adventures in disaster

spending

I am startled at how much I can spend in one day. Ten years ago I was cautious and kept track of every dime. Now I have a decent job that pays pretty good and I am lazy about money.
Being poor taught me nothing about managing money. I guess because I didn't have any to manage.
I also didn't have half the bills I have now.
I have telephone, television , internet and cell phone...Back then I had one telephone and a tiny television with rabbit ears.
Today I bought animal food, the bill was more than what I used to spend for two weeks of people food.
I have a teenager that eats money, twenty dollars a day at minimum.
I have to buy gas for the car and that cost shocks me over and over again.
I need to learn how to spend...and I have an accountant now..HRBlock used to be my accountant.
My accountant cringes when I tell him I never really save, I have crappy life insurance and I didn't bother to invest in one of those education funds for the kid..hell..we were POOR, how was I to know I would get my act together?
So now, late in the game I am trying to figure out the RRSP thingie and saving real money.
My only positive is I have no debts..yeah, the accountant was shocked. But poor people can't get credit cards or mortgages so we pay cash and escape the credit disaster.
I have paid off all my student loans..it was the most painful thing I have ever done.
I think poor people shouldn't be saddled with montrous debt so they can get a decent job. It makes no sense. How can someone just out of school with no experience starting at the bottom of the pay scale be expected to hand over a quarter of their pay cheque? It keeps the poor poor though. I know I will never be in the "middle". That amazing tax bracket where everything is possible..a new car..a house. I will always be a used car and a renter kind of person and I am fine with that.
I see some nurses that work every day..overtime,overtime just so they can pay the car payment and the mortgage. They are never home long enough to enjoy the place.
I would be terrified to own my own home. What do you do when you need a new furnace? or a new roof? or the septic tank goes.
Living in the country means septic tanks and septic beds...and that always makes me laugh because septic means something entirely different to me..
I love that if something goes wrong I can pick up the phone and call for help and someone else has to pay.
Living under hundreds of thousands of dollars of debt would make me nauseated all the time.

It didn't stop me from looking at brand new trucks today though.
Forty thousand dollars for a truck..when did this happen? Oh right around the same time urban idiots thought driving a big truck around the corner to buy milk was a grand idea. These trucks are completely yuppified..leather seats for goodness sake! Our truck will be a farm truck, doing what it was built for and having leather seats is ridiculous.
I am supposed to change my work clothes every time I get in?
It is so pretty the idea of driving it through a field to pick up hay is blasphemous.
So, no new truck for me.
The salesman also tried to sell me on the idea of leasing.Why would I want to give this man all my money for years and at the end of it have nothing to show for it? I want to buy a truck so it is mine not the banks or a leasing company who I am sure would be horrified at the idea of me using the truck as an actual work vehicle.

Buying a used vehicle is like being the dance partner of a sociopath. You have no idea when he will dip or stand on your feet or just dump you on the dance floor. I accept that their goal is to make a fool out of me and steal my money. I just do the best I can in an ugly situation.

Why are used car salesman all crooks? Is it because they aren't making enough money? I don't really think so considering they are selling cars that were under water in New Orleans for top price and they bought them for ten bucks..the mark up for a vintage disaster car is huge!
I think they do it because it's possible, we as consumers don't work very hard at not getting duped, we don't even ask basic questions..my favorite being "how long have you had the car?"
They always lie but check the air in the tires, it's a dead giveaway to a car that has been sitting around for months in a lot.
Ask if it's ever been in an accident..they always lie..look under the wheel wells to see where they repainted..repainting means accident.
Ask for the work record on the car, they will look horrified but they have to give it to you. I saved myself from two near disasters on that question. There really is no happy explanation to why you put a new transmission, all new braking system and new exhaust into a car other than something bad happened but we still have a ton of money sunk into this car and we need an idiot to come take it off our hands. One guy finally admitted that and offered to give it to me at his cost...
If someone is desperate to get rid of something why would I want to have it?

So, the search still continues. I know there is a perfect truck out there waiting for me..hi truck! I am coming! Could you maybe send some smoke signals my way so I can find you? This searching thing kinda sucks..

posted by adventures in disaster @ 10:06 PM 0 comments

driving

I know it's been talked to death but what the hell is wrong with you people? Why can you not drive your damn car without aiming it at me on my way home?
I was nearly wiped out by some idiot woman trying to dial her damn phone using both hands on a major highway. You cannot drop down to thirty miles an hour in the express lane without warning so you can have a little moronic chat with some other moron.

I have seen the end results of all your stupidity. You lay in a bed, drooling and incontinent while your family tries to find a nursing home bed to plant your vegetable ass. I have no sympathy for you but for your family? That is the tragedy. While you were juggling your phone,lipstick and Tim Hortons coffee trying to steer with one knee driving at 120km your family was at home under the assumption you had a functioning brain and wouldn't commit suicide by moron on the way home.
You suck.What makes me even crazier is you don't just wipe yourself out you usually take out some unsuspecting normal person.

Honestly, what the hell is your problem? Who is so important that they will drop dead if you don't call them? No one right? Yeah, you say that right now but I can bet you will do it again tomorrow because you are a moron with a death wish and a nice side of sociopath.



Dear Burger King
I love your chicken sandwich and your fries but couldn't you mention to the cashier that fifty piercings is forty eight too many? Especially all the lip and nose ones..they make me anxious and a little sad, not exactly how I want to feel when I am eating all the weekly recommended fat in one meal..Okay?
Thanks!


Oh House..You have fallen in love and what a fine choice. Your new love can cook a fine meal and brought a friend in to keep the house nice and clean. I like him.
I think they should jettison all the medical drama and stick with these two room mates..But it all seems a little familiar..Like it has been done before.
Hmmm..one is a slob with no manners or tact and the other is neat, tidy...oh! The Odd couple reduxx.....wow how the mighty have fallen. What happened? Writers take a little vacation time and someone was watching that oldies television station and voila! Why be original when you can blatantly rip off someone else.
Gahh..it's incredible to me that I really loved this show once. I feel kinda dirty and stupid.


The Amazing race was actually kind of cool. How refreshing to hear someone say " I don't want to feel that way" when describing irritation with the love of your life. He admitted he felt angry and told her immediately that it made him feel bad. She is blessed to have found someone as profoundly kind as this man. I do have to admit the old killer fatigue really got a few people here. If they had been less tired they would have quickly realized that they had extra pieces but when it's night time at the end of a killer day finding reasonable solutions to problems is just so damn hard to do.
I am surprised to see the fatigue show up so early. It isn't even half way yet and it will only get harder and harder from here on in. I think the guys have the best chance. Both pairs have a light heartedness to them so they don't get easily frustrated. They aren't really heavily invested in the outcome and seem more than happy to just be playing. I think they could both become incredibly competitive near the end though. When the aching exhaustion creeps in and the travel stops being fun and they are just willing themselves to just keep going? The boys team will bear down and take it.....
That madman dentist and his long suffering wife will surely implode soon enough. We all have seen the "intense" guys just collapse into gibbering idiots when the Race cranks it up a notch.
Just a quick trip to Mumbai and a ride on the train should be enough to send the good dentist over the edge. I can't wait to see that and no I have no sympathy for his wife, she picked him so obviously his brand of crazy was exactly what she was shopping for.
I am just glad they haven't allowed it to become a "Jonathon" fiasco. If it devolves into that kind of abuse I will have to stop watching. I still cannot understand why the producers let that little bastard get away with so much. I would have put him on a plane back to the States five seconds after he gave his wife that shove. I would have sent his wife on a cruise to get away from him.
Grabbing for ratings really tarnished the show..I hope they have learned their lesson.


