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  1. What I learned in nursing school is how to set up an IV fluid set, what to do when a patient is exhibiting signs of septic shock, the most intricate details of hundreds of medications, how to give different types of intramuscular injections, and how to titrate oxygen. I learned the best nursing practice measures to prevent infection, how to change a central line dressing, how research drives evidence-based practice, how to complete a head-to-toe physical assessment, how to calculate weight based dosages for pediatric patients, etc. The list goes on and on... But what I really learned in nursing school is how to balance 20 hours of clinical a week with my other classes and a part-time job. I learned how to prepare myself for walking through the hospital doors where I will take care of patients and their families on what may be the worst day of their lives. I learned that listening with open ears can speak more volumes than words and sometimes that is really what my patients need. I learned that my patients want to have a voice, be heard, and be understood. I learned the importance of validation and encouragement. I learned that nursing is extremely difficult but rewarding. I learned how to speak up and advocate for my patients because if I don't, then who will? What I really learned in nursing school is that sometimes what seems like "no big deal" to me can make all the difference. During my medical-surgical rotation, I was taking care of an oncology patient who was receiving chemotherapy and a complicated concoction of medications. After I had completed his physical assessment that morning, I asked if I could get him anything. He told me his bed was making him feel itchy and uncomfortable. Although I figured the itchiness was related to his dry skin from the chemotherapy, I had a few minutes to spare so I ran down to the basement of the hospital to grab special, hypoallergenic sheets for him. While my patient was walking around the unit, I went into his room and did my best to make his bed with the new sheets as perfectly as I possibly could. When he returned to his room and saw his bed all made up for him he got teary-eyed and hugged me. The next day, he told me that he was actually able to sleep for the first time in weeks. Even though this happened two years ago, I remember it because it was the day I learned the true meaning of the saying, "it's the little things." What I really learned in nursing school is that to some, I may be "just a nurse" but to the little toddler who squeezes my hand during scary procedures, I'm a superhero and to the beautiful, elegant lady who spent hours sharing her life stories and wisdom with me while on hospice, I'm an angel. I learned that nursing is extremely challenging but rewarding. I learned that I do not need the significance of my choice of profession to be validated by my peers or by my parents. I learned how to calmly and respectfully answer the question, "You're really smart. Why aren't you becoming a doctor?" I learned that what I'm doing is important and that I have the privilege to make a difference in people's lives every single day. I learned that nursing is science, nursing is art, and nursing is love. What I really learned in nursing school is that I have so much more to learn and although this career I have chosen will never be easy, it will be so, so worth it.
  2. Carol Ebert

    Cultivating Winter Stillness

    I have a chronic condition that has plagued me for about 2 years called Tracheal Stenosis (Idiopathic Subglottic Stenosis). Upon seeing an ENT specialist after experiencing shortness of breath when I tried to make speeches, wheezing, and having difficulty expelling mucus from my lungs, the diagnosis was obtained using a scope into the trachea. I got to see my beautiful insides, but the entry to the trachea had a narrowed opening which was causing my symptoms. And what is it caused by? Who knows. And only white women have this, and not very many I might add. Leave it to me to be a public speaker who now can’t speak publicly! Well, the good news is it can be resolved (temporarily) through a surgical procedure that makes small snips in the opening and then the opening is stretched, and I’m good as new. However, it seems to be a repeat procedure approximately every year. And here I am right now scheduled for surgery (for the 4th time) in the next 3 weeks. Yes I am frustrated because it can’t be cured no matter how healthy I am - and I am Nurse Wellness and have been a role model for wellness for over 40 years. All those wellness strategies I live my life by still couldn’t prevent this. And, so I will survive and do what I need to do to keep on my path as a wellness educator. So how does this tie into STILLNESS? I find that all I can do right now is go into stillness and the fact that it coincides with the Winter Solstice seems to be no accident. I have found that late December through January are cocooning times for my business and for life in the countryside of Minnesota – where we are usually snowbound - which lends itself to being still. Looks like the universe is giving me a reason to be still since I generally have difficulty cultivating that trait. Just to further make that point, a good friend gave me an “Energizer Bunny” stuffed animal for Christmas because that is my M.O. as I am always on the go with teaching. Now let’s go a bit deeper to better understand what surrounds the Winter Solstice. December 21 is the shortest day and longest night of the year. The winter solstice is a time of quiet energy, where you get the opportunity to look within yourself and focus on what you want and need. It's a time to set goals and intentions for the coming year, to examine and let go of our past, and to make changes within ourselves. The solstice is essentially tied to a personal awakening. What Does The Winter Solstice Mean Spiritually? It's Celebrated In Tons Of Religions And Cultures. Nature remembers what we humans have forgotten every cycle must return to stillness, silence, the dark; every out-breath requires an in-breath; every outer endeavor turns back inward to its origins, its center, and begins again; from death comes new life, and from the darkest night, the new dawn is born. A Winter Solstice Mystery: Beauty In the Belly of the Dark Great words of wisdom. But how can we apply the teachings of the Winter Solstice and capitalize on the stillness of this part of the year? Here are some strategies to consider. Solstice is an opportunity to look within yourself and focus on what you want and need Practice “doing nothing” by meditating, visualizing or just sitting in silence with your eyes closed. Just do this for very short periods of time at first to get used to being still and then extend the time. Focus on what you want to have happen this upcoming year that will be fulfilling and pleasurable. Solstice is a time to set goals and intentions for the coming year Once you decide what you want to have happen, write it down as a goal. By December 31, 2020, I will have accomplished: The steps I need to accomplish this goal are: The dates for accomplishment of each step are: Solstice is a time to examine and let go of our past Write down on paper all the past beliefs that have stood in your way from having all you were meant to have in life. Crumple up the paper into a ball and burn it. Thank the burning ball for all the lessons you have learned from those roadblocks Feel the sense of release as they disappear into ashes Solstice is a time to start making changes within ourselves Commit to one personal change you want to make during the new year Determine how you will monitor your personal progress (Journaling, marking on your calendar daily or weekly, chose the method that works for you) Solstice is essentially tied to a personal awakening and the above steps fit right into what most of us already do as we embark on a new year. We set intentions and goals and just forge ahead. This time, however, consider incorporating the STILLNESS factor into your daily life as a way to monitor your progress and keep yourself on track. And this is the perfect reminder for me as well. Once I am post-op I could jump right back in the fast lane with my voice intact and not slow down until next year when it will predictably slow me down to stillness once more. Or I can take time out for stillness along the way to monitor and appreciate my personal growth in an ongoing way. Now, how about you? How can you incorporate stillness in your day – week – month – year?
  3. allnurses

    I Should Be in Jail

    This article was written by a member of allnurses. Due to the delicate and emotionally charged nature of the article as well as details, the member wanted the topic posted anonymously. If other readers have articles they would like published anonymously, please contact me by private message. Let's start out with my first encounter with a parent. I was a paramedic (a newbie..a rookie..an innocent.,,) called to a home of a 4 month old that rolled off of a couch. The baby is seizing and the father is talking about how he was making the baby a bottle. He was alone with the kid and the mom was at work. He claimed to put the baby on the couch and the baby rolled off the couch. A short couch...onto carpet. The story didn't add up. The baby seized the entire 30 minutes it took us to get to the nearest hospital, and then later died from massive head trauma. Shaken baby syndrome. That was some fall. This was my induction into real life. I was out of my protective cocoon and my rose colored glasses cracked in the truth of real life. I have scraped children off of the highway who were unrestrained; I have whisked children out of homes that were besieged with fighting under the protection of cops; and I have taken children to the ED scared to be touched by anyone. The pressure of being a paramedic became too much, so I chose a new profession...pediatric nursing! (insert snarkiness here). I was working in the ED when a mom brought in her 13 year old. Both were afraid and the mom said the dad would be there soon. Mom did not have custody, and the dad was not happy the kid was in the ED. Dad, I am sure after meeting him, is in a gang. The cops were brought in, the mom asked to leave, the dad was cursing up a storm and I confronted him. "We will absolutely not tolerate that type of behavior in the hospital, in a CHILDREN'S HOSPITAL. If you don't sit down and be quiet, you will be escorted out." Nicer than a punch, and I kept my job. I myself was escorted by security to my car after work....fearing what may await me. A 15 year old on life support who OD'd to see if her mom loved her. She did not want to die, she wrote me in a note when she was intubated, she just wanted to see if her mom cared. The child took a turn for the worst with multi-system organ failure. As we strived to make her comfortable and keep her body in a hypothermic state, the mom was mad at ME because the room was too cold. She tried to fire me from being her daughters nurse. This after she so nonchalantly said, "pull the plug". I stayed at the bedside and held her hand as she passed away, mom went to go eat. A 13 year old dying from HIV/AIDS. The dad wanting to be at her side, the step-mom wanting to go do stuff. The dad confided in me once, when he was irritated with his wife, that his daughter was never treated fairly by his wife. He wanted to bring his daughter home to hospice and wanted to redo her room - a makeover - just how she would have loved it. The wife would not hear of it, since the girl was 'gonna die anyway'. And she did, in the hospital room with nursing staff at her side. The mother of an 18 month old who was beaten by the mom's boyfriend. The grandmother had unofficial custody since the day the child was born. She had unofficial custody of 3 of the children because the mom was always partying and never had time for the kids. When the family decided to remove the child from life support after the baby was declared to have brain death, the mother banned the grandmother from the room. That was the only time I did not let a parent help me bathe a patient after the patient died....and I gave them a time limit for grieving as well. The fact that the mother was holding her dead child and talking about going to Chili's and a movie later in the day sort of made up my mind, along with her acting like this was a party and yelling at her brother to "go get me a coke, hey, my baby just died and you need to be nice to me", and "hey, you know that ************ was going to go get a new car today?" Absolutely no feeling at all about the loss of a child, but enough bitterness in her to block the one true person who cared for the baby from being at his side. The four year old who was NPO for surgery. As usual, the patient did not go to OR before lunch and she became fussy and..hungry...I walked past her room to hear her father yell at her to "Shut up!" as she was crying. I went in right away and she was reaching for his lunch. His McDonald's fries and burger he was munching down on. I absolutely kicked him out of the room (sans roundhouse kick to the face). I know that people deal with grief in unusual ways. I have seen grief, I have seen the absolute absence of grief, and I have seen those who pretend to have grief. For me, the people who have not one ounce of compassion for the child who most needs their love are the ones who I cannot and will not ever understand. I know that people don't think beyond their own needs, even when a child is crying and does not understand what is happening. But it doesn't mean I agree with it, or have to like it. As a nurse, the hardest part of my job is to not say and do what I really think and feel. Or I would have been in jail a LONG time ago. What have you seen that makes you want to commit an assault? I-Should-Be-in-Jail.pdf
  4. Ashley Hay, BSN, RN

