a tale of two nurses

18

2010-11-22T09:21:00.001-05:00

I remember being 18. It has been, to date, the best age. I Graduated high school, had a great summer, threw myself a going away party before I started college. Next… I started college. I was so excited about life. about the new adventures coming up. about growing up and becoming a nurse. about the new friends I would make at college. I remember getting dropped off at college. How dad helped my roommate and I get our room set up because her parents were still in Germany. I remember saying goodbye, and being scared to death, until the next day when this crazy girl named chelsie said hi and started the best group of college friends I could have asked for.
Life was good at 18. Really good. And so full of promise... I was positive only good things were going to happen. Looking back, from the advanced age of 23, I know life isn't as easy as I was hoping it would be. I know about different challenges. I know how hard being a grownup really is. But at 18? I had the world and it was mine.

My 18 year old patient has tried to kill herself 3 times in the past 6 months. I look at her, and I know she has no hope. She doesn't look anyone in the eye, but willingly took a massive amount of medications trying to end her life permanently. at 18. I don't know her life story. I suspect it isn't pretty, seeing as how her step mom was the only parent anywhere around, but still. How, at 18, can life look so bleak that you just want to end it? Life is just beginning at 18. The world should be full of hope.

It makes me sad.

Favorite Time of Year!!!

2010-10-28T13:59:00.001-04:00

I love autumn. I love not wearing flip-flops and putting back on my favorite rocket dog shoes, putting back on the denim jacket. (and can we get a cheer for the return of hoodie weather?)

I love the colors. the way red leaves look on green grass.

I love the way they look on trees… especially the baby trees!

I love autumn flowers, both alive and dead.

and I love autumn skies through leave-less trees.

I love this time of year. After the heat has stopped and before the cold has begun… I love autumn.

part of you capture!

:)

2010-10-14T18:47:00.001-04:00

Last week walking around the local college campus, I saw a millipede. does that count as an animal? I guess it is more like a bug, but still….

it is awfully cute. and it had this little guy pushing it to go. I don’t know what he is, but once again, cute :)

(yes. the millipede is wearing high heels. )

on Monday I took pictures of my friend Katy and her husband for Christmas cards. oh, and their two 6 month old puppies. do you have any idea how hard it is to get 2 puppies to look at you? Add in a husband who didn’t want to be there and a wife who spent so much time making sure they were looking that she never was, and it was… interesting. Oh, and it had been raining all day so it was wet and muddy. We had fun, but it was definitely a new challenge. that required lots of laughter. which actually made holding the camera still quite difficult.

I also learned that sometimes with dogs, it matters less that they look at the camera and more that whatever they are looking at holds them still enough that their heads aren’t a pure blur.

It was fun.

You Capture

The faces of family

2010-10-07T10:23:00.001-04:00

This weekend my grandpa threw himself an 80th birthday party. pretty much all but 3 people came to it, and it was an awesome weekend. I wish I could show you pictures of the capture the flag game, but i was too busy helping the cousins beat the old people. 3 games in a row. Life is good.

However, I have become known as the person who takes pictures, it is what I do at these things, so I did get lots of faces to share. I love these people…

I could post about 20 more, but until I figure out how to build storyboards (that is what they are called, yes?) I will leave you with these. Not spectacular pictures, but they make me happy, because spending time with these people makes me happy. Grandpa did a good job with his family.

I think he enjoyed his party.

You Capture

The end of the driveway.

2010-09-23T11:09:00.001-04:00

I am a Kansas girl. Who lives on a farm. Want to know what Kansas girls who live on farms see lots of this time of year?

There is a reason we are called the Sunflower state. There is huge pile of these growing at the end of our cattle road, and I drove down there after work on Tuesday to take some pictures. The morning light was awesome. My photography class officially moved me into the realms of Manual, off of program where I have been quite comfortable for the last year, so there weren’t quite as many expecting good ones as I was expecting. I blew out a lot of color, (so I guess I needed a faster shutter speed for less light? that is what I did with the picture above, but then turned it right back down…) but I love them just the same.

I love the contrast of the bright pretty flowers with the rusty barbed wire.

I haven’t played around with textures for a while, so I added some here. I like it…

What I really want to do is go to the field a couple miles up from our place and sneak around in their pasture, it has all sorts of fall colors going, but I am leery of doing that. Kansas girls who live on farms also see lots of steers, and I am not overly fond of being chased, so these will have to do.

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Part of You Capture

My Choice…

2010-09-16T17:50:00.001-04:00

Favorite pictures of the week:

She loved the dress, the giant diamond ring, and all the attention every single one of her 31 older family members present gave her.(it was the first time we had all been together since before her time) She rocked the flower-girl job :)

My favorite picture from the photography class I started yesterday:

I have no clue what this is. My teacher said it reminded him of a brain, and it does. It was fuzzy, as well. Weird. Pretty, but weird.

My first week in review.

2010-09-12T18:30:00.001-04:00

Lets talk day 1, shall we?

I am, obviously, new. I know where nothing is. I am just getting to know my preceptor, just learning where clean holding IS, and haven’t even had time to browse it.

(I was at my last job for 2 years. for 300 nights I went to the same clean holding, grabbed the same things, and still couldn’t find everything on the first try. and then you have a new clean holding with supplies that look different. It is challenging)

They are getting ready to intubate a guy. He just came in with Resp distress, and bipap wasn’t cutting it. I went in to watch, which is what you do on day 1, watch. The med student starts to put in the tube, they give him a boatload of sedation, and starts to put down the tube. He tries once, misses, pulls back and just as he puts it down his perfectly visualized cords, the guy starts... throwing up stool.

Have you ever seen someone throwing up stool? it smells, it is a weird consistency, and he was putting out A LOT! we had 2 suctions going, the dr stepped in to try to get the tube in and the guy goes into PEA and we start the nastiest code I have ever seen. Every.Single.Chest.Compression (at a rate of 100/minute, mind you) was splattering this stuff out of his mouth while we tried to get a tube down him. Once the tube went down him the stool started bubbling out of it (that is bad.)

I am standing there… holding up his gut so we can try to find a pulse with the doppler, and people keep asking me to get things, find things. I know where nothing is, and fortunately other people were around to get it, but it made me want it to be 6 months in when I actually know how to find things.

We eventually got him back, and they started putting in central lines and arterial lines and dialysis ports (his magnesium was… like 9. higher than I have ever seen it. normal is 2.5) Eventually the doctor went in, told the wife what was going on and she said to stop. pull the lines, pull the tube, let him go. It took him less than 60 seconds after the vent was turned off to die.

They asked me if I had ever been in a code, to which I just laughed. Yes, I think I have. Leave it to me (known at pcu as the Code Queen) to have a code on day one.

Once I got home I took off my scrubs and found little splatters on my clothes, which is a perfect example of why work clothes only get worn at work. nastiness.

Day 2 I had a patient with a bowel evisceration (she had parts of her small bowel sticking out of her incision). I thought it was kind of cool, my preceptor was freaked out, and the doctor didn’t much care, but still. Day 2.

Day 3 was boring. Which was good after days 1 and 2.

I start nights next week. I am kind of scared what is going to happen to my patients.

the words I am not writing

2010-09-07T22:26:00.001-04:00

I have these words I want to write. About my first day and my second day and how I have this weird love/hate relationship with days. It is amazing how much you can get done when your body thinks 9 am is sleeping in. It is amazing how much getting up at 5am every morning sucks. I would write about how frustrated I am with my preceptor and how I am so ready to be my style of nurse again, not hers. about the nasty code and the cute residents who are all married and how I really really miss the people I used to work with. How I want a house but I like living at home because there is sometimes food when I get off.

But I am tired. my brain is fried because I just worked my first day after 18 off and 5 was extra early today and 12 hours was extra long and then I had to drop off my car so that someone can turn off of the check engine light, hopefully by checking the engine, and I don’t feel good so I am going find a book I have read a million times and fill the tub with hot water and probably fall asleep and drown.

the end.

Loving life, morning edition.

2010-09-02T10:38:00.001-04:00

So… I didn’t do the last 2 You Capture challenges, but for a good reason. I spent the last 12 days on vacation in Costa Rica. I was outside playing pretty much every day. I took walks on the beach, I rode a zip line through the rain forest, I walked on hanging bridges 300 feet in the air, and I stayed at a hotel at the bottom of an active volcano: (Arenal first thing in the morning… that is steam coming off. We didn’t get to see any lava, which was a bummer)

I took early morning walks, which I never do, and was amazed at what I saw:

( Hummingbirds all over the place)

( Beautiful flowers glistening after the morning rain)

( Iguana’s loving the morning sun)

We stayed 2 night at the JW Marriott resort on the pacific and the beach in the morning was gorgeous…. As it also was at night.

(I know, not the challenge, but still…)

This is beautiful lake formed by a crater from another (non-active) volcano, Poas, we walked up one morning.

The mysterious reflecting rivers of the Tortuguerro reserve on our morning boat rides.

And a beautiful Butterfly park

I could keep going, literally all day. I took over 1500 pictures, and have spent the last 2 days going through and deleting the bad ones and duplicates. Someday I might edit some of these, but I have enjoyed just going back and looking at the beauty. I needed a week away to relax and unwind, and I got it.

Life is good.

everyday

2010-08-12T11:53:00.001-04:00

Everyday this week there has been the most amazing sunsets… and everyday this week I have been driving while seeing them. The one day I had my camera with me, I stopped. I love Kansas fields and sunsets. I think I have this mental picture of God saying… Okay I know your days are crazy hot, but here is a gorgeous evening sky to make up for it.

part of You Capture.

Summer is…

2010-08-05T12:11:00.001-04:00

Summer is….

My teacher-sister coming home for a visit:

And everyone being really glad to see her:

Summer is… Cousins hanging around telling stories of growing up together:

(apparently the debate was about whether the hamster was killed by being dropped or if it committed suicide by jumping…)

Summer is… being too busy having fun at the barbeque to take pictures of dad grilling like I planned.

Summer is… being reminded that life isn’t fair because my siblings tan and I don’t:

Summer is… cute kids plopping in the grass after running a race:

Summer is… waking up the next morning to find dad playing farmer in his garden.

Summer is… fresh cucumbers and tomatoes and corn and green beans:

Summer is… being told to put down the camera and start helping. and then getting covered with bug bites cause I was smart and gardened in flip flops and shorts.

Summer is… awesome

Part of You Capture

black/white

2010-07-22T19:55:00.001-04:00

I love playing with my pictures, and I was excited about this challenge because last Friday I did a photo shoot with my friend and her girls. It was my first time photographing more than 2 people, and I was wondering how I would do. Conclusion: I love my single-people shots but have no clue how to group more than 2 people. Guess I need to work on that…

Anyway, I would have played with them some more but I have spent the last 4 days on orientation for my new job and pretty much what I have learned is that I did a smart thing by not picking an 8-4:30 job because OH MY WORD I don’t know how people do it. When do you get things accomplished? I am so tired by the of the day that I collapse on the couch. So ready for my 3 12s to come back… and even more ready to be on nights again. Mornings are not my friend.

So… the few I have played with in black and white~

Mom:

Oldest:

Youngest:

Family:

I love black and white pics so I can’t wait to see what everyone else did on You Capture this week!

Healing Hands

2010-07-10T22:08:00.003-04:00

My patients have an awful lot to say about me, I guess because I don't say much of anything so the silence has to be filled somehow, right? Nearly every single shift and sometimes a few times a shift, I get compliments on my hair. All the old people think it's natural and I can't lie so I have to confess it's bottled. But they love it anyway. All the little old ladies think I am so beautiful and I smile sweetly and say "Thank you, now don't move while I put this IV in!".

Last week I took care of an 82 year-old man who introduced me to his wife like this: "This is RaDonna my nurse, she takes really good care of me and she also has a really nice butt!". I was mortified! My face turned a brighter shade than my hair and I ran out there as fast as I could! The funny thing is I got a text the next day from a paramedic friend of mine saying that he was transferring my little old man to the next hospital over and he wouldn't stop going on about my nice butt. So now my derrière is apparently the talk of the county!

My favorite thing that my patients say about me isn't my hair or my tush, but that I have a very gentle touch. It made me so happy when I finished putting in an IV today, and my patient says "Thank you for being so gentle with me." So many times I see nurses or aids roughly turning patients or grabbing their arms to put the blood pressure cuff on them and it makes me so sad. One of the ICU nurses I followed around the last month of nursing school told me that patients can tell you care by the way you touch them. That has stuck with me throughout my year-long nursing career and I hope I never forget it.

I tell you what though, I didn't feel very gentle last Tuesday when I was holding a tiny little 7 week-old baby for a lumbar puncture. Poor little baby had a fever that wouldn't break so we had to give him the full workup: labs, IV fluids, cath urine, lumbar puncture, and antibiotics. I was terrified taking care of such a tiny baby and the worst thing was he never stopped crying the entire 6 hours I took care of him. Every time I walked into the room I brought some other method of torture with me. I looked for a vein on him but had to bring reinforcements because he had nothing that I could see. I catheterized him for the urine sample and that was hard because I had never cath'ed anyone under thirty before! When it was time for the lumbar puncture, we laid him on his side at the edge of the bed and bent him into a fetal position and held on as tight as we could without hurting him. He wailed the entire time but Dr. C was good and nailed it.

We ended up transferring that poor little boy to a hospital with a PICU to rule out sepsis. One thing I hate about emergency nursing is that I rarely get to find out the end result of my patients, and the few times I do find out, I usually don't like what I hear. The little old man who like my butt was transferred because he had a massive aortic aneurysm and he only had a 50% chance of surviving the surgery to repair it. A sweet man I took care of last week for gallstones ended up coding the following day. This morning I cared for a man with a 106.9 F rectal temp and after I finally got him cooled down enough that he wasn't delirious from the fever, all he wanted to do was hold my hand because it was warm.

I don't know if any of these patients lived or died but they touched my heart, each in their own way. I am so glad I can make a difference to them by the gentleness of my touch and hopefully bring God's comfort through my hands.

I found the following blessing for nurse's hands on the internet and I wanted to share it with you.

Blessed be these hands that have touched life.
Blessed be these hands that have felt pain.
Blessed be these hands that have embraced with compassion.
Blessed be these hands that have been clinched with anger or withdrawn in fear.
Blessed be these hands that have drawn blood and administered medicine.
Blessed be these hands that have cleaned beds and disposed of wastes.
Blessed be these hands that have anointed the sick and offered blessings.
Blessed be these hands that grow stiff with age.
Blessed be these hands that have comforted the dying and held the dead.
Blessed be these hands, we hold the future in these hands.
Blessed be our hands for they are the work of Your hands, O Holy One

My Country

2010-07-08T02:10:00.001-04:00

I love the 4th of July. It and Thanksgiving are my favorite holidays. (except St. Patrick's day, but that is a given.)

3 years ago when I spent the summer in South Africa I did okay with the homesickness. S.A is nothing like USA, but I loved it all. Until I realized that on the 4th of July, the holiday celebrating my home, there would be no watermelon, no barbeque, no family sitting on the lake watching the fireworks. Oh… fireworks. I love them . So we were running VBS at this little Indian church in Durban, I was beyond homesick, my teammates all thought I was crazy for being so sad about missing this one little holiday (WE ARE IN AFRICA,CORRIE!) and I walk into church late and see these beautiful children

and hear them yell “Happy independence day, Corrie!”

Pretty sure none of them had any clue what they are talking about but it made me smile, and slightly less longing for home. That is one of my favorite memories of this holiday, the one I spent far from home…

Now… this 4th of July was so~much~fun. It is my friend Tiffany’s birthday, and we celebrated big. I would show pictures, but I was too busy going down water slides and getting into splashing fights to take any. And then as we headed for fireworks, the skies opened up and that plan went out the window. But as far as AMERICA goes, here are my captures:

Joe has spent the last 6 months in Army training, and got to come for a couple of weeks before he goes to his new assignment. He spent the time helping plan their wedding, which we are hoping isn’t delayed by a deployment.

America would not be the awesome country it is without the people who volunteer to protect it.

And the place I love:

People hate on Kansas all the time, but seriously? We have the best skies around. Fireworks or no fireworks.

The weekend ended with me hiding in an empty room to watch the fireworks at work when they set them off on Monday.

I love my country.

Part of You Capture

the next step in the journey

2010-06-30T16:41:00.001-04:00

(3:20. I have been asleep for 5.5hr, and am now wide awake. this is not a good thing.)

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I didn’t want to make the phone call. I wanted to sit down face to face and have a conversation. But… sometimes the reality of night shift is that I don’t know when my boss works, and I sure can’t wait at the hospital for her.

I am scared. nervous. sad. anxious. excited. conflicted.

I told her I had been trying to find her to talk to her, she asked if I wanted to come in. I say no… I have got to go to bed soon.

The words come out of my mouth. she doesn’t like them. really? Oh… that makes me so sad. Family reasons, I tell her. I love my job, I love the people.

You won’t get to help us move to the new building. I know. I was looking forward to it.

This happened really fast. They called the day after I put in my app. I am assuming you don’t need a reference since you got the job without it.

(I got hired without them calling a single reference of mine)

I think you should be a charge nurse. I will definitely give you a reference for that. Thanks… but seeing as how it is an ICU I think it will take me a bit to get there. Oh, true.

If you ever want to come back, just let me know.

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I just quit a job I like to start a new job 3 days later… a job that I wasn’t entirely sold and that I am not going to be as good at as I am now (at least for a while.) A job where I know and like all the people for a job where I know no one. A town where all my friends live for a town where my family is.

It is the right choice. I don’t doubt that (at least not for more than a minute at a time.)

But a scary choice.

My brain has been spinning about what decision to make for so long that now that it has been made… one job accepted, one job quit… I don’t know how to handle the stillness.

Someday I am going to learn not to second-guess my every decision.

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Here is to the next step in the journey of life.

It will be interesting to see what happens.

(3:40. going back to bed now.)

Low.

2010-06-24T11:05:00.001-04:00

Getting low is not something I usually do, probably because I am somewhat tall. But here are my attempts…

Sitting on the side of the pond.

You can’t really tell but that is a turtle in the middle. It was swimming furiously in place… I am somewhat convinced it was stuck but then I just decided it was having fun because honestly? there wasn’t anything I could do to help a stuck turtle in the middle of a pond.

Note to self: laying on the ground in shorts and a tank top to take a picture is a good way to get lots of bug bites. Especially near water with as wet as it has been.

Note to self, Part 2: sitting cross-legged on the trail to take pictures of what is probably a weed is a good way to almost get hit by 2 bikes and a dude on roller-blades. Especially if you are at the bottom of a hill and around a corner.

Part of You Capture.

Age.

2010-06-22T23:32:00.001-04:00

She is young. Young enough that every one of our hospitalist refused to have anything to do with her, and we ended up having to call a pediatrician. Who has never been at our hospital and has no clue how to turn on a computer. The specialist didn't refuse to see her, but freely admitted that there were doctors with more experience of patients her age. The nurses didn't like it... if we wanted to be a peds nurse we wouldn't be working at our hospital. She sits in bed and watches all the romance movies we have, with a parent on one side and a friend on the other. Her parents advocate for her, and she deals with the pain. Who knows what is wrong with her. Hopefully she will be fine, go home and live a good life.

She is young.

She is alive.

She is strong.

She is young. 65, blonde-dyed hair, better at computers than I am. She offered advice at a problem I was having with my computer. It worked. Always cheerful, knew all the respiratory therapist by name, she was living in a world of denial. Every doctor who saw her told her the odds. The realities of end-stage copd compounded by nasty gunk growing in lungs. She insisted she would get better. Over the weeks she spent with us, getting q2h breathing treatments, q4h antibiotics, and q6h steroids she went from insisting she was going home, to agreeing to home health, to talking about rehab, to giving in to a skilled nursing facility. I walked into her room one morning and found the sun shining right on her. The look on her face... that sunshine was pure bliss. I laughed and told her I was going to offer to close the curtains. She said no way. All doctors wrote notes about discussing code status with her, discussing the end. She left us a full code, with lungs so bad I could barely hear the air moving.

She is young.

She is fighting.

She is dying.

She is old. 95 if she is a day. Last time I saw her it was with a rapid response to find a patient seizing... heart rate high then low, a mess. Now she sits next to the window and reads her harlequin romance. I ask her questions, she answers so completely wrong it is sad, but she answers with such a look that I almost feel silly asking the question. I laugh at her reading choice, wonder how much she remembers. A dnr, she is going home with her sister the next day. Family refuses all thought of SNF. I have to wonder how old the sister is.

She is old.

Living

and yet dying.

Age is relative. The 60 year olds who can't rehab after a heart cath. The 90 year olds who bounce back from a CABG stronger than before. Where is the rhyme and reason, I wonder? Where is the sense in the failing lungs of the 65yo with a brilliant mind and the failing mind of the 95yo with the perfect lungs? The kid getting ready to start her life with what could possibly be a chronic condition is going to be strong enough to handle it. The middle-age man who wants us to fix the problem that he pretty much self-inflicted, all the while knowing when he walks out he will cause it again.

Sometimes I don't understand life.

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I love my sister, but when we are 89 and 95, she is so not living with me.

Sorry, Ricki.

My Version Of Water

2010-06-18T09:20:00.001-04:00

Driving to my parents house the other day I took the back dirt roads. Half-way home I randomly stopped and started taking pictures. Here is the river up the road from my house:

All the rivers around our place are crazy full. After all the reading I have done about the flash floods in Arkansas I have spent time thanking God for full rivers that are at least mostly in their banks… and praying for all the families that are dealing with horrible losses this week.

