Everyone has bad days, everyone has bad nights. Everyone is entitled to these. It's a part of life.
Tonight I was placed in a 1:1. The guy was a generally cool guy, and all of his 'delusions' were proven true by his friends showing up and proving to me that he wasn't lying. I took him out for multiple smoke breaks. We talked alot about his emotions and feelings, I felt like I was making progress.
Until he decided he wanted to end it. He first began with beating himself, punching himself hard in the head, neck and jaw. He screamed out as I tried to pin him down, then with the help of the nurse we calmed him down. We then let him make some phone calls to his family, bad idea.
I dropped my notebook from on my lap and jumped over the side rail, trying to pry my hands from around the telephone cord wrapped tightly around his neck. I kicked the nurse call light on with my elbow and tried to wrestle him free from the cord, but he was too strong. Fists flew into my face, arms hitting my arm and knees into my chin as he tried to regain control. I could feel his carotid under my fingers as I fought to get grip of the cord. "I need some help in here!" I yelled, then got kicked back by a knee to my chest. I started to panic and the adrenaline kicked into high gear as I jumped back into action. No one came. We continued to wrestle for a minnute more, him spitting on me and swearing, dropping all the bombs in the book, he gritted his teeth and began to thrash some more. "I need some frickin help!" I yelled, this time a parade of Nurses, aides and the on-call doctor came running in and we helped get him free from it.
My hands shook as I continued to hold him down to the bed by his wrists. We all had adrenaline pumping and tried to calm him down as he yelled and screamed, trying to break free. I could feel his radial pulse pounding quickly, and then realized it was my own pulse I could feel.
I went numb after that, and thank goodness shift change was ten minutes away. I looked at him, feeling empty and insecure, he lay quietly on his bed, watching Scrubs. I just held down a man who tried to kill himself in front of me.
Now I am home, have had a whole long drive, and even tried to eat a little, but it takes it out of you. I know I did the right thing, I had doctors, nurses and other aides shake my hand and inform me I saved his life and did a good job...but I just watched a man try to take his own life.
I'm not quite sure how to feel about it all.
Monday, August 31, 2009
Wednesday, August 26, 2009
It's here!
I know I only posted the 'coming soon' teaser yesterday, but I actually figured out how to work it alot quicker than anticipated! It only took me a week or two to get it started, but I needed to get a better URL, better look and better my blogging for my readers.
After alot of blogging and lots of deliberation about the future of my writing and this blog I decided that this url, http://medicdani.blogspot.com (This Blog) as my night-to-night work and life journal. I have lots of family and friends who keep up with the blog that read up on both aspects of my life and I feel bad for my medical bloggers, I know those bore you.
My new blog is http://danisanatomy.blogspot.com and is where I am posting my 'best-of's as well as the posts I am looking to one day publish. These will be the posts that will have me beating on the keyboard, pulling out my hair, having edited multiple times and researched beyond belief, so I'm sure they will be good reads all around!
As for life and what I am up to I got started with my one simple english class tonight, and my teacher actually has alot of 'in's' with publishers, even smaller ones like for the school and has promised us the courtesy of a listening ear and reading eyes should we have anything ready within the semester. I am really excited and hoping to provide a few posts that I would like to have published by that time! Wish me luck!
So readers, bloggers and healthcare professionals alike, as I stated before, this one is going to be my mundane, boring, typo-ed and out of context blog. The good stuff that takes me weeks at a time to write is over there, so go check it out for me (comments, links and feedback are always welcome!)
After alot of blogging and lots of deliberation about the future of my writing and this blog I decided that this url, http://medicdani.blogspot.com (This Blog) as my night-to-night work and life journal. I have lots of family and friends who keep up with the blog that read up on both aspects of my life and I feel bad for my medical bloggers, I know those bore you.
My new blog is http://danisanatomy.blogspot.com and is where I am posting my 'best-of's as well as the posts I am looking to one day publish. These will be the posts that will have me beating on the keyboard, pulling out my hair, having edited multiple times and researched beyond belief, so I'm sure they will be good reads all around!
As for life and what I am up to I got started with my one simple english class tonight, and my teacher actually has alot of 'in's' with publishers, even smaller ones like for the school and has promised us the courtesy of a listening ear and reading eyes should we have anything ready within the semester. I am really excited and hoping to provide a few posts that I would like to have published by that time! Wish me luck!
So readers, bloggers and healthcare professionals alike, as I stated before, this one is going to be my mundane, boring, typo-ed and out of context blog. The good stuff that takes me weeks at a time to write is over there, so go check it out for me (comments, links and feedback are always welcome!)
Sunday, August 23, 2009
Time: My loosing battle
When you work in a hospital you come to loose a lot of things you once took for granted. Sleep, holidays, friends, family, and mostly, time. We accept this becuse we love our jobs, our co-workers and our patients.
Sitting straight up as I awoke I let myself catch my breath and after a moment flopped back down onto my pillow and close my eyes. The dream I had flashed through my mind again and I sighed deeply. It all came back to me as I lay there, the defibrillator, the sirens, the lights, and the patient, everything moving in slow motion, yet it was still moving too fast.
Dreams don't happen often, so when they do it is a big deal for me to try to remember them. I stare at the dreamcatcher over my bed and I continue to breathe, letting my eyes wander between it and the clock, whose big green letters read 3:45 a.m.
There was once a time I didn't need sleep. I was working two jobs, 5 days a week, and anywhere from 8-14 hours a day. Then, I would come home and hang out with family and friends. I didn't need food, I didn't need bathroom breaks, I didn't need anything, I just kept going. At the time I thought that was just how my body worked, but now, being exhausted all the time and always just wanting to catch up on sleep and sun, I wonder what was my deal.
Everyone I talk to reminds me that I have time, that I don't need to live in fast forward like I am used to. Everyone trys to convince me that I am doing better off than I think I am doing, but there are some people, the only people who honestly make sense to me, who encourage me to keep going in fast forward. "One day, you are gonna wake up a 50-year-old woman and wonder where your life has gone." They say. "Don't stop running. Don't stop moving in fast forward. Don't stop."
Once upon a time I worked in a care center, and a little old lady took me by the hands and pulled me close to her bed. "You are too young for this." She said. I argued, telling her I was the ripe old age of seventeen years old. She nodded. "You are way too young for this. Why are you doing this so young?" When I explained my dreams of being a nurse and a Paramedic, she smiled. "Well then, you keep being young and doing this. You will be the best. Don't slow down." She smiled. "But enjoy the moment, enjoy the time. It goes way too fast."
Life has provided me with many lessons since I have started working in this field. Once I thought this was just a short-term thing, but nothing you do in medicine is short term. We do this for people, and we toss ourselves by the wayside. Medicine isn't for the selfish, its for the selfless, and we loose alot, including time. As Meridith Grey said on an Episode of Grey's Anatomy; "Time takes pleasure in kicking our asses."
Sitting straight up as I awoke I let myself catch my breath and after a moment flopped back down onto my pillow and close my eyes. The dream I had flashed through my mind again and I sighed deeply. It all came back to me as I lay there, the defibrillator, the sirens, the lights, and the patient, everything moving in slow motion, yet it was still moving too fast.
Dreams don't happen often, so when they do it is a big deal for me to try to remember them. I stare at the dreamcatcher over my bed and I continue to breathe, letting my eyes wander between it and the clock, whose big green letters read 3:45 a.m.
There was once a time I didn't need sleep. I was working two jobs, 5 days a week, and anywhere from 8-14 hours a day. Then, I would come home and hang out with family and friends. I didn't need food, I didn't need bathroom breaks, I didn't need anything, I just kept going. At the time I thought that was just how my body worked, but now, being exhausted all the time and always just wanting to catch up on sleep and sun, I wonder what was my deal.
Everyone I talk to reminds me that I have time, that I don't need to live in fast forward like I am used to. Everyone trys to convince me that I am doing better off than I think I am doing, but there are some people, the only people who honestly make sense to me, who encourage me to keep going in fast forward. "One day, you are gonna wake up a 50-year-old woman and wonder where your life has gone." They say. "Don't stop running. Don't stop moving in fast forward. Don't stop."
Once upon a time I worked in a care center, and a little old lady took me by the hands and pulled me close to her bed. "You are too young for this." She said. I argued, telling her I was the ripe old age of seventeen years old. She nodded. "You are way too young for this. Why are you doing this so young?" When I explained my dreams of being a nurse and a Paramedic, she smiled. "Well then, you keep being young and doing this. You will be the best. Don't slow down." She smiled. "But enjoy the moment, enjoy the time. It goes way too fast."