    A Nurse's Sacrifice

    Nurses are usually first to diminish their own contributions and quickly dismiss any outside accolades from those not in the business of healthcare. "Isn't it hard? Nurses are angels. My father had wonderful nurses when he died. I can't imagine how you do it every day." Comments like this bring the focus to us as individuals, making us inherently aware and uncomfortable with reality of the heavy weight our daily role carries. It is usually met with a brisk hand flail and quickened breath - attempting to get onto any other topic. "Oh, thanks. I love my job, it can be hard some days but it's just something you do". This doesn't even come close to representing the struggles nurses endure every single shift. Our humble nature prevents us from accepting any adoration for our professional work and honestly, it's probably because that would cause us to reflect inward on what our work really costs us on a personal level. I have been a registered nurse in oncology, both pediatric & adult, for over 10 years. Yes, I really love what I do. Really. It was only recently, after taking a class on incivility, I realized the true magnitude of personal sacrifices I had made for my beloved profession. Let's start with night shift, shall we? We all know working night shift in any profession can have damaging physical effects; turning your internal clock upside down, shaking it loose for parts and dumping out all of your circadian rhythms along with it. What most nurses don't talk about is things like not being able to have dinner with their families, not being able to sleep next to their spouse, having little patience and nothing left over to give when we finally do come home. Like many, I was told I had to "pay my dues" and work the night shift. So I did - for three years. I remember crying in the staff bathroom at around 12:10 am on New Year's Eve. All of the voicemails from friends and family who were out celebrating made my heart heavy. I needed to collect myself quickly - the call bell rang for me. I saw my elderly patient, alone - a widower, with colorectal cancer, post bowel resection. I focused on the task at hand and shoved my own feelings down as deep as they would go. Moments like these are exactly what we need to start looking at - why do we not allow ourselves to feel badly about missing out on important life events? Most of us couldn't even begin to count all of the weekends, nights, and holidays worked. Most of us don't even really think of it. But, you probably remember the last important thing you had to miss - a child's practice, a friend's birthday, a spouse's corporate event - and it does weigh on us. I even let my schedule dictate where my career would bring me. Going back to school? Need a day shift. Want more time to travel? Need 12 hours. Want get to know your family again? Outpatient clinic, work less holidays. I've seen nurses adjust their own insulin pumps because they don't have time to eat properly while working. I've known nurses who have gotten kidney stones because they don't have time to hydrate, never mind urinate. I have been unable to take my own medication on time during busy shifts. I've gone full shifts without a break. We have all felt utterly exhausted, seriously hypoglycemic and totally emotionally drained - sometimes multiple times per week. This profession is incredibly rewarding but do we know when to draw the line? Would we ever know when to tap out? I'm not so sure. Nurses are bred tough, maybe too tough for our own good. With all this in mind, let us take a moment to fully acknowledge the sacrifices we have made and continue to make every day. Remember to be kind to your fellow nurse. We absolutely must take care of each other. Please, take a mental health day when needed. Your family and your patients will all be happier! Be proud of all you do. It's certainly not an easy job - some days may be totally thankless and bring on tears of frustration or self doubt. But, receiving that tearful 'thank you' from a deeply grateful patient, parent, or spouse can make it all worthwhile. I guess I'm still a sucker for this gig after all.
  5. Lindsey McGraw

    Quest For Girls

    a great opportunity for an internship to become an OR nurse had been offered to me, but after this diagnosis, everything was put on hold. A disease that affects 1 in 8 with today's statistics, is a very scary thing. This article is to "lighten the subject" with my story of my quest for new "girls" after surviving 17 years. Since I have the tenacity of longshore men and a sense of humor, there was no doubt like every other challenge in my life I would turn it into an adventure. Deep down inside I was always shy, putting on a good front for all to see, but an internal emptiness prevailed. Life brings us messages in many forms ie; dreams, visions, or in my case a new good friend Jackie... a pretty blonde with big blue eyes and a nice smile. Sharing with her my dilemma of never having had reconstruction all these years, which was why on occasion I was so shy around the opposite sex, she gladly shared with me that her "girls" were bought and paid for. An added factor that I had lost a husband who could not cope with the situation, so this made it doubly hard to trust anyone of the male gender, let alone date. Almost instantaneously it dawned on me that man-made saline implants were definitely an option for me to make me whole once again. A little slogan ran through my mind "What Mother Nature did not give you saline can fix you." My situation was not a case of just wanting to be enhanced, but one of being whole again, and it a big problem purchasing clothing anymore. With the new sexy looks, "girls" abound. With a limited wardrobe of big shirts, sweatshirts, and tank tops with a shirt to cover my vacant right side, I was anything but fashionable. Determined to not share my secret with anyone yet, I discreetly set up my first appointment which allowed me to stay in my safety zone. Only after I had made a phone call and set up my consultation appointment with a local plastic surgeon, did I tell my best friend? She was shocked, speechless at first, but agreed to accompany me for moral support. The day of my appointment arrived, and LaVern and I drove to the next town where the clinic was located. Sitting in the parking lot of the office building, she made me promise to behave, and not embarrass any of the staff members with my off-handed comments known to come out of my mouth with little notice. Again this was a facade to hide my underlying feelings of insecurity. Once inside the clinic, I patiently waited for my name to be called, and became very nervous with anticipation of what the surgeon would tell me about my options, since I had a grueling surgery back in 1991 of a modified radical mastectomy leaving my arm swollen, (suffering from periodic lymphedema) and whole right side deformed. Even with the subtle floral pictures on the wall, my anxious feelings were not at all relieved. A soft knock on the door, and in walked a young, dark-haired, handsome doctor with kind eyes. He must have sensed my apprehension because was quick to try to put me at ease with some idle chit-chat about careers etc. After he examined me I was delighted when he told me that I was a candidate for an implant, skin expander, that each week a small amount of saline would be added until I reached the desired size to match my remaining girl and to make me whole again. Walking out to the desk after my appointment, he approached me at the desk, placed his arm around me, stated: "it will be just fine." No doubt I was very visibly shaken by this experience and exhilarated at the same time. As I left that day, a flood of varying emotions came over me. Instantly when I reached my truck, a flurry of phone calls was made to some of my other best friends with an update that I was indeed having this reconstruction surgery to make me whole again in while at the same time having episodes of laughter, and crying. A whirlwind of activity followed that day with a scheduled surgery date in the next ten days. I managed to do all of the pre-op requirements, and a final appointment with my doctor to answer any further questions my date was set. Showing up at the hospital for my surgery, I had no idea how scared, apprehensive, and mixed my emotions would be. Everything went well, with being able to return home in a matter of a few hours for my recuperation time of two weeks. In a matter of days I began to feel wonderful, exhilarated, and when looking in the mirror seeing a little " perky girl" where a gaping cavern had been for years gave me a real sense of "Whoo Hoo!" A wonderful and exhilarating feeling that is very hard to describe or put into words. Each week I return to my surgeon to have my implant/skin expander enlarged with a shot of saline to slowly match my good side. Looking in the mirror I have to laugh, because now I have the saggy, perky puppet show going on...because my new implant is high/tight, and of course gravity has set in on my other side. When I have my final phase everything will match up giving me a nice look. My first shopping trip to buy new clothes and the Maidenform store to purchase new bra's found me almost in a state of panic, because no longer am I limited.....bring on the cleavage, world. This story of my personal experience in no way should influence how a woman chooses to handle her own situation of having reconstruction or opting to not have this procedure done. Personally, I will forever remain empathetic for anyone who is suffering from, fighting with, or that has conquered this dreadful disease. It is a woman's own mindset, and an example of how one woman handled her mastectomy issue was to go out and buy a Harley motorcycle, driving off into the sunset. Ladies it is never too late to experience all life can bring you at any age. So, follow your heart and dreams, living life to the fullest. With a time frame of approximately six weeks, I patiently await my final surgery where I will receive my new "perky, pretty girls" with a totally new outlook on life.
  6. canesdukegirl

    Silver Lining

    I stare at the four LED panels in front of me, each displaying cases for every OR, listed by room. I groan inwardly, bracing myself for a busy day. "Canes, you ready?" asks the Medical Director. Every morning, the Medical Director and the Anesthesia Coordinator and I meet to discuss add on cases, and the movement of scheduled cases to ensure the completion of the day's schedule. We collaborate on which cases to move, which order add on cases should go, and discuss any unusual circumstances, such as time constraints for surgeons, specialty staff availability for difficult cases, and special requests. Today is conference day, which means that surgical staff and anesthesia staff meet for the first hour of the morning prior to starting cases. Because I am the charge nurse, I can't attend the surgical staff meeting. Someone has to man the ship, right? "Ok then, Canes. I'm off to conference. Page me if you need anything," the anesthesia coordinator sings over her shoulder as her wooden clogs click on the tile floor. I glance up to acknowledge her, but only see the tail of her white coat as she throws it around her shoulders like a cape. Ahhh...a few minutes of peace. I can get so much done now! No sooner had I turned my back to the glaring LED panels than a resident appears out of nowhere, tugging on the sleeve of my lab coat. "How's your day going?" she asks, traces of a smile dancing on her lips. She blinks rapidly and raises her eyebrows. "Depends on what you are holding in your hand," I reply. There is no smile dancing on my lips. She sighs. "Sorry to be the bearer of bad news, but I have a 65 year old woman in the ED with an incarcerated hernia. We need to get her to the OR now." I glance at the LED panel and search for the trauma room. Several cases had already been posted. Her gaze follows mine, and she reads the board with me. As if she could hear my thoughts, she turned to me and said, "It can't wait. We have to go right now. We will bump ourselves." "Of course," I reply. "I'll page Dr. Thomas and let her know that we need to open the room right now." "Thanks, Canes," she said. "I'll go ahead and bring her to the holding area, ok?" "Yep, that's fine," I reply. Running my finger down the list of staff for each room, I found the staff assigned to that room. Today, conferences were broken up by committee teams, and I didn't know which committee the staff members were on. I paged each manager, asking if Nurse X and Nurse Y were on their committee, because I needed them to start an emergency case. "Hey Canes. Nope, Nurse X isn't on my committee." "Canes, I don't have Nurse Y with me." "An emergency already? Sorry, Canes. Nurse X isn't here." My anxiety started to mount. My options were becoming more and more scant. When the phone rang, I jerked the receiver up. "Canes, I have Nurse X with me. But she's in a meeting," the manager says. "Yes, I know that. An emergency case was just posted, and I need her to start the case," I said. "But she's in a MEETING. She's the recorder for the meeting. Can't you find someone else?" I am incredulous with this response. "Last time I checked, patient care trumped committee meetings," I reply, with barely contained sarcas Nurse X checks in with me, and I fill her in on the details of the case. She is a trauma fiend, and loves the fast paced environment of a good trauma case. "Did you find Nurse Y?" she asks. "I still can't locate her," I said. I paged Nurse Y's manager again. Ten minutes later, the manager calls me. "We're in a meeting, Canes. What's up?" she said with a clipped tone. "I have an emergency case, and I need Nurse Y. Nurse X is already preparing the room," I said. "Oh. Nurse Y isn't scheduled to work today," she said in a matter-of-fact way. "But you listed her in the trauma room," I said. "My mistake. Sorry about that," she said, and hung up. "Canes, our patient is in holding. Can we roll back now?" the resident asks me. "Not quite yet. I'm still looking for another staff member," I said. Luckily, one of the committee meetings broke early, and staff were milling around the desk looking for their assignments. "What's with the frown?" one of the staff asks me. I explain my dilemma, and bless her soul; she volunteers to start the case. One fire put out. As the morning progresses, I find that I am without a secretary. The phones are ringing off the hook. I page my manager. "You rang?" she said. "Did you give our secretary the day off?" I asked. "Oh, yeah. I meant to tell you that. She had to attend her son's graduation this morning," she said. "Did you have a replacement for her?" I asked, my voice reedy. "Well, originally I had planned to come to the desk to answer phones for you, but I forgot that I have back to back meetings and won't be available until two. Do you need help?" Softly, I close my eyes. What was I supposed to say? That she couldn't attend her meetings because she had to play secretary for me? "It's ok. I can get through it," I said, eyes still closed. The next few hours felt like a war zone. As I was assigning lunch reliefs, I posted one emergency case after another, took care of students/observers/reps asking for scrubs, contacted surgeons for availability for cases that could be moved up due to cancellations, kept Dr. Thomas in the loop with every change, handled a registration problem, fixed a computer interface problem, contacted staff/sterile supply/managers to room changes, changed staff in 3 different rooms to ensure competent matches for cases, and guided med students to rooms...the phone would NOT stop ringing. A surgical attending was arguing with me about his case placement, and I couldn't get a word in edgewise. I let the phone continue to ring, adamant that I would get my point across to the surgeon. Looking down at the phone with his face creased into an angry frown, the surgeon said, "You gonna get that?" Seething, I picked up the phone. "OR, this is Canes." "Uh, somebody called me from this number." "I'm sorry, what did you say your name was?" I asked, trying to keep the irritation out of my voice. "Dean. Somebody called me from this number," he said again. "Hey, Dean. Are you a patient?" Somewhere in the cobwebs of my mind, the name 'Dean' stuck out. "Yeah. I was there last month. Somebody called me. I just hit *69. Who called me?" We have about 500 staff members in the surgical services department. Needless to say, I had no idea who called this patient. But he was a PATIENT. He deserved my undivided attention. "OK, Dean, let's you and I try to figure out who might have called you." The surgical attending slapped the counter in front of me in frustration. Two staff members were waiting to get their assignments. Three phone lines were ringing. The pre-op nurse was gesturing to me. An anesthesiologist was talking to me as if I wasn't on the phone. I spent twenty minutes on the phone with Dean, only to realize that he wasn't a surgical patient. He was a dialysis patient, and wanted to know when his next appointment was booked. I knew how frustrating it must have been for Dean to be transferred to one department after the next, and I wasn't going to transfer him again. I put him on hold as I contacted the dialysis unit, and got the information he wanted. As I relayed the information to Dean, his response caught me off guard. "Hey, thanks, lady. Ya' know, I think the call might have come from the transplant surgeon, Dr. A. He called me yesterday and said there might be a match for me, and that I should come to the ED. What do you think? Should I call him, or do you think I should go to the dialysis unit?" In spite of me, tears welled up in my eyes. I looked to my right and focused on the transplant information sheet tacked onto the corkboard. Sure enough, Dean's name and information were clearly written out. "Yes, Dean. I see that you are booked for a kidney transplant. Come on in to the ED. We'll see you in a couple of hours," I said. Gently, I replaced the receiver. I stepped away from the melee at the desk and gathered myself, encouraged that I would meet Dean personally, and help him through his life changing transplant surgery. I'm so glad I picked up the phone.
  7. remoteareanurse

    The best job in the world.

