Oh Geez…

That’s right, I’m a mid-westerner now – so now I say things like “Oh Geez” and “Dontcha Know.”

Actually, I caught myself exclaiming “Oh GEEZ!” the first time I watched Fargo whilst in Australia and “Dontcha Know” somehow crept into my lexicon many years ago…. Albeit not as regularly. I’ll blame it on the lady from Wisconsin that watched my daughter as a baby and my BFF from Michigan. Though, to be fair, I don’t actually recall Dane ever saying those phrases haha.

All that being said… Oh Geez… I hurt.

I worked my first three shifts this week. The first day was HELL I tell you… in as far as how my body reacted to the physicality of it all. That day it dawned on me that I hadn’t worked the floor in over 4 years. My last job was strictly a desk job and the one before that, though in a similar field, was also mostly a desk job. Certainly didn’t have to be on my feet any more than I needed to be.

IMG_4812[1]

My fitbit stats right after getting off of work on day one

My feet were on fire and my back ached like crazy at the end of day one. Day two was a bit better as I acclimated, but also wore gel inserts in my shoes and a back brace. My god I feel like I’m getting old… Day three, I felt even better afterwards. Slowly but surely getting used to 8 hours on my feet. So glad it’s not currently 12 hour shifts like I was otherwise used to previously!

Now I’m on day two of my four days off… and owwwieee… my knees… and …uugggh… everything hurts now that I’ve been sitting down again! I told myself that I would stay up and active while being off  – yet I lied to myself and now look what I did. LOL

Next week will be crazy with two days on, one day off, three days on… then another random shift later that next week I think… Then, thank goodness, I’ll be done with training and will go to my regular part time hours which will be every OTHER week for 4 days in a row. Those stretches I’m sure will be just as exhausting by the end… But hopefully I will have gotten myself much more accustomed to the activity and have ten days between to recover… Phew! (Suffice it to say I am soooooo glad right now with the decision to go back to work only on a part time basis and to choose the 4 day every fortnight position (they originally offered me the other opening that had more shifts, but then they told me about this one in case I wanted to make the choice.))

In any case, pray for me ya’ll… That I heal enough before returning next week LOL

MIA, Medication, and Making Money!

Gosh, I feel like I’ve been MIA again… I suppose I have been, particularly given that my kids have been ill since Friday. They’ve been in high enough spirits and feeling over all well enough… But they are contagious and not allowed to go to school until we can procure the medication – which has been a nightmare so far.

The original prescription was sent off on Friday. I was told then that it had to be ordered and would be available Monday… On Monday I was told it was delayed and they couldn’t get the whole thing filled… AND that with my insurance it would be $300. I called around to all other pharmacies – same story, no one in town or the next town over had it nor could they easily get the full amount needed.

So I had to call the clinic to discuss with them and they were able to figure out a different (and thank goodness generic) medication… side note: who in their right mind ever prescribes meds that aren’t available in generic anymore?? – eff you Friday doctor. That nurse also found a pharmacy in town that could fill it by this afternoon. Crossing fingers there are no more hiccups because I really need these kids back in school!

In no small part due to the fact that I have my first day at my new job tomorrow! Hubby said if need be he’ll take the day off so I don’t screw up the very first day! However, he is also really busy this week so that would be far from ideal.

So anyway… Yay! I found what seems to be a perfect fit job-wise. I interviewed two weeks ago and the next day I had the offer. They were very enthusiastic so that was nice – nice to feel wanted! They wanted to offer me the Part Time position that had more hours, but gave me my choice as they had another position with less hours… I chose the one with less hours. Really, I am just wanting to make a little extra money and get out of the house a bit… keep up some skills while I wait for nursing school to start back up again. Minimal stress, but the ability to pick up extra hours if I want to. I also got offered more money than I expected so… Bonus! Woo!

I’ll be working at a Rehabilitation and Nursing home – apparently (so I’ve heard since taking the position) the best facility of it’s kind to work for in the area… so, another Yay! LOL

I can’t wait to get out of the house tomorrow for orientation… I have been scrubbing this house clean since Saturday – most of the work being done Sat/Sun – and then chasing the kids to keep things clean which of course has been difficult. I still have a big pile of laundry I’m trudging through though…. uuuggghhh…. and, well… I best get back to that I suppose.

ETA: FUCK! Generic is no longer available still out of pocket $300 😦

“What. The Hell. Do. You. Think. You. Are. Doing?!”

