playing dress ups

i went to work today.
(note to self: STOP PICKING UP SHIFTS WHEN YOU ARE TIRED. Like today. And tomorrow)

there were LPN students EVERYWHERE.
well, until their instructor got sick and they all had to leave and dumped all their patients on us and we spent the remaining 8 hours trying to figure out what they had done, had done wrong, and had neglected to do.

i had one patient in ICU (a cardiac), another Cardiac, a suicidal pediatric patient, an Overdose, an Alcohol Withdrawal (i am torn between my dislike for alcohol withdrawal protocols and my dislike of cardiacs), and a Seizure Precaution patient.

and the patient with dementia who's been driving me BONKERS forever wasnt even my patient and i had had enough of her. Her nurse offered to sell her to us. Ha! The best thing about her was this one time, when i went into her room to do something for her, when i was finished she said "you should be a nurse!".

but the Best Part of the Day was that one of the doctors, Dr. M, who was doing the anesthesia in the OR today kept calling me down there to do the IVs for her (so i could practice since i'm a junior nurse) and it felt pretty cool to walk into the OR wing and have them waiting with a labcoat and cap for me and walk into the actual OR and hang out with the Dr. and then the patient would come in and we'd be all professional in our caps and labcoats and consult over their veins.

Special

work started out well, for a Monday.
they gave me the whole medical side - 4 patients, but a student had one of them. That left me with:
a patient with dementia
one with hyponatremia (essentially water intoxication)
and a cardiac.

here's a secret:

CARDIACS SCARE ME.

i made the mistake of telling my coworkers that today.
words spoken at work have a tendency to make things happen.
today, my saying Cardiacs scare me caused me to get a new admission - ANOTHER CARDIAC!
this one was in atrial fib. and was on this crazy diltiazem drip. which the ER nurse was going to start for me until the ambulance called to say they were bringing in an Overdose so the nurse handed me a pile of bottles of drugs and the stretcher with my patient and that was that.
luckily, the Surgical nurse said she'd help me since she's a senior nurse and i'm a junior nurse.
Halfway through she confessed that she had never done one either!
the patient said she felt fine but her blood pressure was awful. very low. with a negligeable difference between the systolic and the diastolic. and her heartrate was still over 140.
so i had to stand there and watch her and take her BP every 15mins and i couldnt stop yawning and the heart monitor of the other cardiac, her roomate, kept going off and i kept having to yell at her to QUIT MOVING (it was making her heartrate go to 160) and NO YOUR HUSBAND CANT BRING YOU CHINESE FOOD.
finally, i pulled in a spare table and chair and made myself comfortable to do some charting and monitor them closely.
except for when i had to keep runing down to the ER to talk to the doctor about the crazy drip and BP.
Because her BP was so low and we had to keep watching her and the BP machine wouldnt work properly, we decided, the Surgical nurse and myself, that we should move my patient into room 11. Sure, yea, that's the best thing, i agreed.
So we moved her in and put her on a heart monitor with an automatic BP machine (sweet!) and i sat down to chart and observe and call the doctor because she wasnt peeing and her lungs were getting crackly (meaning all the fluid was building up in her lungs and other tissues instead of in her bladder) and suddenly i realized that i was a Special (a 1-to-1 nurse).
I had been Specialing her all afternoon.
And as we had moved to room 11, i was now....

THE ICU NURSE!

And it wasnt scary any more. Because i just did it. I didnt have time to think about it. Or about not doing it.

why is it always monday?

every day i worked last week felt like Monday.
not a single one of them was.

this morning, already, i have had a nice moment of panic and it isnt even 630am yet. I havent even gone to work yet!

i was in the kitchen getting ready for work. it was 6am. i threw something in the microwave to defrost and add to my dinner. i switched the kettle on to make some energy tea. i left the room to find my cardigan.
and that's when it went wrong.
it got.....
quiet.
no beep! beep! beep! as the microwave ended.
no click! as the kettle shut itself off.

i blew a fuse!!! IN THE KITCHEN!!!!
great great great.
its 6am and i blew a fuse and its probably too early to call my landlord and now there's no power to my fridge and when i come home in nearly 13hrs and open it everything will be festering. Is this important enough to call my landlord? Is it really too early?

and i realize
its monday again.

she never met you

eleanor roosevelt once wrote that "no one can make you feel inferior without your consent".

clearly, she never met You.

