed slightly. Then he spoke. "Hi ... What's your name?" It was mildly garbled, but clear enough. "Leonidas," proudly, without hesitation, then, "I'm 5 and a half. I have a band called Glaciers." A hint of a lopsided smile, then the gentleman relaxed his posture and his breathing. The ambulance pulled up, and I happened to know one of the EMTs. I told him what I could, and we withdrew. As we were walking back to the car, my son beamed and put his hand up for a high-five then asked me for a ride. He felt like a victory garland on my neck. I answered his questions, and made convincing assurances that the man would be okay. Then I asked him why he told him his age and about Glaciers. He started laughing and said he didn't know, that he was nervous or something. Then we were both laughing like idiots and couldn't stop. Thanksgiving came, and I was grateful for food and family, and food again. Leonidas, when it was his turn to offer grace said that he was "thankful the guy was okay." He had told the story many times already, so everyone knew what he meant. The day passed, then a few weeks. The two of us were walking downtown again. Leo had asked to use some of his own money to buy "something old for nana because she's old, too". We were walking past the window of a little railroad-themed greasy spoon when my son abruptly stopped in his tracks. His improvised song 'Tiny Moby Dick Inside a Bottle' had started falling apart anyway, but had included a catchy rap hook that paraphrased something we had read recently: "Don't talk to me about blasphemy; I'd strike the sun if it insulted me." I was impressed. How does he remember everything? "There he is." I asked him who. "The man at the bottom of the stairs." And there he was, eating alone in an empty cafe. Leo insisted we go in. "Excuse me." He looked up from his hashbrowns. "I remember you. Do you remember me?" He didn't, but then stood up and shook our hands when Leo told him about that night. He asked us to sit down, and we did. He had a brace on his wrist, which was sprained, and told us he had suffered a mini-stroke. A haggard Jimmy Rodgers was the image that came to mind as I looked at his face, and he was swimming in his hickory stripe bib overalls. The three of us proceeded to have a conversation about transient ischemic attacks, the holidays, family, old stuff, and various other topics. We learned his name was Richard, that he was a widower with no children and lived alone in an apartment above the liquor store next door, and that he ate lunch at the Track and Trestle Beanery every day. It was nice to see him, and to know that he wasn't injured badly and was recovering well. He insisted on giving my son a silver dollar, and wouldn't let us refuse. Why do people do that? We stopped by for lunch fairly regularly after that. Leo couldn't get enough stories about World War II or Richard's life as a train brakeman. Just before Christmas, the whole family went to the Track and Trestle for lunch with Richard. My son had made a nice card, and asked that we give him a mug because he loved coffee so much. He gave Leo a vintage tinplate caboose, and said it was the exact one he used to work on. My son, in return, reached into his coat pockets and pulled out the two halves of his favorite geode. My wife and I had no idea. He explained to Richard that "inside the chalcedony shell of the rock are celestite crystals" and that they would each keep a half "forever". It was a grand gesture, and the first time they hugged. What becomes evident when I reflect on that time in my family's life is that the spirit of nursing and the spirit of the holidays are not terribly dissimilar. I consider myself lucky to be a nurse. Although I may tend to idealize or romanticize my role, the fact of the matter is that I get paid to help people. I try to give back by being there - by holding myself accountable, by being an authentic presence, and by being mindful of what motivated me to become a nurse in the first place. Essentially, the guiding principle of nursing is reflected in the parable of the Good Samaritan, and although I'm not a particularly religious person, it is something that comes readily to mind when considering what nursing, the holidays, and trying to be a decent father have come to mean to me. Helping someone in need is how we make a difference in this world; picking someone up when they have fallen, if and when they are ready to be picked up, is how we make our lives worthwhile. Sure, this clich�d sentiment is a bit thick, but, like that movie that made my 6-year-old little boy weep, I don't really care to apologize and, rather, have to insist on its ability to affect people profoundly. If I am able to teach my children how to recognize this principle, to know and appreciate it when they see others performing acts of kindness, to treat people in accordance with it, then I feel like I am doing something right by propagating its message. I look out my window at the leaves or the snow, and I realize that the holidays are meant to be about expressing gratitude and good will. I am lucky, and I am humbled: I look at my son, Leonidas of Glaciers, and I see a truly good person. He's the best of us, Jerry, the best! He is my gift to the world.
