An Agency Nurse Rant.

Do Unto Others as You Would Have Others Do Unto You



Generally, I tend to stray away from reglious posts and tendencies, not wanting to offend others. There are two subjects I have learned young not to talk about, religion and politics, but this stuck out as I saw this patient.

The nurse was an agency, continously bitched about her patients, our unit and her life. Our unit spoils its staff frankly, which pissed me off. You don't come to my home and piss on the carpet- you know what I mean? So as I took report I tried to shake the nurses bitching and try to see past it all- but I heard one of the patients were difficult. The aide urged me to write 'mean and snotty' but I simply wrote difficult, wanting to see for myself.

When I began working with the patient she was the farthest thing from, and when I asked this nurse to simply care for her patient she flipped at me and got mean and snotty with me. The patient asked that her medications and times be explained to her. I know nothing about this, having no knowledge in pharmacology and told the patient I would talk to the nurse about this. When I asked the nurse to do so, the nurse told me to go do it.

"No." I said firmly, feeling myself wanting to jump to boarderline bitch. "I have no knowledge in this and I am not about to go bullshit to a patient. This is YOUR job. Do it." My pulse was racing, I have never stood up to a nurse before like this, let alone an agency nurse.

"God Damnit!" The Agency Nurse yelled. "What is wrong with you aides!?" Then threw her papers down and stormed off into the room, only to return two seconds later, she went into the wrong room. As she emerged she snarled at me, "I have a life and I intend on getting to it."

"AFTER you care for your patients. You took an oath, now keep it or get out of here and let us get a real nurse, one who is actually decent at her job."


I'm glad I simply wrote difficult, because my patient was the sweetest person I had the chance to work with all night.

I am NOT a Patient!

I love doctors, they are generally funny, smart and comforting. However, this is only when I work with them do I like them. When I am the patient I HATE them, knowing that they have no idea that I work in healthcare.

Yesterday I had an appt with a doctor that I actually work with (actually his non-surgical colleague) about a shoulder injury I have. She ordered xrays, and while I was getting them my shoulder was slipping from socket. The X-ray techs kept begging me to make it stop, but the injury consists of a slipping from socket, painful spasming until it falls back into place and then pain throbbing and shooting afterwards. As they went to hold my shoulder in place for one of the xrays the tech placed her hands on my shoulder and her eyes widened. "WOA!" She said, beconing the other tech over. "You have got to feel this." They both played with it and then looked to me. "Doesn't that hurt?" I shook my head and they both looked at each other with a look I could read like a book. "If that doesn't hurt I would hate to see it when it does hurt."

The doctor did her basic assessment and I could tell she thought I was full of crap until she started to do comparisons with the other shoulder. As she stood behind me and wiggled my shoulders she too exclaimed. "Woa, there is a definite difference." She had her student feel and I suddenly realized what was going to be said.

An hour later I was lying in an MRI machiene, headphones blaring a crappy excuse for a country radio station and trying not to breathe 'too big' as the scan kept chugging away with the constant 'thud thud thud thud.' My mind was racing as fast as the imaging was and I was not thrilled with what needed to be done, but it had to be if I ever wanted to be a paramedic. My mind wandered back to the conversation after all my options had been reviewed.

My fiance and I stared at each other, both sharing the same expression of frusteration and despair. I had two options 1. another 3 months of PT after I had done 6 months before and then a year of weight lifting with a routine that was made for rebuilding torn muscle. or 2. get an MRI and then go talk to the shoulder surgeon. Little did this doctor know that the shoulder surgeon was actually in a room with a patient as I was hooking this patient up to a shoulder CPM. As I tried to attach him to it my shoulder rolled and the surgeon told me 'you need to schedule an appt with me ASAP.' After a long conversation I realized I had to do the MRI and the consult if I ever wanted to safely continue to care for patients.

I have yet another appt today, with a whole different doctor, and I am NOT looking forward to it. Next week I meet with the surgeon. I am not a patient patient!

BMT

He was a big eared, freckled face little boy, with gaped teeth in the front and what was left of his brown hair was buzzed by his mom. As I walked into the room I was literally shocked to see a child in the room, I was working BMT (Bone Marrow Transplant). "What can I do for ya bud?" I asked, shutting the door behind me and rubbing the gel-san into my hands.

"Come here." He said, beckoning me with his little pointer finger. I inched closer to him and smiled as a devilish grin spread across his face. "Do you have the yummy brown stuff?" He asked.

"You mean, coke?" I asked.

"As in cola!" He replied, perking up. I nodded. "Well my mommy said I could have some if you guys had it."

"Well it looks like I'll be bringing it in." I replied, and as I turned to leave I heard a 'yippe!' escape his lips.

