Running With Scissors

Holy Crap!

2009-06-26T21:50:00.009-05:00

This was at 6PM tonight. I think I'm melting ............................

Babies - R - Us

2009-01-29T15:01:00.008-06:00

Well ... what a way to pick up blogging after a lengthy time away. I finished my MSN and changed jobs. Putting that aside, it seems that for as dull as my life seems to be, there's never really a dull moment ...

You won't believe what happened to me yesterday morning! There I was ... minding my own business while walking to my office @ 0830 when I encountered a tech from the ER pushing a VERY pregnant lady in a wheelchair. She hopped up out of the w/c and squatted next to it. I knew that wasn't good, so I went to check on her. They were on their way to L&D, but she refused to get back in the w/c and insisted on walking. She said she was having contractions every minute, and this was her 3rd child. Then she squeezed my arm & said she felt the head. What I saw certainly startled me - a huge, growing bulge in the crotch of her sweat pants! OH. MY. GOD!!! Mind you, I am a nurse for critically ill grown-ups, and have been for some twenty years now. I was screaming on the inside, but couldn't let her know that! A Case Manager rounded the corner, thank God.

Well .... we gently laid her down and delivered the baby right there in the hallway. I grabbed it, put it on her chest, and covered it with my jacket. It cried immediately, thank God! When more people showed up, as I stood up, I slipped and fell, hitting the back of my head on the floor. At that moment, I became a patient, too, with a huge scalp hematoma and a laceration that thankfully just bled alot but didn't need suturing.

There's conflicting information as to whether or not I lost consciousness when I fell. I contend that I didn't, but I guess a person wouldn't remember if they did. I do know that I heard a very loud "gong" sound and literally saw stars when my skull met the terrazzo floor. With blood quickly leaving my head (I take Coumadin), and a rapidly growing knot on the back of my head, I then got into the wheelchair that my new patients were in only 10 minutes earlier. The tech made the return trip to the ER pushing me instead of an empty wheelchair. I spent the next 3.5 hrs in the ER, where I got blood work and CT scans. No blood or growths inside my skull, but I have a follow-up with a neurosurgeon in the morning. I do have a masterful headache, but that's to be expected. Tylenol and an ice pack are controlling it pretty well.

I never even knew what flavor the baby was till the director of L&D came to visit me in the ER. I found out it was a girl, named Hannah - my favorite girl name, by the way. Had I ever had one, that would have been her name. Kind of ironic, huh? Hannah weighed in at 6 lb 6 oz.

All's well. Hannah went to the "regular" nursery, and she & Mom are doing just fine at last report. I'd like to think that any other nurse I work with would have helped if they were in the same situation, but with what I see out there, I just can't say for sure.

I got "rewarded" with 2 days off to recover from my headache (thanks to workman's comp). I have to admit ... I'm pretty satisfied with how things worked out. I guess that the year I spent working in L&D @ as a new grad over 20 years ago (God, has it really been that long?) finally came in handy, and that everything happens for a reason!

On Hiatus

2007-10-24T23:08:00.000-05:00

I'm obviously an infrequent poster ... even moreso lately. School started back up a few weeks ago, and like many of you, I am back to the grind. I work full time and am in grad school full time, which is no easy task. I am exhausted all the time, and have little time (or energy) to do much else but work and study. That includes sleep - not much of that going on here, either - a couple of hours here, a couple of hours there. The good news in all of this is that after this semester, I'll only have 3 classes left till I have my Master's degree.

That being said, I need to step back from the blog scene and direct my energy toward my studies. That doesn't mean I won't be doing some occasional lurking on your sites, and maybe even posting a comment here and there! So ... I'm officially "AFK" (away from the keyboard") as far as my blog is concerned, and I know you'll all understand ...

Till we "see" each other again ....
~RWS

Lost in Translation

2007-08-25T15:00:00.000-05:00

This is on the side of a box of condoms. For obvious reasons, I don't think I'd use them! I've seen funny translations like this before... here's some others I have seen in various places:

* "Drop your pants here for best results." -sign at a dry cleaning store in Tokyo

* "We take your bags and send them in all directions." -sign at a Scandinavian airport

* "Ladies may have a fit upstairs." -sign at a dry cleaning store in Bangkok

* "Please leave your values at the front desk." -sign in a hotel in Paris

* "Here speeching American." -sign in a Moroccan shop

* "No smoothen the lion." -sign in a zoo in the Czech Republic

* "The lift is being fixed. During that time we regret that you will be unbearable." -sign in Bucharest hotel lobby

* "Teeth extracted by latest methodists." -sign in Hong Kong dentist's office

* "STOP! Drive Sideways." -detour sign in Japan

* "Ladies, leave your clothes here and spend the afternoon having a good time." -sign in a Rome laundry

* "If you consider our help impolite, you should see the manager." -sign in an Athens hotel

* "Our wines leave you nothing to hope for." -on the menu of a Swiss restaurant

* "It is forbidden to enter a woman even a foreigner if dressed as a man." -in a Bangkok temple

* "Fur coats made for ladies from their own skin." -window of a Swedish furrier

* "Specialist in women and other diseases." -doctor's office in Rome

* "When passenger of foot heave in sight, tootle the horn. Trumpet him melodiously at first, but if he still obstacles your passage then tootle him with vigor." -car rental brochure in Tokyo

Of course, there is a plethora of quotes like these out there. As I said in the intro, these have been picked up here and there. English evidently is one of the hardest languages to master -- hell ... many who have English as their native tongue can't even speak it properly!

~RWS

The Handbook - Part III

2007-08-18T10:23:00.000-05:00

Today, we have the final installment from The Handbook. We'll be discussing different types of patients - those that try your patience. In other words, "Patients That can Make You Lose Your Patience". I have heard they exist, but I have never had any of these, so this will be a learning experience for me. How about you?

First, we have The Slave Driver. They insist that you do just one thing to make them comfortable. I mean, it's your job, right? Just know that these patients won't be comfortable unless you are in there constantly making them that way.

The next type is The Spoiled Slave Driver. These are usually women with maids. Now, don't be mistaken. They can also be of the male persuasion. Anyway, these patients are similar to the slave driver in that they are satisfied while you are in their room doing something for them. They become dissatisfied when you leave, though. As a consequence, they will call you back repeatedly so that you can do everything for them all over again.

Then there's The Push Button Player. These are often children or curious adults. They can't get over the amazing fact that if they press the call button, you (or your designee) will magically show up. They seem to think this is magic. They also drive stewardesses crazy, and they will even pull emergency cords on trains and buses to see if they'll stop.

Let's move on to The Guilt Specialist. This very special type of patient is bold as can be. They will try to do your job for you ... then try to make you feel incompetent. They say things like, "Oh, I took my own temperature and gave myself a bath. I didn't want to bother you."

Next, there's The Yenta. This kind of patient wants to know you personally, dear. They ask about your health, age, social life, sex life, etc. This concern seems to be touching. Then you realize that they are either buttering you up for special treatment, or they are gathering information for future blackmail attempts. Man!

How could we forget The Wanderer? They like to roam around. They can't stay in one place too long - especially bed! They "float" from unit to unit, and it's your job to find them and bring them back. Hooray for bed exit alarms!

Let's examine The Eccentric now. They like to sing at odd hours, or let out the occasional primal scream. Sometimes they like to "watch" the test pattern on TV (at full volume), or tell jokes - mainly dirty ones - and at particularly inopportune times. Sometimes they even perform pranks like putting apple juice in their specimen cups, then drinking it in front of you.

Oh, my gosh! How about The Playboy? He's more often than not a middle-aged, balding married man who has seen The Sensuous Nurse. He has all the lines you don't really want to hear. You see, he is looking for "special", very personal care. He often mistakes medical care for stimulation. But then, he mistakes eating, sleeping, and everything else for stimulation, doesn't he? He usually seems more than eager for a bedbath, even though he is fully capable of going into the shower alone.