  17. nkochrn

    What Makes a Great Nurse

    When I was in nursing school, one thing I always remember hearing the instructors say is straight A's are not what makes a good nurse. There's nothing wrong with getting straight A's of course, but it takes a lot more than that to truly be a good nurse. I believe one of the most important qualities of being a good nurse is having compassion. A nurse with compassion is one who truly cares about her patients well-being and outcome. This nurse treats her patients as she would expect any other nurse to treat herself or own loved ones. The nurse with experience, not experience as a nurse but as a patient. This nurse applies her own experiences into practice. The only way to truly understand what a patient is going through is to have experienced it yourself. Each nurse has different experiences but at some time almost all of us will experience an ER visit, a surgery, or even labor and delivery as a patient. Another great quality in a nurse is being non-judgmental. I know long ago in nursing school we were taught this, but I see it so often and I admit that I've caught myself judging patients. As an example: "30 year old with back pain coming by ambulance, gotta be a drug seeker." Turned out the patient had a back injury after an accident. It seems that many of these patients being judged are being judged because of known or suspected drug abuse. These people are struggling with an illness; addiction is an illness and should be treated that way. These people have their own stories and struggles that have led them to where they are today, some of these struggles way more difficult than we can ever imagine. It's important for nurse's to be efficient, one way of doing this is to be part of a team. Working together with others and delegating to other members of your team helps increase your efficiency. Part of being a team is also helping other members of your team. Being efficient helps you to give your patients the best care. There are many aspects to having an effective team, but it's very important that all members of the team are respectful of each other. Nurses need to be respectful of each other and of their patients. There are many little things about an individual that may drive you crazy, but just remember none of us are perfect. There is probably something about yourself that drives someone else crazy.
  18. tnbutterfly - Mary

    Nurses - The Unsung Heroes

    Once again it is National Nurses Day and the start of National Nurses Week, which always begins on May 6 and goes through May 12, the birthday of Florence Nightingale. This is the week set aside to recognize the contributions and commitments nurses make, a time to educate the public about the significant work they do, and a time for showing appreciation to all the nurses. There are many types of activities planned throughout this week which include banquets, recognition dinners, and lunches. Nurses are honored with gifts, receptions, cards, and flowers by friends and family members, and even co-workers. Some hospitals stagger activities throughout the day and night so that all shifts can participate in the celebration. While it is nice to be recognized during Nurses Week, some of the most memorable gifts of appreciation come from patients......not just during Nurses Week, but throughout the year. Sometimes these expressions of gratitude come at unexpected but opportune times. They come after long working hours, when nurses are tired and wondering if they are in the right profession........when some are questioning themselves whether they are making any difference. Nurses work long and hard hours in many different settings, during many different shifts. Their job is not an easy one. Many nursing jobs involve physical demands. While the physical side of the job is tiring, the mental aspect is so much more draining. Many times, it is after a crisis that we realize the impact we have had......either in saving a life or helping someone slip into a peaceful death. Nurses must possess many qualities. They must have compassion and endurance to meet the needs of the patient, whether it be in the middle of the night or at shift change. Nurses must have patience and courage as they talk with physicians. Above all else, nurses must always advocate for the patient, using their knowledge, skills, and professionalism to insure the quality of care the patient needs and deserves from the healthcare system. Nurses should never minimize the role they play in the lives of their patients. Nurses are the ones who are at the bedside after all the other providers have left. They are the glue that holds the healthcare system together. They are the unsung heroes. Steve Lopez, a contributor to the L. A. Times wrote a story about his close encounter with death. He went into cardiac arrest following a knee-replacement surgery. He credits the actions of a quick-acting and alert nurse who saved his life and opened his eyes to the compassion and dedication of his medical team. He thanked the doctors, but wanted to say something special about the nurses who knew just what to do when he arrested and sprung into action. "Nurses quietly go about their work in a noble profession, uncelebrated soldiers toiling through the days and nights in service to the sick, the injured and the dying." Steve Lopez, LA Times I have a box in my office where I keep notes and cards I have received from patients or family members. They certainly brightened my day when I received them, and they serve as a reminder to me that yes.......what I do does make a difference. To all you wonderful nurses, I would like to say thank you for your dedication to the profession and your ability to make a difference in a person's life, not only during Nurse Week, but every day of the year! Happy Nurses Week! What are some of the memorable expressions of gratitude you have received that made your day? References: Lopez, Steve. A Note of Gratitude to Nurses, Los Angeles Times, Sept. 1, 2012 Read Nursing: Then and Now and other articles in my Body, Mind, and Soul blog.
