Death by Whatever

I went to Six Flags the other day and thought I was going to die. No joke. The history is that I've been there a billion times and have always enjoyed riding roller coasters. This time, as we approached the pinnacle, as my sister and I sat entrapped in this metal container, I thought I was going to see Jesus. I saw the ground so terribly far below me, panicked at how high we actually were, and literally have never been so scared in my life. I've never had that feeling before. The rational part of my brain that is supposed to identify this as "fun" labeled it "imminent doom". Never mind why, in my right mind would I straps myself in willingly, endure a torturous fall where I always black out and leave with a POUNDING headache? I'm assuming this is due mostly to the next statement.

This sounds pretty morbid but let me explain. I imagine scenarios entailing my own death often. I can always identify situations around me that would lead to a horrible demise. I attribute this morbidity to the uncommon circumstances surrounding a majority of our patients injuries. When you see people who got a 2X4 through their neck in a car wreck and are now paralyzed (really happened) or a woman who was in an elevator when it broke and fell 22 feet leaving her with both broken legs (really happened), or a man who got his leg bit off by a random zebra (I wish for his sake that that was false), you see those imaginary situations awaiting for you.

Whenever I'm driving, I never follow behind large trucks with ladders or wood or whatever in the back because that's just asking for one through your windshield, pinning you to the seat as the firemen use the jaws of life to get you out as the gasoline spills out and you are racing the clock.

If I was cooking and my kitchen exploded and my face was horribly burned beyond recognition would I want a face transplant? Who would I want to look like? Would I turn to online dating?

I saw someone in a movie who had gotten their arm cut off in a foreign country and had to get it amputated. It physically caused me agony to think of myself in that situation, more for the horridly unsterile nature of that environment than the actual injury. I would demand a jet from the embassy to take me out, rather than dying of sepsis alone in some godforsaken place.

If I got shot, what part of my body would I most willingly sacrifice? Arm? Leg? Would I get a gang tat after that to legitimize the experience?

If I got kidnapped like the movie Taken and was sold to the European slave trade, would Liam Neilson be there to save me? Or would I have to stab someone with a heroin needle to avoid hallacious STD's and an early death in a brothel?

If I was on a plane and someone emergency surgery and we were in the middle of the Atlantic ocean and there was no help for hours and no one else medical on the plane and the person was asking me to save him on his dying breath, would I perform a tracheotomy to save his life using a straw and a balloon to ventilate him?? Would I???

These are the weird things that go through my mind. I understand if you don't want to be my friend anymore. I can't help it. You could be walking down the street and someone could drop a piano on your head. Unlikely, yes, but somebody once made the mistake of thinking that impossible. But most of the time, I just focus on being alive and thanking the Lord for protecting me thus far.

And if you need help falling asleep at night, I'm not the person to call. Goodnight.

The ICU: PG-13. Only suitable for creepers and crazies.

There’s one word that has been coming up often at work lately: inappropriate.

Example #1: A burly man in his 40’s gets into a single car collision. He insists that he had a “medical episode”, which actually means he’s trying to divert the attention away from his positive tox screen (he’s high as a kite) by making up a fake diagnosis. Unfortunately for him, I did actually pay attention in nursing school and I’m not a complete idiot. He consistently asks me to call his girlfriend but alas, he never memorized the number. He blames it on “those Iphones”, rather than acknowledging the fact that in reality, she’s probably simply his dealer. He asks me to google her. Yeah, let me just google every Jane Doe in Dallas, Texas. That’s simple.

He tells me how to find her… You are a creeper, aren’t you. I’m going to go take my name badge off now just in case your last 5 “girlfriends” are sitting in your freezer right now.

Then it’s bath time and he makes some snide and very offensive “jokes” about slutty nurses….there you have it. Inappropriate. I gave him a piece of my mind that included something about objectifying women and the value of nursing as a noble and selfless profession. Then I told him to shut it. He mocks me, naturally, but then he gets to be bathed by a bunch of guys. Take that.

Example #2: I have an elderly gentleman who wants to chat about anything and everything while I’m doing his assessment.

Pt: “Are you married?”

Me: “Nope”

Pt: “Do you have a boyfriend?”

Me: “Nope”

Pt: “Well don’t you think you should get on it?”

At this point, his daughters are trying not to laugh and they are apologizing. It’s ok ladies, much worse things have been said to me. I go with it.

“Yeah, you and my mother would appreciate that”. I’m attempting to joke with this little old man.

Pt: “Well it’s not like you’re ugly or anything”

Thank you. That’s reassuring. Inappropriate.

Example #3: A young Hispanic girl gets in a car wreck (MVC or motor vehicle collision) and she ends up with us but she’s relatively fine. She’s sitting up in bed, feeding herself, watching tv etc. Her boyfriend comes in, skipping high school no doubt, and he proceeds to lay in the bed with her.

“Sorry buddy you have to stay in the chair. It’s a hazard to the patient because of all those wires”.

“Oh ok, sorry.” And he sits back down.

I come around a few minutes later and he’s halfway sitting on the bed, trying to slowly creep back in. This time I just give him a look. He quits. Then I get a hit (a new admit) so I’m gone for a while.

When I come back, I kid you not, they are full on making out in the bed, him practically on top of her. Inappropriate! Ugh! This is a hospital and you don’t even have a real room, just a curtain! So I threw back the curtain and they both just look at me like deer in headlights (or head lice, if you get that reference…). Anyways, I guess when you’re 16 you don’t care about authority and you just want to make out against the rules so you go for it. Nevermind about rules or germs or a little thing called birth control. That’s probably what you’re both missing in school today. Ironic.

Much worse things have happened but I dare not tell them over the internet. This is a PG-13 blog people… this is all you get for now.

Modern Families

Everyone complains about their family. Everyone has an eccentric aunt or a controlling mother or a passive father. We all know that no one, despite how nice it may look from the outside, has the "perfect" family. But regardless of all the quirks and annoyances and sometimes even deeply rooted hurts, most people would go to bat for their family without question. (Did you catch the Rangers reference....ok we can continue).

We see people at their worst moment; the night they got that phone call they've been dreading all their life. And while my job is to take care of the patient, it would be devastating to ignore the family members who make up a vital part of every patient's life. Family means a connection, something invariably permanent, that supercedes old regrets or arguments. And when something threatens the existence of the family, people completely forget why they have been mad the past 5 years or even that they got divorced 20 years ago.

I've seen ex-wives show up at the bedside for husbands who cheated and left them long ago. I've seen estranged children fly halfway across the country, forsaking even their own families, to hold the hand of a father who never could get it right. The mistakes don't seem to matter when you realize it might be the last time you look upon their living face or say some last words.

I had a patient the other day who had cancer and an extensive surgery to remove tumors. This patient continued to get more and more sick and her sister sat vigilantly at the bedside. Her sister refused to leave, partially because she was so worried, and partially because she had no where to go. She was from out of town and had no car and little money. A dire situation, I think we would all agree.

