Frequent Flyers

    There are a number of patients who are frequent visitors on my floor. They come up, stay for a few days, we send them home, and they're back within a few months. The nurses might say, "____ is back again. It seemed like he was just here!" We know them by name, know what they'll be asking for, and roll our eyes when they end up on the floor again. Most of them come in again and again for the same problem. Maybe they didn't take their medications or missed dialysis treatments or want stronger pain medications. There's one patient who I suspect just likes the attention he gets on our floor. Most of the time, they come in because they didn't follow the instructions we gave them. No matter how many times a nurse or doctor instructed them to take their blood pressure medications every. single. day. they are resistant to it and end up back in the hospital. These are our frequent flyers.

    There were two or three frequent flyers on my floor this week. Seeing them and trying to teach them yet again the importance of following our instructions made me think. When I read the Bible- particularly the first half of the Old Testament- I see some similarities. God rescues these people, gives them very clear commandments, and they screw it up. He forgives them, sends judges or prophets to help them, and they screw it up again. Sometimes I just want to yell at them, "Come on already! God has made it so clear to you and you can't obey for just a little bit?" It's like they're ending up back in the hospital again and again and again. The treatment is clear and doesn't seem that difficult, but they can't manage it.

    After I have these kinds of thoughts, I'm forced to look at my own life. Are there issues in my life where I am a frequent flyer? Mistakes that I make again and again even though I know how to fix it? The answer is yes. No matter how many times God has shown His provision to me, I still doubt His faithfulness. No matter how many times I've come to the conclusion that God is enough and that I can rely on Him completely, I still fall away from that and try to find satisfaction in things of this messed up world. I repeat the same sins again and again and again. It's easy to find excuses, but in the end, I am exactly the same as the frequent flyers and the Israelites. The instructions are clear, but I still make the same mistakes.

   Sorry if that was a little heavy. Things have been pretty good on the floor recently, and I've had a run of pretty decent shifts with patients who were kind and thankful for what I was doing. I got to celebrate Easter morning at my church which is my very favorite holiday. Sometimes it seems like spring is here, and that always puts me in a good mood. Life is good, and God is good. Thank you to everyone who continues to read this blog. Love to all

-C-

Progress

When I had my internship at Mayo, I had an incredible experience that I was able to blog about. Before you read the rest of this post, let's do a Flashback Friday and read the post I wrote back then. http://lettucetomatoandmayo.blogspot.com/2013/08/all-of-summer-iiis-were-given.html

 

Finished? Ok good. Fast forward to this past week. 

   It wasn't my patient, but there was a situation on my floor that was eerily similar to my first code experience. It had been a quiet night so far. Earlier, I had noted that the nurses on my side of the unit were the three newest nurses on the floor. Also, it was our charge nurse's second or third night of being in charge. The nurse of this patient walked into the room to get vital signs, ran out and told me to call a rapid response. She yelled for us to get a breathing mask as soon as possible. The first time I called a rapid response, I was flustered and panicked and didn't know what to do. This time, I calmly and quickly gave the operator the information and then rushed into the room. 

    I walked in and the patient was blue. His eyes were bulging. I took a look at his monitor, and his oxygen levels were 10-20%. The next two minutes or so went by in a blur. I know that I yanked the removable headboard off the back of the bed and somehow got it under him in case we needed to start CPR.  I know that someone yelled for a code to be called. I know that I felt for a pulse and felt one. People were putting on oxygen masks and trying to wake him up. People came rushing in, but because he had a pulse, we didn't need to do CPR. Doctors, ICU nurses, residents, and respiratory therapy all were in the room. At this point, I made myself available, but the things I could contribute at this point were limited. 

    I walked out of the room and had deja vu back to my experience at Mayo. It was so similar, but I had handled it completely differently. The similarities didn't stop there. I looked over and saw the patient's wife. I went and sat down with her and held her hand. I once again was the one who was able to tell her that he still had a pulse. I helped her make a phone call to a family member and prayed with her until the chaplain came. 

    Afterwards while I was reflecting, I thought to myself, "We handled that pretty well." I told the patient's nurse that she had probably saved his life by responding quickly and appropriately. I realized how much I've grown in the past 6 months by how I was able to handle an emergency situation. Instead of watching everyone around me work together as a team, I was a part of the team. And yet I still ended up at the same place- holding hands with the family member and praying. And that's why I'm a nurse. 