Life has provided me with many lessons since I have started working in this field. Once I thought this was just a short-term thing, but nothing you do in medicine is short term. We do this for people, and we toss ourselves by the wayside. Medicine isn't for the selfish, its for the selfless, and we loose alot, including time. As Meridith Grey said on an Episode of Grey's Anatomy; "Time takes pleasure in kicking our asses."
Friday, August 21, 2009
Short Qip - Funny Story
In my unit we focus on spouses and family just as much as the patient. They have sat in a waiting room for about 6 hours, waiting, hoping, while we operate, cut, slice, sew back up and take to recovery. They are nervous, anxious, and tired by the time they even get to our unit, and so are their spouses. I personally take in another cot and make up a bed, I rearrange the room and help them get settled so that they can spend that time with their loved one.
Last night as I went into a room to get some vitals I knocked on the door.
"Come in." The wife said. I continued anyways and passed her on the bed and stood at the patients side of the bed. The room was dark so I was navigating by the light from the hall and from the bathroom on either side of us.
"I'm sorry to wake you," I said softly. "I just need to get some vitals from you."
"I was already awake, but why do you need my vitals?" I looked to the patient and we both looked at his wife, trying not to laugh. I continued and put the blood pressure cuff on his arm.
"How are you feeling?" I asked him, looking at the patient. He kept quiet and his wife corked up again.
"Feeling really good, these cots are suprisingly comfy."
"My pain is about a 5." The patient corked up, and the wife jumped to full alertness, sitting up and wiping her eyes. We all laughed. Sometimes its the little things that add that fun to your shift, just like that.
Last night as I went into a room to get some vitals I knocked on the door.
"Come in." The wife said. I continued anyways and passed her on the bed and stood at the patients side of the bed. The room was dark so I was navigating by the light from the hall and from the bathroom on either side of us.
"I'm sorry to wake you," I said softly. "I just need to get some vitals from you."
"I was already awake, but why do you need my vitals?" I looked to the patient and we both looked at his wife, trying not to laugh. I continued and put the blood pressure cuff on his arm.
"How are you feeling?" I asked him, looking at the patient. He kept quiet and his wife corked up again.
"Feeling really good, these cots are suprisingly comfy."
"My pain is about a 5." The patient corked up, and the wife jumped to full alertness, sitting up and wiping her eyes. We all laughed. Sometimes its the little things that add that fun to your shift, just like that.
Wednesday, August 19, 2009
An ED Problem Brought Upstairs
"I need help." He said, sweat dripping off of his forehead and his hands shaking as he walked up to me. Studying him I suddenly had a feeling about the situation as I saw his duffel bag and one of our mugs attached to it. "I need someone to help me."
I set down the glucometer I was carrying and asked him to sit down in a chair that was out in the hall. Kneeling down next to him he looked at me, his blue eyes boring holes into me, as if he was trying to talk to me.
"What seems to be the problem?" I asked.
"This isn't the right thing to do, I know this isn't the right thing to do." He said, burying his head into his hands. "But the ER keeps discharging me, and I really need help." He paused.
"What is it?" I whispered softly, touching his knee.
"I was here earlier...for an overdose. I had never wanted to do that before...and when I discharged I felt good, but now...I want to hurt myself. I have never wanted that." A single tear fell down his cheek and hit my hand. He sniffed loudly enough that it caught a nurses attention and she knelt down with me as we listened. "I went to the ER three times, they told me I would be arrested if I came back. They think I am abusing the system, but they didn't even do anything. I am not high, I am not drunk, no drugs. I am depressed. I am out of control and I need the help."
The nurse looked to me and then looked to the man. "I'm gonna call the ER; this man needs to be seen."
"I am not looking for a warm meal and a bed like they said, I am looking for help. I have enough pride to go to the shelter instead of abusing the system." At this point he let out a loud sob and bent over completely, hiding his face.
I stepped away for a moment and looked to the nurse who held a phone to her head and phrases like "WHAT THE HELL WHERE YOU THINKING?" and "ARE YOU PEOPLE STUPID?" escaped from her and we all stared in disbelief. I returned to the patient who fell onto me and sobbed sadly. Suddenly we heard the clanging of metal against metal and we both stopped as a deep voice spoke from behind me.
"Mr. Doe we are here to take you to the ER. We were told you are a hazard to yourself and your community."
"What the hell is this?" The nurse yelled as she approached us.
"This is doing the right thing." The security guard said getting nose to nose with the nurse. The patient let out a tight inhale and grabbed my hand, squeezing tightly. "What the hell is it that your team thinks its doing?"
"The humane thing. Get me a damn ER doctor and a gurney and get your asses out of here!" The nurse yelled back, drawing the attention of many other nurses, guests, the other security guards and even a few aides. Silence fell on the scene and all that was heard was breathing from all of us, the patient, the nurses, and the guards. You could feel the tension sitting in the air as the guard shook his head, and then placed a hand on the patient. Without saying a word he began to cuff him and then with a jerk he pulled him to his feet like a criminal. "Your a f*****g bastard." The nurse said. "You take him to the ER."
Between the five of them they hauled him off and like a criminal, like a monster. He hung his head and his shoulders shook uncontrollably as he started to sob as the drug him. It wasn't that he wasn't cooperating, it was that he was so impaired from fear, his want to commit suicide and having no one help, let alone care, that it was too much to ask him to march to his own end.
Forty-five minutes later we called the E.D. No one had seen the man yet, no one knew if he had been through again or not. I wasn't sure if he had even been seen, and angrily the nurse and I nearly left the floor to go find him, but as we looked through the charts and made our seemingly long and endless calls we realized that if he wasn't here, he was somewhere far from here and heading into the dark night. We felt helpless, and more than anything, angry.
Staring up at the starry sky tonight my thoughts drifted to this man, I hope he is alright.
I set down the glucometer I was carrying and asked him to sit down in a chair that was out in the hall. Kneeling down next to him he looked at me, his blue eyes boring holes into me, as if he was trying to talk to me.
"What seems to be the problem?" I asked.
"This isn't the right thing to do, I know this isn't the right thing to do." He said, burying his head into his hands. "But the ER keeps discharging me, and I really need help." He paused.
"What is it?" I whispered softly, touching his knee.
"I was here earlier...for an overdose. I had never wanted to do that before...and when I discharged I felt good, but now...I want to hurt myself. I have never wanted that." A single tear fell down his cheek and hit my hand. He sniffed loudly enough that it caught a nurses attention and she knelt down with me as we listened. "I went to the ER three times, they told me I would be arrested if I came back. They think I am abusing the system, but they didn't even do anything. I am not high, I am not drunk, no drugs. I am depressed. I am out of control and I need the help."
The nurse looked to me and then looked to the man. "I'm gonna call the ER; this man needs to be seen."
"I am not looking for a warm meal and a bed like they said, I am looking for help. I have enough pride to go to the shelter instead of abusing the system." At this point he let out a loud sob and bent over completely, hiding his face.
I stepped away for a moment and looked to the nurse who held a phone to her head and phrases like "WHAT THE HELL WHERE YOU THINKING?" and "ARE YOU PEOPLE STUPID?" escaped from her and we all stared in disbelief. I returned to the patient who fell onto me and sobbed sadly. Suddenly we heard the clanging of metal against metal and we both stopped as a deep voice spoke from behind me.
"Mr. Doe we are here to take you to the ER. We were told you are a hazard to yourself and your community."
"What the hell is this?" The nurse yelled as she approached us.
"This is doing the right thing." The security guard said getting nose to nose with the nurse. The patient let out a tight inhale and grabbed my hand, squeezing tightly. "What the hell is it that your team thinks its doing?"
"The humane thing. Get me a damn ER doctor and a gurney and get your asses out of here!" The nurse yelled back, drawing the attention of many other nurses, guests, the other security guards and even a few aides. Silence fell on the scene and all that was heard was breathing from all of us, the patient, the nurses, and the guards. You could feel the tension sitting in the air as the guard shook his head, and then placed a hand on the patient. Without saying a word he began to cuff him and then with a jerk he pulled him to his feet like a criminal. "Your a f*****g bastard." The nurse said. "You take him to the ER."
Between the five of them they hauled him off and like a criminal, like a monster. He hung his head and his shoulders shook uncontrollably as he started to sob as the drug him. It wasn't that he wasn't cooperating, it was that he was so impaired from fear, his want to commit suicide and having no one help, let alone care, that it was too much to ask him to march to his own end.
Forty-five minutes later we called the E.D. No one had seen the man yet, no one knew if he had been through again or not. I wasn't sure if he had even been seen, and angrily the nurse and I nearly left the floor to go find him, but as we looked through the charts and made our seemingly long and endless calls we realized that if he wasn't here, he was somewhere far from here and heading into the dark night. We felt helpless, and more than anything, angry.