Because I was hanging blood, giving fluid boluses, and trying to figure out why this patient was declining, I wasn't able to attend to the sister, who sat weeping with her face in her hands. We had someone else come talk to her and try to answer her questions.

After my shift was over, I was walking out and saw the sister, staring at her phone as if she was wishing for a miracle from it. I sat down next to her and we talked for a while. I told her I would be praying for sister because I believe the Lord can heal and do miraculous things. Her sister divulged some of the weighty details of their family situation and I felt so much compassion for her, as she was literally at the end of her rope. She joked that she hadn't even brushed her teeth in a day and I gave her a pack of gum. It was all I had but we laughed that at least it was something.

It was a small encounter but I left that day feeling like I had a connection to this family. This all may sound cheesy but it's vividly true. I care about a family I don't even have yet! I pray for my husband and the little children hopefully I will have. Sometimes I feel like I can see their faces, from a distance. Crazy what you feel, even for an imaginary family :) Or maybe I'm just the crazy one.

I feel like I'm getting a little sappy because I'm having a lonely day so I'll wrap it up. Love on people! Christ gives us no greater calling. Love is the greatest of all the commandments. The End.

Out of the morphine the mouth speaks.

These are actual conversations I've had lately...

Me: "What happened? How did you get stabbed?"

Patient: "Well, I wuz tryin to break up the fight and I got stabbed, caught in da crossfire".

Me: "Hmm. Well this house arrest ankle bracelet does make me wonder whether you're telling me the truth or not"

Pt: "That wuz a mistake too!"

Dad comes in later with the charger for the house arrest bracelet. Because obviously you have accessories for those things.

Me: "Sir you can't use that because it's not an approved device"

Pt's dad:" But see if we don't the police come and get real mad! It mean big trouble!"

Me: "Ok sir. But I'm pretty sure they've figured out by now that he's not at home anymore..."

Me: "Sir do you remember what happened to you? Do you remember how you got hurt?"

Pt (clearly dopped up on morphine and speaking in slurs): " I got bit by an alligator"

Me: "Actually it was a zebra, sir."

Pt (throws his hands up): "Ah, Same difference.."

(He actually did have to have his leg amputated because his friends pet zebra bit it off. ??)

Pt (precious elderly gentleman with a head injury who thought we were still in 1954 and looked exactly like the old guy from Up): "Can I give you a kiss?"

Me: "No silly! This is the hospital and I'm your nurse"

Pt: Look of shock. Clearly does not understand the situation, nonetheless the decade.

Me: "Did you think you were at a bar and you were picking up girls?"

Pt:"Yes!"

Pt (high on who knows what and so drunk he got a facilitated trip to the hospital): expletive you. expletive this whole place. you expletive expletive". Charming.

Me: Don't use that kind of language around here, especially in front of women!"

Pt: "You guys are women?"

Me: "Buddy do you know where you are or what happened to you?"

Pt: "This is the worst drug trip ever!"

Me: "You cannot get out of bed. You are on narcotics and it's very dangerous because you might fall".

Pt: grunts as if he understands.

Later

Me: "Sir you cannot get out of bed! I understand you can't pee laying down but do not put your two feet on the ground".

Pt: grunts, as if he gives a crap what I'm saying

A bit later.

Me: "Ok listen buddy. This is the last time I'm going to tell you. DON'T get out of bed or there will be consequences" (in my best mom voice)

A little more later.

Catch the pt in the act. Standing up beside the bed and looks at me as if daring me to yell at him.

Me: "It is 5 in the morning and I've had it! YOU ARE DISRESPECTING ME, THIS HOSPITAL, AND EVERYONE WHO IS TRYING TO TAKE CARE OF YOU. IF YOU FALL, IT'S GOING TO BE ME THAT GETS SUED AND YOU WHO GETS HURT. NOW GET BACK IN BED RIGHT NOW. GOT IT??"

PT: " yes maam"

Winner. Personal victory for achieving a new level of intimidation.

This is by far the most entertaining aspect of my job. You just never know what you're walking into every morning. That's why it's entertaining.

A Peek Into My World

Here I am...almost midnight. I have a cup of tea in hand and I'm kinda hyper. You've been fair warned.

13 hours. 3o min lunch. 2 15 min breaks (if you get them). 3 assessments. 2 I&O's (intake and output). Q1 vitals (Q means every hour). Maybe Q1 glucose sticks if you get the short end of the stick. 1 CT scan. Countless meds. My life at work is measured in chaotic predictability. An oxymoron you say? Things are not what they seem...

People really have no idea what my day to day looks like. They either believe every minute is a trauma scene from ER where I'm sweaty from doing chest compressions and yelling "Get the crash cart STAT dammit!" Or they think I get paid to babysit deranged and demented neuro patients who throw their sippy cup on the floor a billion times and I have to pick it up. It's somewhere in the middle. So here's a layout for you, a night shift layout since that's what I'm currently entrenched in. Ready, set.....set....go.

I arrive at work between 6:30 pm and 6:40 pm (1830-1840). The charge nurse comes in, reads a synopsis of each patient, and then all hell breaks loose. By this time, I've learned to listen for the most pertinent information. Q1 glucose sticks= a huge pain. Contact isolation= skip that one. Wady (our term for actin a fool, trying to get out of bed and such)= guaranteed frustration by the am. Blood pressure issues= a sick patient (aka fun). At the instant the last syllable rolls off the charge nurses tongue, everyone begins screaming the pair that they want. There is a strategy to this: get there early so you get a seat next to the charge nurse and yell directly into their ear or get there late so you can stand over their shoulder for maximum proximity. Sometimes you get lucky, sometimes you panic from all the pressure and end up taking whatever is last. Sometimes it ends in hurt feelings, bitterness, and cussing. All that fun before your shift starts.

You either skip with glee or drag morosely to your side (depending on the pair you got) and get report from the off-going RN. There's also a system to this and some people get really FREAKED out if you don't follow it but that's for another day. You begin your 8pm (2000) assessments. Then you chart. The goal is to be done by 8:30-8:45. Now if your patient throws up or poops or some other calamity, the course of your night will already be altered. But you go with it. Flexibility, people.

At around 9:30 (2130), you can start doing your 10pm stuff. You go get your meds out of the pyxis, empty the foley bag, clear your pumps, give the meds, and chart. We do I&O's (intake and output, remember it- I don't want to have to define it again young lady) twice on night shift which is fine if you have one pump but sucks if you have to count about 9 JP drains, two chest tubes, an ostomy, a foley, and a flexiseal. If you don't know what some of those things are, there's a little thing called google.

Now at this point your night could go several ways. Your side could be getting a lot of new admissions so you spend all your spare time helping your cohorts. You could have an existing patient crump out of nowhere and end up coding him. You could have a habitual pooper (the worst) and spend every 30 mins cleaning up the same you know what. On a magical night, when the mice and birds sing to you and you're home by midnight with both glass slippers, everyone stays quiet. You spend some time chatting with your friends or reading a book. But sometimes you're bored and want to stay busy. So whether it's good or bad depends on how much sleep you got the day before and if you just want to go home already.

