Saturday, October 16, 2010

so you really don't give a crap what gandpa wanted...

I cried like a ridiculous child the other day at work...because i have never in my life felt so helpless for myself and for my pateint! This particular patient had a living will which denoted a healthcare surrogate should he become incapacitated and stated his wishes regarding "life saving" techniques.  Let me say that i HATE PEG tubes...putting them in...cleaning them...feeding people through them...because USUALLY we're just prolonging their misery...and USUALLY it was the family's decision to place the peg tube! So I was bumbling through my patient's chart...and i was admittedly looking for a reason to cancel the surgery! As i bumbled i came across his living will which stated VERY clearly that he did NOT wish to have a feeding tube under any circumstances....RED FLAG! I really didn't want to do the case in the first place...but HELLO HE DOESN"T WANT IT!!!!  I was already told that the healthcare surrogate had signed the consent form...I am disgusted that a healthcare surrogate can override a patient's living will and do anything that they want!!!
I informed the surgeon of the living will...and umm...he didn't care. he gets paid either way right? and nobody starves to death on his watch!
Patient rolls into preop holding along with the healthcare surrogate and some other family member...patient is in fact fairly incapacitated...myself and my manager introduce ourselves to the healthcare surrogate and begin talking with her...i ask her if she knew the patient had a living will...umm...of course she knew, how else did she get free reign over his quality of life!!! So i show it to her. I ask her to read the part about feeding tubes...she obviously doesn't quite understand...she gets that one must have nutrition to stay alive and that is what the feeding tube does...she just can't understand that the sentence "I do NOT want a feeding tube placed....." means that she shouldn't let us put in a feeding tube. I reiterate this and reword it and do everything but get down on my knees and beg her not to let us put the feeding tube into the patient. She still wanted to proceed. I left. I cried and threw a pity party for me and my patient and how morally and ethically and just plain old wrong this was. I called our risk management departent to no avail, the healthcare surrogate legally has the right to do this. I came back to the preop area...all puffy faced and red eyed...finished preparing the patient and took him to endo. I cried when I read the time out...I cried as I helped place the peg tube...I cried when we were done...and I cried when I dropped him off in PACU...I simply could not keep it together. How could this woman know and see it in black and white that this patient did not want this...and yet she still wanted it!!! HOW?
 My coworkers informed me that my problem was that i still care....is this what healthcare has become? nurses should be automated little robots, carrying around their computers, not caring what the patient wants, simply performing tasks, focusing on legalities instead of patient wishes?

Monday, October 11, 2010

god? yep...i'm pretty sure that was him

So every morning I drive into the parking lot of the hospital, turn off my car, and pray...just a quick little prayer thanking god for whatever i happen to feel thankful for that morning, to guide our surgeons' hands, to be with our patients and their families, to help us all extend the healing ministry of christ (i know it's cheesy, it's our hospital's mission statement, haha, but it always seems to fit) and anything else i feel like i can squeeze in there. This morning for some reason I asked God to use me in whatever way I could be used, and for the strength to actually do whatever i was asked. Not a strange prayer for most, but for me it was and i didn't think anything of it until i reflected upon my day.
My patient is scared to death lying on the OR table, literally seconds away from being anesthetized...she asks if there's a priest in house ( i immediately panic because i think she wants her last rites or something...i was like geez lady you are NOT dying in my OR) I told her that we always have one that we can call who can come in to see her, she informed me that she really just wanted to pray with someone before her surgery...I told her that it was probably a little late to get a priest in before her surgery but that we could pray with her if she wanted. So there we were, me, the patient, and the anesthesiologist we all held hands and i led us in prayer...now i realize that most people have probably led someone in prayer a billion times...but for me this was a first..i don't think i've ever prayed out loud before, let alone leading someone in prayer...so this was a big deal for me especially since i struggle with my faith on a regular basis and still don't quite have prayer quite figured out! I have the priveledge of working in a seventh day adventist hospital where religion and spirituality surround me and i think that this has had a huge impact on my faith. And maybe i'm a little over excited about this...but i felt like today was a big step for me...and i now have something else in my arsenal to help me to comfort my patients. Today i felt like i asked god to use me...and he did!

Sunday, October 3, 2010

yes i AM a nurse...that is what i'm paid to do...AT WORK!!!