My go-to's

   I'm sure that no matter what profession you're in, there are things that you find yourself repeating over and over again. These lines get in your routine and it's hard to break that routine. When I worked the drive thru at Taco Bell, I once answered the phone, "Hello, welcome to Taco Bell, I can help you whenever you're ready!" And a few times, someone would come through the drive-thru and order a drink and I would ask them if they'd like any sauce with that.

   Here are a few of the lines that I've found myself repeating as a nurse.

-*Meet the patient, get report* "'I'm Caroline, I'm going to be your nurse tonight. I'll be with you aaaalllll night."

-"I'll be back shortly to check you blood pressure."

-"Can you tell me where you are? What year is it? Who is the president?"

- "I have your heparin shot which is a quick poke in the stomach to keep you from getting blood clots."

-I'll be back shortly to check in on you"

-"I'm going to have to bother you again at three in the morning to get another blood pressure" Then, when three o'clock runs around, I whisper, "I'm so sorry, just going to get your blood pressure."

- "Can you rate your pain on a scale of 1-10?"

- "Now try and get some rest" (In other words, 'for goodness sakes, go to sleep!')

- "I'll be back shortly with your medications."

-"I'm back again. One more medication for you."

- "Anything good on TV?"

-*When I answer the phone* "This is Caroline, how can I help you? "

- "Do you need anything else?"

-"Thanks for calling me back doctor, I'm calling about _____"

-"Have you had a bowel movement today?"

- "I'll be back shortly with some fresh water."

-*When I leave in the morning* "It's been a pleasure taking care of you. I'm going to go get some sleep now, but I hope you have a great day!"

P.S. Sorry this post is boring, but I got called in early to work today, so I'm a little short on time and sleep. Love to all!

-C-

Priorities

   I recently had an admission that came in close to midnight. This patient had a lot going on. She was in restraints after pulling out two IVs, she had a blood transfusion going, she had pressure ulcers, she was on oxygen, she was confused, and had a fast heart rate. When a patient first gets on the floor, there is a LOT of stuff to do. We have to make sure their vital signs are stable, get them into bed with all of the tubes and wires attached to them, we have to get a list of medications, ask admission questions, call the doctors and get orders, and do a buttload of paperwork. Depending on how complicated it is, it can take quite a while to get someone settled.
   While I was taking care of some very basic things with this complicated patient, her daughter proceeded to ask me for things that she thought were very important at that moment. She wanted to be put on the list for a different room, she wanted a fan, she needed lip moisturizer, she wanted a glass of ice, she wanted some gauze to wrap around her mom's arm, and quite a few other things that I am kindly choosing not to remember. While I understand that all of these things are within reasonable requests, at the time they were wildly inappropriate. As a nurse, you have to prioritize. It is one of the hardest things and patients don't always understand why it takes you twenty minutes to bring them a glass of water. I wish it didn't work that way, but it does.
    My priorities with this patient were to make sure she got in bed without pulling out an IV or injuring herself on the restraints, making sure her vital signs were stable and she wasn't having a reaction to the blood she was getting, making sure she was getting enough oxygen, and calling the doctor to get orders. While the daughter continued to ask me for things, my response was, "I'm going to get your mom all settled and comfortable. Then I'll call the doctor and try to work everything out. I'll make sure we get to that in a minute." Yet she still didn't get it and continued to ask for things. For the evening, I succeeded in being patient, but I was pretty exasperated by the end of my shift.
   After I got home and got some sleep, I started thinking about the situation again. (When someone really annoys me, I try to learn something from them to put a positive spin on things) Then I thought about our relationship with God. We ask Him for things that we think are so important and need to happen right now. I make plans for my life and ask God to help me out. We think that our priorities and demands take precedence over God's.  I bet that God in His unending love might want to say to us, "That isn't the priority right now! There are other things in your life that I'm trying to teach you. There are things that I have planned for you that you don't even realize are important. Trust me."
    This was the lesson I am learning through that tough situation. I realize that what I can see and what I think is important is limited by my humanness. I have a very limited view. God sees the whole picture and knows exactly what is best.