At midnight you reassess your patients, give meds and draw labs. If you patient has a great arterial line, then you can draw the blood from there and it takes two seconds. Piece of friggin cake. But let's say Pedro here doesn't get blood return from his existing peripheral IV's and has crappy veins. You spend about 30 minutes looking and poking at veins until finally you get barely enough and pray that lab doesn't cause a ruckus. I can't even get into the subject that is lab. Probably not ever, if I'm attempting to do this thing called sanctification. If you have a neuro patient, you might have to travel down to CT scan. You have to unhook your patient from all non life-sustaining drip meds, pack them up, and transfer them to a stretcher. That takes anywhere from 5-15 mins. Then you and either the respiratory therapist (if you're patient is vented) or a tech go down the elevator, push the stretcher really fast like this is vitally important (it makes it so much more dramatic and entertaining), get to CT, move your patient onto the CT table, take the CT, and do the whole thing in reverse. Reverse. reverse. Everybody clap your hands.

Everyone usually bathes their patients between 2-3 am because there's not much else you need to do during this time. Granted, if your patient is stable and sleeping, you might want to spare them the early morning embarrassment and let them do it themselves during the day shift. At 0400 you reassess again (last time) and chart.

Now around 0500 an ominous thing occurs. If you're a rookie, you get sucked in but later on you learn how to deal with it... Medical students. They come to your bedside about 0515 and want to anything and everything about your patients. If you don't know any better, you'll waste a good 15 minutes updating them because you believe they actually have some impact on patient care. Now don't get me wrong, I love myself a good med student, especially if he's cute and nice to me, but there's a time and place. When I'm tired at 0515 is not that time.

At 0530 you start again with meds, I&O's, and maybe a serial lab or two if we're gettin crazy. The doctor teams starting rounding and everything starts to wake up (except you, who are on your 3rd cup of coffee). Family members come back in and your replacement nurses make a lap or two before shift starts. Those last 30 mins (0630-7) are the longest of your shift. But they do come to an end, you give report, and assuming nothing happens and you don't have to intubate or code anyone, you clock out and go to breakfast. The sun is rising and the early morning traffic is at its best as you drive home to convince your body that yes, now is the time to sleep.

There you have it. I hope this affords more clarity to those of you who see my job as a nebulous cloud of abbreviations and big words. And if you ever want to go to breakfast when I get off, let me know :).

4 Truths and a Lesson

People often ask me "what's the craziest thing you've ever seen at work?" I will now share with you, blogging universe, some of the highlights after my own introspective moment.

Until college, I would not have considered myself an outgoing person. I was perfectly adequate. I was not the life of the party neither did I have fun stories to tell or make people laugh. I became more outgoing partly because I grew up a bit and became more confident but also because I forced myself into a lot of situations that seemed intimidating and did many things on my own. Now I'm the elected social chair of our small group (don't laugh, we like it) and I don't find myself uncomfortable in social situations (save a few, especially if there's a boy I have a crush on. Then I shut up completely). Generally I could talk to a wall and it would like me back.

Now people sit and listen intently and, can you believe it, laugh at my stories! Who would have thought I'd see such a day. Mostly it's because I have a cool job and see ridiculous things. But it's been a new change for me so thanks for laughing guys.

In no particular order....

Crack does more than kill your brain cells.

Gangsta comes in, high as a kite, complaining of a headache. Because it's not a life-threatening injury he doesn't get immediate treatment but waits in a room to be seen by the physician. Some time later a nurse comes in and sees him unconscious with a pool of blood behind his head. So naturally, everyone freaks out, takes him to CT, etc and guess what they find... I know you're waiting on the edge of your seat... Gangsta buddy here has a bullet in his brain! Apparently he was so doped up on crack that he didn't notice he'd been shot in the head. Not really sure how you miss that one...but he landed himself an emergency craniotomy and all expense paid trip to the ICU, complete with restraints and a draining device in his head called a ventriculostomy. Spin the wheel again and see if you get the corvette.

This one was horribly sad and I wish I had never seen it. A middle school aged kid went out to ride 4 wheelers with his dad, like many children do everyday. He had a helmet on and everything. But somehow he took a terrible spill, helmet came off, and he bashed in his brain. After he was delivered from the chopper, they rolled him in and you could see his brain. His skull had been destroyed in one area and I could see the inside. It's cool on a cadaver, not cool on a child.

You thought leeches were a thing of the past huh, along with bloodletting and casting magic spells on people with rabbit's feet. You have been misinformed sir. A young cattle rancher was practicing his roping with a calf, got the rope caught around his thumb, and took it right off. He did get the calf, in case you were curious. So in a valiant attempt to re-attach his thumb, they put leeches on it to improve the circulation and hopefully the thumb would heal back together. So you walk into the med room, open the fridge to look for some jello and hello! there's leeches, not to be confused with the juice or ensure. Just another reason why you should always check expiration dates.

Last one. A young girl is driving down the road, gets hit, runs off the road into a yard, and ends up with a 2X4 from a fence through her neck. THROUGH HER NECK. Because the paramedics can't just take it out, they have to saw off both ends and bring her to the hospital with a part of the wood still in her. (Obviously I did not personally see this but I read the chart so shut up). They take her straight to the operating room and remove the 2X4. At a cost. Her spine was so destroyed from the injury that she became a quadraplegic. I had her as a patient one day and she was the sweetest thing. Most of the time, quad patients are not the most fun and you can't blame them because their life was drastically changed forever. I'd be in a pretty bad mood, no doubt. She was younger than me. Talk about a reality check. You better believe I drove carefully on the way home.

There you go. Snippets of my crazy life. Lessons: drive carefully, flush that crack down the toilet, and call your mom to tell her you love her. Always wear a helmet and a seat belt. Figure out what you think about God. If you want to chat about it, let me know and I'd love to talk with you. Kiss your kids before you leave for work. Always put the safety on. Never go to bed angry. Don't drink and drive. At the end of the day, sometimes things just happen despite what you do to prevent it. But my kids have no chance. Not even sure if I'll let them play baseball. At least I've got some time to decide on that one.

Who I am.

Last night I got into a debate with a co-worker about why God allows a young girl to get into an accident and teeter on the edge of death. This little girl was in the bed in front of us, all too real and close to home. I tried, in vain, to convince this co-worker that God is good, sovereign, and all things fall through His hands. I told him of Christ, who took all the deepest earthly pain and suffering along with the unimaginable wrath of God, so that we might live. He bore the pain so that we wouldn't have to.

But he chose to fight back with arguments and words and I'm not so much into arguing into the wee morning hours so I gave up. If I had another chance, this would be the story I would tell him.