Today I put into action what I have talked about over and over. Communication with family and patients. It was incredibly hard work, uphill all the way but at the end of it good progress was made. Everyone understands a little more.
Trying to explain human physiology to someone with little formal education can be trying but I have discovered that by drawing simple pictures and using familiar examples it can be done.
I have to admit I got hellishly frustrated a few times. When you have to tell someone that there is no "fix" for something they resist it with everything they have. You have to push so hard knowing that with every word you are causing them terrible pain.
How do you say "we can't help anymore" with compassion and patience? How do you do it so that at the end of the conversation they understand all the whys and hows and they come slowly to the same conclusion?
You spend the time, you listen and shut up. You are brutally honest and you give them room to find their own way.
Always the carrot, never the stick.

posted by adventures in disaster @ 10:47 PM 0 comments

Brat

She is sitting in my lap trying to catch my fingers as I type. I picked her out. She was tiny,vocal and ever moving. She wanted out and she wanted to come home with us.
I guess that is why I was so upset that she wandered off.
Was her life so bad? Too much love,good food, a best friend that loved her beyond reason? How could all that be a bad thing?
I am glad she came home, glad she picked us again.


Prison Break is awful. Pure cheeeeeese. I can't watch anymore it has become so goofy. What's next? They get hit with an earthquake? a tornado? and a flood but still our ever plucky half burnt hero will find a way!
Did he have to stay up against that heating pipe? Could he not have moved away maybe a quarter step? More importantly the smell of sizzling flesh is OBVIOUS..drunk guard guy wasn't that drunk..he should have smelt something cooking behind him.
Ahh why do I bother..it's beyond smurfy at this point.

I have to say I loved the Sopranos. The depiction of Tony after extubation sitting in that chair was so completely perfect. That is exactly what people look like. They look destroyed,damaged..filthy and sad. No matter how much you try as a nurse to snazz them up it doesn't work. Coming that close to death and skipping by it leaves a brutal mark. A scar that sometimes only nursing,patients and families see and feel. That person is new...whatever ,whoever they were? That person has been burned out. I wonder who this new Tony will be.
I also loved how Carmela finally got it. She made a choice , informed consent so to speak when she married Tony but those kids never got it.
Those kids now have to make a choice....become a Gotti and protect and defend at all costs no matter what the charges or bail and run away. Forget that they ever had a mother or father.
The kicker is both those kids are now fair game for the FBI. They make one awful mistake and they will be sent on to the same broken bridge Adriana and Pussy fell from .
I wonder how this will change Carmela?


Question to ponder..If you knew you scored on a hand ball do you admit you did? Should you be punished for doing it?
I don't know..I think you always need to finish the play no matter what. You have to wait for the whistle..if you get caught, well so be it. But it's still cheating isn't it? You know it was a handball right? If you were true to the spirit of the game you should stop the play and admit your foul but the pressure, the money...will you lose your position? will you get benched for a week?
Now that football has become so brutally a "business" full of corporations can you take such a gallant stance if it means your team will lose the points?

Tomorrow more acupuncture..last week I got a few days of better pain control. I want to think the acupuncture is working. The nice man who does it is a little skeptical, he thinks I should have had better results much quicker if it is going to work. I tell him I have always been a bit slower about things..maybe I am right.

posted by adventures in disaster @ 10:46 PM 0 comments

weird question

I have a weird habit. I love nail polish.
Not in the usual getting a manicure way. I love getting a certain type of nail polish, Sally Hansens InstaDri. I love it because it dries really quickly so I can pick it off all in one piece. I am a nail picker , I admit it. Is there a group for compulsive nail picking?

I also am addicted to a certain kind of moisturizer SHISHEIDO....oh it is wonderful and damn it is expensive. My stepmother sent it for christmas and now I am lost without it. I have never conditioned my face before, ever..and now I can't stop.

So I pick off expensive nail polish and rub expensive moisturizer on.....

Does anyone else have weird habits? not you know weird weird..but everyday kinda strange?

I bet I am not as weird as I think I may be...I hope.
Now that the wonder cat has staggered home maybe I will slow down on the nail picking. it would help the budget.
So talk to me, let me know your weirdness I promise not to make fun of you.

posted by adventures in disaster @ 11:38 PM 0 comments

she is home,she is home..she is home again

posted by adventures in disaster @ 11:13 PM 0 comments

Education

A realistic guide to being a heart surgery patient:

Learn everything you can about your surgery and the treatments you will receive..GRILL that surgeon until you are absolutely sure you know what the risks are and how much benefit you are going to get. Research the risks....How do you feel about stroke? Is it something you are willing to live with? Can you fit regular dialysis into your schedule?
Now that you are thoroughly educated and are comfortable with all the risks and benefits go to the hospital and tour the unit you will recover in.

Now for the surgery:

First: if you are over eighty years old don't have heart surgery. The chance you will survive the surgery and escape stroke, sternal wound infections, failed ventilator weans is about 5%.
No one lives forever, not even you.

It has become more popular to have heart surgery patients come to hospital the day before their surgery for preop prep. This is a horrible idea that exposes patients to agonizing anxiety and then over treatment with sedation. Patients run the risk of being exposed to all kinds of nasty infections before they even have surgery.
Agree to get to the hospital on time and do your own prep. You will need to do a little strategic shaving..have fun with it.

