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tháng 9 23, 2015
I find one of the most amusing things about my decidedly non-amusing recent hospital stay was the speed with which I slipped into the role of shameless patient.

I was an inpatient for exactly 24 hours. In those 24 hours, I did the following:

1. Left the bathroom door open to pee because the IV pole wouldn't fit with me, not even caring that the room door was also open (no direct line of sight - I'm not THAT shameless).

2. I excitedly hit the callbell so I could inform my nurse that I farted! I usually enjoy farting, but the level of glee in my voice was something typically only reserved for the insincere apologies I offer after dutch-ovening my fiance.

3. Ordered a balanced meal from the cafeteria, consisting of two orders of tomato soup, one chicken broth, one cup of hot tea, one cup of iced tea, a smoothie, and an order of chocolate pudding. I sure did house the entire tray without a second thought. Or first chewing.

4. Walked a lot. On one of my multiple pre-fart laps around the nursing station, I had to sneeze but hurt too bad to not splint, so the arm not holding onto the IV pole went to my abdomen. The back of my gown? Left to its own devices. I think I had it tied shut enough, but I can't be sure and I didn't care enough to check.

5. Took full advantage of the fashionable attire available to me. I was admitted after working a 12 hour shift and didn't get to go home prior to checking in, so I was faced with either wearing dirty underwear all weekend or getting new ones. Since the gift shop doesn't include an aerie store, I got to wear the mesh briefs that are so prevalent in the mother/baby unit. They're super comfortable, for the record.

So, yeah. I guess I can laugh all I want about the ridiculous things that patients do, but give me three minutes in the hospital and I'll damn sure check each one off my own list.
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tháng 9 20, 2015
Let me set the scene - it's such a beautiful weekend here in Oregon. I had plans with friends to go on a wonderful hike today and then go to a new brewery for some delicious beer. I worked Wednesday-Friday night, and planned on having a great couple of days in the sun.

But then, an unexpected adventure began.

I woke up Friday in the middle of the day with some vague belly pain. It almost felt like hunger pains, which since I didn't have breakfast after work didn't really sound that weird. I got up and had a banana, and it didn't help at all. I went back to sleep, not restfully, but figured I had one day left of work so I'd just stick it out and go.

Halfway through my shift, I felt terrible. I had this awful periumbilical pain which was just constant, I didn't feel hungry at all, and then the occasional wave of nausea would hit. Pepcid and tylenol didn't help, and I continued to feel worse. Towards the end of the shift, it hurt to get up or sit down in my chair to chart. I couldn't stand up straight and constantly hunched towards the right. I went and talked to the overnight doc because I knew deep down what it was but didn't want to believe it. After hearing all my symptoms he just gave me a look and told me to go check in as a patient.

Side note, I bet most ER nurses can back me up on this - we rarely check in as patients in our own hospitals, and must essentially be on death's door step to do so. It's the whole "no foleys between friends" rule, I guess. But I digress.

I continued to stick it out the rest of the shift, miserably. When the day shift came on, I handed off my patients to my replacement but before I could do anything else the charge nurse and night doc corralled me to ask what I was going to do. Then they pulled the day shift doc over, and told him my story. "Oh yeah," he said, "you've definitely got appendicitis. I walked around like you are right now for a whole shift and then mine ruptured."

Long story short, he did a quick exam and I had all the classic textbook signs for an appy. I agreed to check in, my WBCs were 14K, and he didn't even bother with a CT before calling the surgeon. I ended up in the OR by 10:00, and this is what they found:


So yeah. I totally had appendicits. And it sucked. You know what else sucked? Being a patient. This was my first time ever going to the ER, first time getting surgery, and first hospital admission. All while being across the country from my family and my fiance. There will be another post about how strange it was to be on the other side of the bed rails, but in the meantime I will say that my coworkers were absolutely fabulous. From offering me places to stay, to visiting me in the hospital room, to bringing me pajamas so I wasn't bareassed in a thin gown all night, they were fantastic.

To end this story, I just want to say how awesome norco is. I hurt right now, but nowhere near my pain from yesterday. Thanks, narcotics! I won't be thanking you when I'm constipated for the next three days, but we'll cross that bridge when we come to it. Also, I'm totally blaming any grammatical or flow errors in this post on the fact that I'm taking pain meds.

TL;DR - I went to work Friday and didn't go home after my shift. Instead I worked 12 hours feeling like shit because I had appendicits, then I went to the OR and said good riddance to my useless vestigal organ. Then I spent the night in the hospital feeling super dopey in my stupid socks and wheelie IV pole, and now I'm back home with awesome pain meds writing terribly edited blog posts. Huzzah!
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tháng 9 15, 2015
Making the rounds on the internet this week is a clip from The View regarding Miss Colorado and her monologue from the talent portion of the Miss America pageant.

Here's the video in case you haven't seen it:



(youtube credit to Kathryn West)

If you don't watch it, here's the gist: The View hosts are discussing the various talents demonstrated, and focus on Miss Colorado who talks about her work with Alzheimer's patients in relation to her job as a nurse. Miss Colorado is then mocked for "reading her emails" instead of performing a real talent, and there is an offhanded comment by Joy Behar about her attire - namely, her "doctor stethoscope."

I want to let that sink in for a moment.

Her "doctor stethoscope."

In two words, the women on The View manage to completely dismiss an entire profession. According to the AACN, there are around 3.1 million RNs nationwide. Three point one million. That's a lot of nurses. They work in Emergency Departments, hospice groups, nursing homes, Operating Rooms, administration, and a multitude of other departments. I myself work in the ER. And I've never once, in almost seven years of work, had my stethoscope referred to as a "doctor stethoscope."