if i have graciously taken over Your Job (even though i am not trained) when you have gone to dinner without taking into consideration that i havent had dinner; if i take over Your Job because you have left and thus i have to fall behind in my own job and skip my dinner so i can finish my job before i go home; if i do all of this and i make some mistakes that do not affect patient care or patient assessment in any way, then you do not have the right to laugh at me about them, especially in front of other health care professionals, and make me feel stupid.
i didnt give You permission to make me feel inferior, so buzz off!

how can i be busy? i have no patients

tuesday morning. first day back at the Job.
i sat down and they passed me the kardex of the surgical side (the heavier side).
and i had to resign myself to a busy day.
but then the PN students took all but 3 of my patients.
thanks.
and then the LPN took one of my patients.
thanks!
and then one of the patients of one of the students went home so she took one of mine.
thanks!!!!
so i had one patient. one whole patient of my very own. i was pretty sure i could handle it.
but the patient was in isolation and i got busy doing all the IV stuff for the students (PNs cant do IVs) and then calling a renal specialist in another hospital and the other LPN was bored so she took my last patient which meant that i had NO PATIENTS.
and then i realized that there was no RN on the other side of the unit, making me THE RN.
dontpanicdontpanicdontpanic.
i didnt panic.
and then two patients got admitted and i was sure that they would be mine since i had zero of my own but then the students took them because their instructor made them (woohoo Instructor!).
and i felt like a big slacker.
only suddenly i realized that it was just as much work if not more having 5 students than having 7 patients.
how is it that i'm only in the third month of my first nursing job and suddenly i'm responsible for FIVE STUDENTS?!?!
bonkers!
surreal.

but it was pretty cool.
especially when one student that i was worried i had overwhelmed into hating me and nursing said thanks at the end of the day for all my help! and i think she was being sincere!
and i had to restart an IV on a patient who was a notoriously hard start (he had some juicy veins in his left arm but his left arm is a no-touch zone because they were saving it to make a fistula for hemodialysis) and i said "oh" in a rather unpositive way when the student had told me that she thought his IV had blown but secretly i was telling myself I CAN DO THIS

and you know what?
i did.
on the first try!!
and it held all day!!
which is good because it meant the med i gave him didnt burn his arm tissues like it would have if his IV site had blown!!!!!!!!
not burning is good.

another post about my work

last night i was working on the floor with another new grad.
the chaos that ensued was her fault.
why?
because she had brought a movie for us to watch on her laptop.
that killed all hope of a quiet evening.
but i shouldnt blame her because she was the one who had the patient having a heart attack who needed a nitro drip (which no one was sure how to run) and we had to call in a nurse to "special" him (provide one-to-one care) until the ambulance could pick him up to take him to the airport in the nearest major city and fly him the hell out of this province.

i thought i was finally going to meet one of the infamous Daves of the Air Ambulance. but no. the air ambulance doesnt land in our town at night. drats. but the air ambulance does have really great hold music.

moving the crash cart outside someone's room "just in case" really changes the atmosphere for the worse.

the older nurse working in ER made me call the doctor for something who then essentially told me never to call him again. but in a nice way. gee thanks. how was i supposed to know that he would pretty much always back up my actions with an order when he comes on in the morning?

once we shipped out the patient, things settled down to a reasonable level and when the nurse returned from the airport, the four of us huddled around the laptop and watched Just Like Heaven which i had heard was bad but it seemed pretty great at 4am in the middle of a darkened hospital.

my advice to you

i dont remember changing my blog to this colour but i guess i did.

so this afternoon i went to the doctor. the reason is irrelevant (and no, i am not pregnant, contrary to any rumours i may have inadvertently started...).
i have decided to change my opinion of this doctor and elevate it a little. mainly because in the middle of chatting, he stopped, cocked his head to the left, and said distractedly "is that rain or snow?" and then had to raise the blinds and look out the window until the matter was settled. i thought that was funny.

here is some advice from my doctor:

• move out of this town!
• go to the City!
• they are threatened by you (the nurses)! They will try to blame you! You know more than them! You cant trust them! Dont tell them anything! They want to turn you into them!
• don't marry someone unless you really like them and love them

great. well, i'm off to work now where they are out to get me because i know more than them. stellar! maybe paranoia will help keep me awake tonight.

ps - that third point makes me think of a sufjan stevens title

edit: those are some fine words of advice but what do they have to do with my heartburn?!

Some Thoughts on Love

confession: i do not like chocolate. i do not have that to look forward to today. i can look forward to meeting someone fun on the plane home in a few hours. and i can remember one of the funniest things i ever learned about today: cartes vinaigres. An old Valentine's Day tradition originating in France whereby people would send little cards (postcards) to people with insults on them. I think it would add some nice balance to today's over-commercialized saccharine mess.