  19. tnbutterfly - Mary

    Be the Nurse You Would Want As a Patient

    If you have had the misfortune of being a patient in the hospital, what stands out about your experience? No matter the specific reason for your admission, I'm sure it was an experience you would rather not have had. What was it that made your experience a good one.......or a not so good one?? Was it the care you received......... or the care you did not receive?? Nurses do not have the ability to change your reason for being in the hospital, but they do have the capacity to make your hospital experience a more pleasant one. I am not talking about customer care, so to speak. I am talking about nursing.........including the little things. What might seem little to us may mean the world to the patient. Think about lying in bed in pain....not being able to get out of bed by yourself....dependent upon strangers for even the small things.....like a drink of cold water......assistance to the bathroom......kind words of explanation regarding tests and procedures......common courtesies. Nurses can change patient experiences-making difficult things less difficult, being present when there are painful and uncomfortable situations, being there to help navigate through the confusing medical world. We all know all the administrative tasks vying for our time as nurses, with technical and managerial aspects of care sometimes taking priority over delivery of care. We also know that increased patient loads decreases the amount of time we can spend with each patient. Sometimes we get so caught up in all the "things" we have to do that we forget what one of our main jobs is.....to compassionately and empathetically care for the patient. But the patient is more than a name, a room number, a diagnosis..... The patient is a real person with feelings, concerns, and needs. We only get to see them while they are hurting. But we must remember, that this patient has a life outside of the hospital......or at least they did before they got to the hospital. For all we know, this may be their last stop before they die. Ours may be the last face that they see......our words the last that they hear. If you were the patient in room 37-H who had just been told that they only had a few weeks to live, how would you feel? What would you want from your nurse? How could she/he help ease the blow you had just been dealt? It is true she/he cannot change your diagnosis.....cannot take away the disease that is slowly taking your life. But she can help to ease some of your physical and mental discomforts.......by just being there......for you and you family. Being there to listen and answer questions. Being there to see if you would like for her/him to call your pastor or the hospital chaplain. Being there to hold your hand when others have gone home for the night. Sometimes we forget that bedside nursing involves being at the bedside for more than procedures, medications, assessments. Yes, all of these things are definitely important to the care of our patient. But we must also remember that it is at the bedside where we can let the true compassion of our profession shine through some of the darkest hours that our patients and their families face. Remember.........one day we will all experience those dark hours. Maybe it will only be a few days before the sun shines again for us and we are discharged home. Or maybe it will be for the final time that we will see the light shine on this side of death. When our time comes, let's hope that we are lucky enough to get the type of nurse we were to our patients. As we go through each day, let's try to imagine what we would think if we were in the patient's place. Let's be the nurse that we would want as a patient. To read more articles, such as Munchausen by Internet: The Lying Disease that Preys on the Heart, and When Nurses Cry, go to my allnurses blog: Body, Mind, and Soul
  20. Not Your Nurse

    Only in New York

    It was 3 AM on the first day of Summer in New York City, I was taking the subway home after working a grueling 12 hours in the emergency department. You must be wondering about the kind of people I run into on the train at that hour. Up until recently, it wasn't anyone I would consider particularly special. But that changed after I was nearly robbed for my phone and who else but "Scratchy" a familiar (homeless) patient, came to my rescue. I was playing Sudoku on my phone as I typically do during the commute. Scratchy was sitting on the opposite end of the empty train car carrying a tattered plastic bag and as usual, scratching his head. His name isnt really Scratchy of course, but thats the name we gave him in the ED after he became a regular admittee. Every time I saw him on the train I wondered if he recognized me from work, but figured he didn't. I was mid-game when suddenly a young man wriggled in as the train doors were shutting close. It was a Saturday so I figured he was coming from a club or something but in retrospect it was odd he chose to stand up with so many available seats. He turned his back looking at his reflection in the dark window. I only had a few more stops to go so I refocused on my game. At the next stop and at the brink of Sudoku victory, I felt my phone violently snatched from my hands, the young man had lunged at me and was trying to run off. I yelled "stop!" but couldn't move. He was darting for the exit when suddenly he dropped like a ton of bricks. His head was nearly pinched between the closing doors but all I could do was watch, I was physically frozen. "He's having a seizure put him on his side!" yelled Scratchy but I couldn't get up, my legs felt like wet noodles, my head was spinning. Finally Scratchy came rushing to the young man and carefully positioned him on his side, "Ain't you a nurse, why don't you help him?!" scolded Scratchy. I'm not sure if it was realizing that Scratchy could talk (he