July, 2005 Archive

going to nursing school was not a breeze. but i liked it.

what i really like about it is the fact that they teach you something that you can actually use/apply when you are in the real world, working.

where i went, we had to practice giving bedbaths, enemas and shots with our classmates, for us to get the real feel of how it is to be on the patient’s shoes.

don’t ask me about the enema. we only had one restroom, and there were 6 pairs of nursing students doing the whole thing at the same time. be creative and imagine how priceless the sight is. students very eager to learn and master the craft of pushing a tube through the rectum, and finding out after a few seconds, that the stuff DOES make you want to push your gut out. knocking at the restroom door with your other hand holding your behind, (hoping that would stop the inevitable), is a mastercard moment too. priceless.

anyway, i’m digressing.

at the nursing school, they taught us stuff.

THERAPEUTIC/EFFECTIVE COMMUNICATION TECHNIQUES
the idea is to communicate to the patients, their family, in such a way that will foster a better relationship.

“how are you tonight mrs. C?” (open ended question)

“not fine. leave me alone.”

“not fine?” (clarifying)

“not feeling well. just leave me alone.”

(silence/listening)

“what the h#% are you still doing here?”

“oh, just in case you need anything, just let me know.” (offering assistance)

“i won’t need anything, just leave me alone. i don’t want to be disturbed.”

i guess i got this whole effective communication process thing all mixed up huh.

“yes, i am mrs.C’s nurse, my name is May” (giving information)

“okay, listen May. this is the 6th time i called today. and everytime i call, nurses tell me my mom is asleep.she cannot be asleep the whole day if you didn’t drug her, can she?”

“R, i know it is frustrating that you have not talked to your mom…” (clarifying/validating)

“no no no no no, don’t start me on that one. tell me right now. what is wrong with my mother, why is she asleep the whole day? what is going on?”

“uhm your mother was…(ABOUT to provide feedback and information)

“don’t interrupt me when i’m talking. you have to let me finish first! now…..

(silence/respecting the person’s feeling/encouraging formulation of plan of action)

“go there and get her on the phone now. i don’t care if you had to wake her up, i want to talk to my mother.”

awww. i definitely was not paying attention when this whole effective communication thing was being discussed. how can i mess it up big time if i was paying attention?

if i didn’t know about effective/therapeutic communication, was there a possibility of a happy ending?

“i’ll leave you alone now.” mrs. C would have been a lot happier if i said that. and when R, her daughter called, i could have just shaken mrs. C out of her deep deep sleep and pressed the phone to her ear, ever so gently. then, they can talk nicely about the nurse, and bitch against each other peacefully. end of story. everybody happy.

could be that, or i need to review these so called effective communication techniques. has it been working out for you?

it was freezing.

i slowly dragged the vital signs machine and hoped the 45 degrees temperature was just my imagination. i came out of my lovely 78 year old patient’s room, with a little smile on my face, because she just told me she was very happy i was her nurse.

it was still freezing.

on to the next patient. listen to lung sounds, check pulses. assess. assess. assess. he said the weather was unbelievable. i agreed. it was 97 degrees outside, but it felt like 110. we both smiled to that. this time i was sure that it was just me. sleeplessness makes that to me. i hallucinate.

no. it was definitely freezing.

“do you KNOW that we are supposed to take vital signs here?” his left eyebrow was on the fifth floor, the right one was left at the lobby. he sounded pissed. i’ll call him michael; because i honestly cannot remember his name no matter how i squeeze my tiny brain. he is one of the PCAs (patient care assistant).

“uh, sorry, i didn’t know” i mumbled. i honestly didn’t. i was floating on this oncology/hematology unit, and i didn’t even bother to ask if i am supposed to take the vitals. how rude of me.

the charge nurse noticed i was putting on my second isolation gown. she thought at first i was THAT scared to be contaminated. when she saw me drink steaming hot, boiled water, and that i was obviously having a weird sort of chills, she realized it was the temperature.

“oh, we just have to deal with it. michael wants it this cold. everybody complains and mess with the thermostat, but he just put it right back to 45-50, ALL the time. we’re tired of playing the up and down game, so we just wear jackets.”

“and oh, WE also do the Intakes and Outputs. just so you know.” michael. he pops up everywhere.

the look of disgust on michael’s face was very unnerving. he flashes it so freely everytime i beat him into answering the call light. thing is, i was not even competing. i thought i was just doing my job.

