Saturday, April 18, 2009

Adventures in Little Old Lady Land

She was 100 years old.
Arriving by ambulance from an assisted living facility complaining of hip pain. She smiled beatifically as she was wheeled in by the EMS crew who had gone to fetch her, her pale little face peeking out from beneath a halo of white blankets.

The crew had gotten to know her pretty well on their brief ride from her facility and let us know she had fallen the night before, but was up and around; there was no overt sign of hip fracture, sometimes a death sentence for the aged. She lived in her own room and was able to get herself to the dining room for her meals; she managed her own medication, contingencies for her assisted living arrangement where there was no professional staff. Up until a couple of years ago she drove a car, but gave up her license following a motor vehicle crash. "Not my fault!" she piped in, bright and alert and spry......although very, very hard of hearing

Sherry and I and the paramedics oh so gently transferred her from the ambulance gurney to the bed as if she were made of porcelain. I can't recall seeing these big guys move someone with so much care. They carefully tucked n her blankets and bid her farewell.

We undressed her with utmost care, and I inspected her soft white skin, so transparent; this skin is 100 years old, I marveled to myself. "It burns", said Alice, our centenarian, rubbing her hip; there were no bruises or swelling as she pointed to the area righ above her hip bone.

"Shingles", Sherry and I mouthed simultaneously to each other.

"Did you fall down ?", Sherry asked. "Yes, I live in town", replied Alice.

I just grinned.

We xrayed Alice's hip and found nothing. We got her up to be sure she could walk; we found a walker so she we could more accurately assess her ability to ambulate. Alice did just fine, and asked to sit in a chair. We covered her with blankets, got her a little snack.

"We're going to send you home! Do you want anything for pain?", Sherry yelled.

"No, I don't like to take pills, not even Tylenol. I'm fine", Alice said in her little bird-like voice. "I want to go home with my daughter".

The local ambulance service is usually one way, and they weren't able to get her home.

We called the daughter. She said she wasn't able to accomodate her mother, and couldn't give her a ride home. That was just as well since I found out she was 80 and probably shouldn't be driving Miss Daisy.

Alice, now that she was upright, called out "Nurse!?" every few minutes. Sherry asked if she would like to sit in our tiny waiting area to watch TV, and she thought that was a good idea while she waited for her ride. We got her completely dressed, again carefully putting on her clothes including her 20 year old Reeboks. Seriously. We wheeled her to the waiting room which is literally 10 feet from our nurses station.

While in the waiting room, instead of calling "Nurse!?" when she had to go, she stood herself up out of the wheelchair and peed on the waiting room chair; and got back in the wheelchair.

I felt bad but that didn't prevent me from laughing. Her person from the assisted living facility brought a change of clothes.

"G'night, Alice!"

Wednesday, April 15, 2009

About a Nurse

I wasn't going to post this, but what the hell. Maybe it will help

When a young colleague dies for no apparent reason in your own ER it just makes no sense. Everyone is a mess. One nurse can't stop thinking about it, and talks incessantly about how awful it is; but we're all thinking the same thing. When things get quiet and we're alone with our thoughts, one of us will start in. "I just can't believe it", someone will say, or "You know, she...", and share some awful aspect of the whole scenario.

I know. I just can't talk about it anymore

Each time you run into someone new, it's like ripping open a wound. The details are hashed over and over. The circumstances of her death. The funeral. How awful it is that a great nurse and mother of two is gone with barely a life lived; so much that she wanted to do with her life that will now never happen.

This is a religious hospital which has done.........nothing for it's guilt-ridden grieving employees.

Yet, life must go on, doesn't it, no matter how difficult it seems. Those girls who had to perform CPR and post-mortem care on a friend, how do you think they are functioning Mr. Hospital Administrator? They had to get up the next day and go to work just like every day after cleaning her blood off a back board, bagging her cut-off clothes and stuffing 3 miles of EKG rhythm strips into a trash bag. Yet, it was a weekend and we did not have the opportunity to have a Critical Incident Stress Debriefing (CISD) from individuals who are trained to help workers deal with the aftermath of a traumatic event. We weren't offered a hospital chaplain or even a social worker. What did the hospital do for us?


Nurses, xray and lab techs from downtown volunteered to work so that all who wished could attend the funeral. One of our nurses sang a song, a beautiful tribute. EMS sent out a "last call" over the radio, honoring her 14 years of service to the local ambulance service; they had the chilling duty to respond to her house for a cardiac arrest. As he left the cemetery, her 3 year old broke my heart as he waved goodbye to his mother's casket.

Nearly two weeks.....two weeks... later we are offered a debriefing or sorts; it is too little too late in my opinion. Please spare me the religiosity; 31 year old healthy females don't belong "in Jesus' arms, resting and relaxing" when they have young children and a whole life ahead of them.

You bet I'm angry. My attitude sucks and I have referred to so many of the dental paineurs and narcotic seekers as douche bags that my co-workers are getting tired of it. Rightfully so.

The hospital clearly doesn't give a fat rat's ass about us or our loss; if or how we deal with it. We are outof sight and out of mind. Our co-worker is buried in the cemetery next to our facility that most of us drive by each and every day. She will be there forever, and we are constantly reminded of that fact.

As nurses we are used to dealing with grieving families, but are at a loss to come to grips with this tragedy. Time will heal of course, and we soldier on for now. We will help each other through this crisis because apparently all we have is each other.


Passed Humanities CLEP! 8 credits for $75 and one morning (plus about 50 hours of study).
Not having to take 2 courses and pay about $2500.00?

Thursday, April 2, 2009

TNCC and stuff

So, I finished my course from hell, A&PI (and lab) last Saturday. I managed, don't know how, to pull an A out of my...well, you know. Unbelievable. I will be taking A&P II (and lab) beginning next week. I privately emailed my advisor to learn that I will not be having the same professor. Excellent! Someone new to break in.

So, what am I doing on my week off? I'm glad you asked. I spent two days sitting in a class taking TNCC (Trauma Nursing Core Curriculum). This is a course that I have taken 3 times over the years. It is two days of lecture the various aspects of what trauma does to the human body and sets forth a systematic approach to patient assessment, discusses interventions and procedures that should be anticipated. It is always good to review this kind of information. Normally I am a wreck going into any type of exam situation where I am one-on-one with an examiner with nothing but my wits........which normally shut down. Last time I took this course I gave the examiner my maiden name although A) I don't use it and B) I had been married about 26 years at the time. Just a bit freaked. This time, I approached the course from a different study perspective and I did.........nothing.

Yep. I am so burnt from school I didn't open the book. I sat and listened. When it came time for the practice session yesterday, I thought I did pretty well even though I got the pregnant, domestic violence patient which means that I actually had 2 patients to run through.

Today as the written tests were handed out, we were told that some of us did so well on the practical yesterday that we already passed. I figured I'm never that lucky; I was amazed to learn that I had in fact already passed the practical and was dismissed handing in my written test, which I also passed. Done for 4 years, I'll probably be dead by then. School will kill me.

I hate to keep ranting about school, I promise I will stop after this. Panic has begun since I have set some pretty unrealistic goals for graduating next May. I am taking the Humanities CLEP this week; if I pass I will get credit for 2 courses. That will leave me with algebra, college math, American government, and chemistry to CLEP. I won't have a problem with American Govt., but the other 3, not so much. I don't have tremendously high hopes, but miracles do happen. Right now I have a head full of "isms", architecture I never heard of and trying to embed the circle of 5ths without confusing it with Circles of Hell. Dante's got nothing on me.

Wish me luck!