never said a coherent word before) or if him knowing medical procedure for seizures snapped me out of shock, but at some point I woke up and went into RN mode. I quickly placed my nursing bag at the base of the subway pole to protect the young man from bashing his head, "YES I am a Nurse...I was scared, he tried to rob me didnt you see!" I retorted glaring at Scratchy. "Anyway, how'd you know he was having a seizure?" He ignored me, eyes planted on the young man who was coming to a calm. During all this time the train was slowly elevating from underground. The whole ordeal probably lasted a couple of minutes but felt like a lifetime. As the train screeched upward I could see the silver moon glowing over the brick buildings, "only in New York" I muttered. Suddenly my phone rang with my husbands ringtone. I got on the floor searching but couldn't find it. I stood up frustrated to find Scratchy with his hand out, my phone in his palm. "By the way, my name is Jerome not Scratchy" he said "Your phone was under the boy". I felt my face flush as a wave of shame came over me. He did recognize me from the ED and he knew we called him Scratchy. I took my phone and explained everything to my husband who somehow was able to meet us on the platform with the authorities in just minutes. I assessed and then warned the young man before the police took him away. I also apologized to Jerome and thanked him for everything. We offered to get him food but he refused. We waited with him for the next train, when one finally arrived he got on, turned back to us and said "That boy, his name's Mark. He got epilepsy, like me. Met him once in the hospital you work at". The doors closed and the train pulled out of sight leaving my husband and I standing in humbled silence. On our way home I reflected on how callous my colleagues and I have become. The ED can be a really intense place. We try to have a sense of humor and although we don't mean any harm when we come up with these pet names, we must keep in mind that our patients are not pets. They are human beings in our care and they deserve respect. I don't take the train home anymore, I also haven't seen Jerome since then. As long as he's safe I'll consider that a good thing and pretend that he's off doing superhero things in the subway like saving lives and cell phones. As a matter of fact, I wouldn't be surprised if that tattered plastic bag he carries is actually where he keeps his cape.
  21. Today is Mother's Day. I celebrated this day with my mother who has taken care of me, loved me since she found out I was inside of her, and has taken years of emotional/mental abuse for me from her ex-husband, my father. I woke up and got my gift ready to present to her which she loved. Let down the car windows for her while she was in the shower so that this Florida weather wouldn't make it so hot when she got in. Cleaned up the house while she was gone to run errands. Just anything that I thought would make her day easier even though I normally do these things anyway. But there is one person I also have on my mind today, and that is my stepmother. At the beginning of the week, I was notified by my friend of several years in class that she was going to die any day. Even though I have known that she was going to die for about a year (around the time I stopped talking and seeing my deadbeat father), it still made me upset. She let me borrow her phone to send one single message of love and goodbye to her that my father may or may have not told her, and if he did, if she were still conscious (my mom told me that if she is this close to death then she might not even know what's going on at this point). I made the decision not to go and see her. I have never in my life been around a dying person before, and it made me very uncomfortable and I don't think I could have handled it. I also could not be around my father because he would have tried to make any little effort to try and get me back under his thumb, which my stepmother could not get out of due to her having to depend on him for financial reasons. I heard he already had a new girlfriend. He was awful to my stepmom and any other woman he has every been with, resulting in domestic violence even. I'm actually relieved that she can finally get away from him, even if it has to be in death. I just hope the other woman is smart enough to find out how he is real quick and run away. My stepmom had two daughters that never talked to her for reasons unknown to me. She would always be severely depressed about it, being moody, crying, not wanting to do anything with her life except plan her next drink (which is what caused the end of her). But she would always tell me how smart and pretty I was, and that she loved me. I was her daughter when the other two were absent. She would enjoy every minute with me when my dad wasn't around. We would go out and about, she would take me to meet her friend at the liquor store, introduce me to her co-workers at Walmart, we would go have lunch, and she would buy me dresses, etc. I was her whole world. And that is why I felt a tremendous amount of guilt for not going to see her in her final days. I hoped and prayed that she wasn't alone, and maybe, just maybe, her daughters went to visit her one last time. Then I thought about the nurse that would be caring for her. It made me see all nurses in a different light and I was so grateful that I knew someone was there for her and was taking care of her. Thank goodness for nurses. Thank you nurses for all that you do, and giving patients and their loved ones the relief of not having to do such daunting things in their worst of times and emotional state. I'm 17 now, and maybe one day I can have the strength to join you and help others with the same problems. I really hope that my stepmom understands why I didn't see her and knows that I love her and always will. Thank you. Happy Mother's Day.