Last, but not least, we have The Doctor's Helper. This patient assumes that the doctor knows everything, and nurses know nothing. They constantly question your authority and actions. Like ... "Why are you emptying my bedpan? Didn't the doctor tell you to do that, or aren't you supposed to measure it?". They'd probably like to bombard the doctor with all of these questions, but since the nurse is the one there, you guessed it! S/he is the target!

All joking aside, patients can also be wonderful and very appreciative. They are not all pains in the ass - not by a long shot! You'll all have your fair share of both types, believe me! Try your hardest to find the best in them and to realize that their bad behavior is often the result of some type of pathological process. If (and sometimes that's a huge "if"!!) you can do that, it'll likely make your shift - and their stay - a bit easier.

Hang in there!

~RWS

A Fallen Colleague

2007-08-11T09:29:00.001-05:00

I'm going to shift gears for a bit and be serious.

It's happened. A nurse has been killed in combat in Iraq. Maria Ines Ortiz, 40, was killed in late July by a mortar attack in the Green Zone in Baghdad. She was buried at Arlington National Cemetary last week.

The Edgewood, Md., resident is the first Army nurse killed in combat since the VietNam War, Maj. Gen. Gale Pollock, the Army's acting surgeon general, said in an interview yesterday. "Having one of the family go down is very, very hard," said Pollock, who also is a nurse. "You feel like a piece of your heart is gone."

Ortiz was returning from physical training July 10 when she was caught outside by a barrage of mortar shells. She was killed by shrapnel.

You can read more about it here.

Whether we agree with the war or not, how about we all stop and say a prayer for ALL of those serving overseas as well as stateside? My opinion ... we'd be nowhere without our military.

My condolences to Maria's family, and to all of the families who have lost a treasured member ...
~RWS

The Handbook - Part II

2007-08-07T23:29:00.000-05:00

OK, gang! Today, we have Lesson II - "A Dozen Things You Have Time to do on Your 'Free' Time During the Shift". I think that we should do this in the same fashion as David Letterman's Top 10 List. So, without further adieu ....

12. List the first item on your shopping list.

11. Open a can of soda.

10. Dial the first digits of your home phone number to see how your kids are doing.

9. Plan the first 30 seconds of your day off.

8. Sneeze once.

7. Put lipstick on your upper lip.

6. Exhale.

5. Read the first two words of the newspaper headlines.

4. Put one quarter into the vending machine.

3. Bend your knees in an effort to sit.

2. Get a spoonful of yougurt halfway to your mouth.

And the #1 thing you'll have time to do during your free time ...

Inhale!

Do any of you have other things you can do during your "free time"? I seem to remember one time that I actually made it into the bathroom and was able to lock the door. Then my SpectraLink phone rang and I had to abort the mission at hand. Is it any wonder that nurses and teachers have the largest and least toned bladders around? Or that the same two groups seem to get more UTIs than anyone else? I, for one, am not surprised in the least! Now let me hear some of your ideas of how to spend all that free time!

~RWS

The Handbook - Part I

2007-08-07T20:11:00.001-05:00

This will be the first of several posts I will make that are based on this book. Its publication date is 1986, which is when I bought it. Some of the "jokes" in it are quite politically incorrect for this day and time, so I will obviously avoid those. In case you can't read the cover well, it's called The Unofficial Nurse's Handbook by Nina Schroeder, RN.

The first topic I will tackle is that of "How to Tell Doctors From Nurses".

Seems pretty straightforward, but with more women in medicine and more men in nursing, it's not so easy anymore. The following guidelines should help you to "de-blur" the lines.

Docs: Show concern with your hospital insurance coverage.
Nurses: Show concern for your hospital comfort.

Docs: Will leave you a written note or prescription.
Nurses: Will decipher the doc’s hieroglyphics for you.

Docs: Admit patients to the hospital.
Nurses: Can actually find the patient once they are admitted.

Docs: Wear Rolex watches, and vacation in Europe and other exotic places.
Nurses: Wear Timex watches and vacation in the lower 48 (Alaska & Hawaii are too expensive).

Docs: Carry pagers so that if they’re needed, they’ll be present.
Nurses: Are omnipresent.

Docs: Are never in their office on Wednesdays.
Nurses: Explain to disgruntled patients why the doctor’s not in on Wednesdays.

Docs: Misplace charts.
Nurses: Take the blame.

Now, the disclaimer: This is all meant to be in fun. I hope it's taken that way! I'm sure that you can think of some other ways to tell the difference - feel free to leave them as comments!

The next lesson from The Handbook will be "What to do on Your Break". Be thinking about what you actually do on your breaks, so that you'll be able to compare with what's recommended in the lesson!

Have a great week!

~RWS

Graduate Nurse or Experienced Nurse?

2007-08-03T09:51:00.000-05:00

One of the docs where I work who is not particularly known for having a sense of humor blessed us with these little observations the other day. Now ... here comes the disclaimer. I know that each of these will likely offend someone who reads this. However, I'm also pretty sure that each of these will be humorous to at least one person.

A graduate nurse throws up when the patient does.

An experienced nurse calls housekeeping.

A graduate nurse wears so many pins on their name badge that you can't read it.

An experienced nurse doesn't wear a name badge (or turns it around) for liability reasons.

A graduate nurse charts too much.

An experienced nurse doesn't chart enough.

A graduate nurse loves to run codes.

An experienced nurse makes graduate nurses run to codes.

A graduate nurse wants everyone to know they are a nurse.

An experienced nurse doesn't want anyone to know they are a nurse.

A graduate nurse keeps detailed notes on a pad of paper.

An experienced nurse writes on the back of their hand, paper towels, bed linens, etc.

A graduate nurse will spend all day trying to reorient a patient.

An experienced nurse will chart that the patient is disoriented, then restrain them.

A graduate nurse can hear a beeping I-med at 50 yards.

An experienced nurse can't hear any alarms at any distance.

A graduate nurse spends 2 hours giving a patient a bath.

An experienced nurse has the CNA do the bath.

A graduate nurse thinks people respect nurses.

An experienced nurse knows that everyone blames everything on the nurse.

A graduate nurse looks for blood on a dressing in hopes that they can change it.

An experienced nurse knows that a little blood never hurt anyone.

A graduate nurse looks for a chance to "work with the family".

An experienced nurse avoids the family.

A graduate nurse always answers their phone.

An experienced nurse always checks their caller ID before answering.

A graduate nurse thinks psych patients are interesting.

An experienced nurse thinks psych patients are crazy.

A graduate nurse carries reference books in their bag.

An experienced nurse carries magazines, lunch, and Advil (or Tylenol) in their bag.

A graduate nurse doesn't find this funny.

An experienced nurse does.

Remember, this is all in fun and not meant to offend. I think it's funny, and find more truths than I care to admit. I hope at least ONE of you chuckled when you read it. Have a great weekend. As for me, I'll be at work wearing my name badge backwards, avoiding families, writing on paper towels, thinking psych patients are crazy, taking Advil, and getting my money's worth out of my caller ID!

~RWS

The Eyes Have It?

2007-07-25T10:03:00.000-05:00

Last Friday, as I was melting in the pedicure chair, I saw a sign about eyelash extensions. Wouldn'tcha know that I got the brilliant idea to try out a set? Now, my eyes are my favorite feature of myself, so I don't know what possessed me. Honestly ... do any of you think I needed eyelash extensions?

Anyway .... I decided to give it a try. My intention was to just get a few wispy extensions - these were the individual lashes, not the full strip kind. Well .... the technician had other intentions. Looking at my coloring, do you think I need black or brown eyelashes? I do brown mascara, and when au naturale, my eyelashes are barely visible.

I laid there for what seemed an eternity, but it was really just under an hour. The process itself wasn't that bad. The aftermath ... well, that's an entirely different story. I arose from the table with eyes that looked and felt like they had big, hairy black tarantulas on them - that were attached to my eyelashes with black SUPERGLUE. It was HORRENDOUS. She said, "They might feel a little heavy until you get used to them." MIGHT? A LITTLE heavy? OMG. Then she said what I thought were the magic words ... "If you want to take them off at home, just put warm wet washrags on your eyes and it will loosen." "Really?", said I. "Yes", said she. NOT HARDLY!!!!!!!

