June, 2005 Archive

i am guilty. of impatience and not advocating breastfeeding till it hurts. i am also guilty of being overpaid. (but no, i’m not really complaining!)

E looked at me like i was from another planet, when i asked her if she wants me to just feed her baby with formula, from the bottle, so she can sleep and have some rest. i looked at my reflection in the bathroom mirror, making sure i didn’t grow a third eye or another nose. obviously, i commited the worst crime in the breastfeeding world; and that is assuming that the enthusiastic but totally exhausted and frustrated new mom is tired of trying.

okay. both her nipples are inverted. the lactation specialist made her use a nipple shield (which, honestly i have never seen in my whole life, so imagine my embarassment when E asked for it and i didn’t know what i was looking for!) to facilitate breastfeeding. thing is, the baby gets frustrated with the big plastic/silicone nipple without the milk. so the little guy would rather sleep, than suck till his tiny lungs collapse. i don’t blame him. his pediatrician is a little bit concerned that he is loosing a lot of weight, so it was suggested he needs formula supplement.

my only responsibilty is to hold the 20 ml syringe with formula, and give it a little push through the feeding tube inserted inside the nipple shield, so the baby gets something. now, to feed a sleeping 5 pound 3 day old baby with a little drop of milk at a time, while expecting him to work for it like his young life depends on it, is like asking an elephant to get inside the refrigerator, and get in there, quick. but E was determined , and i salute her!

how the nipple shield helps facilitate the whole process still escapes me. maybe, if i float there at mother-baby unit again, i’ll eventually find out.

i was paid for 12 hours, but when i thought of what i did in that unit where breastmilk overflows, i would be lying if i say i worked a total of at least 2 hours. if you want to know the truth, my butt hurt. it was on the chair for a very lonnnnng time.

the whole night, i was in the bahamas!

“who said old dogs can’t learn new tricks? they can. it’s just painful to watch them.”
- bill cosby

hi. my name is May. i’m 35, and i don’t know how to drive.
this is my third attempt to master the wheel.
i assume my previous instructors gave up for logical reasons.
i want to prove them wrong…
so help me God.

and if i were YOU: for the next three weeks, (or months!) stay away from cars with a driving school logo. avoid them like the plague. it’s safer that way. you cannot blame me. i repeat, you cannot blame ME. you have been warned!

“who said old dogs can’t learn new tricks? they can. it’s just SCARY to be on their way.”
-May

1840. “J was a headache the whole day. she threatened a thousand times to go home against medical advise. she is noncompliant even with vital signs taking. she has two kids and don’t know how to take care of them. she said she definitely will not have any procedures. she is smoking AND taking pills. she is supposed to be on bed rest, but…GOOD luck May.” (surely there is an exagerrated tone to that, for who can literally threaten to go home AMA a thousand times? but i give the day RN a credit for making it sound interesting)

1915. i handed J the small box of tissue paper. the poor girl (yeah, at my ripe age of 35 i consider a 19 year old, Girl!) has been drying her tears on the sleeves of her hospital gown.

1930. J still sobbing like crazy, getting a little wild with her mama, trying to explain why the “@#$%” she doesn’t want no filter for them DVTs and embolis. (i have two other patients to attend to. one to get ready for an MRI with a BP of 183/86, one moaning continuously no matter what i give or do, so i was thinking… “please girl, put a brake on the tears and let me at least do your vitals”…yeah, heartless as it may seem, things do need to be done at certain times, irregardless of the presence or absence of tears. i hate that thought, but that is the truth)

1945.interventional radiology (IR) resident wanted me to witness J consent to IVC filter placement, central line placement, and possible thrombolysis therapy. the “this-could-kill-you- if-you-we-don’t-do-anything-but-of-course-the decision-is-yours” line made J grab the pen quickly.

2005. J and her mama are still at it. “if you do this J, and quit smoking, you will definitely live up to your 60s. J murmured something profane. me? i can’t wait any longer..i dared to be rude and excused my self by slowly placing the BP cuffs on her left arm. i can’t remember how i managed to finally introduce myself and let them know i’m just a call light away, but i did; and obviously, it was irrelevant considering the situation.

2025. by a miracle only heaven can do…a dispatch was sent to bring J to IR for the procedures. that the IR resident was able to arrange it in such a record breaking short time is still beyond me. especially on a friday night.

2035. dispatch asked me to talk to J, she wanted to ask something before she goes to IR. “yes J, if they decide to do the thrombolysis therapy and you go to ICU, i will send your cranberry juice and chinese takeout there.”

2240. J’s sobbing voice was heard in the hallway. mama is gone, but a 30yish looking female is with her, gently stroking her forehead, saying “baby, it’s okay”, and to me: “can you give her something for pain? she is dying here.” (great, another screaming, glaring woman, like one is not enough for the night!) J said she is in too much pain she CAN’T move; so we had to use the slideboard to transfer her to her bed.

2300. J’s visitor (JV) was putting on the non-slip socks that J requested. hhhmmmmm. she was in her pjs…hhhmmmm.

2305. J and JV are under the blankets.

2315. (i’m definitely gonna be in trouble with the charge nurse and the policies if i don’t do it, so…) to JV: “uhhmmm….were you here last night? uhhhmmm…it’s just that it is our unit’s policy not to let anyone stay overnight unless there is an arrangement with the charge nurse. ah, ah, you’re planning to stay, right? (the dumbest question ever! but hey, i can’t do any better. sometimes, i hate it that i’m so culturally influenced to beat around the bush)

2320. i arranged that JV can stay tonight, but if she wants to stay the next night, they have to fill up some forms at the nursing supervisor’s office, and show some ID to prove that she is J’s caregiver. “i know J, legalities sometimes suck but it is for your and our protection too”.

