September, 2006 Archive

first of all, you make a stupid mistake at work. a mistake that is considered inconsequential because nothing happened to your patient because of your mistake. you keyed in another patient’s medical record number to check another patient’s blood sugar. the result was normal, no harm was done. only, the computer is all knowing, and would not allow you to unchart that result form the wrong patient’s chart.

you are overcome by guilt, even after talking to the doctor, the outgoing and incoming charge nurses, and the computer people, who all assured you it is no big deal. so you call your nurse manager to confess and wish for a punishment. while waiting for her to return your call, you spent the whole morning thinking if the hospital was sending the SWAT team to arrest you. when the nurse manager finally returned your call, you said yes a million times when she said you need to fix it and actually write an incident report as soon as possible. to you, it actually sounded more like “drag your heavy ass here, NOW!”, so you didn’t care that you have not slept in almost 48 hours. you’re off to the hospital, minutes after you said “bye” to your nurse manager.

you got questioned by everybody who saw you for being so ridiculous by making this stupid thing a big deal, but you smile and tell them to bring you something to read when you get to wear that orange uniform. there is no sense in being so obssessed with a very small mistake like this, but you can’t help it.  you realize you might need drugs for this kind of behavior, but you’re not really sure, so you shrug the thought off.

you thought the worst part of the day was over, but then your  three year old said he was tired and wanted to go to his room. you know you either all of a sudden lost your sense of hearing, or something was seriously wrong. you automatically grabbed the thermometer and prayed to the Gods of temperature that you were only imagining his burning skin.

of course the thermometer betrayed you by announcing 102.4 degrees. being the stupid mom that you were, you called his pediatrician for a tylenol dosage even if it clearly said in the bottle that you need to give 7.5 ml to a child between 2-4 years old with a weight of 35-47 pounds. knowing that your child is 3 1/2 years old who weighs 37 pounds, this written instruction doesn’t make sense to your panicked brain, because you definitely cannot trust those labels. so you wait for the pediatrician as she calculated the dosage, while your son throwed out his guts.

then, you went through all possible things that could happen, because hey, it was fever, and it could be serious. you went numb as you imagined the worst. you know you are hopeless, because a fever is seriously not that serious all the time.

the only thing that saved the day was the sight of your younger son, hugging and kissing his older brother with this look of concern in his face that made your stomach flip in really mushy emotions.

the sick one went through all the imaginable and unimaginable motions just to avoid taking the tylenol. you realized calling the pediatrician was futile, and so was the tylenol, which your husband dutifully tried to clean off from the carpet. the second episode of throwing up was less intense, but it was enough to take his strength away, and knock him off. his little brother, lied next to him, trying to comfort him. this sight, no matter how ordinary, took your breath away, and you fought the tears, because what kind of an emotional wreck cries at the idea of her sons caring for each other?

anyway, you have high hopes the fever is nothing serious, so you went through what actually happened in your house this past couple of weeks. you get a letter from whoever it is that sends letters like that, telling you, you owe an extra $2,700.00 for property tax because they got the wrong appraisal price of your house. to make things even more exciting, things broke, leaked, or just completely stopped working. you thought maybe it’s time to take advantage of sign in bonus offers, (in a closer hospital of course) when you tried to take in this pieces of information:

broken garage door replaced:  $700.00
leaking pipe/dry wall replaced:  $575.00
circuit breaker/electrical stuff replaced with 5 year warranty:  $2,060.00

knowing that your home insurance DOES NOT cover any of the above: PRICELESS!

you took a deep breath, and realized that a lot of things are indeed priceless. you concluded that although you were concerned about the things you need to pay, there is nothing more important than the truth that you are not going through this alone. you were also reminded of the fact that you actually have the energy and capacity to work, so you can pay the unexpected bills, and move on. knowing this, you can now quit escaping the inescapable, and stop talking in the third person.

okay.

well, the little guy is still feverish, but is back to his really unstoppable active 3 year old self. the smaller guy is still following his older brother around like a devoted fan. and i, need to go to dreamland even for a couple of hours, so i can get ready for work.

i was not surprised that she was discharged when i worked the next night. she wanted to go home anyway. she was worried about her babies, the three cats. one of them needs daily meds of anti-seizure meds she said.