What followed was no less than 2 full hours of abject misery. I trotted to the kitchen sink and got the water as hot as I could stand. I then proceeded to soak some lap sponges, which I plopped onto my eyes. I waited till they cooled, then tried to remove the tarantulas. They didn't budge ... not even a bit. Holy crap! This went on over and over for what seemed an eternity. So, y'all think plucking your eyebrows hurts? Hah! It's nothing compared to pulling out your eyelashes.

To make a long story short, what ended up happening is that I pulled out almost all of my own eyelashes just to de-tarantulize my eyes. About halfway through the process, I snapped. Surely there is something out there that's available to help me out of this Hell I created for myself. I drove my red-eyed, nose-running, sniveling ass up to the local beauty supply store. There it was! My salvation in all of this! "Individual Eyelash Glue Remover"! Yay!! I snatched up the one remaining bottle and guarded it as if it were solid gold and my life depended on it. Well, in my book it kinda did.

Do you think it worked? Heh ... after my sore, raw eyes almost burned out of my head, the tarantulas didn't budge. Pardon me ... the tarantula. Remember, I got one eye off. Hell just got worse! I then decided to slather triple antibiotic ointment on my eyes in the hopes of maybe loosening up the tarantulas. Do y'all think that idea worked? Hell no it didn't!!! I decided to just suck it up and rip all the remaining mofos off. HOLY HELL!!!

I was so traumatized by the whole series of events that I didn't know what to do with myself. I ended up propping myself up on the couch with icepacks on. My lashless eyes stayed swollen till Monday! I did not take a photo of the tarantulas, nor did I take a photo of the aftermath. This is, however, a close approximation of what my once beautiful eyes now look like:

Pretty sexxay, huh? Moral of the story? Don't do crap like this without really researching the whole process. I seriously think that I have a bonafide case of Eyelash PTSD now. But ... airing it out here has proven to be somewhat cathartic. Thanks for "listening" to my admission of sheer stupidity.

On a side note, I'm going to TRY to make a more concerted effort to post more frequently/regularly. I'm just in a lazy phase right now. Work has been kicking my butt lately, and I don't want to do much during my off time. I hope you understand!

~RWS

I'm Blue ...

2007-06-21T05:02:00.000-05:00

Hmm .... I took Dr. Deb's advice, and went here to see what color my brain is. I know that y'all are all waiting with bated breath, so without further adieu ....

Your Brain is Blue

Of all the brain types, yours is the most mellow.You tend to be in a meditative state most of the time. You don't try to think away your troubles.Your thoughts are realistic, fresh, and honest. You truly see things as how they are.
You tend to spend a lot of time thinking about your friends, your surroundings, and your life.

Huh???? What????? Am I REALLY mellow???? I think not! I may hide it well, but I am about as Type A as a person can get, and Type As are far from being considered "mellow".

The only exception to the "typical" Type A profile is that I am habitually late. I have tried for so many years to overcome my tardiness, but I just can't do it. I used to be waaayyy early all the time, but then I married someone who was late ALL the time. It rubbed off. We weren't married that long, but I never overcame the tardiness. I don't care how much ahead I set the alarm, or whether I have 3 hours or 30 minutes. I'm still late. Any suggestions for me on taming the tardiness beast?

Now on to work stuff ...

What do you do when you are Type A and OCD like I am, and as a logical consequence, an overachiever? I was in nursing management for awhile, but got tired of the rhetoric and the obsession of Mrs. Boss with money. But the trouble is, is now that I'm a staff nurse, they haven't forgotten that I do a good job. So what do they do? They heap on more responsibility and tasks. Being the overachiever that I am, I want to do well on these tasks, but I'm burning out. I've told them that if they don't let up some on me, my burnout will turn white hot and I'll spontaneously combust. If that happens, They'll have one bigass pile of ashes to sweep up. So far, they haven't listened. I'll give them a couple of more chances. I am copying the following from one of my very first posts, because it's very pertinent to the way I have been feeling again lately ...

I was part of middle management at Work for 8 years, but could no longer take the two-faced bullshit they try to feed the staff. I finally vacated that post and became a staff nurse once again, and I have greater peace of mind for having done so.

I suppose that the philosophy or environment at Work is not really much different than at a majority of other places. Those in the proverbial ivory towers of Administration and Corporate offices (yes ... Work is but one facility in a system of many facilities - 12 in my city alone, with two new ones opening in the near future) have NO earthly idea of what actually goes on at the grass roots level. In fact, I'd wager to say that not one executive has donned a set of scrubs and joined us peons for any more than an hour at a time since maybe the 1980's.

Am I bitter? Hell yes, I am! I got into nursing to take care of patients, and I do a damn fine job of it when I'm not doing double or triple charting, or cleaning the patient rooms myself. Everyone knows that nurses are the backbone of healthcare. Why, then, are we treated like the dregs at Work? We are highly trained professionals who have saved many a patient's life and many a doctors' ass on many occasions. All we want is the time and supplies necessary to properly care for our patients. We spend 8, 12, or 16 hours at a time with our patients as opposed to the mere 10 minutes (if that) that the docs spend. But ... we are to cow tow to them, give them what they want when they want it. Work has a huge "good old boy" network, and the powers that be perpetuate and encourage it. He who screams the loudest gets what he wants the quickest.

I think that a HUGE factor (in fact, maybe the biggest factor) in perpetuating all of this negativity among the ranks is the Chief Nursing Officer. The "Chief" at Work is a BSN who went on for an MBA. No MSN. An MBA. In my opinion, therein lies the problem. The bean counting mindset of the MBA made her forget that she is actually a nurse. And we come back full circle to the bottom line ... the almighty dollar. Not so surprising now, is it?

The question now becomes "How are we going to get ourselves out of this nightmare?" Hell if I know. I love my life's work, but the state of things makes me sad. Sad that I don't have time to REALLY talk to a family member who is scared to death (and rightfully so) that their loved one will not survive their head injury or brain bleed. Sad that I don't have the time to sit and hold the hand of a patient who has just been told that the headaches are from an inoperable tumor. Sad that I have to ignore some patients because I have to transport other patients to tests out of the department, answer the phones, enter orders into the computer, or file lab results because the powers that be have abolished entire departments and in the name of cost effectiveness have assigned these tasks to the nurses

Ok ... back to the color of my brain. How does all of this relate? After reading my little repeat rant, can you say that my ideas are fresh? Not really. Are they honest? Yep. Are they realistic? Yep. Does it seem like I think alot about my life and my surroundings? Yep. I'm definitely a meditative thinker. Do I try to think away my troubles? Not really. I think about them, but in terms of how to solve them for myself. BUT ... that doesn't mean I'm not amenable to suggestions, because we're all in this damn boat together!
~RWS

Fingerpainting

2007-06-16T09:40:00.000-05:00

This is some of the coolest artwork I have seen in quite a while.

Check it out ...

Look very closely ...

What do you see?

Yep. These are all painted on someone's hands.

Is this stuff amazing, or what?

The range of mankind's creativity never ceases to amaze me.

I know. I haven't posted in AGES, and this post is pure fluff. Sometimes a person needs fluff and nothing more. After the night I had last night at Work, I definitely need fluff. A full ICU. Half on vents. Two Life Gift (organ donor) patients. Staff that resists the guidance they need so as to not hurt someone. Demanding families that feed patients 30 minutes before a scheduled OR time. A paranoid, combative 250 lb man who insists we are trying to kill him like we already have done to his family. Oh, yeah ... being in charge and carrying the code pager.

A stop at Panera Bread for breakfast on the way home was definitely in order this morning. I opted for the Savory Ham & White Cheddar Scone. I must say that it was worth every one of its 340 calories. Then I had a nice soak in a cucumber melon bubble bath. I think it's supposed to rain today (again), which should make for great sleeping (escapism).

