Snot

Very little gosses me out.  My husband, on the other hand, can't even listen to the music associated with medical shows if he is eating.  It gosses him out that much.  Nurses don't have that luxury.

Most nurses I know have a thing.  The one thing that they can't do.  Mine is snot. 

There is a lot of snot in the ICU.  We wipe it, suction it, collect it, document the color, consistency and frequency of it.  Seriously.  We call it sputum (spew-tum), that's the correct terminology.  "Frequent cough with copious amounts of green-grey, blood tinged, tenacious sputum."  I've charted it.  Patients save it for us in little tissues.  "Look at what I coughed up."  I bet most people will never hear that statement in their entire career, I hear it on a weekly basis.  Just be happy I'm not posting a photo of sputum.  Maybe I'll do that the next time a patient saves a tissue full for me.

Sometimes you just forget to work, and life goes on.

Today, this dumb nurse just decided not to go to work.  The charge nurse had to scramble to get a night shifter to stay over a few hours until she could figure out staffing for the day.  To make matters worse we were already short a monitor tech and had one from nights staying over.  Several calls were made to the offending nurse.  The house supervisor and the charge nurse called her home phone and her cell and left messages.  They even considered calling the police to see if she was okay.

What really sux?  That dumb nurse was me!

I really didn't think I worked today.  It wasn't on my calendar.  I must have transferred the info from the schedule into my calendar wrong.  I work three 12 hour shifts a week.  That's 36 hours people, so it's almost full time.  (don't act like I work part time now)

But damn I look like an idiot.  If only it was the first time I'd made a mistake like this, though it was the first time I'd just not shown up.  I showed up for work on a day I wasn't scheduled but they don't give bonus points for that.

They could use this mistake to get rid of me.  This could be a huge deal with meetings and performance improvement plans and the works.  There is really very little I can do about it.  If they don't like you they will find a way to get rid of you.  Well, here's your opportunity...(waiting for my phone to ring...nope, what's it take to get fired around here?)

Thankfully my charge nurse is pretty forgiving, as was the night shifter who stayed over.  The overtime pay must have softened the blow. I am lucky the boss is on vacation this week and hopefully no one will point out my mistake to her when she gets back.

This is one of the (2 billion) great things about nurses.  We make it work.  No matter what the problem, no matter what the obstacle, we get things done.  We know how to prioritize, plan, execute and move on.  We know God is laughing at our plans so when things change we alter the plan and move on.

There is no time for dwelling.  We do that after the fact, long after, when we have coffee with friends or vent to our husbands or in a weak moment pull the manager off to the side and tell her about the obstacles that kept us from providing the best care.

This isn't to say it's not stressful.  It's very stressful!  There are a million things to do and never enough time or resources to do it with.  It's a constant battle to get it all done.  Sometimes I feel like a soldier dodging bullets, crawling through the muck, losing fellow fighters, dodging friendly fire, and making sacrifices to take the hill.

And no one notices.  I have post traumatic stress disorder (PTSD) from some of my shifts.  That's funny but the truth usually is.  Every once in a while someone notices and it feels real good.  Don't expect that to show up on your eval though.

We are martyrs, most of us.  Though we'll deny it.  We all like to save the day.  We want to be the one that worked hardest or charted best or knew the most.  And we love to be thanked, though we'll say "that's my job".  We're not good at accepting the thanks.

Next time someone says thank you for what you do I want you to respond with "thank you for noticing, I really appreciate it" okay?!  And the next time one of your co-workers forgets to come to work...be forgiving, we can't be perfect every day.

Give Us Our Dammed Data

Give Us Our Dammed Data

I woke up with a cold and have since been surfing the internet on cold medicine. I came across this entry and I think, as a good nurse, I should read each of the books the author writes about. I love art and I love health care, or love to hate it I should say. This link is all about healthcare and patient advocacy, our broken healthcare system and patient rights and the like plus art.

If only I were a good nurse. Someday maybe. So many lofty goals, so little time.