So yes...I am a nurse...and yes i love being a nurse...it is a part of who i am...it is not simply a job...it's my life. however...i simply can not stand it when strangers approach me and want to show me god knows what and ask things like does this look infected? or tell me your symptoms...and expect me to diagnose you...isn't that what your doctor is for? and don't you pay him for that? and doesn't he get to run about 53 tests before he diagnoses you...weirdo stranger person!!! 
I have decided that i'm going to start telling people that i am anything but a nurse when i meet them...maybe that i'm a cosmetologist...at a funeral home!!!
My neighbor spurred this...before i describe that extremely awkward conversation let me say that if my neighbor called me for help because his wife was having a heart attack i'd be there in a minute, happy to help. but that was not the case...i was walking my dog and my creepy neighbor stopped me to talk...he registers about a 7/10 on the creep-o-meter (at first glance he seems ok...then after a minute you get that feeling in your gut to run)...conversation starts off normal enough...talked about my puppy...blah blah blah...and then he said..."i have to ask you something, professionally" and i knew i was in trouble...he followed this up with "i need to have something removed and i don't want to go where my woman works to have it done" oh lord help me now...he then describes that he once had 3 pearls put beneath the skin on his penis to increase his partner's sexual pleasure! OH MY GOD this was awkward!!! so i told him to call a urologist...i'm not sure what he was going for...like an "oh yeah...i'll bring home some local anesthesia from work and i can take them out for you in my garage!" eeewwwwww!!!
These strange things happen all the time when people find out you're a nurse...one day i was getting a pedicure and the nail lady showed me her brand new boobs when nobody was looking...really?! what would possess you to show a total stranger that!!!!
I mean if you need help, I understand and am usually happy to help...but keep your boobs, sexual practices, and infected whatevers to yourself for God's sake!!!

Thursday, September 30, 2010

So I started off all gung ho on this blog...and then forgot about it for a while! In the future i'll try not to forget...no promises though!
On a happy note tomorrow begins breast cancer awareness month! Is it bad that i'm excited to wear cute stuff with pink ribbons, pink ribbon scrub caps, pink ribbon scrub tops, and to dye pink streaks in my hair? What I mean is...is it insensitive to people who actually have breast cancer for me (having no personal ties to the disease) to wear my pink? It's really in support of my patient's and friends who have had breast cancer and are currently battling breast cancer. I think it probably comforts a patient coming in for a mastectomy to see the monotony of the surgical scrubs broken up by a bright pink ribbon scrub hat...but maybe i'm crazy! I think i'm just too worried about offending somebody...but who cares really....i'll be sporting pink all month long and i'll be super cute doing it!
On a ridiculous note my hospital "went live" with CPOE...computerized physician order entry...aka Crap and Piss On Everyone! The docs HATE it...and so does everybody else!!! They can't or won't figure out how to write their orders and then even when they write the stupid orders we can't figure out where to look in the stupid computers to find the orders...stupid stupid stupid!!! The worst part is that our failing team morale has taken a nosedive from low to nonexistent!!! The docs being pissy makes everybody else pissy! One of my favorite docs to work with made me cry last week! Let me say that prior to this I had only been made cry by one doctor one time...who was out of line and embarassed and humiliated me...crying because a physician was mean to me is NOT a regular occurence! I was sick...and really should have gone home, but i would have felt guilty leaving by trainee to fly solo with difficult cases. So...long story short I missed that the doc hadn't signed the consent form for the surgery...he for some reason had gone back to his office...my trainee caught this mistake as we were about to take the patient. So we had to find said doc and made him come back from his office (why he left is a whole nother ball of inappropriateness!!!) He is one of the sweetest, most mild mannered, never yells at anybody, and good looking docs in our OR. He comes in and begins to ream me a new one for making him come back from his ofcfice (was he going to perform surgery from there?) and why didn't i tell him that he didn't sign the consent form (oh is it not ok for me to make one mistake? by the way i don't make many! and did he not look at the consent form himself?) so this went on until i got all teary eyed spun around and stammered out an OKAY...and ran away like a scared little kid...real professional and adult of me! ok...so i guess i'm not quite over that incident...but he's always so nice...and i totally didn't expect it!
the update on the shankopotami...they have begun breeding and the disease appears to be spreading rapidly...so many have been exhiled to the island that it is now sinking!!! I really....really can NOT believe the amount of stupidity running around in the world! I made myself my very own "REALLY!" button to flash whenever i simply cannot believe something...my button also says"is that so" in small letters...a phrase approriate for many situations! I will now include a short scenario in which the really button was necessary. I was on call at our sister hospital and worked from 0630 all day until 0100 the next morning. At 0510 my phone rings...the call nurse at the other hospital isn't answering her phone for a pseudoemergency case that is supposed to start at 0500. My first thought was are you f*cking kidding me...but instead i muttered out "is that so...i'm on my way." I brushed my teeth and sleep-drove to the hospital. Blah Blah Blah....worked for an hour and a half until the other nurse was finally contacted...she said her phone never rang...funny...i called her myself and left a rather nasty voicemail! she gets there and says "Are you happy now?" all i could think was REALLY?!?! because by the way i was with a patient and wasn't going to let my anger get the best of me infront of the poor guy who was scared to death!!! After going home and sleeping I sent her to the island. 
But really...life is good! We bought a new boat and i LOVE LOVE LOVE it!!! it's freaking huge compared to our old boat and it rides so smooth and i'm not afraid that i'm going to fall out constantly! AND somebosy's coming saturday to buy our old boat! woohoo it'll be nice to have some cash in the bank again!!! we're hoping to make a bahamas trip with some friends soon!
I actually played housewife this weekend and cooked like crazy! I made stuffed french toast...it was FANTASTIC! Cooked some other stuff (blueberry muffins, miniquiches, torteloni) but the best was my favorite new recipe....it's called fourty cloves and a chicken! http://www.foodnetwork.com/recipes/alton-brown/40-cloves-and-a-chicken-recipe/index.html
I added a half cup of chicken broth to the bottom of the pan and it was seriously delicious...the breasts did get pretty dry. But the best part about this was toasting up some french bread and dipping it in the sauce left in the pan!!! This i will definetely be making again!