Anyway ... I hope you enjoyed looking at my mindless fluff. Have a great day, a great weekend, and a great Father's Day if applicable!

~RWS

I've Been Tagged!

2007-05-20T02:32:00.000-05:00

I have been tagged by Bohemian Road Nurse for a meme. I feel so ... honored. It's my first meme.

The rules of the meme are as follows:
You simply list eight random facts/habits about yourself.
Feel free to write a little bit about those things if you'd like.
Don't forget to post these rules.
At the end of your posting, tag a bunch of people and leave a comment on their blogs to let them know they're tagged.

OK ... here goes!

1. When I was in tenth grade, I got caught shoplifting a pair of shoes from Target. I didn't think anyone would notice if I just exchanged my raggedy old shoes for a new pair. Was I ever wrong!

2. The same year, and before the shoplifting incident, I won a $10 bet at the same Target. All I had to do was sing something into the microphone at the checkout. I did a stirring rendition of "Strangers in The Night". It just hit me ... no wonder I have an aversion to Target and prefer WalMart!

3. About 7 years ago, I diagnosed myself with a pulmonary embolism. EMS laughed when I said I was in the midst of a P.E. I then informed them that I was an ICU nurse and an ACLS instructor, and I knew the signs & symptoms of a P.E. I had ruled out a CVA and an MI before I called. When I rolled into the ER (of the hospital where I work), I told them I needed a ventilator, and soon! I had a BP of 50/26, and an O2 sat of 80 on a NRB mask. I yelled at them to get me some Dopamine and some tPA. I was fixing to run my own code! Can you imagine the looks on their faces? Anyway, that's what happened. Ventilator for nearly a week, tPA, and dopamine. Once extubated, it was discovered that I had MRSA. Of course, I then got the "big gun" antibiotics. Was I ever pissed! Thanks to those multiple massive P.E.s, I now have an inferior vena cava filter and am on lifelong Coumadin. I hope I don't ever hit my head too hard!

4. I am so totally a "night person". I'm most productive after the sun goes down, and I hate, hate HATE the morning and people that are chipper when the sun comes up. I can't help it ... it's just the way I am!

5. I listen to music of all genres except rap (which isn't really music), but really am most drawn to rock and classic rock. I also love to sing classical choral music.

6. I got dumped for a man on Valentine's Day. It was a long time ago, and was a month after our first anniversary. He had brought home flowers, but they weren't for me. They were for him .... from HIS BOYFRIEND!! Yikes! This was back in the day when such things weren't on Oprah or Jerry Springer every damn day, so I was on my own to muddle through that disaster. The creep ran up $45,000 in cash advances on my credit cards before he left. The kicker is ... for whatever reason, I decided to Google him a few months back. That mofo is a doctor at freakin' Cornell!! He was a measley mall retail manager when we were together. Heh!

7. I am majorly obsessive-compulsive. My spices and albums/CDs are alphabetized. My linen closet has shelf dividers, and the cans in my pantry are all such that you can read every label. The clothes in my closet all face the same way on the hangers, and are sorted according to colors - dark shades to lighter. My shoes are all in plastic boxes and arranged the same way on the closet shelves. One more thing ... I count EVERYTHING, but you'd never know I'm doing it. Oh yeah ... I also check the alarm six times before I can actually go to bed. All I can say is "Thank God for Effexor"!

8. Now for the most personal thing. I am the textbook example of a "yo-yo" dieter. I have lost 100 lbs. three times in my 48 years. Thank God I have been at a healthy weight for the last several years, but it's definitely my cross to bear in this world.

Whew! That wasn't the easiest thing in the world. It was actually kind of hard to narrow it down to 8.

Since I am new to blogging, I only have a couple of people I can tag. One would have been Bo, who tagged me. I was also going to tag Medblog Addict, but she has already played, too. I hereby tag Student Nurse Jack and Third Degree Nurse. I hope you ladies participate!

~RWS

Happy Mother's Day!

2007-05-13T12:03:00.000-05:00

Doesn't she look like she's having fun with all those kids? So much fun, in fact, that her hair is standing on end! This looks like my Mom must have felt on many a day with the five of us. This is my 3rd Mother's Day without my Mom, and I miss her terribly. For those of you that still have Moms, give her an extra hug for me.

Happy Mother's Day to all of you Mothers out there! I can't think of a harder job, or one filled with more responsibility than that of being a parent. I don't mean just giving birth ... I mean being a parent. My hat's off to you! Enjoy your special day, you deserve it!

~RWS

The Glass Nurse

2007-05-01T16:13:00.000-05:00

Isn't this a beautiful depiction of the Lamp of Knowledge? It's in the tracery at the top of a huge stained glass in the Islip Chapel (otherwise known as the "Nurse's Chapel") in Westminster Abbey. The chapel was dedicated to the many nurses who died in World War II. This small chapel is not open to general visitors, nor are photos allowed. I had the good fortune to tour the chapel last Spring with a group of fellow nurses, and the great fortune to have the permission of an Abbey Marshall to take these photos.

This window was designed by Hugh Easton. It has the figures of Our Lady standing on the crescent moon, and carrying the Christ Child, who blesses the figure of a nurse who kneels below. Above the nurse is St. Luke, the beloved physician, standing on a rainbow. The lower left side of the window has the badges of the Nursing Services as well as the names of all the countries from which nurses came to serve in the War.

This is a closeup of the nurse portion of the stained glass. Is this an AWESOME piece, or what?!!

Since my chickadees gave me a renewed spirit, I feel the need to share the Nightingale Pledge.

I solemnly pledge myself before God and

presence of this assembly;
To pass my life in purity and to practice my profession faithfully.
I will abstain from whatever is deleterious and mischievous
and will not take or knowingly administer any harmful drug.
I will do all in my power to maintain and elevate the
standard of my profession and will hold in confidence
all personal matters committed to my keeping
and family affairs coming to my knowledge

in the practice of my calling.
With loyalty will I endeavor to aid the physician in his work,
and devote myself to the welfare of those

committed to my care.

Contrary to what many believe, Florence Nightingale did not write this pledge. It was composed by Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan, and was first used by the hospital’s graduating class in the spring of 1893. It is an adaptation of the Hippocratic Oath taken by physicians.

Can you believe they were thinking about HIPAA way back then? I can. It's how we are.

~RWS

I'm a WINNER!

2007-05-01T02:56:00.000-05:00

I just completed a semester involved in an innovative program to help increase the number of clinical nursing instructors, thereby increasing the number of nursing students schools can accept. What's "WINNER"? It stands for "Workforce Increases in Nurses and Nursing Faculty Excellence in Resource". As a participant in the program, I directly precepted two bright, eager BSN students for the clinical portion of their Adult Healthcare I course. Their enthusiasm is refreshing. They were like sponges, and I swear, they'd have followed me into the bathroom if I'd have let them! They were, in a word, AWESOME! I wish there had been such a program when I was a student. They followed my schedule, even the 11-7 shifts. I think I had as good a time as they did.

Taken from the

UT School of Nursing's website,
"Schools in the Texas Gulf Coast Region turn away qualified applicants to initial RN licensure programs due to limited space within clinical sites and a shortage of clinical faculty. This grant, supported by a consortium of ADN and BSN nursing programs, hospitals, clinical agencies and community partners and funded through the University of Texas School of Nursing at Houston, demonstrates an alternative approach to nurse education. Designed as a preceptorship model, the project addresses a major limitation to increased student enrollment, constrained clinical education capacity. By increasing this capacity, student enrollment can expand and ultimately result in increased numbers of initial licensure programs graduates.

A second objective is to develop a pool of Preceptors for mentoring initial licensure ADRN and BSRN students in the clinical setting in the Texas Gulf Coast Region. Support of this program is expected to increase the collaboration among educational programs and between education and service for the benefit of the Gulf Coast nursing community and the population it serves."