Staring up at the starry sky tonight my thoughts drifted to this man, I hope he is alright.
Tuesday, August 18, 2009
The Chain of Command
When we were kids in school we learned about the chain of command. As the students, we were the peons and had to have permission to even use the bathroom. The teacher had all the power we could see over us, but she didn't have all the power she needed to help her do her job, this is where the principal came in, who had to determine if the teacher was as crazy as we thought or not. No matter what kind of child we were, each of us defied the rules, and at least once, the principal took our side. But sometimes the chain of command gets screwed up, and then problems arise.
The nurses station was buzzing with phones ringing, voices yelling and white coats creating a blur as they passed. As they walked, the interns, brand new from med school and our own batch of young doctors, griped. "I cannot believe the nurse wouldn't give my patient denture cream!" A blond, skinny doctor said in disbelief to her colleagues. She wore high heels and too much makeup, and looked much younger than she probably was.
"I cannot believe it either, I mean what the hell is her problem, the woman needs denture cream!" Another doctor, a short brown haired-boy said. He also looked too young, but was wise enough to wear scrubs. The third doctor, looked to be about thirty years old, he stayed quiet and watched his colleagues intently. He held the patients chart and laughed to himself, but said nothing to the others.
As they entered the patients room to discuss this mishap they stopped and stared at the patient speechless as the elderly lady they were worried about smiled at them, showing off a full pair of natural teeth, complete with a gold tooth on one side.
My pager buzzed endlessly in my pocket, but I couldn't seem to escape from a certain patient. She had something wrong with her, but no one could identify it. I kept thinking back to a scrubs episode where a patient kept thinking everyone was a clone of themselves and trying to hurt her. Her lip trembled as she rambled on and on about going upstairs to a unit that didn't exist. She kept talking about promises that doctors made, and kept talking about doctors screwing up her care. I approached the nurse as soon as I escaped, who rolled his eyes. So I took action. Wearily I walked over to the case managers desk and sat down next to her. She looked over at me. "What?" She grumbled, looking back to her paperwork.
"I need your help." I said, my voice shaking and knowing full well that I could get in a lot of trouble for doing what I was about to do. The case manager looked at me and took off her glasses, studying me. I took in a deep breath, then continued. "I have this patient, who hasn't had a psych consult, and I think she needs one. Also, her nurse seems to think she is crazy, so none of her needs have been met yet. And I am not sure who can call for those or what can be done, but I know you are a patient advocate, and so am I. Can you help me?"
She nodded and put her glasses back on. "I need a patient name and medical record number."
"So you can help me?" I asked.
"You bet your ass I can." She replied.
Thirty minutes later a psych team came to her room and new labs were drawn. The patients needs were met, and she felt better about her care, even if she was crazy, and without a doubt she had some psychological issues. No one knew it was me that told on the nurse about the patient. No one knew that I had overheard the interns arguing over something ridiculous, but the aide that I had to tell on knew that it was me, and for once, I regretted the chain of command, for this information getting slipped.
"I'm not taking report from you, your a bitch." She said, her acne scarred face sneering at me as she scratched the table with her dirty nails and chipped nail polish.
"That's fine." I said, handing my report sheet to one of the male aides. Anger and despise came over me and I felt meaner and nastier than ever as I watched her. Finally my eyes turned to the aide I had handed my report sheet to. He looked at my report sheet and a smile crept across his face.
"You even have their medications on here?" He asked. I nodded. "And their place of work, and their stories?" He looked at me and smiled. "I'm gonna switch shifts just to get report from you." He said. I smiled and clocked out, without a report to give I was burning time.
As I walked out the charge nurse tried to send me back to the break room, but when I explained the situation to her she sighed and apologized. I smiled at her and thanked her for her hard work, then walked out of the hospital, which seemed to be empty.
As kids we never realized all the things we did until it was bedtime, when mom and dad tucked us into bed and asked us about our days. It wasn't until we laid awake wondering what problems tomorrow would bring because of today's actions. As adults, we do the same thing, but our problems don't include apology letters or time out. As adults the repercussions of our actions are much, much bigger...
The nurses station was buzzing with phones ringing, voices yelling and white coats creating a blur as they passed. As they walked, the interns, brand new from med school and our own batch of young doctors, griped. "I cannot believe the nurse wouldn't give my patient denture cream!" A blond, skinny doctor said in disbelief to her colleagues. She wore high heels and too much makeup, and looked much younger than she probably was.
"I cannot believe it either, I mean what the hell is her problem, the woman needs denture cream!" Another doctor, a short brown haired-boy said. He also looked too young, but was wise enough to wear scrubs. The third doctor, looked to be about thirty years old, he stayed quiet and watched his colleagues intently. He held the patients chart and laughed to himself, but said nothing to the others.
As they entered the patients room to discuss this mishap they stopped and stared at the patient speechless as the elderly lady they were worried about smiled at them, showing off a full pair of natural teeth, complete with a gold tooth on one side.
My pager buzzed endlessly in my pocket, but I couldn't seem to escape from a certain patient. She had something wrong with her, but no one could identify it. I kept thinking back to a scrubs episode where a patient kept thinking everyone was a clone of themselves and trying to hurt her. Her lip trembled as she rambled on and on about going upstairs to a unit that didn't exist. She kept talking about promises that doctors made, and kept talking about doctors screwing up her care. I approached the nurse as soon as I escaped, who rolled his eyes. So I took action. Wearily I walked over to the case managers desk and sat down next to her. She looked over at me. "What?" She grumbled, looking back to her paperwork.
"I need your help." I said, my voice shaking and knowing full well that I could get in a lot of trouble for doing what I was about to do. The case manager looked at me and took off her glasses, studying me. I took in a deep breath, then continued. "I have this patient, who hasn't had a psych consult, and I think she needs one. Also, her nurse seems to think she is crazy, so none of her needs have been met yet. And I am not sure who can call for those or what can be done, but I know you are a patient advocate, and so am I. Can you help me?"
She nodded and put her glasses back on. "I need a patient name and medical record number."
"So you can help me?" I asked.
"You bet your ass I can." She replied.
Thirty minutes later a psych team came to her room and new labs were drawn. The patients needs were met, and she felt better about her care, even if she was crazy, and without a doubt she had some psychological issues. No one knew it was me that told on the nurse about the patient. No one knew that I had overheard the interns arguing over something ridiculous, but the aide that I had to tell on knew that it was me, and for once, I regretted the chain of command, for this information getting slipped.
"I'm not taking report from you, your a bitch." She said, her acne scarred face sneering at me as she scratched the table with her dirty nails and chipped nail polish.
"That's fine." I said, handing my report sheet to one of the male aides. Anger and despise came over me and I felt meaner and nastier than ever as I watched her. Finally my eyes turned to the aide I had handed my report sheet to. He looked at my report sheet and a smile crept across his face.
"You even have their medications on here?" He asked. I nodded. "And their place of work, and their stories?" He looked at me and smiled. "I'm gonna switch shifts just to get report from you." He said. I smiled and clocked out, without a report to give I was burning time.
As I walked out the charge nurse tried to send me back to the break room, but when I explained the situation to her she sighed and apologized. I smiled at her and thanked her for her hard work, then walked out of the hospital, which seemed to be empty.
As kids we never realized all the things we did until it was bedtime, when mom and dad tucked us into bed and asked us about our days. It wasn't until we laid awake wondering what problems tomorrow would bring because of today's actions. As adults, we do the same thing, but our problems don't include apology letters or time out. As adults the repercussions of our actions are much, much bigger...
Friday, August 14, 2009
Welcome to the Unit Newbie
(Frankly this is how my first day felt, and after orienting many aides I feel like this is an appropriate example of life as the new kid. This is a mix between my first day, and theirs. Enjoy!)
1500 -So they finally decided to give us one more aide. Wow. I'm surprised. You have no idea what you have gotten yourself into have you? They did discuss pay, the long hours and the fact that certain members of the staff pride themselves on coming in late right? Did they discuss the flow of patients you aren't trained to care for, their long stays and heavy lifting? How good are you at tackling people? Just asking.
Well then, come on newbie, lets go get your time card made.
1530 -Please newbie, quit asking me to tell you stories about the weird shit that happens at night, all the saves and the love of the job. I am trying to drive. If I have to tell you all about it for you to get excited, you are in the wrong career and are in the wrong unit. This unit prides themselves on aides that try to re-live scenes from 'hello dolly', nurses that shit sunshine, and doctors who hum and whistle the tune from the 'Andy Griffith Show' all I can say is, I hope you can keep up.
1600- Just a hint, the guy who operates the camera for the time cards, has no history in photography. If you smile, you look bad, if you frown you look bad. I know that sky blue makes your head look like its floating above your scrubs and makes your hair look oily. Suck it up and enjoy your picture.