There are two kinds of people who read this blog: Those who like nursing and those who like me. If you are reading this blog at all because you're interested in nursing, you should read this blog.
http://www.nurseeyeroll.com/

Love to all.
-C-

Can't complain

Oh blogging world, I wish I could sit down and talk to each of you to hear about your life and talk to you in actual conversation. Here are some excerpts/updates from my life.

a.  I am part of the 0.5% of the population who loves daylight savings time. It means that I get to see the sun for more than a 20 minute drive and when my sleep schedule is bonkers, I feel like I wake up at a more reasonable time. Also, how about this weather? It is amazing what some vitamin D can do for for my mood. I'm lovin it and I can't complain.

2. I'm afraid I'm going to be a little vague at the moment, but I  want to tell you all that I have a new opportunity coming up. If you think of it, pray for me this Thursday. Changes could be happening, and I'm very excited. Further updates to come :)

III. I just got off working a 3 night weekend. I had a patient for all three nights who was on suicide precautions for attempting suicide at home. On one night, I sat in the room for about 25 minutes while his sitter went on a short break. First of all, he was the biggest flirt I've had so far (not in a creepy way but a fun way). Second, I got to talk to him about changes some bad habits, about God, and about hope for his future. It was one of the most uplifting conversations I've had with a patient in a long time. Thirdly, it brought parts of my life into perspective, and I can't complain.

D. I'm still learning lots. I might have mentioned that my floor gets a crazy variety of patients. Sometimes, I have patients that have nothing cardiac related even though they're on a cardiac floor. I see a little bit of everything, so I learn something new each night. Also, I've reached a point where I feel pretty confident in my skills. People ask me questions now and actually value my opinion. I think that the nurses I work with are absolutely fantastic about helping each other out when it comes to trading knowledge. I never feel bad about asking a question, and it makes me feel valued when another nurse asks me for help.

$. Here's a list of things I like. Shamrock shakes, blueberry muffins, sweet potato fries, the book Guernsey Literary and Potato Peel Pie society, ultimate frisbee, zumba, Dancing with the Stars, sunshine, flip flops, vacation days, racquetball, fresh flowers, cheese and crackers, wearing shorts, my Easter playlist, phone calls, and so many other things. I am so blessed.

Love,
-C-

6 Months

   There are times in your life that seem to fly by and others that seem to drag on. Sometimes an hour seems like it can last forever while a day can seem so short. In some ways, time can drag and speed along at the same time. I've been working for 6 months today. In some ways, that time has flown by and I can't believe it's already March. In other ways, I think to myself, "it's only been six months? It's seemed like forever!" 

   I feel like anniversary posts are supposed to be special, but I did not come into this post with a plan so we'll see if anything special happens.

   To start off, I'll tell a short story that made me laugh. 

   We had a patient (not my patient) who was extremely confused and in restraints. When we got there at seven, he was yelling out profanities galore. As the night went on, it got louder and more frequent. As in a constant stream of terrible language at the top of his lungs. I learned a few new combinations that I wouldn't have thought of by myself. The nurse taking care of him got an order for a sedative which you have to give as a shot. She asked me to come in and help hold his arm to make sure he didn't jerk. I agreed and we went into the room to explain the procedure to him. The nurse said, "Mr. _____ we're here to give you a shot that will help you feel more relaxed and calm." He stopped his yelling, looked at us, told us to hold on a sec, turned to the wall, and resumed cussing somebody out. There was no one there. After he got the shot, he was much calmer until early in the morning when the shot was due again. I once again went into help the nurse and as we were talking to him, he started to call us some terrible names. The nurse said, "That's not very nice, sir." He looked at me and stated calmly, "I'm not talking to you." Then he turned to the wall and proceeded to loudly insult the unknown entity. I'm not quite sure what he saw in his mind, but whoever or whatever it was, I want to keep my distance. 

    In honor of 6 months, I'm going to share the top 6 things I've learned. Disclaimer: I might be repeating something mentioned in other posts. 

6. My biggest strength is my focus and efficiency. I am darn good at getting stuff done. I always leave on time and have everything done in a timely manner. I'm pretty proud of this skill. 