There's one more semester of funding for the project. I really hope it continues beyond that, because this methodology is far superior to the traditional clinical education model where one instructor has 10 or 12 students. My little chickadees did more in this one semester than I did during my entire career as a student.

Let's see ... they started Foleys, NG and OG tubes, assisted with bedside procedures such as central line insertions and brace fittings for patients with neck fractures. They also drew blood from those central lines and arterial lines, learned about CVP, A-line, and ICP monitoring. They cared for dying patients, learned about the organ procurement protocol, and saw how to refer a case to the Medical Examiner. They even had a patient in DKA with a glucose of 1087. They administered meds orally, subcutaneously, via IV push and piggyback, IM, and via NG tube. They learned about heparin and insulin drip protocols, and had patients on both. They even did slush enemas on a vented stroke patient with a bowel obstruction. They also started to learn the invaluable skill (or is it an art?) of time management. They even gave change of shift report and made some calls to physicians, and we all know how hard that can be!

I'm very proud of my girls. They gained so much confidence in our 12 short weeks together. They were so scared and intimidated at first. By their last couple of weeks, they walked in acting like they owned the ICU.

The Texas Board of Nurse Examiners is taking such programs under consideration. I can't say enough positive things about being a WINNER. If any of you are ever given the opportunity to participate in such a program, I STRONGLY encourage you to do so. My chickadees' enthusiasm was refreshing, and it helped to rekindle a more positive attitude in me. I'd like to think that I have made a positive difference in their educations, and will have some sort of influence on the kind of nurses they will one day become. I started out this posting by saying that I think I had as good a time as they did. That's not true. I KNOW I did!
~RWS

A Nurse's Hands

2007-04-18T01:50:00.000-05:00

Blessed be these hands that have touched life.

Blessed be these hands that have felt pain.

Blessed be these hands that have embraced

with compassion.

Blessed be these hands that have been clenched

with anger or withdrawn in fear.

Blessed be these hands that have drawn blood

and administered medicine.

Blessed be these hands that have cleaned beds

and disposed of wastes.

Blessed be these hands that have anointed

the sick and offered blessings.

Blessed be these hands that grow stiff with age.

Blessed be these hands that have comforted

the dying and held the dead.

Blessed be these hands, we hold

the future in these hands.

Blessed be our hands for they are the work

of Your hands, O Holy One.

This Blessing of the Hands is from In Praise of Hands, Diann Neu, Waterwheel, Winter 1989. Adapted by Corlette Pierson,

Pastoral Care Resident at

Rush-Presbyterian-St. Luke’s Medical Center, Chicago, IL.

~RWS

Fun With Chocolate

2007-04-08T10:26:00.000-05:00

With it being prime season for giving and eating chocolate, I thought it'd be fun to explore some artwork created with chocolate. First, we have the obligatory chocolate Easter bunnies. It looks like they seem to be having a few problems, though.

Now this lady ... she's swimming in chocolate. I wonder what that's like? I'd imagine you'd need one masterful nuseplug and set of goggles!

Here, we have some chocolate body art. Interesting concept, but I'm thinking she might need a Clorox pen and some Spray-n-Wash handy for this white dress! And, don't even think about the bees and flies!

Next, we have a couple of chocolate castles. I don't think I'd want to live in either one because I think they'd be hard to decorate, and 'll bet they're FULL of ants! Can you spot Dr. Seuss?

How about these??

Some art deco and a white chocolate Matterhorn of sorts ...

What about chocolate methods of transportation? I found a few, but I think you can probably only use them on cold days...

What do you feed a chocolate horse, and what's the fuel for a chocolate train??

Finally ... and appropriate for Easter, He's got the whole world in His hands!

Hallelujah! He is risen! Happy Easter, everyone!

~RWS

Medicating Pets

2007-04-01T11:44:00.000-05:00

No ... this isn't an April Fool's joke!

Here's a photo of this supposed wonder instrument for pill delivery to cats in action. Mmm hmm. And here's the easy enough - sounding instructions for deploying said pill using the "catpiller" device:

-"Giving your cat the tablet ensures he gets the full dose at the prescribed time. It is easier if you have 2 people.

-Put the cat on a table and approach him from behind so that you encircle him in your arms.

-Hold the front legs with your hands, and keep the cat close to your body to limit wriggling.

-The person giving the tablet puts her thumb and second finger of her left hand over the cat’s head on either side of the jaw. As the head is lifted up, the cat’s mouth starts to open.

-Holding the tablet between your thumb and forefinger, use your second finger to open the jaw.

-Drop the tablet down the back of the throat, and if you are quick enough, follow it down with a push with your forefinger to ensure it has disappeared.

-Using a pill popper or pill applicator makes the process much easier.

-If your cat struggles, you can try wrapping him in a towel so that only the head is protruding. Remember the faster the process, the less stress to your cat, and the less he has time to struggle."

Yeah. Mmm hmm. Want to know how it REALLY goes?? Then read on ...

-Pick up cat and cradle it in the crook of your left arm as if holding a baby. Position right forefinger and thumb on either side of cat's mouth and gently apply pressure to cheeks while holding pill in right hand. As cat opens mouth, pop pill into mouth. Allow cat to close mouth and swallow.

-Retrieve pill from floor and cat from behind sofa. Cradle cat in left arm and repeat process. Retrieve cat from bedroom, and throw soggy pill away.

-Take new pill from foil wrap, cradle cat in left arm, holding rear paws tightly with left hand, Force jaws open and push pill to back of mouth with right forefinger. Hold mouth shut for a count of ten.

-Retrieve pill from goldfish bowl and cat from top of wardrobe. Call spouse from garden. Kneel on floor with cat wedged firmly between knees, hold front and rear paws. Ignore low growls emitted by cat. Get spouse to hold head firmly with one hand while forcing wooden ruler into mouth. Drop pill down ruler and rub cat's throat vigorously.

-Retrieve cat from curtain rod; get another pill from foil wrap. Make note to buy new ruler and repair curtains. Carefully sweep shattered figurines and vases from hearth and set to one side for gluing later.

-Wrap cat in large towel and get spouse to lie on cat with head just visible from below armpit. Put pill in end of drinking straw, force mouth open with pencil and blow down drinking straw.

-Check label to make sure pill not harmful to humans, drink one beer to take taste away. Apply Band-Aid to spouse's forearm and remove blood from carpet with cold water and soap. Retrieve cat from neighbor's shed. Get another pill. Open another beer.

-Place cat in cupboard, and close door onto neck, to leave head showing. Force mouth open with dessert spoon. Flick pill down throat with elastic band.

-Fetch screwdriver from garage and put cupboard door back on hinges. Drink beer. Fetch bottle of scotch. Pour shot, drink. Apply cold compress to cheek and check records for date of last tetanus shot. Apply whiskey compress to cheek to disinfect. Toss back another shot. Throw Tee shirt away and fetch new one from bedroom.

-Call fire department to retrieve the damn cat from across the road. Apologize to neighbor who crashed into fence while swerving to avoid cat.

-Take last pill from foil wrap. Tie the little bastard's front paws to rear paws with garden twine and bind tightly to leg of dining table, find heavy-duty pruning gloves from shed. Push pill into mouth followed by large piece of filet steak. Be rough about it. Hold head vertically and pour 2 pints of water down throat to wash pill down. Consume remainder of scotch.

-Get spouse to drive you to the emergency room, sit quietly while doctor stitches fingers and forearm and removes pill remnants from right eye.

-Call furniture shop on way home to order new table.

-Arrange for SPCA to collect mutant cat from Hell and call local pet shop to see if they have any hamsters.

You say you need to give your dog a pill? Wrap it in bacon and toss it up in the air. (Lucky bastards!)

Now ... before I get any hate mail, here's the disclaimer: No cats were harmed while trying to medicate them, nor were they given away when medicating them pretty closely resembled the above scenario. Actually, I love my girls. I just have to laugh, though, about trying to medicate them. I hope you laughed, too.
~RWS

New Drugs For Women

2007-03-27T02:11:00.000-05:00

When taking one of these might seem extreme, maybe one of these oldies-but-goodies might do the trick ....

