Monday, March 20, 2006

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'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'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.


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