February, 2007 Archive

pixelRN tagged me. it’s a bit late, but here are the…4 things that i can’t live without as a nurse, and 1 thing i covet. 

can’t  live without my badge. 
      this does not only let me get through the doors that are only for staff, it also literally records the hours i work. with the technicalities of overtime and undertime pay, it gets really tiring doing a manual clock in and out without the badge. also, it has a little bar code that verifies our identities so we can use equipments in the unit.

can’t live without my dansko shoes.
     it took me almost three years to buy my first pair. if you remember what i keep saying here, that i earned just a little over 100 dollars a month when i left the philippines in 2001, you’ll understand why it took me three years to decide. man, i’ve never had shoes that cost that much money! but you know what, if you walk for a total of 11 hours within a 12 hours shift, you will swear how these shoes are worth every single penny. i’m not even being paid to say this, but i will say it anyway. now that i have tried wearing dansko, you have to pay me (quite a bit of money) to wear a different pair of shoes. seriously.

can’t live without gloves.
     i won’t spoil the appetite of those who read this blog who are not in the medical field. you have no idea what kind of things get through our hands on any given day. without the gloves, i might go home and just not touch my kids till clever people have invented a machine that will completely sterilize my hands. gloves are almost like oxygen. at work, i can’t breathe without them.

can’t live without a sweater/jacket.
     coming from a tropical country where there are only two seasons (hot and hotter), there is no way i can survive a night where the temperature is constantly 55 degrees, without some sort of warming gear. sometimes i think that the majority of the people in our unit are either menopausing or just plain warm blooded. because really, who sets the temperature to 55 degrees even when it is winter? definitely not me. that’s why my sweater goes to work with me. everytime.

i covet the energy of other nurses.
       i work three 12 hours  night shifts a week. and honestly, as far as physical strain is concerned, this is more than enough for me. in the past 4 years that i have worked, i have done one shift of overtime, and one try of three nights in a row. and i have no plans or intention to do any of it again. it made me so tired i could cry. for the life of me, i cannot stop being amazed at how some of my co-workers do it. two or three jobs, no day off, no paid leaves. i mean, where do they get this energy? i can only assume that when i turn 40 in 2009, i won’t be able to manage even the 3 shifts a week schedule. old age is such a pain sometimes.

i tag any nurse who wants to share.

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thanks for your thoughts and prayers for our little guy. as i mentioned, we’ll see his urologist on the third week of march. i am filling  my head with positive thoughts, because the negative ones are totally freaking me out. we didn’t have to be nurses to see that his left kidney is not really funtioning to the fullest. the image on the screen showed a lot of fluid being retained even after he was given IV lasix. while his right kidney just sort of grooved along, draining the expected amount of urine, his left was just pretty overwhelmed. i know he can live with only one kidney, and he is 4 years old and not so tiny anymore, but hey, he is still just our baby. if there is some kind of magic that will take this away from him, i will do that trick without even thinking. as it happens, i do believe in the power of prayer. so yes joe, please add him to your prayer list. we will not mind at all.

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as for the house, the “sold” sign has been nailed to the “for sale” sign about two weeks ago. but as our agent says, “till you don’t get the money in the bank, do not open the champagne yet!” we are supposed to close this coming tuesday. if things go smoothly, we should be out of here by friday. that means i should actually start packing. only, i’m thinking that packing, is almost the same as opening a bottle of champagne. so, the new boxes from home depot are just sitting in the garage, like some patient soldiers waiting for something big to happen.

on the work front… 

i have been wondering what they (my fellow nurses) really feel about this whole patronizing statements.

N, is a 24 year old female patient with Rett Syndrome. she has been in our unit for almost three months now, initally with an infected PEG tube site, then just all sorts of frustrating things. taking care of her is a handful, but i do not mind. R, the patient’s mother is a nurse practitioner who works in the pediatric unit. she is on indefinite leave so she can take care of N full time. she is a very hands on mom, and i don’t mind. i’ve always had a lot of respect for parents, or anybody, who decide to take care of special children. for me, they deserve every positive thing i can offer, because the challenges they face everyday are beyond difficult.

from the very first time i took care of N, R only had good words about me. actually, too good to the point of embarassment. i do not know what i do differently, because just like every nurse assigned to her daughter, i have my misgivings. just like everyone else, unintentionally, i would miss one eye drop. i give some medications late. sometimes, i do not notice her diaper is soaked. with all the cares she requires, a lot of times, no matter how hard i try, i simply cannot keep up. R is always around, and i’m sure she sees i’m not exactly THE wonder nurse.

yet, she would stand in front of the patient assignment list every night, and if she doesn’t see my name accross her daughter’s name, she would vocally express her disappointment. “it’s not fair, when will we ever get May back?”, she would ask. when i do get her daughter on my patient list, she would cheerfully announce “N, we got May tonight, you are lucky” when i enter the room. usually, these statements are said in front of other nurses, it gets rather awkward. i have been told a number of times “she really likes you!” or “she got really excited when she found out you were N’s nurse, i wonder why” in such disconcerting manner, it is beginning to get uncomfortable.