I hate to brag, but I am damn good at inserting urinary catheters. It’s just something I did well when I worked at the hospital in Nashville.

As such, we had at one point a woman that had attempted suicide which ended up not killing her, obviously, but left her permanently paraplegic. She required an in&out catheter every six hours or so to empty her bladder. The idea was to bladder train her so that she didn’t become dependent on a continuous catheter.

I worked with her for a set of three shifts one week in which she discovered that while the RN struggled to do her catheter – causing her pain – I was able to do it quickly, efficiently, and without pain.

The next weekend when I came back on shift I was not assigned to her, but she found out I was there. That nurse approached me and asked me to do this particular task for her because the patient did not wish either person assigned to her to even attempt it if I was on the premises.

I was stressed, I was busy, but I told the nurse I would attempt to fit it in my plan for the night.

The patient’s schedule had her needing her cath three times on night shift. Once at the very beginning, once around midnight/1 AM, and once at the very end of the shift.

I was able to go for the first one, explaining to her that I could not make promises, but I would attempt to come for her other caths as well.

Because she had been suicidal, she had been assigned a “sitter,” someone employed to sit and keep an eye on the patient. They were not employed to do anything for or touch the patient. Only once in a blue moon might we ask one to assist with steadying or rolling a patient when we needed extra hands – but they must be explicitly asked and must do exactly as they were told if they agreed to assist as they otherwise had no clinical training. On night shift their main job was to stay awake. Quite a boring job, really, though they were allowed to entertain themselves by reading, using laptops or watching TV, as long as it didn’t disturb the patient, obviously.

I gathered my supplies, prepped the patient and set up my sterile field.

Before I knew what was happening, the sitter rose, walked to the opposite side of the bed while putting on non-sterile gloves, and reached in to my sterile field and touched it. Literally picked something up with her completely unsterile hands. TOUCHED IT! AGH!

OH

MY

GOD

I was livid.

“What. The Hell. Do. You. Think. You. Are. Doing?” I said in a low menacing voice. My head still bent over the task, but my eyes looking up at her. “Don’t ever do that again.”

She looked frightened and stepped back – hands up, then took off her gloves and hurried back to her seat.

I’m a scary bitch when I want to be, apparently.

I ripped off my sterile gloves and tossed them in the middle of the field before gathering it all up in the sterile wrapping underneath and tossing it directly into the trashcan beside me.

“Apologies, Lisa*, my sterile field was contaminated. I need to go get another packet; I’d hate for you to get an infection,” I said.

“Okay,” she said. “Thank you.”

“I’ll be right back,” I assured her.

I quickly got new supplies and returned to finish the task. Once I was done I informed her nurse what had happened.

“Are you kidding me?! ARE YOU KIDDING ME??!!” I raged. “What the fuck… SERIOUSLY… Has she not been trained?!” I asked incredulously. “INAPPROPRIATE!!”

I clearly had some choice words.

The RN assured me she would talk to her, then later returned to let me know she had done it.

I was unable to make it for her mid-shift cath, but was able to fit in the end of shift one – just barely, but I made it work.

I walked into her room with my supplies at around 6:30 AM. I breezed past the sitter and went directly to the bedside, my back turned to the sitter.

“Good Morning, Lisa!” I said with a smile. “Wasn’t sure I’d make it, but found I could squeeze you in!”

“Oh thank God,” she said with a sigh of relief and a smile.

I went about setting up for my task once again. As my sterile field was set out, my gloves on, and my head lowered once again… I saw a movement… Someone coming around the bed. Eyes moved up again as I saw that fucking sitter coming into my line of sight – putting fucking latex gloves on again.

This time I didn’t say a damn word.

The DON’T YOU FUCKING DARE look on my face said it all.

She realized it was me again and she quickly took her gloves off and went back to her seat again.

Afterwards I went to the charge nurse to complain. About not only the sterile field incidents, but also other things I had witnessed – for instance this woman playing very loud ethnic music on her laptop in the patient’s room. Clearly not my very classic Tennessee country girl patient’s choice.

“Inappropriate!” I bitched again.

“Well, I understand she’s a nursing student, that’s probably why she wanted to help or practice,” the charge nurse said diplomatically. I knew she was one that liked to give people the benefit of the doubt and give second… and third… chances.

