So, the first miracle, is that I am going to attempt to rejoin the blogging world after a long absense. The second would be that I finally remembered how to sign back in to my own blog in order to repost. I guess it's been awhile.
There are nights in all of our lives I suppose, where we need the reminder to look up and see the miracles that happen all around us on a daily basis. This might be one of those nights for me. Accompanying the weight of adulthood responsibilities are the heaviness of big decisions and loss and change that are certainly innevitable, and necessary. And, occasionally the exhaustion of weekly jet lag catches up and I sit here in the quiet moments, kept awake only by incessant alarms that never seem to quit in a setting such as this. :) Still, even through the exhaustion it is possible to look up and see the miracles. So tonight that is precisely what I want to write about.
Miracles can be found in so many different areas of life, and on so many levels. One of the reasons I am willing to come to work at every hour of the day or night is because of those miracle moments that bring color and perspective to life, and make me grateful to be alive. Most miracles are ones that I witness. Sometimes the miracle is only found in how it affects me. One night shortly after I graduated from nursing school and was heading into work for one of my first night shifts, I remember feeling overwhelmed and frightened. (Alright, so that was actually most nights at first :)) I will never forget how I kept looking down at my nametag, just to reassure myself that it did, in fact, say "RN" on it... something that was supposed to convince me of my own competence. I had been praying for strength and courage, and peace. The ICU is a frightening place for a brand new nurse. I had read the words of a priesthood blessing I had recieved years before shortly before leaving for work that night. One of the lines in the blessing said something to the effect that there would be angels around me to strengthen me in my times of need. I remember thinking of those words specifically as I prayed for the competence I needed to perform well in such a high pressure position. That night I took care of a woman who was very sick. As I cared for her the best that I could, she seemed discouraged and worn out. I don't remember anything of our conversation, only that in my best attempts to show compassion, as I turned out the lights to leave her to sleep, for what I later learned was her last night on earth, she smiled at me, took my hand in hers and said to me, "God bless you. There are angels all around you." I will never forget that. Maybe those were her dilusions, or maybe that was a phrase she used on everyone. In fact, when I came back the next night and learned that she had passed away that day, the nurse giving me report mentioned that she had said the same phrase to her. I don't think she necessarily literally saw angels. It doesn't matter whether she did or not. It was a gift from God to me to strengthen me when I needed it most. Coincidental, maybe. But it was a miracle for me.
For the last two months I have spent a large majority of my shifts caring for a woman in her early 50s who has been critically ill for several months now. Her illness had disabled her to the point where she had been unable to move anything but her facial features. Her picture was grim and yet her family remained hopeful. After two months of struggling and fighting, one night two weeks ago I went in to help her with her physical therapy, such as it was. We were in the habit of sitting her by the side of her bed, nearly fully supporting her weight, but hoping that balance and strength would eventually begin to develop, so far with little success. On this night, two weeks ago, I crouched at her side, with her husband sitting beside her and my charge nurse behind her holding her weight. As I held her hand, suddenly I thought to ask her if she could wiggle her fingers. The task that seems so simple to you or I was something that we wondered if she would ever be able to do again. To my amazement, I first saw one finger twitch, and then, there it was. Unmistakeably she was moving her fingers, something we had seen no signs of for the past two months she had been with us. Before I could catch myself, I literally cried out to her husband, "Did you see that?!?" Optomistic and cheerful as he always was, this time his face was sober. He just stared at her, and then at me, shook his head gratefully, and said, "This is a night of miracles at LDS hospital." My eyes filled with tears. This time, he was the one that reminded me of the source. There was no questioning the odds had been beaten, and a miracle had occured. Suddenly I remembered why I do what I do.
These are the moments that strengthen us I beleive... even at 1 am. And now it is only 6 1/2 hours! Thanks for keeping me company tonight. :)
Tuesday, June 23, 2009
Monday, March 2, 2009
A Day in the Life of a Nurse
This post is dedicated to my cousin Janssen, who has been the voice of encouragement suggesting that this blog is being read. Thanks Janssen. :)
Sometimes as I head into the hospital for a twelve hour shift I catch a glimpse of myself in the full length windows at the front of the hospital, all decked out in my scrubs with my nametag and my stethescope, and I wonder what the next 12 hours might hold. And then I wonder if people really understand what it's like to be a nurse.