You will go to preop on arrival and get an IV started and have an assessment by a nurse. Your family can be with you prior to surgery but don't be ridiculous about it. Immediate family only...that means no sons-in-law,cousins-in-law, that guy at the corner store who tells good jokes..
You will go to the OR and be met by the nurses who will help move you to the operating table. It will be really cold in there. The idea is that bacteria loves the heat..so we keep things too cold for the bad bugs . You can and should ask for a warm blanket. The anesthetist will come in and talk to you and fiddle with machines for awhile and check your IV and move your arms onto the arm boards. The arm boards are not weird torture racks, they are there to keep your arms out of the sterile area so if the doc needs to quickly start a new IV he can do it without trashing the whole sterile field.
Soon it will feel like there are way too many people in the room. You will have at least two nurses, a respiratory therapist,OR tech, anesthesia, a couple of junior doctors, the perfusionist who runs the bypass machine and finally your surgeon will probably come and say hello. The anesthetist will then look in your throat and bend your head back to get a look at how easy or hard it will be to get the breathing tube in. Then he will prepare you for getting knocked out. It always starts with IV medication and sometimes that medication can burn a little going in. Once you are knocked out and the doc has placed the breathing tube you will be as we call it "lined up". The docs will place two different IV's : one in your wrist (or groin) in an artery to monitor your blood pressure, the second in your neck or in your chest right below your clavicle. This IV is big to allow for a second catheter to be inserted and floated through your heart to monitor the pressure in your heart and lungs.
Once this is done someone will call in the surgeon and you will be ventilated with general anesthetic, IV pain medication and a drug that completely paralyzes you.
Generally if a doc has residents or fellows they will do the cutting and harvesting of grafts. Once the chest is open the surgeon will perform your surgery.
Once he is done the assistants will close and transport you to the critical care unit.
You will stay ventilated and will not have your anesthesia reversed. You will wake up naturally.
Your nurse will be giving you lots of pain medicine even before you wake up, she will continue to give you pain medicine whether you ask for it or not (well, the good ones will).
As you wake up you will be asked over and over again to do some very basic things..you must be able to squeeze my hand when I ask you to and let go when I ask you to. You must be able to wiggle your toes on command. Generally you have to very calm, very patient despite the fact that you are gagging horribly on a tube down your throat and are unable to speak and most likely you have both your hands tied to the bed.
That image is pretty damn awful isn't it?
Be aware heart surgery isn't for cowards.
Once you prove that you can breath on your own without the ventilator and you can follow commands and have a stable blood pressure and heart function you get the tube out. You are an active participant in tube removal..you need to cough that thing out.

Getting off the ventilator means you aren't bleeding, have a crap blood pressure, stopped peeing ..it means you won the heart surgery lottery.

Things that go wrong:
You can bleed..a lot..so much that you need massive transfusions and a return to the OR. Having your chest re-opened increases your mortality rate by a lot..too much.
So when they tell you to stop taking your aspirin.. DO IT
If you know that the food you eat is great for making the blood thin..don't eat it the night before surgery.
Sometimes you bleed because something came undone, it happens and it sucks.

Stroke...
the older you are the bigger the risk, assume that you have brain artery disease if you have coronary artery disease...you are a walking stroke risk.
Most of the time postbypass stroke is ischemic..a little clot or chunk broke off during surgery.
These chunks are made up of calcified tissue...no "clot buster" is really going to be helpful.
The only treatment we offer for stroke is sit around and watch and hope for the best. We do control blood pressure and all that but we do nothing that could change the outcome..we don't have the tools or the knowledge yet.

Acute Renal failure
because you have heart disease it is likely you have disease to the renal arteries. When you have a low enough blood pressure for a long enough time your kidneys will pack it in. The older you are it is almost guaranteed. Especially if you are a diabetic.
A rough surgery with some bleeding can lead to low blood pressure which will lead to renal failure and land you on dialysis.

Failure to wean
If you are old and have heart disease you probably smoked and now have COPD or what we used to call emphysema. So your breathing is bad. Having heart surgery means someone may collapse a lung or two. It takes hard work and lots of deep breathing and coughing to blow those lungs back up..well you really can't do that so you cannot get off the ventilator. Every time we take away the tube and the machine you lay gasping unable to cough and end up retubed..eventually you will get trached and sent to a nursing home to recover.

A lot of you or your loved ones will lose the heart surgery lottery.

Be reasonable. If some bad things happened recovery is going to take time..STOP asking me when they are going to get better..I haven't got a clue..in fact I haven't got a clue whether they actually will get better, they could drop dead in the next five minutes..so back off already okay?
When I say "it's hour by hour" get with the program..ask "how is she/he doing right now" and I have the answer!
Keep the family craziness to a minimum. Yes, it may be a crisis but I still don't care what your brother or sister did ten years ago to get dropped from the will.

Be reasonable, if your loved one failed so badly they had a really bad stroke, are vented with dialysis and need tons of blood pressure support consider that death isn't an enemy....remember they would have died if we hadn't ripped away that option.

If you made it through you need to be proactive. When your physiotherapist tells you what exercises you need to do DO THEM. We pay them a lot of money..your tax money..try taking advantage of their services. Get out of bed as soon as you can.
If you are family don't just sit there, glassy eyed, watching the clock for the respectable visiting time limit. Offer to help them get up, walk with them, help them bath and brush their hair...act like you love them.
Over and over again families tell me that the most intimate moments they had with their parents was washing their back or their face, applying lipstick when they couldn't..fulfilling important, compassionate, necessary jobs. Touching your loved ones.
Don't sit there and wait for the nurse and bitch about the care..you are family get off your ass and help. Hospitals are not hotels..we don't provide spa experiences. If your mother needs some vaseline for her lips do it or even better get her some really nice chapstick.
Sitting in a grumpy group whining about the care solves nothing.If there is something you can do that will make things better do it without whining.

Get Involved.
Nurses are bad at asking for this because we think it reflects badly on us but we are stealing something important away from sons and daughters. Fifty years ago it was still common for people to die at home cared for till the end by their family. When we steal that experience we leave families bereft, with no special, intimate moments of their own to remember.
On the other side they are ill prepared to help in recovery, they don't know what to do to help when their loved one gets home. If they had been encouraged to help during the hospital stay they would feel confident and empowered on discharge. Instead we get families sending loved ones to rehab centers and nursing homes..they could have gone home with help but we never offered that option.

Even in death we never encourage families to take their loved ones home. We know it is possible, we have specialists in home care trained in the art of palliative care but we don't mention it all.
We should give families more credit, we should assume they want to be involved instead of rebuffing their attempts. A little encouragement, a little education and a family member can become an excellent caregiver.
Why don't we do this?

Because we have institutionalized patients and their families. Scared them with our rules, regulations ,white sheets and wailing alarms, red flashing lights and frazzled nurses.
Ofcourse all they want to do is run away as fast as they can.

Health care needs to change, really change. We need to stop writing, talking and having focus groups..we need to force the implementation of change. We need to force the issue ...we all will feel better when we are all on the same health care team.
Wouldn't you feel better knowing your family was there, hands on, ready to do whatever was within their rights to do? I would.

posted by adventures in disaster @ 9:03 PM 0 comments

when being right is wrong

Sometimes you will have a patient who is violating certain parameters or well "being sick" and you have a choice of treatment. You can feel in your bones that your choice of treatment is absolutely right, all prior experience says "this is the right call" and you can end up being horribly wrong.
I hate it when patients do this. I blame them entirely for being so contrary , so stubborn to respond to a well known obvious treatment by promptly trying to die.
A lot of time there is no good reason for their response but other times you find out that the information you were basing your decision on was faulty.
A surgeon or a doctor made an assessment that was wrong. They didn't bother to take the next investigational step or they misinterpreted what they were seeing.
If you start with the wrong information you will ofcourse continue to make wrong choices...and that sucks.

