August, 2007 Archive

a big THANK YOU to all who greeted me on my birthday. you guys make me feel so special! 

i have been off for 5 days, then i work tonight.

that doesn’t sound so bad, except of course, my body was sort of getting used to sleeping at night. for those who have never experienced working at night, you are not missing anything, except of course, the $4/hour night differential.

i have been contemplating going back to day shift, because it is totally cool to sleep when the whole world is asleep, except of course, i still have nightmares of the times i worked days.

when i worked days, i used to go home at night, fall on the living room floor, tired as an abused mule, crying tears of self pity. my muscles ached like i was mauled, and there have been a few times, when i just fell asleep on the floor, unable to drag my hurting feet and legs up to the bedroom.

really, the memories still haunt me like a traumatic past.

anyway, enough of the whining. the past five days off were spent on a daze of things all related to our so called “almost house”. it is on escrow. if the stars align where they are expected to, meaning to say, if our prayers will be answered in a way we expected it to be, we will be inhaling that new house smell in about a week or two.

it is probably a cheap shot at parallelism, but trying to “buy” (the quotes indicating it is actually the lending complany buying it, but hey, in 30 years, it will be fully paid, right?) a new house from the time it was just an empty lot, is almost like being pregnant.

one day, nobody even notices that you are having a baby. then, week after week after week, they see changes, and you get very excited. as it is, as far as moving in is concerned, as compared to being pregnant, we are so ready for the water to break, and extremely excited for that true labor pains. the anxiety of morning sickness is over. those were the days when we were anxious about how the cabinets will look like with the tiles and carpet we picked. now, it’s all about that pleasant and/or scary anticipation. lots of it.

as you can see, there is nothing of substance from this post really. i was just tyring to bore you with details of why at this time, i am widely awake when i’m supposed to be asleep.

sometimes, being excited is so underrated.

K overheard me talking to another nurse who was asking me if i want extra guacamole on my burrito. although the guacamole sounded great, i didn’t have the extra 1.40 to pay for it, so i said “no thanks, i only have 5 bucks.”

“May, May!” K’s voice sounded urgent, and at first it sort of annoyed me. i was just with him a few minutes ago, and i was wondering what he needed that was so urgent, that he had to interrupt me in the middle of checking my other patient (whose bed was just next to his), and while i was talking to another nurse.

i told him i will be with him shortly. the nurse who was asking for the dinner order asked for the second time just to confirm that i didn’t want the extra guacamole.

“May, May!” he hollered again.

impatiently, i told my other patient that i’ll be back, because i have to attend to K. i pulled the curtain and asked him what he needed. it was all professional and to the point, sans the usual tone of being nice.

“i have extra money here May, you should get that extra guacamole.”

i thanked him a few times and graciously declined his offer. i told him he didn’t have to do it.

“well, you take care of me, it’s the least i can do.”

to say that i was embarassed with the way i reacted to his urgent calls would be a major understatement. there are certain situations that put one’s thoughts in the right perspective, and this is one of those situations. after the guilt, i got really sappy. i know it’s no big deal, but it’s not everyday that i get to have patients who want to get me that extra guacamole.

by the way, on a totally unrelated thought, there is something good about believing that old saying “age is JUST a number”. if you believe it, even if you are 38, you can still feel 25.

so yeah, i just turned 38 yesterday, and with all honesty, i still feel like i am 25. even if the mirror is trying very hard to convince me otherwise, i still stand to my belief. and i will stubbornly continue to, until they give me that senior citizen card.

and lastly, as i tell everyone at work…i will continue to accept birthday gifts till december. cash is preferred, but if you are one of those kinds who think giving cash is tacky, i am always open for whatever it is that you have in mind. except snakes, i don’t like snakes.

just kidding.
not about the snakes, but about the presents

the heat seems to be eating up all the remaining cells in my brain.

she was all over me, hovering, breathing over my neck like a hen to her chick. it took a lot of patience and composure to act professional. at one point, she even asked me if i was wearing a new glove. she refixed the linens i fixed. she repositioned him after i did. she asked about everything i did, only to imply that i was doing things wrong.

