Happiness

This weekend, happiness is:

* planning meals for my husband
* going on long walks with the husband around the lake
*baking one mean, yummy bread pudding
*watching hummingbirds gather at our feeder
* planting mums and pansies in the backyard
*surprising my best friend with a gift subscription to a magazine--for no reason
*doing my Bible study
*going to open houses with my husband
*buying myself a little something and not feeling guilty over it
*sleeping in
*accepting that I don't have to be perfect to be happy

What will you do this weekend?

A Typical Week

One patient in complete denial of her diagnosis. Two patients under forty with really aggressive cancer. Three patients on hospice care. Four patients with a new cancer diagnosis. One patient whose screams could be heard down the hall because she was so embarrassed by her tumor erupting through her skin that she hid it for months, even, from her husband, and is now dying for it--and experiencing a pain that only sedation will quell. One nursing assistant who gets multiple complaints by patients and family members for her lack of compassion. One nursing manager who won't do anything about it. A plethora of management members who would rather argue about minute points of idiocy rather than compromise and actually achieve something positive for my patients.

I held hands with patients, loved them, hoped for them, and cried with family members this week. I tried to remember that I have two ears and one mouth and should listen before I speak. I was not perfect. As a matter of fact, I made some mistakes. I'm still proud of the work week. I'm also savoring my days off.

Happy Anniversary

Four years ago, I married the wittiest and most intelligent man on the face of the earth. He is patient and has a large heart, and he tries to help me become a better person. He also cooks--yes cooks!-- when I pull my twelve hour shifts. I can't help but think that I get far more out of this deal than he does. This has been a tough year for us with health scares for the both of us, a move, and the loss of my Dad. He has gone above and beyond what I could have hoped for in a husband. I am really looking forward to our date night tonight!

Seeking Ties That Bind

I don't have a lot of family on my father's side of the family. They simply don't make it to old age. Heck, they seldom make it to middle age if you want to get specific about it. I found one of his cousins in a nursing home after quite a bit of searching around. She is the only member of that family to make it to an advanced age. I've been dropping by the nursing home to spend time with her.
I've found most elderly people to be overly trusting of strangers or a little suspicious. She falls into the latter category. She keeps telling me she doesn't know why I'm there. I've explained that I don't have a lot of family left and that I'd like to get to know her. She probably thinks I'm some scandalous miscreant trying to get her to sign over her estate. I really just want to hear stories about my ancestors.
She is one of those strong-minded spinster Southern ladies who doesn't dare let anone see her without full make up. She wears dress pants and blouses, wears beautiful jewelry, and went to college when girls didn't attend college. She's fierce about her single status: "Well, it wasn't for lack of opportunity!" She is an accomplished musician. She can also smoke a Pall Mall in about 3 drags, an accomplishment that sickens me while I visit her. I could reap less second-hand exposure by sleeping in a bar.
She doesn't quite know what to make of me yet, but I like her.

Head Banging Deux

Quote of the patient about her night shift nurse:
"I just love "Amy". I've got her pegged. When she comes into the room, I just start feeding compliments to her and she eats it up. I use that to get my way all the time."
Okay, people, I feel the need to point the soon-to-follow fact out because most of the American population for whatever reason doesn't believe it. Nurses know when they are being manipulated. Really and truly. We do. Why? Because you aren't the first patient to try to pull that. I know that you think you are ingenious, lying in your hospital bed and thinking of ways to cadge what you want out of me. I'm just professional enough to not let on all the time. Not only have most of us done extensive psychiatric rotations but we've had enough patients to have what you might call "good character judgment". I know if you're phony, narcissistic, drug-seeking, or neurotic.
I reminded myself that she is young, very ill, and has everything to lose. I performed her chemo, turned a blind eye to her less than savory character, and was as congenial to her as I am to the rest of my patients.

Head Banging

That sound you hear is my forehead banging against the wall.
I have a girl in my care with newly diagnosed cancer. She is a couple of years younger than me. The problem is that she has been coddled a preposterous amount and talks in a baby voice. For those of you poo-pooing my shocking lack of compassion: she was doing this before the diagnosis! I am routinely called into the room around six times per hour for meaningless tasks such as her showing me another tatoo. Or asking me if I want a piece of candy. Or making up symptoms for attention like taking a piece of toilet paper and throwing it in the toilet and telling me that its a piece of skin that came out when she peed. Yes, folks, patients make up symptoms sometimes! Even cancer patients. How about calling me into the room to introduce me to family that she's introduced me to four times already that day? She says we "get paid very well" to take care of her. Not the last time I looked at my paycheck.
She is unemployed, is not married, has a car load of children, has a drug habit, and intentionally lisps. Initially, my heart poured over with compassion for this mere child. Now that the week is drawing to a close and I've heard all about how funny she thinks it is that she's worn the same underwear for four days, my nerves are being worn thin. She is so busy trying to be cute that she won't even let me educate her on her impending cancer treatment. She isn't in shock or denial. She isn't depressed. I'm fighting for her life while she plays in her hospital bed. It's ludicrous.
Everyone who has been involved in her care is considering taking a breather from her. I'd like to, but my conscience is killing me. She genuinely likes me, and she trusts me. How can I swap her for a different patient even if she doesn't care for herself?

Passing Thoughts

We had a beloved patient pass away this week. Shortly before he died, he said:

"People have it all wrong. We should weep when someone is born and rejoice when they die."

Nurses Eat Their Own

Yesterday I received a post-op patient, a very simple case. She was comfortable and sleeping, and each time I went to check on her, her family member said she didn't need anything. In about four hours, the family member said that she needed some pain medicine and some washclothes. I went into the room with the morphine, checked all the patient's arm bands and began to give it. The family member flipped out.
"Techs give pain medicine in this hospital?" she thundered. "I told you to get washclothes, too!"
"No, that's illegal. I'm the nurse," I politely proclaimed, pointing to my name tag. "So and so, your tech is at the linen cart right now getting you washclothes."
My name tag has "RN" on it in capital letters about an inch high.
"I guess I misread your tag," she said, leaning perilously close to my chest, taking in all the other letters behind my name--because I've got plenty of them, having received extra training.
She interpreted all those extra letters and announced that she was a nurse, too, as if that justified her special brand of rudeness.
The part that really angers me is that I introduced myself as the nurse and I introduced the tech to her as soon they arrived on our unit. I also completed a head-to-toe assessment on her family member while the technician took vitals and made up the bed right before her very eyes. She wasn't listening because she was on her cell phone arguing with someone.
Part of what gives nurses a bad name is the way that we behave in hospitals when we aren't working.

Labor Day

Generally, I don't heart the holidays as I should simply because I'm going to work the majority of them. The time away from my husband makes me sad. This Labor Day was no exception.
Nurses know that on a holiday the hospital will be overrun with patients or there will be no patients. This Labor Day I had three patients and I only had a fourth by the end of twelve looooong hours of sitting at the desk. My patients were all a day or so away from being discharged and really didn't need me. I like to be busy at work. Something has to make those twelve hours fly by!
There were even a few hundred Hurricane Gustave refugees nearby, but no one needed care.
Meanwhile, my husband was at home, feet up, enjoying a beautiful day off while I sat in the nurse's station of a nearly empty hospital, twiddling my thumbs and missing him.