“I don’t care!” I said. “You know me,” I continued. “If she had actually asked to watch or asked me to explain what I was doing and why I was doing it, I would happily oblige… But… she didn’t. She didn’t ask. She decided herself to ‘help,’ when it was not needed nor welcome. She decided to do it regardless of the rules for her position – COME ON! You know as well as anyone she shouldn’t be doing anything like that as a sitter! It doesn’t matter what she’s studying outside of work! Besides which she was told TWICE,” I emphasized my point by raising two fingers, “in ONE shift not to do it – by me and then the RN – and then tried to do it again when she thought I was someone else! For fuck’s sake… STERILE FIELD! INFECTION CONTROL! FIRST FUCKING YEAR!!!!” ([of nursing school] – indicating that if she was in nursing school she should know better already.)

The charge nurse sighed, “Yes, you’re right,” she said. “I’ll make the report.”

“THANK YOU!” I said in a tone that said both FINALLY! and THANK GOD! at the same time.

 

~~~~~~

Medical memory number 5…

*Name Changed

and… hmmm… guess I showed my bitchy side in this one… but…. COME ON!

LOL

 

 

 

“So Perfect it Sickens Me”

“What’s your success rate?” He asked me nervously – referring to my ability to draw blood; as that was what I was preparing to do.

“100% so far,” I assured him with a smile. “Though either way, our policy is no more than two attempts. If we don’t get it after two, we leave it and have a different person try a little later.”

He breathed a sigh of relief. He certainly didn’t need to go through someone digging for veins or otherwise causing him undue pain.

This patient had recently had a double thorocotomy – basically, both lungs had been operated on. He was a trooper though, always friendly to the staff, never complaining even when he was clearly in pain, always patient, and tried his best to get up to walk among other Doctor’s orders even though it was hard work.

After setting up my supplies, I put on my gloves and swabbed his arm with alcohol before sliding the needle easily into his vein and collecting the necessary samples in their respective tubes.

I pressed a cotton ball over the insertion site and tugged on the tube. It was a safety butterfly needle so this action was supposed to pull the needle out of his arm and into the plastic casing, thereby making it less of a risk for accidental needle sticks.

Still keeping the pressure on the cotton until I could tape it down, I pulled the needle away from his arm and went to grab the tube up with the intent of tossing it in the sharps container.

Except.

Fuck.

The needle hadn’t retracted. It poked me in the forefinger of my left hand.

I paused for a minute, looked up at the nurse who had started examining the patient’s chest tube insertion sites and said “Uuuuuhhhhmmmm…. Staaaacey…. I think I just stuck myself with the needle….”

I squinted; wanting to close my eyes, but knew I needed to look. I hoped that perhaps… MAYBE… these latex gloves were thicker than they seemed… Totally plausible, right?

I pulled my glove off.

Nope.

Blood. Blood inside my glove.

Motherfucker.

I squeezed blood out of the prick wound and washed my hands thoroughly – per procedure.

I notified the charge nurse that I had sustained a bio-injury who then pulled out the necessary paperwork and then sent me down to the Emergency Department for my own now-required labs  to be drawn.

I felt horrible because I knew now the charge nurse was on her way to take further labs from the patient – now they’d have to test him for other diseases that could have been passed on to me – HIV, Hepatitis, etc.

I strolled into the ED and told the triage nurse why I was there. It was a very slow, quiet night (I can say that now that it’s years later 😉 It’s bad luck to say the “Q” word in a hospital – it ensures that the shit will hit the fan, so to speak, and ruin a shift.)

He took me directly back to draw my labs himself.

He was very talkative and frankly flamingly gay. Stereotype embodied, to be sure.

He had to take my vitals before poking me with one of his needles. We chit-chatted about how our respective shifts were going as he took my temperature, counted my heart rate, and then measured my blood pressure.

“120 over 80,” he stated. “So perfect it sickens me.”

I cracked a smile, the way he said it made me want to laugh out loud. 120/80 is literally textbook perfect, so that’s why I can still remember it exactly this many years later.

Not matching his feigned disdain, I cheerily responded “Thanks!”

We finished up within a few minutes and I headed back up to the 9th floor to finish my shift.

Before the shift was over that morning I was notified that the patient’s samples had returned negative for any diseases.

Oh, thank fuck.

“I feel like I want to go in there and thank him for not being a crack addict.”

The charge nurse just gave me a look; curiosity, disbelief maybe.

“No?”

“No.”

“Yeah… I thought not,” I said as I grinned at her and then walked away.

~~~~~~

Medical memory series number 4… Hmmm… Back to nursing school? Still haven’t decided… 😉

“I promise you, I will lose my job”

The RN came to stand in front of me – on the other side of the nurse’s station where I was sitting.