One night about two weeks ago, I came on shift at 7 pm, ready to work the night away. I had my 20 oz jamba juice with the caffeine free energy boost (I wonder what's in a caffeine free energy boost anyway) and immediately walked into my patient's room where the day shift nurse was furiously typing up reports on the computer, and trying to multi task about five different things at once. As she ran next door to answer a call light, I offered to place an NG tube (nasogastric... through the nose into the stomach to suck out stomach contents on patients who are not digesting properly) on the patient who's room we were already in. NG tube in place with no problem, I walked next door to find patient number two complaining that her chest tube dressing needed changing... again. We trouble shooted and solved that problem, and after about a half hour of solving problems, sat down for report. So, I started out the shift, a half hour behind, and with several tasks left over from the day shift nurse, who had had a hectic day. This of course did not bother me, because I know what it's like to have a day like that. Keep reading. :)
After spending a good 45 minutes settling patient number one, various problems kept arising... missing medications from pharmacy, patient's ventilator kept alarming because the patient was overbreathing the machine due to poor pain control (which we fixed with higher doses of morphine :)) etc. etc. Every time I tried to get next door, something else would alarm, or need immediate attentiong. Finally, I looked at the chest xray verifying central line placement before giving any meds through it, and realized that it was not correctly placed. The doctor then had to insert a new central line and needed assistance with set up. I had poked my head in next door several times assuring patient #2 I was coming shortly, but then one thing after another seemed to go wrong and I was already two hours behind and stress levels were rising. It was now 9 pm and I was just getting to my second, much more stable patient. She was very annoyed, made the comment that "You ought to be able to call more help in if you can't get to your patients" and then proceeded to tell me that her entire dressing would have to be changed again. I took a deep breath, smiled, and started in on the task. Within two minutes all alarms were blaring that my heart rhythm next door was dangerous and I bolted out of poor patient #2's room again. Eventually, I returned next door, and sometime around midnight, I sat down for a moment to enjoy my melted jamba juice.
Two weeks later, I was on day five of six... not completely in a row but with a turn around from night shifts to day shifts. I was exhausted from extreme lack of sleep, and my body clock was majorly messed up. I had two patients in the morning, both of which were to be transfered out, which made for a fairly calm morning. Patient number one went at 10:30 am, and patient number two was waiting on a social work consult. Early in the afternoon I was informed that I would be getting a GI bleed patient coming directly from a clinic, admitted by one of our critical care docs. I was still waiting on transfering my other patient, but was ok with the prospect of taking a second amidst the transfer process. Just as I was finishing up my 15 minute lunch (ah the luxery of a 15 minute lunch! Normally I'm lucky to get five! AND I have become extremely talented at eating a sandwitch in under a minute!) I recieved a call from the same critical care doctor, asking to speak with the charge nurse. As the charge nurse, my good friend, was downstairs getting her own fifteen minute lunch, I took the message that we were to take another admit, a bone marrow transplant patient who had a severe lung infection, and upon doing a bronchoscopy (tube down into lungs to take pictures and irrigate) in the endoscopy department, had gone into a very rapid, dangerous rhythm and would be transfered to ICU for a cardioversion. (If you've ever seen the shock paddles on TV, that's what it is... we just use half the voltage on a patient who isn't dead). I told the doctor we would take it and then ran downstairs to inform Aubrey that we were getting a patient, and I was taking her.
As luck would have it, my somewhat calm morning exploded into a horrible afternoon. As I was waiting for my cardioversion patient, in rolled the GI bleed patient... who I thought wasn't coming until much later. I scrambled to get him settled in the five minutes before cardioversion patient rolled through the door. With two brand new admits, 7 pages of new orders between the two of them, plus transfer orders on my original patient, I frantically tried to keep up all afternoon. Upon cardioverting, my little cancer lady converted beautifully back into a normal heart rhythm. I love to watch that happen, it is so miraculous. We were all happy with the result. That afternoon was one chaotic mess after another. Pharmacy missed an important medication order that I didn't notice was missing until the patient went back into the rhythm three hours later because she had not been given the proper medication. The nurse practitioner was yelling, and I was beside myself at having missed it... we depend so much on our great pharmacists that we go straight to the computer and simply give what they have told us to give based on the orders. I should have caught it, but so should he. And I was the one responsible for her having to stay another night in the ICU. Meanwhile I was frantically trying to keep up on my new admit orders next door as well, and transfer my third patient out. The last straw came towards the end of the day when the doctor ordered a very common drug that we use when someone's heart rhythm is too fast. It's called diltiazem, and it functions to slow down the rate of the heart. We normally give a bolus to begin with, and then start a drip to maintain the heart rhythm until the body can do it on it's own. Once again, scanning a vial of a medication we are only suppsed to give part of, should bring up an alert, but in this case it didn't. I had read the order, but not carefully enough, and was again, depending on the system to tell me what to do. With no alert, I gave the entire vial, which ended up being two and a half times what the patient was supposed to recieve. She was sitting on the side of her bed, and just about the time I looked up with horror at a blood pressure of 60/40, she looked up at me and said, "I feel really dizzy." Speaking much calmer than I felt I said, "Yeah, I'll bet, here let me help you lie down." As soon as she was safely horizontal, I reached up to the bag of fluid I had running in and started squeezing with both hands to get her volume levels up as quickly as possible. I called for the doctor who came in, assessed the situation and told me to keep pushing fluid until it came back up again. Her pressures came up after about a half hour of me standing there nervously watching and squeezing in fluid. That was when I realized my mistake. It was past time for shift change and now I was the nurse in the room frantically printing off reports... full well realizing I was leaving a lot for the night shift nurse. Seeing my medication error that had actually caused harm to a patient was the last straw. I walked out of the hospital that night... after 13 1/2 hours, aching literally from head to toe and emotionally defeated. The next morning the cardiology nurse practitioner said that she "could have died" with pressures of 60/40. The critical care doc just laughed at my expression. Luckily she didn't die,(as my friend DJ said, 'Just cost tax payers an awful lot of money ;)) but I still wanted to say "Please, take my licence away. I obviously don't know how to safely take care of patients."