The night was something no one warned me about, and not even the biggest warnings could have warned me of this. I have had cancer in my family, I have had family members go through chemo, but no one could have warned you for this. When I found out they had transferred me for the night to BMT I kept asking for what I needed to know. The only answer I got was 'learn chemo precautions.' Chemo precautions was nothing compared to the shock I got when I began to take vitals on these patients, and it make me realize how ....healthy....the rest of them are in comparison.

I walked into the room to see a guy who I assumed was at least 200 lbs at one point, but the treatments had killed his body down to under 150. Weak, skinny, frail and starting to bald in patches he kept a smile, and even opened the door for me, explaining that he would not be able to forgive himself if he wasn't a gentleman at all times.

Another patient was a doctor, and it was textbook 'Isabel Stevens' from Grey's Anatomy, but that's where I got angry. Grey's makes fighting cancer look poetic, and makes it look so much different than what it really is. There is no group cancer session where they all get chemo and chit-chat, they do not wear scarves on their heads and they don't have energy to cruise around the hospital. They are bedridden, they loose their hair in patches and they fight like they have never fought before. Watching this patient I realized how strong she is, and she was more than admirable.

Truly, it was hard, and when I got home tears filled my eyes as my body curled up and into a ball. my muscles ached, my mind racing and the inability to sleep kept me waking up with hot tears escaping my eyes, each time I closed my eyes I realized their struggle, their battle and how strong they are. When sleep finally came, I dreamt about the little boy.
__________________
'The higher you climb, the greater the pressure, those who manage to endure learn that the distance between top and the bottom is obscenely great, and those who succeed know this secret...there isn't one.'

A Birthday

It happened.
It really happened.
My fiance turned the big 2 1.

Yep. He is offically a grown man by most peoples standards, however his mother diagrees saying that if you are to be a man you must have these three things: 1. Chest hair 2. Be 21 and 3. Have a child. So, he'll still be mommas little boy, but he's now my big man.

Happy birthday hun- Glad to see you survived the long haul to 21.

"Why Bother?"

My Monday shift consisted of a patient dying. Tuesday one friend lost a grandfather, and the other her father. They say that people die in 3's, 7's, and 12's but is this true if you're the bystander?

Because of who they lost it caused me to lay awake last night, thinking about my life. I too lost my grandfather a few years back, and loosing grandparents is a simple fact of life, but it is incredibly difficult. Back then I lost two people in my life at the same time, the same night, 45 minutes away from each other, and I was out of town when it happened.

I found out about my friend first. A kid I went to school with for years, a kid I had worked with, and a kid who was like my brother. He passed away by suicide, something none of us would have predicted he was planning. He was an outgoing kid, a band geek, smarter than anyone else I knew and was going to an Early-College-High-School for Marine Biology. He was the kid I could turn to when my life got hard, and we spent so many cold winter days sitting on the front porch, talking, thinking and wondering about life. I was at an EMT competition when another girl from our high school tearfully told me. My heart sank and my mind turned off. I couldn't focus on anything, let alone our win. The bus ride home one of my classmates sat close to me, my head on his shoulder and slow, hot, tears falling down my face. When I got home, he would be gone.

When I arrived home I realized my grandmother was at our house. This was so weird for our home, we were remodeling, and the house was a mess. After kicking off my shoes and letting out a deep breath I shakily told my dad why I was crying. Sadly, he had me sit on the couch with my grandmother, all she had to do was say my name. I knew what happened. I locked myself in my parents office. Simply staring at the wall. Finally I turned on ITunes, and put it on country, hoping to find some comfort from the crazyness, instead Emerson Drive's song 'A Good Man' came on, and I sobbed even harder.

Two days later I picked up a friend of mine,(a man who still struggles with this to this day), both of us dressed in black. We were headed to our friends viewing. I would be unable to make it to the funeral, and I promised him I would drive. We both stood in that long line for two hours, just to pause for a moment and finally say goodbye. I closed my eyes and shook my head. You just cannot say a true goodbye to a corpse. Tears filled our eyes and my friend and I left, having no desire or intention to meet up with everyone else later. We stayed up til 3 a.m, talking and laughing about the 'good ole days.' But it still didn't seem real.

When I was 16 my grandfather made me a promise I haven't forgotten. He promised me that he wouldn't leave this world until he saw me get married. When I was 17 the doctors helped us realize how sick he really was, and at various trips to visit him I had to use EMS care to help him til the hospice team came. He was in pain, and now he isn't, but it still doesn't change the fact that I miss him, and I hate that he won't be around to see me get married. Its hard, going to see your grandmother and expecting to see him there, yelling at the soccer game on TV and laughing with that hearty belly laugh.