Being a nurse I can only suggest a course of treatment. I cannot order anything and in all honesty I cannot stop a doctor from making a wrong choice. I can refuse to carry out an order if I think it is harmful but I cannot stop the doctor from doing it himself.
Weird imagery of wrestling a doc to the ground right now.
It's weird to have so much responsibility for the outcome but absolutely no power over the treaments.
I used to fight against this, rail against the limitations of my profession. I was endlessly pissed at bad decisions. Now I realize I can only do what my profession allows me to do. I have to find contentment in doing my job and stop worrying about how others do theirs. Even when they screw up so badly I want to scream and quite possibly whack them over the head and wear them as a coat but we'll get to that later.

I wanted to write today about how dumb patients have become. Despite all the talk and hype patients still don't bother to find out anything, They never bother to ask any questions. They read their little pamphlet or watch the five minute video and their only concern is "will it hurt?"
A hysterically dumb question..ofcourse it's going to hurt..it's surgery...
They never ask how long will I be ventilated? What does ventilated mean? What is a chest tube? Can I see one? What are all these IV's? What do they do? How am I going to pee? Why can't I get out of bed to use the bathroom two hours after surgery when I am ventilated?
Why can't I get morphine every five minutes until I am unconscious for the entire duration of my hospital stay?
Why do I have to cough? Why do I have to get up, feed myself, bath myself when I am on the ward..isn't that the purpose of the nurse? Why can't someone else be responsible for my recovery? Why can''t they do everything for me and let me lay motionless in the bed for a week?

If you knew that moving made you feel better, that coughing prevented pneumonia and independence is the evidence we look for to allow for discharge you would feel better and stop thinking we were trying to torture you. If you knew what all the wires and tubes did it would be less scary and you would feel more confident, hell maybe you would recover faster.
Patients want to stick their heads in the sand so they can have the option of saying "no one ever told me, it's all your fault this happened". We can only offer up so much education..patients need to join in and become a part of the equation.
And stop lying to us..if you didn't quit smoking don't write down you quit. There is nothing worse than trying to figure out why someone is all over the bed, irritable and antsy only to find out they lied and now are in nicotine withdrawal.
If we had known we could have slapped a patch on you and skipped the freak out.


At work I am compulsively neat, everything must be at hand, organized and tidy. At home I am a slob. I cannot reconcile the two me's. I just know I cannot even start working if my bedside is disorganized. I see some nurses who are slobs and it irritates me. I worry that something will happen, like it did a little while back and I wont be able to find a damn thing. I was frantic and furious and thought about it later. I am a control freak...that's my thing, not theirs.




I am ashamed of my country for whacking baby seals over the head for their furcoats. What kind of asshole would wear a baby seal coat? Do you wake up in the morning and say to yourself "oooh dead baby seal..must wear the dead baby"?
I think if we all made a pact to whack anyone wearing baby seal over the head the hunt would stop. I think if all day complete strangers came up to you and whacked you really hard it would change the way you thought about how you dress.
It wouldn't hurt if some brain trust thought maybe we could make more money dragging tourists out on to the ice to see baby seals than whacking baby seals. It worked with the whales , so why not give it a go?

What kind of world is it when we are murdering babies?
I don't care if you and your children starve , whacking baby anythings over the head to make a living is EVIL. In fact I hope you and your whole family do starve..We don't need you in the world.....what the hell is wrong with you? Why not get a real job? How about getting a highschool diploma? You could be the first one in your family to do it.
Canada sucks and so does the Prime Minister for allowing this to go on.
The only bright spot is the ice is very thin, let's all hope the evil ,stupid bastards fall in and get eaten by pissed off baby seal mothers.

posted by adventures in disaster @ 7:40 PM 0 comments

Polar bears

So, I was over at Sludgie.com today a relatively new environmental blog that stee had recommended and read that of all things George Bush is considering making polar bears a threatened species.
So, according to George and his new best boy friend Micheal Crichton global warming doesn't exist so what is up with them goofy polar bears? Maybe it's depression, depression about carrying around toxic pesticides in it's fat from eating fish and seals.
It couldn't be the fact that the ice is taking longer and longer to freeze and they end up in the penitentiary at Churchill for months right?
Health care workers can't decide whether to get the Inuit to stop breast feeding because their breast milk is filled with mercury , pesticides and toxic fertilizers..cool right?
The oceans are dead or dying, fish stocks have disappeared but two people I know just bought SUV's.
An oil based economy is suicide, Brazil for hells sake knows this..they run on ethanol from sugar cane. Soon they will be the only damn country in the world completely independent from the oil based economy.
So when we are back in the stone age after the oil runs out or it becomes so expensive only Hollywood actors can buy it Brazil will be ticking along laughing it's ass off at us.

Personally there is some part of me that cannot wait for the day the earth kicks us really hard in the ass..not Katrina that was just a tiny warning, not the tsunami, that was tiny too..a really good global asskicking and then we will wake up.

Check out Sludgie..get some facts and start making some reasonable choices before you have to ride your bike.



Oh, today at work..there are no words to describe some patients..sometimes you just have to stop and tell them that you are not their slave and be done with it. I want to stay coldly professional, above the fray but some patients wont let you. They pick,gripe, moan, twist,wiggle and make you NUTS and then their family comes in and suddenly it all makes sense. They are all nuts and no matter how accommadating you are it will not matter. They cannot be satisfied, they have never been satisfied and you, in your puny nurse role are planted on this earth only to serve their every whim.......I wanted to run, screaming from the bedside about a hundred times today.
I was on such a geat run with such great patients..damn them for ruining the streak.

American Idol sucks..all the singers are awful...how did they get passed through? How is that twitchy, blinky guy still in the competition? I am totally with Simon and if Paula says one more time how wonderful someone looks I will find her and make her sleep with that creepy Corey guy again. Who the hell cares how they look you idiot? Half the most famous singers in the world are pretty damn strange looking but they can sing a little bit..not like these tone deaf talentless hacks.
That old guy with the gray hair does karaoke every week and paula pees her pants. it's gross.
This is worse than Star Search. Really, do they believe that the next American Idol is going to sing Barry Manilow covers? Or how about trashing Stevie Wonder? Anyone out there going to cough up twenty bucks to listen to this bunch ?

posted by adventures in disaster @ 11:21 PM 0 comments

Happy and sad

I loved my patient last night. Loved him..He was everything a good patient is. Co-operative, funny and involved in his own care. He suffered a hell of a scare but handled it with grace and understanding and accepted it as a "shit happens' moment. His family was equally understanding after a good long honest explanation. Telling the truth about complications makes your relationship with everyone so much easier. Trust is everything in my interaction with my patients. I do some pretty painful interventions, they have to trust in me that I do what I do for a reason and that I am doing it for their benefit.