That night as I was leaving the hospital I texted two of my closest friends and said, "I'm quitting my job, I'm a horrible nurse." One of them is a nurse and he texted back to say, "Everyone makes mistakes Em." That meant a lot to me. The other texted and said, "I'm sure you're a great nurse, you can practice on me anytime you want.:)" It gave me enough courage to go back again, anyway. That night I kept waking up throughout the night, and couldn't get back to sleep as easily as usual. The hardest part was waking up with feet still sore from the night before, and walking back into the hospital to face another 12 hours. Luckily the Lord knew I would need a break and the next day was fairly calm and though busy, not unmanageable or chaotic.
So the next time you are in the hospital, and your nurse seems preoccupied, irresponsible, inefficient, or unorganized, try to remember that she probably didn't eat any lunch that day. She probably is working a day shift after staying up working night shifts all weekend when everyone else was out playing and sleeping. That she may have only slept 10 hours in the last three days, that she probably had nightmares all night the night before about making a big mistake. That she's probably already been yelled at by doctors, hit in the face by crazy patients, cleaned up the kind of messes that you can't even dream up in your worst nightmares, and has most likely picked up several diseases, shortened her life span by several years because of long anti-circadian rhythm shifts, and ruined her back from lifting too many people.
Do I love my job? Yes. Every day is a new adventure, and it stretches me to new limits constantly. But be kind to your nurses. Chances are, they are sacrificing a lot in order to be there when you need them. And anyone who is willing to forgive us for how human we often times are, are those who make it all worth it.
Sometimes as I head into the hospital for a twelve hour shift I catch a glimpse of myself in the full length windows at the front of the hospital, all decked out in my scrubs with my nametag and my stethescope, and I wonder what the next 12 hours might hold. And then I wonder if people really understand what it's like to be a nurse.
One night about two weeks ago, I came on shift at 7 pm, ready to work the night away. I had my 20 oz jamba juice with the caffeine free energy boost (I wonder what's in a caffeine free energy boost anyway) and immediately walked into my patient's room where the day shift nurse was furiously typing up reports on the computer, and trying to multi task about five different things at once. As she ran next door to answer a call light, I offered to place an NG tube (nasogastric... through the nose into the stomach to suck out stomach contents on patients who are not digesting properly) on the patient who's room we were already in. NG tube in place with no problem, I walked next door to find patient number two complaining that her chest tube dressing needed changing... again. We trouble shooted and solved that problem, and after about a half hour of solving problems, sat down for report. So, I started out the shift, a half hour behind, and with several tasks left over from the day shift nurse, who had had a hectic day. This of course did not bother me, because I know what it's like to have a day like that. Keep reading. :)
After spending a good 45 minutes settling patient number one, various problems kept arising... missing medications from pharmacy, patient's ventilator kept alarming because the patient was overbreathing the machine due to poor pain control (which we fixed with higher doses of morphine :)) etc. etc. Every time I tried to get next door, something else would alarm, or need immediate attentiong. Finally, I looked at the chest xray verifying central line placement before giving any meds through it, and realized that it was not correctly placed. The doctor then had to insert a new central line and needed assistance with set up. I had poked my head in next door several times assuring patient #2 I was coming shortly, but then one thing after another seemed to go wrong and I was already two hours behind and stress levels were rising. It was now 9 pm and I was just getting to my second, much more stable patient. She was very annoyed, made the comment that "You ought to be able to call more help in if you can't get to your patients" and then proceeded to tell me that her entire dressing would have to be changed again. I took a deep breath, smiled, and started in on the task. Within two minutes all alarms were blaring that my heart rhythm next door was dangerous and I bolted out of poor patient #2's room again. Eventually, I returned next door, and sometime around midnight, I sat down for a moment to enjoy my melted jamba juice.