5 excerpts from my first book that pertain to love-dovey things:
There once was a girl named Frieda, who went out on the town with Jill. They had dinner. She ate hers and part of Jill’s. She got pepper in her teeth. Jill didn’t tell her. She didn’t know. They thanked each other for a lovely meal with lovely company, exited the restaurant and parted ways. Frieda headed west down the sidewalk to find a bus stop. What we should really say is, Frieda headed west down the sidewalk to find a husband, her husband. But Frieda didn’t know that her walk was going to be so life-altering. She didn’t know she was about to walk down the aisle…. Arriving at her bus stop she very quickly discovered that she would not be waiting alone tonight for already standing under the shelter of a lovely oak was a man. Oh yes, a man. A tall dark stranger. His brown locks were curly and unruly. There was the hint of growth on his chin, giving him a heart-warming scruffy look. Like an outdoorsy – hippie trying to be a man in a business world. The collar of his black wool coat was turned up to protect him from the November wind and afforded but a glimpse of his vivid red scarf. His eyes were of a colour difficult to distinguish in the pale moon light, but she could see well enough to know they were large, sparkling, alive, and beautiful. He had a strong brow, one that seemed at ease brooding, if given the chance. But he was mellow and joyous by nature. She smiled at him. He automatically began to return her smile and then paused. “Excuse me” he said. “By any chance, is that pepper in your teeth?”. Frieda instantly crimsoned. “Why yes, I suppose it is”. The man allowed his smile to continue on its path to a nothing held back, pearly teeth, half-laugh grin. “In that case” he said. “Would you marry me?”

**
I think that I may be a hunter. I feel as if I should identify with the old stereotype of men being more interested in the thrill of the hunt, in the romantic pursuit, then in the actual union. Now that I have officially obtained the affections of another, I am ready to move on.
My sentiments, my emotions and desires of another’s love and affections are like the moon. The inconstant moon described by poetic William Shakespeare as monthly changing in her seasoned orb. Like the moon, I wax and I wane. As I have secured the affections of another (the peak of light, the full moon state) but just yesterday, already my interest is waning.

**
Just call me Wheezy. My poor heart is overworked. Overexerted. I ran outside in the snow gathering amongst the traffic. My heart is struggling to meet my demands for oxygen. And it is making me wheeze. I think that my heart needs some special attention. It has been too abused and subsequently neglected as of late. Love triangles can do that to a heart.

***
Thoughts on Love
My current dichotomous state of affairs induces the following thoughts: what is the defining characteristic of a True Relationship? Is it desire? Lust? General compatibility? With Spec 1, there is desire. Up until now, there has been very minimal communication. I do not know him as I know Spec 2. We do not talk endlessly, passionately as Spec 2 and I do. He inspires me. He causes great things to happen by his original, profound thoughts. I crave him. But I do not desire him. I feel that the time will come very soon when I am forced to pick between the two of them to focus my attentions. I know not how to do this. Is one of them the proper basis for a serious committed monogamous relationship? Is neither of them the true basis? Should I reject both variables A and B and search for unknown option C?

**
Things change. People change. Desires change. People (like me?) panic and run away to isolated places. People like me say it is because of money and jobs and being responsible. People like me are liars. It is about being afraid. I have gotten no closer to understanding how to recognize love, true love, the right love. I’m an employed sheltered person with confused notions of love and what I deserve. So here we are. In this place where things are about to change. Where a new adventure is about to begin. There are no major revelations. There are no big life lessons. There is no deeper understanding.

Happy "Dump Your Significant Jerk" Day.
And dont worry if you are reading this late - some sources claim this is a week-long event!

good things

the sun is out.
the sky is blue.
i have the day off,
i'm free to sit by the windows and stare at the fields of snow hedged by proud mountaints.
i received a surprise mixed CD in the mail.
i am having a scrumptious sandwich with the glorious spiced gouda.
the cake is cooling.
the ticket is booked.
i'm calling in sick and going on holidays soon.

but i cant sing, i have a sore finger

yesterday was my first experience with death.
my first experience of being the first on scene.
my first time pronouncing a death.
my first time having a person die while i was touching them.