My friend has crashed into burnout. I didn't see it coming but recognized it immediately in his eyes. Burnout is hard to describe for someone who doesn't do the work we do. It is an anxiety, an exhaustion and a worsening feeling that no matter what you do it makes no difference and that no one cares or appreciates your effort. It is a crashing feeling of helplessness and depression.
There is only one cure for it and that is take a vacation and quit your job for something else. You have to do something else for awhile or you will never be able to return.
I have always been on the look out for burnout. We are regularly subjected to caring for the dead and the dying. We are forced to do things that violate all the rules of our compassion, we violate our own ethics because families don't share our beliefs.
When your ethics and morals are written in stone violating them can destroy your soul. I have avoided that by having an open mind, I cling to no religion, no rigid set of rules that would crush me with their weight if I was forced to ignore them.
Nursing is as much about the nurse as it is about the patient. We must remove ourselves from the equation and it is almost impossible. My friend has a rigid view of the world that cannot bend, he still fights against the impossible, still expecting a respect that will never materialize. He so wanted to see change and couldn't understand that moving a monolith is impossible and the monolith will only crush you.
I hope he will go off and re-evaluate, find something that wont challenge his own beliefs so much. I want him to be happy and find why he became a nurse once again before it is too late.

Nursing has become something so different now. Old people used to die, they don't anymore. We keep them going and going, vented with dialysis and drugs and more drugs. We operate on people twenty years ago we would have sent home to die.
I live in terror of the baby boomers getting ill..they believe they will live forever, no matter what. They are willing to do anything to keep going and it will be our responsibility to fulfill their fantasies of perfect health with little effort. They have no idea what we can do and I think they should be horrified.
The future looks bad and I am planning to get out of nursing before they start arriving in waves..all baffled that their bodies have failed .

I wish that every person that comes into the hospital would be forced to declare exactly what their plan for a good death was. They would have to produce a valid living will with a good substitute decision maker ready to do what needed to be done. Only then would they be allowed to be treated. The joy of actually knowing what the patient wanted when it all went to hell would save a thousand cases of burnout.
I wish the public would clue in to what their indecision, their lack of planning is doing to nurses and doctors and their own families. Everybody dies, make a plan already.


In other news , George Bush is an idiot. If the ex prime minister of Iraq says it's a civil war..it's a civil war. How long can he and Cheney keep up the bs? I think Iraq could be in Flames from one end to the other and these two fools would be oh it's fine, it's just a bump in the road..lalalala..look over there at the pretty flowers. I have an awful feeling there wont be anyone left alive to govern if things keep going this way..fifty to sixty people dead a day in Baghdad..Who knows how many dead everywhere else?



I am really surprised at how Chelsea seems to be falling apart at the seams lately. I don't understand it. It seems a failure of confidence and concentration. Maybe not taking their opponents seriously enough. I don't think it's going to change the end result but it's strange. I don't think it's a coaching failure.
I cannot watch Sunderland anymore. It's just awful, the result is obvious . I feel like they should just concede the damn games and save everyone the trouble. What is infuriating is they don't get beat badly. They aren't so awful they get thumped, they lose 1-0 all the time. It's just that they always lose.
Manchester seems shambly too. I don't like Sir Alex, I think he is a vindictive jerk always bullying. He can't or wont just leave a successful line alone. He is always punishing someone and that disrupts the lines and screws the flow of the players. Just leave things alone already. When you are making a last desperate surge it's not the time to start playing around with your defense, or worse embarrassing your strikers. I don't care what Ruud said that hurt the little despots feelings let him play, that is what he is being paid to do.

I love the dark imagery of the Sopranos. It is going to be a really good year. I can't say the same about Prison Break. Nice copout..it's called prison break....lets get the break out already with all the characters not just the main ones. A real failure of imagination going on there.

posted by adventures in disaster @ 10:42 PM 0 comments

going shopping and love

I hate shopping for groceries. First I don't cook so hunting for interesting and exotic food is not me. I buy things that go in the oven for thirty minutes and then I tear off the plastic put whatever it is on a plate and announce that dinner is ready. The problem is all the food is the same. I am bored, bored,bored of noodles and vegetables and three small whitish lumps masquerading as chicken..blech.
I can make mashed potatoes..I add a ton of butter and mayo..fat is good for brain function..I wouldn't lie to you, I am a nurse! heh..tastes really good too.
I don't like meat. I am not a PETA extremist though..I just don't like the texture or the taste.
I can't digest red meat and for years I defaulted to chicken because I was raised by immigrants that felt a meal wasn't a meal without a piece of meat. Only really poor people ate vegetables and they were sickly and died early, sad deaths according to my grandmother. Maybe vegetarianism is a reaction to being raised by people who lived in terror of what the neighbours thought.
I never understood that myself but I knew my mother and father both came from very small villages in disparate parts of the United Kingdom surrounded by family that new every damn thing you did all the time.
I guess it did make them constantly vigilant for any sign that they were making a bad impression.
I was raised poor, really poor..the salvation army clothing kind of poor but you would never have known it. My mother went as often as she could, scouring the racks for clothes with "good" labels. She could never keep her mouth shut though. She would tell us as soon as we got home from school what incredible deals she had scored.
Over at Dooce she talks candidly about her post partum depression and her panic. My mother suffered her whole life with depression and panic. Back in the dark ages before effective drugs they did "therapy"....It was useless. You cannot talk the body out of being sick. It would be like telling the cancer victim that she could talk the cancer away. So our childhood was a miserable , terrifying experience. Living with the mentally ill every day is exhausting, maddening and sad.
Part of me can never forgive her for not giving us to my father to raise.
She held such bitterness and rage against him she couldn't see what would have been best. She had a right to be bitter, he was, as Hillary once said of Bill " a hard man to keep on the porch".
He was a good father though and he would have been the sane choice but there is the rub, she was insane and couldn't make sane choices.
My step father stayed with her for many, many years and I hold great admiration for him. He finally left when all of us kids moved out. He felt a real obligation to try to create a home for us, he was an invisible man though. He worked hard and paid our bills and drove my mother to the hospital when she would start screaming and couldn't stop.
When he finally left my mother he disappeared completely. He ignored all contact and I understood completely, He had done his duty to a woman he had loved only for a moment and children he fell in love with forever...he got us through safely and now he wanted a chance to get back to his own life.
It is strange how people fall in and out of your life. I found an old girlfriend recently and to my surprise I still liked her. She was as funny , smart and sarcastic as she was twenty years ago.
She had changed in some small ways, hardened a little about love and commitment. I had wished that she would have met someone to love her as she is lovable but her luck has been bad.
I don't understand much about bad relationships, the kind that hurt you so badly that you are changed in some fundamental way. I got lucky and stayed lucky. I picked someone I liked , I liked the tone of his voice, the way he moved..I knew I would be making a choice for forever.
Maybe if people stopped for a moment and thought "can I stand to listen to that voice for fifty years?" they would reconsider their bad choices.
I don't believe that true love blinds you, lust blinds you..so when you are blinded to egregious faults know this is not love..If I loved this person I would see them wholly..all their faults fully visible. Choice would be possible..lust makes you an idiot.
I remember lust and cringe. It's a good thing memory fades with time.