I've never had my stethoscope referred to that way because there is no such thing. It is a stethoscope. Utilized by both doctors and nurses. And while our job functions in healthcare are different, they are both valid. To illustrate this, think back on the last time you went to the ER. After checking in with a triage nurse, you come back to a room if one is available. If not, the triage nurse makes the determination that you're safe sitting in the waiting room a bit longer while other, more critical patients are brought back first. When you do come back, the primary nurse is the first one to assess you. Why? There are more nurses than there are providers. Unless you're critically ill and the whole team is waiting for your arrival, generally the nurses assess you before the doctor ever comes into the room. The nurse listens with a stethoscope, to your lungs, your heart, or your abdomen to get an idea of what is going on. Do we hear abnormal breath sounds? No breath sounds at all on one side? What about a heart murmur? Are those bowel sounds hypoactive? Do your physical complaints match up with your story? What other symptoms are you having, and for how long?

All of these questions are part of our assessment. An assessment that is done entirely independently of a doctor. An assessment that may determine if the doctor gets pulled in to see you immediately or if you can wait until your turn. An assessment that goes into our documentation and into the medical record. An assessment that can be questioned in court if needed. An assessment that is taught in nursing school to be thorough and correct.

We don't learn all of this just so we can use a "doctor stethoscope" and pretend to know what we're doing. We aren't an accessory to physicians and only exist in the hospital to be eye candy, find bedpans, or make coffee. We've never bought "doctor scrubs" or "doctor shoes" or "doctor clicky pens" to wear during our grueling 12 hour shifts without lunch or a bathroom break.

We are the ones that you see first. We will be the professional with you the vast majority of the time. We're the ones who will start your IV, hang the medication and titrate it to a desired response, stand in the room with your family after time of death is called on your loved one, monitor you for improvement after you've received treatments, and hit the code blue button if you try to stop being alive. We get you up to the bathroom and wrangle the oxygen tubing as well so you don't desaturate. We work the highly specialized equipment you may require, like ECMO. We're the ones who constantly monitor your vital signs and notify the physician when they start to tank. We are the ones who are with you enough to notice when something doesn't seem right.

When the phrase "doctor stethoscope" is blithely uttered by someone who has no concept of how nurses actually function, it denigrates our entire profession. It shortchanges over three million healthcare workers in this country and makes the statement that the only people who matter are doctors. This infuriates me.

We matter. We are educated professionals, and we are not to be dismissed by someone so ill-informed as to carelessly assume we're just accessories. The fact that the women on The View even feel this way is the most upsetting part - if they view nursing so poorly as to offhandedly state this in the first place, how can we ever expect the general public to understand that what we do is mentally, physically, and emotionally difficult?

I don't know the answer to these questions. I wish I could more eloquently express the amount of rage, shame, and disappointment I feel over this video and the deeper opinion held of nurses. I wish I had a better outlet to educate those who agree with the women on The View. I wish I could change the perception of nurses to be as respected as physicians. I wish a lot of things, but mostly I wish I didn't have to fight this fight.
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tháng 9 15, 2015
YOU GUYS. I'm super excited! I've been wanting to learn photography for a long time, and finally took the jump and bought a nice camera. I don't ever plan on becoming any sort of professional - I just want to learn how to take great pictures and have some control over the kind of shots I get.

So with that said, I treated myself to a Nikon D3300 as my first step into DSLR. It's quite the upgrade from my current iPhone and old coolpix point-and-shoot. With that said, oh my good lord photography is overwhelming. Seriously. So much information.

I'm super excited to start learning this art though, and I'll keep you all updated on my progress. Feel free to send some tips my way, especially ones that helped you not feel totally in over your head in the beginning.


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tháng 9 12, 2015
If I've done it before, I can't remember - I asked to hug a patient last night, because she was the absolute nicest, sweetest, hilarious lady who got dealt an awful hand. I've said it so many times before, but cancer is the worst. I am in complete awe of this lady, who took bad news so well and it just breaks my heart when people who are so clearly just good are faced with this fight.

I hope if I am ever at this same junction, I can act as classy as that lady.
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tháng 9 01, 2015
Sometimes we get a psych patient with real medical issues, and sometimes we get a medical patient with background psych issues. Either way, they're a challenge to take care of. The psych aspect to the care means that the medical stuff is harder to do - the patient is often either unable or unwilling to comprehend why certain care is being given, and it can make for a very difficult time. Mostly it's just a sad feeling to be taking care of someone who got dealt such a shitty hand in life.

Sometimes though, the psych issues and the medical issues join forces in a glorious display of hilarity. Like, for example, the sweet guy I took care of the other day. He was withdrawing from alcohol, which is awful, and also had a myriad of mental health problems. One result of his psych background was a deep abiding love for Jimmy Buffett. It was such a deep love that he was convinced he was actually Jimmy himself...and sang, at the top of his lungs, Son of a son of a Sailor. For a good twenty minutes. Remarkably in key, too.

That song happens to be one of my favorites which meant I essentially had a personal mini concert from JB. His singing was enough to draw a crowd of security guards, other nurses, and the doctor. By the end of the extended song, he got a round of applause from the crowd and serious props from me. I guess the joy from singing worked wonders, because after the concert he was the best patient ever.

He even said thank you for making the tremors stop, and was generally the most cooperative hallucinating withdrawal patient I've ever had. And the best part? He proclaimed that my reward is lifetime tickets to every one of his concerts and a free meal at Margaritaville.

Mental illness is hard. But sometimes, just sometimes, there's a bit of joy to be found in it.
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