This picture doesn’t have any water in it, but as soon as I saw it all I could think of was the song that goes “rain makes corn, corn makes whiskey…” I don’t actually drink whiskey, but the song makes me laugh and I love fields full of corn:

Of course, all of the rain is actually hurting the crops at this point, but still, the world is amazingly green right now.

Driving back along the turnpike to work on Wednesday was interesting. It was a day full of gorgeous clouds…

… that as soon as I was under I had to stop taking pictures because at the rate the water was falling from the sky I could barely stay on the road. I made it out from the other side of the clouds and got home safely, only to have the clouds land right over my apartment as I left for work. Nothing like starting work in wet clothes…

And for one last picture, pretty sure the ducks are liking all the water right now…

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You Capture on I should be folding laundry.

Fun!!!

2010-06-10T16:58:00.002-04:00

With fun being this week’s You Capture challenge, I was wondering what I would take pictures of… driving back and forth, working 4 in a row… not a lot of time for fun. But then Tuesday night it ended up storming, and my dad made me hang out in the car in a parking lot for a couple of hours so I wasn’t on the turnpike during all the flooding. As unhappy I was not being able to go straight home, it ended up being a good thing. and whereas it doesn’t take a great picture…

… those 108minutes I spent on the phone with a very good friend who lives way to far away and whom I don’t get to talk to near enough? without a doubt the best and most fun 108 minutes of my week.

I am puppy sitting for my brother and sister in law this week, and Hurley has been moping because they aren’t here. Today we decided to go to the park, thinking I could take some cute pictures. Apparently the park is all it took to make Hurley happy again, because he had a blast and all my pictures ended up looking like this:

or this:

So in the end Hurley had fun and I failed at getting any good pictures,but that’s okay.

In other news, after filling out application after application, I have an interview for tomorrow! In a cardiac intensive care unit… and I am so excited. and nervous. I really believe that moving closer to family is what I am supposed to do, and that is only possible if I get a job here. So… prayers that I can speak clearly and make a good impression would be greatly appreciated!

The E-Mail I didn’t mail.

2010-06-07T09:36:00.001-04:00

I was informed recently that I send really depressing emails from work to my parents. I was in a funk for a while… I am gradually coming out of it, but it took too long. Night before last I started to write an e-mail, and I stopped. It went as follows…

this is not a depressing email from work.
I think I have a concussion I have been banging my head against a brick wall for so long.
it is frustrating to call doctor after doctor and have no one acknowledge that something is wrong.
I will leave knowing I did everything i could for my patient.
and that his doctors let him down.
not a good feeling.

Pt had a bp of 212/102 for somewhere around 30hrs WHILE in the hospital. By the time I’d got him he had some pretty significant expressive aphasia… meaning he was still talking, but having a super hard time finding his words. This gradually went to him talking but making not the slightest sense. I called the primary… who ordered 1 pointless drug and a neuro consult. I called neuro, who yelled at me for calling him at 1030 on a Saturday night. Never had any problem with this neurologist, and he yelled at me for calling about dangerous BP, mental status changes and a pounding headache… I was not a happy person. Neuro called cardiology… who ordered a pill. a pill that is really a prostate pill that lowers blood pressure as a side effect. It did AMAZING things… lowered the blood pressure to 198/96. I made doctor calls like 6 times. I had my charge nurse call, cause they were obviously not listening to me. They pretty much ignored her too.

Fast forward to 8am. Day nurse comes in… the same as the day before. She walks into the room to assess the patient, says “oh my word his bp is high and his mental status has changed from yesterday!”. she called a rapid response, 3 doctors showed up (I talked to them all the night before, remember…) and all of a sudden they order what they should have done 2 days before and all is well.

I was so frustrated. I DID MY JOB. I advocated for my patient. I got yelled at multiple times by multiple doctors. and yet… I feel I failed my patient because I couldn’t do what needed to be done… but there was nothing else I could do. Day shift walks in and everything falls into place. There are times I hate working nights. There are times I wish day shift could work a night so they will stop talking about how easy we have it…

And then there are times when I just need to acknowledge that the system has flaws, that some doctors are jerks, and that I walked into my patients room last night, 24hrs after he flat out couldn’t talk, and he saw me and said “hi Corrie!”. He knew me, he is okay, and now it is time to put it to rest and sleep…

Choosing just one…

2010-06-03T11:37:00.002-04:00

Today the challenge on You Capture was to post just 1 picture. I am more of a take a million pictures type of person, but I actually didn’t take that many this week thanks to the whole moving thing. So… my favorite capture?

My brother is big into cars, magnums to be specific. This is his beauty, which is actually a “chargum”. Somehow he took the front half of a charger and put it on a magnum… yeah, I don’t get it, but it makes him happy. Anyway, he enters into all sorts of competitions and one of them was for black and white pictures. I was going to take some good ones and then convert them in Photoshop, but apparently that would get him banned, so here is a straight from the camera black and white. I didn’t even know my rebel did black and white, and it seems a little flat to me, but I still like it… and it makes it a new challenge to take good pictures without the help of Photoshop afterward.

Go Blurry

2010-05-20T17:21:00.001-04:00

It was sometime after I moved into my apartment that I discovered the world of blogs. It probably happened during that month that I lived alone for the first time ever… I spent enough time on the internet I got hooked on several different ones. One thing I noticed was that everyone had awesome photography, it just seemed like if you had a blog, you had great pictures. and I loved them. I especially loved the blurry background look… oh how I loved it. So then one day I read a tutorial on how to achieve that look, and I realized it involved a big camera. I decided to get one, did a couple weeks of research, and last June I bought my Canon Rebel. Later on I bought my 50mm lens because it got an even shallower depth of field. I took a couple of photography classes so I could figure out what depth of field is, and now I love it all the more.

These are senior pics I took for one of my friends that graduated a couple of weeks ago. We went and hung out at the park on Monday, until my battery died. A second battery is now on my shopping list.

I love how the trees just blend all together

how she can be in focus with everything behind her just a tad softer.

and to change directions a bit… I love taking flower pics where they fade out.

and I love the thought of taking clear images of K-State beads while making KU go blurry. Just saying… I’m a purple kind of girl.

And I love this kid. Which really has nothing to do with anything, but still.

There you have it… my You Capture for this week.

Taking pictures I like of a color I don’t

2010-05-13T13:35:00.001-04:00

The challenge this week was to take pictures of yellow. I am not a huge fan of yellow, more of a green, blue, and purple person. I wasn’t expecting to get much that I like with yellow… I was wrong.

Things I like:

1. Colorful flowers set off by yellow centers/yellow flowers in the bouquet.

2. Taking pictures with the new macro filters I got for my 50mm.

3. I don’t know what these are… some sort of corn cob flower? I think they are fascinating. and weird

4. I like the fact that my mom said my coming home for mother’s day (and taking pictures of all the flowers everyone but me got her…) was enough of a present.

5. I like old, closed, train stations full of old memorabilia that I find while wandering around my home town.

Next time I am going to climb over the fence and get closer.

I am super excited about next week’s challenge, Depth of Field. Seeing as how I bought my DSLR for the express purpose of getting blurry backgrounds, it will be fun to see what everyone comes up with.

Part of You Capture

Life

2010-05-10T23:47:00.001-04:00

It hasn’t gone as planned the past few days. I was all set to write a big 2 year post, and then life happened. Yesterday I walked in a 5 k. My friend and I did it in 44.56 minutes, which means a 14.24 minute mile, or something like that. Afterwards I was able to go home. It was a last minute thing, but my grandparents were visiting my parents so I drove 2 hours to hang out for a couple of hours. Right after that set of grandparents left, my grandpa T called to say that they were rushing my grandma to the ER.

I hate end-stage COPD.

She is okay, just some difficulty breathing and a rapid heart rate. Some extra oxygen, breathing treatments and she was good to go, but still.

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It has been a hard spring for lungs. I don’t know if it is the pollen count, the colder than normal temperatures, or what, but our frequent flyers have been in more frequently and for longer times, we have had several middle-age women with asthma coming in, people who have never required anything more than a rescue inhaler. Even though my area never got hit hard with the flu, seasonal or h1n1, it still has seemed hard.

I have had the opportunity to spend time with lots of family members as they make the choice for hospice. There is something really hard, but also very “nursey”(I can’t think of the perfect word for this. empowering? inspiring? touching?) about sitting with a family and explaining how their loved one was going to die. They needed to know. They needed me to explain. They needed the knowledge to help the person they love die in peace. Sometimes helping the family help the patient is what nursing is all about.

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Funny story: the nurses in the ED seemed really nice (that isn’t the funny part.) so they kept coming in and checking vitals, giving breathing treatments, starting IVs. As they worked, grandma kept asking me questions. “what kind of medicine is this? how long is it going to last"? why do I need an IV? can I have coffee?” As she asked, clearly looking at me, the nurses/rt techs would answer. She would then look at me to verify. As soon as they left we had to repeat the conversation, with me saying the same thing they had already said.

I truly am her nurse.

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In other news, I now I have an active Alaska license.

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Life is random.

For Randi and Rachel

2010-05-08T11:03:00.005-04:00

Happy Nurses Week to all my fellow nurses out there!

This was my first time celebrating it as an actual RN and I was blessed to be nominated as the "Rookie Nurse of the Year" at my hospital and I won! The ceremony was beautiful and I had no idea I had won til I got there. My boss called my parents and they were able to come and share this special moment with me. I actually got 4 free tickets to Disney world too!

I had a very boring three day weekend at work last week. Nothing happened and I was hounding the doctors for stuff to do and annoying my fellow nurses with constantly asking them if they needed help. So yesterday I had to pay for all my boredness. I had a 44 year old woman come in as a diabetic unresponsiveness but that was actually the least of her problems. She had liver cancer and her prognosis was very poor, her oncologist had told her already that there was nothing that could be done for her. She was a train wreck, all her systems were already shutting down. Her lungs were filling up with fluid, her abdomen was distended with what the ED doctor thought was blood because her hemoglobin was half that of a healthy person. She wouldn't keep her blood pressure up, her kidneys weren't working and although she was conscious, she was confused and unresponsive to everything going on around her. Her core temperature was only 91 degrees.

She was going to die. I knew it, the other nurses knew it, and the doctors knew it but her sisters wouldn't accept it.

Liver Cancer runs in their family, one of the sisters had already had a liver transplant. I don't know if they thought this one sister could survive the cancer because the other sister already had or what. Either they didn't understand how grave my patients situation was or they just didn't want to accept it but they told us that they wanted everything done for this poor woman.

EVERYTHING.

I let the two sisters stay in the room because I knew they didn't have much more time together. I had to work to keep my mind busy on all the interventions I was doing like foley catheter, NG tube, and managing all 5 of the IV pumps, because every time I let myself focus on the three woman in the room with me, I would tear up because they reminded me of myself and my beautiful sisters. The nurse in me was incredulous that these women would allow my poor patient to suffer like she was but at the same time, the sister in me could understand because I am sure I wouldn't want to let go of one of my sisters at such a young age.

I stabilized her as much as I possibly could and had my charge nurse help me transport her to the ICU. We were a very grave procession going down the hall followed by the chaplain, the sisters, and the rest of the family. They coded her 3 times in the ICU, the second time was right at shift change and since I didn't have any patients, I went up with the ED doctor to work it. I found out from the ICU nurses that the patient hadn't wanted all of this...she didn't want the tube down her throat or her heart being shocked back into rhythm. But family members can overrule the patient's wishes. Finally, after she coded for the fourth time, her family signed the DNR and let her go.

When I got home last night, I just wanted to hug my sisters. Being the young age that I am, I still have that immortal mentality that hard things will never happen to me. Days like this show me that I don't know what the future will hold for me and my family. I hope that if I ever find myself in a similar situation I will make the right choice. But I won't know what the right choice will be until I get there. So for now, I won't yell at Randi Jean when she steals my perfume or say no to Rachel when she asks me to ride bikes with her. God truly blessed me when he linked me for life with these two women(oh my word, I'm crying right now!). I pray that I will always cherish them for as long as I am privileged to have them.

2004

2009

She is your mirror, shining back at you with a world of possibilities. She is your witness, who sees you at your worst and best, and loves you anyway. She is your partner in crime, your midnight companion, someone who knows when you are smiling, even in the dark. She is your teacher, your defense attorney, your personal press agent, even your shrink. Some days, she's the reason you wish you were an only child.
~Barbara Alpert

The best weekend in spring...

2010-05-07T00:00:00.009-04:00

Spring. For the longest time spring was the end of the school year... the time before summer break... the time before graduation. And though I graduated 2 years ago, the "slow" ones of my my group of freshman graduated this past weekend, and the best weekend of spring commenced. I love graduation... I loved my graduation. I love the ceremony the singing of the alma mater. I especially loved this year, because it was the first time the group had been together in quite a while. 4 nights in a row we had parties, late night ihop runs, cake, and many many games. It was a good weekend.

Green won

This might be my favorite picture ever. I so love those girls...

The memories that come from walking around my campus... I walked up that sidewalk towards the library twice a day for 3 years.

Class of 20008! I have a brick! (I remember ordering the brick... but I didn't think I had one because I don't remember actually sending in the check to pay for the brick.)

Is it bad to want a master's degree so I can wear the colorful hood?

It was a very good, very needed weekend.
I am so loving this spring.
(part of You Capture: Spring again. all pictures SOOC thanks to the fact that my computer got wiped clean when windows 7 got uploaded this week and I haven't gotten around to putting photoshop back on. Sigh. I sometimes hate computers.)

Spring’s Perspective…

2010-04-29T01:16:00.002-04:00

It was a rough winter. Lots of snow, gray clouds and bad roads. There was this one day when I had had enough. I needed air… needed to breath in something other than my furnace. That being said, I went to the park. In –1 degree weather.

Last week I went to the park with my friend Tiffany. We had both had crazy busy weeks spent in hospitals and houses, and we needed some air. To take a slow walk in 65 degree weather and chat about life, jobs, friends and plans. Neither of us have set plans… both of us are waiting on jobs before we find out the next step. So we went out. We felt the sunshine and we smiled.

And where in winter the lane looked like this:

In spring it looked like this:

When the lake was frozen and covered with snow:

It was now thawed, and surrounded by families:

And where the world was shades of gray and white before,

I found the ultimate proof that life moves forward and that Spring has sprung:

What a difference 4 months makes.

I can’t wait to see what the next 4 months brings. There are so many things up in the air, things I am struggling to turn over to God and not stress about. I look at these pictures and I smile. As little of time 4 months seem, big changes can occur. Things that are the same can be so different all at the same time.

I am getting excited about the changes the next 4 months will bring.

Life is good. Spring has come.

(part of You Capture)

Florida: Heaven's Waiting Room

2010-04-23T12:48:00.000-04:00

The last few weeks I have been struggling through dealing with death. Particularly elderly patients being brought to my room in full cardiac arrest and me and my co-workers do everything we can and despite all efforts, it's not enough and my patients die. In 3 weeks I have had four patients just like that and it's rough. For two of the patients, I had to go with the physician and tell their spouses that we couldn't save their beloved family member. It caused me nightmares and it put many questions in my mind about how I am supposed to react to this situation because I know I am going to have to deal with this my entire nursing career.

I received very wise counsel from several nurses that I work with and also Nurse Corrie, and my hero daddy who is also a nurse (not sure if I have mentioned this fact before). Life and death are not in my hands nor in the hands of my co-workers or the physician's. It is solely in the Master's hands. My responsibility is to use the gifts and skills that He gave me to carry out His plan.

Even though I understand this, it's still hard to prepare a body for the morgue. This is something I don't think I will ever get used to doing and I don't like it one bit. I've done it twice and I can't even express how hard it is for me. But, it's part of my job.

Last night I had a different sort of patient. He came to us as a possible overdose and he was only in his 30's. EMS brought him to us and he was barely breathing but they hadn't intubated him. He was completely unresponsive and Narcan did nothing to bring him around. The doctor prepared to intubate him and since he was my patient, I had to grab the drugs. I was nervous and my hands were shaking because the physician working the patient has a reputation for being harsh during code situations which this wasn't but it ended up turning that direction.

Almost everything went wrong with this guy, he was tough to intubate and even after the doc and respiratory got it he still wasn't ventilating well. It turns out that the cuff on the intubation tube that keeps it in place was blown so they had to switch the tube out. After he was intubated his blood pressure dropped to almost nothing and nothing we did could get it up. Bag after bag of fluids were hung, two types of pressors were started and still his pressure was only like 70/50. I felt such despair and hopelessness because I felt like all my efforts were for naught and he wasn't going to make it.

I juggled with the pressure issue for like 45 mins and finally got it stabilized but then it was another issue and then another. This young man was sick and I was virtually taking care of him by myself because five patients from a car accident were brought in who required the attention of the doc and the rest of the nurses.

I really can't even properly express how tough this patient was to care for and how badly I wanted him to pull through and how defeated I felt. He ended up being in rhabdomyolysis and metobolic acidosis, secondary to whatever he overdosed on. He never woke up despite not being on any type of depressive medicine to keep him asleep while intubated. I never did get him stabilized enough to take him to get his head scanned in CT. Night shift came and even though I would have liked to have gotten the patient up to the ICU, they weren't ready for him yet so I had to pass report to night shift. Luckily the night nurse is a man whom I respect very much and he has taught me a lot through this first year of me being a nurse and he didn't criticize what had or hadn't done and he didn't complain about getting dumped this drain-circling patient.

I didn't leave work til 8pm which NEVER happens because I had to catch up on charting for the past 4 hours. I was mentally and physically exhausted when I got home. I called my dad to talk about everything and see if I did right by this patient. I work again Sunday so it will be interesting to see if I can figure out what happened to this patient after I left and how he's doing now. I am pretty sure I did the best I could and I hope it was enough. I learned a whole lot through all of this and I hope it makes me a better nurse.

A nurse once quoted M*A*S*H to me, actually the very same nurse who took over for me last night. He said, "The first rule of medicine is people die. The second rule is doctors (and nurses) can't change the first rule."

I must press on and keep doing my best and leave the outcome in God's hands. So much easier said than done.

Sharing some sweet

2010-04-22T17:34:00.001-04:00

It has been a crazy week at work. I had a patient that REFUSED to leave. Seriously, they were supposed to be out of the hospital at 5, and I didn’t convince them to leave until 9. There were patients with extreme dementia who would try to kick you every time you got close. Patients who had made complaints against staff and required 2 of us in the room at all times. 3 out of the past 5 nights I didn’t even start passing meds until 930, much less be done by then. It has been like a 2 week long full moon.

Last week in the midst of the confusion one of my coworkers brought in dark chocolate cookies with toffee chips. They were awesome… and much needed on a bad night. So when Hy-Vee put their strawberries on sale for 4lbs for $4, I decided it was my turn to return the favor.

You start with a not-sweet biscuit. if you are me, you start with a not sweet biscuit that has 2 different kinds of sugar in it because when you run to the store to buy more flour you don’t realize you are out of white sugar as well..

Add a pile of strawberries that were sprinkled with powder sugar and left in the fridge to create their own sweet juice…

And cover with whip cream for the final touch of sweetness.

(and if you are me, you go back halfway through for more whip cream because you ate the whip cream faster than the strawberries…)

Then you take it to work where some amazing nurses who all look a little ragged by 1am all get excited when you plop it on the counter in the galley, and tell you how fast they inhale it in between delivering pain meds and charting. And what started out as a fairly bad night turned into a pretty good one.

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And just for grins… I think this picture is pretty sweet because it is the first one I figured out how to run an action on. I still don’t have it all down, but just figuring out the basics made me happy.

(vintage action from Rita’s Coffeeshop)

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Part of You Capture

Fresh

2010-04-15T17:15:00.001-04:00

Sitting on my couch with fresh air streaming in the open balcony doors is heavenly. My apartment no longer smells of stale heater air and my glade air freshener. It smells… like sunshine and spring. Fresh.

I went to the zoo the other day and found someone else enjoying fresh air and sunshine

I don’t think Mr. Hippo moved the whole time we were there.

And I desperately wanted to get a book and a glass of lemonade and hang out here for a couple of hours.

Fresh white flowers against a blue, blue sky…

And a baby just waiting to burst through.

I am loving spring.

Part of You Capture

Walk of Shame

2010-04-14T10:33:00.000-04:00

I got written up today. 4 years at the same job and I got written up. It was for a very stupid reason too. It wasn't because I had yelled at patient or had given poor care. Nope. I got written up for a misplaced mouse click. My boss called me into her office and showed me a sheet of labs with my name at the top saying I had printed it.

Dang Technology.

I had printed a patient her labs of the computer which apparently I am not supposed to do without having her sign a consent. And to top it all off, I printed the wrong patient's labs off. This is a HIPAA violation. Ouch. I feel like a complete moron. I totally know better. My boss was sorry that she had to write me up. She said she wished she could play it off or make it a verbal warning but she couldn't because it involved higher ups and all that jazz. I think she is used to people whining and trying to fight it because she was like "Do you understand? I am sooo sorry!". Yeah I understand. Obviously I did it. Obviously they are for the wrong patient. I won't be doing that anymore that's for sure.

I was glad in a way that it happened because it was a reminder that everything I do can have repercussions. In a hospital, you have to be ever mindful of everything you do because it can come back and bite you. I need to be very careful and precise with all charting and especially printing. I also had a nice chat with my boss because I don't spend time in her office very often. She asked how I was feeling about everything and if there is anything that is causing me trouble. I told I don't feel too awfully comfortable managing medication drips because I don't do it very often and that I hoped all my charting was thorough enough. We talked about it for awhile and I feel a bit better after our conversation.