i’m talking about N, a remarkable human being i met two nights ago at work. she was one of my patients.

it would have been nice to know how she was doing. i can easily look up her phone number and just say hi. but i stopped myself because i have to be cautious. this is america, and what we filipinos usually think as perfectly normal, might be misinterpreted as odd or suspicious, or even a violation of the incomprehensible (at least to me!) confidentiality/HIPPA law.

so here is the burning question:

if you are a patient, and you are already home after being discharged, would it totally freak you out to receive a phone call from one of your nurses? would you find it weird, unprofessional, crazy, that your nurse just actually wants to know how you are doing? would you be paranoid and think about anything horrible if your nurse tells you that she just called because she wants to wish you well? would you call the hospital patient relations to complain that your privacy was violated by one of the nurses because she pulled out your phone number from your records just to give you a “friendly” call?

if you are a nurse, or anyone in the medical field, and you find out that one of your colleagues called one of her previous patients just to say hi and find out if that patient is doing well, would you find that completely inappropriate?

i’d like to hear it guys. thanks.

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not that the songs that i am listening to are really that interesting, but i am sharing them anyway because i was tagged by crystal, and i am a willing victim:) 

i enjoy listening to all kinds of music, except hard rock (mainly because it hurts my ears), but this list is of the ones that currently stand out:

1. “Jesus Take The Wheel” by Carrie Underwood
       you have no idea how TERRIFIED i was when i started driving just a year ago. this is literal for me, as much as spiritual.

2. “The Air That I Breathe” by Barry Manilow
       …”sometimes all I need is the air that i breathe and to love you”  because it pretty much sums up how i feel about him. most, if not all of the times.

3. “Everybody Hurts” by The Corrs
     “…when you think you’ve had enough of this life, hang on. don’t let yourself go, coz everybody cries, everybody hurts. sometimes, sometimes everything is wrong…if you feel like letting go, hold on…if you’re sure you’ve had too much of this life, hang on. coz everybody hurts sometimes…don’t blow your head if you feel like you’re alone. no, no, no, you’re not alone…”  i totally agree.

4. “Promises” by Basia
      “…go and ask anybody, they will all say the same…love is contagious, we are part of a chain…”  we are either bound by love. or not. i think.

5. “It Is You” by Dana Glover (from the soundtrack of Shrek I)
     “…no more mystery, it is finally clear to me. you’re the home my heart searched for so long. it is you i have loved all along.”  because. very personal reason.

6. “Please Remember” by Le Ann Rimes (from the soundtrack of Coyote Ugly)
     “…goodbye, there’s just no sadder word to say. and it’s sad to walk away with just the memory. who’s to know what might have been…” just because goodbyes are sad.

7. “Carol Ann” by Michael W. Smith
     this is an instrumental piece that takes me to the most emotional part of my being and makes me want to cry. for reasons unknown even to myself.

i tag anybody who wants to play.

self inflicted or accidental? N’s records were conflicting. the doctors cannot agree on the cause.

she had that superficial wound, approximately 2 inches wide, on her abdomen. the day nurse said he honestly didn’t have time to ask her what the real story was, but it was passed on that she was stabbed by a knife, by herself, while feeding her cats.

of course she was referred for psych consult.

she woke up with an excruciating headache at 1 o’clock. i bargained with the doctor to give her more pain medicine, but he wouldn’t budge. he was concerned that she was extremely drowsy the whole day, and 2 mg of Dilaudid per hour is more than enough. i went back to her room and saw her standing. her hands on her head, her head on the table, crying. i helped her back to bed and apologized that i can’t give her anything for her pain. she mumbled that she understood.

having no further options, i decided to do what i thought was best, given the situation.

diversion.

“do you remember what happened to you?”

“yeah. i was having this really bad headache the whole day, but i needed to feed my cats. i was cooking. i was slicing something, then i tripped over one of the cats and i don’t know how the knife ended on my stomach, but the next thing i knew, blood was dripping from it.”

“did you lose consciousness?”