death, my friends, is a strange strange thing. And he wears many masks.
i have experienced the prelude to death many times.
And the void and relief once it has finally concluded.
but i had yet to be there as it happened.
i had yet to feel the conglomeration of emotions associated with being there in physical contact at the moment of passing,
the confusion of not being able to tell if the person was still alive,
the dread of talking to family members while still not knowing if the patient was 100% on the other side,
the long wait for a call from the coroner telling you if the death was suspicious and necessitates the performance of an autopsy.
the surreal feeling of pushing the loaded gurney through the hospital, in perfect silence, and entering the walk-in cold box serving as a morgue.

it is a heavy job.
physically heavy
heavy demands
emotionally laden.

but there are always brief moments of lightness.
speaking in brogues with the unit clerk to make fun of the doctor on call.
eating lemon pudding from the patient fridge.
holding up my sore finger for the unit clerk to see (who was actually very interested in it) and then breaking into movie lines ("but i cant sing - i have a sore finger").
having the interlocutor recognize the movie line.
being encouraged to join the local dramatic society
ice cream cake

just another day at the office

me: do i look like a pet person?
unit clerk: yes you do. wow. you really do.

***
doctor to unit clerk: when jv comes back from lunch, we'll tell her that he took one big gasp after she gave him the midazolam, and died!
***
unit clerk to me: so the doctor wanted to tell you that your patient had died.
me: is that supposed to be funny?
nurse: yea, is it? joking about death isnt funny if the person is that close to it already
unit clerk: ok, so this is what we are going to do. We'll call the doctor and tell him that we told you the news and you FAINTED and hit your head and that now you are in emerg and he needs to come suture your lacerations.
***
unit clerk: he's still in emerg! We'll call down there and tell him we just told you the news and you fainted and he needs to come down here. Lay on the floor and when he bends down, yell PSYCH!
me: i draw the line at laying on the hospital floor
nurse: slump over the table with your head down and i'll pretend to be taking your vitals when he comes in!

***
me to doctor: doctor! ohmygoodness! guess what happened!? by the way, i heard about the joke you wanted to pull. Nice try. But seriously, when i went in to give him the midazolam, i was three-quarters through the procedure when suddenly he did this HUGE GASP....

mon dieu! que fais-je?!

it seems that i may have agreed to a new challenge. Nanowrimo, round 2. A certain best friend has decided to re-attempt to write a 50,000 word novel in a month. And the shortest month at that. apparently i too am attempting it, to support my friend as all friends should do. Though, i have consulted a lawyer who agrees that my contract is not binding.

now, last time i was able to complete the challenge; however, i had no obligations whatsoever at the time. I could sit all day in the library or a coffeeshop and type and sit up until the wee hours of the morning should i feel the need. And even then, it was a rather overwhelming thing to do. This time round, i have a crazy job and a house to keep and i'm 2 months behind on a few christmas projects. I have serious doubts about my fitness for the task at hand. And so, since i highly doubt i'll be able to win a second time, i've decided i might as well raise the impossibility meter even more and write the damn thing in french.

last time it was "no plot? no problem".
since i've already done the no plot thing, Anastasia thinks i should do an entire novel without any characters. ugh. that sounds like an awful task. what would it be then? a manual of sorts? is it theoretically possible to write a work of fiction without any characters? without even the voice of the narrator implying one?

"no characters? no conflict!"

scandaleux!

i think i may have quite possibly created the potential for scandal. Ah, scandal. So fun. I doubt it'll catch though. There's already a lot of it around here and some of it is pretty tough to top.

best quote of the day: "you're cocky and i'm pregnant?!?"

from the nest

last night was my final mentored shift. Henceforth i am on my own.

some highlights from the night:

• eating. it started with half a rocky road square (because i felt it my duty to know what they are like). then it moved on to party mixed, closely followed by licorice allsorts, a nice salad (the 2am health break), the other half of the square (i figured it was my duty to finish it because no one else would and then it would be wasted *gasp*), a round of popcorn (the perfect 4am snack), and a pre-sleep snack of yogurt and fruit. And i wonder why i'm never hungry when i wake after a nightshift?
• reading (Son of a Witch, by Gregory Maguire)
• knitting (i have fallen very far behind on my knitting. i hang my head in shame. and in snobbery because i couldnt help but think that the blanket a colleague was crocheting was U-G-L-Y. warm, but not so asthetically pleasing. too busy.)
• games! First i learned how to play skip-bo. then we were going to play Spit but as i am a rather loud Spit player and it was 5am - a little too early to wake up my patients. instead i learned how to play a fun and easy card game called Golf.
• not accidently euthanizing my palliative patient
• the following quote declared by a coworker to me: "at least you can say you got felt up tonight"