Knowing too much

Sometimes when you've been a nurse for a while you just end up knowing to much.  As in when my husband, aka "the medically clueless", is talking on the phone long distance to his uncle and he tells me that a family member is hospitalized with "a swollen leg, lung problems and she's confused".  

Now, I have only met this family member once and all I really know about her is that she is rich, old and she drinks a little too much.  Oh, and that her husband was a recluse who also drank too much.  He died a few years ago.  Never-the-less, I immediately know that she had a DVT (deep vein thrombosis) in her leg, that she now has a PE (pulmonary embolism) that is causing her breathing problems and that she is also going through alcohol withdrawal causing her to be confused.  I know that she is on a telemetry or step-down unit, is on oxygen, and has a heparin drip running into her IV line.  Turns out, I was right on.  I love it when I'm right.

Sometimes this gift is not a good thing.  As in when you are walking through the grocery store and know the guy you just passed has pancreatic cancer or some other horrible and deadly illness.  

Sometimes this gift also translates into thinking you yourself have the worst possible illnesses based on your own symptoms.  Especially when you happen to be an ICU nurse who sees the worst possible scenarios on a daily basis.  I myself am easily convinced that I have cancer.  I know this because my family doesn't have heart disease, we have cancer.  Both parents and most of my grandparents died of cancer.  Mom died at a young age of 58, pancreatic cancer.  Dad died at 65, stomach cancer.  

My cholesterol is really low and my blood pressure is under control, low-normal even.   I don't do drugs, smoke, or partake in dangerous extra-curricular activities.  So, it's gonna be cancer that gets me.  If I have abdominal pain; it's cancer.  Hip pain; no, it can't be bursitis, I must have cancer.  A headache; that's a brain tumor.  That mole on my hand; it'll be cancer some day.  My family laughs at me now but one of these days I'll be right.

Knowing too much can also make it hard to find a good primary care provider.  It's hard to trust them when you have seen how stupid they are sometimes.  I had to change primary care providers when mine told me that my fasting blood sugar of 85 was too low and that I should consider adding more protein to my diet.  It was hard not to openly balk.  I asked her if she knew that was my fasting blood sugar.  She didn't really have any idea why I would point that out.  I didn't see her again.   Besides, 85 is a great fasting blood sugar, any higher and she'd be telling me I have diabetes.  That's the last thing I need.  How could I trust her to find my cancer when she doesn't even know a good fasting blood sugar when she sees one?

In the end, knowing too much is good for my patients, maybe not so good for me.

PS  If anyone knows how adding protein to my diet will increase my fasting blood sugar please let me know.

Contemplating wearing Ted hose to work.

The needy nurse

There are many types of people in this world and it follows that there are many types of nurses.  The first type of nurse I would like to outline is the needy nurse.

This nurse needs help more than any other co-worker, hence, the name.  I know it sounds unbelievable but most of these nurses don't even know that they are needy.  So, in Jeff Foxworthy fashion, I will help you figure out if you are the needy nurse.

• If you go into an isolation room, don't have a saline flush and decide to vocera (a communication device nurses wear) a co-worker on the other side of the unit to get one for you, you might be a needy nurse.
• If you go into an isolation room, don't have an alcohol swab, and decide to vocera a co-worker on the other side of the unit to get one for you, you might be a needy nurse.
• If you page doctors to the unit secretary's line rather than the line you're sitting at, you might be a needy nurse.
• If you page doctors then immediately walk away from the phone you paged them to...
• If you find yourself asking co-workers to fetch you some linens, a gown, some wipes, some lotion...each one at a time, and separately...
• If you never have an easy day....(really, you never have an easy day?)...
• If your co-workers spend more time in your patient rooms than they do in their own...

You might be a needy nurse!

That was the short list.  Please stop being a needy nurse.  I don't mind helping but I have work to do too.  At least try to remember to go into your rooms prepared.  Thank you.

Learning to blog

Learning this blog thing.

Quote of the day:  "Serving ice cream is easy, but dealing with the public without killing them is not."

(name withheld)