    Lets be honest here. Nurses love to whinge. And to be fair, we do have a lot to whinge about. Pay, for example. It took me four years of university to gain a nursing degree. In that same time I could have qualified in law, architecture or pharmacy, any of which would mean that I'd be on a pretty good income now, thirty years on. The hours. Finishing at 11pm, back at 7am. Night duty- oh god, don't get me started. And when the majority of the population is sitting down to Christmas lunch, or whooping it up at midnight on New Year, where are we likely to be? Interns. Year in, year out, that influx of baby doctors, many of whom actually believe that they know more than us about our patients. The ones who recognise us as a valuable resource are a delight, the others- a nightmare. Try educating someone who honestly believes that they have nothing to learn from you. New graduate nurses. Every year, teaching them that nursing really is very simple, and boils down to very basic principles. Treat your patients the way you'd like someone you love to be treated. Make them laugh- a happy patient who trusts you and believes you like them is REALLY easy to nurse. I could go on and on. Truly, if whinging were an Olympic sport, we'd all medal. But here's the secret all that whinging conceals. (I'll probably be drummed out of the profession for revealing this). I actually have the best job in the world. Seriously. At risk of my career, I'll tell you why. Every single day I meet and have in-depth interactions with extraordinary people. Folk I would never meet in my day-to-day life outside work. Elderly people who have lived amazing lives through incredibly interesting times. Kids who have faced more in their short lives than you or I ever will. Teenagers who introduce me to new music and all the latest fashions and expressions. Mothers who give me great recipes. Folk from every country, culture, level of society and job. Other nurses who have THE funniest stories, none of which we could ever tell non-nurses. And I meet my patients at a time in their lives when they have no interest in or energy for artifice or subterfuge. It's a bit hard to be worrying about your image, and others' opinion of you, when you're deathly ill, in pain, or frightened out of your wits. I meet them and get to know them in all the fullness of their characters and personalities. People who make me laugh to the point of incontinence, trust me with their darkest fears, or allow me the privilege of sharing their tears. Families, who sometimes appear rude or demanding, but are in reality just scared stiff and trying to cope with unbelievable stress. Who trust and accept me as a valued member of their special family team. But all that's just the icing. Here's the best bit. Every single day, absolutely without fail, at least one person looks me in the eye and says a heartfelt "thank you". Just for doing my job! And I get to go home knowing that I made a difference. That's gold. Try getting that working in a bank.
  8. Cynthiahowardrnphd

    Competition in Healthcare: Just a Nurse

    This question came up recently when my mother went in for open heart surgery, "Why not be a doctor? Are you happy just being a nurse?" In the course of my mother's surgery, we approached the doctors and nurses on the team with questions, alternatives and options. During this dialogue, one of the nurses asked the question I have heard many times during my career as a nurse, "why not become a doctor?" Last year the Association of American Medical Colleges announced that US medical schools were on track to increase enrollment by 30% between the years 2009 and 2017. Medical school notoriously super competitive would now be opening up more seats increasing the odds of getting in. For me, nursing was not a second choice to medical school; fear of not getting accepted or of doing the work did not keep me out of medical school. I chose nursing school and for 40 years, I continue to choose nursing as my profession despite having other options. This question allowed me to reflect again on my decision to be a nurse and the advantages of this decision. It also had me think about this competition within healthcare. Are we not all on the same team? It is true that physicians get the spotlight in any organization and in any breaking story about healthcare. Even in the current Ebola crisis, it was physicians and the work they do that was highlighted, until a nurse became the first person to contract the disease in the US. And then the first response by physicians was to blame the nurse for a "breach in protocol" that exposed her to the deadly virus. This is a scenario that most nurses have experienced at some point in their career. I remember working in an ICU and losing a patient after he bled out from his stomach, and as the doctor walked the family out of the unit, I overheard him say, "the nurse was not able to get the blood in fast enough..." I felt weak in the knees. I had been a nurse for about 3 years and loved my job and the challenges of blending the art and science of caring in an ICU. I, along with the team of healthcare professionals worked furiously to save this man. I had a blood bath to prove it and when the attending physician blamed nurses, I felt betrayed and confused. Weren't we all fighting for the same end - excellent patient outcomes? In this case, that meant life. This was my introduction to the blame game that does permeate healthcare. Does it have to be this way? I went to graduate school to better understand what was happening in this misguided competition between nurses and physicians. Competition in healthcare needs to be between the disease and the healthcare system not within its ranks. What is even more important is to learn from every experience. Part of the problem is that nurses and doctors do not really talk to each other. When was the last time a group of MD's and RN's sat down and talked about what it was like for each in their role within your institution? I know when I was at the bedside, in the ICU, I attempted to organize such a meeting and it was quickly squelched by Administration. The explanation was, "no time." I think it is fear. Fear of losing control? The mere presence of fear means control is already lost. Nursing by its nature puts the good of the whole in front of the individuals performing the duties. The spotlight for the nurse comes within the intimacy of the family unit when the effort and caring are acknowledged as making a difference in their lives. This is true for me and so many other nurses I have talked with. I love being a part of patient and families support system during difficult times of their life (or death). Physicians are tuned into the disease process while nurses tune into the patient's experience of the disease. The climate today where medication and pharmacology rules has physicians fighting disease rather than supporting health. I chose to support patients during their disease and or struggle with health along the continuum of life. It is the innate strength of the patient that ultimately supports healing. I like being for the process of healing as opposed to fighting the disease. And it is in finding balance that nursing excels. This is why I believe it is nurses that hold the key to improvements in the culture of healthcare and the end of competition. It is time to stand up, side by side with physicians as partners in the quest for health. It is time for nursing to shift the focus to health vs disease. Nursing is part of the healthcare team and yet quite capable of leading this transformation. This question that prompted this post, "Why be just a nurse?," is a question all nurses should reflect on and then proudly claim. What are your reasons for becoming (and staying) a nurse? The passion for making a difference, for being on the team and by the side of patients is a worthy calling and one that has changed the world of millions of patients.
  9. VivaLasViejas

    You Can't Go Home Again

    It was just an ancient nursing home, with Vander lifts parked in the too-narrow hallways and the hustle and bustle of staff members on their way to answer the constant shrieks of tab alarms. Located on top of what must be the biggest ant hill this side of the Rockies, it was utilitarian and built for efficiency, not looks, although the powers that be kept trying to improve it by installing hardwood floors and elegant lighting systems in the hallways. I tried telling them once that it was pretty much like putting a Ferrari engine in a Honda, but of course that suggestion fell on deaf ears. I'd worked at Shady Acres for almost three years, however, and as happy as I was with the job I have now, I still missed the camaraderie between the staff members, residents, and even management of this place. This was a facility where you would see the DNS working the floor, the resident care manager passing meds, the administrator running out to buy Popsicles for everyone on a 100-degree day, the dietary manager helping to pass trays in the dining room. In other words, the teamwork was the best I've seen anywhere, and I'd figured on staying there for the rest of my career. Alas, fate intervened in the form of a floor career-ending injury to my left knee which required surgery. At the same time, a new company had taken over, staff cuts had begun, and I noticed the fact that most of the available hours were going to younger, faster nurses. By the time I was finally laid off, my confidence was shot and I was faced with being unemployed in an economy that was not at all kind to the over-50 crowd. Still, I never blamed the facility for my misfortune. Management had been good to me up until the day they let me go, and my co-workers were the best ever......so I made the promise to visit as soon as I got settled in at a new job and update everyone on where I'd landed. In the meantime, we kept up through Facebook and bumped into one another in town on occasion, and for a long time it was enough. But the idea of visiting my old 'home away from home' stayed with me. Out of all the places I've worked in my career, Shady Acres was the one where I'd truly felt at home, and a part of me still yearned to be part of the team again despite my contentment with my current job. So why was I so hesitant to actually go there?? Last Wednesday, I found out. I figured there was no better time to do what I'd been promising my friends for months and months, and stopped in after a doctor's appointment. I'd lost weight, had my hair colored and styled, and was in high spirits thanks to a new medication that had kicked the last of my winter depression to the curb. I pulled into the employee parking lot and went in through the back door, just as I had in the old days; of course, I was spotted almost immediately, and it seemed as if the next hour was spent being hugged and squeezed. Yes, the gang had missed me. Several of them asked when I was coming back; others were curious about my "new" position (I've been there 2 1/2 years) and wanted to know what I did and where I was doing it. Almost to a person, they were complimentary about my appearance and demeanor, noting that they'd never seen me as happy as I seemed to be at that moment. Yet something was very, very different. The place, the people, the residents all looked pretty much the same as when I'd left them......it was I who had moved on. As much as I'd missed this old nursing home, as much as I'd wished I could work with this splendid team again, I didn't belong here any more. I hadn't known it then, but when those doors had shut behind me back in summer of 2010, they'd closed forever.....I was now firmly ensconced and comfortable in my nurse/administrator position, and even if I hadn't been, I was no longer part of Shady Acres. Of course, all these folks are my friends and will always be, and doubtless I'll stop in again for some chatter, a few hugs, a laugh or two. But as my parents' generation used to say, "you can't go home again"......and the place I once called my home away from home, wlll never be home to me again. And that's OK.
  10. Sabr