I still love my job and (almost) all the people I work with. There is always a helping hand around. Someone to turn to for advice. No one ever makes me feel stupid. I am finally beginning to connect with my coworkers. It's going to be tough when I decide to leave someday because I am quite comfortable in my little emergency department. That's not always a good thing.

Attitude Adjustments.

2010-04-14T02:04:00.001-04:00

Last night one of the respiratory therapists asked me what was wrong, and said that I always look unhappy.

Always look unhappy.

That made me want to cry. I am not unhappy at work. Believe it or not, most nights I like my job. I usually like my patients.

(At least on the nights where I don’t have 2 individual patients having various degrees of a psychotic break at the same time. Those nights I neither like my patients or my job.)

Why do I not look happy? Do I not smile enough? I have been thinking lately that I need to work on some attitude adjustments… I don’t like how often I join in the gripping about things we don’t like. How often I bring up the negative. How often I complain about day shift and ER and all that jazz… I do it a lot at work.

But still… I never expected to be told I always look unhappy.

Sigh. My attitude has stunk lately. I know it… the people who talk to me daily know it.

I was told that my facebook status updates have sounded depressed lately. I had a friend come and take a 2 hour walk with me today after working for 10 hours because she was worried about me. Now, that says great things about my friend, but not good for me.

I tell people I like my life. I like my job, I love my apartment. I have good friends. But yet I act like it isn’t enough.

Dad was talking to me tonight about a client who is having panic attacks as she sets up a trust fund for her grandson. She so desperately wants to make the right choice she is having a hard time making any choice. dad’s thought was that anything was better than what she had now, which is nothing. There is no losing.

I have a lot of great options, great choices, in my life coming up. In reality, non of them are bad choices. Staying here is no more a bad choice than going to alaska or moving back to my hometown. I have good choices, and eventually I will chose one and be done with it. But I have always said that I want to be happy where I am now. Without making a million conditions… I will be happy when I get a house or when I get this job or when I make this group of friends.

I am failing at this goal of being happy. I don’t like failing, and especially here, so I need to change. How, I do not know exactly. I am still working on a plan. (we all know how I love my plans.)

I always hear people talk about choosing to be happy.

I want people at work to see me as the girl who is happy. Who smiles and doesn’t sit around whining about everything that is wrong with the world.

So. That is my new goal… one attitude adjustment coming right up. We shall see how it goes…

Comfort

2010-04-08T16:45:00.002-04:00

I made it home for the first Easter since I left for college this past weekend. I somehow made easter into the break to road trip to some other place, not ever caring that I wasn’t home. This year, however, I was super excited about getting to go home. Of course, in the pattern of nothing I plan actually working out, I ended up going home 2 days later than planned thanks to a fever, abdominal pain and utter exhaustion requiring me to sleep for 36 hours straight.

My mom prayed I would get good friends in college. This group of girls was a huge comfort to her, to know I was doing okay with amazing friends. My core group, my roomies… Easter 2009, right before half of them got married, we went on a road trip to St. Louis. Awesome weekend…

Our next big road trip is planned for the year we turn 25. We are all going sky diving. Except for tiffany and katy who think jumping out of a plane is crazy and who plan on staying on the comfort of the ground and taking pictures.

When I got to the comfort of my home (with a fever of 100.5 at that point) the first thing I saw was this:

CeCe seemed to think since I was paying her attention I should get down and pet her.

I don’t get down on puppy level all that often, but she seemed to be looking for some love, so I gave in…

Is there any comfort better than have a good belly rub? She thinks not.

Of course 5 minutes later I was sitting on her because mom wanted pictures of her 1 surprise lily and that was the only way I could get a picture without CeCe knocking over the flowers.

And there is one other thing I took comfort in this week. Awhile ago I started an intense search for a camera bag that I liked. After weeks of not finding anything I liked I called my mom and went into a rant… everything is black. BLACK. I hate black. and they say CANON. OR NIKON. Or some other big name. who wants to carry a bag proudly proclaiming look at me! I have the potential to have many thousands of dollars of equipment in me! (not that my bag does.) I want to travel. I want to travel with a camera bag that doesn’t look like a camera bag. And pockets. I want pockets, mom!!! I want to be able to put my wallet and my phone and keys and probably a book cause I always have a book, but none of these bags have the right pockets! I don’t usually carry one bag I am definitely not carrying a purse and a camera bag! and they are all backpacks or with short handles. I hate backpacks! I want an across the shoulder bag so I can actually reach things in it. And I want it to be pretty! and not expensive… omw mom if I was going to spend $200 on a camera accessory I want a new lens! I can’t find anything I like (end on a wail….)

and so it went on. Seriously. anyone who knows me knows once I start ranting it goes on for a while. and usually happens again later. My mom finally stopped answering the phone… and then last weekend made me this.

I am in love. It is neither black or a backpack.

It has pockets! They are even extra padded as a last minute request. (Yay! my lens can rest in comfort!)

It doesn’t say CANON, but it does have a wooded daisy button from my great grandma’s collection.

Why do I find this a comfort? Because, Ladies and Gentleman, this bag right here? It is proof that someone can listen to my rants and actually understand me.

Isn’t it beautiful? I think I am getting the Canon 55-250 to put in it this week. (anyone have any opinions on that lens? I already have 18-55 and the set 50).

Part of you capture hosted this week by Keli and usually by Beth.

Feet.

2010-04-01T17:28:00.001-04:00

When I was in Florida a couple of weeks ago Ricki and I went for a spa day in St. Augustine. We got massages… facials… and pedicures. I LOVE the final products of pedicures… smooth heels, pretty nails. I HATE the the filing part, though. It gives me chills and makes me flinch, which is not good when someone is messing with your feet. But still, don’t they make toes look pretty?

OHH!!! And while we are on Florida and feet and all that jazz, check out Nurse RaDonna’s super hot birthday shoes

She claims they are very comfortable, but she was the first one to kick them off later in the evening…

I am in this photography class and we have been going to a museum across the street from the school to take pictures. Last class everyone was focusing on taking pictures in the reflecting pool, but I saw the freaky headless statue thingy's and instantly thought, FEET!!!

I love this photo. I do not know why. I just find myself staring at it…

I also love photoshop elements. I am just learning how to use it, and it seems endlessly complicated, but I figured out how to do textures a couple of weeks ago and it is just so.much.fun.

Granted, so far no one I have shown this picture to seems to like it. I have heard the words “weird”, “interesting”, and “I don’t get it” from several people. But I like it, and that is the important part.

(Part of You Capture this week being hosted by Keli at Kidnapped by Suburbia while Beth enjoys her beautiful baby boy.)

Saying No

2010-03-30T09:43:00.001-04:00

I told my boss this morning the reasons why I don’t like going to the other unit that they have been floating me to often. She took notes while I said things like “not nice” and “there is a weird vibe” and “I feel there are landmines waiting to blow up in my face” and “they hate their manager” and “they treat me like I am incompetent”. Not sure she knew what to do with my it has been a long night fighting fevers and I am tired, statement that I was sorry I couldn’t more be more technically technical about why I didn’t like it.

Good way to impress your boss, say things like technically technical.

They wanted me to go last night. At midnight. Leave my patients, go over to the unit and get all new patients. I said no, unless they would give me callback pay. They didn’t send me.

I don’t say no often… I go to meetings, I get up early to take computer classes. I am the only nurse on nights who hasn’t flat out refused to float to the unit. I am on committees and a super user. My boss loves me because as a rule night nurses don’t do things. They are much less likely to get involved than day shift… we tend to come to work, do our job and go home. So for me to agree to do it all makes them happy, and makes me feel less bad about saying no.

in a completely random not even connected sort of way, I am having a good morning. One of the local rehabs brought breakfast in for the nurses, as a recommend us to your patients thing, and they served bacon. REAL BACON. My hospital doesn’t do real bacon, it does turkey bacon. Same with sausage. So, the real bacon was yummy. And now I am sitting on my couch eating a Hersey's chocolate bar with almonds. Healthy breakfast, that.

Bacon and Chocolate. 2 basic food groups.

nite.

For A Moment…

2010-03-26T15:47:00.001-04:00

(I am late again with You Capture but it was vital to my sanity that I get my suitcase out of the middle of my living room last night as opposed to play with my pictures… so here we go)

For a moment, the sun reflect perfectly across the reflecting pool at the Nelson Atkins Museum…

As the building itself, for that moment, also reflected….

For a moment, as I stared at this fence, I could pretend I was back in one my favorite places, the country-side of Ireland …

(and seriously? for a moment a wondered how hard it would be to buy a house with a stone fence. I do so love them…)

For a moment… my instructor was there, and then not. Can you see him? We are practicing light painting… it has something to do with a black card and leaving your shutter open for a very long time… I did not quite get the concept, but it looked pretty cool. (if, you know, the person holding the camera did it right, which none of us did…)

For a moment… I could play with my camera, dream about the lens I am going to buy (as soon as I decide which one I want) with the money from the extra shift I worked (crazy corrie working 5 shifts in 6 days…), and forget about all the stresses floating around my brain and the decisions I am scared to make. It was a good moment…

Grading Myself

2010-03-23T19:56:00.001-04:00

In the grand scheme of things, I am a good nurse.

I know this as surely as I know that the sun is shining and my balcony door is open. I know this as much as I know that cardizem will lower heart rates but to watch the blood pressure… as surely as I know that I don't want to be the nurse giving ambien to anyone over 65 for the first time… as much as I know that regardless of what their oxygen saturation is putting a patient on oxygen will instantly make them feel better because it is something medical being done…

I had the same patients for 3 nights in a row. I laughed with them, took them on walks in the hallway. Called 2 doctors on 2 patients all 3 nights… blood sugar high. hemoglobin low.

Had a dude with a splenic infarct… think a heart attack in the spleen. It is interesting having to worry about strokes and heart attacks and blood clots all at once… the doctor was convinced he was going to throw a clot from the dead spleen, we just didn't know where that clot would land.

I got floated on my last night. Night 4, all of my patients were still here and they floated me to my least favorite place. I think the time has come for me to stop being so nice and agreeing to do things I don’t want to do. I need to talk to my boss about it…

I filled out the skills checklist for a couple of the traveling companies I am looking into working with, and then yesterday ended up talking to one of them… she said I didn’t do very good. What? Apparently I scored myself a 2.6/4. She said you can usually tell the good nurses because they are honest… it is the people with a perfect 4 she worries about. I think I took the test as a brutal self assessment of my skills, and now I need to take it again as a selling myself to potential employers test. I am a tad worried about the other skills list I filled out, though… haven’t talked to that recruiter yet.

I am a good nurse. I know this as surely as I know that sometimes you don’t need haldol to calm down the slightly confused/agitated post stroke with expressive aphasia(aka can’t make sense with his words…), you just need to sit with him and hold his hand while he falls asleep.

As much as I know that sometimes a short walk in the hallway can make a patient totally depressed about his health smile again… look, I am getting better!

As truly as I know that sometimes (not always) giving 5 blood pressure medications at once is a stupid idea, as surely as i know that very few doctors care about anything not directly related to imminent death in the middle of the night, as much as I know that as a nurse it is my job to occasionally call doctors about things not related to imminent death because my number 1 job is to be an advocate for my patient.

I still fail fairly often at IVs. I still ask questions. and more questions. I still occasionally let my bags of Amiodarone run out, and avoid going into a patient’s room cause they give me the creeps.

But still, I am a good nurse. I just don’t know how you put a grade on that…

You want me to do what???

2010-03-20T21:59:00.000-04:00

So I stroll into work today and check the assignment sheet and it's blank! The night charge nurse was on the phone and when he got off he said, "The day charge nurse called off, the Manager is talking to the triage nurse, then she wants to talk to you." My heart sunk...I knew what was coming. You see, we can't seem to hold a charge nurse. Nobody wants to do it and so far I have managed to dodge that bullet due to the fact that I am only 9 months out of school. Well, there was no dodging it today. There was only the 3 of us 7a-7p nurses, one was agency so she can't be in charge, and the other has been a nurse a year or so longer than I but she only just transferred to the ED. So I was named Charge by default.

All I had to do was last until noon when some more nurses came in. I was a nervous wreck...a few days ago I had just been telling Nurse Corrie that my biggest fear was having to be charge. Granted, I know the system and flow of the ED as well as most of the nurses including the other charges. But I have such little experience, I am so afraid that I won't be able to recognize a serious problem when I see it or that I won't be able to handle the drips or meds or codes if the situation were to arise.

The first few hours went by very nicely...not busy at all! Then we got 5 ambulances one right after the other...it was ridiculous! Nothing too serious but still, it's rough finding some place to put everyone and not giving too much to a particular nurse. By the time noon came around, we were full and I had 3 patients as well as still being in charge. I decided to stay in charge til three and gave my assignment to one of the noon nurses. Another couple of hours went by and I was relieved to have gotten everyone to lunch and the place wasn't overly packed, we were able to handle it.

The most exciting patient we got was an older woman I had care for before that was in SVT. I love SVT for some reason, I think I love being able to stop a patient's heart with the flush of a syringe! Sadly we didn't need to give her Adenosine, the doc had me start her on Amiodarone instead.

1500 rolls around and the crew talked me into staying in charge because things were going ok. It truly wasn't so bad except I was constantly waiting for the other shoe to drop. There was no relaxing and my stress level was through the roof. But I do a good job staying cool, not letting the situations get to me. Apparently I was hitting the OBS side with too many patients in too quick of succession because one of the nurses came and was basically complaining about the load I had given him, but he didn't even have his facts straight, he just jumped the gun and came and complained about it to me. So I calmly set him straight and he went on his way, I was glad I kept myself in check and stood by my decisions.

An hour before shift change, ICU called a code blue which one ED doc and the ED charge nurse are required to attend. It was a cool code, the patient had just been put in bed after being up in his chair for awhile and he suddenly went unresponsive, apneic, and pulse less. By the time we got up there his pulse was back but it tachy at 150 beats per minute and he still wasn't breathing. He was really tough for Dr. C to intubate and when he finally got it, it appeared that he had aspirated something. I was no longer needed so I moseyed back downstairs...by this time I only had 40 more minutes til shift change!!!

Night charge showed up and I gave him report. I knew the story on every single patient and the place wasn't entirely in shambles so I think I was a success! I am so relieved to have this day behind me. I've always known this day would come so it's nice to have conquered this mountain. The first time is the hardest and now it's behind me. I truly love my job and all the people I work with, and am grateful for the experience I gained today!

Reaching Florida

2010-03-19T13:43:00.003-04:00

This week I was able to go to Florida to celebrate my Birthday with nurse RaDonna and my big sister and brother in law. I try to go see them twice a year... life is good.

I reach for some of this every time I am at my sister’s house

(want the best bbq recipe around? Buy a ticket to Florida. Call your sister and beg for chicken. Show up and find your brother in law grilling chicken that has been marinating for hours. Eat. Eat some more. For good measure go back a couple of hours later for another piece. or two. then, as an added bonus freeze the leftovers and put them in your suitcase to take home… on the plane.)

His tongue is reaching for a taste, but it shall be denied. That chicken is mine. All mine.

Mini golf is my favorite thing to do in Florida. Nathan usually ends up reaching for my ball when I whack it into the water… Hit it HARD is my motto.

Me and my big sister. We like being grown up friends. I find it very unfair that she tans and has non frizzy hair.

And then I got to reach out for a huge with my bestest friend NurseRaDonna!!! And of course that requires reaching out to take a self-taken portrait! (or 2. or 3. or an uncountable number…)

All decked out for my birthday!!!

(is there any better day than St. Patrick’s day to have a birthday?)

(Corrie, RaDonna, and Randi)

I leave you with a picture taken by the very talented Randi Jean (RaDonna’s sister… and the photographer behind the new blog header)

This picture might look like I am reaching out to her.

But no.

I am pushing her.

I am that kind of friend.

The end.

(written at 7am sitting in the Memphis airport. Being in the Memphis airport at 7am means I got on a plane at the Jacksonville airport at 6am. Oh… and I go to work in approx. 10 hours and work the next 4 nights. Woe is me.)

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Part of You Capture!

Chapter 23

2010-03-17T00:04:00.002-04:00

Today I turn 23.

23 has been a big deal to me for years. For some reason I decided when I was like 13 that 23 was going to be the perfect age. Out of college long enough to have a career, be comfortable in my job, making good money… it was the right age.

For the past several months I have been struggling with some changes to make in my life, to the point where I am pretty sure I am moving in the next couple of months. (moving=new job=way scary.)

Where? I have no clue. (well, I have a clue, but no idea what is going to work out, so therefore… no clue)

Several of the things I have planned in the last year have fallen through, and that is hard… no air force. no Uganda. no masters.

Enough failures makes taking the next step hard. But I am determined too. Determined to be proud of the life I am living. To not sit home in my apartment because I am scared to leave it.

So here is to you, 23. There are decisions I will be making during your year that will be hard, scary. I think you and I are going to be good friends. I am excited to see what you have in store for me.

And so the next chapter begins…

Quiet.

2010-03-11T09:28:00.002-05:00

This past weekend I did one of my favorite things to do… I went to my grandparents. They live in a tiny town near the Kansas/Nebraska border called Axtell. I always feel better after being there… refreshed, happy. It is quiet. No big city noises, no constant beeps at work. When I am there I don’t dream of IVs going off in the background and patients yelling my name. Some of my favorite memories growing up are the weeks in the summer I would stay with Grandma and Grandpa, usually with a cousin or two. The quiet house I love now was not so quiet back then.

This house has everything I love about old houses. It has history~it used to be the town hospital. It has character~there is still a window from a bedroom into the hall in what used to be the nursery. It has a huge porch… many times I drive up and see them sitting on the porch swing waiting for me.

This is my grandma. She is the quiet one of the household, but full of strength. She raised 6 kids, moving them around the country and holding down the fort while grandpa traveled to various places with the Air Force. She wrote a column for years, and has written 4 books. Every time I go she talks about some other award she has gotten for various articles she writes.

We went on a walk Saturday, Grandma and I. I don’t think it gets much quieter than main street.

There wasn’t much work going on at the grain (silo? elevator? my small town vocabulary is failing here…)

Come fall and it will be less quiet I am sure.

Grandpa is rarely quiet. (maybe that is where I get it from, along with my red hair and Gin Rummy skills (at one point in time I was 6 cents ahead! That is a record!) and love of telling people what to do.)

I go there, and I rest. I curl on the couch and read some of grandma’s old columns. I play cards. I eat food I don’t have to cook, and I help do dishes afterwards without even thinking about it. I smile… take long walks… talk about the never-ending supply of great aunts and uncles and cousins twice removed and the daughter of the sister of the uncle by marriage who moved in across town… go to pancake breakfasts to support the local fire department… take naps in the sun… and in the end, I get a hug and a “Love you, babe” from grandpa, and life is good.

(part of you capture)

Hope.

2010-03-04T17:26:00.001-05:00

Hope is wearing your sunglasses for the first time in 2 months

Being Hopeful that spring is coming

Hoping that March turns into the wonderful month I have been choosing to believe it will be for the last 2 months.

Hope, like the gleaming tapers light,

Adorns and cheers our way;

And still, as darker grows the night,

Emits a brighter Ray

~Oliver Goldsmith

(part of you capture at I should be folding laundry.)

(Taken while driving to Topeka the other day. I hope I learned my lesson… don’t tell your mom that you take pictures while driving down the highway. It makes life less stressful for everyone…)

The day

2010-03-03T17:39:00.001-05:00

There is an obituary on the bulletin board in the galley. For a man who spent over half of the last several years of his life in our hospital. He was my first rapid response, my first blood sugar of 17. I took care of him many a time, and even though he was grouchy and noncompliant and tended to make things harder than they needed to be, even though he was a 57yo man living with his mother, I found myself saddened by his death in a way I wasn’t expecting. And saddened that he died at a different hospital. Is that weird? After spending so much time with us, he went somewhere else to die. And as much as I would gripe about getting him again if he were my patient tonight, it is sad.

Rest in peace, Mr. N.

It has been a hard month at my work, for a million reasons that I will not get into. Moral is down, and there is this negative energy flowing.

It has been hard to go to work. Hard to get the motivation. There is the feeling that as hard as we try, it is never good enough.

A patient of my had a seizure this morning. Completely unresponsive… three of us did sternal rubs before she finally came out of it… slowly. Scared me a little bit, I thought we would have to rapid response her. But she was okay. Then, as I sat there waiting fro the dr to call me back, my admit showed up. At 530. Crazy times… crashing patients and new patients and I was stressed. And you know what? I made it out of the hospital at 720. And that happened for one reason only.

I work with an amazing group of nurses. Nurses who checked in my admit. Who did the ekg on my seizure lady and who called monitor techs and who put up my charts and walked my pt to the bathroom. Who asked what needed to be done and then did it. Who did some things before I even asked. We are a team, which makes my job doable. I have worked on other floors that have less of the team like atmosphere, and I don’t know how they do it.

Today I was reminded why I like my job. Why I am not sure I want to leave it. Why I will never regret where I chose to get my first few years of experience in this crazy career of mine.

It was a reminder I needed.

You Capture: Shapes!

2010-02-24T15:49:00.003-05:00

This past weekend was amazing. A mini college reunion where a group of us flew out to Wisconsin to help another friend celebrate her birthday.