D A M N I T O L: Take 2 and the rest of the world can go to Hell for up to 8 full hours.

ST. M O M M A'S W O R T: Plant extract that treats mom's depression by rendering preschoolers unconscious for up to two days.

E M P T Y N E S T R O G E N: Suppository that eliminates melancholy and loneliness by reminding you of how awful they were as teenagers and how you couldn't wait till they moved out.

P E P T O B I M B O: Liquid silicone drink for single women. Two full cups swallowed before an evening out increases breast size, decreases intelligence, and prevents conception.

D U M B E R O L: When taken with Peptobimbo, can cause dangerously low IQ, resulting in enjoyment of country music and pickup trucks.

F L I P I T O R: Increases life expectancy of commuters by controlling road rage and the urge to flip off other drivers.

M E N I C I L L I N: Potent anti-boy-otic for older women. Increases resistance to such lethal lines as, "You make me want to be a better person ... Can we get naked now?”

BUYAGRA: Injectable stimulant taken prior to shopping Increases potency, duration, and credit limit of spending spree.

J A C K A S S P I R I N: Relieves headache caused by a man who can't remember your birthday, anniversary, phone number, or to lift the toilet seat.

A N T I - T A L K S I D E N T: A spray carried in a purse or wallet to be used on anyone too eager to share their life stories with total strangers in elevators.

N A G A M E N T: When administered to a boyfriend or husband, provides the same irritation level as nagging him.

Just take two and call me in the morning ...
~RWS

Suicide Watch

2007-03-26T12:23:00.000-05:00

And we care if this guy kills himself why??

This is who he killed, dismembered, then grilled.

Just when I think I have heard it all, something like this crops up. I suspected the dude all along, but this is unbelievable to me. She was 20 years old, and had so much ahead of her. She was a bright young woman who was studying engineering on a scholarship at Texas A&M. The full story is here. Again, I ask "Why should we care if this Satan's spawn offs himself? I say let him go for it. Hell ... give him a rope and leave the room for awhile. It will save the State God-knows how much money. Our prisons are too full, anyway.

What kind of evil breeds thoughts and behavior like this? Honestly, I don't really know what else to say about this except that karma is a bitch that comes around when you least expect it.

My thoughts and prayers go out to Tynesha's family. No one should have to endure grief like I am certain this has evoked. I am sure that Tynesha is reveling in the glory of her special place in Heaven.

~RWS

P.I.T.A.

2007-03-24T17:04:00.000-05:00

Have you ever encountered a "PITA"? If you deal with people, the answer certainly has to be "yes!" What's a PITA? It's a Pain In The Ass, that's what!

A PITA can be a coworker, a patient, a family, or Heaven forbid ... a doctor. We have had a gaggle of PITAs at Work this past week. Our biggest PITAs were family members. There were two patients in particular that had associated PITAs. The patients themselves weren't PITAs, but their families certainly were. PITA #1 was mild compared to PITA #2, but was a huge PITA nonetheless.

PITA #1 belonged to a 30-something patient who had a MAJOR surgery, but was very stable and not a problem in and of him/herself. Spouse, Mom, and Sister were another story, though. Patient needed a calm, quiet environment with minimal stimulation, but Family wasn't willing/able to provide this. They constantly hovered, talked to, and touched Patient. The end result? The most impressive projectile vomiting I have ever witnessed.

Also ... despite our rule of no overnight family, they demanded to spend the night with Patient. The stimulation and constant calls to the nurses continued. Fortunately, the projectile puking didn't persist. The minute Patient would wake up, Family called for pain or nausea medicine. Patient didn't want or need said medicine. They constantly spoke for Patient and made requests on Patient's behalf. Patient finally got the balls to tell them to knock it off. Thank God they (notice I said "they") went home while I was off. If I had to care for them one more day, I'd have probably poked myself in the eye with a pencil.

PITA #2 was exponentially worse than PITA #1. This PITA belonged to a little old person who had a potentially life-threatening injury. Son in PITA #2 family was the Power of Attorney for healthcare, but you'd never have known it. There is a physician in the family, but Doctor isn't a blood relative and doesn't practice here ... not even in this city. Doctor decided that s/he would make all decisions, regardless of what Family wanted. Doctor was even overheard asking other family members, "Who's the doctor here?" Too bad Family was spineless and felt they couldn't stop Doctor in his/her tracks. And too bad Patient's doctors were the same way. ALOT of arguing and wasting of time could have been avoided. You'll be happy to know that Patient is doing fine and wasn't done in by the potentially life threatening injury.

Who spends the most time dealing with PITAs? You guessed it! We nurses do. I just want to go to work and take care of my patients, not their PITA families. Sometimes I think to myself "A little Valium for Patient ... a little Valium for PITA ... a little Valium for me". Of course, we all know that's not the answer. We just bite our tongues and bring more ice chips served up with a smile.

Carrying on the theme of asking from my previous post, I frequently ask myself:
-When did nursing get this way?
-Why do PITAS act the way they do?
-Didn't anyone ever tell them that the ruder they get, the less anyone wants to help them and the more people avoid them - not the other way around?
-Is this a hospital, or is it the Hilton?
-When did it become OK for PITAS to berate nurses?
-When did it become OK for administration to tell nurses to endure this abuse in the name of "customer service"?
-Maybe most importantly ... Why do I go back day after day for more? Sometimes I wonder, but deep down I know. It's for the Patient, not their PITA.
~RWS

"Ask Me"

2007-03-21T00:01:00.000-05:00

Thanks to Edwin Leap for his insights/modifications regarding the "It's OK to Ask If I've Washed My Hands" campaign.

He says, "I was thinking. Maybe, as we do our time-outs and scrub our hands red, as we smile and get cups of ice and endure abuse with a smile, we could create our own ‘Ask Me’ buttons. But let’s ask some questions with a twist. How about some buttons that ask the things clinicians want to ask everyone else?" Almost all of these are his, but I've added some of my own.

Sooo .... Go ahead ... Ask Me ...

Ask me: How tired I am
Ask me: If I’m depressed
Ask me: How many holidays and birthdays I’ve missed with my family
Ask me: If I’m addicted to caffeine, or anything else
Ask me: If my hands ever bleed or crack from washing too often
Ask me: About the last time a physician belittled me on the phone or worse yet, in public
Ask me: If this is all that I hoped it would be
Ask me: If my opinion has ever been silenced with the threat of retribution
Ask me: What I’d do if I could do anything in the world … other than this
Ask me: How I feel when I do postmortem care
Ask me: How I feel when I am keeping a brain dead patient alive so his organs can be harvested for transplantation
Ask me: How I feel when I am taking that same patient to the OR for the harvesting after I've spent a very busy night keeping him alive
Ask me: If I’d recommend this job to anyone else
Ask me: If I ever fell asleep or ran red lights while driving home from nightshift
Ask me: How many times I do someone else’s job because they are lazy or stupid ... or because I am told that I have to
Ask me: About how compassionate I feel after several challenging shifts, or at the end of a double night shift
Ask me: If I feel like I'm a victim of slave labor sometimes
As me: If I think my employer REALLY cares about something other than money
Ask me: If anyone has lied to me today
Ask me: What it feels like to watch someone die and be helpless to stop it
Ask me: If I think patient satisfaction scores are really accurate ... or really matter
Ask me: What I think of the whole "customer service" approach to healthcare
Ask me: If my own pain is a zero … or a ten
Ask me: How it felt to be sued or deposed
Ask me: Anything except "Can you stay over and work tonight?"
Ask me: How it feels to be assaulted or verbally abused on a regular basis
Ask me: What I think about most doctors
Ask me: What I think of most of my nurse coworkers
Ask me: What a pain in the ass I think alot of families are
Ask me: For my views on the social welfare system
Ask me: How deeply I am moved by the suffering of my truly suffering patients
Ask me: How I feel about using my time and talent on someone who has tried to take his own life
Ask me: If I’m still able to cry
Ask me: How often I wonder when tragedy will strike my family
Ask me: How I could fix the broken system
Ask me: How many years, months, weeks, days and hours until I can retire
Ask me: If I’ve been treated fairly by my supervisor or employer
Ask me: When the last time was that I didn't have a UTI because there was actually time to go to the bathroom during a shift
Ask me: About the last time I had a 30 minute uninterrupted break
Ask me: What my dearest dream is
Ask me: What gives me hope
Ask me: Why I still do it
Ask me: If I ever allow myself to think I’m good enough
Ask me: What I use to determine my worth
Ask me: How my day is going, but mean it

Ask me: Anything … but be prepared for the truth, and only ask if you really want to know what I think.
~RWS

Delinquency

2007-02-04T01:41:00.000-06:00

I know, I know! I'm a blogging delinquent! Shit happens, and for me, blogging has NOT been one of those things to happen lately. I promise I'll make a few entries SOON!