When I was 14 I sat in that hospital bed. Right down the hall from the one we were looking at last night. I was afraid, in pain, and honestly had a moment or two thinking "what if I die from this?". I had a bad turn on a go-cart and ended up wedged underneath a van in the parking lot at my dad's office. I couldn't breathe (punctured lung) and everything seemed distant and surreal. This is shock, I assume, a state of protection for your body that protects you from feeling pain at that moment and almost gives you a sense of euphoria, from the catecholamines.

My dad threw me in the back of the car and raced me to the hospital. If you ever want to get right in without a wait, just come in sucking air and collapse on the countertop. It works.

I remember them cutting my clothes off and I didn't care, which was significant for me because I was a little Christian girl who didn't hardly wear spaghetti strap shirts. After a CT, they told my parents that a level 1 trauma center is what I needed so off I flew. Comically, the only thing I remember about that flight was that the guy nurse was cute and I cursed myself for looking so terrible on this occasion. Better luck next time.

I was admitted to the ICU, started on some fantastic drugs, and monitored for complications. Truthfully, I have almost no recollection of my time in the ICU, probably because of the medications. I can only wonder what ridiculous things I said under the influence. I'm sure my mother will never tell me.

The team was watching my blood levels, hemoglobin and hematocrit, to determine if I would need surgery because I had basically cut my liver in half inside my body. Your liver is a very vascular organ so you can bleed out quickly and drastically. They were watching for my levels to get to a certain number then they would take me to the OR and cut me open. At the time, the mortality of this surgery was close to 40%. Meaning, out of every 10 people that go in there, 4 don't come out. This is exactly what parents want to hear while they've already jumped off the cliff of sanity.

By the sheer grace and mercy of God, my blood levels got to the lowest they could go, then started coming back up. My body was healing itself and, fun fact: your liver is the only organ in your body that regenerates itself! Crazy, huh?! So my good ole liver started doing it's business, my lungs decided to grant me some air, and I got better. There were countless complications that I could have encountered but I was spared them all.

This sounds like a horrible experience to have as a young child you might say. Well, yes and no. Horrible because I couldn't hardly move my body for a month because of intense muscle spasms. Great because I basically got out of doing school for that amount of time and everyone glossed over the fact that I just didn't take my finals.

About two years later, I had a dream. In the dream, I was the patient in the bed, the same bed that I had on the floor actually. But I was also the nurse, taking care of myself. I was looking down on the scene as an observer and woke with a feeling of overwhelming sobriety, as if God had communicated a very secret and special truth to me. I didn't fully understand it at the time but soon decided to be a nurse and have never, not ever, changed my mind. Ask anyone halfway through college and they will tell you that to know what you want to do is rare and to be a nurse is arduous and time-consuming. You have to want it and I did.

Through a series of crazy, God-ordained circumstances, I now work on the same unit that I was patient. Some of the nurses remember taking care of me. I still joke with my doctor about how he told me I couldn't cheerlead for a while and I cried.

Does that sound like God didn't know what He was doing? I don't think so. I think it's hard for us to see past certain difficult, even tortuous experiences but God isn't surprised. He lets everything fall through His hands and "works for the good of those who love him, who are called according to His purpose" (Romans 8:28).

I could say much more on this subject but that's for another day. I'd love to hear your thoughts. I think a testimony is about the most powerful thing that I have to offer on this subject. I know it's true because I lived it.

An Inconceivable Love

Three weeks out, India still seems like a jumble of experience, coated with culture, and laced with a sense of foreign mysticism (and possibly dysentery). The country does take on a personality, a life of it's own that forms in your mind in it's own unique way. Everyone sees it differently, takes away various nuggets of truth, and finally realizes they have a love for it they did not immediately perceive, especially after eating straight naan for a week. It's invariably true that you come to love even the disgusting or repulsive parts along with the beautiful because, in the end, it wouldn't be one without the other.

My writing right now has no cohesive train of thought. Stream of consciousness in it's highest and most chaotic sense. I believe part of this to be due to the nature of India. In India, anything can and does happen. If you can't leave the hotel because of a train workers strike, then so be it. If the rain causes the conference to be delayed a day, so be it. If you work so hard on planting your crops or harvesting and it gets destroyed in an instant, so it shall go. Start over and stop crying about it. Thus is the mindset of the people and it's manifestation in life. No one starts yelling "but I need to get to work!" because everyone adapts to the changes and no one takes the liberty of getting upset at others. No one furiously spats, "I'm an important person and I deserve better!" because the harsh reality is that there are a billion people in this country, and you sir, are simply ONE of them. This country was built around a collective humility of self that doesn't allow one individual to demand of others. People die if they don't work together. And you sir, will get swallowed up by the masses that you viciously insult. Don't mess with a billion devoted people.

Contrast this to The Great U.S. of A. We perpetuate the idea that everyone should rise to the top, be an individual, build a great building and put your name on it. Then you will be immortal in the science building of Texas Tech University. Sorry, but we strive for these lame claim to fame's as if a 100 years from now, anyone will care. I'm pretty sure no one cares about Tech now, but I'm only joking.

I left the airport in India (Mumbai might be my most horrific travel experience thus far, but that's another blog for another day) with a feeling of lazy contentment that excluded any sense of the frantic, stressful, and overstimulated. But what did I do when I landed in Chicago? Pulled out my phone and caught up on the 400 tweets I had missed. Checked my facebook to see who had desperately missed me while I was gone. Called my parents (probably the only noble thing I did while waiting in that customs line). I seriously could have kissed that dirty, germ-infested airport linoleum for the sake of being back in the familiar and getting a giant spinach salad. Yes, these toilets looked safe for human life and I was allowed to wear my shoes in them. Bless American hygiene.

Now, looking at photos nostalgically and remembering that yes, I was there and yes, it was real, I find myself losing all of the lessons I learned so very quickly. You go to a foreign country to glean some better aspects of their culture, correct? Then why am I so desperately attached to mine, even when I realize that some parts of it destroy my soul in little bits everyday?

Music in the car was offensive to me when I returned. Not just, turn it down but oh my gosh this crap causes me to have facial contorsions and spit it out like a knuckle in a chicken. Gross, I know. But now I don't mind. I've settled into the routine again and honestly, it pisses me off. It's as if America is some natural born addiction that forces me to pump Entertainment and Pleasure into my veins through an 18 gauge. I feel nauseous and unsettled without it because it's what's expected of me here. In India, I could get away with laying around for 2 hours, chatting, reading etc and not feel a sting of guilt about it. Well that feeling has long passed and I wonder how to get it back. What's it going to take for me to sustain those feelings against our culture of constant busyness, over-booked schedules, and obsession with success and beauty? Not one of those is a valiant quality and we have unknowingly, used our precious and valuable freedom to a sickening extent.

I don't have the answer, just an awareness of it. There's no anecdotal conclusion to this blog, no sentimental truth to leave you with except don't be ignorant of what the Lord shows you- here at home or at the farthest corners of the earth. Ignorance is not always bliss. Knowledge is uncomfortable but eventually, life-changing. I choose change any day of the week.

p.s. I realize these blogs aren't about nursing at all but get over it, my two followers :).