    To My Dear Fellow Nurses

    My nursing journey has been quite an interesting one; in a matter of 2 years post-graduation, I managed to work in a hospital, in a school, in home care and shortly I will be a travel nurse. How did I do it? Long story, but thanks be to God. What I will briefly share with you is how I came to love Home Care because of how much it blends with my personality and future endeavors as a nurse. From my little experience in Home Care, there is a greater level of flexibility and time to complete all nursing tasks efficiently. This is very different from the hospital setting where time management is key as the pressure is so high to complete all tasks within a limited time frame. Some days at the hospital were heaven; I dotted all my I's and crossed all my T's. Other days, I attempted to do the same and managed only to keep my patients medicated and alive. To all you new nurses out there who can't stand being in the hospital sometimes, I have been there. Sometimes you feel that nobody cares. Sometimes you feel no one has your back. Sometimes you feel your supervisors are of no help, sometimes you feel time is given to trivial things while the more significant aspects of care are not addressed. Sometimes you want to quit. And some of us do. But I am here to tell you, hang in there. It will be okay. Mariann Williamson once said "Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure. It is our light not our darkness that frightens us." This quotation could not be truer in our beautiful profession. In a profession where critical thinking is an essential survival skill, where young and old nurses work together, where some nurses are bullied, where each hospital has its own P & P, where we sometimes doubt how competent we are based on the judgments of others, where gossip is rampant, you have to know your fears and overcome them in order to be successful. As nurses, we fear imperfection because imperfection translates to poor patient outcomes if that imperfection causes the patient to be directly affected. But we mustn't fear to be perfectly imperfect. In most cases, we tend to ignore our gut feelings in order to prove ourselves in some way or follow what everyone else is doing. My advice is: refer back to the above citation and remember never to be afraid of your light. Your light will shine brightly only if you let it. Be honest and forthright but never darken your light! Always make the best choices for your patient regardless of what others say whether in home care or the hospital or any other setting. Never quit before exhausting all of your major resources and making your voice heard about what caused you to decide that place was not a fit for you. Leave on a good note. Always have something better lined up before transition into another position. Make the best choice of which nursing niche would fit your personality and your life. And love it. Our profession is not an easy one; no one ever said it was. And nothing in life is. But it can always be an empowering and enjoyable one. As a new grad who was stunned at the difference between clinical rotations and being an actual floor nurse, I went through a phase where I hated being a nurse and thought: "This is not what I signed up for!" In retrospect, however, that uncomfortable period in the hospital is what makes me the nurse I am today only two years into nursing. And I could not be more proud of myself and all the other nurses that are hanging in there despite the multitudinous challenges. Back to home care, I see myself working in home care for years to come even if it is per diem or part-time. It helps me be the nurse I always wanted to be- a nurse who successfully blends the art and science of caring and being fully present. I love my job, my life and myself. And I believe these qualities are what make me a great nurse. And consequently, I have gained the confidence and self-assurance needed to forge ahead and explore the smorgasbord of specialties in nursing. I have never been more excited in my life and I hope my enthusiasm is contagious because I want the same and better for you.
  11. CheesePotato

    A Hand in the Dark

    It was there. Just there. But I still could not reach. Humidity laden air choked with the smell of smoldering grass, prickled razor sharp from the relentless summer drought, dimly aware of the sounds of a woman sobbing some distance away, the dampened moans of a wounded man, the haunting stillness of a hurt woman, incessant chatter of others not injured but no action. Not enough action. Pain. Blood. Through a haze wondering if it would be wise to be worried but dismissing it in the same breath as each victim is analyzed, checked, dismissed, catalogued: dislocated open ankle fracture, mild head injury with good pupil and neuro checks, broken fingers, terrified tears. Grateful for the pair of gloves keeping residence in the glove compartment of my sedan, ever stable, ever the same, parked carefully on the side of the roaring expressway saturated with life teeming along with the same intensity as the stinging sweat pooling down my brow. Some try to help. Some stop. Most drive on, content with a glance, perhaps a stare, a phone call. The most disconcerting are the ones that pause a little too long, phones held a little too steady, memorializing the moment as a photo op, a "hey look what I saw on my way to work" brag to post on some blog, some chat site, some socialization network. They single handedly rob the moment of what it is. They have no right. None. Stop. Focus. Pick the splinter of windshield glass from its place nestled in my grimy forearm. Not quite sure how it got there. Perhaps when I was checking around the vehicle, or rather, what remained of it where it lie on its side, crumpled, a seemingly discarded giant child's plaything tumbled to rest on a berm. I know better than to get near the vehicle. Trained as an emergency responder back when I was still cutting teeth of adulthood, I know the rule of thumb: individual safety first. Secure the scene, then the victims. But there is magnetism. A draw. A pull. A whisper in the part of me, the same part of me that guided my car to the shoulder, that guided me out, that made me stop. The crunch of needle grass beneath denim clad knees, for once glad of the jeans in the heat, grateful for the protection from the debris. Vision obscured by toppled, crunched car seats, tattered remnants of interior, depressed metal, caved plastic, it's peering into a cave in the broad daylight, hoping to see the treasure in the far alcove. Praying to see nothing. Finding your worst nightmare. A hand. Just there. A hand. Intact. Pale. Unmoving. Calling for attention, for hands, for eyes and knowing the sharp wail from the now pacing woman is that of realization and recognition. One is missing. No one noticed in the chaos. A momentary reflection on life mimicking slight of hand or a street magician's shell game. Stop. Focus. Sliding forward on belly and chest, arm outstretched, oblivious, in hindsight, not thinking. Pulled by some tether, some gossamer thread older than any study of medicine, the raw feeling of humanity seeking to aid another of its own. Reaching. Aware every movement could spell disaster--could end in a loss of precious balance and topple several tons of suffocating metal, melting rubber and steaming plastic. Unable to stop. Unable to succeed. The whimpering of sirens turns to a wailing shriek. More people. More chatter. Pulled away but still reaching with blind determination. Protests are noted but dismissed. Vaguely hearing the words fire, drought, gas leak. Forced to move away. Forced to abandon. Forced to let a life fade to potentially save my own, forced to allow a last breath to be drawn in terror, alone, wrapped in demolished hell, heat, noise. Unable to reassure. Unable to be reassured that it was already too late. Praying it was quick, instant, painless. Abandoned. A hand. Just there. A hand I will never reach.
  12. ElizabethStoneRN

    The Gifts of Nursing

    It is better to give then to receive...those classic words of wisdom ring especially true for those who chose nursing as their profession. Many of the "gifts" of nursing, for me, have actually been moments in time, memories about patients and feelings about certain experiences with them which help remind me why I became a nurse. Others are related to the nursing profession in general- those perks that we all can appreciate. The following are some of the gifts from my career as a pediatric emergency nurse: 1) The adrenaline rush that comes from working with my peers to intervene quickly to help save a critically ill child; the thrill of succeeding. 2) The instant gratification that comes from seeing so many ill and injured children feel better within hours because children are SO resilient. 3) The satisfaction that comes from helping to collect evidence towards the prosecution of sexual offenders and child abusers- and from helping to remove the children from those situations. 4) The laughs that come from impromptu conversations with patients and their families- the happiness I feel from knowing that they feel comfortable enough to have these conversations with me. 5) Educating many parents about how to care for their ill or injured child at home and empowering them to do so. 6) Earning the trust of young children who have been injured and are brought in as pediatric traumas; the sense of accomplishment that comes from being able to reassure them by simply looking into their eyes, holding their hand, and speaking to them gently in terms that they understand. 7) Collaborating with other members of the healthcare team to support bedside presence during multiple codes and at the end of life; helping to advocate for this and facilitate it. Seeing the sense of closure that this brings to families. Helping to keep a young child alive until her mother could arrive to hold her during her last moments on earth. 9) Giving a newborn baby who was abandoned in a restaurant's bathroom his first bottle, and holding him for several hours after my shift was over. Witnessing the goodness of others who came in to pray for him. Seeing him again later that year with his new family, as a happy and healthy 6-month old. 10) The inspiration from witnessing the strength and love of a family who is losing their young child to cancer yet still is able to experience joy and humor together- learning through them that death is a part of life, even when it happens much too early. 11) The simple joy that comes from being able to hold babies and converse with young children on a regular basis. 12) The flexibility of my schedule- the fact that with every major phase of my working life- from young adulthood, to parenthood, I have had the opportunity to alter my work schedule to meet my family's needs because nursing is a 24/7 profession! 13) The endless options of the nursing profession...I can think of no other career which offers so many options, from clinical practice to research, writing, teaching and consulting. 14) The learning that never ends. There will never be a point at which I know everything there is to know as a nurse, and that's how I like it. I see something interesting and learn something new every week. 15) The sense of pride I feel from being part of a healthcare team which works together to do amazing things for our patients- from helping to heal them, to alleviating their suffering, to advocating for them so that they are safe at home. Being a small part of this is both an honor and a privilege. These gifts remind me that despite all of the giving that nurses do on a regular basis, what we receive in return is far greater. This, to me, is the greatest gift of nursing. Please share some of your gifts as well!
  13. fetch

    Running the Spring Marathon

    I used to work at a theme park, and the 2 weeks around spring break were unofficially known as "marathon" because we went from weekends only to daily operation. But since most of the high schoolers only have one week off, and a lot of summer people haven't been hired yet, everyone winds up working 60+ hour weeks. Pay period weeks ran from Monday through Sunday, with only one mandated day off per pay week, so it was common to work more than seven days in a row. The upshot of it all is that after marathon, everyone but a barebones staff gets two or three days off, and sleeping in for the first day is AMAZING. I haven't worked as a nurse in a hospital, so I don't know what the timing of the marathon shifts is like in that setting. But for my school district, now that we're back from spring break, it's clear that the end of April is our spring marathon. I've had more kids coming in each day, for an increasing variety of reasons. Within a two week time span, we have scheduled three field trips, a visit from the mobile dentist, an immunization clinic from the health department, and an open house. Spring allergies means that everything is coated yellow, and asthma kids who haven't had issues all year are showing up daily with wheezing. There's been a bunch of new students registered, more in the past 3 days after spring break than we had in all of March. We're looking ahead to the end of the year and cleaning up health folders, as well as putting together allergy and asthma packets for kids who are returning. New medications, changed medications, the discovery of kids who were supposed to have medications all year but parents have just been sending inhalers in their backpacks every morning and never taking anything to the nurse (seriously!). Kids are wound up and worn out, and fights are more frequent. The winner for today's "Kids Are So Strange Oh My Gosh I Can't Believe We All Used To Be Tiny Humans Like That" Award goes to whichever 3rd grade boy decided to roll some scrap paper together, pinch it up like a joint, and then try to smoke it in the bathroom. (The runner up to this award is the kindergarten girl who decided one part of the playground equipment is a "jumping board" -- it's like a diving board, but you just jump onto the mulch. She thought it was still ok to try to dive off it though.) And since the weather's warming up, there are 5k runs and races all around town every weekend. (Two of which I signed up for 6 months ago, not realizing how much would be going on this time of year.) We locally had a 16 year old die in a half marathon just last month, and there's been more reports from across the country of people who thought they were perfectly healthy but die before crossing the finish line. This confluence of increase in work load and personal matters on the weekend means that I am collapsing into bed late and getting up early, with only one day a week to really rest. It's spring marathon all over again, and I'm only on mile 5. But I keep this quote in mind, and I know I can keep going.
  14. dodoy

    Nursing Life Daily Checklist..

    Today is just like any other ordinary day of my life. The alarm clock didn't have to bother screaming loudly as I've been awake way before it was supposed to do its job. Despite the cozy warmth of the blanket and an enticing bed weather, I have to get up. It took a couple of minutes before the urge to finally get up came. However, in between that time of waking up and getting out of bed, the machine in my head has started its day. A myriad of thoughts has started flashing, like a dam-release. No holding back. Bills. Career. Relationship. Long-term plans. Each has their own chunk of space in my head. Screaming, yearning for answers. Churning out questions. Knocking the wits out of me. And just like how life's supposed to be lived, I try to find solutions. It all happened in a matter of minutes, but it made me feel drowned in the thoughts. We can never always find all the right game plan for all our issues in an instant, or can we? There will always be some bits and pieces that will need sorting. The cool December breeze was all it took to nudge me from the limbo. "You still have a shift to do", I told myself. After a quick shower and a few minutes of prep, I found myself walking towards the hospital. A Monday surely is a guarantee of a busy day, and I've found myself sensitized to such. In my head, I was thinking that this is a good thing. Or at least that's what I was trying to convince myself. At least there's an ongoing solution for the bills. Bills - Check. The handover was given quickly, albeit a bit crappy. I found myself again, tapping my shoulders, saying to myself "To make you focus on something else". Thankfully, the shift was quite uneventful. The things that were left for me and my co-nurses to do kept us occupied, but not too much for the shift to be unsafe. As the shift was coming to its end, the head nurse came to speak to me about the changes in shift hours and why will be there some revisions in the future. To make it short, they would have to cut the hours of some due to staffing-related issues. I have been contemplating about leaving the unit as I've perceived before that this will be happening in the future. Career - pending. On my way home, I checked my mobile and read the almost-template message of my girlfriend from halfway across the globe. It has been like that for quite some time. Add to that the idea that she doesn't want to move over where I am, and I won't be able to move to her place due to difference in plans. It felt like a deadlock. Relationship - pending. With the advent of change in hours and a relationship-difference, the steering wheel for my life has been on a confused state. Should I get registered there? When should I start? When do I file my resignation? Will I be able to support myself if I transfer to somewhere else? Long-term goals - pending. As I arrived at home, with clothes changed and shower done, I sat over the balcony with a cup of warm tea in my hand. It came to me how utterly amazing the healthcare workers are. That despite all the issues and inner battles that we have within ourselves, it has always been like an automatic response to show a kind and caring demeanor in our workplace. It was only during that time I remembered how thankful the patient was for being cleaned after her bowel movement. The smile from the eyes of a long-term patient when I congratulated him for his discharge tomorrow morning after a 2-month stay due to an eventful procedure, just in time before Christmas. The appreciation of a porter who needed someone to keep the unit doors open as he pushed a hospital bed out of the unit. These things, in all their varying degrees of relevance to nursing, has amazingly kept me occupied from whatever I needs sorting in my own life. And ironically, sane. Today's life checklist might not be fully completed, but I can say I've found solace. Tomorrow's another day.
  15. Joyful2bee

    I Had No Idea!

