"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.
Tuesday, August 11, 2009
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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