5. My biggest weakness is my focus and efficiency. Sometimes I am so focused on getting stuff done that I miss moments where slowing down would be beneficial. Hopefully, when I write my next post about new things I've learned, I will have figured out how to still be focused but not miss those important moments. 

4. I want to go back to school soon. I thought when I started nursing that I could be a floor nurse forever. I've learned that even though it is a good fit for me now, I recognize the fact that I can't do it for the rest of my life. It's hard and exhausting physically, emotionally, and mentally. I want to go to school so I can have other options. 

3. People will never cease to surprise me. I am so often startled by a person's remarks or the way a person reacts to something. I have developed a poker face that I use frequently to mask my surprise at something someone says. I love the variety. I love the surprises. I love people. They make life interesting. 

2. Living life as a new grad, getting an apartment, starting a new job, working night shift, adjusting  to change.... these are really tough things. Change is hard. There are times that I feel like I'm rocking this life and there are times when I question my ability to function. As I'm sitting here reflecting on the last six months, I am trying to picture where I was six months ago. I have come a long way and accomplished a lot of things that I wanted to. I also have a long way to go. I have a list of both my accomplishments and my goals.  Life is hard, but I have a fantastic support system and a faithful God. I'm looking forward to where the next six months will take me. Hopefully, I'll have a few more things figured out :) 

1. I was reading in Matthew the other day and I read the verse, "Whatever you did for the least of these, you did for me." This gave me the reminder that even when I turn someone who can't even turn themself and can't even say thank you, I am serving the Lord. When I put a 300 pound woman on the bedpan every half hour, I am serving the Lord. "Whatever you do, do with all your heart, as working for the Lord and not for men." Even when it is so hard to see any fruit from my hard work, I can remember that it's not about me. I am so thankful for this because I admit that there are times when it doesn't feel very good. If I was a nurse only for me, I'd lose my compassion and my ambition. This has to be the biggest thing that I've learned. And ultimately, it makes it all worth it. 

I think that pretty much covered it. Thanks for reading. Love to all. 

-C-

Soapbox #2

Brace yourselves....You've had your warning.

    Here's the thing. We bring people into the hospital to help them get healthier and stronger. Then we feed them hospital food. The food that is brought doesn't look very tasty. It doesn't smell very tasty. And it's not very healthy. If someone is supposed to eat soft foods that are easy on their stomach, they bring them mush. If someone has an early breakfast tray so they can go to their test, they get a muffin and a little box of cereal. There are extremely limited options for anyone who has dietary restrictions. If a patient is admitted at night and missed dinner, their only options are a cold sandwich (if they're lucky), applesauce, and graham crackers. When they go home, we tell them all of these things that they're not allowed to eat anymore. If they're a diabetic, it seems like we're telling them not to eat anything. If they have heart failure, they have to limit how much water they drink every day. And that's all of the information we're giving them. The system we have stinks.
    Imagine a 50 year old man who just had his first heart attack and suddenly you are told to stop drinking, to cut out processed foods including all fast food, to limit sweets, and to eat more vegetables. If he doesn't cook and travels a lot, chances are that he's not going to be able to follow those instructions very well. And why would he want to anyway? Or imagine a 80 year old woman who lives in a nursing home. She eats what is placed in front of her. She doesn't have many options.
    There are dietitians who talk to people about nutrition in the hospital, but there might be 3 or 4 covering over 700 beds. There is no way they will talk to even a quarter of them. My mom is a dietitian, so I might be a little biased, but I think that there should be WAY more emphasis placed on nutrition than there is currently. I know that I can totally tell a difference in the way I feel by what I eat. If I eat out a lot, I have less energy, my stomach makes weird noises, and I feel gross. When I eat healthy, I feel good about myself, my skin looks better, and I have more energy.
   Also, eating well doesn't have to include only buying quinoa or kale. There are ways of giving your body good nutrients without spending half your paycheck. On top of that, I actually like the food I eat. It tastes good. If people in the hospital were truly educated on how to eat better and were fed good food in the hospital, I think it would make a huge difference. I think it's important to go beyond telling them what they can't eat, and to start telling them how to shop for food, how to cook tasty but healthy meals, and how to make do with the food they are allowed to have.

*Inhales* *Exhales*

That's all.
Sorry I'm not more interesting, but I had to get this off my chest. Thanks.
Bye.