October, 2005 Archive

October 28, 2005, 1:47 pm

things i learned at staff meeting

healing environment is the thing. it is not new, but apparently, our hospital is way way behind when it comes to what is new. therefore, we are finally jumping into the wagon, by changing the paints and the curtains, and the floor, to facilitate healing. and since we are trying to get there, the nurses are part of the environment, therefore, we need to wear something that will facilitate healing. no prints, no striking color; just solid scrubs that will stop a patient from throwing up even when he just had chemo. i don’t know anything about this, but if you see leaves growing out of my ears because i am so one with nature wearing healing scrubs, do not blame me, okay? i am just an employee who does not really want to argue with what the latest in healing environment is.

we are keeping a “hair care box” in our unit now. blow dryer, hair clips, etc. i have nothing against this, but it makes me wonder. if someone can actually go through the motion of blow drying their hair, he/she does not really sound like a patient to me. or am i missing the whole point? i hate it when i don’t totally get it. although i have a vision of me holding some mirror while a patient is using one of things in our hair care box. in my vision, i am not really doing a good job.

they are our guests. from now on, we are not to call them clients, customers, or patients. they are our guests. apparently when you say they are your guests, it is self explanatory what we do with them, because we are always nice to our guests. hhhhmmmm….i say they should feel at home and just help themselves with the morphine and the dilaudid; after all, i want my guests to feel comfortable. and at home. why lock the narcotics? that is an insult to our guests.

if i don’t let the PCAs (patient care assistants), who are certified, take my patients’ (ooooppps, i meant guests!) vital signs, i have a problem. well, it was suggested that i should learn how to let go. for the record, i have nothing against the PCAs taking the vitals, i just want to know first hand how my patients (oooopppss) are doing before i do anything else. i am a visual person when it comes to these things. it is not enough for me to know that the temperature is normal, i want to see that he is okay beyond the vitals. i guess i need to see a professional to get help for this; because i’m the only one who doesn’t mind taking the vitals.

other than that, most of the things are just pretty much nothing. or maybe, i was already drooling. i was so sleepy, even the nurse manager looked like a big, soft pillow to me…

October 25, 2005, 10:01 am

there’s something about doctors

“my lower back is hurting and i’m sure it’s my kidneys. can you get the doctor for me?”, he asked.

“R, is this something new? what kind of pain is it?”, i asked.

“it’s in my lower back, and i’m sure it’s my kidneys”, he insisted.

“do you have pain or difficulty when you pee?”, i asked.

“no, i pee okay, but i’m sure it’s my kidneys”, he insisted.

“how about burning or dribbling, like you can’t pee continuously but just drops at a time?” i asked.

“no, i have no burning, but my back just hurts and i’m sure it’s my kidneys”, he insisted.

“okay, have you been lying on that same position since you got here yesterday?”, i asked.

“well yeah, but that has nothing to do with my back pain, i’m sure it’s my kidneys”, he insisted.

“do you want to take pain medication before the doctor comes?”, i asked.

“no, it’s my kidneys, i need it checked; besides, i NEVER take pain medications”, he said, a little bit irritated.

let’s make the short story even shorter.

dr. B came. asked him exactly THE SAME questions i asked. it was eerie because i was like listening to myself a few minutes back. only, when she suggested pain medication, R said: “okay, i’ll take it if you think i need it”.

i tell you, there’s something about doctors…

their voices make the patients feel better; their presence heals…

and on a side note worth mentioning, my hats off to you dr. B! you took time out of your rather busy and crazy night, to talk to my patient who would have been awake the whole night thinking he needed a kidney transplant, if not for your reassuring and calming presence and words. i don’t care if you wear running shoes in the middle of the night, and tucked your shirt into your jogging pants, all i care about is that you did your job and you did it with a smile. you are my kind of doctor and i will pray till my knees hurt that all interns will be like you!

thank you dr. B! you made my patient’s life, and my night, less complicated.

October 19, 2005, 9:59 pm

the robot

i can’t pronounce his real name, even when i asked him to say it very slowly. romanian. late 40s. schizophrenic. end stage renal disease. that’s all i know about him.

i was warned but i don’t really let those kinds of warning get into me. i reasoned that is being judgmental, and is not very nice. i regret it now, but it is too late. i should have taken the warning seriously; then i would have been more prepared. i could have gone to a quiet place, meditated, and freshened up my memory about some things. about why i am a nurse and why i love being one.

just a few minutes after our first encounter, B was already screaming at me. literally. i had to shake my head, hoping that by doing that, i have shaken my ear drums back into place. within 15 minutes it was apparent that he was sent by a higher being to test my patience. he was really good at it, but i was determined to maintain composure. and compassion.

i hate to go into the boring details of how he followed me around half naked and stood so close to me i can almost hear his heart beating. of how he screamed and threw stuff that the charge nurse was going to call security. of how many times i have to follow him around reminding him not to eat other patient’s food because if he is hungry all he has to do is tell me. of how he cried and told me he was so scared and so sick of being in the hospital. of how he asked me a lot of times why i was so mean, and bad, and rude, and why i never listen and never understand him.

the whole night was like a lousy dragging movie. i was not very pleased with my performance. and the supporting actors were very questionable. the on call doctor kept ordering 10 mg of hydralazine PO for a blood pressure of 249/131. the charge nurse apologized endlessly that i have to go through such an ordeal. all the other nurses, not really knowing what their roles are, either patronized me, or teased me about being incompetent because i can’t contain my patient.