i cannot just go upfront and ask her why she really likes me, but i can see why my fellow nurses (all have been N’s nurse at some point) are slightly slighted. i’ll probably feel the same if the situation is reversed.

i can only wish i am this dynamic, caring, smartest super nurse…then, i will never think twice in saying thanks when some hyperbolic statements of gratefulness are thrown at me like i really deserve it. oh well.

on the homefront…

my eldest little one (who is not so little anymore because he turned 4 a couple of weeks ago) had his annual urology check up and we had a little concerning news. his hydronephrosis, which was found when i was just 20 weeks pregnant with him, is “slightly worse”. i had to put the quotation marks there because the very impersonal urologist actually used the quotation mark sign with her four fingers in the air when she said it.

“it is not worse, it’s just “slightly worse”, she said. now, if you are a parent, you know that the word “slight” was not invented to make you worry a little less. the truth is, if you ask me, the word “sllight”, in this matter, has very little significance. the word “worse” however, was invented to totally rock a parent’s imaginary perfect world. you know, that world we make up in our head where our kids will never get sick or hurt.

so, he is scheduled to have another renogram this thursday. after that, who knows? the very busy impersonal urologist is fully booked, and the soonest we can see her again is on the third week of march. the waiting will be torture because he might need surgery depending on the result.

to get our mind off the possiility of surgery that terrifies us despite the fact that we are both nurses, my husband and i are faced with moving concerns. as the selling of our house seems to move along smoothly, we have things to throw, pack, and give away. that should be enough to keep us busy while waiting for the day when we meet the very unfriendly, impersonal urologist.

pardon me for being so redundant with the adjective, but there is nothing more exact to describe my son’s new urologist. since he was two weeks old, he was seen by the same urologist, who all of a sudden just left. we have no choice but to see the one who replaced him. although the former was as busy as this new one, we give him credit for at least greeting us and smiling when he sees my son for three minutes. after all, he sort of acknowledged the fact that we have been waiting for two long hours, all the while worried sick about what he had to say.

dr. impersonal however, does not know what time it was, so there was no “good afternoon” or something like that. never mind that our appointment was actually two hours ago. that fact does not make us deserving of a simple greeting. “lie up here, pull down your pants” she said. to which, our little boy robotically obliged. she palpated here and there, and she was done after less than 15 seconds. she narrated the reasons why she wanted the renogram done while writing frantically on the chart. quickly, she looked up and asked “do you have any questions?” with a tone so unnervingly cold, i wouldn’t dare ask anyway, even if i happened to have questions.

i am not saying i expect her to sit down with us, hold our hands, and hug us, because we are scared for our little guy. i don’t think i am that needy. i’m just saying that a little smile or a hint of the slightest concern wouldn’t really hurt, and would have meant the world to us.

but really, who am i kidding? i totally get it. i am reminded once again that life is so hectic in this world we individually choose to live in, it was simply arrogant of me to expect a little human touch.

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before i forget… 

to those who are interested, the essay writing contest for nursing scholarship is still on. go ahead and check it out, and make sure you submit your entries before march 19. for some inspration to ignite your writing enthusiasm, the very first non blogger entry for the contest is posted here.

and lastly, i know this is long overdue, but i know it will still be helpful. if you want some real answers to your blogging questions, the very helpful Shane, (who happens to manage this blog) just started a new blog. whether you are new or a pro at this blogging thing, if you have a burning blogging question that keeps you awake, Shane is your man. go, ask him.

“WHAT’S YOUR NAME?”

i pulled my badge out and showed her my last name, after saying “May”. she was so mad, she was shaky. while i was holding out my badge, she wrote what i assumed was my name in her little piece of paper.

there is something about being asked your name loudly, and being told, nonverbally, that you are in big trouble. it made me giddy. sadly, not giddy enough to apologize. so i kept quiet. the whole night, i saw her, walk past through her, and all i have given her was silence.

i don’t know her name, but i’ll call her Snarly, she was the daughter of the patient in bed 1, who wasn’t my patient. P, my 26 year old mentally retarded patient was in bed 2. Snarly was allowed to stay at the bedside overnight because her mom didn’t speak a word of english. since i started my shift, she reeked of cigarette and had somebody with her whom she chatted with endlessly. once, i saw her waking up her mom in the mddle of a rather peaceful sleep, sounding like she was asking if she was okay. her mother, disturbed, would answer “si”, a signal for her to leave for her smoke break.

P wore a helmet, because it was her habit to hit her head either on the side rails, or with her hands, occasionally. no reason for the hitting, she will just do it for a few minutes, 5 minutes was the longest i noticed, and then stop. she will then sleep for two to three hours, and wake up to do the hitting again, coupled with those incomprehensible sounds that do sound like moaning.