Two weeks later, I was on day five of six... not completely in a row but with a turn around from night shifts to day shifts. I was exhausted from extreme lack of sleep, and my body clock was majorly messed up. I had two patients in the morning, both of which were to be transfered out, which made for a fairly calm morning. Patient number one went at 10:30 am, and patient number two was waiting on a social work consult. Early in the afternoon I was informed that I would be getting a GI bleed patient coming directly from a clinic, admitted by one of our critical care docs. I was still waiting on transfering my other patient, but was ok with the prospect of taking a second amidst the transfer process. Just as I was finishing up my 15 minute lunch (ah the luxery of a 15 minute lunch! Normally I'm lucky to get five! AND I have become extremely talented at eating a sandwitch in under a minute!) I recieved a call from the same critical care doctor, asking to speak with the charge nurse. As the charge nurse, my good friend, was downstairs getting her own fifteen minute lunch, I took the message that we were to take another admit, a bone marrow transplant patient who had a severe lung infection, and upon doing a bronchoscopy (tube down into lungs to take pictures and irrigate) in the endoscopy department, had gone into a very rapid, dangerous rhythm and would be transfered to ICU for a cardioversion. (If you've ever seen the shock paddles on TV, that's what it is... we just use half the voltage on a patient who isn't dead). I told the doctor we would take it and then ran downstairs to inform Aubrey that we were getting a patient, and I was taking her.
As luck would have it, my somewhat calm morning exploded into a horrible afternoon. As I was waiting for my cardioversion patient, in rolled the GI bleed patient... who I thought wasn't coming until much later. I scrambled to get him settled in the five minutes before cardioversion patient rolled through the door. With two brand new admits, 7 pages of new orders between the two of them, plus transfer orders on my original patient, I frantically tried to keep up all afternoon. Upon cardioverting, my little cancer lady converted beautifully back into a normal heart rhythm. I love to watch that happen, it is so miraculous. We were all happy with the result. That afternoon was one chaotic mess after another. Pharmacy missed an important medication order that I didn't notice was missing until the patient went back into the rhythm three hours later because she had not been given the proper medication. The nurse practitioner was yelling, and I was beside myself at having missed it... we depend so much on our great pharmacists that we go straight to the computer and simply give what they have told us to give based on the orders. I should have caught it, but so should he. And I was the one responsible for her having to stay another night in the ICU. Meanwhile I was frantically trying to keep up on my new admit orders next door as well, and transfer my third patient out. The last straw came towards the end of the day when the doctor ordered a very common drug that we use when someone's heart rhythm is too fast. It's called diltiazem, and it functions to slow down the rate of the heart. We normally give a bolus to begin with, and then start a drip to maintain the heart rhythm until the body can do it on it's own. Once again, scanning a vial of a medication we are only suppsed to give part of, should bring up an alert, but in this case it didn't. I had read the order, but not carefully enough, and was again, depending on the system to tell me what to do. With no alert, I gave the entire vial, which ended up being two and a half times what the patient was supposed to recieve. She was sitting on the side of her bed, and just about the time I looked up with horror at a blood pressure of 60/40, she looked up at me and said, "I feel really dizzy." Speaking much calmer than I felt I said, "Yeah, I'll bet, here let me help you lie down." As soon as she was safely horizontal, I reached up to the bag of fluid I had running in and started squeezing with both hands to get her volume levels up as quickly as possible. I called for the doctor who came in, assessed the situation and told me to keep pushing fluid until it came back up again. Her pressures came up after about a half hour of me standing there nervously watching and squeezing in fluid. That was when I realized my mistake. It was past time for shift change and now I was the nurse in the room frantically printing off reports... full well realizing I was leaving a lot for the night shift nurse. Seeing my medication error that had actually caused harm to a patient was the last straw. I walked out of the hospital that night... after 13 1/2 hours, aching literally from head to toe and emotionally defeated. The next morning the cardiology nurse practitioner said that she "could have died" with pressures of 60/40. The critical care doc just laughed at my expression. Luckily she didn't die,(as my friend DJ said, 'Just cost tax payers an awful lot of money ;)) but I still wanted to say "Please, take my licence away. I obviously don't know how to safely take care of patients."