We were the annoying people on the plane who were laughing an talking and playing uno at 530 in the morning. A lot of caffeine was consumed that day.

While there we went to the Milwaukee Discovery World (which was way cool) and saw many shapes…

As a Kansas girl I am glad that shape is confined in a clear tube and not out in the field headed towards my house…

Jellyfish have got to be the weirdest thing ever. Where is their brain? Blood? Nerves? Do they have any of those things? They are very round… not sure I knew that.

And what would a girl’s weekend be without a Hersey's town square full of melted chocolate and surrounded by blocks of pineapple and angel food cake, round pretzel sticks and marshmallows and fresh strawberries?

I have been blessed with friends in many shapes and sizes, and I thank God for each and every one of them!

(part of the you capture series over at I should be folding laundry)

My night to music

2010-02-19T16:10:00.003-05:00

I am tired. Behind on charting. I have a manic patient, or an overdose patient, or a withdrawal patient. Confused people. Overweight people. Husbands who refuse to leave because they can't be apart from their spouse.

There is always music running through my brain. Usually the last song I heard before I get out of my car. Sometimes a random song. A song played on a commercial in a room.

I had my zune on shuffle. A song pulled up... one I haven't listened to a lot. I got it to put on a playlist for my BIL.

I had visions, I was in them,
I was looking into the mirror
To see a little bit clearer
The rottenness and evil in me

it gets put on pause. the earbud comes out of my ear and I go tell the OD patient she can't have more morphine.

I'm not sick, but I'm not well
and I'm so hot 'cause I'm in hell

I have had a lot more BHAC patients lately. Manic. Depressed. They take patience.One lady sat at my desk for so long I finally walked her to her room and went and charted on the other side of the unit.

Put me in the hospital for nerves
And then they had to commit me
You told them all I was crazy
They cut off my legs now I'm an amputee,

Lots of middle age women stressed about life going through menopause have chest pain. stereotypical? I have repeatedly stated that I will drop dead of a MI before coming into the hospital with CP. Not a good attitude to have, but the world does not know how to handle stress.

I'm not sick, but I'm not well
And I'm so hot cause I'm in hell
I'm not sick, but I'm not well
And it's a sin, to live so well

People try to numb the pain. A fully functioning adult whose business went bust started drinking. A spouse being divorced swallows a bottle of pills. Cutting. Overeating. I see it all. They don't want to think, they want to feel good...

I wanna publish 'zines
And rage against machines
I wanna pierce my tongue
It doesn't hurt, it feels fine
The trivial sublime
I'd like to turn off time
And kill my mind
You kill my mind
Mind...

I might possibly have gotten cynical in my long nursing career of 18 months

Paranoia, paranoia
Everybody's comin' to get me
Just say you never met me
I'm runnin' underground with the moles
Diggin' holes
Hear the voices in my head
I swear to God it sounds like they're snoring
But if you're bored then you're boring
The agony and the irony, they're killing me, whoa!

So I hear pieces of this song as I come and go, and in the morning as I hang out with some of the night nurses waiting for days to finish report, I hear myself singing

I'm not sick, but I'm not well
And I'm so hot cause I'm in hell
I'm not sick, but I'm not well
And it's a sin to live this well

It fits so well. And yet it is so wrong, all at the same time.

I think I need to start listening to some new music at work.

Flagpole Sitta By Harvey Danger
Edited some due to the whole my mom reads this blog thing.
Video Here

Green is Good.

2010-02-16T10:06:00.003-05:00

It is the day after valentines day, and the blog is now green.

Except the header, because I forgot how to change it and my brain is dead.

so we have a green blog and a red header. But not Christmas colors, so it is good.

I love st. patricks day.

probably because it is my day.

Last night I had an OD pt with a 1:1 sitter. Who fell asleep. So hard that I was shaking her shoulder calling her name before she woke up. A couple of minutes later the patient started vomiting... almost aspirated. I don't think the lady would have woken up with the vomiting if I hadn't woke her up first. So I told my charge nurse, who told the house supervisor, who went and talked to the sitter. Who proceeded to ignore me the rest of the night. I don't feel bad, but I would have rather they talk to her after I was done working with her.

I woke up to go to a meeting early yesterday.

Going to bed early does not make getting up early easier. Just saying

The meeting was supposed to last for an hour. I finally left after an hour and 45 minutes because I had to get ready for work. I need to stop agreeing to go to so many meetings.

I am getting the feeling I should stop typing and start sleeping now.

Good night.

Work!

2010-02-11T23:19:00.002-05:00

So this blog is primarily about my work, so when the You Capture challenge was to take pictures of work, I smiled.

My shoes. Sketchers, because they are my favorites. Sitting on the tile of my entryway, because they are not allowed to touch my carpet. Why, you ask? Well, because of this. and this. and because of the patient who broke their IV tubing and came out the hallway flinging blood everywhere. “hey, look, it’s bleeding”. There is still a spot of that blood on the white part of my shoe(explain to me how I can have 90% blue shoes but the blood always hits the white?). I use 4 bleach wipes every morning before I come home, and they still don’t.touch.the.carpet.

This is my work bag. It holds my clipboard, a collection of important pieces of information that get stuck in my mailbox at work, some magazines, a book or two, my zune, some medical supplies that I can’t get at night so I just carry around with me… the list goes on. It is bright and colorful, because I love color and hospitals don’t have much. It also stays on the tile of my entryway and doesn’t come into my apartment. Why? because it spends it’s nights on the carpet at work. That’s why.

My purple bottle… no danger of someone else drinking my water. or me drinking someone else’s water. my pill crusher… I got tired of never being able to find one, so I bought my own. My collection of pens. I am somewhat in love with collecting pens, especially good heavy ones. I get most of them from my dad. I sit at his desk at work and steal the ones I like. Similar to how I pick all the quarters off of his dresser whenever I go home… he doesn’t have to pay for laundry. (yes, I know. I am spoiled.)

My hospital has a uniform of white tops with navy pants. I hate it. Walking into a uniform store and only being allowed to buy plain white scrub tops is like walking in a baskin robbins with 31 flavors and being told you have to have vanilla. in a cup. Me, I am more of a double scoop mint chocolate chip and reeses pb cup in a chocolate covered waffle cone sort of girl. I don’t like white. (and that doesn’t even touch on the logic of making people who spend all day cleaning up body fluids wear white.)

That is why the shirts I wear under my white scrub tops look like this:

I like color. (especially green, considering the fact that 4/7 are predominately green.)

(and that is the end of my ridiculously long post…)

Bus Ride

2010-02-05T22:17:00.000-05:00

I'm not sure if I have mentioned this to ya'll before but I come from a family who is waist deep in Emergency Medicine. My dad helped found the rescue squad in his hometown and he has been an EMT, ED RN, Flight Nurse, and ED Director, among others. My older sister has been an EMT for 5 years and is currently a Paramedic. I always enjoy hearing my dad and sister talk about life on the street and the excitement of being in an ambulance and secretly I have always been a little jealous. Well, Monday I got to ride in a ambulance during an emergency transport of my patient to the closest hospital with a neurosurgeon!

It started with a call from an ambulance crew stating they were brining in a patient with a severe headache and left sided weakness that had started 30 minutes ago. The patient was a gentleman in his 60s who was visiting from up north with no prior health problems except an enlarged prostate. After he arrived we started to work him up and we saw that he was experiencing decerebrate posturing only on his left side, meaning his left arm and leg were involuntarily spasming and rigid. His pupils were unequal and sluggish and he was lethargic but oriented.

We scurried around to initiate the Brain Attack protocol and soon enough I was accompanying him over to ct scan. I am no ct tech but even I could see the bleed in his brain as the images from the scan scrolled across the screen. After I rolled him back to the resus room, I had to start him on a drip to keep his blood pressure below 120 mmHg systolic. The secretary quickly made arrangements and the patient soon had an accepting physician at the nearest hospital with a neurosurgeon. The ambulance crew soon rolled in and as I gave the lead medic report he stopped me and said that he would need a nurse rider because the blood pressure drip the patient was on wasn't in their protocols so he wasn't allowed to titrate it.

I was excited because I've been looking forward to my first ride-along and this was the perfect patient because he was relatively stable, I just needed to keep an eye on his pressure and adjust the drip as necessary to keep it down. Plus I knew the ambulance crew better than most so I was comfortable with them.

They loaded the patient up and I hopped in. We drove all the way to the hospital lights and sirens and I was surprised how bumpy it was in the back of the ambulance. I don't know what I was expecting but definitely not such a fast and crazy ride. The patient remained stable for the duration of the transfer and I only had to adjust his meds a few times. The ride over went super quick and we arrived before I knew it. I gave report to the nurse, transferred the patient over and headed home.

I felt like a grown up nurse, doing my first transfer. I cannot wait until I get to do another because then I won't be as nervous and I'll know what to expect the second time around. It gave me taste of life on the streets and I got to see why the unpredictability and excitement of bus life is so enticing. Someday, I think I would like to be a flight nurse. I haven't made it a definite goal for my future but I am keeping it on the back burner. We shall see...

a post of randomness.

2010-02-05T16:28:00.002-05:00

1. 2 Things my patients learned this week that I could have told them ahead of time...
* a gallon of alcohol for a week straight is a bad idea.
* urinals work better when you take the lid off... otherwise the urine
goes flying. possibly hitting the nurse.

2. I was catching up on my ana-recommended news articles this morning (okay... afternoon. I don't do mornings) and I found a couple that were interesting.
* Huntington Hospital upgrades nurses' communications
how awesome would it be to have the hospital give you an ipod touch? I can't
tell if every nurse just gets one or it you pick them up when you get to work,
but still. Something I can pretty much guarantee my hospital will never do.
*For Heart Health, Focus on Risk Factors
At first I thought this would be one of those articles I would make fun of (like
the one I read last week that said something to the effect of NEWS!! WE HAVE
DISCOVERED THAT OBESITY INCREASES HEART RISK!! because I totally didn't know
that!!) but this one was actually interesting. we have been putting more and
more patients on statins, even when their cholesterol is normal, because it has
been proved to have protective qualities in addition to lowering lipids. I wish
I could find a good patient-friendly article to hand out to patients regarding
this, because it is a lot of the younger patients who come in (by young I mean
40-50yo)that we do this for, and they want to know why, and the patient drug
information we print and give still focuses mainly on cholesterol levels.
Decreasing overall heart risk is a good thing, and sometimes a simple medication
is good thing. (however, as the article says, if the only thing wrong is high
cholesterol and your overall risk is low, then don't look to medications to
change it. Work on diet and exercise first. People want easy answers, even if
they aren't the best long term solutions. (I wish I could find the article I
read a couple of months ago about this subject... hence the blogging about this
one, keep it easy to find.)

And in honor of it being wear red for women's heart health awareness day here are a couple of articles on warning signs and symptoms for heart attacks in women. Notice that chest pain is usually last on the list, if it even makes the list. Also notice that heart disease is the number one killer of women, and it gets one day of red as opposed to breast cancer which gets an entire month of pink. Also notice that the risk for heart attacks is highest in the years leading up to and away from menopause, because of the hormonal changes.
hidden signs in women
Women's heart health (good website with lots of info...)

So, in conclusion... if you are a woman age 40-60 you have increased risk, chest pain doesn't always happen and is often the last symptom, and extreme fatigue and flu-like symptoms are often the first. Know your risks, know your body... stay alive. i tell my patients all the time that my number one goal is for them to keep breathing and their heart to stay beating.

That being said I am now going to get off the couch and go hit the gym.

You Capture: Faces

2010-02-04T18:12:00.008-05:00

the You Capture Challenge this week is faces.

Meet the Thiessen Girls. Last week my Aunt Ann was in town to see the family, and I managed to be home at the same time. My mom wanted a good picture of the three sisters, so I took my camera over to the grandparents.

In order of age:
Isn't my mom beautiful? This picture was actually taken at Dad's office right before we headed over to the Hillcrest.

Aunt Chris: this is her "I don't want my picture taken but corrie isn't listening to me" face. Classic Chrissy..

The baby of the family (I do so love being the baby of the family. She is also very good at the role...)

Sisters:

I love my family.

and just for kicks... this is the little boy my SIL Karina babysits. He was almost as hard to get a good picture of as Hurley, because he also doesn't hold still. But this face is adorable...

Color!

2010-01-28T20:29:00.007-05:00

This week on you capture: Find Color!

There has not been a lot of color in the world lately. We had 3 weeks of snow. A week of somewhat sunny weather to melt the snow. Then it got gray outside for a week… then it was foggy. As in, normal visibility is 10 miles; we were down to .3 miles. For 5 days straight. Then it went gray and gloomy again, and I about went mad. Then I woke up Tuesday morning in my parent’s house. My apartment has the bedroom windows blocked so I can sleep during the day. At home there are a million windows to allow in bright sunshine. I ran outside and it was warm! Around 40, I would say, and the sun was shining so bright! Blue skies! I know this picture is somewhat boring… but the sky made me happy. Especially since today it turned cold and we are supposed to get 4-8 inches of snow. Lovely…

I love this flower… one of the last ones still hanging on the bush outside my dad’s office.

Meet Hurley, my Sister Karina’s puppy. The most beautiful brown fur… his ears are longer than his head is wide, and he has such lovely puppy energy. It was hard to get a picture of him that wasn’t pure blur from him moving. This is him enjoying the sun streaming in the window after playing hard all afternoon…

The Golden Rule: nurses version

2010-01-26T01:48:00.006-05:00

This morning I told the day nurse that I "despised that patient's soul". In my defense, I didn't mean it quite that way. That was the talk of a nurse who had been running for 3 days straight, getting out late, dealing with computer downtimes, icu transfers, falls, and her. room 48. Every day the nurse told me she was the sweetest lady. Every night she turned into something... not sweet. She argued with me. She called me names. She called her daughter and told her I had tied her down with a metal bar. She got so bad I called the daughter and asked her to come in. at 3am. Not sure i have ever done that before. She was very obviously hallucinating. First clue? She wanted to know why I was purple with one big eye. at the beginning of the evening she cried about how she treated me. Three hours later it would start again. I helped her to the commode, called the doctor, gave her haldol (which did nothing.) I came so close to losing my patience. I complained about her at the desk, and I told the day nurse I despised her soul. Bad choice of words, but honestly, by this morning I was done with her. But you know what? I was the nicest thing with her. I smiled, I held her hand. I spoke softly and patiently with her. I got her up to the commode every 45 minutes for 12 hours straight. I closed the door and kept people out when she fell asleep at 630. I know when she wakes up, somewhat rested, her mind will clear. she will remember the person she was over night, and she will cry. she will hate it.
I came close to losing it, to refusing to go back in. Then it happened. During the night, when I got her up, I asked questions. Questions to see if she could remember things about her life in the midst of the muddle her mind was. You know what I learned? She has 3 kids, who took turns spending the night. She has 8 grandkids. 11 great-grandkids. One of them drew Godzilla on her whiteboard. SHer grandson called from Beijing. Another Grandson comes over every Sunday afternoon to play backgammon and crazy eights. She lives with her daughter. Despite all that was going on, the smile on her face when I said that she must have a special family. Yes, yes I do, she responded. A good life to show for at 95 years old.
A couple rooms down there is a lady I have had many times. A dialysis pt who needs a CABG but has had positive blood cultures for over a month. She is grouchy. Demanding. Refuses to move on her own, wants everything she wants 5 minutes ago. We have been dragging her out of bed, and she hates us for that. She refuses insulin. We have her on a fluid/diet restriction. She thinks we are starving her. I have had her for 4 nights in the past 2 weeks. And she wears at my soul. Never happy, never grateful. Always complaining. I did my best to stay calm, and I think I succeeded. I didn't let her have extra, but I made sure the water she did have was fresh and cold. And then the last night? She was smiling when I got there. SMILING. I noticed something else... pictures on the ledge. Grandkids. A drawn picture that read, my grandma is swet and kinde. I asked about them, and she talked on and on. And slept better that night then I think she has in the month she has been on our floor.

I have been working really hard lately to stay positive. To smile in my patients room, even when I want to strangle someone. The reason? Let me introduce them to you:

Meet my adopted Grandma Julia. She fell a couple of months ago, and ended up spending some time in a nursing home. She cried every time I went to visit her. It wasn't home, the nurses were over worked. Over new years her kids moved her into assisted living. Tomorrow I will go see her in her new home, and smile and tell her how much I love it. It is hard when you can't live alone anymore.

Meet my grandpa. He send me e-mails about how to cook roast and invest my money. He has a heart valve that should have stopped working something like 15 years ago, gets wounds on his leg cause he does things like go shopping when the wind is blowing so hard it slams his car door shut. He takes care of my grandma, who announce a couple of years back that after cooking for 50 years she was done. I love him, and have the distinct impression he would be one of those patients that argues with his nurses a lot.

Meet my mom's mom. She is very proud of me lately because I have developed a love of football. She was put on oxygen this year, and is pretty weak. She still runs the family, though. She is currently unhappy with her doctor because he told her he wasn't a KState fan the day after they beat Texas in a big upset.

Meet my dad's parents. My grandpa has had lung problems for years, and has to go to the hospital a couple of times a week for rehab and iv medications. He has charmed all the nurses so much that every time he goes he gets cookies, cinnamon rolls, fresh coffee, whatever he wants. I went to visit him in the hospital last year when he had pneumonia, and in his tiny-town hospital, pretty sure every person there stopped by to say hi and see how he was doing. pretty sure we are related to half of the staff. My grandma has always been the healthiest of my grandparents, but she has had a rough year with some AFIB, and troubles adjusting her medications. They live in this tiny town that is hands-down my favorite place to go unwind for a couple of days.

These are my reasons for working so hard to stay calm. To smile, to give the absolute best personal care I can to my patients no matter how trying they can be. The reason I have started slowing down, acknowleding that spending some time chatting about the news with the lady in isolation who is all alone is more important than getting every pill passed on time. Not talking medical care, but working more on the personal side. My patients. My people. I am doing it for the basic reasoning behind the golden rule. Do unto others as you want them to do you. Only I am turning it to nursing addition.

Take care of your patients as you hope other nurses are taking care of the people you love who are patients.

I love my grands. I love them, and I am watching as their health fails. I am watching it, I am hating it, and I am praying that they get the best care possible. and that the nurses who care for those I love take the time to talk to them. To learn about the kids, the grandkids, the stories behind their lives.

And while I pray that for them, I walk into room 48 with a smile.

Welcome to Six Flags

2010-01-23T23:19:00.004-05:00

I have decided that a roller coaster theme park is the perfect visual for my less than perfect life.

January has definitely been a ride so far and if it's any indication for the rest of the year, I'm gonna need some Dramamine.

The highlight of the month so far was the five day cruise I went on with my family. We all had such a blast and we picked literally the coldest week in Florida to go visit the Caribbean so it worked out beautifully.

I have finally decided that I am now an Emergency Department Nurse. It has taken 7 months of patient's blood and my sweat and tears to get to this point I never thought I would reach. It occurred to me as I watched my patient's heartbeat blip across the screen in a beautifully symmetrical supraventricular tachycardic rhythm. I knew precisely what was wrong with my patient and I knew exactly what he needed to correct his problem. All I needed was the physician to write the orders.

I am finally to the point where I can walk into an exam room with confidence and assist my fellow ED nurses, knowing that I am actually going to do more good than harm. I can finally start thinking about the reason my patient is ill instead of just focusing on each task as the Doctor orders them.

I have by no means "arrived" but the destination is getting closer each and every day.

The low point this month would have to be the mid-twenties young woman who rolled into our ED dead on arrival because she had taken 90 days worth of her anti-depressants at once. Her mom and dad weeped in each other's arms and her finance's anguished cries echoed throughout the department and I was stunned. I wondered what happened to this poor girl to cause her to think that death was the only alternative. I tried to picture what it would be like to discover that someone in my family or one of my friends had taken their own life and I was instantly choked up. I got home that night and hugged my mom and sat on my baby sister's bed as we chatted about her day.

I love my job but I didn't that day. I adore being Super Nurse and victoriously snatching people from the fangs of death. I hated the thought that this beautiful woman who had so much to live for could only see the pain and tears and chose to end her own life prematurely.

I hope that God never lets me grow callous towards the plights of my patients.

So there you have it. 2010 starts off with bang.

In my personal opinion, roller coasters are the best part of theme parks even though some times you drop so low you don't feel like you can take it anymore and you want off so bad but you know there is now way out unless you hang on for the ride. Why should I spend my journey scared and miserable, clinging to the handrail in terror? The best way to ride a coaster is with both arms high in the air, screaming with laughter.

I'm going to enjoy the ride.

Things I love!

2010-01-21T17:06:00.006-05:00

The challenge this week is to take pictures of things you love around your home. I love my apartment... always have. The living room is huge, big enough for all of my people. I have an extra room for a library/sewing room. All of my stuff from Africa/Guatemala/Europe. I loved having roommates, and I have enjoyed having it to myself. There are a million things I thought about taking pictures of, but two things stuck out,so here we go:

This is a clock my great grandma gave me. I love the story behind it. Great Grandpa Ross took her to detroit. She didn't want to go, but he had a line on a new car for free, maybe, or a significant discount, so she went along. While they were there they went shopping and found this clock. Grandma mentioned liking it, Grandpa said he hated it, and she bought it. It hung on their living room wall for 40 some odd years. I have these memories of going over in high school and helping her glue back on the diamonds. When she moved into assisted living, she wanted it to go with her. 4 months later, when we were taking down her apartment after she died, my name was taped to the back of it. It requires winding, which I never do so it isn't actually functional, but I love it all the same.