After hearing about the "pirates" off the coast of Somalia firing on a US naval warship today all I can say is what were you smoking guys? Did you really think you could take on the US Navy?
I can only imagine the reaction on that warship..they were probably laughing so hard they could barely blow the damn pirates up.
I remember when we all cared about Somalia until they showed us they couldn't care less and we had to agree. Sad for the population but you cannot force people to behave, a lesson George Bush the dumber never really understood. Now we have a civil war in Iraq and Iran gleeful. George Bush took a stable country and blew it up so he could play Caesar, Emperor of the known world...What a mess and no way out. Vietnam was a cakewalk compared to this disaster.

You cannot force people to behave. You can only show them a safe way of life and hope they choose that path. You show them the carrot and forget the stick..the stick makes them hate you and forget about the carrot. Why is this so hard?

If George keeps on his path he will force Iran to react and he wont have enough troops to keep Iraq under control while beating up Iran and what about Afghanistan? My country is now trying to stabilize a country that has a government financed solely though drug money and welfare checks from other countries. Afghanistan is Germany after the first world war..destitute and desperate and we aren't paying attention to what is happening. Why is the Taliban still supported there? Why is the country still covered in poppy flowers? Because the people want it that way and you cannot force people to change.
There are danger signs everywhere but we are looking at Iraq and not paying attention to where the real trouble is brewing. Hamas, Taliban....the Saudi's..we have no idea what is happening and we are too stupid to believe that the Saudis are behind the whole thing..The Saudis created the Taliban, the Taliban created AlQueda...none of this has anything to do with Sunnis and Shiites does it? But where is our attention? Diversion everywhere so the Americans don't pay attention to Pakistan and Afghanistan where the real threat lies.
The world has become a really scary place and I wish George Bush was closer to the end of his term and the possibility of a new president was closer so we could begin to start stabilizing the world and start mending hurt feelings and get everyone back on the same side.
I want people to start caring about this planet and it's resources and the creatures including us that live here. We need to stop shooting at each other already.......We have solved NOTHING with this never ending violence, retribution and vengeance.
We haven't evolved at all..still cavemen beating each over the head with rocks.

posted by adventures in disaster @ 9:50 PM 0 comments

weirdness

I had a really bad itchy heels for the last few days and because I am human last I checked I scratched..and scratched some more. My heels now look like I have been walking over ground glass. They thankfully aren't painful, just hideous and still itchy.
I don't like the look or feel of feet. Especially old guy feet with those scary long, sharp toenails.
I have had so many patients with awful feet and I know this is a recurring theme but please enough of the cracked fungus feet.
We had an incredible run of all patients all the time diarrhea this last week. I am amazed the patients didn't disappear into prune shapes from loss of essential fluids. The smell was just overwhelming. Every time a visitor walked in you could see them flinch and then grimace in shared shame and sympathy. I think there can be nothing more destructive to your dignity than to have lost control of your bowels not once but over and over again.
I understand the patients humiliation but damn the sheer workload involved in cleaning up all this is astronomical, Backs were just breaking at the end of the day. It sucks and sucked. We blame the nutritionists who can never seem to get the tube feeds right. Either too constipated or sheer flowing liquid. The docs don't care and refuse to prescribe anything to make it stop. We end the day exhausted and furious with everyone and stinking.
All you want to do is get home and scrub but the smell wont leave the nose and the thought of having to wake up and go do it all over again makes me ill.
Please stop pooping nice people we are tired and we are sure you have pooped enough for all of us.
Here is another conundrum: why do the elderly become bowel obsessed? I have had patients literally in tears over not having a bowel movement for a day. They refused to explain or be reasoned with. No one must have a bm every day, you will not drop dead if you skip a day and no one should be taking laxatives compulsively in fear that it might not happen for them today.

I had a bizarre twelve hours of english as a second language with the most absurdly cheerful guy I have ever met. He babbled away as if we were having a grand conversation..I didn't bother to ruin his delusion I just played along nodding away hopefully in the right places.
It was a lot of fun really. He was so happy and really didn't seem to care at all if he was being understood. Maybe it was the pain medications. His not mine ofcourse.
Nursing can be so strange.

posted by adventures in disaster @ 8:32 PM 0 comments

Opportunities

I am a sometime fan of the Amazing race but lately I am getting more and more and disgusted by the competitors. I get that it is a race, a competition and a reality show but it is also a chance of a lifetime to see the world and experience their cultures.
I listen to them whine and I want to reach into my TV and whack them really,really hard.
I hate the old decrepit couples who can't stop expecting failure at every turn. They are always throwing in the damn towel at any sight of hardship. The minute they get behind it's an uncomfortable litany of unfairness, they never accept that they made simple mistakes that can be fixed. Their hopelessness and passive aggressive helplessness makes my teeth hurt. Why would you go through the entire audition process blind to the fact that you are going to be stressed, uncomfortable and always out of your element?
Why does it always come as such a damn surprise to these old folks? Did they think there was a special geriatric version?


I was irritated and irritable today.I am amazed at the abilities some people have to avoid work. I have seen people create tiny crawl spaces for themselves, hidden deep behind hospital supplies. You have to carve out a little time to create and send out a search party for them, calling their name while they giggle , hidden in their little cave safe from doing any work. Their greatest achievement is the constantly expanding break. Breaks that used to last fifteen minutes are now an hour, hour breaks are two and a half. They need coffee and lunch and a damn good nap to get through the morning. Then there is an afternoon nap and supper! This doesn't include "hiding" time that could be a few hours too!
I wish it wasn't too late to apply.
Imagine if they used that ingenuity for work..They would have found the cure for cancer by now.
I am all for getting your breaks, hell I'm usually the first one out the door but damn I don't have the guts to skip any work entirely for an eight hour nap. I don't care that they duck work, what I care about is when they are ducking out they are creating more work for me and I don't have any time left to schedule in any more work.If it doesn't affect anyone else I am all for taking a nap but if you are screwing five other people expect them to be really pissed and less than friendly. It's just common sense.