~RWS

"The" Donald vs. Rosie

2007-01-05T07:26:00.000-06:00

Well .... I have tried and tried, but I can no longer hold my tongue on this one. "The" Donald (what a ridiculous "title", by the way) ranting on Rosie's looks is like shit calling puke "stinky". Give me a break! That being said .... I absolutely cannot stand either of them.

Like Joan Rivers, Rosie has made a career of being mean to people. If it weren't for insults, she'd have NOTHING. She has no talent and no appeal. Not that I was a big fan of The View before, but I think that a huge mistake was made by adding Rosie. She is a caustic entity. Wasn't there something or other in the past about Rosie and child abuse? Maybe I'm not remembering correctly.

And Donald ... ALL he has going for him is his money. Period. Does he REALLY think that his beautiful young wife is with him because of his wit, charm, and looks? Yeah ... and it'll be snowing in Miami tonight. The hair ... the beady eyes ... the puckered lips. He looks as if he has a stick shoved so far up his ass that he can't relax. Do you think he even has a Tshirt or a pair of sweats? I'd wager to say "no".

I'm not going to waste much time, thought, or effort into the feud. In fact, I can't even really believe I blogged about it. At any rate ... who gives a shit about these two and who "wins"? Certainly not I.

~RWS

The Ultimate Christmas Gift

2007-01-02T01:57:00.001-06:00

I spent my final shift of the year keeping a brain dead organ donor alive so that his organs would remain viable for transplantation. If you have never cared for one of these patients, I am here to tell you that they usually require more work than even very ill ICU patients. In fact, ask any ICU nurse who has cared for a donor patient, and they will likely tell you that these patients require 1:1 care.

Let me give you a little background on B (not his real initial, of course). He was a vibrant, intelligent man of 51 years who never made it home from midnight mass on Christmas. He was pulled over for suspected drunk driving when, in fact, he was in the middle of a massive stroke. The police recognized this and immediately summoned EMS. But it was all for naught. He was well within the 3 hour limit for tPA when he arrived in the ER at Work. But nooooo. They were "too busy" with all the drunks to give him the attention that he needed. In fact, he didn't even get heparin (never mind tPA) until about 8 hours later. As a result, by the time he arrived in the ICU, he had complete left hemiparesis and aphasia. He could, however, communicate his needs pretty well. I wish there was a way that I could ethically and in good conscience tell B's family that they should file suit against Work, because I think that the ER was grossly negligent and his death could have been avoided.

When I cared for him 2 nights after his admission, he began the swift downward spiral. When I arrived for my shift , his GCS was 13. When I left at the end of my shift, it was 3 - the worst a person can have. We intubated him at the very end of my 16 hour overnight shift. About 2 hours after that, he was declared brain dead. As is Work's protocol, the bedside nurse calls our regional organ procurement organization, and they are the ones who approach the family about donation. It took B's family almost a whole day to decide to donate. For some families, it's an easy decision and for others, it's gut-wrenching. It wasn't easy for this family.

The care of donors is extremely involved. Placement of arterial and CVC lines if not already in place. Hourly vitals and suctioning. Chest Xray and hypo/hyperthermia blanket as indicated. STRICT hourly I & O, with cc for cc + 50 cc replacement IV fluids for urine output - e.g. 250 cc urine out = 300 cc IVF in the next hour. Initial set of labs (22 tubes PLUS 2 sets of blood cultures, sputum and urine cultures). Of course, pulling all that blood necessitated an increase in his Dopamine dose. Then, every 4 hour labs and ABG's. BP was maintained with Dopamine titrate and phenylephrine at a steady 25 mcg per minute. THEN .... any other meds or treatments as indicated by the q 4 hr labs ... like amps of bicarb here and there, mannitol here and there, insulin and calcium chloride now and then. It almost seems ridiculous to do all of this for a dead person. We needed to keep the organs as viable as possible. Intellectually, I understand the need for the rigamarole, but emotionally, it's hard.

It was with mixed emotions that I helped roll B to the OR for his organ harvesting. It felt like I was taking him to the gallows for an execution, and I had to keep reminding myself that he was already dead. I also had to keep reminding myself that many people would benefit from this tragedy. He had become a liver, kidney, pancreas, and heart valve donor. It is a very rewarding experience ... one that I hope all of you can experience at least once during your career.

I went home physically and emotionally exhausted, but after all was said and done, it would be a Merry Christmas for at least 5 families after all.

~RWS

I Hereby Resolve ...

2007-01-01T02:12:00.000-06:00

"Should auld acquaintance be forgot,
and never brought to mind?
Should auld acquaintance be forgot
and days of auld lang syne?

For auld lang syne, my dear,
For auld lang syne,
We'll take a cup o' kindness yet
For auld lang syne."

For those of you who may not know, the song was written by Robert Burns in 1741, and was first published in 1796 after his death. "Auld Lang Syne" literally means "old long ago," or simply, "the good old days." BUT ... are they really the "good old days"? Is there something in your life or about yourself that you'd like to change? I know that for me, the answer is a resounding "yes!"
In no particular order, I, RWS, do hereby resolve to:
1. Have more patience with intellectually challenged coworkers. I simply cannot stand working around idiotic people.
2. Strike a happier balance between my work, school, and personal lives. My personal life is sorely lacking due to, you guessed it, work and school. No doubt about it, this HAS to change!
3. Lose weight. Yeah, yeah. Just like every year heretofore!
4. Increase my activity levels. What downtime I do have between work and school is most often spent sleeping. It's just a hunch that if I increase my activity levels, my social life will improve. So, call me "crazy"!
5. To not be so damn judgmental all the time.
6. To see things more positively. Mmm hmmm. Yeah.
7. To not want to strangle the shit out of coworkers (and Boss) so much.
8. To TRY to blog at least twice weekly (see resolutions #2 and #4).
There's a few more, but I don't want to set myself up for failure this early on! What are some of YOUR resolutions?
Happy, Happy New Year!!
~RWS

A Fresh Start

2006-12-31T22:30:00.000-06:00

Here we are on the brink of another year. I wonder how many of you are like me and choose to stay home to ring in the New Year? I think that I have gone out MAYBE twice during my adult years. I don't imbibe, so I fully trust myself. It's the other guy I don't trust. I know ... I'm boring. But I'll tell you what ... I'm alive and in one piece to see in the New Year. I also don't have a hangover from Hell. I usually spend the day cleaning my house like a maniac because I like to open the New Year with a really clean home. I didn't do that this time, because I hired domestic help and it's already done. But wait!! I DID have my vehicle washed today. I had started feeling like a slacker for having such a dirty ... no ... FILTHY ride. Hmm ... what to do now? I know ... I'll work on my scrapbook! It's the PERFECT hobby for someone with OCD! I'm about 2/3 finished with my Europe trip book. OK, so the trip was in March '06. So, sue me! I was busy this year.