I have a lot of picture frames. I figured I would stick all the pictures together, because there are a lot. These aren't even all of them, just the ones in the biggest groups (for the record, my sister has probably 3 times as many as I do. It is a family thing). I love them, because I live here, by myself, with my favorite people spread out all over the place. I have pictures of people in florida, pictures of grandparents, pictures from graduation and pictures of road trips. It doesn't matter how bad my day is. I can't make it to my bed, out of my bedroom, to the dining room, or to my books, without passing a collection of pictures, a collection of memories, that make me smile. And don't we all need something that is guaranteed to make us smile?

(update: so apparently I fail at MckLinky cause my link didn't work the first time... so I just added it again. hopefully it works this time. sigh.)

the week from...

2010-01-16T13:29:00.003-05:00

This week was less than good. I made the stupid decision to go in early on Tuesday, they desperately needed help and I am trying to pick up extra hours. I seriously underestimated how different working 15 hours is as compared to 13 hours. I was beat by the end of the first night, and never recovered... and that was just the first night. I had three nights of irrigating bladders every hour, turning post-stroke patients, convincing a patient that the bed wasn't moving on it's own, calling doctors (4 times on one patient... by the last time she was like, yes corrie? of course, by then she didn't care what I had to say and didn't order anything... 5 minutes later the next doctor came in and wanted to know why we weren't giving the patient any blood. oh... and why we didn't have a continuous irrigation set up, which the doctor refused to order 6 hours before. *sigh* life would be easier if doctors would just listen to the nurses. just saying...).
On it went. The last night was by no means an easy night, but by that point it was so much better than the previous that I called it good... and at the end I came home. slept for 8 hours. was awake for 6 hours. slept for 12 more. I am starting to feel slightly more human. slightly.

I like my job, but there are weeks that wear me out. Weeks that I do everything I can, and then day shift comes in and criticizes the one thing I didn't get done. Weeks when I answer every call the patient makes, only to have them criticize me to the doctors. Weeks I come home feeling like an utter failure, and dream of iv's beeping in the background. Yet there were good parts... I got to sit a station with one of my favorite nurses, and we listened to Wilco. I had an aide who actually helped. and on the first night, which was by far the worst, I looked in my mailbox at work and found a letter:
Dear NurseCorrie,
I got compliments from the patient in 4** for your care. She thought you were wonderful and attentive.
Thanks for all you do for our floor... wound care, great patient care, helping other staff.
K**** (my boss)

I smiled. Stuck it on my desk next to my computer... and answered the next page.

Winter

2010-01-14T09:26:00.010-05:00

So one of my goals for 2010 is to both get better at using my camera and to get better at photoshop. To go along with that there is a challenge called "you capture" hosted over on the "I should be folding laundry" blog. Each week they get a new challenge... and I am wanting to play along. Not sure if I will make it every week, but we will see...

This week's goal is to capture winter. Winter this year has equaled a longer run of colder temps than we have had in many many years... more snow on the ground and for longer than anyone can remember... a white christmas that meant getting to the celebrations was hard... and getting so incredibly tired of being inside that I took my camera to the local park when it was <1 outside and took pictures for over an hour. My fingers were cold.

There is a lake there in the background... I so wanted to go sliding around on it like the people on the other side but I couldn't even step off of the road without being in snow over my boots

I totally want to string lights around this tree and make it a giant christmas tree. and seriously? What determines what branches get snow? I love the dusting...

I am so going to find this bench sometime when there isn't 6 inches of snow on it. Doesn't it just look like it is perfect for a good book on a sunny day?

not even

2010-01-03T13:59:00.004-05:00

So 2010 came in with a flood... a flood of C-Diff that my patient covered the floor with every time she stood up. I told her not too, she didn't listen, and I ended up using 6 purple-top wipes and 2 bleach wipes on my shoes before I would let them in my car.

I have a lot on my mind today... this whole past couple of weeks. It is overwhelming, swirling in circles and I can't get out of it. I have talked so much my dad is refusing to have the conversation again. So much I don't want to have it again.

I have goals for 201:
1) become an ICU nurse.
2) get a house with a laundry room, garage, and backyard.
3) get certified in something. anything.
4) get involved in something that includes non-married people my age. I am so tired of married people. not that I don't love my married friends, but still.

Good goals, right? Here in lies the problem. I don't know how to accomplish these goals. I don't know where I want to live... kc or home... and the thought of making that choice freaks me out so completely I don't know how I ever will. For the first time there is no clear direction. First there was highschool.... work as hard as possible, get good grades, take college classes, get A's. Find a college with a good nursing program. Not a lot of options for christian colleges with good nursing programs close to home. I went to MNU. There it was easy... go to class. Do good. Make friends. Graduate. I got a job where my internship was. I knew I liked it, I got hired. I stayed. Step by step I knew what was next, and now I don't. I told RaDonna last night that I am scared of failing... she laughed. But honestly? I feel like this is where I determine a big point of my life, and that scares me. Where I go from here determines where my career goes. What college I end up teaching at (my eventual goal). What ICU I work for... if I work at a cardiac icu or surgical. Where I get my masters. It determines life things. Who I meet. do I live near family or friends? and honestly, if I move to Wichita I want to go to alaska as a travel nurse first. So can I apply to a hospital in wichita telling them I can't start for 4 months?

Sigh

I like my life. I don't like how freaked out I get about the next year. I really don't like that no one understands WHY I get freaked out. and no one does. They do get frustrated about it though, which so doesn't help.

I think part of it is that I am making this call on my own. Yes, I get advice from the people around me (parents especially) but in the end I have to make this decision. All by myself.

I will probably move to Wichita. Because family is the most important thing to me, and over the last month I have really enjoyed spending time with my SIL. My mom. If I moved home my dad would take me out for breakfast. My brother would plow my driveway. I would be connected... and I want that. And my career will be okay. I will be okay. Better than okay... I will be awesome.

RaDonna just sent me a quote":
“The best day of your life is the one on which you decide your life is your own. No apologies or excuses. No one to lean on, rely on, or blame. The gift is yours - it is an amazing journey - and you alone are responsible for the quality of it. This is the day your life really begins.” Bob Moawad quotes

Life is good, my friends. Life is good.

out with the old, in with the new

2010-01-03T00:33:00.000-05:00

2009 has been a much harder year than I thought it would be. I endured the toughest semester of nursing school, started out my nursing career in the emergency department, survived the flu and shingles in one week, went right back to school and proceeded to fail College Chemistry, and had my heart ripped out my chest and was left to bleed. Wow...it sounds awful when I put it that way. I had such high expectations last New Year. "I'm going to be a nurse and all my problems will be solved".

Silly Girl.

I think back to who I was a mere 365 days ago and I honestly barely even recognize that girl. I'm thinking that's a good thing. I was living stagnantly for the past 3 years. Same boyfriend, same school, same secretary's desk--every day was exactly the same. I was was living in a tiny box and I was very comfortable there. Thankfully circumstances both of my own doing and some out of my control, have destroyed my cozy little box and forced me out into an open space that I have no idea where it ends.

So what have I learned?

1) My family rocks. I have the two most beautiful, smart, funny, and amazing sisters that roam God's green earth. Yes, we still fight and I still want to inflict bodily harm on them occasionally but I love these two girls. They truly are my best friends and I wouldn't trade them for anyone! My parents are so supportive and thoughtful and just overall awesome. My dad has been my biggest cheer leader listening to me talk about my patients and encouraging me when I want to throw in the towel. My mom has put up with my valley's and rejoiced with me on my mountaintops. Always there for me and really good at keeping my feet on the ground. Yes...I love them all so.

2) Don't give up and never let them see you cry. I just realized today that I have been an ED nurse for 6 months. 6 MONTHS! I feel that this is a major accomplishment. I have never once cried at work since I became a nurse and this is also a major accomplishment for me! I may have cried after I got home but that's ok. There has been about 3-5 days at work that I have wanted to give up and say "screw it, I don't need this career" and I seriously was considering walking away. But that's not an option for me and I am glad I have stuck with it. I am learning so much in my ED and lately I have been getting assigned one of the resuscitation room which is scary but a great way for me to learn.

3) Life goes on. Be grateful for the good times and forget about the bad.

As Good Charlotte says...

"We break up
It's something that we do now
Everyone has got to do it sometime
It's okay, let it go
Get out there and find someone

It's too late to be trippin' on the phone here
Get off the wire
You know everything is good here
Stop what you're doin'
You don't wanna ruin
The chance that you got to
find a new one"

And that's all I'm going to say about that.

4)God doesn't give us more than we can handle. Sure I had a rough year and few times I didn't think I was going to make it or quite frankly, I didn't want to make it, but here I am. I'm alive, I have my health and my family and my awesome friends who keep me sane. God has a plan and purpose for me and these rough patches are shaping me to fulfill my destiny.

So welcome 2010, I'm glad you are here. Let's have a good time, eh? :)

P.S. Corrie, you rock. Thanks for always being there. 2010 will be great! Enjoy the journey my friend!

The Act of Patience.

2009-12-09T09:41:00.005-05:00

I have been struggling with patience lately. Not usually something I have a problem with, in all honesty (can I admit that without sounding stuck up? I have issues, just not that one...) I don't know what is different lately, but my guess is a combo of a crazy schedule (try on 2, off 1, on 1, off 1, on 2 and see how well your body knows what way is up), the fact that the fall is finally winding down, the fact that I desperately want to go home (TOMORROW), the fact that I have been worried about friends and am more stressed than I have been since Junior year when I started researching waitress jobs in Alaska.

There is an IA (IA=information associate=unit secretary) on our floor who is pretty much worthless. As in, half of the orders she puts in are wrong, if she doesn't understand it she tends to skip it, and she asks the same questions over and over. Normally I handle it okay... normally I whine in my head but answer her questions with a smile, double check the double check and put in my own orders whenever possible. The last few nights, however, I have just not been able to handle her. She called me last night to ask a question, and I was abrupt. I told her I didn't know and hung up. I didn't say thanks when got my chart. I didn't tell her it wasn't an issue when I had to take the chart back up twice to get things fixed. I told her what I needed and when she started asking questions I said "I don't know ask someone else" and walked away. This morning I am not proud of myself. That is not the nurse I want to be. The co-worked I want to be. I like helping people learn. And I want to be the person who is nice, not the rude person. I hate that last night I forgot how hard she is trying... how much she works to do her job that supports her and her daughter/granddaughter. How she is (I am sure) really under-educated. I forgot that. and maybe there is reason. After doing a job for as long as her, she should be better. But I should be, too. Cause I ask a lot of questions. And I know what it is like to be over your head. and I have a standard to live up too... the ultimate healer's standard, in fact, and I failed last night.

I was going to blog today how good I am getting at IVs. I have gotten the last several that I have started, easy=peasy. Then, I failed. Twice. and about cried. I hate that I can't start IVs. I hate that I don't want to be a charge nurse because what kind of leader can't do IVs? I hate that out of all the things in this career I cannot conquer, it is something that easy. They tell me to visualize it, to do it by touch and not sight. To go in believing that I can do... negative attitude is the pits. But I didn't even hit blood last night. Not even like I blew the vein, I never found it. But then I started thinking... maybe I need to have more patience with myself. I soared through school... it was my thing. I was on top and I loved it. Then I hit the floor and the bottom dropped... and I am still trying to find my wings. I want to be super nurse. I want to be the one others look at and say, oh she is good. I want to be there now. But honestly? I have done this job for 18 months. It is okay that I don't know everything. I am learning something new every day. It is okay that I don't get all the IVs that I start. I get a lot, and I keep making myself try before I bring someone else in. and whereas I will always struggle to be better, maybe I need to have some more patience with the fact that I am still a baby nurse and it is okay for me to not be perfect. Even if that is what I want with all my being. and you know what? In 20 years I am going to be a force to reckon with... and i am going to rock at IVs. Until then? I need to learn to show myself some grace. and remember to pass that grace along to others. Not always and easy thing to do...

Because I am bored and I was reading my facebook notes...

2009-12-01T21:12:00.004-05:00

I posted this on facebook last fall. It made me happy to read it today, so I thought I would share.

1. I have a Wii. With Mario Kart. I am very bad at Mario Kart. I run into the walls. I also have a Wii Fit board. I am considered unbalanced. Probably true. I beat Tiffany at Mario Kart, but not on the fit board. she is more balanced.
2. I read a lot. My mom says I am an emotional reader in ways that people are emotional eaters. Does this make sense to anyone?
3. I am turning into my mother. Which is okay, cause my mom is cool.
4. I have gotten very good at chest compressions in the past two months. Which is not especially a good thing.
5. I love the idea of living in Alaska. Someday I will travel nurse there and stay for a while. Feel free to come visit me.
6. My favorite places in the world: 1. Axtell/Hillcrest (aka grandparents). 2. Paradise Valley Nature Reserve (waterfall beats ocean any day). I wish there was something like it here 3. Florida. Hate the place, but a lot of my favorite people are there.4. My couch with a good book. even better, at home where mom is cooking while I sit on the couch.
7. I just bought a new car. A 2009 Hyundai elantra. I love it like mad, but I still kind of miss my old grandma car. A lot of good memories happened in that car.
8. There are squirrels that live in our ceiling. I listen to them a lot, and am thinking about naming them. The one that keeps running into the duct work I think I shall name crash.
9. I watch a lot of Sci Fi, which is kind of funny. I was very sad when they canceled Starga te:Atlantis.
10. Some people thrift store shop for clothes or furniture. I buy books. I have more books than I have room for, which is sad. Because I totally plan on buying more (such as the one that is in the mail right now that I bought cause I felt sorry for myself cause I was sick and I had to go to work. That is the kind of excuse I use to buy books)
11. I feel guilty when they call and ask me to work extra. Even if I already have plans, and I say no, I still feel guilty. I need to get over this soon, since they tend to call a lot.
12. I have lived/am living with the best group of roommates ever. They were an answer to my mother's prayer that Corrie make good friends at college. They make me happy. Keep me grounded. God is good.
13. I love my job. I complain about it a lot, but I really do love it. I wouldn't want to do anything else, even be a waitress in Alaska, which was my backup plan throughout college.
14. Calling and bugging my brother is high up on my list of favorite things to do. It is a game to see how long I can make him talk to me before he finds an excuse to hang up.
15. I am very proud of the e-mails I write, especially to my grandparents. They make people laugh.
16. I am the only person in my family with red hair. I have been to family reunions, no red hair. It does appear in the beards of various brothers/uncles/cousins. On the same note, my mother has always been very opposed to me dyeing my hair. I did it, and she didn't notice for 4 days. I told her she is no longer allowed to comment.
17. My birthday is my favorite day of the year. My apartment will be turning green sometime in the next couple of weeks. Everyone should celebrate it. ( and no, chelsie, it is not just about beer and greed.)
18. I love Africa. I am planning on going back. Maybe this year, if I can find a good trip. Anyone know of any good medical missions to Africa?
19. I love school. I am planning on starting my master's soon, for no other reason than I want to take advanced pathophysiology.
20. In my opinion no one who graduates from nursing school has any clue whatsoever how to be a nurse. I have been doing this job for 6 months, and I still feel clueless. Slightly less clueless, it is true, but still clueless.
21. My dad thinks I should be able to write a book since I read so many. I tell him it is not quite the same thing. He doesn't believe me. Maybe some day I will give in and write a good mystery involving a nurse who solves the crime and gets the guy.
22. I am a greenbay Packers fan. Thanks to my roomie from WI. It helps that their team color is green.
23. I love being the baby of my family. I am spoiled, I freely admit it, and it is nice. Very nice.
24. When I am bored at work I sit and look at house through www.frontdoor.com I picked out my dream house on Roosevelt road, College Hill, Wichita. I really want a house. With a library. And a dog. Lots of windows. Laundry room where I don't have to use quarters. Ahhh... dream big.
25. Freshman seminar I called myself Chatterbox Corrie. My prof laughed at that, because up until that point I had said, well, nothing. But I do chatter. a lot. My dad tells me, Corrie, your mouth runneth over. I eventually started talking in class too, so my prof believed me. I discovered it was faster to give the right answer and move on than wait for anyone else to talk ( I have not yet decided if that is a good attitude to have, but honestly, 4 hours of HR a day called for that attitude).
26. (cause I like going over) I think I like the person I have become. That makes me happy.

Thoughts a year later: I have been doing this job for 18months and I am starting to feel like I have got it. I desperately want a house, to the extent I am not sure about going to Alaska anymore. They have stopped calling and asking me to work extra, and started calling and asking me to stay home. I am done saying yes. I am now living alone, thanks to people getting married all the time, but I still have the best group of friends. I still enjoy my job.

I do like the person I have become. It is official. And that does make me happy.

Realities.

2009-11-13T17:15:00.005-05:00

Today I am in Wisconsin, hanging out with a really good friend from college. Life is good.

3 days ago I was getting ready to work my 6th day in a row when the phone rang. It was my bank telling me of suspicious activity on my debit card. Someone managed to empty out my checking account over the previous 4 days. Life wasn't so good then.

That night I went to work already beyond stressed, only to discover a post-op patient with a trach that wasn't on oxygen, was struggling to breath and desperately needed suction. I did, and pulled out what looked suspiciously like his tube feeding from his lungs. His life isn't going so good either. I spent the night suctioning his lungs every half hour. checking his blood pressure as it came too close to tanking too many times. Calling doctors for fevers, blood sugars, crappy lungs and urine output of less than 200 over 12 hours.

Did I mention the dude didn't speak English? That makes things fun.

I do not understand the medical community sometimes. This man did not become so sick that day. His lungs were pretty bad before they took him to surgery and removed one leg and completely redid his veins in the other. He had so many co-morbidities that I sit here and wonder what the doctor was thinking we would accomplish?

Some nights go better than others. Some nights you swab wounds and culture sputum and check UA's without orders, cause the order will be written first thing in the morning anyway. Some nights you can make the night without calling a doctor, some nights you have to decide which one to call first.

By the time I left, his lungs sounded marginally better, his secretions were thinning out thanks to the mist and the breathing treatments and his blood pressure and urine output were improving thanks to a fluid bolus. I think I improved the situation... his situation. In that shift, I made a positive difference.

But really? In the long run, at what point is it okay to say that someone has no quality of life left, maybe we should stop the invasive procedures and just manage symptoms? at what point is it okay for me as a nurse to start wondering why I have to be doing all the things I do? I firmly believe that there is a good way to die. I just don't think we let people do it often enough.

Thursdays.

2009-11-06T08:48:00.002-05:00

Here is the e-mail I sent my dad the other night:

I think maybe I am just cursed in winter.

My patient just coded.

Drats.

It might be a long couple of months.

(in other news... I have no news. i was having a good night. until I walked in the room and my patient wasn't breathing. that kind of killed the good night. )

I hope you have a good day. And that no one stops breathing during it.

At least I didn't have to do compressions, although those are kind of fun.

I would still rather not have to do them... I will take a beating heart over a not beating heart any day. Even without breathing.

Now, give me a patient with both a beating heart and the ability to breathe, and I am a happy camper.

I don't think I ask for much, do you?

Sometimes the way my brain works while I am taking a 5minute lunch break at 5:30am worries me. I don't really think chest compressions are fun. Really. I do like it when my patients are breathing, that much is true. I really cannot tell you how much I liked going back to work last night and having that patient back on our floor... he is okay! Or as okay as someone could be who stopped breathing for a bit. Life is Good. I finally had a code patient live.

3 crazy days

2009-11-02T20:09:00.002-05:00

I worked this past weekend and Friday as well, and boy did I have a crazy three shifts! It started with a pretty busy morning, my favorite part was helping the vascular surgeon put in a chest tube! It was awesome!!! It was the first I had assisted as the primary nurse! The patient did it on 0.5 mg Dilaudid and local anesthetic which probably explains why he jumped 6 inches off the stretcher! The surgeon was mad!! He was like "I said don't move!!!" I felt sorry for the guy, it was a spontaneous pneumothorax and he was only 26, he nearly cried.

After that, I got my first review as an RN and I got high marks! I was pleased to discover that my coworkers enjoy working with me and my boss thinks I am doing a good job!

Saturday was a strange day, we saw barely any patients all day long until 1500 when we got a call from EMS saying they were bringing in a 25 year old unrestrained driver involved in an accident on 95, she had been ejected 40 feet from her vehicle. Originally they were brining her to us to be pronounced because no one ever dies in an ambulance but halfway to our hospital she got pulses back so we were gonna have to stabilize her then fly her to Halifax. Right after that trauma call came over the radio we got another saying that a 7 year old in respiratory arrest was coming in. 7! I was ready to freak out because I had the pediatric trauma room so that patient would automatically go to me!

I raced around my room, hooking up the small blood pressure cuff and whipping out the Broslow tape, all the while terrified because I knew half the help would be with the trauma and not in there helping me with the child! Thankfully, we got a correction on the age and it was a 75 year old not 7. I was relieved but still nervous. My respiratory arrest arrived first, intubated, and as they rolled her into the room, they handed me the DNR. I was very confused as to why they had a patient with a valid DNR intubated but we rolled with it. She was in PEA which means the electrical circuit in her heart was still running but her heart wasn't actually beating. As soon as the doctor came in he pronounced her and we ceased all life saving measures. Dr T asked me to go with him to tell the family and after informing them that their mother didn't make it, the son asked what do we do now? Dr T says "RaDonna will tell you" and he walked out of the room.
Keep in mind that this is my fist expired patient and I have never had to deal with grieving family members before so I did my best and was as kind and compassionate as I could be and I called a priest for them and after removing all the tubes and cleaning her face, I let them come be with their mother. It was scary dealing with this new experience and also with preparing the body but you just have to take the hand you are dealt and learn to adapt.