Ever have someone ask you for advice and all you can think is "damn if you are that dumb you deserve everything you get?" But you can't actually say that so you make up some tired bullshit last heard from Dear Abby? Then you are kind of embarrassed you actually said "if you love something let it free and if it comes back to you it was meant to be". I mean who the hell actually says that to people and means it? I said it but I didn't mean it. I just wanted to be able to escape the conversation without laughing and pointing. People can be so blind it's funny.
"He won't let you meet his friends or his family" gosh do you think this relationship will last?
Hell no it won't but you can't say that can you? It would be rude and cruel. I want to . I want to start telling people the brutal truth all the time. Maybe it is a sign of mental illness..Who knows.
Maybe just a sign of sleep deprivation. Or maybe people should just shutup around me but I am one of those people. Everybody knows us, strange people stop us on the street and reveal their life story, everyone comes to us "just to talk". We attract the bizarre, the insane and the brutally unlucky in love. We would like to report to the world that just because we have an open, sympathetic face doesn't actually mean we are actually all that sympathetic. Stop talking to us, you are freaking us out.

Acupuncture was a walk in the park. Absolutely painless. I have no idea if it has done anything but I am happy to report it is the first time I have tried something that didn't have sickening or painful side effects. I hope it helps. I have opened my mind to any possible treatment. Anything is better than doing nothing. I think if I can retain a sense of motion in my treatment, a positivity, I can tolerate the situation better. Stagnation is what terrifies, being stuck with no way out. Sciatica is ridicuously resistant to treatment.
Who knows, next week biofeedback and Kabbalah..I can get some red thread around here somewhere I am sure of it.

posted by adventures in disaster @ 8:48 PM 0 comments

Oh how I love thee

The Sopranos that is. Junior! We never suspected for a moment.
I loved the premiere. It reminded me that it wasn't about glamour, it is a brutal soul destroying way of life. Introducing a brand new character as if we had known him all along was genius and honestly we did know him. He was Tony if Tony had not become boss, he was Tony before we met him. I also think he represented what Tony ultimately wants, to escape the life.
I understood why he took his own life. He was trapped by his own actions, his needs. He could not betray Tony without betraying himself, he had nowhere to go. The feds will give him the chair or Tony will put a bullet in his head. He made his own way out.

Long day of doing nothing, waiting for my patient. It's weird to have to wait, wondering if the surgery was a success, will they be easy or difficult to care for? I guess it's a little like family in the waiting room without the personal,emotional connection.

We were talking seriously today about leadership. A lack of leadership sours an entire organization. A good leader is smart, educated about what they are managing. They have real experience so they can understand the needs of the people and the area they manage.
A good leader can make decisions, easy ones and really painful ones. Good managers support their staff always.They are always on their teams side, presenting a united strong front.
Bad managers haven't got a clue about their employees and have never done the job they are supervising. They are indecisive , constantly trying to please everyone.Always trying to avoid conflict so everyone will like them. Bad managers are not interested in education, they do their best to avoid creating time for new learning experiences. They are obsessed with the schedule and track sick time fanatically.Always thinking someone is trying to beat the system, always cynical.
I hate a bad manager. Even when they are good, kind people bad leaders suck the energy from the entire team.
I have been ridiculously lucky in my career. I have had brilliant managers, full of excitement and energy. They are thrilled with any success, small or huge.
I have had strong decisive managers.
I have only had one bad experience long ago when I was quite ill and struggling. It was a very sad experience that reminded me managers are not my friend. They are my employer.
It has changed how I interact with my manager now. I am impressed and feel supported and appreciated and even better understood but still: my manager right?
I had a friend who had a hilarious manager who honestly could not remember the line between employer/employee. He would tell everything to anyone anytime. My friend couldn't wait to call and tell me about the latest wild ride of her boss. He was unhappily married , with a scary girlfriend and a bad drug habit. He would talk about his sad sex life asking everyone for advice.
Despite everyone telling him that his girlfriend was a nightmare he divorced his wife and married her. Shortly after the honeymoon he started coming in with black eyes...No one wanted to be the one to ask what was going on..ofcourse they didn't have to..He couldn't wait to tell all.
He insanely found himself a new girlfriend and his brand new second wife found out and had taken to beating him up.
What do you say to a guy who can't keep it in his pants two weeks after his honeymoon? When he is your boss? She quit . I thought it was the only move she had..Who knows what the insane wife would have done next? She heard through the expert hospital grapevine that he had to call the cops in the middle of the night because she gave him the beating of his life. He moved out and became a medical missionary in South America or the alternate story was he went into a psych hospital for six months...Who knows?
That is my idea of a really bad boss.


I am struggling again with my medications and tomorrow I finally get to try acupuncture. I hope the reader that wanted to know about it will drop by tomorrow night when I tell all.
I also want anyone who has questions about drugs and procedures to feel free to ask. I always think arming yourself with some ideas can be helpful. It is only my experience though, many people have different experiences. I can only talk about what I went through and direct you to others who have gone through the same . Chronic pain is different for everyone. In my "real" life I know three people who have gone through completely different procedures but we can still share our feelings about life and the struggle to work everyday despite our deficits. I do want this blog to be a two way conversation if people have an interest.
Right now I am struggling to find words. A side effect I think of some of my drugs. It is irritating and embarrassing. I have the word in my head I just can't spit it out. It's not quite a stutter really, just a long pause. Everyone is getting used to it and are allowing me that moment instead of playing the word game.
Everyone has experienced the word game:
"Is it a car?"
"no"
Is it a house?"
"no"
"a dog?"
"NO, give me a second okay?"
"oh"
"driveway"
"driveway?"
"yeah"
"um," what were we talking about again?"
"I can't remember"

sigh....
Better to just allow for the pause right?
It is amazing that they put up with me, bad back, can't talk..Thank goodness my brain is still valuable. The minute I start forgetting the nursing stuff I am doomed.

I am listening to the news right now. I think it would be incredibly hard to give up a body part..Maybe for my kid or my siblings but I don't think for anyone else. They are talking about how both people will then be unable to work..So no job, no money..Social assistance,.
You can go broke and become homeless...Wow.
I then thought about that jerk who promised his kid a kidney and the judge let him out of prison to take the tests and he bolted. He offered his kid the kidney as a con..It is so low an act it can hardly be described. I wonder what the other prisoners will be thinking when they finally catch him and lock him up?
My hope for that guy is he needs a kidney. No punishment is worse than never ending dialysis while your body slowly deteriorates around you. He can know intimately how his child suffered because of him.
I am good at retribution. I used to spend a lot of time thinking about it before I got tired and stopped caring.



I have a secret, I hate Wolf Blitzer. I think he has mumble mouth (right I am one to talk). He sounds all full of saliva and sloppy tongue. Not that I ever think of Wolf that way but still..All that "you're in the thitsuAtation room" and he can't help repeating his own last three words, like a tic of some kind. I just don't like him and I do remember that time when he got lost in Iraq so his credibility isn't there. What gets me is how he reacts when that old "curmudgeon" Jack Cafferty blurts out something completely outrageous, he is stone faced. That is when I get that he isn't listening to a word anyone else is saying. He is just waiting for his cue to say "this is the thitsuAtion room. Weird right? Jack is another story. He is hilarious because he knows no one is listening. Everyone is talking over each other desperate to get their three minutes of camera time and Jack couldn't care less...So he makes me laugh.
I can't watch the other guy..Mr Immigration..As if immigration is a brand new concept just thought up by radical communists. Interesting side note: with an increase in immigration studies have shown the crime rate dramatically drops. Immigrants that move into small neighborhoods with a collective sense of community create a social conscious that prevents crime. Why doesn't anyone talk about that?

posted by adventures in disaster @ 8:29 PM 0 comments

thoughts: random, disorganized

When I was in training we had to experience different areas of medicine. We would be thrust into the hospital for six week rotations. The standard was geriatrics first, then medicine,surgery,labour,delivery and postnatal care, pediatrics and psychiatry.