“I GOT IT!” michael hissed when he saw me stood up to see what my patient needed when the light went off.

well michael, I DON’T get it. i mean, calm down man, i’m not here to take your job away. we were supposed to be a team. do YOU know that? it doesnt matter WHO answers the call light. what matters is that SOMEONE answers it.

coming out of my patient’s room, his face was blank. i read the nonverbal message. he wanted me to shut up. but i thought it was about my patient, so i asked. “what did he need?” a moment of silence. and then, “nothing, I already helped him” he said.

it was freezing, and michael was joyously sipping his iced coffee. if he was menopausing, i could have blamed every attitude he’s got to the mighty hormones. since he wasn’t, and only seemed to be wishing he had the hormones to blame, i kept quiet. opening the linen closet, i found a warm, thick blanket to wrap around my clueless freezing self.

this could be midlife crisis.

i am in a place where i can’t keep my self still. i have been in med-surg telemetry a little over two years now, and lately, i have been plagued by thoughts of transferring to a different unit, or trying other fields of nursing. i have been ignoring the idea. but the urge is getting stronger, i cannot ignore it any longer. why? i am clueless.

i love where i am working right now. i admit there are days when i get home so physically and emotionally drained, i feel like lying on the floor hoping work was easier; but at the end of the day, this is what i want to do. i got laughed at when i actually said one day that i am not only working for money, but for fulfillment. some nurses looked at me like i came from outerspace. i thought, since when did being honest become embarassing? i don’t see any reason why i should be ashamed to say that i love what i’m doing. i get home tired, but i realize i made a difference; no matter how small, and it gives me a high. it’s a healthy, cheap way to get those endorphins flowing. i do good things for other people. and the fact that i am paid to do that is definitely a plus.

however, i feel like i want/need to move on. to the next level? or go back a fews steps?there is that nagging question: “what next?” if my nursing career is a journey, there is a thought that where i am now is just a stopover, and i have overstayed. and i have overstayed so long, i don’t even remember where i’m actually going. that sounds pathologic, doesn’t it?

where do i want to go? what do i want to do?

maternity? too predictable, my ass hurts. i’m considering it when i’m 50. no offense to maternity RNs, but i just can’t take it THAT slow right now. no.

NICU? the babies are so fragile, and i don’t think i have what it takes to be ever so gentle. besides, it is so heartbreaking to see those tiny bodies with all sorts of tubes and stuff. no.

trauma ICU? too much action; i feel like i’m too old for all that running and juggling. and, do i have what it takes to be called an ICU nurse? no.

cardiothoracic ICU? a little interesting…bypass, heart transplant, lobectomy. if only they will be patient enough to train. maybe.

ER? all kinds of drama. i am thinking what if i become like most of them there? they always send us patients who had accidents obviously hours ago (i don’t need to be smart to figure out that its dried urine and stool that is in the gown or diaper) then, they apologize because they have been too busy to clean them up. i don’t want to be that busy. no.

other ICUs? although some of the ICU nurses i’ve met are really kind and patient, a lot of ICU nurses drive me off the wall. either they tell me straight to my face that i don’t deserve to be there because i don’t have enough brain cells, or i get embarassed by the way they treat the resident doctors, or sometimes, even the attendings. there is nothing wrong with being smart, but i don’t think it gives somebody the right to be rude and insensitive. also, i am not comfortable with ICUs where patients are mostly intubated. i want to hear patients talk, it makes my job a lot more interesting. and yeah, i am not that smart. so, no.

behavioral medicine? now we’re talking. imagine working where you actually belong? it’s like working at home i guess. thing is, it is 8 hour shifts in there, that can’t work out. putting the boys in day care is not an option at the moment. also, what if they find out i’m supposed to be one of the patients? it could be a disaster, but still, interesting. maybe.

oncology? i have dreamed of working there since forever! my roomate, who happened to be the father of my two children, said no when we just got married because all the radiation might affect our future children. the argument sounded logical, so i listened. now, that argument is nonexistent. i am definitely considering it. big maybe.

school nurse? home health nurse? how about teaching? nursing homes? so many choices…

the possibilities are endless. there are so many places…

then again, do i really have the energy to rock the boat?

how long does a midlife crisis last?

1. i don’t enjoy baths in the middle of the night. or at 3 AM! i just don’t. so what if i was not given a bath yesterday?

2. i do not want to be awakened to take my sleeping pill.

3. showing my butt off with those fashionable hospital gowns open at the back is not my idea of fun.

4. i hate telling EVERY person in white coat why i was brought to the emergency room. especially if they come one at a time, every hour.

5. plastic fork, spoon and knife do not increase my appetite.

6. i hate being interrupted in the middle of a good movie.

7. i need to take a stool softener every night? what’s up with that?

8. there are a lot of liars in the hospital. they say “i’ll be right back” when what they really mean is “dream on!”

9. privacy? say that again? unheard of.

10. i am not really sick.

not in that order. but yeah, that’s what the patients, or their family say. or think. (i think!)