My charge nurse was also very nice and helpful and he showed me how to fill out all the paperwork and told me everything I had to do. The rest of the day went pretty uneventful but we were all a little somber, especially when we found out that the trauma victim didn't make it.
Sunday was a crazy day. I think it was actually a full moon. I had this one nice lady who was only a couple weeks older than my mom who came in for new onset seizures. She was very scared and worried that maybe it was a side effect from the flu medicine she recently started. Unfortunately, after a CT scan, the ED Dr. diagnosed her with a frontal lobe tumor. She had never had cancer of any sort and this came as a complete shock to both her and her husband. The week before they had buried a family member who had died as a result from cancer. I felt completely incapable of caring for this woman emotionally which is part of my job as a nurse. My heart ached for this woman who after sobbing in her husbands arms for more than half an hour, just sat on her bed, staring at the sheet. There was absolutely nothing I could do for her. All I could do was work on transferring her to nearby Hospital for neurosurgical care.

Meanwhile, in room 9, I was given a 15 year old boy who snapped his femur falling off a motor cross bike. He is crying in pain and if that isn't enough to make me feel bad for him, I have to deal with his father in my face at the nurses station asking me why his son hasn't been medicated for pain. I calmly explained the nicest I could that I am realize that his son is in pain and a doctor would see him asap, but until then, aside from an ice pack, there was nothing I could do for him.

(I have had a broken ankle and that hurt like heck so I can't imagine the pain that he was in but seriously, there isn't anything I could do without a doctors order aside from having it x-rayed. Just wanted to make sure ya'll don't think I am heartless shrew. Besides, both docs were busy with a lady who had O2 sats in the 70s and a STEMI)

The father didn't believe me that there was nothing I could do and kept demanding that I do something. Unortunately, my forked tongue betrayed me and I said in not the nicest of tones: "Sir, I do not have a medical license, therefore, I cannot give your son anything for pain! You are going to have to wait until the doctor sees him!" I felt bad afterwards because I can't imagine how hard it is to see your son suffer but he wasn't listening to me! Plus, I was stressed to the max because I had my poor tumor lady in 10, and a SOB guy in 8, AND a pneumonia lady in the hall. I never have four patients and needless to say I was a bit frazzled.

After the doctor finally saw him and I gave him some happy juice, the dad apologized and in my sweetest nurse voice I told him there was no need, because I understood he was stressed.

Everything ended up quieting down and I didn't receive any phone calls today from the Florida Board of Nursing informing me that they would be revoking my license for shoddy patient care so I guess I'm good. I learned so much and had some great experiences this weekend. I wish I could hear how my tumor lady ends up. I don't think the prognosis will be good though because she has developed some abnormality to the roof of her mouth and the CT report said it required further testing. Please keep her in your prayers.

One of the nurses I worked with on Saturday said that one day it will hit me and I will say to myself "I'm an ED nurse". I'm not there yet but I'm getting closer everyday.

The parts that I hate.

2009-10-28T16:30:00.004-04:00

There are times I really hate the knowledge that comes with the job.

Times I really hate living in Kansas City.

Times like when I get the phone call from my mom telling me that my grandpa fell and is on the way to the hospital and she doesn't know what is going on yet. When she tells me she is going to tell Grandma in person so grandma doesn't freak out.

When the first thing that goes through my mind is fall= broken hip and people with broken hips have like a 75% likelihood of dying in the next 12 months.

Then she tells me he didn't fall, just was so weak he couldn't stand up by himself and when they went to help him he sank to his knees.

The first thing then was... what is his potassium? weakness=low potassium. Or low hemoglobin. GI bleed? CHF flair= we need to know his BNP now.

The thoughts are endless. He is probably okay... trying to talk mom into taking him home cause "he thinks he can walk now". He's alert, oriented.

But in my brain, I think of the things that it could be. And I want to be there. I want access to the blood work, the doctors notes. I want to make sure his nurse knows what she/he is doing.

So I sit here. I pray. I know that if mom says I need to come home, I will be calling in sick to work and driving home. And I thank God every day that I have been blessed to be loved and to love my grandparents for as long as I have, and pray for just a little bit more.

Monday Blues

2009-10-25T12:56:00.002-04:00

I have to go back to work tomorrow and I really, truly don't want to go. I am terrified. I used to feel pretty good about my job and my abilities to function as a nurse but lately I seem to have misplaced my confidence and instead there is nasty dread and fear. I think it has something to do with our census creeping up and the fact that all of the patients have been sicker. I also think I should not be getting the trauma room assignments. I am but a baby nurse and 3 very critical patients is a bit much for me. I still need to perfect my time management skills,something that is difficult to do when I have to give one-to-one care to three patients.
I thought that once I graduated, all my problems would dissipate and I would be a kick butt nurse. But instead, I have a whole new set of problems like being scared of losing my license and causing permanent damage or death to my patients. Another new problem is the loneliness, when I had a "boyfriend" I was never, ever lonely. Now I am lonely all the friggin' time. I also thought that school would no longer be an issue but I am struggling so very hard to keep my head above water in my chemistry class/lab.
I guess problems will never go and they will always come. We just have different problems and we have to conquer each one as it comes along. I would like to think I will be happier next spring but that is too much to hope. Something else will come along and I will have to struggle through it. The point must be that it depends on my reaction to the problems. Do I come home from a hard days work and snap peoples heads off, cry and curl up in a fetal position or do I come home, shake it off and pull out my text book so I can handle the situation better in the future and thank God for the experience?

Yes...that must be it...I must react better so that I can learn this lesson and move on to the next lesson. I must be happy with and in myself. Co-dependency is very unattractive and something I shall never be again. I guess I need to give myself some credit too. I cannot rely on everyone else to stroke my ego and say "RaDonna, you are a good nurse." I need to believe it and do my best. The rest will fall into place eventually if I live and learn.

I wish I could have a pre-name and post name for this blog. My pre-name is "Monday Blues", the post name should be "Live and Learn".

P.S. Sorry for the particularly rambling state of this blog. I can't seem to dust the cobwebs off my mind today.

CNA School

2009-10-24T10:10:00.004-04:00

In 2004, Corrie and I went to CNA school together. As we started class in the spring of that year, we were full of optimism and cute as buttons in our beautiful scubs that our moms made for us. Little did we know how completely terrifying it would be! Our first encounter with patients of any kind were an elderly couple, both had to be in there 80's. They shared a room with each other in the nursing home and we were told to help them get up and ready for breakfast. Seems simple enough, right? Well, for starters, the wife had bilateral amputations above the knee and I was supposed to help her put on her prosthetic legs. We hadn't exactly gone over that in Nurses Aide 101! And I had to empty my first bedpan! I nearly puked and spent the next half-hour hiding in the hall. Corrie decided that she never wanted to get old and was pretty sure that she didn't want to be a nurse's aide, much less a nurse.
We manged to pull ourselves up by our bootstraps and by the end of our 2 month clinical rotation, we were passing trays and dressing the elderly like nobody's business. I would say about 99% of the time, we didn't go anywhere in that nursing home without the other one. We were completely co-dependent! We both got our licences after passing the state board exam the first time around. We relied on each other so much during CNA school and we continued to rely on the other one during nursing school.
Even though Corrie wasn't standing beside me when I put my first foley catheter in or started my first IV, I knew she had done it already and it sucked just as much for her as it was sucking for me right now. And I knew that when I got home I would be able to get on instant messenger and tell her all about it as we played backgammon. I would listen to Corrie in awe as she described watching her first open heart surgery and I laughed at her when she told me about one of the many times she made a fool of herself in front of her patients. I would rejoice for her when she passed another test with a fantastical 99, and dread my NCLEX after hearing her describe the horrendous test.
It's hard to believe we both are licensed professionals when I think back to our humble beginnings but here we are, and I am pretty sure I wouldn't have survived the entire ordeal without Nurse Corrie!

Us

2009-10-23T22:13:00.009-04:00

Nurse Corrie
PLUS
Nurse RaDonna

EQUALS:

Us getting into some totally random situations we are not sure how to get out of.

The end.

I am feeling the need to rant. I hereby declare you my audience.

2009-10-14T00:07:00.005-04:00

So last week I had a couple of nights where I wasn't done with everything until around 6am... just in time to finish things up and leave relatively close to on time. The week before that I didn't get out of there until 8, because I didn't start charting until another nurse assumed responsibility for my patients. Our patients are getting sicker, and the number of isolation's on the floor have at least doubled.

This morning I went to a staff meeting. It was at 715, so I was not really awake to begin with. Then, in the middle of a bunch of routine business, our nurse educator started pulling out patient protocols. These are the things that tell us what we have to do. We have always worked off the "care of the acutely ill pt" protocol. However, with the opening of the CCU they just developed a new protocol for acutely ill cardiac patients. Apparently someone just realized that our floor gets some of these patients so we now have to follow it as well. To summarize we now have to completely assess each patient twice a shift (normally we do it at the beginning of the shift), 6 hours apart. We have to assess all pulses every 4 hours. Every pulse that is a 1+ or less has to be dopplered (we have old cardiac patients. no one has good pulses). We have to diagnose every strip printed on the teles, not just 1. There is more... but that is the main part of it. Oh, and then after that it was announced that our patient satisfaction scores have gone down on noise at night, and could night shift please be more quiet so our patients can sleep?

I asses at 730-8pm. midnight vitals get done 1130-12. I guess I do pulses then. Second assessment would be 130-2am? then pulses again around 4am, with morning vitals. When do they expect patients to sleep? When do they expect me to chart? They get after us for patients saying we don't respond to their needs fast enough, that we don't make life quiet enough and then they give us things like this that will do nothing but make it worse. I respectfully explained my problems with the subject to the nurse educator, and she thanked me for my input.

Last month they started bedside checks where the oncoming nurse has to go around and meet each nurse with the off-going nurse. It isn't a completely bad system, but it makes me about 20 minutes late in everything I do for the first couple of hours.

They are completely changing the charting system the first week of December. Yup... right in the middle of holiday season. I am a computer super-user, and am taking the class on Thursday. The plan as of right now is to have me and several others go to a 4 hour long class, then take go and in the middle of the night teach the other nurses... have them take turns holding pagers so that nurses can have the class. If it is going to take headquarters 4 hours to teach me how do they expect me to do it in an hour? And with all the extra stuff they are making us do how do they expect anyone to have time to take a class in the middle of a shift? Don't want to pay us to learn new charting? Don't change the charting.

I like my job. I really do. I don't like this part of it. Not at all. It is life, however, life at a hospital facing budget cuts, staff shortage and a whole bunch of new regulations coming down the road.

This is my blog, so I can rant on it if I want. Tomorrow I will go to work, and I will do my job. I will do it to the best of my ability, fulfill their requirements as much as I can, and pray to heaven above that I don't forget to do something and lose my license because it was written on a protocol by someone who hasn't had direct patient care in more years than anyone can remember.
I am a nurse. My responsibility is my patient. As long as I remember that it will all work out in the end.

Thanks for listening to my rant.

Growing Pains

2009-10-11T18:33:00.004-04:00

The beginning of the latest schedule at work marked the beginning of my life as an Independent ED RN. I was now officially off orientation and ready to take my very own assignment! My first shift went great and nothing unusual happened and all my patients survived!

The next day was Monday and I got my first Code STEMI all on my own and did pretty well, even had a cardiologist breathing down my neck and still got the heparin hung and the second IV started and the patient shipped out in excellent time! And then I asked the Physicians Assistant to look at the suspicious rash that had been developing on my neck and shoulder and she diagnosed me with shingles! Normally I would have just let it go it's own course and get better over time but there are three prego nurses at work and I would never have been able to forgive myself if my shingles caused harm to their babies. So I told my boss and was promptly sent home from work for a week! I was disappointed because I really wanted to keep up my momentum and get into my own pattern and ways of doing things. But I used the time to relax and tried to find ways of cutting the stress out of my life because that is why I got the shingles at such a young age!

Then I got the flu on Sunday, the day before I was supposed to go back to work, so I had to call out again! I had never been so sick in my life and what's more my mom was out of town so I had to nurse myself back to health! ( I am a very whinny sick girl!) But I finally got better and went back to work. I was behind in school though and my teacher was giving me grief about a doctors note and yadda yadda and through all of this I was doing an excellent job at feeling sorry for myself!

I finally got things back on track and felt like life was going good again until that Sunday I helped work my first pediatric code. It is impossible to describe how it feels to see a 6 year olds' body mangled and broken on the stretcher and seeing all the nurses and doctor working as hard as they can to save him while wiping tears from their eyes. He didn't make it and we didn't have time to grieve for him before two more pediatric patients from the same accident came rolling through the ambulance bay doors. Those were three of the hardest hours I've had so far as a nurse and I'm sure I will have many harder ones to come.

I had been doing pretty well working on my own, all was well and the biggest personal triumph I've had is that I've only needed help twice starting an IV and even was able to get a successful IV start on a 6 year old dehydrated boy on the first shot! That made me happy! For some reason I am fixated on IVs. :)

Like I said, everything was going fine until last Wednesday. I had a 67 year old male patient complaining of blood in his stool. He said he’d been eating raspberries the night before and now his stool looked as pink as my scrub pants. His vital signs looked great, in fact his blood pressure was actually elevated at 152/90. His skin was warm and dry and his color was great: nice and tan. I hooked him up to the monitor and started a line on him and went ahead and ordered some labs tests on him and sent the blood down to the lab since I knew that Doctor wasn’t going to be able to see him anytime soon.

15 minutest later, I walk past the room to find blood all over the floor, the stretcher, my patient, and even the wall. It looked like someone had slaughtered a pig in my patient’s room. He had lost what looked like .25 to .50 of a liter of blood from his GI tract. He was pale, drenched in sweat and complaining of weakness and horrible cramping. I called for help from a tech and another nurse and I started running fluids on him immediately. By this time his blood pressure is now 100/55 and I am downright terrified. The doctor came in, examined him and ordered 2 units of blood stat for him. Meanwhile, a code was coming in so I lost the help of the other nurse and the tech. I got him all cleaned up, the best I could, and after about thirty minutes got him stable enough that I wasn’t certain he was going to keel over any second. About an hour and a half later, I shipped him up the ICU to get his blood transfusion.

I feel like I failed him. I wish I had been able to recognize sooner that he was so sick and was going to go downhill so quickly. I should have gotten a doctor in there sooner to see him or at least observed his stool so I could determine that yeah, this man was having an active GI bleed and not just overreacting about some raspberries. The rest of this shift and day, I felt like a horrible nurse. On Friday, I was grateful I got to work in fast track which meant I had a 99.99% certainty that I wouldn’t kill anyone because all the patient’s were just complaining of minor issues like colds and lacerations.

So now I am terrified of going to work tomorrow. It’s Monday and I know it’s going to be crazy busy and I will be running my butt off and will probably get some very sick patients. I just pray to God that He will be merciful to me and my patients and use my hands and my mind to bring healing and not harm to each and every one of my patients.

I bought some new scrub tops and a nifty new stethoscope hip holder so I am going to walk in to work tomorrow dressed to impress, with apprehension in my stomach and this prayer on my lips: Please God, please don’t let me kill anyone today.

Amen.

Queen of....

2009-10-08T09:00:00.003-04:00

Last winter I went through a tough spot in my nursing career. all 6 months of it. Over the course of December-February, I had a either a code blue or a rapid response every week. every-single-week. Not all the codes where my patients, but I worked them all. and to be honest, most were my patients. The first one never should have happened. A healthy 60-somethingish woman post heart cath... no complications, the most routine thing ever. Until she went into sustained VFIB and we had to shock her 3 times to get her out of it. Fortunately, she woke up and talked to us and actually made it out of the hospital alive. That was the only one of my codes that ever did that. There was the lady who blew her fem-pop, spraying blood all over the room. She didn't code, but came super close. There was the guy whose doctor I call 3 times over 2 hours telling him that something bad was going to happen, and it did. The guy's wife had to take him off the vent the next day. One day they floated me to 3north. The charge nurse assured me that I got the easiest group. 6 hours later as I transported my second patient to the ICU for post-op complications I realized there was no such thing as easy. There were more... on and on it went. I was on a first name basis with every ICU nurse there was. People started talking... and somehow I became known as the code queen. I am good at chest compressions... and let me tell you this, compressions on a 400lb man are SIGNIFICANTLY harder than on the little rubber dummy in class. So life was hard and I was about to think I was cursed and then it was march and I love march and people stopped dying and life was good again.

Until this week. In the past week I have had two patients fall. Hit the ground and do enough damage that I had to fix their problems. One dude was peeing blood clots after pulling his foley out... wasn't that fun to fix. My lady this morning slammed her hip into the ground... hopefully it isn't broken. 2 incident reports. 2 calls to doctors telling them I let their patients fall. I don't like falls. I don't like patients getting hurt on my watch. I don't like bad patterns either.

I really don't want to be queen of falls.

the pursuit of knowledge and experiences.

2009-09-28T09:23:00.003-04:00

So I don't really like working weekends. On nights weekends consist of Friday Saturday and Sunday. Usually you only work one or two of them. This week I worked all three. Last weekend I work Friday and Saturday. I HATE WEEKENDS. Seriously. I missed church, I missed football, I did nothing.

I did, however, do a whole bunch of things I had never done before. One night I did peritoneal dialysis. I had no clue what I was doing, figured I could fake it and found out soon that it wasn't possible. I ended up having to get a nurse from the renal floor to come help. She treated me like a retard, not knowing how to do it. Of course, later that night I got a transfer from that nurses floor who was like, "I don't really know but I think his heart was regular". Seriously? How hard is it to tell if a heart is beating regularly? Anyway, peritoneal dialysis is an interesting process. You put a bunch of fluid into the stomach cavity, where through the process of osmosis all the toxins in the body float into the fluid, and then we drain it out. How awesome is the human body?

then I got to access a port a cath. Basically that is a port stuck under the skin that you stick a needle into. They are supposed to be changed every week, and this guy had his for over a month. I GOT TO STICK A NEEDLE IN HIS CHEST. How totally cool is that? This isn't some tiny needle, either, it was stinkin huge. and bent. and I shoved it in his chest. Sometimes this job is totally fun.

Not so sure he thought it was fun.

There is always something new to learn, always something I don't know. I like that about my job. In the next month I am going to be taking 5 all day classes to prepare to get my PCCN certification. I am excited for the review, the chance to gain more knowledge. We shall see how it goes.

Carpet.

2009-09-15T14:18:00.005-04:00

If there is one thing that should not be in hospitals, at least in the parts that have patients, is carpet. YUCK. Do you know what I get on my shoes on a daily bases? MRSA, CDiff. Blood. Patients leak on the floor on the way to the bathroom. They drop things. Their bandages fall off. NASTINESS gets on floors in hospitals. Up until last year when I first started working, we had carpet in patient rooms,which was gross. Then they got smart and my boss had it all replaced with linoleum. Ugly, but when a patient has a fem pop blow and looses have of her blood in two minutes flat until I can start holding pressure and yelling for help all I have to do is get house-keeping to come mop it up. When the patient starting chasing us in the hallway with a full urinal trying to splash us and then tripped and fell backwards and slammed his head into the floor and started bleeding out of his ear, that blood was still there nine months later thanks to the carpet. There is a limit to now much you can get out of carpet. Especially when it is ten years old and already full of nasty junk.

Nine months being the key word to when the carpet was replaced last week. We were all excited about the new floors, until we figured out that they were putting down more carpet. Yup. My hospital which is perpetually broke spent money to place more carpet down, not something solid that we can mop. want to see what it looks like?
(okay, so apparently I fail at paint and this pic is kind of small but if you click on it it gets bigger)

nice, huh? We are somewhat flabbergasted. The carpet is actually somewhat nice looking. At least it was, until like the second day after it was laid when one of B's patients managed to break his IV tubing, leaving the port open and blood pouring out of his arm. He walked out of his nice, linoleumated floor and onto our brand new carpet to get help. There is now blood all over that section of floor.

Blood that will probably be there for the next 10 years until they get around to replacing it again.

That, my friends, is why I will never like carpet. And why I will never wear work shoes anywhere but work.

(in other news, my dad had an article published in the Wichita Eagle about health care reform. He used some of the info I sent him... exciting. Click here to read it)

My Love For Foamy Soap

2009-08-29T00:43:00.007-04:00

I could handle most of it. I was okay with the smell. It had the classic hospital smell of sick people. What it didn't have was the disinfecting smell that covered the sick people smell... you know, the bleach, industrial smell that covers everything else. All I could smell was sick people. I handled the lack of masks for the tb patients. Here, patients with tb go into rooms with reverse air flow and we wear special masks. There, there was big rooms full of sick patients, all in the same ward.

I saw the lack of supplies. They took me into the supply room with the code cart and I wanted to cry. How do you work like this?
We were just there as volunteers, going around and hanging out with patients. Nothing exciting. Lots of bingo. All of the patients that were physically able seemed to be selling items, necklaces bracelets, that sort of thing to send money home. Completely foreign, but we played bingo on home made cards and smiled.