I hated psychiatry. Because I was raised by a woman who was seriously mentally ill I hated to be exposed to these people. I had no sympathy,no patience except for those suffering with schizophrenia. To me at that time schizophrenia was the only true mental illness. It had science behind it. Eventually I added bipolar because it reacted so dramatically and positively to medication.
As I got older and reconciled my own feelings about my mother I allowed myself to understand that depression is in fact a real disease. It is not something chosen, it is not a bratty selfish thing like I thought when I was thirteen and feeling lost in puberty.
I had my own transient twenty four hour run in with drug induced depression and my relief, my joy when that black cloud finally lifted truly opened my eyes.
Looking back I missed an important learning experience because I refused to let go of being absolutely pissed at my crazy mother.

My pediatric rotation was heartbreaking, confirming for me that I could never be rational when caring for a sick child..that option was out.
I loved labour and delivery. I loved being a part of such a momentous thing, being a hand to hold, a voice that guided a mother through labour. I couldn't do it for a living though. The threat of a lawsuit for my entire life was too great a burden for my family to endure. Any mother can sue you up to the eighteenth birthday of the child you helped deliver. Some nurses got sued because some kid didn't get into the college of their choice. The mother said she was sure the nurses had done something to make their kid dumb..the dumbness seemed to appear only at college application time and only for Ivy League..the kid got a place at the state college. They settled out of court.I can't live with that over my head.


I was on a medical floor caring for a very kind gentleman who had fainted at home. In his embarrassment he refused to tell his children what was wrong so they called an ambulance. When he arrived he told the doctor he had been bleeding quite profusely from the rectum for weeks.. He explained that he had always had trouble with hemorrhoids so he thought it would just go away on it's own like it had so many times before. I came in that morning, got report and went into see this man. He seemed very sad and humiliated. I asked him what was wrong and he began to cry and said he thought he had soiled himself and that he was very,very sorry.
I held his hand and told him he had nothing to be sorry for , that he was sick and weak and that thesethings happen and that is why I was there to care for him.
I got some clean linen and a basin and asked him to turn over...I couldn't breath when I saw the blood. It was everywhere, thick and red. I quickly washed him and placed new linens. . All I wanted to do was run from the room screaming but something steely inside held me back. I had a job I promised I would do. I did it.
I walked out of that room and straight to the nurse in charge and told her I believed that he was bleeding out through his rectum.
The first time you see a staff gear up for an emergency is awesome. Monitors come sliding in and are hooked up, blood bank is called and runners make mad dashes to the lab and for blood. I got my chance to insert a nasogastric tube. A tube that enters through the nose and is fed carefully down the throat into the stomach and then hooked to suction. Blood came flashing through the tube. This poor man was assaulted by technicians, nurses and surgeons and I never left his side. I cleaned him over and over as he continued to bleed faster than we could pump it back in. Finally the operating room called and said they were ready. I went with him into the OR and held his hand as he drifted under the anesthesia. I watched as the surgeon removed a massive amount of colon but happily said it doesn't look like cancer. I waited with everyone else for the labs decision and we all cheered when it came back no cancer.
I went to the intensive care unit with my patient.
I was so completely overwhelmed. All the IV's , the pumps, monitors and ventilators.
I ended my day knowing that I thrived on crisis. The ICU was my home.
I spent more time with that man who taught me what my vocation was. I was as happy as he was the day of his discharge I think. To see someone at the brink of death pulled back by sheer teamwork, that awesome engine at work.
A six week rotation seems very short in theory but in practice it is more than enough time to teach you what you will love and what you will never,ever want to do.



I had a good laugh reading the New York Times today:
Hospitals short on Ventilators if Bird Flu hits by Donald G McNeil Jr.

Gosh didn't I just write about that a few weeks ago?
There is no way we will have enough ventilators for a quarter of the patients. We don't have enough vents for the patients we already have. I agree with using CPAP and temporary vents. They are cheap and do the job. I really wish the media could stop the panic crap. How about figuring out ways to be ready for when the shit hits instead of whining about what we don't have?
I wish we had more ways to force action instead of so much talking and meeting and holding hearings and blah blah.

We were bored at work the other day and we were talking about how the media and the public hold two completely contrary views of nurses. In movies and television we are usually whores. We sleep with every doctor in the hospital happily passing on gonorrhea or worse mental angst and inability to commit. Please, if Goran wants to marry you and have little Goran babies you would have to be a nutcase to refuse. Then the next exnurse/new doc walks up to bat and gets knocked up. Movies always describe the nurse as hot and visitors ask patients if the nurse" gave them a bath yet" and did they get off. It's bizarre because in the next breath nurses are described as saints full of endless care and compassion. We are given shiny halos.
We were laughing because some of the descriptions are true. Just like in any profession we have nurses who have sex with doctors..lot's of obvious, irritating sex and we have nurses that would not be amiss in a nuns outfit.
The other irritation is nurses all want to be doctors. No we don't. Most nurses love the fact that when their shift is done they can go home. No one calls you at home at three am either. Nurses love the fact that they get to have a real relationship with their patient. Doctors have so many patients it's a wonder they can remember any of them.

Nurses are just like the rest of the world..kinda slutty sometimes, kinda saintly other times.

There is a weird thing that happens in hospitals sometimes that I have never quite figured out how to deal with. Sometimes you will walk in and a patient will be masturbating or their wife or girlfriend will be offering" aid". I understand that people don't lose their sexuality just because they become patients but part of me always says "holy shit" and I am embarrassed. I become all weirdly conservative and pissy. I wish I could just stop being so priggish and leave them be instead of going all nurse and behaving like my patient is being assaulted by a stranger. When they are masturbating alone I feel creeped out.. I know they are as embarrassed as I am but I feel judgmental like Dear Abby " all there is a time and a place for that" but what better time and place? You feel sick, you have pain wouldn't an orgasm be a good thing? Endorphins release and you feel happier painfree..maybe we should encourage masturbation..give a prescription....

Why are we such prudes about the whole thing?

As nurses we have seen a million penises, peni? vaginas, we understand all about sex and needs and how beneficial a healthy sexual relationship can be..I need to stop being so weird and think about how happy it makes my patients and happy patients are easy to care for..that makes my job easier..right?

posted by adventures in disaster @ 4:19 PM 0 comments