  22. maxiaochen

    Air RN

    The food was tolerable; drinks were still free and the children were behaving. I was watching movies with periodically daydreaming about sitting in a first class seat... Suddenly, the movie stopped, replaced by an announcement: "all passengers, if you are a medical doctor, please let us know. We need help." I looked around, and hesitated. It was not a US company flight. The cabin was quiet. "maybe everything is ok now." I thought. Then, I heard the announcement again. I took a deep breath, explained to my husband and kids, and stood up like a hero going to a war. "I am a nurse and a nurse practitioner, can I help?" I introduced myself. After giving the crew my name and work place, I was led to front cabin washroom. A middle age man was moaning and curled up on the floor. He is the co-pilot. He started experiencing nausea, vomiting, diarrhea, and sever abdominal pain about 30 minutes ago. After obtaining necessary history and exam, I believe he suffered acute gastroenteritis likely from left over food he ate last night at home. A crew member communicated to the ground doctors about my assessment. He then asked me: "Do you think we have to land now? The closest airport was Anchorage, Alaska." "Alaska? I have to decide?" I felt my body was heating up, and my breath was deeper. I am on an airplane! Luckily, I quickly calmed dawn. I assessed the patient again and checked the first aid kits available. I was happy that they have decent supplies of equipments and medicines. I decided that he was stable enough to stay on. I was told I could give him iv gravol and iv fluid and repeat if needed. Before I could ask any questions, the ground doctor hung up. Gravol, what is that? I got my palm pilot out and found out it was Canadian brand name for dimenhydrinate. Talking about bring the resources with you! The crew members helped me getting the patient up to the small and dark cabin that the pilots use to rest. The ceiling is about 4 feet tall. It has two chairs and a roughly full size bed. Both sides and the foot of the bed are against the walls. The patient lay down with his feet in. I kneel on the floor and could barely see his face. He closed his eyes and moaned all the time. I've been teaching and working as a NP for the last few years. I haven't started an iv for a while. Despite my nervousness, the instability of the plane and patient's reluctant to keep the arm straight, I was able to insert the catheter easily under a flush light. It took me longer time to figure out how to get the inlet out and connect the tubing because they were not US brand supplies. Then I found there were no places that I could hang the iv bag! After being creative, handy and didn't have to break the air tight plane, I finally hung the bag on top of the ceiling by using rubber bands and gloves...I pushed the medicine. The patient felt a little better about 20 minutes after he got the medicine and the fluid. I felt exhausted. It was around 2 am Eastern standard time. We were still 4-5 hours away from landing. I gave him another dose of dimenhydrinate and total 1500 ml of normal saline. He was stable and somewhat comfortable through out the journey. I stayed with him all the time, held his hand, and talked to him. We landed in China on time. I talked to the local doctors in Chinese and told the patient where he would go and answered all his questions. By then, he was able to sit up, get dressed, shake hands with me and thank me. He told me that was the first time he saw my face. He said my soft voice and the hand held got him through. It doesn't matter that you and your patient shared different culture background and nationalities, your patient can feel your heart. I am proud to give my heart and share my skills and knowledge. The crew members treated me like a hero and gave me bottle of wine as a souvenir. It's just a little taste of first class. I shared my wine with my family and friends in China while I proudly shared my "heroic" experience with them. We always say: once a nurse, always a nurse, no matter where and when. I had done some nursing rescue in supermarket, subway. But I had never thought that my first international nursing experience would be like this. I had a chance testing my knowledge and skills. I am proud to be a nurse and nurse practitioner. When i came back to the us, i found the airline company rewarded me 10,000 flight miles. It feels nice that my work is acknowledged.