    H. was scheduled for the removal of a colon polyp after a colonoscopy failed to reach the tissue for biopsy. My husband was a very obese diabetic, who had recovered from a Wallenberg Stroke four years before with only a residual weakness in his balance center. His return to his job four months later demonstrated great determination and strength to endure the rigorous therapy required to achieve this recovery. These qualities helped him later as you will see. Responsibility, Loneliness, and Fear We arrived in the pre-operative area early for the prep for the surgery. I watched as the staff rolled my husband of 35 years away from me into an area where I could not go. I had been his advocate and caregiver after the stroke and felt very protective and responsible for him. I felt so helpless and anxious for his well being now. The thought that surgeons are human and can make mistakes hovered in my mind. While waiting for our son to arrive, I felt so alone and helpless. As soon as he arrived I felt his support shoring up my strength and calmness. A family member needs someone to help them spend the long hours that tick by so slowly during the surgery and recovery room care of a loved one. They don't know if there will be complications. Encourage them to call someone if they are alone. Regardless of years of experience and understanding of how things go in the hospital, I felt very alone until M came. Anxiety of Potential Complications So we waited. M, our son, was concerned that they might not be able to inflate the weight of his father's abdominal adipose tissue for the lap surgery. Sure enough, the surgeon came out and told us they needed to make a mid-line incision to reach the polyp. We understood and I gave consent. Soon an anesthetist came out and told us that three different anesthesiologists had been unable to put a central line in my husband's neck because it was so short and obese. I gave consent for a PIC line. Stress was mounting! What else could go wrong? What if he had another stroke? What if he had more complications? Even with the information given to the family, anxiety can run rampant especially when there are already complications. We soon found out about complications. After his surgery which actually went better than it started, there was no bed in ICU, so he was placed in CCU overnight for monitoring while on an epidural drip. Exhaustion His O2 saturation dropped into the 70s so he needed oxygen. He had a nasogastric tube and was supposed to be using his CPAP for his severe sleep apnea. Trying to fit a CPAP mask over a nasogastric tube was impossible to do. So we kept the oxygen flowing and raised his head slightly. I had been an ICU/CCU nurse for 17 years and didn't mind helping the nurses in the unit. During the night in a confused state, he repeatedly removed his oxygen mask. So about every 15 minutes the O2 saturation alarms declared his dropping oxygen level; I would hop up quickly and put the O2 back on his face. Finally, in exasperation or desperation, I ordered him to put his oxygen back on! He glared at me and said, "NO!" and removed it again! I am a very kind, polite and nice person, but was severely sleep deprived, had lots of stress, and worry that day. I said something I would never say normally. "Fine! Take the oxygen off! When you pass out, I'll just put it back on again!" I believe the nurses realized how exhausted I was and told me they could watch him so I could sleep. Yes, people do not behave normally when they haven't had enough sleep and are stressed out! Ask for a chaplain to help the family member be realistic about what they can do and how much sleep they need and make them leave for a while. Need More than Reassurances Please deal kindly and compassionately with the family's irritation or anger. Remember how many times someone has told you, "Don't worry, things will be fine." But they weren't? Words don't always help. Allow the family to express their fears to help them. It helps just to know someone is listening. Remember they are turning their beloved over to doctors, nurses and staff who they have never met before, who may be very busy, and who may not understand the patient's requests or needs. Then there are more "What ifs." "What if he develops another problem?" What if he won't be able to go back to work or his hobbies? What if...?" Believe me, there are many imagined "What ifs." That night one nurse did something I will never forget. My husband liked to be cold so there was a fan blowing on him. I like to be warm but I wanted to see him and him to see me at all times. So I pulled the recliner to his bedside and faced him. One angel brought a pile of heated blankets and without being asked to literally tucked me in! I never felt so cared for since I was a child! She understood and was so kind! I slept some after that. If you can, take time to listen or offer a small kindness for the family. Offer to call their pastor, the hospital chaplain, or the supervisor. Advocacy and Responsibility After a couple of nights, the epidural was removed and the doctor ordered Percocet two tablets every 4 hours for pain. I know the doctor was trying to keep him comfortable and considering my husband's size and history of back surgery and sciatica he ordered a large dose. The thing he did not consider was that my husband was narcotic naive. After one day H could not sit up; slept all the time; drank very little; and ate nothing. So on day three the doctor came and told my husband in no uncertain terms that he "had to get up." The doctor's tone of voice was the one they use when they are being firm with a manipulative or lazy patient. I was a bit upset that he assumed that H was lazy! But I knew something else had to be done. Since I knew H was not lazy. I began to worry that he might have had a second stroke. After several futile attempts by the staff to get H up, I spoke with the hospitalist that night. My husband had a high tolerance for pain, was very independent, and absolutely not lazy. I had to be his advocate. The hospitalist decreased the Percocet. As H came out of the drug-induced stupor he started acting like himself. He refused any more pain medicine as soon as he was lucid enough to understand what had happened. He related how he had been having hallucinations, confusion and terror attacks! Finally, he was moving around and helped staff get him up. He preferred to have pain rather than losing control of his own mind. It took physical therapy three weeks during his stay and after his discharge to increase his strength to near normalcy. Fears Being a nurse I know and understand that doctors and nurses are people and they make mistakes. We all do. But when my loved one has so many problems and complications I could not help but worry about mistakes or misjudgments being made. Plus there were always the questions that caused fear: How long will he need to recover? Will he be able to go back to work soon? (He loved his job.) I knew he had lots of sick time and had a good stable job but some patients don't. Some families may be very anxious about how to pay for the hospital stay plus the tests, IV fluids, lab work, radiologist bill and so many bills for so many treatments. Get them someone from case management to help them navigate this sea of bills they will receive. Reality: Complications After 11 days for what should have been a three-day stay, the staples were removed and H was discharged. But that is still not the end of this story. Three days after the staples were removed it was evident that his abdomen had not healed well. The wound dehisced in four places. The largest area was a tunneled wound 1 inch by 1 ½ inches and two inches deep in the middle of the incision. It took four months for the areas to heal. I cleaned and packed them twice a day for him. Imagine the stark terror of a non-medical person if they had seen their loved one's wound opening up and then having to treat it. Conclusion So family members need their own nurse? Well, not really. They just need lots of understanding and compassion from the ones caring for their loved one. We know nurses cannot do everything. When you cannot help in some area ask for help. But try to understand what the family is going through. Remember, "Walk a mile in someone's moccasins before you judge them." A lot goes on that we don't know about in the family's mind.
  16. Ironically, it was nursing school that made me realize that my symptoms of self-perceived madness weren't just eccentricities. I'm sure we all were self diagnosed hypochondriacs but the shoes actually fit and it clicked that I was the symptoms and cluster of behaviors that I'd wondered about in my high school psychology class. What kind of teenager thinks to themselves, "If I had any sort of mental illness, it would probably be bipolar disorder?" I'd never done much in depth exploring of mental illness prior to being plunged head-first into it while taking my psychiatric nursing class in undergrad. Hell, I minored in psychology and had even taked abnormal psychology, but it was learning the nursing interventions that made everything come full circle in my head. It was the group projects about coping skills that had me applying my classwork to my mundane life outside of the classroom. It turned on a switch that triggered me to seek wellness and health and to organize the clutter inside my head. Despite the fact that my mother and I saw a therapist while I was in high school for what she remembered as six sessions and I remember as two, I was constantly told that I was just "moody" and (my favorite) "just a teenager". Somehow, my early symptoms of hypersexuality, irritability and impulsivity were me "acting out" or "attention seeking". That didn't stop my mom from calling my after-school job, picking me up in the middle of my shift with silence, and then her and my father threatening to ground me and take away all of my privileges and electronic devices because I was writing sexually explicit notes with a freshman although I was a senior getting ready to graduate and was in a relationship. I spent way too much of my french class thinking of getting into people's pants rather than realizing the similarities between the Spanish I'd already learned and the French that was placed in front of me. That night, I threatened to walk out with none of my possessions and never come back, and I was serious. I screamed louder than I ever had in my life and though my mother threatened to drive me an hour and a half away to the only psychiatric hospital in the state that she knew of, she had no idea of what to really do with me. I spent the night at my grandmother's house, swearing to never talk to my parents again. There were other warning signs, like the deep pits of despair that caused me to stop "applying" myself in my classes, nearly failing AP English Lit and Biology, even though I ended up acing both of those exams at the end of the school year. There was my very first panic attack, during my timed AP biology exam where I felt like I couldn't breathe and that I was going to implode if I couldn't get out of the room. There were my nights of staying up until 0200 and getting up at 0600 without any problems OR caffeine. There were the notebooks full of exceptionally morbid poetry. I'm not even going to go into more depth about my dysfunctional relationship with my family because although it certainly doesn't make my diagnosis of mental illness any easier, it's *MY* problem to live with. Whenever clinicians ask me about my family history of mental illness, I always have to clarify, "You mean are there *symptoms* of mental illness, right? Nobody gets diagnosed in my family." I spent most of my spare time at the beginning of the Fall semester reading my psych nursing textbook cover to cover, devouring everything I could about bipolar disorder, GAD, anxiety disorders and it wasn't enough. I had quickly conceptualized what was wrong with me, but it wasn't until I found myself sitting on the floor of my apartment after having run out to the grocery store at 0300 to buy glitter glue, die cut letters, stickers and colored paper to embellish my teaching plan for my the next day, where presentation was only worth 5% of my grade for the assignment that it actually clicked that I was likely driving everyone else around me absolutely insane and that I might be having a hypomanic episode. I was working 2-3 on campus jobs in addition to my classes and that still wasn't enough for me to keep the bills paid and afford everything that I thought I just *NEEDED*. I promptly scheduled an appointment with the counseling center on campus to see a therapist and then the school psychiatrist shortly after. I don't much remember the counselor that I saw at the time, but I do remember the psychiatrist and the first few words he said to me. "I'm no better than you are. I have the prescription pad and you don't, but you know what's going on in between your ears better than I do." He started me on Klonopin after our first appointment and then he started Lamictal shortly afterwards. It's been a whirlwind of ups and downs, back and forth, and side to side ever since. I've scared a therapist, who had no idea how to get me to the hospital after a session in which I told her that I just couldn't handle things anymore. (Gee, why didn't she just call 911?) She actually let me drive home to pack some things for the hospital, on the promise that I'd keep her posted. I've quit a job because I was bitten by a patient and nearly had a panic attack on the floor in front of my colleagues, and even though another staff member was hurt too, there was no de-briefing with security or my nurse manager present to explore how we could avoid the situation from happening again or what warning signs in the patient we had missed. I decided to apply to teach at a high school although I was in no way really prepared for the job (my teaching practicum at a community college didn't cut it) and I stressed myself out even more than I had been on the floor. I burned myself out even more and found myself wanting to go back to what I knew, seeing and helping people who weren't that much different than me. It's been almost 5 months since my last medication overhaul and although things are still shaky in my world, I feel more grounded than I ever have. I pull out all of my prescription bottles at the beginning of the week and fill two medication calendars, one for my AM/PM meds, and one for my afternoon meds. I know I'll probably never be able to work straight night shifts ever again. I know that I need to work harder at setting limits with patients than any of my colleagues will ever have to do. I know that I need to check and double check things and then still spot check because I end up letting myself get over-confident. It will always sting when I hear a co-worker say, "Oh that patient is just attention seeking." (Maybe if you pay attention to what they're doing or saying, rather than how that makes you feel, you'll remember that they're in the hospital for a reason.) I'll bite my tongue when I get told, "That patient needs PRNs around the clock because they're out of control." (Is there something that's triggering them that we should be more mindful of? Are we doing our best to notice warning signs and address them *before* the patient gets out of control?) They say "It takes one to know one," and I think that's a pretty accurate statement. I'm not saying that you need to have mental illness to work with patients suffering from mental illness, but a.) it helps and b.) we all have our issues and lie somewhere on the mental health/illness spectrum. It helps to acknowledge that we're human and mental illness is the most pervasive illness among those 18-25. Take a look around and recognize that it's not a death sentence but it can become one if it's ignored or not treated. After all, we're all a little bit mad, right?
  17. I had the weekend off, the first in a long time. My husband and I decided to ignore the world (the kids at their friends' homes for sleep overs) and binge on movies. Leaving my phone in the kitchen where we had made our dinner, we escaped to the back room with our dinner, drinks, and several movies. It wasn't until almost midnight when we returned to the kitchen to clean up our mess, and I noticed my phone was blinking. I had many missed phone calls and text messages. I dialed my sister-in-law - the last one to call - and the first words out of her mouth were, "Dad had a stroke." Unfortunately, due to the fact that I had been drinking, and the fact that my parents live four hours away, I had to wait until morning to "rush" to his bedside. Finding my brothers and their wives waiting for me at the hospital, I pushed into his room and found my mom holding his hand. Of course, when mom saw me, she started crying all over again. And there in the bed looking fragile and pale, lay my hero - my WWII Navy Vet who drove U-boats; my dad who once knelt down cradling my tear stained face and asked me, after my first fight in grade school, if I won; my counselor who listened to me cry when life didn't treat me "right". Fragile. Pale. He turned his head ever so slightly and held his hand out to me - the youngest and only daughter. I grabbed his hand and the strength and reserve that had kept me going until now rushed out in sobs. This is not the first time, nor the last, that I have had to run to the hospital to see a family member with a medical emergency. Nor will it be the last time I have had to put aside my own personal angst in order to do my job. How do we as nurses put aside our lives in order to care for those patients who are scared, frightened, anxious, and in pain? Do our own personal experiences make us better nurses? How do we go about providing care and assurance to our patients and their families without burdening them with ours? As nurses, we focus on caring for the needs of others. We are taught in nursing school to show empathy and compassion, have professional boundaries (not discuss our personal lives and problems with our patients), and act in a professional manner at all times. So - HOW do we DO it??? I have found that I have to compartmentalize my life. When I walk in through the doors at work, my home life is no longer the compartment I am working in, that door is closed until I walk out of those doors at the end of the day. Likewise, when I walk out the doors at work, that is exactly where work stays - all of the drama, heartaches, craziness -inside those walls and I, after years of working on it, do not bring that home to my family. I will say that is not always easy. For instance, one time I found out some particularly devastating news about a family member who was making choices that were destructive and shattering to my family. Knowing there is nothing that I could do about the situation, I had to return to work the next day, but my heart was breaking as I felt the weight of the world crushing me. Try as I might, I was losing my battle at work with keeping my tears in check - often ducking into the break room to take a deep breath, say a prayer, and wipe my face. I managed to do my job, but I didn't feel very effective. I decided to ask my charge nurse for a break and I called our hospital chaplain (who I adore and trust). She came immediately and listened to me have a mini-breakdown. After about 10 minutes of crying and blubbering, I felt better. I wiped away the tears for the last time, and went out stronger and more determined than ever to serve my patients. Once again, I was able to compartmentalize. "Sucking it up" is not always easy. However, we are professionals. Our patients are the ones in crisis, and when we are at work, we MUST make them our number one priority. If we have a problem making it through the shift - do whatever it takes to make it right. From asking your manager/director for a few minutes to talk so you can vent, to possibly taking the day off if you absolutely cannot function in the professional capacity. We all need a personal day - and there is nothing wrong with that. If we - as a professional nurse - absolutely cannot do your job safely and keep your patient your number one priority - you probably should not be at work! Nurses are a committed, tough, resilient, caring, loyal bunch - and we are able to cope with any number of situations. However, when it comes to a crisis in our own lives, it can sometimes throw us for a loop. Learning how to cope with our "stuff" is vital. Sometimes at work, I feel like that old poster of a duck on the water - all cool and collected above surface - but paddling like hell below the surface. I don't particularly think there is anything wrong with that. I am determined to provide every skill and all of my attention to my patient, and treat them exactly how I would have my family member treated in the same situation. I have stuff to deal with, like every nurse out there. We all have a story to tell, a crisis to crawl through, and a hell we may be living in, at any given time in our career. Are we able to hide that under the surface in order to be professional? Do we know how to cope, or what strategies are available to us, to keep us from cracking under pressure? Figuring out your strategy now can be crucial for future reference. You need to have a pool of information to draw upon so that one day, God forbid, you should have to go through trial by fire and have to provide care to a patient when you yourself feel like you could just curl up in a ball and cry. If you are a nurse who already has had to deal with a situation of tucking away your personal life in order to deal with your patient's crisis, please share your strategies! New South Wales Nursing Association cites 10 things nurses should do in stressful situations. I think these tips are important enough to share and some can be used when our own life makes it hard to work: Try to: Keep things in perspective Share your worries with families and friends Clear up misconceptions - increased knowledge helps alleviate fears Do not be too hard on yourself Worry will not solve anything; confront your problems and figure out how to solve them Set realistic goals for yourself Eat healthy and get regular exercise Utilize the relaxation techniques you were taught in nursing school!!! Think positive; enjoy new experiences; have fun with friends and family Be realistic - it is normal to have setbacks but they can be overcome On the day my world seem to fall apart when I grabbed my father's hand after his stroke, I probably would have wanted to scream if his nurse came in and started telling me about her problems. Instead, she was professional and caring. She calmly provided information and made us all feel like my dad was getting the best care. She was an amazing nurse. I don't know if she had any issues in her own life, but if she did, she kept them to herself. She made my dad her number one priority. I appreciated that. Reference NSW Nurses' Association. (2006). Stress management for nurses. Retrieved from: https://www.health.nsw.gov.au/nursing/Publications/stress-mngt.pdf
  18. 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.
  19. SICUshortCait