as i said, the heat has been eating me up, so i did not have the energy to complain. the attending doctor already told her that anytime she messes with the cardiac monitor or other things connected to her dad again, like she did earlier, security will be called and she will be asked to step out of the room. to be honest, i don’t want to see that, so i kept quiet the whole time. silence would have been good if it meant respect, but i intended it to mean the opposite. frankly, i was disgusted with her attitude.

i mean, all proofs point to her neglecting her nonverbal, contracted dad. there were bruises of different stages on his rib areas, his wounds were never attended, they eventually became so gross. he was also moderately malnourished. she contradicted her own words a number of  times when asked the same questions by different people.

i don’t really understand the extreme attention to details and the condescending, demanding, on-your-face ways she proudly executed at bedside. attitude that have caused a number of nurses to be unwilling to deal with her.

why was she doing that? did she actually believe that by acting all concerned and caring now, APS will change their decision and send her dad back home to her? and the way she tried to redo the wound dressings with her bare hands, did she actually think that will disprove the fact that she had a part in making those wounds worse?

i will not say i felt sorry for her, because that will be a lie. if you want to know the truth, i wanted so bad to confront her and give her a piece of my mind, if only i am confrontational. sadly, my nature is to show disapproval in deafening bouts of silence. if she knew that, she will realize i really felt bad for her dad.

i finally had it when she was pushing the idea that the NGT has to be changed because it has a hole that caused her dad to aspirate. i showed her how i gave him a cup of water without aspirating, but she was very insistent, lifting and examining the tube like some store item she was about to buy. i whispered to the charge nurse that she had to go. i didn’t mind her being around overnight, but she tested my patience to the roof, and although i knew it was a bit cold of me to request the charge nurse to ask her to leave, it was also a relief.

when she unemotionally glanced towards me before she left, i understood that she meant she wasn’t happy to go, but i had no real sympathy. i hope i can say that it  was not because i am inherently mean and use her extremely challenging behavior as an excuse, but i can’t because maybe i am really mean. i know i should have been more patient, but i had no more left.

well….as i said, the heat seems to be eating all the cells in my brain. unfortunately, it seems like the same thing is also happening in my heart.

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random bloopers in america.

1. the first time i went to the grocery, i was a bit pissed that they didn’t give me my change. imagine my embarassment when i found out that my change was in that coin change dispenser. well, i have never seen that where i came from.

2. at Smart and Final, we were trying to walk away with the grocery cart as far as we could, but everytime we reached the parking lot, the cart wheels just stopped. we changed the cart twice, then we saw the notice that said it was meant to be like that so customers won’t take the cart home. not that we planned to, but i’m pretty sure it definitely looked that way to those who saw us. 

3. i was so fascinated and curious about the street named “ped xing”. i kept wondering how people never get confused that a lot of street were named “ped xing”. i finally figured it out, but when i remember it now, i still find it embarassingly hilarious.

4. i have never filled up gas back home. when i started driving last year, i will not do it if somebody else was in the gas station. i will keep driving, cricling the area, till i know for sure that i am all alone. when somebody comes and i’m not done yet, i would get so stressed, i would sweat like a pig. people will then ask if i was okay, because it sure looked like i was being chased by some murderer or something.

5. a patient asked me: “can i have a Slice?” i asked her: “a slice of what?” we went back and forth, back and forth a few times. she ended up exasperated and told me to forget it. i thought she was out of it. she on the other hand, thought i was stupid. and no, i did not disagree with her.

6. a patient asked me if we have half and half. again, back and forth, back and forth. the patient gave up, i gave up. nobody was happy.

ferdz, i’m sorry this is late, and that i can’t come up with 8. i have already done the random things, so i hope this is will do. thanks for the kind words.