Uptown Billionaire vs. Slumdog Millionare

I woke up this morning to an empty suitcase, clothes thrown around the room, and a frantic checklist of items I needed. Then it dawned on me...."I'm going where? I'm leaving when? Como say what?"

There are three sides to the internal cacophany that is my mind. First stage: the state of conscious, the part that makes decisions and entertains passing thoughts throughout the day. This part is what I regurgitate into this scattered stream of consciousness blog that I still can't believe anyone reads.

Stage Two: the "It will all be alright" state of mind. This is the part of me that, when I don't feel like fretting over some huge or small circumstance, dismisses whatever it is and decides that no matter what happens, it will all turn out ok. This is the part of me that feels better about life because I believe in the existence of prayer, insurance, and Liam Neilson when he's angry. However, I should know better than anyone through working in trauma, that sometimes that's not the case. It's not alright and you end up with a 2X4 in your neck, paralyzed from the chest down. (That really happened btw. Chew on that). Yeah that's real life. Hence leading to the last part of my consciousness.

Stage Three is the rational, type A, oldest child, I'm-a-freak part of me that makes to-do lists, has a stash of emergency band-aids in the car, and checks CNN for travel alerts. Besides the fact that my environment and genes lend me these insane characteristics, there are obvious advantages to being on top of life. Organization leads to less stress and saved money, as in no overdraft fees, stupid late fees at blockbuster (that I thought we got rid of 18 years ago) and a feeling that yes, I'm reliable. You can count on me. Let me just put on a blinding fake smile, pretend to be a megachurch pastor, and solve your problems. Yes, *smile*, you.

I am in constant conflict with the last two parts of my personality and I expect it to be so in India. I want to rid myself of my American tendencies but that's easier said then done. I want to go with the flow but we are already 12 minutes late! Sorry self, but no one cares in India. Meeting someone at 3 means between 1 and 5. Throw the planner mentality out the window. And the accompanying small lightweight pen. Do it.

I am gallavanting halfway across the world and bringing all of my American sentiments and bad habits with me. "Oh, no matter that Americans can be ethnocentric spoiled brats because you need us to help you. My one tiny insignificant self can change your country for the better. In two weeks. You're welcome, I'll be expecting my thank you card from the Dali Lama asap".

Ha. India is a beast that honestly, I'm not ready to experience in all it's smelly overstimulating glory. It's going to require putting aside many of my (American) bad habits: timeliness, expectation of functionality, fear of loss of control and the unknown. At home, I ardently attempt to control my life because it's easier that way. I can prevent undo stress or heartbreak or annoyance by expecting the world to do my bidding. That works for about 20 minutes and then you get a flat tire, forget a doctor's appointment, or get in a car wreck. Ask anyone over the age of 11 and they will agree. Shit happens. But life would be boring without it.

I hope that I can shed these fears and insecurities to embrace Indian life and culture, as raucous as that might be. There's a part of me that desperately longs to discard the aforementioned addictions and be free to listen and hear what the Lord has for me.

And knowing myself, I'll probably come back and want to save all the baby children, not buy shoes for a year, and eat curry (maybe not the last one). But would that really be so bad? To valiantly go against the cultural grain and make drastic changes to live for something more? I don't think so. I think the slumdog is going to win this one.

So here I go, the good along with the bad. My ethnocentrism combined with a deep love for people and culture. My timeliness along side a beautiful spontaneity that exists in this country. And if anything goes down, there's always Liam Neilson to kick some ass. I feel pretty good about that.

Assault on the Senses: Part Auditory

When I get home at night (or get home in the morning) I hear incessant beeping. Ventilator alarms. SCD alarms. IV pumps. Heart rate alarms. Apnea alarms. Tube feed pumps. Are you getting where I am going with this? It's an overload of my auditory system and the noises creep in to haunt me in my dreams. It's like I live there. All the time. This whole thing is nuts.

When I first started working in the ICU, I ran around like a frantically confused sprinter, dashing left and suddenly turning right as if I'm in a seriously deranged scavenger hunt. Looked quite insane not surprisingly. Why, you ask? Because as a resident, you HAVE to respond to your alarms because despite the fact that there are 12 other people around, it's the middle of the day, family is at the bedside, and I can actually see him from where I'm sitting...I need to be there in 2.4 seconds. Time travel is slower than your reaction time.

The resident downfall is you haven't yet determined which alarm makes which noise. It's a cruel but entertaining game for everyone else as I run around trying to prove my worth and figure out which patient is beeping, is this alarm something vital, or can I go back to being behind on my charting and making my crazy to-do list. (Residency leads to an unexpected level of insanity; I think I was normal before I started all this...)

I tell Javier to quit bending his arm because every time he does, the IV pump stops working. He clearly does not comprehend this and I try again in espanol. Then in french. I even make up some Mandarin just for good effort and use extravagant hand gestures. No luck. Short of taping him arm to the bed, I have no choice but to sit there and play that game where you hit the head of the mole as many times as quickly as you can. Because clearly I'm too intimidated at this point to just put in another IV and switch the line. Way to NOT be resourceful Nat.

One night I have a patient who I personally diagnosed as paranoid schizo, ADHD, Bipolar, defiant, and plain freakin crazy- for one characteristic. He ground his teeth. AUDIBLY. ALL NIGHT. So I spent the 12 hours having a consistent layer of goosebumps because I was sitting in front of nails on a chalkboard. We tried a bite block. I tried to rebuke him in spanish. I gave him every drug and he was just as chipper as ever. Drug tolerance is a bitch.

As if my ears weren't already ruined for life, I now know every cuss word in the dictionary. In spanish. I can't even begin to talk about this because my mother reads this. (Hi, mom). You'll get a neuro patient who has DAI and doesn't have the slightest clue what's going on in the world. They just know that you are princess star sword and you are going to leave them there with the monkeys to die. Yes, clearly that's what's happening here. They cuss and you tell them to shut it, "that's not appropriate talk, this is a hospital", and they continue to keep you as a fish on their line who has to stay at their bed to continually re-iterate that, despite the fact that they are being torchered by us (the evil pirates), we are in fact, trying to save your demented self.

I could go on and on and on and on (wilco song anyone?) of stories that hurt my ears to recall. At least now I have mastered the alarms and can watch new residents and make fun of them. In an empathetic way. I feel for you, little baby nurse who burns 12,000 calories a day in constant motion. It's the way it goes around here.

And I've never been more thankful for my full set of lovely, not ground teeth.

Drama in the ICU

It's amazing to me how annoyed I get when patients are independent. You would think that this would be a good thing- that they can eat, get up to the bathroom, and hold a conversation with you. Good for you, trauma victim, but you need to get out of the ICU already.

It's bothersome when you spend 45 minutes helping meemaw eat her red jello. It takes 45 minutes because she chews like a cow and somehow everything seems come back up and get chewed again. Precious meemaw, but I really don't have time for this. Then she will undoubtably throw it up in 15 minutes and now you are back to square one with a vomit bucket that patients think is blood. Don't freak out, meemaw, remember, it's your jello.

