Cheers!

I feel like cancer patients should get a Dave Ramsey cheer when they find out they're cancer free. I'm cancer free!!! Occasionally my patients get better and I get really excited for them.

Realist.

One of my favorite articles, ever about ICU nursing. Definitely a subject I feel passionately about. There's a BIG difference between dying with dignity and giving up. I wish everyone would read this article and take it to heart. http://nypost.com/2012/12/09/diary-of-an-intensive-care-nurse/

Letter to ICU patient's families

I shared this on FB today, but I LOVE this article. It's so true. We all have morbid senses of humor and laugh at inappropriate things because If we didn't laugh we'd cry and we couldn't function. http://www.savortheessenceoflife.com/2014/01/12/a-letter-to-the-family-of-my-icu-patient/

"Don't mess with me, I have needles..."

So I figured it was about time I wrote this blog since I am never going to live this story down at work, I thought I'd share. A few months ago I was working one night and my patient (we'll call her YS) was someone I had had the week before when she was on the ventilator. Now she was extubated and using a BiPap machine to breathe. Long time smoker, very large (I'm being nice here), multiple problems, etc., etc. On the ventilator she had been an ok patient. However, during report this night the day nurse said that the patient occasionally would get confused and let's say difficult (combative). She had done great all day though and I did not expect anything different. So, I go in to do my assessment and I am talking to her and WHAM out of nowhere, she punches me in the nose. She did it about 3 more times before I could grab her wrist and stop her. Ok, that hurt and now I'm peeved. So I try to figure out what is wrong, but the patient won't let me touch her and I am unable to understand her because of the face mask. I can't take the mask off because her oxygen saturation plummets to the 80% in seconds without it. So another nurse comes in and tries to talk to YS. She beckons the nurse to come closer and then starts laughing. The darn lady is enjoying this. She wants to abuse us. She got a stern talking to and I finished my assessment while staying out of the reach of one wrist and holding the other. Not very effective. So now my charge nurse (head nurse for the floor for the shift) comes in to try to give her a pill (anti-anxiety, she needs it badly to help calm her down). We mix it in applesauce and quickly take off the mask to give the pill. As soon as that mouthful was in there though, she spits it all over the charge nurse (needless to say, she was not amused). I was on the other side of the bed and missed the spray, thankfully. So I am still really really trying to be patient and figure out what this lady needs/wants but she is seriously stretching my patience thin. So I get a piece of paper to see if she can write what she needs. First she scratches out the word "suck." So I am trying to be empathic and say "oh this sucks, being here in the hospital. I know." She shakes her head vigorously "no." Then she rewrites and I discern out two words that decided her fate for the rest of the night: "YOU SUCK." She starts laughing. Ok, I'm done. Now, I am pissed and my patience is gone. Not "this sucks," "you suck." Directly aimed at me. It takes quite a bit to break my patience like that, but once it's gone, it's gone. Of course I had to take the note to show all the other nurses, which they thought was incredibly funny (I do too now, but at the time I was a little less amused). This story has now spread and more people know from my unit. I may be forever known as the nurse who got told that "you suck" by a patient. Awesome. Back to YS: We told her that she really should be nice to her nurses, we are just trying to help her. After the note I then told her that she really should be nice to me, I'm the one with the needles...I proceeded to get some Geodon (anti-psychotic which also makes people sleepy, yay) which is an IM shot, long needle that goes into the thigh. Unfortunately, with all of her subcutaneous tissue (fat) I'm not sure it even got to the muscle (I'm not being mean, I'm serious), but I got a little satisfaction from sticking her just the same. Later, I also got to give her her Insulin shot, she didn't like that at all, at which I told her "yeah I told you not to mess with me, I have needles." Normally, I don't like sticking my patients, but this night was an exception. Apparently, after an interesting discussion with her MD, we theorized that as her CO2 levels in her body rose, she got crazier. One thing I have learned is that you CANNOT reason with a crazy person, it doesn't work. The longer she wore the mask the better her CO2 levels would come down and her mind/actions would return to normal. So when I walked in the room at 4AM to do her blood draw and bathe her she was a COMPLETELY different person. She was nice, helpful, friendly, talkative, etc. She even helped us bathe her. I don't think she even remembered what had happened 8 hours ago. Ugghhhh...I guess I can't hate her too much, she wasn't in her right mind. People do things they would normally never do otherwise when they are sick and their mind isn't all there. Most would probably be horrified to find out some of the things they do (I've seen them be dumbfounded when they hear what they did and apologize profusely for their actions). This is exactly why I never take anything personally at work, even a note that says "You suck."