So this is probably really just a long rant/ramble about nothing and everything...but that's ok!

Saturday, August 7, 2010

the shankopotami are running rampant...

Yesterday was friday woohoo! I was banished to endo as punishment for some unknown offense but actually had a great time there! we had big boy docs who played well with eachother...for once we weren't running doctor daycare! our new endo tech makes all the difference in the attitude of the depertment and i thoroughly enjoy working with her. we even have some new terminology that confuse the hell out of our patients! first is bawk...replaces most curses well...confuses patients...and makes us laugh hysterically even when we're stressed out and want to scream! and my favorite word is shankopotamous....this describes those very special people that make you want to scream BAAWWWKK! the plural is shankpotami! i met the queen of the shankopatami the other day...young girl, crazy as can be, smelled horrible, and recognized me in public...ugh! so overall yesterday was a great day except for the fact that i felt (& still feel like) death. all day everyone looked at me and said..you look horrible/awful/sick...like i really needed them to TELL me that i looked awful! it feels like someone pulled a could down and stuck it on top of my head and set my throat on fire! so now i'm loaded up on antibiotics and cough syrup waiting to feel better!
in other not so exciting news i THINK i've decided to stay working the OR for a while longer than i had planned...this means that after school is over i'll start studying for my certification and see where that goes. we (my husband and i) decided that going right back to school again is just not what's best for us right now. between school and taking call i hadn't seen my stepson for 3 months and i feel like he's growing up and i'm missing his life. speaking of my stepson we picked him up this morning and we get to keep him until next sunday and i'm excited to get to spend time with him. we're spending the weekend with my husband's parents and then taking the munchkin over to st.augustine and hopefully we'll have a nice time there with him before i have to go back to work on thursday. 
an issue that's been pulling at me is one of our patients...and it reminds me that you must discuss your wishes with your family and carefully pick your power of attorney or healthcare surrogate and have it well documented. our patient population is mostly geriatric and this is a constant issue for us; however, there are special patients that i feel we are simply prolonging their suffering. the particular patient bothering me has been down with us in surgery at least 5 times now for different procedures and has not been coherent once in the last month...her body has failed her but we just keep doing things to keep her living...every time i think of her all i can think is "GO TO THE LIGHT!" and she's tried to die a couple times but then we step in and save her....are we really saving her? is this the right thing to do or is it cruel? i really don't know and we have to follow her poa's decisions....maybe i'm just a cynical person but i feel like god is waiting up in heaven wih open arms for her and we're just standing in her way!