Say cheese!
1700 -Now for the technical crap. Here is your binder. Yes, EVERY paper is a worksheet you need to have filled out to keep this job. Yes, I am very aware that this is a 3-inch-binder and is very full. No, this isn't the only stuff. Each week the people we call 'managers' decide that we need to keep learning. Go ahead and find a quiet spot to work on it newbie, and meet me at shift change.
Oh, and if you haven't had a hit of caffeine yet, do it now.
1900 - If you don't get those damn shoes tied and your hair pulled up in 30 seconds I swear I will make your night miserable. Come on kid, you said you've done this before! Good, now grab a piece of paper and sit your butt down. Its time for report, so we are gonna listen to our other aide give report, and please don't interrupt, she may not give all the information- or even half of the information - that we need, but that's what charts are for. Eyes and ears this way newbie.
We are gonna go do what I call 'introductions' with the patients. Go say hi, talk for a moment, smile and offer to help them. Give them the agenda for the evening so they can plan family visits and pain medications accordingly. No you cannot 'just shadow me' tonight kid, you said you've been an aide for years, get in there and show me what you got!
2000 - This here is our vitals machine. This nifty machine is someone you are gonna know more than your spouse. Each button has a function and some sends this baby off screaming for no reason. You will have an intimate relationship with this machine, because of all the time you spend carting it around.
No, I really don't want to know if you are married, I am just trying to prove a point. Yes, I know I am being mean- this is orientation and until you pass everything off I get to be a bitch. Please tell me you know what all these tools are...
Its called a Pulse Oximeter dude...
That attaches to a blood pressure cuff...
Newbie, that's the thermometer...the oral thermometer.
You can go ahead and wipe down the machine now. I can wait, use the good wipes, the ones with the purple lid. Those kill everything.
2200 - When I asked if you had any questions about the job I was looking for a serious question kid. I was looking for 'can you guide me through the IV pumps again', or even 'show me how to work a CPM.' Something more along the lines of 'what is the code to the galley?' or 'Remind me of the Nurses names?'
I was not looking for 'is there anything we do that doesn't involve pee or pillows?' as a question. Lets review. Smile. Help them pee. Hold your pee for 12 hours. Keep smiling. Deal while they whine. Their pain is real. Write that one down. Keep smiling. Don't forget to chart.
2400- You are only halfway through this shift kid don't even THINK about yawning. Lets go take more vitals and check in on our patients. What will you be checking for you ask? Vitals out of range, comfort levels, worries and concerns. Teach the patient everything they want to know about. If you don't know, you learn. FAST. Please quit staring at me like I just slapped your sister.
Oh, and don't say you are bored, because I will find so much more work for you to do than just this orienting crap. I just made a pot of coffee, down a cup and meet me over in the clean utility closet so we can get it organized. After we are done you can start on that hellish binder.
0200- So kid, we've had downtime for almost two hours now, lets check your binder and see what all you have gotten done.
Oh. My. Word.
You have one page done and the other two have drawings of pony's and daises? Yes I know they are daises! If you didn't know the answer you have a binder on your left that has the answers and an orienter down the hall who is filling out some of her own educational material. Please get back to work, and just know, any more daises may cause me to kick your ass.
No I don't have to shit sunshine, that's the nurses.
0300 - Come on newbie, lets go clean our machines and wipe up counters. Make sure to put on gloves, that stuff is used to wipe down O.R.'s and will sting your hands. Okay, looks good, now lets go ahead and hit up the dirty utility closet. That's the room with dirty machines and equipment stacked to the ceiling. On second thought, bring another canister of the wipes, would ya?
0400 - I am really glad I don't work the psych unit because they would have me admitted. You may feel the same. Please quit strumming your lip like a guitar. Why? Cause you have nasty stuff on your hands. I am so glad its only your first day, or else I would kick your ass... The antiseptic gel does not kill everything, plus it tastes nasty. Fine, don't believe me, but don't put your hands in your mouth.
When I can catch my breath from laughing so hard, remind me to tell you....Told ya so.
0600- Follow me as we get the bandage box put together for the doctors. No this isn't in the job description, but it is what we do here on this unit. Helps the doctors out and in return they help us, called teamwork. We do a lot of that here kid, hope you can handle it. Remember the boxes of 4x4s, the sterile ones. The tape and the tegaderm. Its all about tape and gauze here, if you haven't learned anything else, please remember that.
Answer me one question kid, why are your scrubs stained? And please tell me its not blood stains...
0630- Its called a HEMO-VAC. Let me remind you. HEMO-VAC. It drains the blood from the surgical site into this spring loaded canister. SPRING LOADED. Lets think of other things that are spring loaded, jack-in-the-box, latches on car hoods, clicky pens, and cuckoo clocks. Do you get the idea of spring loaded? Good. Now apply PRESSURE. Let me emphasise on the pressure, are you putting pressure on it? Use your whole hand, and crack it open. Flip and drain blood, and then flush appropriately. Now to close. Put PRESSURE on it and then flip it closed.
Please tell me you understood that. Please?
0700 - So, is your charting done? Good. How about those first three pages of Orientation? Fine, I'll take the two and a half. But tomorrow I expect you to have seven pages done. Yes, we can even ask the nurses tomorrow too. You look tired as hell. Go do a power run to the next call light, it will help you wake up.
Please quit bitching about the other aide being late, I warned you that this is what she does. Use the time to keep up with your charting and hang in there. One day we will all kick her ass and it will land her out of the door. We all hate her for it.
0730- You did well newbie, you hung in there, dealt with the queen of the bitch nest, even got close to singing at one point. Keep your chin up, its a process, even if we seem evil now you'll learn to love us.
Let me show you out of the building. That guy with the full beard is here so early cause he slept here, that's one hell of a dedicated nurse. The gal carrying the newspapers, well I don't know what she does, but she's always here. Seems to be a pretty nice person. That's our environmental services manager, the one out back smoking, she works til 1 am most nights!
Working nights is tough kid, but you did it. We walk out as the doctors walk in, and we get none of the credit. But that is the job, now get your ass home and get some sleep, you look like shit.
Oh and newbie, welcome to the unit.
(Thanks to Capt Schmoe for the idea!)
1500 -So they finally decided to give us one more aide. Wow. I'm surprised. You have no idea what you have gotten yourself into have you? They did discuss pay, the long hours and the fact that certain members of the staff pride themselves on coming in late right? Did they discuss the flow of patients you aren't trained to care for, their long stays and heavy lifting? How good are you at tackling people? Just asking.
Well then, come on newbie, lets go get your time card made.
1530 -Please newbie, quit asking me to tell you stories about the weird shit that happens at night, all the saves and the love of the job. I am trying to drive. If I have to tell you all about it for you to get excited, you are in the wrong career and are in the wrong unit. This unit prides themselves on aides that try to re-live scenes from 'hello dolly', nurses that shit sunshine, and doctors who hum and whistle the tune from the 'Andy Griffith Show' all I can say is, I hope you can keep up.
1600- Just a hint, the guy who operates the camera for the time cards, has no history in photography. If you smile, you look bad, if you frown you look bad. I know that sky blue makes your head look like its floating above your scrubs and makes your hair look oily. Suck it up and enjoy your picture.
Say cheese!
1700 -Now for the technical crap. Here is your binder. Yes, EVERY paper is a worksheet you need to have filled out to keep this job. Yes, I am very aware that this is a 3-inch-binder and is very full. No, this isn't the only stuff. Each week the people we call 'managers' decide that we need to keep learning. Go ahead and find a quiet spot to work on it newbie, and meet me at shift change.
Oh, and if you haven't had a hit of caffeine yet, do it now.
1900 - If you don't get those damn shoes tied and your hair pulled up in 30 seconds I swear I will make your night miserable. Come on kid, you said you've done this before! Good, now grab a piece of paper and sit your butt down. Its time for report, so we are gonna listen to our other aide give report, and please don't interrupt, she may not give all the information- or even half of the information - that we need, but that's what charts are for. Eyes and ears this way newbie.
We are gonna go do what I call 'introductions' with the patients. Go say hi, talk for a moment, smile and offer to help them. Give them the agenda for the evening so they can plan family visits and pain medications accordingly. No you cannot 'just shadow me' tonight kid, you said you've been an aide for years, get in there and show me what you got!
2000 - This here is our vitals machine. This nifty machine is someone you are gonna know more than your spouse. Each button has a function and some sends this baby off screaming for no reason. You will have an intimate relationship with this machine, because of all the time you spend carting it around.