    What Happens When We Leave Our Dream Job?

    What happens when we have to find a new dream? When we came to a fork in the road; chose our path; ran towards our destiny and hit a dead end? Nursing is career of passion and a commitment not only to ourselves but to those future faces waiting with a name and date of birth. We sample different floors and hospitals throughout our education and excitedly tell each other stories of what we saw that day. We may have started school with a specialty we're sure of, but then it happens. We have that day; our day; our epiphany moment where we choose our path. Maybe it happens during clinical, maybe it happens long after we've been at the first job we're offered. There is that moment where those are OUR patients and that is OUR specialty. For me I was on a trauma unit for school; a far cry from the pediatric oncology unit I thought I would be on when I applied to school. My patient had crashed his motorcycle, had an MI, and a K+ of 6.8. We were bandaging his road rash while ortho discussed his broken bones and then we whisked him off to dialysis. I walked out of this step down and with wide eyes asked my instructor where these patients went when they were sicker. From that moment on I was on the fast track to SICU. Those were my patients. That was my unit. Fast forward 8 months to multiple knee surgeries and a fleeting return to work where I couldn't lift "My patients". I couldn't handle "My unit". Obviously I could have been in far worse shape, but that wasn't the issue at hand. Where do we go from there? How do we start over when we were so sure of what we loved? I talked to a friend recently who was leaving her dream unit and felt an enormous sense of fear and dread. There is a guilt we feel when we switch our path. That sense that we're giving up; abandoning the patients we once called "ours". In the days that followed leaving behind my dream I talked to friends and coworkers and scoured the internet looking for my new passion. Repeatedly I was told to go to the NICU. " The patients are lighter and the cribs are higher" I was told time and again. I dug in my heels, because as trauma nurses we don't do cute and cuddly. There was a sense that I was turning my back on my people by even seeming interested in the idea. I spent weeks toying with jobs that I had no passion for, but would allow me to sit. Something I didn't enjoy, but would provide me the time to go to school while I figured it out; anything but working with babies. Out of loyalty to my hospital I finally went upstairs to tour the NICU. I walked around arms crossed looking on respectfully. The first baby I saw was only 23 weeks old. As we continued to make the loop I saw hopeful parents sitting, waiting for news of an ounce gained. By the time I walked to the last decorated door, I was filled with questions for the nurse and a secret I was keeping from myself. A secret, that I may just be fully confessing now. I loved it. My head was spinning when I left. How could I love this unit? This was the unit I had shy'd away from since I started school. Babies? Babies. I thought it would never be me. I was afraid to even hold them and yet there I was. And that's when it hit me. I am a nurse. We are not our units. We are not our specialties. We may love them dearly, and we may thrive in one environment over another, but we are nurses first and foremost. We see people in distress, no matter how small, and we want to help. We want to fix the situation, and we want to learn. We accept the challenge and charge ahead. Our abilities are not limited to what we already know, because we were work in a field with an endless number of possibilities that we should start taking advantage of. While this story may be a bit autobiographical, it is meant to give hope to the other die hard specialty nurses out there whose circumstances may have changed. Whether you have to leave because of family, a big move, injury, or burnout, you are not alone and there is hope. This is not the end of the road, but an opportunity. The scariest dog is always guarding the door to the biggest prize. You will still find your way, because you my friend, are a nurse.
  20. ExtraShotNoWhip

    My Papa. Why I Am The Nurse I Am Today.