Sweet Lupita can get up to use the bedside commode. So you unhook her leads, saline lock her IV's, put down the bedrails, swing her legs over, help her up, and finally back down on the makeshift toilet (we don't have real bathrooms, our hospital is slightly ghetto...). You leave the room, she sits there for 5 minutes, and you do the whole fiasco backwards. 35 minutes later you start again. She mentions something about overactive bladder. Ah. Perfect.

Meanwhile you are giving saline boluses for low blood pressure and administering blood products on your clearly sicker patient. But Lupita can't wait. At this point, you sequester the help of your neighborly nurses and promise to write them a nice "star" on the board. They are clearly overjoyed at this high honor. Yeah right. But they help you out anyway.

Clark is lonely. And he wants to tell you his life story. He was married, then decided he was gay and then his lover died etc etc etc. He's full of drama. Clark wants you to read his text messages from his new lover, to decide if he's really serious about him or not. Well has he come to visit you in the hospital? That might be a good indicator...

You avoid Clark as best you can, not because you aren't interested in his tumultuous love life (it's clearly interesting), but because you're behind and you have to be efficient. Clark finally appears to be asleep so you sneak in to count up the I&O's (intake and output). You tip toe around the room, obviously holding your breath because Clark has some seriously intune senses. You manage to do your job and it looks like escape is within your grasp when....the apnea alarm goes off. It's very loud and annoying and clearly I can see him breathing so it's a false alarm. Your cover is blown and Clark pops open his eyes to show you the most recent text. Well, it was a good effort. Better luck next time.

Sometimes the root of this annoyance is making sure you give good care to both patients. But mostly it's selfishness. It makes my job harder and I'd rather you just lay there sedated and intubated. No talking, no consciousness. Sounds terrible, but ask any ICU nurse and they will admit the same thing. I'd rather be busy anyday titrating pressors and giving blood and going to stat CT scan than helping you up to pee about one drop then get back in bed to do this all over again. I guess that's why I don't work on the floor.

The Lord has been teaching me patience lately mostly because of this issue. This entry is a comic confession of my sinfulness. I like things to happen quickly and efficiently and I get frustrated when something doesn't go the way it should. But the reality is life is just like that, no matter what job you have or what you are doing. Things don't go as planned and it will go a lot better in the future if you and I realize this now. I am attempting to give up some of this type A control issue and pursue a more relaxed and flexible perspective.

So I bite my tongue and do my job, suppressing the thought in my head that this is a pain in the ass. At least I have good stories right? And there's always Clark there to give me relationship advice. He's actually a good listener with great advice. Who would have thought.

Code. Blue.

A friend asked me the other day if it bothered me to see people who had devastating injuries and weren't going to make it. I answered not usually. Then he asked if it bothered me that it didn't bother me.

As an individual, it's rather rare to have a patient that codes and dies, unless you are one of those brave people who takes those patients frequently. I haven't quite made it there yet with my whole 11 months of vast knowledge and experience. But it has happened to me. And it is why I work where I do. That might sound strange so let me explain.

Whenever I have a sick patient, my mind focuses on certain things and I work almost completely in tasks. Look at the blood pressure. Titrate the levophed (a pressor that helps keep the blood pressure up by constricting your vessels). Send for the blood. Check the blood. Hang the blood. Talk to the doctor. Receive an order. Implement the order. Etc.

When a patient codes, multiply this approach times ten. The patient is bradycardic to the 40's, blood pressure 65/40. (Hopefully you've already realized what's happening before the pt's BP is 65/40 but sometimes it happens pretty quickly). Call for help. Get the crash cart. Someone else is putting on the defibrillator pads as you break open the med drawer. Tear open the atropine box. Connect the plunger. Give the drug. Flush. Check your heart rate. Still dropping. Heart rythmn is an indistinguishable loose wave. Check a pulse. Not there. Start compressions. Someone is writing down all the times that you give the drugs so that you know when you can give the next one. Etc.

You receive the cooler of blood for massive transfusion protocol and someone checks and hangs the first unit through the Level one infuser (a machine that pumps blood in under pressure so that it goes in very quickly). You hang 8 units and nothing has changed. You've been doing compressions for 25 minutes and nothing has changed. You've given all your epi, atropine, and vasopressin and nothing has worked. The doctor calls the code. Everyone stops. It's done.

Undoubtably, this is a horrible and devastating experience. But I can go home and sleep at night because I know that everyone did all that they could. Death isn't an uncommon or even feared outcome in the ICU. Sometimes patients have been in the unit for weeks and everyone is relieved when the family chooses to withdraw care because there was no quality of life, for anyone.

I have seen the attending doctors come and take a patient back to surgery as a last ditch effort even though usually they just code them in the unit. I can honestly say that they did every single thing they could but the damage was too great. That makes me proud of where I work and also you better send me there if I am in a life-threatening situation.

It's this crazy adrenaline rush as you move from task to task with your mind running a mile a minute. I would liken it to the feeling a marathon runner has at the end of a race. Or a mountain climber when he reaches it to the top. The journey itself wasn't necessarily pleasant but you feel accomplished and purposeful at the end of it. And you know you've done something that's bigger than yourself.

It doesn't happen often, but when it does you have to pull out everything you've learned and use it. You have to put your emotions aside and focus. Because this is the end of the line for this person. It doesn't get more serious than this. And I work here? That still amazes me.

Sometimes I go home all worked up and eat my dinner in about 3 minutes. I can't seem to calm down but it helps to talk to a friend or watch tv to get my mind off of it. If I go out after work, my mind is still processing the events of the day. It does bother me. But it can't while I'm at the bedside because that's my job- to try and save a life.

I've never cried about it. Maybe one day I will. Maybe I should cry. Or maybe it's simply a self-preservation technique so that I will indeed come back the next day. And without fail, I do come back for more. It's the addicting paradox of the ICU. And I love it.

The scenario goes like this:

Stupid kid goes to the bar with his buddies, has not one, but twelve too many. Starts a ruckus of some kind, probably swinging punches at the guy who unfortunately happened to glance in the direction of this guy's girl while he was looking for the score of the game. Fight breaks out, police jump into action and stupid drunk kid is so out of it that he starts to lose his airway and EMS has to come. Intubated for low GCS (Glascow Coma Scale- determines level of consciousness) and combativeness. Comes to the ICU for...no reason... except that he's a jackass.

...No matter that actually sick people need the beds when you decided to let all those bottled up emotions out at one time. Hope you got it out of your system. Next time try the gym..

Anyways, mom comes in hysterical, crying and pacing while asking questions in incomplete sentences. The doctor tells her that though her son is unconscious right now due to his blood alcohol level, he will wake up and will be extubated (breathing tube removed) with, most likely, no problems. Mom starts to pick up that there's nothing wrong with him and calms down.

