My John 13 Moment

"When he had finished washing their feet, he put on his clothes and returned to his place. “Do you understand what I have done for you?” he asked them. “You call me ‘Teacher’ and ‘Lord,’ and rightly so, for that is what I am.  Now that I, your Lord and Teacher, have washed your feet, you also should wash one another’s feet.  I have set you an example that you should do as I have done for you.  Very truly I tell you, no servant is greater than his master, nor is a messenger greater than the one who sent him.  Now that you know these things, you will be blessed if you do them."

Picture this:

It's 3am. I'm walking into my patient's room to get a set of vital signs. She is on isolation because she has a very contagious skin disease. I get into my gown, booties, hair net, and gloves. I quickly get the blood pressure while the patient is still mostly sleeping and start to head back out to assess my other patients. My patient wakes up and asks me if she can go to the bathroom. I help her up and escort her to the restroom. She tells me it'll take a while so I take off all my gear and head out of the room. I'm about to walk into another patient's room when she puts on the call light. Sighing with exasperation, I head back into the room, once again putting on all of the isolation equipment. I am getting her back into bed when she asks me if she can wash up. I think to myself, "It's 3am! Who in the world would want to wash up at 3am?" In addition, she's not very steady on her feet, so I feel obliged to stay in the room to make sure she doesn't fall. I help her get the soap and water situated and remake her bed as she starts to get clean. 

    After I finish with the bed, I stand there as she takes her sweet time. She turns to me and says, "I can't reach my feet. Can you get them for me?" My honest feeling here was annoyance. At this point, I had been in the room for over 20 minutes and I felt like there were other things that I needed to do. I help her into bed and start to wash her feet. I tried to do it quickly and efficiently but then my patient asked me to do it again. I had to get down on my knees and start scrubbing her feet. 

    I'm going to confess to you some of my short comings. At times like this, I start having thoughts like, "I'm not your maid or your personal servant" "Can't this wait til morning?" "This wasn't in my job description" "Of course it had to be the isolation room" I was doing the act, but my heart and attitude were in the wrong place. My patient made a comment about how she wanted to get washed up while there was still someone who was willing to help her. 

    It was then that it hit me. This woman was the modern day version of a leper or an 'untouchable'. She was an undesirable patient. Nobody wanted to touch her. She had made a comment earlier about how another nurse had made her feel like she was a dangerous and disgusting thing. And there I was, kneeling at her feet at 3:30 in the morning, scrubbing her feet. Whoa. 

    Our current sermon theme is the book of John. We had just gone through John 13 where Jesus washes the disciples feet. Jesus tells them, "Now that I, your Lord and Teacher, have washed your feet, you also should wash one another’s feet.  I have set you an example that you should do as I have done for you." I had the perfect opportunity to be like Jesus, and I had almost missed it because of my surly attitude. What an amazing job that forces and allows me to humble myself every single day- to remember that my Lord humbled himself for me, and I am expected to do exactly the same. My attitude changed a little bit after that :) 

Thoughts from a sleepyhead

Sleeping has been a lot better recently. Thanks to everyone who has prayed for me. December was a rough month, but I've been a lot better at adjusting my schedule. However, on my nights off, I only take a nap after work and then force myself to stay up so that  I can quickly adjust to a day schedule. It works well, but then I end up sleepy and my thought processes aren't the most logical or rational. Here's the result.

My latest theory is that God was having a lot of fun when He created people. He made sure that things down here don't get too boring. Not only are we incredibly different when it comes to appearance, but the plethora of ways that the human mind can deal with the same kind of things astound me.
 One person can be in their 40s and extremely ill because they haven't taken their medications or followed their diet. They are going to have major surgery because their heart is failing, but they still tell you what you can and can't do. They argue with their doctors and refuse treatments because they feel too tired.
Another person can have cancer 4 times and still be the sweetest human being to walk the earth. She can make you laugh out loud at 3am when you have to take her vital signs. She can ask you to call her 'auntie' and make a toast to 'our futures' with her midnight ice water and graham crackers. Another can be in the manic stage of her bipolar disorder and make your life miserable for 12 hours. Another patient might sleep the entire time you're there and wake up to take his medications and then fall back asleep.
Walking into work can be a little scary. You never know what you're going to get.

Oh how I wish I could let each of you join me on the floor for a night. Can you imagine how different the world would be if we could all live one day in another person's life? How would I treat my neighbor/teacher/cashier/waitress differently if I knew what their day looked like? I am positive that if some of my patients lived a day as a nurse, they would be very different.