  23. cool_nurse

    Types of Relatives We Nurses Love

    The irony of the title describes something funny or annoying or whatever and true-to-life (not patient-centered though) encounters with relatives whom at their front we smile, but at their back we just want to put a label on their heads. In patients with such, we understand at our highest level of patience. But among the relatives, it just doesn't feel right. Though by being at their shoes, yes, it is very much reasonable to act with such. But hopefully, not beyond what we can't bear. Toxic Relative The first label is for the "Toxic Relative". There are these days when something isn't just right with our hospital duties wherein there are three NGT feedings, continuous blood transfusions, post-ICU trans-ins which we always dub as toxic. In line with this nerve-wracking duties are toxic relatives with endless requests wherein fact, they are already making us PDN's or private duty nurses. The other fact is that these relatives are just too lazy to perform their basic duties as a looker even by just feeding their loved ones. Some relatives would even question your capability of helping their relatives by judging your body frame since they are looking for bulkier personnel who are also busy. Paranoid Relative Next,the "Paranoid Relative" is someone who is overly reacting on their loved one's condition therefore us nurses requiring explaining this and that nuggets of facts routinely. Another example is that some relatives would also insist on such measures such as blood transfusions in their dengue-infested loved ones and we would always tell them that interventions are individualized. No two people with the same condition are alike. Physicians also experience the same upon their clinical rounds and the thing is, physicians are also annoyed by such. OFW or Imported Relative Another one is the "OFW or Imported Relative". He or she is someone who boasts of healthcare facilities and interventions abroad and compares it here in the Philippines. These are also relatives who do not believe in the capabilities of nurses and doctors here. We often hear them saying, "In the (insert first world country here), patients aren't intervened by such". And at the back of our minds, "Then let your relatives stay at St. Lukes or Asian Hospital if you want the vibes of international facilities." Frustrated Nurse / Doctor Relative Lastly,the "Frustrated Nurse/Doctor Relative" is someone who provides healthcare duties and responsibilities ahead without the consent of the nurse and the doctor. An example of this are parents with a child with soaring fever in which they are overdosing their child with antipyretics despite explaining to them the round-the-clock antipyretics given by the pediatricians. We can't just argue with them but just give them the best advice by not doing it again. For the peace and harmony of hospital duties, we nurses still do our best and wear our smile amid these situations. Though we don't let ourselves drift emotionally into such circumstances, we just welcome every relative with their questions, misconceptions and demands with the fullest of our capabilities. Besides, we are very much immune to them ten-fold. Have you encountered such? And so, which type?