i stood there, smelling his breath, questioning the whole situation like a moron. why is it that psych units do not accept patients with medical/surgical problems? is it because they were not specially trained to handle medical/surgical issues? why is it that medical/surgical units accept patients with psych problems? can’t we refuse them because we were not specially trained to handle psych issues? please, if somebody knows the real answer, enlighten me. i am not ashamed to admit that most of the times, i stood next to him, and a lot of other patients like him, clueless.

when his face was an inch away from my face, and he was, for the nth time asking me in a very loud voice why i can’t give him more morphine and sleeping pill, i looked him in the eye and told him for the nth time that i just gave him sleeping pill and everything (Ativan IV 1 mg, Haldol 1 mg, Dilaudid 8 mg PO, Morphine 4 mg IV, Tylenol 650 mg), there is i can give him. i said i’m sorry i can’t give him anything anymore. to which he threw a fit and went over the litany of how i was mean, bad, rude, and mean, and bad, and rude.

did i say something about maintaining composure and compassion? i forgot.

four hours into the shift, i lost it. i am not proud of that, but that is the truth. the test was given, i took it, and i failed.

“the opposite of love is not hate, apathy is.”

he called me “HEY!”, he called me all sorts of name. i take his blood pressure.
he threw water. i pick the cup up, i place a towel on the floor, i hand him the hydralazine.
he followed me around crying and screaming alternately. i give him a chair, tuck him in.

i looked straight through him. no love, no hate, just nothing. i took in everything he said and did. i took it all in, without a trace of emotion.

it was apathy, perfected.

at the end of the shift, he was sitting on the chair outside his room. i handed him another dose of hydralazine. he said thank you. i heard him, but i said nothing.

i went home. i rant about it. i slept, hoping it will make it all better.

it didn’t.

i woke up feeling scared.

you know those nurses who go around doing their job so perfectly? so competently? they have faces so serene, they almost seem angelic. they smile and call the patients “sweetie”. they act like they have it all together. only, every little thing is a facade. in reality, they don’t really care about the patient. they only care about the fact that they need the money to get by. they inwardly count the minutes till the shift ends, and they don’t give a hoot what happens after their shift. “another day, another dollar”, they say. “yeah, i’m here to serve humanity”, they sarcastically say.

i am beginning to act like them. or worse, i am already one of them.

B has nothing to do with it. the confusing policies have nothing to do with it.

it’s all about me loosing my values. and all about me loosing my vision.

i need help.

B was sitting on the floor at the corner of the nurse manager’s office. he was finishing up a leftover bread he found from the dirty utility room. one RN teased about him getting ready to complain about me to the nurse manager. i joked about giving him the paper to write his formal complaint.

it was 0300 in the morning. i was tired. i had no time to keep the game going. so what if B was in the hallway, half naked, eating leftovers after raiding the dirty utility? i needed a break and i deserved it. i headed to the breakroom, looked at him for a quarter of a second, and closed the door behind me. i had the gall sleep. i even felt refreshed after that 30 minute uninterrupted sleep.

but now, sleep evades me. the sight of B sitting on that floor, his mouth full of leftover brea….

this scene keeps playing in my head. like an old, black and white movie that never ends.

i need help.

October 17, 2005, 1:36 pm

be it ever so humble…

i am sick.

the little ones are sick.

if you’re a mom, you know what that means. you forget you’re sick, and go on being a mom.

it is at times like this that i have an aching, burning desire to go home. i do not really know why, but i guess having somebody else look after the kids while you curl up in bed after a grueling but comforting massage from an old lady who will tell you “you have a lot of air in your muscles” sounds like a really good idea.

well, well, i’ll be honest. i want to go home all the time. even when i’m not sick. i don’t really know why. maybe it’s just the stupid person living in my body. all of my friends believe that going home for good is a bad idea.

i’ve been here for almost four years. i think that is enough proof that yeah, i accept that it is definitely stupid to go home for good.

i’m looking at the situation and i’m putting it in writing so i can see things more clearly:

back home, the philippines, that is:

working in a private 100 plus bed hospital 40 hours a week, i earn 6,000 pesos (about 110 US dollars) a month. i return my tithe, i pay my bedspace rent of 1,200 pesos, the only monthly bill i ever pay. the rest of the money is for food, personal stuff, transportation for window shopping.

at the end of the month, i look at my paycheck and let it sink that it’s all just paper now, and all i gotta do to live a decent life is to go on and work no matter how ridiculous that figure that i see in my paycheck month after month after month.

i have no money, no house, no car, no insurance of any kind. all i have is a lot time. and a lot of people to spend it with.

the best part of the deal however is this: i owe nothing to no one. i mean no debt, no loan, not a single cent. zero! i sleep with a smile on my face, knowing in my heart that if i never wake up, people will not miss me because i owe them something.

here, in the western part of the US:

working in a private 800 plus bed hospital, i earn…you know how much. i return my tithe. i pay: house mortgage, house insurance, car mortgage, car insurance, security alarm, pest control, cable, health insurance, term life insurance, disability insurance, credit card bills used for real shopping.

at the end of the month, i look at my paycheck and let it sink that it’s all just paper now; and all i gotta do to live a decent life is to go on and work.

the house will be paid off in 29 years, the car in 59 months…all the other bills, well, they come every month, not missing a month. before i sleep at night, i’m thinking: i couldn’t possibly die tonight…how about my debts?

i know, i can’t have the best of both worlds.

i chose to give up the idea of a simple, debtless life when i embraced the comfort of a warm shower, the cool or warm private ride in my own car, the lavish life of actually putting body lotion all over my body.

i chose it and i have no one to blame. i am not blaming anyone.

fall has just started and it already feels like winter.

even so, i don’t think the climate is to blame…

don’t get me wrong, i like it here…

i am just sick and dreaming it would be nice to be home…