The one think I couldn't handle was the lack of soap. SOAP. There was none. (okay... noto none. One bathroom had one bar of soap.) We were in a 4 story AIDS HOSPITAL where most of the patients had TB and there was no soap. I spent an entire class my first semester of nursing school learning how to properly wash hands, and now I was in a place that had one bar of soap for an entire hospital. (someday I will tell you my opinion of bar soap, but at that point it was all we had.) We went in and out of rooms. We took care of patients. We touched and smelled and played and then we went home and took the longest shower we could. The next week we went to another hospital, where it was more of the same. Big hospital, lots of people, no soap. No gloves, either. Thank goodness for the antibacterial hand wash. But still, sometimes soap is just needed.

the day after we got back from South Africa my friend Rachael got this weird allergic reaction where her face swelled up all the way. I ended up going with her to the hospital a couple of blocks away from our hotel, where mom and dad were going to meet us. (note to self- want to get in to see a doctor fast? tell them you just got back from Africa.) I walked back with her to the ED and it was AMAZING! It was bright! And clean! and it had that disinfectant smell I never before liked! Then I saw it... SOAP!!! I made a very loud noise and went RACHAEL!! THERE IS SOAP!!! Of course, right as I said that the nurse walked in and looked at me like I was nuts, but I didn't really notice... too busy washing my hands. That is the day I fell in love with foamy soap. I never feel as clean as I do if the soap foams. A couple of months ago I discovered foaming soap from bath and body works, and life will never be the same. Not only does if FOAM, but is SMELLS amazing. Heavenly.
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Last night at work I was muttering about the new soap dispensers we have. They get stuck all the time and you have to work to make them pump, but then out comes the foamy soap that kills all manner of bad stuff, and life is good. I don't know how the hospitals in that part of the world that I love are doing, but I hope they found a way to buy some soap. Someday I will make it back over there... and when I go I will take some with me.

the perfect kind of night

2009-08-23T18:01:00.003-04:00

last night was the perfect kind of night. not entirely perfect,because no night really is, but it was a good night. One of the best I have had the last couple of weeks. For starters, no one needed an IV which instantly makes it good because these days my failures at IV will instantly ruin a good night.

I started with 4, 3 of which I had had the previous 3 nights, and got an admit immediately. ED called before they brought him up, which totally surprised me but I completely appreciated. I was able to get him settled quickly, and do my meds before his admission. I had a patient who was very much dependent on a wide variety of drugs, and I was able to make some decisions about what to give her and when that I don't think I would have made last year. Last year I would have seen scheduled zanax, and I would have given it. This year I didn't mention she had it, she didn't ask for it and I was able to help her system clear out just a little.

Word to the wise... when you take so many meds that you have a perpetual slur, something is probably wrong.

I had a colon ca patient with a bowel resection that threw a fever in the middle of the night. I hate bowel surgeries, they can go wrong so fast, but I was able to sit her up and make her do her incentive spirometry, deep deep breathes, that it came down. The body amazes me. 4 hours of sleeping and not taking deep breaths and it gets a fever. I like fevers. The body is telling you something is wrong, and it is working to correct it. Her fever came down, I actually let her sleep, and all was well.

I got another admit around midnight that I still can't tell you why we bothered admitting, but hey, census is low so why not. I got her pain meds reordered and then she was happy and sleeping.

Note to the wise ED Doctor: if you have a patient that takes oxycodone, oxycontin and morphine at home, and choose to admit them to the floor with a kidney infection, PERCOCET is not going to cut it. Or even pretend to cut it. All it does is make me call someone in the middle of the night to get the right stuff ordered.

I don't know. Nothing major happened, but it was a good steady pace. I was never overwhelmed, I had time to spend with each of my patients, but I wasn't bored out of my mind at 3am.

Another fun thing: all of our CAs have gone back to school now. The one I was working with is going to have to work on priorities, because she pulls out the study books way to early in the night, but she still did a pretty good job so I didn't say anything. Anyway, she is studying rhythms, and not understanding it at all, so I spent around an hour working with her on it, explaining strips, counting them out with her, showing her AFIB and some blocks on the monitor.

I am going to get my Masters at WSU, and then I am going to teach, and it is going to be wonderful. I am excited about that part of my career, because I love doing it. I love explaining things and having people understand it... such a high. I loved tutoring. It just makes me happy.

Long Overdue

2009-08-19T19:36:00.003-04:00

Today I went to the movies and watched Julie & Julia and was inspired to once again do my part and contribute to A tale of Two Nurses.

Hi--Longtime no see :D

I feel like a different person since the last time we have spoken. I have been through the ringer so to speak and emerged a little damaged and a lot changed. For the better I hope. Oh where to begin...the last time I blogged I was trying to keep from freaking out over a dirty needle stick.

Clinically I am still a spastic nurse...I recently attempted to bleed a patient out one of her anticubital veins because I started her IV without properly preparing my supplies and when I scored a superb vein, I was unable to staunch the flow and had to call in reinforcements to help me unwrap my supplies and cap the the IV catheter. The patients daughter was on the verge of freaking out. I was mortified. And about a week ago I forgot to take the tourniquet off my patient's arm after drawing blood. The tourniquet was found by the paramedic who wrote on it "No circulation is a great thing!!! RaDonna!! Ha ha ha!!!" I was humiliated!!! But I learned 2 valuable lessons that I won't soon forget.

Educationally I am now Trauma Nurse Core Course Certified and Emergency Nurse Pediatric Course Certified which means I will better be able to care for my patients in crisis situations and I will also be more marketable in the likely event I don't stay at my current hospital for the rest of my life. And as of Tuesday I will be a University student! I am going straight back to school for BSN because knowing me if I lose momentum now I won't ever go back. I will also be taking College Chemistry which is the the only class to ever kick my butt so I am going back for more! Wish me luck because it is making me nervous.

Emotionally I am doing pretty horribly. A week ago today I broke up with boyfriend of nearly two years. Irreconcilable differences I suppose would be the technical reason...we just started sucking at being together and decided to call it quits. We are trying the friend route which I really hope works out well because not only was he my boyfriend he was also my best friend and he knows me better than anyone. So we'll see where this goes. I am filling my newly found time with lots of sleeping, lots of Call of Duty 4, some crying and a bit of self-loathing and pity. But I am doing my best to keep my spirits up and look on the bright side...I can now wear high-heels and will be able to focus more on my school this fall. People say that breaking up is hard to do and I think that is a serious understatement. I actually feel like I am walking around with a gaping hole in my chest and nothing that anyone says or does will make it better. But I will be ok, I will emerge a better and more complete person, it will just take time.

That is all for tonight...I am typed out for the present...

Mental health and all that...

2009-08-17T00:27:00.004-04:00

I am off for a week again. I get these long breaks every three weeks. This time is longer than normal because I took Wednesday off. I took call. The beautiful thing of the census being 14 patients less than what we are staffed for, for over a month running now, is that you can put yourself on call and no one cares. Actually they think it is a good thing, because it is one less nurse to call and beg not to work. (side note= I would not like staffing job... getting turned down all the time. people are also talking about mandatory canceling. I wonder if that is allowed.)
Anyway, I called it my mental health day. I needed it. I could have gone to work. I would have given okay care. Not excellent care though, which is why I didn't go. Do you ever feel so tired your brain can't focus? Honestly, my eyes wouldn't focus on the computer screen. My brain was a sludge. I could not think. I wasn't sleeping well, because I had switched back and forth so many times from day to night that my brain couldn't figure out when it was supposed to shut down. I woke up more tired than when I went to bed. Over the last 4 days I have slept probably about the same amount of time I have been awake. That is probably not normal, but it has felt good and my brain is actually functioning again. That has to be a good thing. Going for a month with either work or something major planned every day is not conduicive to my well being. I will remember that in the future.

Today I bought two new books on amazon... books to help me prepare for my PCCN certificiation. RaDonna has motivated me. I don't even know what all she has done since she graduated but it is definetly more than me. Time for catch up.

I went to the wound care meeting this past week. We are getting some new products I am excited about. I really like being involved, one of the first to hear about the new things.

Life is good.

MY HAIR IS GREEN!!!

2009-08-06T17:35:00.005-04:00

Well, not really. It is red, rather bright. Sometimes curly. always frizzy.

When I was little I hated my red hair. Probably due to the fact that everyone made a big deal about it, probably because I was the only person in my family to have red hair. All my uncles/brother/dad have dark brown hair, and red beards. That is me, I match their beards. When I was five I had the eye doctor convinced I was color blind because I insisted that my hair was GREEN, not red. My grandpa still comments on my green hair.
Today I read 2 articles about redheads. My grandma sent me one, and I found one in the new york times health blog. Redheads make up only 2% of the population. It is a recessive gene, so both parents have to have it (I have been at family reunions for both sides of the family... tons of people and I am still the only redhead). Our pigment clings to the hair follicle tightly, which is why it is very hard to dye red hair. I should know, I have tried to go brown twice, and not even my mom noticed.

Of course, it is also the most asked for color in hair salons, and it is the hardest to achieve. Normally you can tell the difference between a natural and a not.

What I found interesting about the second article in the New York Times is that there is now evidence that redheads are resistant to anesthesia, which means in procedures if we are given the amount of meds normal patients are given it is less effective. We hurt more at the dentist because Novocain is not as strong in our system. I have also read, not today, that redheads bleed more. Combine with bleeding more and hurting more, Doctors are told to keep an especially close eye on us when we are giving birth, as we are more inclined for complications.

Oh joy.

I find genetics fascinating. I have heard of patients refuse medications because it is a blood pressure med designed specifically for African Americans. There is no difference, I am trying to discriminate, give me the stuff you give everyone else. Yet it is proven to be more effective. The way the body works, and is formed, is amazing. The fact that we have the technology and knowledge to find out how people are wired different and give them different treatments, incredible,

And trust me, I will have no problem using my hair color as an excuse for more pain meds if I ever need too.

(just found another article about how we need more general anesthesia as well.

The one in which I talk what little politics I know.

2009-07-28T16:46:00.003-04:00

I get an e-mail every day from the ANA with the most important news articles regarding health care. I like it, because it keeps me updated on things going on without me having to search around for articles. I found an article that was very interesting to me, as it pretty much sums up the job I want to have some day. (not today, mind you. some day.)WSJ article
http://online.wsj.com/article/SB124873545269485081.html

I want to do long term outpatient care. Not in a nursing home setting, but it a HOME setting. I get so many repeat patients, frequent fliers as we call them. People with CHF, COPD, renal problems. I truly believe that if we could do more with them as outpatients we could prevent this. If I could call Mr. W once a weeks and talk to him about his meds and his weight and what his blood pressure was doing, if we could visit and I could check for swelling, if I could do this than he wouldn't know my name because I have taken care of him every couple of months for the last year.

And now I get political. IT ISN'T PAID FOR! Home health won't cover it, because most of our patients don't fall under the guidelines for qualifying. Apparently Medicare is now threatening to cut funding for repeat customers, and yet they aren't setting up programs to help pay to keep people out. The Massachusetts hospital that has a program like this had this to say:
"readmission rates for these patients (in the outpatient program) have fallen. But it isn't reimbursed for much of its efforts. "You do it because it's the right thing to do," says Diane Kelly, the hospital's chief operating officer. "But doing the right thing is getting expensive."
We could control this by helping with blood pressure, weight gain, swelling, etc. We can adjust outpatient meds to keep people OUTPATIENT.

"Attention to these issues can reduce readmission for heart failure by as much as 30% to 40%, according to pilot projects studied by Yale cardiologist Harlan Krumholz. But the services in such projects often don't qualify for reimbursement by private and public health plans. In a 2005 study, Dr. Krumholz and his colleagues reported that 13 of 15 successful projects to reduce readmissions were canceled after special funding for them ran out.
"These hospitals knew they had something that worked," Dr. Krumholz said. "But they couldn't come up with a business model that could afford it."

So here is what I am saying. If medicare and private insurance wants to keep people out of the hospital, they need to stop threatening us with taking away our funding, and instead start offering to fund some new programs. SERIOUSLY, HOW HARD IS THAT TO UNDERSTAND???

I really like this article. Things like this work. It is proven. There are stats. There just aren't enough programs like it. No offense, I understand that you think health care should be cheap, and that we add things just for the sake of it, but if hospitals are businesses and trying to make money we can't expect them to run programs for free. Here is something else. When I first got hired(or maybe when I was in school..) someone told me that patients will only remember like 10% of the education we do in hospitals. That is why we send so much printed paperwork home with people, so they can read it later. So don't get after us for not educating enough, not making sure people have enough and know enough to come back. WE EDUCATE LIKE CRAZY!!! Every time I give meds, talk about procedures, EVERYTHING i do with patients I am trying to educate, trying to do everything I could to keep them from coming back. Honestly, though, trying to teach while someone is sick isn't the most effective. Outpatient is.

Does any of this make sense? I am trying to put my thoughts into words... I might have to revise.

Winslow, Rob and Jacob Goldstein. Cutting repeat hospital trips--simple idea, hard to pull off. WSJ http://online.wsj.com/article/SB124873545269485081.html

My hospital rocks.

2009-07-15T08:54:00.002-04:00

I read two e-mails posted to various bulletin boards last night.

The first: CONGRATULATIONS NURSES!!! S*** (my hospital) has been voted as having the best nursing staff giving the best nursing care in J************** county (my county). It was an exciting e-mail to read. Most of the time we are being told how we need to do better on stuff, so it was exciting to see how people already think we are doing a good job.

The Second: a note in a much less obvious place telling us how most of us set up facebook/twitter/youtube/blogs as a personal forum for family and friends, but that we signed a code of conduct and we are reps of our hospital and how they except us to only share positive things. Or something like that.

So for the record, I like my hospital. I would let people I love go there. I would handpick their doctors. and nurses. but I would let them go. These are the positive S*** thoughts I am sending into the universe.

I had my midyear review today. Probably shouldn't have agreed to do it this morning, due to being seriously pe-od at a person in a department I shall not name in honor of being nice to my hospital, for this post anyway (but, RaDonna, was not the ED for once. Just to let you know). We talked about things I am doing, and I came away feeling fairly confident that with a little effort I can get in the exellence category towards raises next year. If, you know, they give us raises. She is going to get me info on becoming a PCU certified nurse, which I would totally love. I also found out that PCU is apparently considered critical care. It seems to be somewhat controversial, our CNO thinks it is, and my manager (who I love, by the way) thinks we are more advanced med-surg than easy CC. Who knows.

and my boss thinks I should take some leadership classes. Who knows why, but I think i will, since she suggested it. Maybe something cool will come of it...

end of post.

And so begins the second chapter.

2009-07-12T22:38:00.003-04:00

When I graduated last May, I figured that I would be doing this job, in some form or another, for 40 years. Be a floor nurse for a while, get an advanced degree and do that for a while, get a job teaching and do that for a while.

The first year was hard. Oh so hard. Around April, 9 months in, I woke up one morning. (and by morning I mean afternoon. I don't do mornings.), and realized that it was starting to make sense. That I was comfortable in my skills as a nurse. That I was calling Doctors without first asking advice. That I can handle chest pain without calling the charge nurse. That I can be insanely busy with really sick patients and not panic. That I can prioritize.

Day number one of year number 2/40 started with a phone call at 7pm. "Corrie, It's Nancy from staffing. We were concerned that you were not here yet." Apparently I have lost the ability to remember my schedule, and I thought I was supposed to work Thursday. Not Wednesday. I made it out my door in 6 minutes. I was at the hospital 15 minutes after the phone call. I started getting report at the same time I usually get done getting report. Everyone was teasing me. It is a testament to how excited I was about Colorado that all the nurses, day and night, all were teasing me that I still had Vacation on the mind and asking me how Colorado is.

It was a good week. A good way to start year number two. I talked to RaDonna last week about how her job is going, and all the feelings of the newbie nurse. I remember those days, but am starting to feel like I am past them. Not entirely. There is so much more to learn it is a little overwhelming. But still. I have made it through the first year.

It is a good feeling.

In other news. This day last week I was floating down the San Juan river, at a temp of 54 degrees, give or take, freezing my toes off. It was fun. We have no pics to share, mainly because there is no logical way to take pictures in a river without getting the camera wet. Last night I went camping, and it was pleasant. I mean, as pleasant as sleeping in a tent can be. until like 530 this morning, when the worst thunderstorm of the summer happened. With me in a tent by myself. I pulled on clothes on top of my other clothes, packed my bags, and hi-tailed it over to my parents tent.

I am now done pretending to like it outdoors, and plan on spending the rest of the summer sitting on my couch reading.

an unfourtunate event

2009-07-11T19:38:00.005-04:00

Have you ever had one of those moments where time stands still and in that moment you ask yourself "Did I really just do that?". The room closes in around and you realize in shock that yes, yes you did do that terrible thing you dread. You would rather be swallowed up into the floor than face the consequences of your actions.

Obviously I had one of those moments today.

It occurred at 10:50 am and in 3 seconds I was aware of the fact that I had stuck myself with a dirty needle. I was sick with shame and fear. I calmly threw away the offending sharp and ripped my gloves off. Blood pooled on the tip of my thumb as I walked over to the sink and scrubbed my thumb with soap and hot water. It's amazing how what little they taught me about needle sticks in nursing school, somehow floated to the forefront of my mind. I continued to wash my thumb for several minutes and squeezed blood out of the puncture wound. I slapped a 2x2 on it and sought out my charge nurse.

She calmly heard me out then proceeded to check me into room 17, take my vitals and helped me start the huge file of paperwork. I had a few minutes before the ED doc was going to come in and evaluate me so I went outside to get some air and call my mom. That's when the tears came. I wasn't exactly scared for myself (the patient was very low risk as far as possibly having HIV and Hep B or C), I was mostly furiously angry at myself. I could only imagine what everyone was thinking. "Newbie nurse should have been more careful". I felt so inadequate and stupid. My mom told me it would be ok and it was a good learning experience for me. This is true but I would have rather have learned this lesson some other way.

For the rest of my nursing career, I know I am going to be so cautious with sharps of any sort, especially 23 gauge butterfly straight stick needles. Even now I cringe thinking about what happened! How could I have done this! I know better! ARRRRRRGGGGGHHHHH!

My preceptor found me sniffling in the parking lot and assured me that she had been stuck several times with dirty needs and was even put on the anti-viral medications. So many healthcare workers have stuck themselves but it made them all better at their jobs. She said the risk for getting something was slim to none and to not worry, it would all end up ok. So I pulled myself up by my bootstraps and went back inside and down to the lab to have my baseline labs drawn and to get a urine drug screen (workman's comp you see). The patient consented to having his blood drawn for HIV testing, amoung other tests. The results to the rapid HIV test came back negative much to my relief.

I learned a valuable lesson today, one that I won't soon forget.

Colorado: 3 days of awesomeness. plus two days in the car.

2009-07-07T01:06:00.007-04:00

We had grand plans to post while in Colorado. However, we were too busy having fun, or recovering from having fun, to do so.

It was fun. We had no schedule, no set plans, no place we had to be at any certain time. It was my mom, dad, cousin Jessy, RaDonna and myself, and we just relaxed. And did more exercise than either of us do in a month.

We walked around town with the craft fair. I got sunburned all over my shoulders and back. It hurt the rest of the week. We went to a great mexican restaurant. We walked around Echo Lake,

and up Treasure Falls.

For the record, mountain runoff waterfalls are cold. As in my toes froze in less than 2 seconds and it hurt like mad cold. BRRRR.

We talked. We hung out. We enjoyed life. We saw beautiful views that girls from Kansas and Florida don't often see.

2009-07-01T18:37:00.002-04:00

I don't have to go back for 8 days.

She is on a plane flying to me as we speak. Or type.

Life is good.

what I was going to write. and reality.

2009-06-30T17:05:00.002-04:00

I had this post all planned out in my head last night. want to hear it?
Last night, I:
was not done with meds by 9 like I usually am. Or 930. or for that matter 10. I wasn't done with my chart checks by midnight, not to mention my charting. I had a bed alarm go off 3 (maybe 4?) times. A patient refuse to take her meds. I showed up with 2 patients without IVs. a guy who was laying stark naked on the bed and refused to wear any clothes. This night had the basic definition of a bad night.

But now the rest of the story.
Last night I spent 10 minutes with naked guys wife talking about the nursing homes she had visited that day, after realizing that her husband who was driving a month ago was so confused and weak she could never take care of him at home. A hard thing to realize. I also spent almost 30 minutes with the son of bed alarm lady explaining everything going on with her medically, and reinforcing what he had been told all day about why she couldn't go home alone. "she is so independant" he said. She can't tell me where she is, and she is obviously not tracking this conversation at all, I replied. I think I made headway. I moved a pt to a bed by the window so she could see the sunset. I talked on the phone to the significant other of the guy in 1*, who she had signed hte papers to make a DNR that day.
It was a good night. I love talking to pts and families. Doing basic education. That is the one thing I miss about working days.

That was going to be my post today. Until 205 this morning when I got a page that 41*s heart rate had just dropped in half, and ran into the room to find an O2 sat of 41%. I had been checking on him all night long, halfway expecting him to die, but still, not easy to find the man who the night before was talkking to me laying unresponsive and gray. My first patient died this morning. While I was on the phone once again with the significant other explaining, that no, we didn't expect him to get better two other nurses were listening for 2 minutes verifying no heart beat. Even after I got off I stiill wasn't sure she understood.

He was a DNR. A very sick man. who had been struggling to breathe, and in pain. Now he isn't. And that is good. Someday I will expound on why I am such a firm believer in DNRs and Advanced Directives. He didn't die alone, which was something I promised myself the day I saw a nurse sitting at the desk while her pt died and the family members didn't bother coming in. Unless there is just no way to avoid it, my pts won't die alone. There will be family present, and if that is not possible, I will be present. Everyone deserves to have someone with them at the end of life. It always made me feel better that my dad had made it to the hospital before Grandma Ross died. That she was with someone who could tell her how loved she was.