What happened to 2006?

Let's see ... I FINALLY graduated with the BSN portion of my RN to MSN program after 15 years as an ADN. Not only that, I did it summa cum laude with a 4.0 GPA. (*Pats self on the back for that accomplishment*) Oh, yeah ... I also worked full time during school. Talk about exhausting! I think that the school/work combo caught me up in a time warp of sorts. As if the BSN wasn't enough, I went directly to graduate school, and yes, I still work full time. The year has flown by and is a mere blur. Someone PLEASE slap me and help me come to my senses!

I wonder what's in store for this coming new year?

It looks like it will likely be more of the same, but a little different. I have decided that since I'm no spring chicken anymore, I can move school to a part time endeavor. Work has to remain full time because someone has to pay the bills! Any volunteers? Fortunately, Work has a very generous tuition reimbursement program. Between scholarships and reimbursement, I actually ended up getting paid to obtain my BSN! Can't beat that!

Besides school and work, it also looks like the usual assortment of resolutions, which I will report on tomorrow. I'm sure many of you have alot of the same resolutions!

At any rate ...

Here's wishing you all happiness, health, and prosperity for 2007.

~RWS

A Nurses' Christmas Poem

2006-12-24T06:48:00.000-06:00

Let me start off by saying that I have NO idea who wrote this and deserves the credit, but it bears sharing with my online cohorts. I found it lying on the desk at Work.

T'was the week before Christmas, and all through the floor,
The lasix was filling the Foleys galore.
Stockings were worn to prevent emboli.
They came in two styles: knee- and thigh-high.

The patients were nestled half-assed in their beds,
While visions of stool softeners danced in their heads.
We in our scrubs, and they in their gowns -
Fashions created to hide extra pounds.

When down in the E.R. it became such a zoo.
They called for admissions for me and for you.
They're coming, they're going, they're looking the same.
My patience for patients is starting to wane.

Now call lights are ringing, the patient expounds
"I have not had my peri-care, please send someone down."
So now delegation seems like a good plan.
We pass on to others the needs of this man.

When, what to my wondering eyes should appear
But Santa himself and 8 tiny reindeer.
He states that he came in from Central Supply
To bring us LR, NS, and D5.

The doctors then scribbled what no one could read.
Orders for patients, to measure their pee.
We try to decipher illegible words.
Orders for patients, to guiac their turds.

The new shift arriving, our day is now through.
How'd the stool and the emesis get in my shoe?
We give them report and pass on the facts,
And tell them of Duoderm lining the cracks.

And the Nurses exclaimed as they drove out of sight,
"Ambien to all! And to all a good night!"

Rain, Rain, Go Away!

2006-12-24T06:33:00.000-06:00

It's very early the morning of Christmas Eve, and it's pouring rain! I love the sound of the rain ... except when I need to be out and about ... like today. Yes, the stores are already open, and I need to be in them.

I'm the master procrastinator, and I always wait till Christmas Eve to do my gift shopping. Why do I wait? Because the two (yes, TWO) years that I decided to shop ahead of time, I waaaayyyyy overspent. How did that happen? I'll tell you! Early on, I purchased what I thought my gift recipients would like. As the weeks passed, I saw more and more items that I thought my recipients would like more. Did I take back the original stuff? Hell no! So everyone raked it in those two years, and my wallet suffered. That's not happening again, besides ... I work well under pressure! Everyone shakes their heads at me for my shopping behavior, but hey! It's all part of my charm!

Wish me luck and lots of patience!

~RWS

Magnet? Or Repellent?

2006-12-22T03:30:00.000-06:00

Does your facility "enjoy" magnet status? Mine would like to think that we someday can. My opinion on that is "Uh huh ... and people in Hell would like ice water, too!". What is it, and why do I not think we'll ever achieve it?

Well .... a "magnet" facility is one that purportedly provides the "best of the best" care, and any nurse in his or her right mind would kill to work there. These facillities employ shared governance, wherein every employee has a stake in the daily operations of said facility. These are nationally-recognized hospitals that supposedly draw the cream of the crop in medical personnel, and since the care is so superb, they are then sought out by the public as hospitals of choice should a person become ill. Mmm hmm. Yeah.

Why don't I think my employer can achieve this?

Anyone hear of the "critical nursing shortage"? Anyone else work a place that's supposedly not-for-profit, yet the bottom line is all they really care about? Anyone besides me work somewhere that the facility CEO tells every new employee on the FIRST DAY orientation that "our main goal is to make the doctors happy and give them what they want, because they are our bread and butter"? Anyone else work somewhere that every unit is staffed in such a bare-boned fashion that they are BARELY able to provide even the most basic care for their patients? Anyone as stupid as me for working at such a place for 15 years?

I was part of middle management at Work for 8 years, but could no longer take the two-faced bullshit they tried to feed the staff. I finally vacated that post and became a staff nurse once again, and I have greater peace of mind for having done so. I suppose that the philosophy or environment at Work is not really much different than at a majority of other places. Those in the proverbial ivory towers of Administration and Corporate offices (yes ... Work is but one facility in a system of many facilities - 12 in my city alone, with two new ones opening in the near future) have NO earthly idea of what actually goes on at the grass roots level. In fact, I'd wager to say that not one executive has donned a set of scrubs and joined us peons for any more than an hour at a time since maybe the 1980's.

Am I bitter? Hell yes, I am! I got into nursing to take care of patients, and I do a damn fine job of it when I'm not doing double or triple charting, or cleaning the patient rooms myself. Everyone knows that nurses are the backbone of healthcare. Why, then, are we treated like the dregs at Work? We are highly trained professionals who have saved many a patient's life and many a doctors' ass on many occasions. All we want is the time and supplies necessary to properly care for our patients. We spend 8, 12, or 16 hours at a time with our patients as opposed to the mere 10 minutes (if that) that the docs spend. But ... we are to cow tow to them, give them what they want when they want it. Work has a huge "good old boy" network, and the powers that be perpetuate and encourage it. He who screams the loudest gets what he wants the quickest.

I think that a HUGE factor is the Chief Nursing Officer. The "Chief" at Work is a BSN who went on for an MBA. Therein lies the problem. The bean counting mindset of the MBA made her forget that she is actually a nurse. And we come back full circle to the bottom line. Not so surprising now, is it? The question now becomes "How are we going to get ourselves out of this nightmare?" Hell if I know.

I love my life's work, but the state of things makes me sad. Sad that I don't have time to REALLY talk to a family member who is scared to death (and rightfully so) that their loved one will not survive their head injury. Sad that I don't have the time to sit and hold the hand of a patient who has just been told that the headaches are from an inoperable tumor. Sad that I have to ignore some patients because I have to transport other patients to tests out of the department, answer the phones, enter orders into the computer, or file lab results because the powers that be have abolished entire departments and in the name of cost effectiveness have assigned these tasks to the nurses.

So ... back to the original question. Magnet? Or repellent? Given all of this nonsense and bullshit, I'd hafta go with "repellent". I wonder ... how much longer till I'm totally repelled?

~RWS

Now I've gone and done it!

2006-12-21T01:31:00.000-06:00

Well, here begins my attempt to get a blog off of the ground. I mean, really .... as if I have the spare time to work full time, go to school full time AND blog on a regular basis! All I can say at this point is that I'll do my best to live up to my expectations for myself, and that I ask those of you who are seasoned bloggers and blog frequenters to be patient with me as I learn this whole process.

I am inspired by all of the medical bloggers out there ... Fat Doctor, Mother Jones (aka "Nurse Ratched"), Scalpel or Sword, Rosebuttons (aka "Knitting in the Dark") to name but a few of the thousands out there. I understand that this can be a very cathartic experience, and who doesn't need some good catharsis on occasion?

Well ... I have to go start getting ready to run with scissors in the Neuro ICU (aka "Work") ... I'm doing the night shift tonight. I'll be sure to sharpen my scissors before I start running with them tonight - one never knows when a good point will come in handy!

~RWS