The next morning, now just stupid hung over kid, wakes up and flips out, trying to pull out his endotracheal tube. By now he's following commands and is with it enough to pull the tube. The doctor comes to the bedside and the respiratory therapist extubates him.

Here's the great part. Mom comes back to the bedside and the first thing out of her mouth is "I'm gonna whoop your ass!" To your tremendous surprise, parents don't like paying for an unnecessary hospital stay for a diagnosis of immaturity and impulsivity. Mom lectures said stupid kid about how he's coming home with HER this time and "there ain't gonna be no more of this bullcrap" Or almost as likely, the equivalent of this conversation in spanish complete with grandiose hand gestures including pointing and "A Dios mio" every once and while.

After extubation, now stupid whiny kid complains about everything from the temperature in the room to his throat hurting to why can't he sign himself out now and leave.

ME: "Yeah your throat is going to hurt. You had a tube down it for 24 hours. It will go away. Here's some meds"
ME: "You can leave AMA (against medical advice)" (You are thinking to yourself "knock yourself out, sign the paper and get out of my face") You actually say, "It's better that you stay here until the doctors are ready to discharge you. You were very drunk"
SWK (stupid whiny kid): "Like why do I gotta be here? Don't touch me. Ooooooowwwwwwwwwwww.
ME: "Sorry, all I did was lower your bed"
SWK: "Yeah but you did it too fast. Can't you be more considerate?"

And this goes on all day. I didn't go through four years of school to be your babysitter or your personal assistant or someone for you to bitch at. Let's start a new chapter of your life entitled "Actions have Consequences".

I realize this sounds very cynical and sarcastic. It's a coping mechanism and it's pretty funny to me honestly when I think about what some of these crazy people do. But in reality, I do care about their life and I want them to make better choices. Sometimes it's better to lay it all out for them and set them straight. Being super nice doesn't work most of the time. Setting limits does. Not letting patients bully you around does. Otherwise I'll get taken advantage of and they might not ever have someone get in their face about the reality of their life.

Most of these people don't have an education. They've never been taught better or didn't have any good examples to follow. This is what they saw growing up and unfortunately, it's what most of their kids will end up doing. It's a cycle of ignorance and poor choices. So if stupid drunk, hung over, whiny kid wakes up to the fact that the next time he comes in, it might be in a plastic bag, then maybe it was worth it for him to take up that bed overnight.

It's much more tragic when mom doesn't come in and yell at stupid kid but stares at him with apathy. Or she doesn't come at all. But at the end of the day this kid will go home and back to his normal life. Hopefully somewhat wiser and less rambunctious.

"Nurse?" (Because there are only two pronouns in the hospital: Nurse and Doctor, despite the fact that thousands of people work there)
"Yep. What's up?"
"So I can still drink right?...."

Oh dear goodness. Square one. Here we are, standing on it.

Would you like another martini?

ICU psychosis might be one of the more comic aspects of my job. Mostly because I'm slightly mean and it is actually hilarious to encounter these folks in their delirium.

Consider Mr. You-Better-Take-Me-Seriously. He, in his altered state, ardently believed that he deserved a cocktail and deserved it now. It probably was close to 5 o'clock but how would he have known that?....Anyways, he's screaming at every person who walks by that he "need a martini! On the rocks!"

ICU psychosis is a condition that some people develop as a result of constantly being woken up for procedures, having the lights on at all hours of the day, and soon losing track of whether it was 1 am or pm. Because we draw labs at midnight, tend to do baths at 3 am, and re-assessments at 4 am, you can imagine how much restful sleep one gets.

So we indulge Mr. You-Better-Take-Me-Seriously and give him an empty cup, telling him it's his martini just like he wanted. (And the funnier part is that going along with it often puts them at ease). He started sipping his empty glass, saying it "hits the spot". He was content and only then began to tell us tales that seemed to be a compilation of Vietnam war stories and vignettes about his house full of cats. It ended up being a fusion of war-ready felines and it was hilarious.

Usually we put patients on a sleep-wake cycle, which generally means that you aren't supposed to wake the patient up from 11 pm to 5 am to do baths etc. This is usually feasible, except when the patient is on the neurosurgery service and has to be woken up every hour for a neuro check. A neuro check consists of asking them simple questions like their name, where we are right now, and what's the year or who's the president. It takes one minute but you can probably guess that patients are ecstatic when you wake them up to ask them if they know their own name.

Little Miss Precious-Old-Lady was just that. Precious. And 79 years old. She was delightfully confused black woman who had ICU psychosis and waved to everyone walking by. She was restrained so it ended up looking like she was having a spastic hand cramp under the sheet because she couldn't lift her arm off the bed. But she wasn't phased by this. She looked at everyone who came up like she had known them for years and was so pleasantly surprised by their visit! One time I simply looked at her with a big smile and she said "I love you too dear!" We don't get that kind of affirmation from our patients often so I laughed out loud and told her I loved her too. Precious.

She wised up to the fact that we were asking her where she was every hour...and that she couldn't remember.
"Miss Precious, do you know where we are right now?"
"Yes"
"Where are we?"
"Here"
"Where's here?"
"This building"
"What kind of place is this?"
"A business"
This went on for a while as she cleverly tried to maneuver her way around her own dementia. You've got to give her points for trying.

All in all, you have to wonder what you would say if you were in the same spot. Would you tell your biggest secrets or talk about your family? Would you be pleasant or onery?

I think I would tell everyone I love them... just like I do when I have one too many. But I would be pleasant and I hope people would indugle me.

I think Little Miss Precious and I could be good friends. You've got to the love the old people in your life. Because even if they are confused, they have lots of love to give. So give it back, because one day we will all find ourselves in the same spot...probably asking for a cocktail.

Thoughts on Mortality

This one might be on the verge of morbid so you've been warned.

Working with trauma patients makes you realize how seemingly random life really is. There are people who get hit by a bus walking down the street or go to work one day and get shot by a crazy employee or stop to help someone by the side of the road and lose both their legs. It can get to you if you think about it long enough, because it makes you look for the situations that put you in danger. I'm driving up the Tollway and think "if I made one slight wrong turn of the wheel, I would be dead". And that's the reality.

Good things happen to good people. Bad things happen to bad people. Bad things happen to good people. And so on. There's no formula and, while you can calculate the risks to some extent, it's still out of our hands.

If you're like me and ponder such things, you are forced to decide what you think about these "spontaneous and unpredictable" events. Is it some kind of natural law of fate? Is it karma? Is there a God? How can He be good if He allows horrible things to happen?

Take the tragedies around the world lately. People were at home fast asleep in bed when suddenly their house crashed in on them. Here in America, we support financially and pray and do what we can but the truth is we don't want to dwell on that. We don't want to believe that such things could happen to us. It makes life too real. And most of the time, we prefer our ignorance induced by television and convenient distractions. I do it too, it's a natural reaction.

So I made my decision about this subject. And that's how I sleep at night. And go to work everyday. And drive on the Tollway.