Okay. Just started crying for the first time all day. I expected I would start bawling when I walked in my front door, but I felt horrid so I just climbed into bed and slept for 8 hours.

Some nights, this job is harder than others. Yet sometimes I think it is the hard nights that makes it all worth while. that make me feel like the nurse I want to be.

The things I think about/want to tell people when I am at work.

2009-06-26T08:54:00.003-04:00

Dear ED nurse,
Hello! this is Corrie from 4th floor. I would jsut like to say a couple of things to you. Notice I do not say these things during shift change, because I for one acknowledge that you are busy. So maybe next time you send me a pt at 715, you could show just a hint of awareness that 715 is a really bad tiime to get a pt? and that when we ask you to wait until at least 730, we are totally serious? and that calling me and getting mad that I cannot talk to you that exact minute is not going to make me any less busy and unable to talk? Oh, and for the record(and I send this out to admitting concerning direct admits too)it really wouldn't kill you to spend 60seconds finding me to tell me you dropped off the pt. or find my aid. or for that matter, tell the IA you are dropping off the orders. really, tell anyone. Just don't make me walk into a room and find the pt sitting there. it looks bad, and makes me mad enough to last all shift. Just a thought. Feel free to ignore it.

Dear People who design scrubs,
Hello. I was wondering if you are all men? Cause I have been wearing scrubs for quite some time now, and I am pretty sure a man designed them. Why, you ask? Cause most women have butts that are bigger than their waists, and buy clothes accordingly. Seriously, for me to get a scrub top that fits my chest, it is almost always too tight around my bottom, which makes it bunch up annoyingly. MAKE THE SLITS BIGGER! Seriously. I am tall, which means they shorter on me anyway. The things just don't make any logical sense. Oh, and Dickies? Yeah, I hate you. I might own 3 pairs of your pants, but I for the life of me cannot figure out the drawstring, and I always feel trapped cause I can't get it to loosen. Learn about elastic, people. Makes life easier. (in your defense, I love the flair.)

Dear God,
Hi! So I just wanted to thank you for the miracle of the fact that RaDonna and I managed through no planning to have 7 days off at the EXACT SAME TIME, and that she could find cheap tickets on a holiday weekend, and that she is coming and we are going, and I am so excited and it totally had to be a You thing so thanks. You must know how much I could use a week with my friend. Oh, and thank you also that my pt that coded twice this week already didn't code on me. It made my night so much better.

I spent almost an hour the other night sitting with an older woman while others coded her husband. She just looked at me... we have been married 64 years. He is my soul mate. I don't know how to live without him. I hate to see him suffering.

that kind of love? I don't see it all that often, but it was so real. I could feel her fighting for her husband, trying to make him fight. How do you tell a woman who doesn't know how to live without her man that maybe the best thing she could do is let him go? I didn't... just sat there, made sure she wasn't alone. That was probably the most important 45 minutes of my last 3 nights.

Someday I would like a love like that.

A week of 1sts

2009-06-20T18:19:00.003-04:00

I am now a Registered Nurse :)

Thank you to everyone for believing in me and supporting me through this long and hard journey. It isn't cliche' when I say I couldn't have done it without my wonderful family and friends. You truly are amazing and I thank God for you all daily.

I am now settling a little better into my new role at work. It's taking some adjusting not to jump for the phone every time it rings and when the ED doc tells me to call the hospitalist, I politely remind him that I am no longer a secretary. Now I have to retrain my ears to be alert to the sounds of cardiac monitors and call bells, and when the patient in room 12 is calling "Nurse", he means me.

I don't feel stuck in the middle anymore. Going from graduate nurse to rn has made me feel much more purposeful, like I actually belong in ED instead of just looking on from the outside.

All the nurses and doctors and my bosses have been so kind to me at work. They seem almost as excited as I am with my new position. So encouraging and always looking for opportunities to teach me.

I have had many new experiences this week, some good...some bad. I had my first amputation, that was fun! Now I know you wrap the loose appendage (in this case it was a finger tip--painted nail and all!) in moistened gauze then put it on ice. Unfortunately, it didn't look like the orthopedic surgeon was going to be able to save the tip but she would still have most of her finger.

I had a gnarly old man patient that was trying to get me to come home with him and an anxious woman who yelled at me for not being able to read her mind. I am getting better at my IV starts, I can do them on feeling alone now without being able to visualize the vein at all.

There was also a little boy who got hit by a car that was brought into our ED who was in asystole and I was able to watch from a distance as my fellow nurses and the doctors tried their hardest to keep him alive. They brought him back, ct scanned him, and had him packed on a chopper in under an hour. Sadly the 8 year old boy's injuries were too extensive and he died approximately 24 hours later.

Although the outcome was a tradgedy, I was amazed to see how well the nurses and doctors worked together and knew exactly what to do. I can't wait til I am at that skill level and can help save lives.

So I am doing what I can to prepare myself. Under the advice of my daddy, I am taking a Trauma Nurse Core Course next month and tonight, I bought a book called "Emergency Nursing made Incredibly Easy". I don't see how anything in nursing can be termed easy but we will see if it can whip me into shape!

My goal is to be the best possible ED nurse I can and my dear sister Randi Jean says that's the first step in greatness, wanting it to be so and doing everything in my power to achieve it. I'll have to let God do the rest.

Dearest RaDonna...

2009-06-15T04:07:00.002-04:00

My dearest RaDonna.

In a few short hours you are going to take the most horrible test of your life. (At least I hope it is, because if we ever have to take a worse one I will be very unhappy.) Anyway, it is going to be hard. Bad. You are going to leave it and be convinced you failed.

You won't.

I have so much faith in you. Faith in your ability to read the questions, narrow the answers and choose the right one. I have watched you, friend, the past years. I have talked with you about nursing things, and heard the wisdom and understanding in your voice.

I always judge the people I work with by who I would let take care of my family. I know what doctors I would choose, what nurses I would ask for. More importantly, I know who I would not let anywhere near someone I love. You, I would trust. I would trust you to take good, competent care of the people I love. Even though you are young (which can be a surprisingly big drawback for old people... get me someone with experience is something I have heard several times).

So today, NCLEX becomes the last great hurdle. When it is done, when you pass (not if, just when. cause you will. cause you are brilliant. and beautiful. not that beauty matters on test taking, but it can't hurt...), you will be a nurse. not a student nurse. or a graduate nurse. just a nurse. you will have the two vital initials behind your name to be able to walk into a room and say "Hi, I am RaDonna and I am going to be your nurse today."

And life will be wonderful.

There will be days when you want to quit. days when this job is so bad you want to go home and cry. days when you WILL go home and cry. But that is okay. Because for every one of those days there will be the days when you walk out the doors feeling like you did some good today. Like you made a difference, saved a life, or just sat and talked with a patient and made them feel better about everything going on in their life. It is the small things that count. When those days happen, you will know. Know that this job, it is great. It is hard and messy and stressful, true, but still. I wouldn't trade it for any other job.

You won't read this before the big test. That is okay, because I know you are ready to go rock the NCLEX world. You can read it later, during those horrible I think I failed why won't they just post the stupid results already hours. Just know you didn't fail, and it will soon just be a nightmare that will fade in memory.

I look forward to getting your text on Tuesday.
Corrie

NCLEX Blues

2009-06-14T20:45:00.002-04:00

in exactly 12 hours, I will be 45 minutes into the dreaded NCLEX exam. I am not ready for this.

Heaven help me

my month is over.

2009-06-07T22:44:00.007-04:00

not the literal month. The literal month just began. My month of madness, however, ended at 6 tonight. My friends graduated here the first weekend of may, parties and ceremonies all weekend long. Two days later I flew to Florida for a week. 3 days after I got home I went to a wedding 3 hours away. I took the bride and groom to the airport. I watched as my living room filled with the new roommates stuff moving in and the old roommates stuff on the way out. MASS CHAOS is what my apartment has been. I stopped trying to pick up because, quite frankly, why bother. This past week I went to the old roommate, Tiffany's, wedding. Went on Wednesday to a tiny kansas town 7 hours away. Spent all week running like a madwoman.

I really don't like the part where they file your nails in pedicures...

I am tired. I am home. I really don't want to see anyone for like the next month.

My attitude has been increasingly bad. For the most part I have been able to hide it, but today it exploded. My friend Chelsie was in the car with me, and she just grabbed the ipod and put on happy music. It worked for a while, but now that I am home I am just *blah*

There comes a time when I need to not be around people. When I need to just be by myself and breathe. I haven't had time to do that in a month. Maybe this week I can. I had a grand total of 9 days off of work... three more nights to go! I am excited. On my last night my boss asked when I was going to start building the wound care box on our floor. I think she expects me to do it during work, and yet, I have barely had time to sit down the past couple of weeks. She is either going to have to pay me to do it on a day off, or accept that it might not happen anytime soon. That is my opinion, and I am sticking to it.

I was so excited to see a new RaDonna post! I haven't gotten to talk to her in forever, but I am so excited things are going well. I still hate putting in IV's. She does them all the time in the ED, I am sure, but I don't do them all that often, so I still don't feel 100% comfortable. Then the hospital changed the brand we use... so didn't help.

I so remember the feelings of the first couple of days. weeks. months. Believe it or not, it gets better.

Oh! I forgot to add that last weekend my dad and mom came up and we did the american.heart.walk. It was fun, but one more thing to add to a crazy month...

my hospital made us wear green wigs because they didn't think we got enough press coverage last year considering the fact that we are corporate sponsors. Green wigs were supposed to get attention from the press... no word yet on if it worked. I like green, so I was okay with it.

Wow. this post was random. I think I am going to go to IHOP now and get butterscotch pancakes and a splashberry.

fake it til you make it

2009-06-06T19:39:00.001-04:00

I have completed 4 shifts in the emergency department as a nurse so far and I feel like I have absolutely no idea what I am doing. I make the silliest mistakes like taking a blood pressure in the arm of a man whose finger was so infected and swollen that his skin split. Something is strangely a muck with my IV's--I got them all today but they just didn't seem quite right. I somehow manage to blood-let every one of patients! :)

I feel adrift in the nursing world. Being a graduate nurse is kind of crippling. I am in limbo between Registered Nurse and Secretary and I can't really find my niche. Soon though! 8 days and counting!

I did have my first "trauma" today. An 80 year old man who took a spill on his scooter going thirty miles per hour. Wouldn't have been so bad except he was on a blood thinner so it took a bit of work to get all his bumps and abrasions to quit oozing. He was so nice and sweet but his wife called me Rhianna...haven't heard that one before!

I love being a nurse though. I enjoy being the hands that bring God's healing touch. My people skills are improving so much. Dealing with all kinds of people in all different kinds of situations has a way of launching a crash course in diplomacy and patience. I have been so protected these past 3 years, deep in the nurses station only interacting with the doctors and nurses. Now I am one of them (almost) and I couldn't be happier!

My plan is to take it one day at a time. Do the best I can with each and every patient I see. And continue to fake it til I make it :)

GN day 1

2009-06-01T20:55:00.001-04:00

I have blood on my right shoe. I survived 3 years of working in the Emergency Department as a tech and 2 years of nursing school and never once did a drop of blood ever come in contact with my scrubs. But my very first day as a Graduate Nurse and I get blood on me.

How awesome is that? :D

I had a very successful first day I think. I missed 66% of my IV starts, charted on the wrong patient only once, and got to perform CPR for the first time. My preceptor called in sick today so I was following around a different nurse than I am used to, who is great but just not what I am used to. It was good to see how other nurses assess their patients and chart and to discover what they have learned over the years and what stuck out the most to them.

I am so very tired though...I think I will write more in the next couple of days because I am just so tired.

Music to My Ears.

2009-05-29T08:49:00.000-04:00

So most nights at work I listen to music. One earbud in, volume on low I listen while I chart. While people sleep all around me and it is quiet. I so don't do quiet.

Last night, I didn't listen to music. I wanted to. I reached for it several times. Every time I stopped myself. Why, you may ask? Two reasons. Room 27, room 46.

Nurse, we need help in here! Yells the family member with 27s roommate.

Corrie, your guy in 46 is up again... naked this time. Yells the nurses sitting across the pod from me.

Leave it to me to turn two completely sane people into crazy lunatics who pull out foleys and try to fall every 10 minutes.

that is not even mentioning the other lady in 27 who every time I touched her yelled something to the effect of "why are you hurting me I thought you would help me stop it" over and over again. In my defense she was out of it before she became my patient.

I felt it very important to be able to hear every little noise around me, waiting for someone to finally hit the ground. They never did, which makes not listening to my music worth it.

Something cool happened the other night. I am the official wound care person on our floor, meaning I go to wound care committees and am eventually supposed to set up a wound care box. I also spent a day with a wound care nurse, and am available to help with dressing changes. I like wounds. Well, the other day a nurse who has worked on our floor for longer than I have been alive came and got me to help her do a dressing change on a new admit. I helped her measure, pack, all of it. She was asking my advice on what do to.

Me, the person who has done this job for ALMOST a year was giving advice to to a 25yr nurse. It made me feel good, like maybe after all the questions I have asked everyone I am finally getting to a point where I can contribute.

I love my job.

(and I can't wait for NURSE RaDonna to tell me all about her first day as a GN next week!)

the place I hate, the people I love. Florida May 2009

2009-05-23T09:33:00.000-04:00

Some day I will figure out how to rotate. Sure.

Florida is not my favorite place. However, it was amazing watching RaDonna get pinned! She is going to be an amazing nurse, and I am glad I was there for the begining of the process.

And I am never eating sushi again.

True story.

Her nurse

2009-05-18T20:23:00.000-04:00

My family is so not into medical field. Not a person on either side has anything to do with being a Doctor, nurse, anything medically involved. Well, I have one aunt who works in HR at a hospital. That is it. We are mostly teachers and business people.

Except for me.

When I became a nurse, I became the first in my family, and that instantly made me the expert.

Especially to my Grandma.

She calls me her redheaded wonder woman. She has declared me her nurse, and asks me questions about everything medically related. I love her to pieces.

A couple of weeks ago I got a call from my mom. "Corrie, grandma is having chest pain. What should we do?" I tell her to call an ambulance. She tells me to call and talk to my grandma.

I call, and Grandpa answers the phone. I ask him what is going on, he tells me she is having some chest pressure, shortness of breath. I told him, well, you should get her to the hospital. Better to get these things checked out.

"talk to your grandma".

It took a couple of minutes, but I said I thought she should go, and she went.

I am her nurse, after all.

Then the cardiologist wanted to do a stress test as an outpatient. Grandpa didn't like the idea. He thought the cardiologist was trying to take over her care, and they already had a doctor. Why does she need any more tests, anyway? I talked him into it, said I thought she should do it, and she went.

I am her nurse, after all.

I don't know very much. So much of my life I feel like I am barely keeping afloat, like I should know so much more than I do. Yet I want to learn. I want to soak up as much information as I can. I read articles, and read magizines. I join the ANA. I obsessively look for the perfect master's program, although granted, I don't know what I want to major in. I want to have as much knowledge as possible. To be the best nurse I can be. Because people count on me to know what I am talking about. They trust me to give them good advice, to give them the right medication. To present the right information to the doctor. They trust me to do my job, which is to be their advocate, the last line of defense. I do my best. I am not always perfect. If anything, this past week has taught be that although I do not have to be perfect, I do have to try my best. Be willing to ask questions of those who know more. Be willing to sit and talk to my patients even when I am frustrated and behind.

I prayed all day that nothing would go wrong with the test. That she would come through with flying colors. That I gave good advice to have the test. Because with her, more than anyone, I want to give the right advice, the right information.

Because no matter what happens anywhere else,

I am her nurse.

Flutterby

2009-05-15T11:59:00.000-04:00

A couple of days ago, I did something that might not have been the best of ideas. I did something that could possibly be quite damaging to my nursing career. I made a completely unnecessary decision that will remain with me for the rest of my life.

I got a tattoo.

But not just any tattoo...a neck tattoo!

What was I thinking? I will now be pre-judged whenever I meet someone new. "Radical" and "Crazy" are words that could possibly be used to describe me and they would be correct. Who in there right mind gets an insect permanently etched into there neck? Granted, it is a charming little butterfly tucked behind my left ear and I can hide it with my hair whenever I want. But, for the rest of my life, I will have a little black butterfly following me wherever I go.

And I couldn't be more pleased!

It was the first decision I made on my own as 22 year old regarding body modification. For the first time, my parents said, "you are now 22, you are capable of making this kind of decision yourself". Now that I am college graduate, it kind of represents my new birth as a nurse. A fresh start. Nurse RaDonna, ready to take the world by storm!

I'm not gonna lie--it makes me feel wicked cool.

Now I just need to think of a name for her...any suggestions?

Supergirl

2009-05-14T21:35:00.000-04:00

It's been awhile since I wrote anything other than careplans but I'm gonna give this a shot. Don't expect greatness.

I have known Corrie for the past nine years and a what a blessing she has been to my life. The first night I met her and Liz, I thought how lucky they were to have each other, and I have to admit I was jealous. I never expected Corrie to become my BFF and when I discovered she shared my dream of becoming a nurse someday, I thought this was too good to be true!

We grew closer and closer as the years went by despite going to colleges 1259.15 miles away from each other. We kept in touch through hour long phone conversations, instant messaging, and most recently through text. We alone understood what the other was going through when we were worried about a test or clinicals and when I told Corrie about my experiance in watching an open heart surgery, she knew exactly what I was talking about.

Corrie was my hero all the way through school. I regaled my friends with "Corrie Stories", my favorite was the one where the old man told her to be a lady and not a cold-hearted B!tch when she was putting a foley catheter into his bladder. Corrie was proof that nursing school was survivable and you could enter the nursing world with a smile on your face and hope to heal the world!

She still is my hero.

I am amazed by all she has accomlished for herself and how hard she works at becoming the best nurse she can be. She has jumped into nursing all the way up to neck and makes me so proud! Even though we don't agree on everthing and she thinks I went crazy once I moved to FL, we balance one another so splendidly and understand the other better than anyone else.

So here's to you Corrie my dear friend. I am so sorry it's raining in your life right now but I know you'll make it through this and emerge an even better nurse than you were a 3 days ago. Keep on shining like you do so well and let God bring you out of this storm. You rock! ;)

room 410 thinks she is in the basement.

2009-05-14T09:29:00.001-04:00

What a great page to get at 230am. I walk into the room and ask her, can you tell me where you are? Well, she replied, I am pretty sure I am in the basement. After all, look at those walls.

I never know how to respond.

With the confused guy in 5, who thinks we have trapped him on the pirate ship for the past 10 days, I just go along with it. Probably not the best method to ask the name of the ship, but after reorienting him 5 times, does it really matter? His sitter was about ready to jump ship anyway.

Of course, his roommate (who is sharing the poor lone sitter) threw such a big fit night before last that every single guy working on the floor showed up in the room to make sure he wasn't swinging at me. I wasn't overly worried, but it was nice to have backup.

The 88 year old lady in 6 wants to know why she has to go to a rehab place when her sister and husband can take care of her. "my house is perfectly flat, and everyone knows rehabs stink." Of course, her sister is 85 and deaf and very obviously wants nothing to do with taking care of her, and I was suprised her husband could still walk when I saw him this morning. But she wants to go home. I would too.

Getting an idea of what my week has been like? A great begining to being back after 12 days off.

I made my first error this morning. In all honestly, it wasn't entirely my fault. I was told faulty info, and I acted according. Not grand. I survived. I'm not perfect, but I do try my absolute best to be. This morning it just wasn't possible.

Maybe I should go hide in the basement with the lady in 410.

The beginnings

2009-05-09T11:33:00.002-04:00

She lives in Florida, went to DSC, works in an ER. I live in Kansas, went to MNU, work on a PCU. How exactly did we become the kind of friends we are? Well... that is a story...

Back in seventh grade we all lived in a smallish kansas town. We were both homeschooled all the way through, and it was time for our town's homeschool graduation. We were the official escorts for the 8th graders graduating. I was there with my best friend at the time, Liz, and then RaDonna was the third escort. It was the first time we had met. She refused to talk to us. We tried talking to her, she didn't really respond, and Liz and I gave up and did what best friends do, ignored everyone else. A couple of months later her and her sisters started a play, Anne of Green Gables. My group of friends were all in it, so I joined as well. That began the friendship of RaDonna, her sisters and myself. Over the next couple of years my family started attending their church, we started doing more and more together, and at some point she became the person in the world who got me. By the time I headed off to college a couple of hours away she became the friend I missed the most. When she moved to Florida with her family partway through freshman year of college, I cried. When I about lost my mind that spring, playing backgammon with her on IM was the main thing that pulled me through. We have talked each other through years of school, clinicals, the highs and lows that only someone who has experienced nursing school can understand. Last year I graduated, and she flew in for a grand total of 36 hours to watch my pinning ceremony, before she went to texas to say goodbye to her dad who was leaving for Iraq. This week I flew in for her pinning ceremony, and I just about burst out crying through the whole thing.

We made it, RaDonna. We are finally done.

Being a new nurse is terrifying. I know this, she is going to figure it out soon. The constant fear that you will screw up because honestly, I don't know near enough to do this job, can be cripling if you think about it. This blog is so we can share our thoughts, fears, experiences. So on the exciting days when something went right I can write about it and she can celebrate with me. On the days when everything went wrong, she can write about it and I can comiserate.

This is us, figuring it out.