No, I really don't want to know if you are married, I am just trying to prove a point. Yes, I know I am being mean- this is orientation and until you pass everything off I get to be a bitch. Please tell me you know what all these tools are...
Its called a Pulse Oximeter dude...
That attaches to a blood pressure cuff...
Newbie, that's the thermometer...the oral thermometer.
You can go ahead and wipe down the machine now. I can wait, use the good wipes, the ones with the purple lid. Those kill everything.
2200 - When I asked if you had any questions about the job I was looking for a serious question kid. I was looking for 'can you guide me through the IV pumps again', or even 'show me how to work a CPM.' Something more along the lines of 'what is the code to the galley?' or 'Remind me of the Nurses names?'
I was not looking for 'is there anything we do that doesn't involve pee or pillows?' as a question. Lets review. Smile. Help them pee. Hold your pee for 12 hours. Keep smiling. Deal while they whine. Their pain is real. Write that one down. Keep smiling. Don't forget to chart.
2400- You are only halfway through this shift kid don't even THINK about yawning. Lets go take more vitals and check in on our patients. What will you be checking for you ask? Vitals out of range, comfort levels, worries and concerns. Teach the patient everything they want to know about. If you don't know, you learn. FAST. Please quit staring at me like I just slapped your sister.
Oh, and don't say you are bored, because I will find so much more work for you to do than just this orienting crap. I just made a pot of coffee, down a cup and meet me over in the clean utility closet so we can get it organized. After we are done you can start on that hellish binder.
0200- So kid, we've had downtime for almost two hours now, lets check your binder and see what all you have gotten done.
Oh. My. Word.
You have one page done and the other two have drawings of pony's and daises? Yes I know they are daises! If you didn't know the answer you have a binder on your left that has the answers and an orienter down the hall who is filling out some of her own educational material. Please get back to work, and just know, any more daises may cause me to kick your ass.
No I don't have to shit sunshine, that's the nurses.
0300 - Come on newbie, lets go clean our machines and wipe up counters. Make sure to put on gloves, that stuff is used to wipe down O.R.'s and will sting your hands. Okay, looks good, now lets go ahead and hit up the dirty utility closet. That's the room with dirty machines and equipment stacked to the ceiling. On second thought, bring another canister of the wipes, would ya?
0400 - I am really glad I don't work the psych unit because they would have me admitted. You may feel the same. Please quit strumming your lip like a guitar. Why? Cause you have nasty stuff on your hands. I am so glad its only your first day, or else I would kick your ass... The antiseptic gel does not kill everything, plus it tastes nasty. Fine, don't believe me, but don't put your hands in your mouth.
When I can catch my breath from laughing so hard, remind me to tell you....Told ya so.
0600- Follow me as we get the bandage box put together for the doctors. No this isn't in the job description, but it is what we do here on this unit. Helps the doctors out and in return they help us, called teamwork. We do a lot of that here kid, hope you can handle it. Remember the boxes of 4x4s, the sterile ones. The tape and the tegaderm. Its all about tape and gauze here, if you haven't learned anything else, please remember that.
Answer me one question kid, why are your scrubs stained? And please tell me its not blood stains...
0630- Its called a HEMO-VAC. Let me remind you. HEMO-VAC. It drains the blood from the surgical site into this spring loaded canister. SPRING LOADED. Lets think of other things that are spring loaded, jack-in-the-box, latches on car hoods, clicky pens, and cuckoo clocks. Do you get the idea of spring loaded? Good. Now apply PRESSURE. Let me emphasise on the pressure, are you putting pressure on it? Use your whole hand, and crack it open. Flip and drain blood, and then flush appropriately. Now to close. Put PRESSURE on it and then flip it closed.
Please tell me you understood that. Please?
0700 - So, is your charting done? Good. How about those first three pages of Orientation? Fine, I'll take the two and a half. But tomorrow I expect you to have seven pages done. Yes, we can even ask the nurses tomorrow too. You look tired as hell. Go do a power run to the next call light, it will help you wake up.
Please quit bitching about the other aide being late, I warned you that this is what she does. Use the time to keep up with your charting and hang in there. One day we will all kick her ass and it will land her out of the door. We all hate her for it.
0730- You did well newbie, you hung in there, dealt with the queen of the bitch nest, even got close to singing at one point. Keep your chin up, its a process, even if we seem evil now you'll learn to love us.
Let me show you out of the building. That guy with the full beard is here so early cause he slept here, that's one hell of a dedicated nurse. The gal carrying the newspapers, well I don't know what she does, but she's always here. Seems to be a pretty nice person. That's our environmental services manager, the one out back smoking, she works til 1 am most nights!
Working nights is tough kid, but you did it. We walk out as the doctors walk in, and we get none of the credit. But that is the job, now get your ass home and get some sleep, you look like shit.
Oh and newbie, welcome to the unit.
(Thanks to Capt Schmoe for the idea!)
Wednesday, August 12, 2009
Television and its Effects on Medicine
At a red light in the sunshine, On a Sunday nothing to say, don't even try,
Some are coming home, Some are leaving town, While my world's crashing down
On a Sunday in the sunshine at a red light
- David Nail "Red Light"
Driving home is the perfect time to think about everything. On TV shows doctors hide in closets and sit in parking lots, but in real life we do it on the way home. You really can't unwind and think if you're still sitting in the buildings shadows. Don't get me wrong, I love the hospital and our addition to it has it looking just like it came out of a movie and is beyond beautiful, but you never see someone in scrubs sitting in the lobbies, cafeteria, or coffee shop trying to think.
Sadly some of the saddest shifts I have worked havent had the happy endings or even the justified final scenes. Once upon a time I thought that on the way home from work it would be dark, my mind racing, my radio up and a single tear down my cheek. Now that I have worked this job for a little bit, its easy to see that there is no such thing as one tear, there is no such thing as the radio up loud enough, and its almost never dark enough.
All medical professionals have seen those shows, and most generally enjoy them. Why? I get Scrubs, its a funny show and genuinely shows humor in medicine (as well as all different kinds of employees) so its a good way to unwind. However, shows like Grey's Anatomy, House, and E.R. really has an impact we don't see on our patients.
"So with my diagnosis, is it like house?" A patient once asked me. "Cause I've seen like 4 different doctors, and one is the boss-man. Do I really need that?" The patient didn't understand the system of residents, interns and our teaching hospital. He was also severly confused that the nurses knew more about him than the doctors did.
"I need a new doctor." Another patient said with a sense of urgency. "I cannot trust her. She has a ring on her finger and probably a zillion other problems than me." I stared at the patient, confused as to where she was drawing this conclusion. "Its like the hospital system on Grey's right?" She later on asked. Insert light bulb clicking 'on'.
Even at hospital orientation they informed us that our patients rely on TV to figure out what goes on in the hospitals while they are there. I see a BIG problem with that, and wish I knew how we could fix it. Until then, I turn the radio up and just drive.
Some are coming home, Some are leaving town, While my world's crashing down
On a Sunday in the sunshine at a red light
- David Nail "Red Light"
Driving home is the perfect time to think about everything. On TV shows doctors hide in closets and sit in parking lots, but in real life we do it on the way home. You really can't unwind and think if you're still sitting in the buildings shadows. Don't get me wrong, I love the hospital and our addition to it has it looking just like it came out of a movie and is beyond beautiful, but you never see someone in scrubs sitting in the lobbies, cafeteria, or coffee shop trying to think.
Sadly some of the saddest shifts I have worked havent had the happy endings or even the justified final scenes. Once upon a time I thought that on the way home from work it would be dark, my mind racing, my radio up and a single tear down my cheek. Now that I have worked this job for a little bit, its easy to see that there is no such thing as one tear, there is no such thing as the radio up loud enough, and its almost never dark enough.
All medical professionals have seen those shows, and most generally enjoy them. Why? I get Scrubs, its a funny show and genuinely shows humor in medicine (as well as all different kinds of employees) so its a good way to unwind. However, shows like Grey's Anatomy, House, and E.R. really has an impact we don't see on our patients.
"So with my diagnosis, is it like house?" A patient once asked me. "Cause I've seen like 4 different doctors, and one is the boss-man. Do I really need that?" The patient didn't understand the system of residents, interns and our teaching hospital. He was also severly confused that the nurses knew more about him than the doctors did.
"I need a new doctor." Another patient said with a sense of urgency. "I cannot trust her. She has a ring on her finger and probably a zillion other problems than me." I stared at the patient, confused as to where she was drawing this conclusion. "Its like the hospital system on Grey's right?" She later on asked. Insert light bulb clicking 'on'.
Even at hospital orientation they informed us that our patients rely on TV to figure out what goes on in the hospitals while they are there. I see a BIG problem with that, and wish I knew how we could fix it. Until then, I turn the radio up and just drive.