Snarly complained to H (her mother’s nurse) at about 9 pm, saying that her mom can’t sleep because of the moaning, and asked “can’t her nurse give her anything?” i told the nurse what she already knew. my patient was not in pain, she was not agitated, i will not give her any kind of narcotic just to knock her out. there is no medicne i can give her to stop her from hitting her head. irritated, i added: “they should be grateful she is like that, because at least she doesn’t complain about them talking endlessly, and coming in and out smelling like a burning lobe of lung.”

at 0130, Snarly was not in her chair when i went to see my patient,  who was sleeping like a baby. at 0137, Snarly was at the door, both her arms accross her chest, looking rather…well, snarly. she started pacing in front of the door, an action that led H to save her face and call out my name, making sure Snarly heard her. making sure Snarly heard me, i responded rather…well, snarly: “what do you want me to do H?” then, i asked the charge nurse: “is there a way we can transfer my patient to another room?”

this is the part where Snarly snapped and walked right in front of me, shaking, asking my name. after putting the paper in her pocket, she asked “can’t you at least check on her because she has been doing that for a while maybe she is in pain maybe she needs something just go there at least.”

“i just checked her….” i looked at the clock and it was just 7 minutes ago, but i kept my mouth shut.

“when? she has been doing THAT for a LOOONNGG time!”

i walked past through Snarly without a word, and went straight to the room. i stood at the bedside, whispered “it’s okay P” a couple of times. P did not even see me, but as expected, she stopped hitting her head, and was quiet again.

after that, between Snarly and me, the silence was deafening. maybe i should have, but as i said, i did not apologize.

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it has been a week. what did she do with that piece of paper? i have not heard from the nurse manager. not heard anything from patient relations. not even anything from the charge nurse.

what has writing my name in a piece of paper accomplish?

intimidation? threat?

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it’s called reflective practice. to look back on a certain situation and analyze what you have done. play out the previous scenes in your head and find out why you did what you did. reflect and see if you could have done better. then, do better next time.

well, if i listened to my mean, bitchy self, i would say i have done better if i said…

 ”look Snarly, i don’t care if you want to die of lung cancer. i don’t even care if you dote on your mother to the point of literal suffocation. most importantly, i don’t care if you disrespect my patient’s right to have a peaceful night by yakking your night away with your brother or husband or friend. all i care about is that you should at least have a little understanding and patience towards my patient. it is not my patient’s fault that she is mentally retarded and does not know that there are other ways to express herself other than hitting her head. i know you are important, but that does not give you the right to get angry with my patient just because she is being herself. do you understand? do you?”

only, my bitchy self is supposed to be getting older now, and this is supposed to be the time when i’m expected to be more understanding and mellow. so, i know i could have done better if i said…

“Snarly, i deeply apologize for disturbing your mother. i understand you want the best for her and it must be very frustrating to see her awake when all you want is for her to have a good rest and get better. i will do everything within my power to calm my patient down. if needed, i will put her on restraint just so she will stop hitting her head, so you, your visitor, and your mother, can have a peaceful sleep. i assure you, i will not hesitate in giving her the maximum dose of ativan just so she will get zonked and you can rest. thank you for being so patient and i again, i apologize. i hope that a pack of cigarette from our unit will appease your anger, and will let you know how sincerely sorry i am.”

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somehow, something doesn’t sound right.
let me sleep on it. i might come up with a better “next time” scenario.

i love reflective practice. i do it all the time. i honestly think it is very useful. sometimes, after a decent amount of time reflecting, i come up with brilliant ideas. sometimes, i come up with nothing. i guess i’m just too tired to reflect sensibly at this time, because it’s pretty obvious i came up with nothing.

…but seriously, i do intend to be a better nurse. any suggestions on how i could have handled this situation better? i don’t want my name in a piece of paper next time. not like that anyway.

our household has been quite busy this week.

the house is on escrow, and if not jinxed by this post and everything goes smoothly, we need to move out of here on the first week of march. thing is, we cannot finalize a deposit for an apartment until we are truly sure the buyers will not cancel at the last minute, (like the day before escrow closes) so we are sort of hanging. the previous buyer cancelled when we least expected it, so we are very cautious about getting excited in packing our stuff.

the main thing that constantly occupies our mind is where to move. out of state: arizona and texas came up. still in california, bakersfield and beaumont came up. then again, there’s nearby communities that seem perfect, except that houses there seem to cost like they were built on top of an oil mine or something. even the most unrealistic idea of going back home to the philippines for good came up. of course  we are moving somewhere, but i don’t want to put a final word on it till the “for sale” sign has been covered with a “sold” sign.

anyway, termite inspection tomorrow, house inspection on thursday. add two toddlers who had stomach flu in for the past three days, and a husband who got the bug and doubled the symptoms, the house is definitely smoking with activities.

here’s hoping your days are not loaded with things that need thinking, and deciding, but with things that are both entertaining and relaxing.