Germ-O-Phobe

I am a germ-o-phobe. A germ freak. Completely OCD (obsessive compulsive disorder) about germs. I don't know if nursing has made this better or worse, mostly likely worse. I imagine unseen germs on everything everywhere. For instance, I have an entire routine for dressing, going to work, and undressing. I put on my scrubs for work and since I bring little things like alcohol pads and blunt tip needles home in my pockets, I load up my pockets, then wash my hands. I grab the rest of my crap for work. I leave my name tag and stethoscope in my car and yell at anyone who tries to touch them- I then make them wash their hands. At work I have to have everything in my room in order, clean, and straight, especially my IV lines and other tubes and you better not touch anything in that room either. As I've discovered, this is actually a common trait of night ICU RN's. We all seem to be OCD about cleanliness and order for some reason. Back to germs...Everytime I touch something in the room, especially the patient I basically use alcohol rub or wash my hands. I use alcohol pads on everything too. Hey, better overly cautious than under, right?! My biggest pet peeve is seeing RN's not wearing gowns, gloves (and sometimes masks) in isolation rooms. Drives me nuts. What's even worse than that is when I notice they don't wash their hands, I cringe inside everytime. C-Diff is the worst (a nasty bacteria in stool that spreads like crazy and stinks, by the way) because you CANNOT use alcohol rub on your hands with c-diff patients. It basically takes off all the good bugs on your hands and allows the c-diff to grow. GROSSSSS....You HAVE TO wash your hands. Yet people still don't wash their hands. Ugh. Moving on to heading home. I only wear 1 specific coat to work and I don't wear it anywhere else, same with gloves, scarf, and hat. These items all touch my germy body and scrubs, why would I want to wear them on my day off and invite those germs back onto my body. No thanks. I know basically no one else thinks of this and I wish they would. When I get home, I don't touch anything without washing my hands first and I UNDER NO CIRCUMSTANCES will let anyone touch me. My scrubs go directly into the dirty laundry baskets. My shoes have their own box in a separate closet. They are essentially quarantined. haha I shower, then put on new clothes. Some mornings this sucks cuz our water isn't very warm and all I want to do is sleep. But there is no way I would lay in my sheets with my nasty scrubs/ skin. Do you have any idea how many bodily fluids, gross things, germs I touch at work a night?! I don't want that on my sheets. (Shudder) YUCK. When I do the laundry (or the rare occassion my husband does it) I immediately wash my hands after putting it in the washer. Yes, I am actually that bad. You should see me with germs in the rest of my life. But I can't get this story from another nurse out of my head, where she said they swabbed the nostrils of the nurse her entire family and even the family dog and they ALL came back positive for MRSA (nasty antibiotic resistant bacteria). Yeah, I want to avoid that if at all possible. My poor future children will never get to play anywhere in public. Alright, now that I have the willies thinking about germs, I'm gonna go now. You should wash your hands. Trust me, you don't know what you've been touching! PERFECT! I'm glad other nurses see invisible germs growing on surfaces.

Glamorous, this is....NOT

A little update since I haven't blogged in so long- I am currently working as a nurse (duh) in a new hospital in an Intensive Care Unit. We do everything from Medical/ Surgical to Coronary Care to Cardiovascular to a small amount of Neuroscience (MSICU, CCU, CVICU, & NSICU). I always thought I would specialize in something, but at least this keeps me up on all of my body systems. Who am I kidding though, most of the time I feel like I don't have a clue about what the hell I am doing. Comforting, huh?! So much for getting out of school and not having to study anymore. Haha, yeah, no deal. I still have to study a ton. I've learned nursing school didn't teach me squat. Bleh. One of my coworkers was telling me the other night about her sister who never got a degree and now makes 6 figures and gets to dress up to go to work everyday. We, on the other hand, wear what is basically pajamas to work everynight. I had to work my ass off to get two degrees over 7 1/2 years of college and I make barely enough to get by. What kind of deal is that? Really. As I was standing in this lovely outfit(plus gloves)

that we have to wear in isolation (infection patients) rooms holding the head of a puking, kicking, punching, screaming, crapping patient while another nurse put down a NG tube (nasogastric tube so she won't puke anymore), I reflected on the fact, glamorous this job is, not; and we are, not. Nights like that I honestly have to search really deep to find a reason why I keep doing this and why I ever wanted to do it in the first place. Cuz' let me tell you just how fun this is. I don't even like germs (that's another blog, coming soon though). Haha, not that anyone likes germs. Wiping butts (when it's not your own kids) and being there when a family finds out that their family member is dying is not really my idea of a good time. SO glad I spent so much on school for this. Oh well, I guess it's the occasional feeling of knowing that you might have actually helped someone (patient or family) or easied their pain for a night. It's the occasional adrenaline rush that I live for. It's the love of medicine. It's the thrill of getting to do all the things I've wanted to do for so long. It's the teaching. It's the occasional thank you's. It's the hoping that you actually made a difference in someone's life. It's the things I learn everyday. It's the joy of getting to tell someone that they're doing better. It's getting to be real. It's being me...Oh well, I guess glamour will have to wait for another day.