  24. We all have bad days. I remember when I was new, bright eyed, bushy tailed, rampantly sarcastic (look, some things never change, alright?) and I used to look about and wonder why in the world it never seemed like the most awesome of the awesome never had a bad day, a hair out of place, a drop of sweat on their brow, or their teeth set so hard they were gritted down to nubs. I used to pray to be so unflappable. I used to dream of the time when I would be viewed through that blushing lens of being labeled the go-to, the machine, the reference, the "strong" nurse. And then one afternoon, I'm roosting in the lounge with a pack of saltines and a glass of ginger ale (be sure to take care of your stomachs, my friends. Ulcers are no laughing matter), and this new nurse marches up to me and steals one of my saltines. Okay, fair enough. That is one way to get my undivided attention. Yet before I can question what spurred this random theft of my stomach appeasing snack, there is gesturing, crumbs speckling through the air like confetti and the firm demand, "Tell me what makes you so special?!" christened on the end of a pointing index finger. The beauty of the OR? We let our eyes talk for us. And as I had a mouth full of saltine, I allowed for therapeutic silence and some good old fashioned eye contact. She nibbled her cracker with a defeated sigh. "Nothing seems to faze you. You...you're just awesome." So let me tell you what I told her: No, I'm not awesome. I just do what I do the same way every day. I still have a lot to learn. And yes, a lot fazes me. The rest? What you see? Well that's just acting. I pretend, therefore I am. It is in this spirit of leveling, of "dipping my hand" so to speak, that I will now tell you about my day of epicness so astounding, so thrilling, so riddled with KaBAM power, that you may have to avert your eyes or at the very least wear sunglasses: My day began as any other, sans hair conditioner. Now, to some this doesn't sound like a big deal, but with my hair which hangs down to my rump, no conditioner generally equals doing battle with the equivalent of a premenstrual yeti suffering from a septic hang nail and a case of mange. Hair finally subdued, dressed, etc etc, I attempt to leave only to lock my keys....all of my keys... securely in my house. Thank goodness this time I was actually dressed when it happened so I could go to my neighbor and fetch my emergency key. Key fiasco squared away, off to work I go. Now at work, in fact, I'm still at work (yay for call), my journey (which the bards shall sing of for ages to come) continued thusly: Coffee maker remains broken. I remain sad. Surgeons having screaming matches with anesthesia in the hall for reasons equaling something along the lines of: He won't give me my Slinky! A frisky patient attempted to goose my ta-ta A kidlet, who was supposedly NPO, spewing My favorite trauma shears snapped in half while cutting through a patient's pants and, of course, the surgeon looks at me like I'm some nit-wit that had nothing better to do than set him up with a sure to implode pair of scissors. Later in that same case, while flipping the foley up in order to shift the patient over to the inpatient bed, the foley bag exploded, yes, that's right, exploded. You guessed it: demise of lower region undergarment and change of scrubs #2. By the way, if any of you are interested, the mesh pants commonly given to patients as dressing or in L&D are actually quite comfortable. Make a note of it. Moving along. Blah blah blah, a case and a half later, I'm in the middle of a lap chole turned open, when I'm scuttling across the room, trip over the kick bucket (how in the world do you miss a bucket?! A bucket that you put there?!), and catch myself from falling by deploying my forehead against the wall as a make shift kick stand. Dragging my wounded pride with me, I managed to get everything for the field and things seem settled until I'm answering the surgeon's pager and he's giving me the eye. I'm annoyed and in no mood so after a hissed, "What!?" He gives a little jabbing motion with his chin and answers, "How are you liking the breeze?" The scrub tech is snickering, anesthesia is about a split second away from aspirating his mask and I am dumbfounded. My friends, apparently under the strain of fighting gravity, my pants had exploded. I'm not talking ripped a little or split a seam or even became threadbare. I'm talking shredded like a pair curtains shut in with eighteen cats on a catnip bender. How in the world I didn't feel anything...I will never know. But thank heaven for mesh pants. And so here I sit, nibbling saltines and nursing a ginger ale and wanting you all to know: We all have days where we doubt, where we question, where we wonder why in the world do I do what I do. We all have bad days. But in the end we have to hang on, learn what we can, hike up our mesh pants, move forward and keep in mind that, if nothing else, it makes for an interesting story. Keep the faith, ~~CP~~
  25. morecoffeepls

    On Becoming a Nurse