Saturday, July 31, 2010

where to start

So...i've been meaning to start a blog for a LOOOOOONG time now! i have a lot going on and i really just need a place to put some of it down. i work full time as an rn in the operating room of a fairly small hospital in central florida...i'm a full time student at usf...i'm a wife & a stepmother...and i have 4, yes 4, dogs that remind me daily how we as people should be treating eachother...without the butt sniffing and surprise humping of course!!!
nursing is a huge part of my life...i work 50-60 hours a week between my regular hours, working late, and taking call...i'm considering a cot in our lounge!!! let me start my discussion on nursing as saying that i LOVE being a nurse...i just think that nurses are walked on and disrespected on a regular basis! I also love working in the operating room...it's definitely the environment in which i belong, it's my home...but i really don't like what i do as a circulator because it i do my job right all that i have to do is sit in the corner and document...how boring!!! and of course there's the part where EVERYTHING is my responsibility...i'm not so big on that part! but i thrive in the controlled environment and i live for rules and the "right" way to do things...probably because i'm a natural born worrier and the rules take part of the worry away! i frequently feel like my opinions and position as an rn are not respected...sometimes because i'm "just a nurse" and sometimes because i'm only 23 years old and most of the people who i work with have kids older than me...
on to feeling like i'm just the nurse...i have "just a nurse" days frequently...i really do know my stuff and it frustrates me to NO END when i tell the dr or the tech something and they tell me i'm wrong and do it their own way and then in the end it turns out that i was right! why don't drs listen to me? why doesn't my tech listen to me? is it because i'm just a nurse or because i'm young and they don't think i know anything? hmmm....this is one of the reasons i felt the need to blog...a way to get out some of the frustration without losing my job!
dogs...i wouldn't trade them anyday but sometimes it is difficult to have four of them! first there's princess...she came to me with that name...she's a medium sized mutt and a total spazz...i wish they made xanax for dogs! then comes roxy my rottwieler...she's the sweetest dog i've ever met and it's hilarious to me when people are scared of her! but she has severe hip dysplasia so i never really know how much longer we'll be able to keep her comfortable. then there's rusty...he's supposedly a pit bull who lives in our backyard and hog hunts in his spare time, when he's not king of my deck or the picnic table....rusty is gross...he's always dirty (even minutes after a bath) he's covered in scars...he's blind in one eye....he slobbers like crazy...and he'll hump you if given the opportunity! and last there's tank....our newest addition...he was going to the pound and i simply couldn't let that happen to him...although with as cute as he was at 12 weeks old he would have been adopted in no time...so he is terrorizing my house while i wait for him to grow up! i have never seen a puppy get into so many strange positions...into the dishwasher...on top of the dining room table...on top of the bathtub, he fell and turned the water on it was hilarious!
hmm....what else...i'm married to a wonderful man and marriage is everything that everyone told me it would be....good and bad! we try to spend time together but i feel like i'm constantly tied up with school and work lately!
as a step-mother i'm constantly questioning my role in my son's life and questioning my own actions. sometime i think it would be easier if he lived with us because i would be a constant in his life and not just there sometimes on the weekends. but i suppose what is important is that i do love him to death and want the very best for him!!! he's an amazingly smart 8 year old boy and i'm constantly worrying about him everytime he climbs on something because why? because i'm a worry wart! our week with him in the summer is coming up and i'm ridiculously excited to take him to st.augustine!
as a student...i think i'm crazy...why am i not happy just being an associate degree nurse? oh i don't know...but i'm not! so i'm one semester away from finishing my bachelor's in nursing...which i've decided is a complete BS degree as it is listed as a BSN....and most  of my classes have been BS classes!!! but that has been much harder to keep up with than i imagined! i have a tshirt that says "nursing school is not for sissies" and i think that holds very true! i am beyond excited to be finished in december!!!
i'm really not quite sure how htis whole blog thing works yet...but i think i'll wrap this up for now and maybe work on telling you about myself some more later!