That night as I was leaving the hospital I texted two of my closest friends and said, "I'm quitting my job, I'm a horrible nurse." One of them is a nurse and he texted back to say, "Everyone makes mistakes Em." That meant a lot to me. The other texted and said, "I'm sure you're a great nurse, you can practice on me anytime you want.:)" It gave me enough courage to go back again, anyway. That night I kept waking up throughout the night, and couldn't get back to sleep as easily as usual. The hardest part was waking up with feet still sore from the night before, and walking back into the hospital to face another 12 hours. Luckily the Lord knew I would need a break and the next day was fairly calm and though busy, not unmanageable or chaotic.
So the next time you are in the hospital, and your nurse seems preoccupied, irresponsible, inefficient, or unorganized, try to remember that she probably didn't eat any lunch that day. She probably is working a day shift after staying up working night shifts all weekend when everyone else was out playing and sleeping. That she may have only slept 10 hours in the last three days, that she probably had nightmares all night the night before about making a big mistake. That she's probably already been yelled at by doctors, hit in the face by crazy patients, cleaned up the kind of messes that you can't even dream up in your worst nightmares, and has most likely picked up several diseases, shortened her life span by several years because of long anti-circadian rhythm shifts, and ruined her back from lifting too many people.
Do I love my job? Yes. Every day is a new adventure, and it stretches me to new limits constantly. But be kind to your nurses. Chances are, they are sacrificing a lot in order to be there when you need them. And anyone who is willing to forgive us for how human we often times are, are those who make it all worth it.
Thursday, February 12, 2009
Valentine's Day Ideas
Lucky for me, I get to work on Valentine's Day night, again this year. However, it has not dampened my holiday cheer, even a little bit. A friend and I are gearing up to throw a big party next Saturday, in honor of Valentine's day month. In fact, we have been working on throwing parties once a month lately, and so far it's been very fun. In January we had about 60 people turn out.
Our big idea for February is an "in case you missed out last week" party based all around love. (How sweet). Our big activity is going to be a trivia game, with the best movie quotes and song lyrics having to do with love. We are trying to get a few male perspectives, so this doesn't end up being exclusively chick flick centered. We plan to have various movie quotes followed by movie clips, and various song lyric quotes followed by 30 second sound clips. I want a wide variety of both movie clips and songs. With the use of my friend Mike's 60" plasma screen, and my friend DJ's full sound system, I am excited about the possibilities. :) (This is where the rich single guys in their 30's with lots of accumulated toys come in really handy.)
Just kidding Mike. You know I love you.
Anyway, this is where I need advice. What are your favorite movie quotes or love songs, that would be fitting for the month of love..... ? Please contribute to your heart's content. :)
Our big idea for February is an "in case you missed out last week" party based all around love. (How sweet). Our big activity is going to be a trivia game, with the best movie quotes and song lyrics having to do with love. We are trying to get a few male perspectives, so this doesn't end up being exclusively chick flick centered. We plan to have various movie quotes followed by movie clips, and various song lyric quotes followed by 30 second sound clips. I want a wide variety of both movie clips and songs. With the use of my friend Mike's 60" plasma screen, and my friend DJ's full sound system, I am excited about the possibilities. :) (This is where the rich single guys in their 30's with lots of accumulated toys come in really handy.)
Just kidding Mike. You know I love you.
Anyway, this is where I need advice. What are your favorite movie quotes or love songs, that would be fitting for the month of love..... ? Please contribute to your heart's content. :)
Sunday, February 8, 2009
Lost about LOST
Warning: Do not read this post if you are interested in LOST but are not up to date. This is primarily for people who are as in love with the show as I am. If you are a fan want to be, you may also read this post. :)
First let me say that I do not watch a lot of TV. I've never been one of those people who has a TV show or two every night waiting on their DVR. My first year of nursing school, my roomates started having half the ward over on Wednesday nights to watch the TV show LOST. This was the second season. I started watching, mainly for social reasons, and now here I am, in season five, completely frustrated, and yet religious about Wednesday nights.
So, here we are in season five. Nearly all options of creating confusion have already been used. We have traveled back to the past for three seasons straight, and then when that got old, we started traveling to the future. Sometimes, we would travel to the past and the future. What started out as a great story about a series of really loveable characters learning to live with each other on a beautiful tropical island after a plane crash, intermingled with insights into each characters' past lives, has turned into some weird version of "how to come up with a BIGGER more UNBELIEVABLE catch (like spinning a wheel and making the island disappear, WHAT?) all while turning everyone against each other, and bringing out evil in everyone. I mean, I'm sorry, does Jack (who is beautiful by the way) really have to turn into a druggy? And there is no way you can convince me that Sun is actually going to use that gun next episode. PLEASE!
And did I mention, that we keep introducing new characters, with new issues. All of these characters are ALSO intermingled with all of the other characters somehow, and all the while we keep coming up with plenty MORE issues and questions, and still aren't solving any of the ones that have been building up for the last five seasons.