    I was a banker when I met my wife. Before that, among other things, a silver-tongued used car salesman. A lifetime ago, I was in the Human Services field, helping people with special needs and struggling to pay my bills. I've had several careers and a myriad of jobs. When my wife's family persuaded me to manage their successful restaurant with an imminent ownership carrot, I felt my future was secured; however, when my wife became pregnant with our first son, working twelve hours a day seven days a week wasn't an option any longer. So we sold the business and I started nursing school. There was a nursing shortage at the time, and I wanted to have a career where I felt like I was helping people beyond satisfying their consumer needs. That was about seven years ago and my wife is now fairly pregnant with our fourth son. Presently, I am a psychiatric nurse. I love my job, and am able to pay my bills. I am content. I look at my three boys and my expanding wife and am grateful for the choices and paths that led me to them and to where we are today. Then I realize that my oldest son is going to be nine years old soon, and I remember one of the more obscure or profound reasons why I became a nurse. The memory is a little ambiguous, and the twinge of nostalgia is bittersweet. I was severely asthmatic as a child. It began and quickly developed when I was nine. I couldn't say if it was allergies, genetics, my somatic response to a burgeoning understanding of the world, or any other dumb guess, but my autoimmune system hijacked an otherwise pretty idyllic childhood. I became a regular at the local hospital emergency room and at the nurse's office when I actually attended school. I remember the anxiety when my restricted airways failed to respond to a rescue inhaler. I remember the kidney-shaped bowl my mother would hold for me as I vomited phlegm in-between racking coughs; the look on her face. Or when the Albuterol and Salmeterol nebulizer treatments didn't touch me and they'd have to inject me with adrenaline. I recall an attack that required a series of more of these shots than usual, and being laughed at by the doctor when I asked if I could go run around the parking lot for a while. One time on vacation I had a bad attack and didn't want to go to an unfamiliar hospital, so I tried to be stoic as I sat rigidly on the edge of that hotel room bed feigning indifference and the ability to breathe. By the time I got to the hospital, one of my lungs had partially collapsed. I was admitted to the PICU for a week of observation when the frequency and severity of attacks became excessive. This was an entirely different world from the ER. I was excited when I saw they had video games, and then embarrassed and disappointed when I asked if I could play and was told that they were just a different type of vital signs monitor than I was used to. In my defense, they did resemble Donkey Kong. That week felt interminable. I realize now how brief a period of time those seven days were. In the room next to me, separated by a glass partition, was a boy who had been in the local news for a while. I still remember his name - David Yarmush. He had been hit by a car and was in a coma and on life support. We were the same age. I believe staring at him all day and night and the people who came to visit him changed and shaped my perspective. Boys like us get hurt, we get sick; sometimes badly enough to die. I was frightened and melancholy; sinking into myself. The kindness of strangers kept me afloat. I want to say I remember each nurse from each shift distinctly; their names, their scents, their individual voices or laughter. I can't, though. As human and warm as they were then, they have become a set of ideals to me now, a paradigm. One name I remember is Sarah, "with an a-i-t-c-h". One nurse was so achingly beautiful and smelled so unbearably pleasant that I blame her for an early onset of puberty. An older nurse with an accent softly hummed the same song incessantly, like some chronic disorder ('La Vie en Rose'). I do recall that each nurse I encountered was an authentic presence. They genuinely wanted to be there; to see to my needs and that I was not embarrassed by them; to help me and to listen; to comfort me; and, ultimately, to teach me compassion. However, it was watching them take care of the boy next to me that made me fall in love them. They were as genuine with this tragic, unresponsive victim of circumstance as they were with the scared, overly polite boy who watched him incessantly and imagined the life of the mind within that broken body. I wondered a few months later, after the news of his death had been broadcast, if he had been able to appreciate the kindness of these women. In the romanticized version, the summation of David's internal responses to these nurses - to the scent of an intensely adult woman's hair as she reaches over you to "unkink" an IV tube, the sharp staccato laughter of the chubby little night nurse, to being awoken by the benign touch of a foreign woman's cool hand against your cheek and forehead, and so on - was the same as mine: profound gratitude. In that version, Edith Piaf echoed over the verdant landscape of his deep sleep. I still prefer this naive, apocryphal version of an unfortunate boy's last days over any rational, neurobiological understanding. I allow myself to idealize my role as a nurse because of that experience. Those exceptional women taught me the virtue of kindness. I am able to channel them, to try to be a Good Samaritan with each clinical encounter. This is why I am a nurse: I am afforded the opportunity to give comfort to strangers. In dreams, I have been assigned as a nurse to those two little boys. I am kind to them, I ease their suffering, and they break my heart and change me into something better than I am. In dreams, I am David, on the other side of that glass partition, alone and dying inside a ravaged body, and I feel a gentle hand touch my skin, I smell something clean and mildly intoxicating, I hear distant music or laughter resonate; then I slowly rise from the bed and walk out of the room, away from what I know, and with alarming suddenness, I burst out laughing and start running.