ranting RN

A nurse's way to cope : A collection of anecdotal rantings

Funerals? Yes? No?

I have no excuses for my extended hiatus, so I won’t even try to make any.

Had a patient for a while, you know, the one’s you just can’t help but falling in love with them and their families. I remember the day I admitted him, I said to myself, please God, let them send him home so he doesn’t have to die here. This might sound harsh to some but he was still in good spirits, still capable of taking care of himself and enjoying life for a little longer regardless of being saturated with cancer. He was inoperable, and not a candidate for chemo due to longstanding infections with his PTC drain. Alas, as I deep down knew, he would remain until his last days in my care.

Day after day, week after week, I became so frustrated. I would ask his family if they had been approached about palliative measures.. According to them, the surgical team were not ready to have that discussion… Now I understand a surgeon’s fundamental job is to go in and fix the problems, slice and dice, dissect away but one must ask – AT WHAT COST AND FOR WHAT OUTCOMES?

In the end, I went in to visit him and his family. He was now totally sedated, and was so obviously in his last moments. This particular patients family asked me for my cellphone number so they could contact me about the funeral arrangements. Now I believe in this line of work, everyone needs to draw a personal line, one where, if you crossed it, you’d jeopardize your sanity.

My line is funerals. 

I can give myself 110% during my twelve hours, but after that, I can’t take my patients home with me. I care, but one must always be careful, at what cost?

What is your line?

Comic Relief

When you’re in dire need of a good

belly crunching, knee slapping, laughing fit.

Check this out

http://whatshouldwecallnursing.tumblr.com

Spotted

I find it hard to point out the miracle recoveries on the floor. The families seem to spot them so easily. I usually think very objective and scientific thoughts that justify their improvements. However, this one guy really was a full on miracle.

A “long-term resident” of our surgical unit, had just about every complication in the book from his bowel surgery, constantly contorted in pain from his mismanaged RA and was recently diagnosed with active TB+. All the doctors were stumped on him. This guy was the definition of skin and bones. He was miserable, especially since his family lived in some remote location in the North. Let’s just say he was a far cry from a happy camper, and caring for him was an immense challenge.

He was finally deemed palliative. and told the dreaded “we’ve done the best we could, we will keep you comfortable in your last days”.

I was off for a couple weeks, and upon my return, there he is, walking around the unit, trailing his “buddy” the IV pole around with a huge smile. Not only was he on the mend, but the docs thought he’d be making a full recovery. The TPN was evidently doing some good work, he was starting to fill out the voids in between his bones.

All the nurses were starring, eyes shinning, and he just looked so proud.

He should be discharged before christmas if all goes well.

A true christmas miracle.

That Moment When…

UGH. Today was one of those days where your feet literally ache from exhaustion. Ran around all morning until about 1330 before I finally had a break.

Gotta love that moment when you glance at yourself in the mirror and almost cringe at the site of your hair and dark circles and yet know that at least your patients and coworkers aren’t judging you for it. Thank god nursing is no beauty contest or I would have been dead last.

On an unrelated note, my 84 year old palliative pt today had his fiancé come visit, they met at their retirement home and I just about died from their cuteness. I hope I’m loved like that in my old age.

Even The Manliest Experience Fear

My pt was this young guy in for diverticulitis, post op day 10 or so, and things were at a standstill. The Docs had been trying to get him to accept and NG for a couple hours now, without avail, because his stomach was so distended he looked about 6 months pregnant. This guy was a tough guy and was determined to just let things try to work themselves out.

I went in to chat with him and realized that no one had really explained to him the procedure, nor had anyone taken the time to try to dispel some of his fears. Him and I watched a youtube video on his phone so he could visualize it. He finally decided to go for it, with the help of some Ativan.

When it was all said and done, with tears in his eyes, he wanted to thank me for simply holding his hand.

Just another day in the life.

Almost peed my own pants at some of these.
Keep Calm & Nurse On has been my personal mantra since reading this post. Thanks KLE-BLOGGIN IT

No Sugar Coating Here

Sometimes, a little sugar coating could have gone a long way.

I walk into my patients room just as some nurse is telling my pt that he really need to get moving because if he doesn’t HE WILL GET A BOWEL OBSTRUCTION. Poor guy looks terrified at the sound of that and courageously asks the infamous questions: “What’s that”?

She answers simply with “You’d be full of shit”.

Talk about the damage control I had to do after that bomb drop. He’s already freaked out his abdo incision is severely infected and his new colostomy is barely draining, now he’s got to picture himself to be literally full of shit.

Then again, sometimes you really do need some tough love.

DESENSITIZATION

DESENSITIZATION

I tend to refer to it as my “Nursing Mask”.

Literal Baby Making

The birthing process is a true miracle.

I was assigned to a woman having her third child, she was well into her thirties and was a great sport about the whole ordeal, that is until things got messy. Literally.

The OBGYN came in to assess her, the resident started with her vaginal examination and immediately shot a confused look at the OBGYN. He was next to give it a try. He states so matter-of-factly that it was a face presentation. This means that the baby was belly-up doing a sort-of backflip and was coming out face first. He walked out saying to give him a call when it was imminent.

Ten minutes later, I’m looking at the fetal heart rate monitor and we’re down to about 40 bpm, when it should be anywhere from 110 to 180. OH SHIT. We maxed out mom’s IV’s, put the O2 mask on full blast and pulled the emerg bell. People poured in, it was hectic. Doctors barking orders, RT setting himself up and just about a dozen nurses running around acting as gofers.

OBGYN tells Mom that she has three pushes to try her luck then they’re rushing her to emergency C-section. I’ve never seen anyone look to terrified in her life and yet so determined at the same time. I could hardly believe it, that baby popped right out of this woman.

I have never felt as relieved as I did when I heard that baby cry. You felt the entire room sigh and then burst into tears. Very rarely have I witnessed an entire crew cry as we did that day. The docs, the nurses, heck even the RT were all reduced to such tears of joy. We shared that moment with the parents.

It was a magical moment, one that reminds me why I’m in this business. 

Good Day

Today was a fantastic day. Everything went smoothly, and time management was for once an actual tangible thing. I got to enjoy my patients, get to know them and actually have time to sit and chat. I witnessed a very interesting VAC dressing done on an opened laparatomy incision that had gone awire.

Today was a Good Day, and I cherished it.

Fingers crossed for tomorrow.

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