you know that crappy feeling you get when you thought something mean about somebody, and conclude you are such a bitch or an ass for thinking such hateful thoughts?

well, that was how i felt after i posted yesterday’s blog. i might have edited some of my thoughts about A, the pregnant RN who floated to us from neurosurgery unit, and refused ANY isolation patient, but i must admit, i did have quite a few of those umentionable thoughts.

anyway, your comments made me feel so much better. it made me realize it wasn’t so mean of me to think such ugly thoughts. i felt exactly the same. i mean, when i was pregnant with my first baby, i didn’t work till i was on the second trimester because i was paranoid about being exposed to ANYTHING. since that was my husband’s and my choice, we settled on a small, cheap apartment and lived simply, knowing that keeping my sanity out of work was more important than working for more money and at the same time being a pain to my coworkers .

that was my exact thought when A was giving us all a taste of her famous attitude. i thought to myself, “if you are extremely careful and scared of your baby’s condition, you could have asked to be transferred to modified work, or just not work at all, until you give birth”. thoughts that i immediately regretted because i am guilt stricken like that.

only, i found out when i came back last night, that A’s pregnancy hormones, which i used to excuse her condescending tones, were not really to blame for her attitude. it turns out that even when she wasn’t pregnant she’s always carried that attitude. it was the talk of the night, and honestly, it gave me relief.

then, YOUR comments. it is not expected that we should all be on the same page all the time, but we were/are on this one, and i won’t lie, it felt good.

thank you.

i came home late from work this morning.

i was going to give report to a float coming from another unit. when she found out that one of the patients i was givng her was being treated for meningitis, she said she will not take the patient because she is 20 weeks pregnant and she already arranged with staffing that she will never be given a patient on isolation. according to her, she had a miscarriage caused by taking care of an isolated patient and she will not risk her baby this time.

i totally understand her sentiment, so i said okay. what made me uncomfortable was the way she said all this. she had this condescending, demanding tone that almost made me feel like i was being questioned for not thinking about her situation. thing is, we don’t even know who the floats are until they get to our unit. most of the times, we just know what unit they’re coming from, and we are not psychics to know if they are pregnant. i shrugged my negative reaction off, because yes, i understand pregnancy hormones like i understand how chocolate cakes melt in my mouth.

anyway, when the charge nurse arranged for a switch in list, she was again given a patient with VRE of the sputum (a case that most if not all of our pregnant staff have been taking care of), she then raised her voice, i assume to evoke a sense of irritation, and said, i quote: “i will not take ANY isolation patient, and if you want i will call staffing to fix THIS.”

i have worked during my two pregnancies. since our unit has always been swamped with isolated patients (VRE, MRSA, scabies, lice, meningitis, suspected TB, etc), i found it unfair not to take “safe” isolated patients for nine months when everybody has 2 or 3 isolations. i did this after my OB told me that there really was no study done that concluded being exposed to isolated patients exposed fetuses at risk. she told me it would be best to stay away from isolated patients as much as possible, but if unable, just make sure i strictly observe the precautions. which i did, and both my kids are okay. and so are all the kids delivered by my coworkers who all took care of a lot of isolated patients.

this of course 5 years ago, and i am not updated with he new studies about the subject, so i don’t know anything. to be clear, i am not questioning the fact that she wanted to be excused from taking care of an isolated patient. what i was uncomfortable with was the attitude. it would have been easier if she was a little nicer in expressing her request. i have always believed in “it’s not what you say, it’s how you say it.” i mean, she may have the right to demand a privilege because she was pregnant, but would it hurt to be nice about it? i just thought there was no reason to raise her voice and appear all snappy about it because after all, she is still asking for some sort of a favor. or i could be wrong.

anyway, i almost forgot the question: i want to know what any of you know about the whole isolation-affecting-unborn-babies issue. what is new out there, and what do you think about pregnant nurses being exposed to isolated patients?

i apologize i had to dump this question to you guys, but i have no time to research. i’m a few minutes away from getting ready for my third and last shift before i go on a 6 days off. we’ll be away for three nights, and yes, i’m easy, because really, i’m drooling with excitement.

i just have to get this question out there.
THANK YOU!

i’ve only slept for over four hours. i shouldn’t complain, but i want to. i am working again tonight and if i will have the same busy night tonight, i am doomed.

i finally transferred  my patient to ICU after running my butt off for the first 5 hours of the shift. the ICU and medicine docs were back and forth about transferring her, and selfishly, i felt like the victim. i won’t share the boring details because i’m sure bedside nurses know exactly what i mean. the system just feels so frustrating sometimes.

i just have to get it off my chest that time was really out of my hands last night, and it robbed me of the chance to show any hint of compassion to my patient. i didn’t really have the luxury of thinking about it last night, but now that i’m home, unable to sleep, it makes me uncomfortable.

she was on the phone with her son while i was charting on the computer just next to her bed. crying, catching her breath, she said: ” i have been calling you. why didn’t you pick up the phone? i am being transferred to ICU, and there is a big possibility i might not make it tonight. i am dying and you can’t even pick up your phone?”

my professional opinion was that she will make it through the night. but let’s face it, that opinion was irrelevant and unreliable. the point was, she was scared and vulnerable, and i literally didn’t have the time even just to hold her hand, a gesture that i have learned can calm patients down even without the aid of words.

anyway, i was so focused on giving the boluses, rechecking the blood pressure, calling the docs, charting, giving other meds, updating the charge nurse, and of course, going back and forth to my other two patients, one with meningitis, (the N95 mask driving me nuts everytime i had to enter her room) and one who had knee surgery gone bad. i blinked, and the next thing i knew, after 4.5 liters of NS bolused, and her BP just barely making it to the 70s, the two parties finally agreed, and my patient was accepted to ICU. even when she was leaving, i didn’t have time to say goodbye. i was on the phone about some issues with the pharmacy.

good intentions are never enough.
even things that are free, like a simple touch, are sometimes impossible to give.
and time, even when we get the same amount everyday, is not always on our side.
the abundance of good intention never wins over the unpredictability and passing of time.

sad.

we had a dying patient in room 6. when i came in last monday, i heard about how the family made it very clear that they were not ready to let go. apparently, they were not ready to change her status to DNR and they want everything done.

the nurse assigned to the patient sat them down and gave them a run down of what was going to happen when the patient codes. that, and the conclusion that resuscitating her will only prolong her life in agony, finally made them decide, at the end of the day, to accept her fate and just let her die in peace.

the patient was left in the room alone, and family members were allowed to fill the room at all times, so they can say goodbye. i heard the day nurse tell the night nurse, that it will be pretty soon, so she should get ready for another admit in a few hours.

the whole night, i saw family members in and out of the room. my patient was in the next room, she wasn’t my patient, so i have never seen her, but i can imagine how things were inside that room. i imagined everybody saying their goodbyes, quietly or otherwise. whatever it was they were doing, they did, thinking that it was the patient’s last hours. the whole night, the patient was never alone.

tuesday night, i still saw the patient’s name at the door. it wasn’t because they forgot to take it off. it was because she was still alive. the room was quiet, and the whole night of tuesday, i didn’t see any family member visit the patient.

i’m sure there were reasonable reasons why the patient was left alone, but i still wondered. i wondered what exactly were the thoughts of the patient’s family members as they rode the roller coaster of emotions as they waited for death to come. death that they were told was certain in a few hours, but dragged to days without any explanation.

it occurred to me that despite advances in medical technology and knowledge, death still comes when it pleases and predicting it is not really in the hands of doctors and nurses.

nothing new with that thought, i know.
it still fascinates me though.
don’t ask me why.