Tuesday, August 11, 2009
Ignoring the Pain
"Dani I need help in here!" I didn't even need to look to see what room she was calling from, I didn't even need to respond, all I needed to do was focus. The sound of my heartbeat filled my ears and the ice cold sensation of adrenaline filled my veins. I grabbed the door frame and slid on the freshly cleaned floors and spun into the patients room. Gloving up I stood next to the nurse to see a patient screaming in pain and to see the nurse holding pressure on his hip, blood covering the sheets and the pillows elevating his leg. I took over the pressure and she ran out of the room, explaining that the on-call doc was on his way as well as the surgical team.
We generally don't see anything like this, for the most part our nights are full of long conversations about life and advice between bathroom breaks and checking in on snoring patients. But every now and then, excitement jumps in, and I get a chance to show off my skills. I made small talk with the patient as the nurse made frantic phone calls. Suddenly a doctor sprinted into the room, finishing putting on his scrub top and grabbed gloves. As he saw me and then saw the nurse run in after him he looked to her.
"Who did you call?" He asked.
"Everyone." The Nurse replied breathlessly.
He had what appeared to be a hematoma. When we first recieved the patient from the PACU he mentioned pain on a graft site and we examined it, but we weren't quite sure what it could be. We applied ice to it and paged a doctor, and from there, I had no idea what had happened until this moment. According to the patient his site just...exploded and the blood oozed everywhere. I placed tighter pressure on his site and I studied his face as he winced in pain.
"Lets get this guy some pain meds!" I holled out to the doctor and nurse who were talking right outside the door. As I yelled this another doc came running in and then did a quick examination. The decision had been made, he had to be sutured there and then.
This doesn't always happen in medicine. This doesn't always happen in real life, but we do always ignore that little bit of pain. Sure we examine it, we feel it, but then we toss it aside and wait for something bigger to happen.
My father did the same thing. He always had migraines, he always had stomach aches. It just became a way of life that after dad ate, he was sick. We figured it was stress, or simply his job, but one day after work my mother took him to the hospital. He dropped over 10 lbs in a week. He was sick, and we had to do something. He was just trying to ignore the pain.
A good friend of mine had a similar situation, he had stomachaches that left him bedridden for days, he would sleep for days at a time. He was sick, and instead blamed it on his habits (drinking and smoking) and decided against a doctor. Two months ago he went to a doctor, and has been to the doctor 3-4 times a week since, there is still no diagnosis. There may have been, if he hadn't ignored the pain.
We need pain in our lives to help us know when we are okay and when we are not. We need the pain just like we need the air we breathe. It just sucks that we have to feel it so often.
We generally don't see anything like this, for the most part our nights are full of long conversations about life and advice between bathroom breaks and checking in on snoring patients. But every now and then, excitement jumps in, and I get a chance to show off my skills. I made small talk with the patient as the nurse made frantic phone calls. Suddenly a doctor sprinted into the room, finishing putting on his scrub top and grabbed gloves. As he saw me and then saw the nurse run in after him he looked to her.
"Who did you call?" He asked.
"Everyone." The Nurse replied breathlessly.
He had what appeared to be a hematoma. When we first recieved the patient from the PACU he mentioned pain on a graft site and we examined it, but we weren't quite sure what it could be. We applied ice to it and paged a doctor, and from there, I had no idea what had happened until this moment. According to the patient his site just...exploded and the blood oozed everywhere. I placed tighter pressure on his site and I studied his face as he winced in pain.
"Lets get this guy some pain meds!" I holled out to the doctor and nurse who were talking right outside the door. As I yelled this another doc came running in and then did a quick examination. The decision had been made, he had to be sutured there and then.
This doesn't always happen in medicine. This doesn't always happen in real life, but we do always ignore that little bit of pain. Sure we examine it, we feel it, but then we toss it aside and wait for something bigger to happen.
My father did the same thing. He always had migraines, he always had stomach aches. It just became a way of life that after dad ate, he was sick. We figured it was stress, or simply his job, but one day after work my mother took him to the hospital. He dropped over 10 lbs in a week. He was sick, and we had to do something. He was just trying to ignore the pain.
A good friend of mine had a similar situation, he had stomachaches that left him bedridden for days, he would sleep for days at a time. He was sick, and instead blamed it on his habits (drinking and smoking) and decided against a doctor. Two months ago he went to a doctor, and has been to the doctor 3-4 times a week since, there is still no diagnosis. There may have been, if he hadn't ignored the pain.
We need pain in our lives to help us know when we are okay and when we are not. We need the pain just like we need the air we breathe. It just sucks that we have to feel it so often.
Sunday, August 9, 2009
Realizing Reality
I have a tear in my labrium. I have tendons torn everywhere, and I am in an amazing amount of pain.
Its time for me to quit hiding behind the realities and start to face these facts, as hard as it may be. I can't have my surgery until November at least, and thats the soonest possible time, however thats only considering work. Considering my personal life and hoping to have a paycheck, big or small during that time I will need to wait until June, at least.
I despise that I have to be on pain medications to ease the pain, and completely and totally fear an addiction to them, even if it is minor pain meds. It scares me to see my patients and realize that we are the same people, and that I am no longer the knight in shining armor there to save them from their impending pain and discomfort.
Since having my MRI read to me by a resident and reviewing all of this with my fiance I have filed the CD away and I have only my body to rely on when it comes to my current situation. The pain in my shoulders causes me to maunever in weird ways, which causes a strain on my other muscles; neck, back, arms and even hips. I try not to take the pain meds for the pain, but I hurt, and working the job I do makes it that much harder.
My mom put it best to me 'By the time you are 25 years old, wherever you are, whatever you do, you will be the wisest 25 year old on the planet.'
Its been incredibly hard for me to be open about this on here, since there are plenty of bloggers I do know, I have been trying to say it, but with the amount of new blogs that have found my site, I have been hesitant to say it. However, saying it on here helps me better. Thanks for listening to me.
Its time for me to quit hiding behind the realities and start to face these facts, as hard as it may be. I can't have my surgery until November at least, and thats the soonest possible time, however thats only considering work. Considering my personal life and hoping to have a paycheck, big or small during that time I will need to wait until June, at least.
I despise that I have to be on pain medications to ease the pain, and completely and totally fear an addiction to them, even if it is minor pain meds. It scares me to see my patients and realize that we are the same people, and that I am no longer the knight in shining armor there to save them from their impending pain and discomfort.
Since having my MRI read to me by a resident and reviewing all of this with my fiance I have filed the CD away and I have only my body to rely on when it comes to my current situation. The pain in my shoulders causes me to maunever in weird ways, which causes a strain on my other muscles; neck, back, arms and even hips. I try not to take the pain meds for the pain, but I hurt, and working the job I do makes it that much harder.
My mom put it best to me 'By the time you are 25 years old, wherever you are, whatever you do, you will be the wisest 25 year old on the planet.'
Its been incredibly hard for me to be open about this on here, since there are plenty of bloggers I do know, I have been trying to say it, but with the amount of new blogs that have found my site, I have been hesitant to say it. However, saying it on here helps me better. Thanks for listening to me.
Saturday, August 8, 2009
Abuse, TV and MRI Results
She was my height, my age. Her diagnosis seemed worrysome, and after talking to her we realized it wasn't due to the injury the doctors had written it was. They had it reported as an athletic injury, it was a fall. As she talked to me about her life, the horrifying stories were told as if it was nothing, and I looked to the nurse as we listened, within our eyes a conversation was held.
In medical dramas and TV shows you see patients who have been abused multiple times and the criminal got away. You watch as the doctors and nurses stare at each other and you can read their thoughts. Its a popular subject, but by the end of the 45 minute television episode all is righted in the world. The abuser is in prision for years and the patient has found herself and is happy. Its really depressing that real life is nothing like that.
As the doctors came in for rounds the nurse demanded they talk to her and that she recieve a psych consult. Phrases like 'my life in ruined', 'i hate my f***in life' and 'im glad i hurt, he dont hit when your hurt' were scattered throughout the night. There was no hiding it, this girl was a victim. The doctors only half listened as they flipped through the paperwork and then told us what we already knew - go to case management. Before night shift clocked out we waited to see case management go into the room- then paged the doctors again to ensure she got appropriate care.
All was not right in the world when my episode ended. The patient was still with him and he threatened her during the day, all things the other staff should have noticed. As I cared for her my heart broke and my pulse raced. I knew the problem would return in the morning and I worried about my patient and her care as soon as she left our unit. Sometimes worrying is all you can do.
I also got my MRI results back last night and spent hours staring at it, trying to see what the doctors could see, and failed miserably. However, I did find a way to save these images, and since I the patient give my consent, here they are for your viewing pleasure.