“Just spoke to switchboard – apparently room 9218* has been calling a particular family repeatedly in the middle of the night yelling at them when they tell her it’s a wrong number. It’s stressing them out, as you can imagine, so help me keep an eye on her and stop her from using the phone tonight?”

“Oh, for crying out loud,” I said. “Well, I’m about to go in there… I’ll see what I can do.”

This patient was in isolation – not my favorite type of patient, simply because the gowns and gloves never ceased to make me feel like I was burning alive if I had to be in the rooms for more than a couple of minutes. Regardless, I suited up and stepped into the room just in time to hear her yell.

“STOP LYING! This IS Macys! I need the customer service desk! …No shut up! I know the Macys’ number by heart! You’re just an idiot!”

“Ms Barkly*!” I said, “Who are you talking to?”

She stopped and looked at me for a moment, and not taking the phone away from her ear she said “None of your business!”

“It is my business, Ms Barkly, because that is my phone.”

“No it’s not! You don’t even work here! Look! You aren’t even wearing the uniform! How did you get in here?!” She demanded.

“Ma’am, we don’t wear uniforms on this unit. I do work here, and that phone is my business; besides which, it is 1 AM and Macys is not open. Let me talk to whoever is on the line.”

She squinted at me and grunted. Begrudgingly handing it over after realizing I wasn’t going to just give up.

“Hello,” I said before introducing who I was.

A desperate sounding man on the other side of the phone explained who he was and how many of this middle of the night calls he had been receiving from her – always claiming she was trying to get a hold of Macys, then verbally abusing him or his wife. He also explained that all they could see is the generic Vanderbilt number on their caller ID – and they have a family member admitted on another unit so they can’t not pick up…

“I am so sorry sir,” I stated. “We were just informed of this issue a few minutes ago. I am taking care of it right now – her phone will be disconnected.”

With a deep sigh of relief he thanked me profusely.

“Apologies again, sir. Goodnight,” I said, and with one fell swoop I hung up the phone and pulled the cord from the wall. Letting the nurse know what happened when I walked out of the room.

Ms Barkly continued to verbally abuse me the entire shift – well, she did so to anyone that dared to come in her sight line. One big issue was trying to not allow me to use the disposable equipment reserved for isolation patients insisting that I should use the $500 thermometer on her instead. When I refused she insisted she would go get another opinion at another hospital that would treat her right – fact was we were the second opinion. She had already pulled the same threat at St Thomas’. Alright, lady…. I told her it was her decision where to receive the medical care for her gaping thorocotomy (Lung removal) wound on her right side. Big enough that to pack the wound, one’s forearm would go in completely.

Throughout the wee hours of the morning she continued to try to use her phone – abusing the Medical Receptionist (as she was within her sight line) about us bugging her phone and letting the aliens disconnect her and all sorts of nonsense. Of course it was all the poor Medical Receptionist’s fault because she had the unit’s multi-line phone so she must have flipped a switch from there. I apologized to Chris for what she was having to put up with, but she knew it was a necessary action I had to take.

Our unit was good about consistency of care – using the same staff to care for the same patients as much as possible, especially when working shifts in a row. They were also good about trying to accommodate staff requests when certain people did not want to work with certain patients. A request that a handful of staff made often for various, what I considered superficial reasons. I; however, only ever made that request once.

At the end of the night I approached the charge nurse.