So the question here is.... do the writers know what's going on? On one hand, if they do, this is going to have a heck of a finale next season. But do they? Or are they just going to make everything so complicated that eventually we are so confused we will jut give up, because we forgot all of our original questions anyway?
Did I mention that now, since we ran out of traveling to the past and the future options, we are traveling through time. Seriously?
All that said... it's amusing to me that nearly everyone I talk to, shares my opinion of how utterly rediculous the show has become. And yet, let's face it, we are as addicted to it as ever. :) Each week, I will be glued to that TV screen, secretly deciding whether I'm in love with Jack or Sawyer, hoping for Jin and Sun to be reunited (Ok, wasn't THAT a great moment last week? I KNEW he wasn't dead!!!!), wondering how the 6 are going to get back to the island, and experiencing the highs and lows of each character's experiences. (I loved the Sawyer moment when he saw Kate last week). Wanting Hurley to succeed, hoping Jack and Kate work things out, loving Sawyer's one liners and wondering when we will see Claire again. The list goes on and on and on.
So amidst all the confusion and silly new plot twists, I remain a loyal LOST fan. The truth is, I missed them the last 8 months. They feel like my friends now, and I love to see what happens to them next. :)
First let me say that I do not watch a lot of TV. I've never been one of those people who has a TV show or two every night waiting on their DVR. My first year of nursing school, my roomates started having half the ward over on Wednesday nights to watch the TV show LOST. This was the second season. I started watching, mainly for social reasons, and now here I am, in season five, completely frustrated, and yet religious about Wednesday nights.
So, here we are in season five. Nearly all options of creating confusion have already been used. We have traveled back to the past for three seasons straight, and then when that got old, we started traveling to the future. Sometimes, we would travel to the past and the future. What started out as a great story about a series of really loveable characters learning to live with each other on a beautiful tropical island after a plane crash, intermingled with insights into each characters' past lives, has turned into some weird version of "how to come up with a BIGGER more UNBELIEVABLE catch (like spinning a wheel and making the island disappear, WHAT?) all while turning everyone against each other, and bringing out evil in everyone. I mean, I'm sorry, does Jack (who is beautiful by the way) really have to turn into a druggy? And there is no way you can convince me that Sun is actually going to use that gun next episode. PLEASE!
And did I mention, that we keep introducing new characters, with new issues. All of these characters are ALSO intermingled with all of the other characters somehow, and all the while we keep coming up with plenty MORE issues and questions, and still aren't solving any of the ones that have been building up for the last five seasons.
So the question here is.... do the writers know what's going on? On one hand, if they do, this is going to have a heck of a finale next season. But do they? Or are they just going to make everything so complicated that eventually we are so confused we will jut give up, because we forgot all of our original questions anyway?
Did I mention that now, since we ran out of traveling to the past and the future options, we are traveling through time. Seriously?
All that said... it's amusing to me that nearly everyone I talk to, shares my opinion of how utterly rediculous the show has become. And yet, let's face it, we are as addicted to it as ever. :) Each week, I will be glued to that TV screen, secretly deciding whether I'm in love with Jack or Sawyer, hoping for Jin and Sun to be reunited (Ok, wasn't THAT a great moment last week? I KNEW he wasn't dead!!!!), wondering how the 6 are going to get back to the island, and experiencing the highs and lows of each character's experiences. (I loved the Sawyer moment when he saw Kate last week). Wanting Hurley to succeed, hoping Jack and Kate work things out, loving Sawyer's one liners and wondering when we will see Claire again. The list goes on and on and on.
So amidst all the confusion and silly new plot twists, I remain a loyal LOST fan. The truth is, I missed them the last 8 months. They feel like my friends now, and I love to see what happens to them next. :)
Friday, February 6, 2009
Necrotizing Fasciitis
This post is mainly dedicated to my dear cousin-in-law Camille, who has a strange love for wound care. (Ewwww?)
I have to say, although I always thought wound care was about the most disgusting and unappealing area of nursing you could possibly go into, I gained a new appreciation for wound care nurses today. (Note: this does not mean I have developed even the slightest interest to become one).
My day began as most do in the ICU.... behind. I continued to get further and further behind as the day progressed and I was deeply involved in maintaining a blood pressure above 60/40 on one patient, while trying to keep on eye on my other patient who managed to "accidentally" pull out her feeding tube while I was dealing with crashing blood pressures. It was really shaping up to be a fabulous morning.
During report this morning, I was told that patient number two, (feeding tube sabotager) had a diagnosis of necrotizing fasciitis. Do you know what that is?
First imagine the most horrific movie you've ever seen. Now imagine the most horrific dream (about the worst kind of torture you can imagine) that you've ever had. Now put the two together, and you get necrotizing fasciitis.