“i don’t think so, because i was able to drive myself to the hospital. it was stupid, but that’s me, always trying to be independent, so what if i dripped blood on my car on the way to the ER? i wasn’t scared because i knew it was not that bad, but i had to pull over a few times because of my headache.”

it was working. it could have been the dilaudid, it could have been the diversion. it didn’t matter. at least she appeared a little bit relieved.

although very slowly, she kept on talking.

she just got back from Iraq about 10 months ago. she worked there as an army nurse. she was with two other nurses, a doctor, and a driver when the humvee they were on, passed by an abandoned, wrecked car with an IED (improvised explosive device). three died and she was one of the two who survived. she was brought to germany and was in an ICU for a while, for anoxic brain injury among other things. her left side paralyzed, she was told that she will never be able to walk normally again. she had a metal plate on the right side of her forehead that she guided my palm to feel. she told me that the terrible pain did not really go away after the surgery, but some days were better than others.

her husband of five years, a navy, went to see her in germany while she was still in the ICU. everything was a blur, but she vividly remembers him with his arms accross his chest, looking at her unemotinally, saying “i will not stay married to a cripple.” this statement must have been in her ears and heart all this time, because she said it a number of times, with such raw, gnawing sense of pain, that i can almost touch.

that was the last time she saw him. the papers are being finalized. it pains her that he did not take the “till death do us part” portion of the vow seriously, because she did not believe in divorce, but she can’t force him to stay if he doesn’t want her. “a door was closed but a window will open”, she said.

“i know part of it was because we were always apart, but i do not regret anything i have done. i will do it all over again. i will do it all over again. i have been walking five months now, and once i regain my normal strength in my left hand, i will go back. it is hard, but i will do it again. it is not political for me, the war. it is because i know i can make a difference out there. no matter how small.”

“you know what the hardest part is? the kids. you see them dying on the street and that is the hardest part. you want to scoop them in your arms and make everything better, but you can’t. you can’t take all of them. you just can’t. that’s the hardest part. it’s not the fear of getting killed, it’s those kids. they tear your heart apart. that’s the hardest part.”

i was overcome by silence. i was in the presence of greatness, and there was nothing relevant to say.

she went on to tell me the other places she’s been assigned. korea. australia. papua new guinea. she reminisced how she met her husband. she told me she started in the army when she was 21. it has been over 16 years. she remembered her mom and dad, she told me how she can never have children. she told me how her three cats are her babies. she told me how she used to work in a boys’ town kind of facility in hawaii. she told me how four teenagers she connected with still call her up once in a while. she asked about me and my life. she told me that just like her, i am “making a difference”. she told me i should not be like the others, who treated her “like a number, maybe because they didn’t know i am a nurse, or maybe because they were too tired.”

we were both quiet for a while. i was thinking about the “making a difference” part of what she said. thinking about how i do not really live up to my self proclaimed goal of doing that, much more to the idea that just like her, i was making that much of a difference. she was quiet too, she seemed very far away.

i knew i was standing there listening to her for almost an hour, but i did not know how to stop listening. i finally said “thank you for sharing your stories, your life.” she became very quiet, and appeared to be in really deep thought, so i stepped back to leave.

she motioned to hug me, and i hugged her back. it was the least i can do to let her know i appreciate the work she did, and all those who risk their lives for others. i was silent, because no words were necessary.

my personal opinion is that she is a human being hurt by her past, painful, personal and work experiences. i don’t think the wound was self inflicted. but that is not an expert’s opinion, i am not a doctor. the psychiatry resident will come up with the professional decision. if he/she thinks N is suicidal, it won’t really be a shocker. war does that to human beings. life either becomes so precious and fragile you go crazy trying to save everyone. or it becomes so senseless, your own has no value. needless to say, war is ugly, and it does cruel things to people.

i finished the remaining hours of my shift with a diefferent perspective. the things i complain about are nothing, absolutely nothing compared to what other nurses are forced to deal with in a war. my so called commitment to make a difference pales in significance to what other nurses have suffered, in the name of commitment.

one has to make big sacrifices to make a small difference. it is no accident that there are people like N, who are willing to make that sacrifice.

truth, by anonymous:

“uninterrupted sex after children is unheard of” 

absolute truth, by May:

“quiet, uninterrupted sleep after a 12 hour night shift, with two healthy, active, male toddlers is humanly impossible”

you may disagree with anonymous, but you can never disagree with me.