“Please let day shift know that when making the assignments for tonight I request not to be assigned to Ms Barkly again. I promise you, I will lose my job if I have to care for that woman again.”

~~~~~~

*Name and room number changed

# 3 of my medical memories

“Hold My Hand”

It was a Sunday evening – I had just started my last 12 hour night shift of the week.

I knocked on the open door – a quick tap with two fingers as I entered.

Mrs Farley* was laying on her hospital bed, as always; grossly swollen and dripping wet. She was severely edemic – her body holding on to too much fluid. Unable to store or process the fluid further, it had started to seep out of her skin at a constant rate.

“How you doing, Mrs  Farley?” I asked. I knew full well she was miserable, but I attempted to keep a sunny demeanor regardless.

Her incessant low pitched groaning she tended to do stopped as she looked at me and with as much of a smile as she could muster, she answered that she was glad that I was back on shift.

Then, embarrassed, she asked me to check if she had soiled herself. She had lost all sensation when it came to such things – thus the need to layer chux pads underneath her.

I put on my gloves after gathering the other supplies I’d need, and went about the business of rolling her to her side and checking her pads.

“Yup, needs changing,” I said in a chipper voice. “Just hold tight a minute while I clean you up!”

“I am so embarrassed,” she said; her voice cracking with imminent tears. “I’m so sorry,” she added.

I told her there was no need to apologise. “It’s my job, Mrs Farley! You’re just giving me something to do!” I smiled at her and asked her if she would rather I’d be bored at work.

I finished cleaning her up and checking her vitals, then asked her if she needed anything else before I left.

“Sit with me a minute?” she asked hopefully. “Hold my hand and sit with me?”

“Certainly,” I said. “I can spare a few minutes.”

I set my stuff down and moved the chair a little closer to the bed on her left side. I put my hand in hers and sat quietly with her.

After a few minutes, her eyes glazed over and stared off at an angle while she squeezed my hand tighter.

“Mama,” she said faintly before starting to cry. “Mommy, I don’t want to die,” she said further, shaking her head like a petulant child. I squeezed her hand all the more tightly, but stayed silent.

“Mommy… Please… I don’t want to die yet,” she begged.

I shushed her and stroked her hand with my fingers until she quieted down and closed her eyes.

When I walked back out into the brightly lit hall I approached her RN saying soberly “Mrs Farley is going to die soon.” I then told her what had just occurred. “I’d be surprised if she’s still here next weekend when we get back on shift.” The RN agreed.

Truth be told, I was surprised every time she was still there for the past few weeks.

The next Friday night when I came back on to work, I looked up at the board that noted the patient rooms and names along with staff assignments – as I always did.

Mrs Farley’s name was gone.

I was told that she had finally been sent to hospice care after having been with us for about 2 months… and within that week she had, in fact, died.

~~~~~~~

*Name Changed

This has been #2 of my medical-related memories pending my decision about what to do as I plan to go back to University… 😉

 

“He Needs You”

“Get out!” He yelled at her as he stormed into the hospital room’s bathroom. He was on our critical care unit due to a traumatic brain injury, and she was his wife.

She burst into tears as I walked into the room.

“I can’t do this anymore,” she said, her voice cracking as she started to gather up her purse and coat.

I strode over to her quickly, setting my equipment down as I passed the bed. I put my arms around her while she shook with almost silent tears.

“I’ve got to leave,” she said. “I can’t stay here with him anymore.”

“Mary*, take some deep breaths,” I said as I reached for a tissue. “It’s Okay to need a break. Go for a walk, clear your head – but please don’t do anything you’ll regret.”

I didn’t want her leaving her husband – not only because it was easier to care for high needs patients when their families are around – but because a rash decision made in a high emotional state could be damaging to the both of them in the long run.

She gulped some air, but fresh tears started again. I indicated that she should sit down.

“He’s changed,” she said as she lowered into the chair. “He said he wants to divorce me! He’s been saying horrible things to me! What did I do wrong? Why doesn’t he love me anymore? What am I putting myself through this for?!”

“You have done nothing wrong… and I know how you feel,” I stated. “My husband had an issue with his brain a few years ago that required surgery. Issues with brains can cause personality changes – my husband became downright mean… but after it was all said and done… after he recovered … it all got so much better again.”

She was wiping her eyes when she looked up at me and asked “Really?”

“Really,” I assured her. “I’m certain he doesn’t really mean what he says… he probably thinks he does right now, but when he’s better he will regret it – or likely won’t even remember he spoke to you that way.”

I don’t recall then if I stepped out into the hall to let the RN know what was going on, or if she had come in on her own – but I gave her a quick briefing of what was occurring.

The RN knelt down in front of the still seated Mary and grasped her hands. She assured her that what she was going through and feeling was normal. His behavior was also a normal side effect some people get in such situations. She reiterated that it was normal and healthy to take a break for herself – she need not shut herself up in his room for weeks without a break just because she is his wife.

“Take a break, Mary, but please come back. It may not seem like it… But he needs you.”

She took a deep breath as she nodded, gathered up her things, and walked out of the room.

~~~~~~~

*Name was changed

I’ve been thinking about whether or not to go back to nursing school (or do something else, like continue my science degree to a Microbiology degree or do Health Business like my old Exec of Nursing suggested I do). I had started with Nursing School but couldn’t finish due to the move to Australia. I started thinking about certain flashes of memory to do with my medical experiences and thought maybe I’d document a few more here over the next few days… hope you all enjoy 🙂