Now that you're dying of suspense, let me give you a brief history of my experience with necrotizing fasciitis.
Case #1- About 6 months ago I am called into work at 9 pm to take care of a patient coming back from surgery. No big deal. They tell me this one is unstable and may die tonight. I groan inwardly, but still feel up to the task. This is, after all, the reality of my job. Little did I know it would turn out to be one of the must grueling nights of my career thus far. They tell me he has necrotizing fasciitis. (What is that?) They tell me it's a strep A infection that develops rapidly into a flesh eating bacteria that literally eats your flesh away.... and fast. "How did he get this?" I ask. "He fell yesterday and cut his elbow on his kitchen floor." They brought him back from surgery, open wounds for me to watch all night long as I worked tirelessly through the night desperately trying to save his life as I watched one system after another go into organ failure in front of my eyes. He died the next morning, three hours after I left. It was 48 hours after he cut his elbow on his kitchen floor.
Flesh eating bacteria that kills you 48 hours after a cut, WHAT? Is this stuff contagious? Wouldn't I have liked to know after spending nine hours with it. (Luckily, it's not, or you might be reading my eulogy instead of my blog.)
Several months after that, a man with a diabetic foot ulcer has to have an amputation. (Did you hear about Larry Miller?? This was not him). The wound was closed with infection still inside and it rapidly developed into our good friend necrotizing fasciitis. The surgeon and I caught it and sent him to emergency surgery within a matter of hours. (I had nightmares for days about what would have happened had I not caught it when I did). He came back to me, much less serious than nec fasc. case #1, however, because they had to continue the amputation further up the leg and leave it open until the infection healed, but they couldn't cut into the bone, he came back to me with a very see through dressing exposing his femur... yes that's right.... I was looking at a real femur bone... not like in anatomy class, but a real one attached to a real person. That was weird.
So here I am on nec fasc case 3 in a six month period. I am thinking, "Why do I get all the necrotizing patients?" Especially since it's an extremely rare, freaky disease. It's starting to disturb me. I certainly hope this is not one of those "prepare you for life experiences" things.
This woman cut her finger cleaning her oven. Yes, seriously disturbing. I cut my finger just two days ago, cleaning out a blender to make smoothies. In any case, Cut finger day one, intense redness spreading up arm day two, Operating Room day three. In this case they managed to save her arm. However, they cut away all the tissue down to the muscle from her armpit to her fingers. Today it was my duty to assist the wound care nurse in a dressing change...... that took two hours, and the kind of narcotic doses that would knock you and I out for a week. Meanwhile my hypotensive patient next door goes into respiratory failure and gets intubated. All in a days work.
But the thing I wanted to say is that although at first, I was quite sure I might vomit (and trust me, it takes a lot these days), I was amazed at how fascinating (in a gruesome sort of way) that arm looked! As the wound care nurse skillfully cut away the dressing, it slowly revealed an entire arm that was cut down to the bare muscle, exposing the anatomy of the arm that I have only seen on cadavers back in nursing school. I could see not only muscle, but tendons, bones, and even veins! And the miraculous part about it is, that it was still functioning! I could actually see the veins with blood still running through them, supplying oxygen to the fingers, and the rest of the tissues up and down the arm. This arm is going to heal! Amazing. Modern medicine is amazing.
Necrotizing fasciitis on the other hand.... I'll put that on my list of "experiences not to have."
I have to say, although I always thought wound care was about the most disgusting and unappealing area of nursing you could possibly go into, I gained a new appreciation for wound care nurses today. (Note: this does not mean I have developed even the slightest interest to become one).
My day began as most do in the ICU.... behind. I continued to get further and further behind as the day progressed and I was deeply involved in maintaining a blood pressure above 60/40 on one patient, while trying to keep on eye on my other patient who managed to "accidentally" pull out her feeding tube while I was dealing with crashing blood pressures. It was really shaping up to be a fabulous morning.
During report this morning, I was told that patient number two, (feeding tube sabotager) had a diagnosis of necrotizing fasciitis. Do you know what that is?
First imagine the most horrific movie you've ever seen. Now imagine the most horrific dream (about the worst kind of torture you can imagine) that you've ever had. Now put the two together, and you get necrotizing fasciitis.
Now that you're dying of suspense, let me give you a brief history of my experience with necrotizing fasciitis.