    His journey began two years prior. He received the diagnosis of colon cancer and began chemotherapy. All of the nurses at the treatment center would fight over who got to take care of him. I cannot think of a person who did not love this man or at the least enjoy his company. Papa got a little better than much worse. It began to spread. The man I grew up with who always bought me the most beautiful winter coats, threw me in the biggest pile of raked up leaves I had ever seen, and always had a big smile, hug and kiss for me suddenly became very human. His weight began to wither; at one time he was a little more than a regular size man with a large belly. The belly looked like a pregnant woman's would and whenever a family member or close friend would get pregnant they would take a picture of the bellies. He eventually withered down to a very thin man. The hospital trips were becoming a little more frequent at this time. He eventually had an operation to remove part of his colon and needed a colostomy. He took it in stride. One of the things that hurt him the most is that he was unable to attend my high school graduation. Before the event, my mom, dad, grandma, then boyfriend; now husband, and I went up to the hospital to visit him. He and my grandma gave me my graduation card. When I opened it I saw a cut-out picture of a Chevy caviler. Behind the picture written in the card, among other things was "Let's go beater shopping". There was a running joke between all of us that I would use my graduation money to buy my first car. The mood was light but it became very heavy when we were all leaving my papa to go to my graduation. Fast forward I do not even know how many months. My family is one of the closest families you will ever meet. When he started getting really bad my mom moved in with my grandma and papa full time to help take care of him. He had a hospital bed in the house. Their family room was converted into a bedroom for him, everyone helped, and he showed much appreciation. I believe this was around the time he stopped eating enough. His doctor prescribed Marinol as an appetite stimulant. This worked for about the first week or so and then did not. The first time he took it he said, "I could eat the whole house". My mom had to call 911 on three different occasions because my papa's blood sugar plummeted to 32 and below. Before treatment, he did not have problems with his blood sugar. He was getting weaker and weaker. This is when he brought up whether to continue treatment or not. This decision was made in the hospital with my grandma, mom, and me. He asked us if we thought he should keep trying. This was a very tearful and difficult conversation. The end result was where we meet earth angels, at a Hospice. When we arrived my papa said, "you checked me into the taj mahal". This was an inpatient hospice, the unit was beautiful, one would never know that is was attached to the regular part of the hospital. The hospice center was one hallway with no more than 12 rooms; if I remember correctly. The unit was dim but very much adequate, the rooms looked like real bedrooms, no one had to share a room, the family/ patient lounge looked like a regular living room with a kitchenette off the side. The nurses, aids, social workers, and any staff on the unit were magnificent. I truly believe God handpicked these people to be there. My mom and grandma were there every day. I visited as much as I could; I was in LPN school at the time. This devastated me that I could not be there as much as I wanted. My papa had so many visitors however they were all respectful to his needs. There were times where he just wanted to move around but could not due to lack of energy and deteriorated condition. My mom would wheel him around the hallways of the lobby and quiet parts of the hospital he really enjoyed this. I would come in and he would get a sparkle in his eye and my papa's smile not the big ear to ear grin of the past but it was still his. One time I brought us both raspberry milkshakes from Dairy Queen. Whenever my grandparents and I would stop there that is usually what he got. He said he was not hungry at the time so I put it in the freezer, but he watched me have mine and we all could tell this made him happy. He began to go downhill fairly quickly after this. He went into a semi-coma state; he sat in a chair and had his legs out in front of him in another chair. My papa was in this state for about 30 hours. He woke up and was hungry, which he had not been in a very long time. He asked if my uncle Jim*, his wife's brother-in-law, would make him a perch dinner. My papa ate all of the dinner. Three days before he died he asked my mom if she wanted to take a walk, which meant her pushing him in his wheelchair. She asked where he wanted to go and he said outside to the garden. The hospice grounds had a beautiful garden that was dedicated to all the current and past patients that stayed there. The garden included flowers, trees, grass, benches, and a large brick patio like area. Many of the bricks had inscriptions on them from families who had their loved ones there. After my papa passed we bought two bricks one with his name, birth, and death date, as well as one with a poem I wrote for him on it. My mom took him to the garden and she said he just stared at everything; he touched everything: the grass, leaves, flowers, and trees. The day he died I had the privilege to be there all day and night until he passed. I knew he was going to die that day. The room had a smell to it and he just had that look. None of us had the "it is ok to die talk" with him. I went to the nurses and asked them how he was; they knew from my tone what I meant. She asked me if anyone had told him that it was ok to go, I said no, and she suggested maybe today was that day. I thanked her and went back to the room where my papa, grandma, mom, and dad were. The nurses asked if we had told him it was ok to go and everyone said no. They said we needed to tell him it was ok and that he needed to know we would be ok. I went in to talk to him first. This was the hardest most painful conversation I have ever had to have. I sat next to him and held his hand, looked up into his eyes and tears began to fall from my eyes. He looked at me with a knowing look. I asked him, "How am I suppose to tell you it is ok to die". He looked at me with a little smile. I told him it was ok; I loved him very much and asked him some questions that will stay between us. I told him that we would take care of B, what I call my grandma, and that she would move in with my parents and me and we would take care of her. I talked about all of the things I remember doing with him, how he was such an important part of my life and that he always would be. I gave him a kiss and we hugged we both just sat for a little looking at each other then I held on to the top part of his arm and rested myself up against his side and let the silent tears fall. He brought his other arm around his front, put it on my arm, and lightly rubbed me. I wanted to stay but I knew everyone else wanted to talk with him. I told him everyone else would come in and talk to him just him and them; he said "ok I love you " I said I love you too papa. One by one my mom dad and finally grandma went in and talked to him. We already knew we were going to spend the night. After everyone was done we all went in together. I sat with him on the bed he was sitting up but a little hunched over, he said he back hurt, I asked if I could rub it; he nodded yes. My mom was sitting on the other side of him. He held his arms away from his body very stiff and began rocking back and forth while trying to stand. We stood him up and then helped him sit back down. We all got ready for bed my grandma was coming out of the bathroom from taking off her makeup, my papa was sitting in the recliner, my dad was in the family room, my mom was sitting next to him, and I was sitting up in my sleeping bag at his feet. He looked at all of us. My papa took a big breath and three little breaths and was gone. This was, I believe, around 3 am. We got my dad and told the nurses. They gave us some time with him and asked us to wait in the living room while they got him into bed and cleaned up. When we all came back into the room my grandma was crying heavily and kneeled by him with her hands on him saying, "oh Charles* my Charles* my lifeline". I could not look at him laying on the bed dead it was his body not my papa. I had never seen a dead body before. It was my papa's body but he was not there. I did not know how long to stand there and stare at it. I went into the garden sat on the bench and cried and cried. I talked to him saying I know you are not hurting anymore, I know you are free of this, I am hurting I need to feel you, I want to hug you one more time, talk to you one more time, hear your voice and laugh one more time. I know your wife needs to feel you more but please help me too. I closed my eyes heard the leaves blow and even though it was the very end of October, felt a light warm breeze. I knew it was going to be hard but I also knew he was there. I still feel him from time to time and talk to him. I miss him so very much and always will. I knew at that moment this is why I am in nursing school and why I will. One of the core beliefs in nursing is helping those that cannot help themselves. I fully am prepared to continue to do this. This took place in October of 2005. Right now I am a working LPN as well as a RN student. I will graduate in May of 2010, I will pass my NCLEX, and I will push to be a nurse I am proud of. *name or names changed for privacy
  21. I could say I pursued nursing because I wanted to follow the footsteps of my mother who is RN, but that is the usual every other day story you normally hear. This was one of the reasons why I decided to become a nurse, however, one of my other reasons of pursing to become a part of the nursing career is the most unusual, it was my strange fascination with needles. Yes, needles! Needles, the one thing most people cannot stand the sight of. To dreadful visits of receiving vaccines for their own child. Well, I defiantly was one of those 5-yead-kids who cried at the doctor's office, but as I grew older and started girl scouts at the age of 11. I was introduced to the world of crafty. This is where I learned the basics of hand sewing and that is how it began. I was fascinated by the cute little accessories I can make by using simply a needle and thread. The needle was the one that awed me more then the thread. It was at that point I really began to realize how much the needle has done for our society. It has given us clothes to wear, to protect us from cold winters, or to hats to protect us from the sun. To giving us flu shots each year, and helping people with diabetes control their sugar. I was only eleven years old at this time, and still, unaware nursing would later become my passion. Years had gone by and I had grown older, and soon going to enter college. Still unaware of what I like to pursue become, and my fascination with needles had faded away and been forgotten. At that time, I thought maybe becoming a school teacher may be nice, but I sure did not want to spend the rest of my life in a classroom. Then I thought about my mother, who had a great stable job for so long, and gave her more than enough hours than she can handle. "Hmm, nursing?" I thought, "Well, I defiantly want to help people, and have job security. Yes, this would seem fit for me." It was at that point I decided on nursing and went on to pursue my LVN, since I felt it be best to take it step by step with this new interest. It was not until the day our teacher taught us how to give shots when my fascination with needles began again, it was soon after that I started looking forward to days in clinics and got to help with simple insulin shots even excited me. It just amazed me of how much the needle has helped the human body stay alive, even on just merely TPN. Something so small, yet rather painful device has done so much good for our society. It was at this point I knew the number one reason I wanted to become a nurse, it was my love for needles, and how I wanted to learn how to use it properly to help people with their health conditions.
  22. I was a new nurse not too many years ago, but I still remember the stress. I was very shy as a nursing student and as a new graduate. I felt like I was the most hopeless nurse in the world. I had very little confidence in myself and frequently put myself down. I know many students/new nurses feel the same, so here's a little list of my mistakes or mistakes others have made that I am aware of. Actually broke a vital sign machine at one of my clinical sites. My instructor was furious. So were the nurses who worked on the floor. I always said "I'm sorry". Every mistake, everything I didn't know, I would repeatedly apologize. I was very insecure. I stumbled through most phone conversations with physicians. I always seemed to be missing an important value, said "Um..." all the time, talked a million miles an hour (ripping off the bandaid, I thought), and usually wound up crying if the doctor fussed at me. I couldn't understand some of the physicians' accents over the phone and had to ask "Can you repeat that?" after every order. I once spilled a pitcher of ice water on a post-partum patient-and her cell phone. Babies, especially newborns, were terrifying to me. They were so delicate and fragile-I was always afraid I was holding them wrong, changing them wrong, and pretty much doing everything wrong. What was the worst was that my classmates loved the babies and seemed so confident-and the instructor was impatient with me. (I think she was still mad about the BP machine on top of being frustrated with my insecurity. I don't fault her. I was hopeless in Maternity. I like my adults and little elderly people.) My conversations with patients were sometimes very awkward. I didn't know what to say or what to do when a patient expired and the family was actively grieving. I asked a woman who had had a hysterectomy if the baby was a boy or girl. I once offered to help a double amputee to the toilet. I have mistaken a man for a woman. My cheeks were constantly red with embarrassment or frustration. Why can't I do anything right? I'll never be a good nurse. What's wrong with me? Why can't I do ANYTHING right? Everyone seems to "get it" but me. What's their secret? I was also intimidated by the other nurses. They seemed to know so much, and could sometimes could be very short with me. I later learned that their frustration wasn't personal-their job was fast-paced and demanding, and it usually more time for me to perform a task than the nurse could do herself. And everybody knew everybody but me. During down time I would read charts over and over because I felt absolutely out of place. Or I would read textbooks or drug guides because I didn't want to interrupt the nurses' conversations about aspects of their lives that I didn't know. 8. Got tripped up my multiple IV lines, or catheters, or the side of the bed-everything. I was so wrapped up with my emotional insecurity that I didn't notice things I should've noticed. I only tripped and dislodged one IV, but of course he was a hard stick and was furious that I was so clumsy and that he needed to have a new IV put in. He of course wanted a new nurse. I spilled urine all over myself while trying to empty a catheter. I've gotten poop on my pants and shoes and lab jacket. I've been vomited on and bled on. I've known a few new nurses and nursing students who have been soaked with IV fluids when they accidentally punctured the bag. One girl ruptured a blood bag all over herself and her patient. I've tripped over my own feet and face-planted in the hall, spilling meds everywhere. I knew about nursing students who had confused the red and blue thermometers. One of my classmates fainted in the OR. Luckily, he did not contaminate the sterile field or take anyone else out with him. He became an excellent surgical nurse and later a nurse anesthetist. The bottom line is that we aren't perfect, but with perseverance even the most awkward, timid nurse can succeed. You learn from your mistakes. You hone your skills with repetition. The first year and a half, I wasn't confident. I now know that confidence comes with experience. So, for those of you who feel stressed, hopeless, and awkward, know that those feelings are shared by many. You're not alone.
  23. Hope4us