"Who has understood the mind of the Lord, or instructed him as his counselor?" Isaiah 40:13
Everyone from Job to Isaiah to the Psalms has struggled with this question and the answer is that God is sovereign. He does what He pleases. And His ways are right and good.

I will never understand why bad things happen but I can rest because my Father knows. He planned it out and He works for the good of those who love Him, who are called according to his purpose. So as Jesus says "You must be ready" for we do not know the future. And I can trust that.

So for now, I do my best to help those people heal and I try and not take my health, my security, my comforts for granted. Because you never know.

Resuming said blog

Alright, I know I have slacked off for the past however many weeks but I have discovered the root of the problem.
I have writer's anxiety. I get anxious that people won't like my blog or that it won't be funny and I have decided to abandon such thoughts. I love to write and, while I will continue to write about the crazy things that happen to me at work, I am going to throw in random thoughts.

So here we go. Again.

Yesterday my patient told me his previous doctors told him he had "sleep acne". After a split second of rumination, I realized he meant "sleep apnea". I held in my amusement but it continued. I was about to give him a subcutaneous injection of insulin, which is standard protocol in the ICU. He freaked out at the sight of a needle, regardless of how tiny it was, and said he refused a shot. I tried to explain that it wouldn't hurt and we give it to everyone. But he resisted further when I told him it was insulin.

He started protesting that he wasn't diabetic and he didn't need insulin. He then stated that he was "not gonna get addicted to that stuff!" I was laughing so hard internally that I didn't even protest. Insulin is made by your body; that's like being addicted to water. I should have done some education there but I let it go.

2 units of insulin: not given, patient refused.

Unfortunately, this man did not have a permanent residence. He lived in a shelter and, surprisingly to me, had one of the most pleasant dispositions I have encountered as of late. It made me think about how much I complain and compare when I have so much to be thankful for in my life. I take my nice apartment and supportive parents and meaningful job for granted. In Ecclesiastes, Solomon talks about how there's nothing "under the sun" but to work hard and enjoy the blessings you have been given. I aim to be more grateful and enjoy the little moments in my life. Cliche, yes, but nonetheless true.

My patient's girlfriend was laying in the bed with him every time I walked in. Not usually allowed, but pick your battles. The next thing I hear is her yelling "You don't know me at all!" and storming out. Hope it works out.

16 and RN

There is one question that I get asked more frequently than any other: How old are you? Apparently being twenty-two but looking like you’re sixteen is not in your favor when people are literally entrusting their lives to you. Who would have thought?

When I walk into the room, the patients give me this quizzical look that doesn’t exactly make me feel warm and fuzzy inside. The look says, “Why are they letting high school kids act like nurses?” Often I want to waltz in and pretend that this supposition is actually the case.

“Ya, it’s crazy that they let me come and play today! I’ve like never really done this before but I’m sure it like can’t be that hard. You can like tell me if I do something wrong right?” Brilliant fantasy.

It’s almost more awkward when I get a patient who is close to my age. They either ignore me and don’t comprehend the authority that I have over them (like I’m not keeping you alive…) or try and be my best friend by asking extremely personal questions and requesting a bed bath. Both are bad approaches.

LaDamien was near my age and seemed very bored. I went in to check the Mavs score and see how he was doing. He proceeds to play twenty questions with me like we were on a blind date involving stool softeners and vomit buckets. At least he cared to know what my favorite color was. Sweet, very sweet.

He asks for a piece of paper and a pen and in my naivete, I give it to him without thinking. He concentrates for a moment then hands it back to me with his phone number scribbled on it. I’m shocked honestly and fumble around for words that end up in “wow, thanks! Yeah that’s great”. No matter that it’s completely weird and against hospital policy to date patients. Unless he was rich and attractive, then I might reconsider.

All in all, it was a flattering, uncomfortable, and entertaining experience.

And then I had to take out his foley catheter. Yeah, that’s right.

Hey-sus

The Extraordinary Adventures of Nurse Natalie

I could not get Jesus (Hey-sus) to be still for the life of me.

Round one. “Hey-sus be still. You’re gonna hurt yourself. Be still Hey-sus,” I sit there telling him in my sternest, oldest voice. He doesn’t seem to care. Many patients in the hospital become delusional after a while due to narcotics, or psychosis, or just the fact that they are ornery and are trying to cause you additional angst and frustration. Hey-sus is a prime example of a neuro patient who thought that he desperately needed to get out of bed, and was going to take out all of his IV’s and the drain in his brain in the process. Real smart. Restraints become your best friend in this situation.

Somewhere along the line, I figure I will engage in espanol and see what happens.

“Hey-sus esta bien. Esta bien!” He begins nodding his head like he understands me. Finally. He lays back in the bed and I think I have won against this little Mexican sneak. At least for a little while.

Round two. Hey-sus comes off the bed despite his wrist, ankle, AND vest restraints. The veins are popping out of his neck and his fat, round face begins to get very red in frustration. Apparently my exhortations are ineffective or he thinks we are keeping him to do all kinds of secret tests and pump him full of experimental drugs only used on rats.

“Hey-sus I’m getting frustrated. You need to be still or you’re going to blow another aneurysm. I’m serious buddy.” No luck. My cohorts are staring at me with smug smiles on their faces because everyone has had this experience from time to time and everyone gloats when it’s not them.

Dan busts into the room, “Jesus! (No Hey-sus) What is the problem??” Whether he is cussing at this man or using his God-given name was debatable and I die laughing.

Round three. After yelling at Hey-sus in every language I can think of and throwing some threatening looks, he begins to mock me. Yes, the delirious Mexican man with a bleed in his brain thinks he’s funny.

“Hey-sus esta bien. Esta bein!” He taunts in his best half-English valley girl voice. At this point, I don’t know whether to burst out laughing or get really pissed. I choose to laugh as I slump down in my chair and watch him at his futile efforts to escape my carefully constructed jail cell.

Finally Jake comes over and says in his best gay voice, “I’ve had enough of this shit. Give this senor a Benadryl for goodness sake”.

Benadryl is a miracle drug in the hospital and often the first thing you look for when scanning through their medication list in hopeful expectation. Whenever you have a patient that is annoying or crazy or you’re just plain tired, you ask, “Are you itching?” with a sly smile that reveals your nefarious motives.

“Yes, actually I am itching” or sometimes with our less loquacious customers “Yeah, I can’t stand this shit, get me out of this hell hole”. Perfect answer! Then you give them the magic pink pill and they drift off to sleep while you enjoy an hour or two of peace and quiet. It sounds horrible but when you have a patient who asks you to clean out their ears with q-tips or keeps trying to get out of bed because they have to feed their cat, you would understand.

And at the mercy of the Benadryl, Hey-sus’ tense body relaxes and the irresistible pull of sleep envelopes him as I offer up a prayer of thanks. I guess I cheated in our game of nurse vs. patient but drugs are my natural advantage, my career superpower. All in a days work.

Valiant effort Hey-sus, one of the best. Until next time...