I'm going to jot down a quick list off the top of my head on how to be a good patient:
- Bring a list of medications with you.
- Try your very best not to ask for anything when the nurses are changing shift. This is their busiest time.
-If they tell you that you can get up, please do. If they tell you not to get up without help, DON'T!
- Try to pee when the nurse or nurse assistant is already in the room.
- Don't get upset with the nurse if they can't give you something right away. We need to call the doctors and get an order. We can't give you even a tylenol or a sandwich without an order. Sometimes the doctors take a long time to call back. We're sorry.
-When the hospital calls you after you go home, give honest feedback. If you had a great nurse, say so. If you weren't satisfied, tell them why.
-If you're having pain, describe it. It can be sharp, throbbing, stabbing, aching, cramping, pressure, burning, dull, radiating... use your words!

That's all for now. See ya soon!

A Night in the Life

A few months ago, I wrote a post entitled, "A Day in the Life" which attempted to show you what an average day on my floor looked like. Now I've been on night shift for over 2 months and I think it's time for this post.

05:00-05:30pm- Caroline wakes up and gets ready for the day. I've found that I usually eat breakfast foods at this time.
06:00pm- Head out the door with a hot drink in hand
06:30-40- arrive on unit, get all supplies for the day, get assignment and start looking up patients
07:00-07:30- Get report on patients from other nurses
07:30-8:00ish- Do full assessments on patients and determine any immediate needs for that night (If I do this now, that prevents me from having to call doctors at 1 in the morning.)
8:00-9:00ish- Give night medications
9:00- Start charting and filling out patient sheets. My unit has report sheets that has a lot of patient information on it for report. Night shift gets to rewrite them with all of the updated information. I actually really like doing this even though it's a lot of work because I have to look through all of the orders, notes, and results in detail to know what's going on with the patient. I get to look at the whole picture and see the big plan for the patient.

And that's where the consistency stops. Ha. Here's the lovely thing about my unit. Most of our patients end up going home in the afternoon which means that when I come onto the floor, there are either a whole bunch of patients who just got there or a lot of empty beds. The night shift usually ends up admitting a lot of patients right off the bat which can throw off your entire night. If I get an admission when I walk in, I'm running behind until midnight when I can catch up. If I'm lucky, I end up getting an admission later in the night so that I have time to do a majority of my tasks before the admission comes. Unfortunately, most nights I have to walk in to work ready to hit the ground running as new patients come in. I prefer late night admissions, but the downside to that is I might have to call a doctor at 2:00 in the morning for admission orders and no one likes that...

At 11:00 I start the next assessments and chart them.
When I'm done with that, I write the progress notes on the patient and sign off on their heart monitor strips.
Usually around 1-1:30am, I eat my 'lunch' at my computer while reading through patient notes. If I have good patients, I can end up not doing a whole lot at this point. I don't want to wake my patients up, so it has the potential to be quiet. That being said, there is rarely a night where my patients are all asleep and behaving. Here are some of the things that can take up time:

-Answering the call light for insomniacs who are so bored that they end up riding the call light all night asking for things because they can't sleep
-Taking people to the bathroom
-Making sure my confused patients don't jump out of bed and fall
-Helping other nurses with admissions
-Turning bedridden patients and cleaning them up
-Getting people fresh water/late night snacks
-Changing wound dressings
-Inserting new IVs
-Replacing batteries and electrodes on the heart monitors
-Sneaking around in the dark trying not to wake anyone up
-Various other nursing tasks that can't really be predicted

3am- I have another assessment
5:30am- morning medications
6:00- If there's anything that I wanted to ask a doctor that wasn't urgent, I call around 6.
6:30- Morning labs come back and I call doctors with any critical results for orders
7:00-7:30- Give report to next nurses
Here's the thing. Most patients wake up between 6 and 7. At this point, everyone needs to go to the bathroom, everyone wants their breakfast, everybody's family starts calling, everyone suddenly needs their pain medication, and someone ends up ripping their IV out. Sometimes it feels like I've been in control all night but when the day shift comes, my patients are all a mess. I hate that feeling, but it's kind of out of my control.
7:30- drive home
8:00- eat 'dinner', shower, pack lunch for next night, take a few minutes to breathe, fall asleep.

Hope this helps!

-C-