2325. J was pissed off. (understatement of the decade!) she WALKED out of the room and talked, no, ah YELLED at the charge nurse. “all i want y’all to show me, is a paper that shows that my own care provider, who takes care of me at home everyday, and gets paid for it every two weeks, and has been staying with me everytime i am in the hospital CAN’T stay with me overnight! i NEED a wheelchair, i CAN’T cope with these. YOU aggravated me i just NEED to smoke!”(what happened to severe pain she CAN’T move?)

2340. “yes dr. D, i just want to inform you that patient J is off the unit without my consent. she was upset about something. yeah, she said i “aggravated” her, so now she NEEDS to smoke. yes, i already documented it.”

0110. a.nauseated. b.still in 10/10 pain. c. dressing on neck is hurting like hell, can you chnage it? yes, phenergan and more morphine. but no, i can’t change the dressing. first, it is dry, second, i’m not supposed to touch it for 24 hours unless necessary. i can loosen it a little bit. of course, J was not very happy. and me? i want the remote, so i can change the channel.

0240. pain still 10/10, and can you tell bed 1 to shut up? or if you can’t, transfer me to another room NOW? yes, 2 tabs vicodin. no, i can’t tell bed 1 to shut up, no, i can’t transfer you NOW. of course, J was not very happy. and me? i want to go to the beach and hang out with richard gere.

0430. “you think she’s really her caregiver? how could she lie like that and show us a calling card with a logo that says “senior care” and then say she is her caregiver?” the charge nurse wants to know. “i am clueless. all i know is they call each other “baby”.

0530. “J, i’m sorry to wake you up, but i need to give you your blood thinner shot in your belly. also, JV, i need to draw blood from the IVC sheath, so i’m afraid you have to get up”. of course, J was not very happy. me? i was imagining breakfast. a bowl of sliced mangoes, avocados, papayas, and blueberries…yum!

0630. J opened her eyes when i was doing my last check if she was okay. “what time do the doctors come? i want to transfer to another hospital. i don’t want to stay here and be paranoid because i can’t cope with a surgery and my caregiver not being allowed to stay.” “baby, calm down”, JV whispered. (man, i thought we had a connection here…that really hurts…but if you really want to go…)

0640. “tell her i said GOODbye”…dr. D said when i told her about the contemplated threat of transfer. (i didn’t know interns can smile LIKE that!) and me? i honestly felt guilty i was not very nice to J in my thoughts, but i’m using my two other patients as my excuse. they needed me too, and it would have been unfair if i neglected them just to pay full attention to J’s mini movie.

0650. “have a fun day” i told the day RN. “yeah May, yeah.”

this is why i don’t watch soap operas. too much supply of tears, too little time. too many twists and turns, i can’t follow the predictable plots. i’m way too old for this.

D didn’t show any emotion while i was taking his medical history.

30 year old male, HIV positive when he was 17, full blown AIDS in 2003. to date, he has gone through quite a bit after it became full blown. he was supposed to see an ophthalmologist for a sudden blindness on his left eye. ridiculous as it may seem, blindness is not urgent enough for him to be granted a same day appointment. he was told the earliest appointment available is in september. he had no choice but to go to the ER.

although we do get full blown AIDS and HIV positive patients in our unit, they are not that common. understandably, the staff, mostly the RNs, are always curious as to how the disease was acquired.

it wasn’t a surprise when after i came out of the room, nurses flocked to me like hungry dogs awaiting a hefty meal. all with the same query: “so May, HOW did he get IT?”

“i don’t know. i didn’t ask. was i supposed to?” i replied coldly.

“does he look like a druggie? maybe one of those needles huh” M said.

“is he gay?” T asked.

“oh my God, i hope not from blood transfusion, it always makes me sad to hear that” L exclaimed.

i listened to them but didn’t say a thing. i acted busy doing D’s paperworks.

why don’t i ask THAT question? this is not the first time i’ve had an AIDS patient, and always, i never ask how they get it. most of the times, they eventually tell me without me asking.

i reckon it won’t make a difference; it doesn’t matter. but is it something deeper? am i afraid my own prejudices will make me a biased, judgmental nurse who would do differently if a patient somehow “chose” the lifestyle that led to the disease?

am i wrong to think that it doesn’t matter? is it hypocritical to think that the patient deserves the same care even if he has a “part” in being sick?

i remember taking care of A, an alcoholic drug addict who had a stroke at 37, and was paralyzed. almost everybody took care of him on auto pilot, smiling at family members, giving him everything he needs, but when his doors are closed, they all openly talk about how “he deserves everything that he is now”. i usually keep my distance when RNs discuss situations like these. when they air out their opinions about a smoker with lung cancer, an alcoholic with liver cirrhosis, a drug addict with AIDS, i keep quiet and cringe. i always thought i have no right to judge them, and therefore i am not in the position to conclude what “punishment” they should endure because of their choices.

do i really, honestly believe that, or am i the world’s biggest, fattest liar?