Case #1- About 6 months ago I am called into work at 9 pm to take care of a patient coming back from surgery. No big deal. They tell me this one is unstable and may die tonight. I groan inwardly, but still feel up to the task. This is, after all, the reality of my job. Little did I know it would turn out to be one of the must grueling nights of my career thus far. They tell me he has necrotizing fasciitis. (What is that?) They tell me it's a strep A infection that develops rapidly into a flesh eating bacteria that literally eats your flesh away.... and fast. "How did he get this?" I ask. "He fell yesterday and cut his elbow on his kitchen floor." They brought him back from surgery, open wounds for me to watch all night long as I worked tirelessly through the night desperately trying to save his life as I watched one system after another go into organ failure in front of my eyes. He died the next morning, three hours after I left. It was 48 hours after he cut his elbow on his kitchen floor.
Flesh eating bacteria that kills you 48 hours after a cut, WHAT? Is this stuff contagious? Wouldn't I have liked to know after spending nine hours with it. (Luckily, it's not, or you might be reading my eulogy instead of my blog.)
Several months after that, a man with a diabetic foot ulcer has to have an amputation. (Did you hear about Larry Miller?? This was not him). The wound was closed with infection still inside and it rapidly developed into our good friend necrotizing fasciitis. The surgeon and I caught it and sent him to emergency surgery within a matter of hours. (I had nightmares for days about what would have happened had I not caught it when I did). He came back to me, much less serious than nec fasc. case #1, however, because they had to continue the amputation further up the leg and leave it open until the infection healed, but they couldn't cut into the bone, he came back to me with a very see through dressing exposing his femur... yes that's right.... I was looking at a real femur bone... not like in anatomy class, but a real one attached to a real person. That was weird.
So here I am on nec fasc case 3 in a six month period. I am thinking, "Why do I get all the necrotizing patients?" Especially since it's an extremely rare, freaky disease. It's starting to disturb me. I certainly hope this is not one of those "prepare you for life experiences" things.
This woman cut her finger cleaning her oven. Yes, seriously disturbing. I cut my finger just two days ago, cleaning out a blender to make smoothies. In any case, Cut finger day one, intense redness spreading up arm day two, Operating Room day three. In this case they managed to save her arm. However, they cut away all the tissue down to the muscle from her armpit to her fingers. Today it was my duty to assist the wound care nurse in a dressing change...... that took two hours, and the kind of narcotic doses that would knock you and I out for a week. Meanwhile my hypotensive patient next door goes into respiratory failure and gets intubated. All in a days work.
But the thing I wanted to say is that although at first, I was quite sure I might vomit (and trust me, it takes a lot these days), I was amazed at how fascinating (in a gruesome sort of way) that arm looked! As the wound care nurse skillfully cut away the dressing, it slowly revealed an entire arm that was cut down to the bare muscle, exposing the anatomy of the arm that I have only seen on cadavers back in nursing school. I could see not only muscle, but tendons, bones, and even veins! And the miraculous part about it is, that it was still functioning! I could actually see the veins with blood still running through them, supplying oxygen to the fingers, and the rest of the tissues up and down the arm. This arm is going to heal! Amazing. Modern medicine is amazing.
Necrotizing fasciitis on the other hand.... I'll put that on my list of "experiences not to have."
Thursday, February 5, 2009
Jumping on the bandwagon
I have been thinking lately, that I don't waste enough time on the internet. Facebook and hotmail just aren't taking up enough of my day anymore, and I need another reason to stare blankly at my computer screen for hours on end.
The truth is, this is actually a way for me to journal some of my life events as they happen, in a way I might not if I thought no one was reading them. (So if you aren't, don't tell me. It may be detrimental to my posterity). In addition, I have lately been inspired by my cousin Janssen's writing skills, my cousin Merrick's beautiful art, my sister Laura's fun baby pictures and parenthood experiences, and my cousin Ashley's exciting New York City adventures, among many others. I figured being a part of the blogging world might be fun, and maybe you, my friends and family, would enjoy some insights into what life in an ICU is like. (I'll try to cut down on the graphic details.)
So, for any and all who are interested, here are some insights into the mind of a 26 year old ICU nurse, living in the big city and experiencing the joys and dramas of single adulthood.
The truth is, this is actually a way for me to journal some of my life events as they happen, in a way I might not if I thought no one was reading them. (So if you aren't, don't tell me. It may be detrimental to my posterity). In addition, I have lately been inspired by my cousin Janssen's writing skills, my cousin Merrick's beautiful art, my sister Laura's fun baby pictures and parenthood experiences, and my cousin Ashley's exciting New York City adventures, among many others. I figured being a part of the blogging world might be fun, and maybe you, my friends and family, would enjoy some insights into what life in an ICU is like. (I'll try to cut down on the graphic details.)
So, for any and all who are interested, here are some insights into the mind of a 26 year old ICU nurse, living in the big city and experiencing the joys and dramas of single adulthood.
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