Last night I finally broke down and cried. I hate crying, I feel like it shows weakness, but I am so frusterated with my job, with the people I take care of, and my personal life. It seems like all anyone does is die.

"Why bother?" I asked my fiance last night with tear-filled-eyes. "All I do is take care of people who die."

"Because your the strong one who CAN take care of them before and while they do, and how many honestly die compared to the ones you have saved?" We talked for about an hour, and finally I was done trying to explain, and done keeping him awake all night. We turned in and fell asleep, but I awoke this morning to the same thoughts.

I'm guessing its something that everyone goes through, something that everyone thinks at one point or another. Today I saw that my friends have posts all over facebook and myspace, they too are wondering the same thing I was; 'why bother?'

Suicide, Attempted and Accomplished

They were the same age, had the identical diagnosis and were from completely different places of life. One was a wealthy woman, who wore more jewelery than any patient I had ever seen in my life. The other was a poor woman, who wore a motorcycle jacket and had no teeth. Both had ODed on over-the-counter drugs in an attempt to end their lives, and I was taking part in their 1:1. Both patients lived, both patients were going to be fine, but both patients were upset, the consequences of their actions made them regret everything and they vocalized their depression and anxiety about all of it.

Oddly enough I love working 1:1's with psych patients. If they are alert and oriented, we can talk to them like old friends and not like patients, but if they are not alert, oriented or even close to, they are fun because they say things and do things that simply make your day better. For example, we had one of them on a NPO diet, and she wanted Ice chips so badly. We tried to explain to her as we swabbed her mouth- but she didn't understand. "So do only the pregnant women get ice chips then?" She asked me, her big blue eyes looking into mine with genuine worry. I tried so incredibly hard not to laugh as I tried again to explain, but she was long asleep by this point.

Its something we deal with day in and day out. Life and Death. When you get a bunch of EMT's, CNA's, Nurses, Firemen and even Cops together eventually the subject will be brought up. How will we go? Going through schooling we always laughed at those kids who slashed across the street and were 'too stupid' to go down the river. We laughed at those people who thought a handful of baby aspirin would do them in, didn't they know that a whole bottle was needed at least? More than once have I talked about how I would go, and I always imagined myself doing something heroic. I'm not one who has ever wanted to be a old person, sure, I want to see grandkids, but I don't want to be that old that I only see them on Sundays when they come to the care center.

I hate it when patients attempt to kill themselves, and they succeed. I really hate it when they attempt, we care for them for nearly a month and they pass unbelievably quickly. Its terribly sad, and horrible for all of those who are doing the post-mortem care. I wasn't the one to do it- but it was terribly sad to know that another soul had passed on and that two of my colleagues, who had put their blood, sweat and tears into caring for him, had to now place him in a bag with a tag on his toe.

Not many people know this, but I pray when we loose someone, locking myself in the locker room or taking that extra few minutes before turning over my engine and heading home. I pray that their soul can find its way home and to peace. That all of their pain and suffering will disappear and they will finally find rest. At times I feel like the only person who does this, and I know my colleagues would laugh if they knew this, but its what I do to give myself clarity and peace of mind. Maybe I am crazy for doing it. Maybe I am just a believer.

Going Shootin'

"Wait, so your trying to tell me I'm gonna have a gun-slinging, jump-kit-carrying, talking-like-a-cowboy, daughter-in-law?" I laughed and smiled at my future mother in law as she said this. We had just spent the day trying to teach me all about guns, ammo and the big noises they make when you shoot them off.

The day started out perfect and we made it safely out to the boonies and my fiance and his older brother taught me all the mechanics of shooting a gun. By days end I could clean, load, aim, shoot and reload a 22 rifle. The boys seemed very impressed when I shot out 10 of the 15 clay pidgeons within my first few attempts. The shotgun (seen in the photo above) was not actually attempted (I have a shoulder injury and I was NOT about to go see a doctor to put it back in place after shooting that sucker off!)

At first I got incredibly frusterated, grumbling and firing off before aiming correctly and even switching arms, trying to get the feel of it. Before too long my fiance wrapped his arms around me, and tried to help me aim the gun, position it in my shoulder and talk to me about the mechanics of this. "Hunny, its not gonna come as easy as you hope it will." He said, placing his hands on the gun and pressing his cheek against mine. "Think of it like the last hardest thing you had to do, like trying to start an IV or doing a 12-lead." I looked over to him and he took the gun from me. " Tell me how to do a 12-lead."

As I instruced him on how to do a 12-lead he took one step at a time on how to shoot a gun- then handed the gun over to me. As the instuctions for each lead placement ran through my head I found my target, inhaled and then blew the clay pidgeon to nothingness. I high-fived my fiance and smiled. Who knew that would be the outcome?

Back to work and to your regular programming today - and I'm hoping for some great stories!