    The Little Round Thing

    When I started that day it seemed the paramount thing to me just to get rid of the dress bypassing my state board exams. My clinical rotations had become routine stuff after two years. My mentor hardly bothered to check on me anymore. I thought I was ready to be released into the real world of nursing, until that day! Hectic! Four call lights were ringing and they were all my patients. The aide on my rotation was taking extra long time to give a bed bath when I needed her help, it seemed to me. I had a pain shot in one hand, but I looked into room 369 on my way past to say, "Sylvia, I'll be right with you." I turned off her call light. When I came out from giving the shot, Sylvia's light was on again. I stepped in. She was sitting on the edge of her bed with her arms on her raised side table, gasping for breath as she had been for the eight days she had been in the hospital. She was what we called a frequent flyer with advanced COPD. She usually rallied after a week or two in the hospital and went home again. "I need a little round thing out of this drawer," Sylvia told me. The drawer on her nightstand was open and I fumbled through it, wondering when the aide was going to be available to do this stuff I didn't have time to do. I couldn't see anything round in the drawer. After eight days the drawer was quite full of papers and silverware, jam and salt and pepper packets, whatever Sylvia wanted to hang onto. It was so hard for Sylvia to get air to talk that all conversation with her had to be yes, no questions and I was in a hurry. I told her I'd be back. I turned off her call light as I went out the door. When I came out from giving the next pain shot, three call lights were ringing. One of them was Sylvia's. The aide was nowhere to be seen. I felt a little impatient. I put on my smile and stopped to wash my hands as I entered the room. A deep COPD grunt of disapproval came from Sylvia. She did not have time for me to wash my hands the grunt said. "Now," Sylvia gasped, "you find it!" I began to ask questions as I dumped the drawer on the top of the stand. I showed her as I put each thing back in the drawer, one at a time. "Is it a pen or pencil?" No, her eyes said. "Smaller?" Her eyes registered frustration. "Shorter than a pen?" Yes her relieved eyes told me. "Wider?" Yes. By then I was to the bottom of the stack. The only thing in the whole drawer that could be called round was her glasses case, and it wasn't really round. I held it up. Sylvia motioned for me to put it in the drawer and flipped her hand towards the door as if she was the queen and I was a disobedient servant whom she had no further use for and she was sending me out of the room. "Your breathing is much worse," I told her, "I checked and you have taken everything you can take but the nebulizer. I'll bring it to you right away." I was surprised how much air and energy Sylvia was able to muster to spit out a very decided and upset, "No!" "You don't want your nebulizer?" I asked with genuine surprise. "No!" This time it was louder and more determined than before. "Just find the round thing," Sylvia hissed at me with a gasp between each word. "I'll be back after I give another shot," I told her. I had to work to keep the impatience out of my voice. By the time I had the shot ready, Sylvia's light was on again. It was still on when I was done. The aide wasn't back yet. I stepped in the room again and went to Sylvia's closet telling her, "I'll look some more, but I don't really know what I'm looking for. It would help if you could tell me more about it." "Yellow." I came up with nothing round and I had gone through the whole room now. I could see nothing yellow anywhere. Tears came to Sylvia's eyes, and I understood see she was trapped in her body and helpless and didn't even have enough energy to cuss at me. I softened as we stared at each other. I told her, "There is a very patient man down the hall who has been waiting for a pain shot. I need to take care of him, and then I will come and ask you some more questions and try to understand what you need unless the aide can come first. One of us will come, okay?" It was not okay. She shook her head. She grunted about the man who didn't need me as much as she did. She was serious and she was helpless. As for me, I was starting to feel like maybe I did need my uniform and it seemed to fit a little better than it had earlier in the day. It took more than a change of dress and passing exams to make a nurse I was thinking. After I gave the next pain shot there was only one light ringing. It was Sylvia's. I heaved a very big, impatient sigh and tried hard to remember the lesson in class on how to deal with difficult patients. Cooled down, I went to Sylvia's room more relaxed. It was quiet. Nobody was waiting for me this time when I went in. I could spend some time with her. She was lying back in her bed! "Sylvia!" It was extra quiet. It wasn't just because I turned off her call light. There was no wheezing sounds - no difficult breathing sounds. In a flash, I was at the bedside taking Sylvia's carotid pulse. It was barely there. I grabbed at the automatic BP cuff, put it on her arm and hit the button with one hand while I got the bed ready for CPR with the other. I had heard a faint breath when I put my ear to her nose. As I picked up the phone to call for help the BP read 30/10. Then it hit me with a repulsive shudder that rocked me from head to toe. DNR. Sylvia was a do not resuscitate patient. I quickly checked her pulse again. Nothing. I hit the blood pressure button. As my mentor flew through the door into the room, the blood pressure monitor read nothing. No heartbeat. No breath. No blood pressure. I have never felt more frustrated in my life in twenty years than I did at that moment when I was not allowed to start CPR. I even thought of trying it, just in case, for a split second. My mentor looked like she felt about how I did. The doctor came in right away. The family was called. The mentor, aide and I cleaned Sylvia of her incontinent bowel and bladder mess and got her all ready for the family visit. We put on crisp clean sheets and combed her hair and made everything look as natural as we could for the farewell. We were in a hurry to have it done, knowing the family was rushing to get there to say their good-byes. "Why rushing?" I wanted to know. They were the ones who didn't want her resuscitated. They had all agreed. Now they were rushing to see her when it was too late for anything but good by. "How could they do a DNR?" I asked again. It was so upsetting to me. I looked at the mentor as we left the room. "The only other thing I feel bad about is that I didn't find her little round thing," I told her. "Her nebulizer?" my mentor asked me. "What!" "Sylvia calls her nebulizer a little round thing. She always sneaks one in from home. The doctor knew her condition would improve with the new stuff and he also knows she didn't take hers as it is prescribed so she wasn't supposed to have any at the bedside, but she always gets one smuggled in from home. She doesn't like the new stuff. Last night the aide found her contraband and put it in her glasses case. We were going to ask the doctor what to do this morning." I stayed behind in the room as the mentor went out. I opened the drawer and took out the glasses case. I shook the little round thing out of the case. It had a yellow band around it. It seemed to me my student uniform fit me perfectly. I had an examination to make before I ever faced nursing board exams. I had to examine me and what life is all about. What rights do patients have? What rights did I have? Why didn't we start CPR? If I had found the nebulizer what would I have done? How would I have treated the patient? If she had found it, would it have given her a little more relief? Would it have given her minutes to live? Would it have held her over to her IV dose? Would she be wheezing away right this minute? "I'm sorry Sylvia. I'm sorry I didn't find your little round thing. I'm sorry you died in here all alone. Your need was more important than the patient man down the hall waiting for his shot just like you told me with your eyes. I didn't believe you and I am sorry, Sylvia." Name changed
  24. VivaLasViejas

    You Can't Make This Stuff Up!

    ........Some years ago when I was still working Med/Surg, I had a patient who could be described diplomatically only as "fluffy". In actuality, she was a diabetic who weighed more than 400 lbs. A pleasant sort, she struck up conversation with me as I performed her PM assessment; when the aide brought her supper tray in, she mentioned that she'd lost her lower dentures at breakfast and asked if I'd seen them. Of course, I hadn't---at least, not until I turned her onto her side so I could listen to her lungs. There, firmly implanted in her left buttock, were the teeth. They'd made such an indentation that I literally had to pry them off her cheek with a gloved finger..........whereupon she whisked them out of my hand, said "Ahhh, thanks, honey", and popped them into her mouth before I even had a chance to wash them! ........Same hospital: we had this little old man from a nursing home; naturally, he was terribly confused, and much to the dismay of the entire floor yelled incoherently for hours and tried repeatedly to climb out of bed. Finally, after several complaints from other patients and a couple of Ativan tablets that did nothing but wind him up even more, his nurse found a geri-chair and brought him out to the nurses' station so we could keep an eye on him. In exasperation, she told the man, "Now you be quiet---I don't want to hear so much as a squeak out of you." That was when we found out he wasn't quite as demented as we'd assumed. With a sly grin on his face and an unmistakable twinkle in his faded blue eyes, he said "SQUEAK!" and promptly subsided, content to watch the corridor and nibble on graham crackers. ........Another time, an aide and I were cleaning up after a patient who'd been incontinent of a rather impressive river of loose stool..........in fact, it was pouring off the bed and splattering on the floor (not to mention our shoes). Why I was reminded just then of the need to pick up some chocolate fudge cake mix on the way home, I'll never know, but when I said as much, the aide turned a funny shade of green and fled the room! .........Here's a patient I'm sure many of us have met: the nineteen-year-old primigravida with tattoos all over her upper body who screeched like a frightened toddler when I tried to start an IV because she "didn't like needles"........... .........More fun from the OB unit: I've worked three-day stretches in postpartum without seeing even ONE married couple. Sent new parents home who couldn't even read the directions on the box their infant car seat came in. Caught a baby in my bare hands when the L&D nurse was on break and the doctor hadn't arrived yet because Mom was only at 6 cm and the contractions were still three minutes apart after eight hours of labor. And I've spent nights in a hospital nursery with a baby in each arm, wondering what I'd done to deserve the privilege of actually getting paid to sit in a rocking chair, cradling downy heads and inhaling deeply of the scent of new life. Nope, you really CAN'T make this stuff up.
  25. VivaLasViejas

    Who the Heck Am I Now??

    Imagine being seated on a comfortable sofa in a warm, well-appointed office designed to make you feel at home, fidgeting nervously and struggling to find a neutral position as the man across the table from you delivers his findings in a kind, but regretful tone. "I'm diagnosing you with (fancy medical term) disorder," he says, shattering your world into a billion pieces even as he clearly wishes he didn't have to. "We need to talk about starting you on some meds." You've suspected this was coming for months....maybe even years. But thinking you might have a condition is one thing; you can still play the denial game and lose yourself in all sorts of imaginings, with both happily-ever-afters and tragedy as possible outcomes. Knowing you have a real, life-threatening illness---hearing the words said out loud by an impartial observer and seeing them written on a piece of paper---is a whole other ballgame. First, all you can see is the problems....dear God, how do I tell my family? My boss? Will these meds work? What will they do to me? What if they DON'T work? And worst of all: will I ever be the same? That last one is perhaps one of the cruelest aspects of being diagnosed with a psychiatric disorder. You go along living your life for three, four, even five or so decades, believing yourself to be a decent sort and being more or less contented with who you've become as you've aged........then suddenly a sucker-punch comes flying in out of nowhere and knocks you into the middle of next week. There you are, flat on your assets in the dirt, reeling from the shock and surprise and wondering what to do. Then panic sets in as you realize there are no answers forthcoming, because nobody tells you how to survive the initial shock, let alone the emotional devastation that immediately follows it. There are publications galore that deal with medications, treatments, therapy, and other useful information, but what are you supposed to do when you've just lost the person you thought you knew best---yourself? For me, that's been the most difficult aspect of all. I'd just turned 53 when I was literally forced into a psychiatry referral by my internist; that's a lot of years to build a life and a persona that, although certainly flawed, were good enough for me. I was successful in my nursing career, had a good marriage and four wonderful grown children to prove it. I had enough material goods and earned more money in a year than my parents ever saw in five. I had my church activities, my involvement here at Allnurses, and no shortage of friends. So what in Heaven's name drove me to go and mess it all up, time after time after time? Yes, I'd suspected bipolar for a number of years, and confirmation was an enormous relief at first. Finally, there was something (besides perversity and what my mother had called "mule-headed stubbornness" to explain why I've had such horrid mood swings and done so many stupid, reckless, self-destructive things in my life. But that didn't last long, and I was soon engulfed in grief for the loss of the woman I'd thought I was. Who am I now that I have this label? I asked myself during one of my deeper, darker moods---the one that hit me shortly after being diagnosed---when I'd make the 25-mile commute home in the evening and fantasize about crashing my car into a tree at 75 MPH. I'd lost count of the times I've had to start over, and I honestly didn't think I had enough strength left to do it yet again. I was too old.......too tired.....and I just didn't want to. The next few weeks were some of the most brutal I've ever been through, as I mourned my old self-image and tried to deny the very existence of the illness. I could not bring myself to think of it as a part of me; I wanted to put it over in a corner and tell it to stay there and behave while I resumed my appointed rounds. Better yet, I told my bipolar self, just go away and leave me alone. It wasn't until I joined a support group and met people who had already walked this same lonesome valley that I understood: We are still ourselves. We don't lose that when we receive a diagnosis of mental illness; all we do is carry some extra baggage. In fact, we've ALWAYS carried it---the only difference is we know about it. And knowledge, as they say, is power. So until someone much smarter than I figures out a cure for what ails us, it would benefit anyone with a psychiatric disorder to learn to gently accept oneself as s/he is, and put away all notions of how things "ought" to be. Dwelling on what can never be is unhealthy, and worse, it gives our minds an excuse to wander along dark and dangerous pathways best left unexplored. As odd as it sounds, there's never been a better time to be depressed, anxious, manic, paranoid, delusional, or neurotic. Medications and other therapies are constantly being developed and improved; scientists and other mental health experts continue to learn better ways of recognizing problems while they are more easily treated. And while the mentally ill are still stigmatized in some ways, more and more of you "normal" folk are realizing that we work alongside you, live next door to you, and even make life-or-death decisions for you on occasion. In fact, we're a lot like you. We ARE you.

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