Friday, August 7, 2009
Stuck in a Rut
Lately I'm struggling to find inspiration to do my job. I'm struggling to keep attentive and compassionate, mainly after the types of patients I have been assigned to. Patients who moan and scream, in the hopes that they will get more narcotics. Patients who lie to all the staff, and cannot keep up with the lies. Hard-core psych patients. High needs patients. I feel like I am drowning in a sea of patients and people, and am no longer doing what I once loved to do.
As I walk into patient rooms now I see the patient I will have to become to chase my dream. I see myself in the bed, in the sling, and with the pain. I see myself trying to remember why I did it after all. I search the community college pages endlessly in the vain hopes of anything else that catches my eye for education. Anything that I could possibly do that wouldn't harm my injury or my body. Nothing catches my eye. I only want to be a paramedic.
I wonder if its worth it, a 16 week recovery period. Not being able to even have the surgery until late this year if I decide to go on with it. With the Paramedic program I want to go into I would have to quit my job- the schedule is Mon-Fri 7a-5p and Sat 8a-2p. There is literally no time to work and study and be successful for this career. I wouldn't want to work. I want to pass. I think about my options. I think about life. My fiance starts POST on Sept 8. He's got his future started and ready to go, and not being one to lie I am envious.
Last night kicked my ass. Still being sore from my appointment with the surgeon and still stressed as can be I tried my damnedest to keep up with the fast pace. I was in pain, and I kept smiling, doing what I had to do to simply do my job, but in the back of my mind I kept wondering if any of it was worth it.
It could be worse. I could be exactly like some of my patients. I could be in such a mess that no one knows how to save them, let alone deal with them. I could be admitted to a psych ward any time now without reason or rhyme. I could be continuously abusing myself and my loved ones. I'm simply just a girl with a road block.
Its back to work tonight, and back to the unit. Hopefully I can get back out of my funk and back to doing the job I set out to do.
As I walk into patient rooms now I see the patient I will have to become to chase my dream. I see myself in the bed, in the sling, and with the pain. I see myself trying to remember why I did it after all. I search the community college pages endlessly in the vain hopes of anything else that catches my eye for education. Anything that I could possibly do that wouldn't harm my injury or my body. Nothing catches my eye. I only want to be a paramedic.
I wonder if its worth it, a 16 week recovery period. Not being able to even have the surgery until late this year if I decide to go on with it. With the Paramedic program I want to go into I would have to quit my job- the schedule is Mon-Fri 7a-5p and Sat 8a-2p. There is literally no time to work and study and be successful for this career. I wouldn't want to work. I want to pass. I think about my options. I think about life. My fiance starts POST on Sept 8. He's got his future started and ready to go, and not being one to lie I am envious.
Last night kicked my ass. Still being sore from my appointment with the surgeon and still stressed as can be I tried my damnedest to keep up with the fast pace. I was in pain, and I kept smiling, doing what I had to do to simply do my job, but in the back of my mind I kept wondering if any of it was worth it.
It could be worse. I could be exactly like some of my patients. I could be in such a mess that no one knows how to save them, let alone deal with them. I could be admitted to a psych ward any time now without reason or rhyme. I could be continuously abusing myself and my loved ones. I'm simply just a girl with a road block.
Its back to work tonight, and back to the unit. Hopefully I can get back out of my funk and back to doing the job I set out to do.
Tuesday, August 4, 2009
Surgery
I work in surgery. I work at the exact place I went to for my appointments. I work with that surgeon, and have worked one-on-one with him and his patients many times. I know the situation, but instead of the scrubs, I was the gown.
As soon as I placed the gown on and he asked me to stand to see what I can and cannot do, I realized this was business. He played with my range of motion and frankly put me into way more pain than I had bargained for in a one-hour visit. He could see that my joint was loose, but he had no idea how loose we were talking about. As soon as we sat down to talk he told me that he found things on my MRI, but I needed a different one.
Fantastic. There goes my paycheck.
As we spoke it became apparent to me what I need to do to even attempt to become a Paramedic. Its not just going to school anymore. When I can no longer hug my fiance, when I can no longer make a bed (a big part of life as well as life as a CNA), and when I can barely lift a patient, I knew it was time to call in the big shots. I am gonna need to have a surgery to do my job as an aide, as well as even consider being eligible to reach my dreams.
He explained the procedure well, and I can honestly say he is the best doctor I have been to yet, making sure I understood the procedure. Even his student was well educated and knew exactly what should be done (not bad for a first year resident!). But as I drove home with my mother I kept thinking to myself about the whole thing.
My injury ached, it creaked and it throbbed. I am a 20-year-old female with high aspirations and now this. No one my age should be in this much pain, but then again, I know I have a high pain threshold (I broke my collarbone and didn't know it until this shoulder injury years later when the injury had healed itself). How much pain am I really in?
As I stared down the freeway it seemed endless, somewhat like my dreams of becoming a Paramedic. Would I ever find the end and reach my dreams, or will I have to jump off an exit too soon and give it up? Would I ever have the glory and the richness of that first real save?
Tonight I continue to try to keep the pain under control and keep my mind off of this now touchy subject, hoping that inspiration will find me and that I will know what to do. But until then, I sit back, enjoy my pepsi and try not to feel overwhelmed about it all.
As soon as I placed the gown on and he asked me to stand to see what I can and cannot do, I realized this was business. He played with my range of motion and frankly put me into way more pain than I had bargained for in a one-hour visit. He could see that my joint was loose, but he had no idea how loose we were talking about. As soon as we sat down to talk he told me that he found things on my MRI, but I needed a different one.
Fantastic. There goes my paycheck.
As we spoke it became apparent to me what I need to do to even attempt to become a Paramedic. Its not just going to school anymore. When I can no longer hug my fiance, when I can no longer make a bed (a big part of life as well as life as a CNA), and when I can barely lift a patient, I knew it was time to call in the big shots. I am gonna need to have a surgery to do my job as an aide, as well as even consider being eligible to reach my dreams.
He explained the procedure well, and I can honestly say he is the best doctor I have been to yet, making sure I understood the procedure. Even his student was well educated and knew exactly what should be done (not bad for a first year resident!). But as I drove home with my mother I kept thinking to myself about the whole thing.
My injury ached, it creaked and it throbbed. I am a 20-year-old female with high aspirations and now this. No one my age should be in this much pain, but then again, I know I have a high pain threshold (I broke my collarbone and didn't know it until this shoulder injury years later when the injury had healed itself). How much pain am I really in?
As I stared down the freeway it seemed endless, somewhat like my dreams of becoming a Paramedic. Would I ever find the end and reach my dreams, or will I have to jump off an exit too soon and give it up? Would I ever have the glory and the richness of that first real save?
Tonight I continue to try to keep the pain under control and keep my mind off of this now touchy subject, hoping that inspiration will find me and that I will know what to do. But until then, I sit back, enjoy my pepsi and try not to feel overwhelmed about it all.
Understanding
In previous posts I have discussed my many recent visits to the doctors offices, and how badly I hate doctors when I am not working for them. Last week I spent time seeing a non-surgical Orthopaedic specialist, getting an MRI and an hour spent getting Xrays, only to be referred to a Surgeon (who I have to see today. Ick.) Every time I whine about it to my fiance, he always reminds me 'this will make you better at what you do. You will understand what the patient is going through because you have been the patient.'
At the hospital I always try to remember that. During my training as a CNA and as an EMT the school where I got my training always had us remember one thing - if you're gonna do it to a patient you better do it to yourself first. I have been restrained as a psych patient. I have had to wear a c-collar for hours at a time, I have been rolled, moved and repositioned, I have had thickened foods and mushy meals. I have ingested activated charcoal and had glucose ground into my gums. I have been the patient, but it has truly helped me be a better caregiver. I can explain the patient what it is in my own words, and tell them that I have done those things before.
Last night I had young patients, which is rare enough as it is, let alone patients who know the system, both of them working in medicine and working towards their RN. As I received report on one of them the NSI I got report from got quiet and looked sadly as he started to explain the situation about the patient.
'I'm not gonna name names,' He said sadly clicking his pen and pausing, as if he was wondering whether to tell me or not. 'But the aide last night was really mean to the patient and must have told her she is being a baby about her pain or something because all morning the patient made comments about being a baby and being in 'too much pain', because of this her pain is out of control, she is now very emotional and is not doing well. She works in a hospital, she knows whats going on.'
Sadly I nodded, whoever the aide was better not find me because my wrath for shit like that isn't right. I started my shift and found my patient to be just like the rest of us aides, a good kid just trying to make it to living the dream. As I worked with her I felt angry, how dare someone do that to another human being.