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lastly, cathy…thanks. that was very kind of you.

it took me a little over 30 minutes to clean and change the dressings on his wounds. the biggest one, on his sacrum, was as big as a really large grapefruit. he also had one on each hip, half the size of the biggest one. on both, his bones were exposed.

his daughter was his primary caregiver and he lived with her. the fact that he was brought to the emergency room with wounds THAT bad and THAT big was a red light to everyone. to everyone, but me.

i am not wired like everyone else.  for the sake of not demeaning myself, i will not say upfront that it is because i am stupid that i did not suspect anything out of the ordinary.

if i may, i will use my culture as an excuse. in the philippines, the norm is to take care of the older family members until they breathe their last. i am not saying that everyone back home is overly enthusiastic about the idea of caring for a dependent elderly, but everyone is sort of expected to hopefully develop a sincere purpose in doing it. there is no law requiring children to take care of their parents/grandparents at home, but it is an unspoken and noble way of showing love, respect and gratitude towards them.

it is in that premise why i say i have never really entertained the idea that it is possible for a child or any family member to consciously do, or not do something that can harm the older ones. i may have been aware of this reality, but unfortunately, i will admit that i do not really take it as real. growing up in a place where high regard for older folks is extremely encouraged, harming them in any way is simply unthinkable. it is not something i just think of people are capable of doing that easily. this makes me clueless in spotting a possible abusive caregiver, because sadly, i literally do not have a clear concept of this whole abuse issue.

anyway, please don’t get me wrong. even if i am strongly influenced by our culture and i completely support the idea of taking care of loved ones at home, i also totally understand the idea of sending a loved to live in a nursing home. the reality is, there are a lot of acceptable reasons why a person who needs total care should be taken to a place where he/she can get that care rather than stay home and be neglected. every family’s situation is unique. at the end of the day, the most important thing to consider is that we respect our loved ones by trying to provide the care they need, whether it is in our own home, or anywhere else.

in retrospect, when i saw his wounds, it never occured to me that there was a possibility of abuse. if the  nurse before me was thinking like me, APS (Adult Protective Services) would have never been contacted, and the whole investigation would have been delayed.

the night i took care of him was the night after the investigation. i was asked by the charge nurse if the daughter’s presence bothered me, and if i mind if she stayed for the night. honestly, with the way she was sobbing on the chair at the corner, i did not have the heart to ask her to leave. i don’t know exactly why she was crying, but there was that apologetic look on her face that almost made me conclude she was indeed guilty. for a moment, i actually felt sorry for her.

the next night, i saw a note on the chart, addressed to the case manager. “per APS, this patient will not be discharged to his daughter’s home.” for the first time in many days, unlike the routine we’ve seen, she didn’t show up. i wondered if one of the insinuations were true, that she will never be allowed to see him again.

i don’t know. this whole situation bothered me in different levels.

     first of all, i felt irresponsible and stupid for being so ignorant about elder abuse. when am i going to adapt to all these new things and be a real patient advocate?
     then, there was that unexplainable sympathy i felt towards the daughter. i mean, let’s just say she is truly guilty of neglecting him, is that enough reason to just take him away from her like that? worse, to not let her see him at all? 
     then, there was that rumor people were talking about…that maybe, she was just taking advantage of the situation by claiming monetary benefits for being his caregiver, but she is not really concerned about his well being. i can’t really wrap my head around that thought, so let’s not even go there anymore.
     then there was that question of why is it so hard for us to admit that we need help? why did the daughter feel the whole responsibility of acting like a superhuman by doing it all, on top of being a primary caregiver? 
    
then, the confusing thoughts…
     now that APS will take over, will the patient be better off?
     how can he be better off in an unfamiliar place, without anybody he knows?
     by doubting the system, am i actually saying that i believe the patient will be better off staying with his daughter?
     why is it that although i can’t get over the fact that it was heartless for the daughter to let this thing happen to her father,  i can’t seem to honestly accept the decision of APS to take him away either?

i have heard a lot of horrible stories of abuse in nursing homes. it makes sense to me why there are people who are strongly against putting their loved ones in one. i guess my final question is: if we truly love our parents or grandparents, where do we stand in this situation? to act heroic by taking care of them at home, risking the possiblity of neglecting them; or to send them to a facility, risking the possibility of other people neglecting them? how do we make that decision? how do we live with the consequences of our decision? 
    
somebody needs to help me clear these things up in my head, because i have given up on understanding what i really feel about it. 
i don’t even know what to think anymore.