At one point in the night the patient was feeling anxious, was maxed out on pain meds and was crying, feeling overwhelmed and sad. I shut the door and sat on the end of her bed and rubbed her back softly. She stopped crying long enough to spurt out a line that almost made me cry. "I'm sorry, I know I'm a problem patient and that I'm taking time away from other patients. I know I'm a pain in your ass." I stopped. Patients don't just come up with that kind of stuff on their own.
"You are not a pain in my ass and if my other patients needed something there are other aides on the floor to help me, hell there are even nurses." I replied, continuing to rub her back. She sobbed and kept apologizing and wincing in pain. "You know, this is gonna make you such a good nurse." I said.
"How do you figure?" She replied.
"Well, when your patients are going through this and dealing with the pain you will be able to honestly tell them you know their pain, you know the situation." She rolled over and I handed her a box of Kleenex. "Some of these RN's graduate and are frankly snitty, they are mean and have no idea what the deal is. If this was light and fluffy and fun you would do this from home where you could wear your own stuff. You are gonna be able to be such a cool, compassionate nurse."
She smiled a small smile and embraced me, then asked me to help her figure out pain meds, which she immediately received and she was able to sleep through the night. Before I left I packaged my bracelet with a small note and placed it on her tray, knowing that when she awoke it would be there for her. From one student to another.
As I sat down to give report I felt good about myself and my shift. I did lots of things I don't generally do. Lots of UA's, lots of DCing foleys, and lots of things I do often, vitals and blood sugars. The other aides sat down next to me at the table and we all awaited to give report to each other. As I began report to the aide sitting closest to me I watched her pop a diet coke and chug it, then slam it down and stare at me oddly. As I watched this I felt awkward and had an odd gut feeling. Report finished on my other patients and now it was time for the patient I was most worried about.
"Oh my gosh she is such a snot. Every hour she is in pain- its like boo-frickin-hoo get over it."
My jaw dropped. "Her diagnosis is EXTREMELY painful, I have seen the strongest, most tough of men drop to the ground when they have it. Don't you dare." Then I finished report, complete with her eye rolling and her shitty comments. My stomach churned. My mind raced.
I found the other aide and asked her to keep an eye on my patient. As she agreed she asked why, I explained and her jaw dropped. We both agreed this was something that needed to be addressed to the charge nurse. I hate tattling on my colleagues but this was out of control. As I told the charge nurse she looked up at me worriedly.
"That's bull." She said. I nodded. "Dani, I appreciate you telling me about this. Its a hard thing to do, but its whats best for the patient." Then she looked to the board and quietly sighed. "But no other patient will take her as their aide."
As I left work I felt bad that I told on her. I feel bad that my patient was depressed. But I felt good, knowing that I did my job and I did it damn well.
At the hospital I always try to remember that. During my training as a CNA and as an EMT the school where I got my training always had us remember one thing - if you're gonna do it to a patient you better do it to yourself first. I have been restrained as a psych patient. I have had to wear a c-collar for hours at a time, I have been rolled, moved and repositioned, I have had thickened foods and mushy meals. I have ingested activated charcoal and had glucose ground into my gums. I have been the patient, but it has truly helped me be a better caregiver. I can explain the patient what it is in my own words, and tell them that I have done those things before.
Last night I had young patients, which is rare enough as it is, let alone patients who know the system, both of them working in medicine and working towards their RN. As I received report on one of them the NSI I got report from got quiet and looked sadly as he started to explain the situation about the patient.
'I'm not gonna name names,' He said sadly clicking his pen and pausing, as if he was wondering whether to tell me or not. 'But the aide last night was really mean to the patient and must have told her she is being a baby about her pain or something because all morning the patient made comments about being a baby and being in 'too much pain', because of this her pain is out of control, she is now very emotional and is not doing well. She works in a hospital, she knows whats going on.'
Sadly I nodded, whoever the aide was better not find me because my wrath for shit like that isn't right. I started my shift and found my patient to be just like the rest of us aides, a good kid just trying to make it to living the dream. As I worked with her I felt angry, how dare someone do that to another human being.
At one point in the night the patient was feeling anxious, was maxed out on pain meds and was crying, feeling overwhelmed and sad. I shut the door and sat on the end of her bed and rubbed her back softly. She stopped crying long enough to spurt out a line that almost made me cry. "I'm sorry, I know I'm a problem patient and that I'm taking time away from other patients. I know I'm a pain in your ass." I stopped. Patients don't just come up with that kind of stuff on their own.
"You are not a pain in my ass and if my other patients needed something there are other aides on the floor to help me, hell there are even nurses." I replied, continuing to rub her back. She sobbed and kept apologizing and wincing in pain. "You know, this is gonna make you such a good nurse." I said.
"How do you figure?" She replied.
"Well, when your patients are going through this and dealing with the pain you will be able to honestly tell them you know their pain, you know the situation." She rolled over and I handed her a box of Kleenex. "Some of these RN's graduate and are frankly snitty, they are mean and have no idea what the deal is. If this was light and fluffy and fun you would do this from home where you could wear your own stuff. You are gonna be able to be such a cool, compassionate nurse."
She smiled a small smile and embraced me, then asked me to help her figure out pain meds, which she immediately received and she was able to sleep through the night. Before I left I packaged my bracelet with a small note and placed it on her tray, knowing that when she awoke it would be there for her. From one student to another.
As I sat down to give report I felt good about myself and my shift. I did lots of things I don't generally do. Lots of UA's, lots of DCing foleys, and lots of things I do often, vitals and blood sugars. The other aides sat down next to me at the table and we all awaited to give report to each other. As I began report to the aide sitting closest to me I watched her pop a diet coke and chug it, then slam it down and stare at me oddly. As I watched this I felt awkward and had an odd gut feeling. Report finished on my other patients and now it was time for the patient I was most worried about.
"Oh my gosh she is such a snot. Every hour she is in pain- its like boo-frickin-hoo get over it."
My jaw dropped. "Her diagnosis is EXTREMELY painful, I have seen the strongest, most tough of men drop to the ground when they have it. Don't you dare." Then I finished report, complete with her eye rolling and her shitty comments. My stomach churned. My mind raced.
I found the other aide and asked her to keep an eye on my patient. As she agreed she asked why, I explained and her jaw dropped. We both agreed this was something that needed to be addressed to the charge nurse. I hate tattling on my colleagues but this was out of control. As I told the charge nurse she looked up at me worriedly.
"That's bull." She said. I nodded. "Dani, I appreciate you telling me about this. Its a hard thing to do, but its whats best for the patient." Then she looked to the board and quietly sighed. "But no other patient will take her as their aide."
As I left work I felt bad that I told on her. I feel bad that my patient was depressed. But I felt good, knowing that I did my job and I did it damn well.
Monday, August 3, 2009
"Heal"
On Saturday I went to a Family Reuinon for my Fiances' family, and needless to say I was SCARED to meet everybody! It was a perfect day, complete with playing in the sand (and a gorgeous sand castle!), playing in the water, eating great dutch-oven meals and sword fighting all the kids (we made them toy swords). There was even a station where everyone was crafting jewelery.
"When my brother got diagnosed with diabetes he got a teddy bear and a couple childrens books and such, and he really liked that. I can't do the same thing, but I can give a simple gift to a patient when the time is right."
The jewelery was a washer and hemp yarn and they were using modge podge and gluing scrapbook paper to it, or stamping words into it, using a hammer and a stamp set. My future mother in law drug us girls over there and we all sat down to begin stamping and scrapping some jewelery. As I laid my washer out in front of me I could only think of one thing, and that was how much I didn't want to keep the jewelery for myself. So I studied the washer and then handed my fiance the letters and began measuring the yarn.
When we were all finished my mother in law studied it, not sure what to make of it. They did necklaces made of scrapbook paper, and they turned out cute. She smiled, told me it was cute and continued on looking at her other daughter-in-laws jewelery. My fiance took it from my hands and studied it. "Heal?" He asked and I nodded. "You didn't make this for you." He said, eyeing me with a small smile.
"Nope, I sure didn't." I said as he handed it back to me. "I made it so that I could give it to a patient."
"A patient?" He asked.
"When my brother got diagnosed with diabetes he got a teddy bear and a couple childrens books and such, and he really liked that. I can't do the same thing, but I can give a simple gift to a patient when the time is right." My fiance smiled at me, then wrapped an arm around me. "That is really sweet." He then paused and gave me a devilish grin. "Do I need to go buy a stamp set and a new hammer?" I laughed out loud.
Today I am wearing my "Heal" Bracelet to work, knowing full well its purpose, its point and forcing me to keep my eyes open in all aspects of things. Its a small thing, a simple thing, but its the thing people love the most.
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