Turn on, Tune in, Drop out

What is up with people in their 50's, 60's and 70's smokin' weed? And every day at that? The sixties are over, man. Timothy Leary is dead (to quote the Moody Blues).

I have gone months using the Admission Screening tool without anyone copping to recreational drugs. People admit to smoking, but I just can't believe that the entire state of NH are just casual smokers. Patients will tell me "oh, 3 or 4 cigarettes a day". Yeah, right; you just naturally smell like an ashtray. Drinking I just automatically assume they are underestimating, unless, as I did yesterday I get a response of "I have 4-5 beers a day and 3 highballs". One guy told me he drinks a 5th of vodka a day. I'm sure he is pickled, and that his BAL ALWAYS hovers around 300. But hey, their honesty is refreshing and we can at least anticipate withdrawal and do something about it.

Very Bad Things

For many years I worked at a really tiny community hospital. The ER was miniscule, only 6 rooms. We used to say "a river runs through it" because the main corridor bisected the ambulance bay, waiting room and 1/2 of the treatment rooms from the registration desk and the remainder of the patient rooms. Even though it was small, we would still get the occasional "really bad thing" that kept us nurses honest, as well as serious about maintaining and upgrading our skills. In fact, 98 percent of the nurses (12 of us) were CEN's (Certified Emergency Nurse). No small feat I can assure you.

I was thinking that this summer is the 20th anniversary of the murder of a local woman by a man who lived in town. There hadn't been a murder in about 60 years, so violent crime was not a mainstay of this bedroom community. The murderer mutilated and partially ingested parts of the corpse (eww) prior to the arrival of the police, and subsequently complained of chest pain and was brought to our ER. It was a media circus for sure, yet we maintained our professionalism and composure even when the police were bagging the vomit for evidence (double eww). The very evil man went to prison for a few years, and eventually died of cancer.

Choosing the ER: Surviving and Thriving

Braden at 20 out of 10 asked me to write a bit on why I chose ER nursing out of all the kinds of nursing that exist. Actually, it was one of many I tried out, but I have done it the longest. I thought back over 30 years to my exposure to various specialties, and it was like Goldilocks' take on the 3 bears house:

Critical Care? Too long in one room with one patient!

OR? Too cold, and too long in one room with one patient!

Pedi? Did that. School nursing, too. Loved the kids, parents were all nuts!

Psych? NOOOOOOOOOOOOOOOO!

Med surg? Did that, but not enough action! Gave me good assessment skills though.

OB? Um, not my cup of tea.

I fell in love with the ER the first day. It was different. It was fast. The nurses were assertive, smart, confident. They were taking care of babies, kids, teens, adults and grannies all at the same time. The nurses in the ER seemed to magically juggle 3 bowling balls and a chain saw while starting IV's, giving meds, giving instructions, and actually making people better so they could go home. The docs not only worked with the nurses, they were depending on them; clearly they couldn't do their jobs without them, and there was none of that "handmaiden" crap that was beginning to go out of style in the 70's. Finally I had found a home where collaborative practice existed. Wow

If you asked 20 ER nurses why they do what they do, you would probably get 20 different answers. Variety. Adrenaline. Challenge. The need to know about a lot of different kinds of nursing, and nursing care across the life span. Some would tell you blood and guts, and it may be partially true; the real answer is probably closer to really helping people when their lives are hanging in the balance, to REALLY make a difference.

ER nursing is physical, demanding, often overwhelming, frequently frustrating, sometimes heartbreaking; the patients flow in endlessly, and the floors often can't/won't take the admissions which creates a bottleneck. What keeps an ER nurse going back day after day, year after year? Well, for me the answer is being part of team; knowing that I can always do better; making a point of learning something new everyday; and choosing to make CARE the most important part of Emergency Nursing Care. That's what makes me an ER survivor.

I'm Back (Part 2)

Where else have I been? Attending graduations, taking two killer courses that I am thankful are over (and for my 2 well deserved A's), having a stress echo, and seeing old friends. I seem to have left a lot of people in my wake over the years, and just reconnected with people from three groups from my past. I spent a weekend at a lake house with four gals I graduated from nursing school with. I had not seen 3 of them in 20 years; it's been 30 since I saw the other one. Let me tell you, we did nothing but laugh for two solid days except for when we were asleep. We did a fair amount of drinking of course, and talked and talked and talked. About family, husbands, life, death of parents, kids and kids, antidepressants, menopause, sex--you name it, no subject was taboo. We even took a drunken canoe ride on the beautiful lake and annoyed the neighbors with our off-key singing. Ah, memories. Nothing better than renewing old friendships. What an amazing group of women.

Naturally we talked about nursing; 5 nurses together of COURSE we talked about nursing. Here I was thinking I am the only diploma nurse left on the planet, yet two of my closes friends in nursing school have also not completed their BSN either. One is 30 credits shy of her degree, the other has only taken 2 courses. I am just about 1/2 way through. The other two each have masters degrees; one is a director of nursing, the other is a nurse practitioner (she went back for that after she got tired of attending meetings as a Clinical Spec.). Of the remaining two, one is still a staff nurse in the ICU, and like me did her share of being a manager. The other works in Quality.

The others were floored but excited that I want to teach, and were full of encouragement. I never thought I was very smart in nursing school, but it turns out I just never studied. Imagine that! My classmates, I discovered, thought I was brilliant cause I didn't crack the books. Turns out the actual "being a nurse" part of nursing school was easy for me, and I took to it like a duck to water; guess I was something of a nurse savant.

Regardless of our education since graduation, we all agreed that we wouldn't have traded it for all the 4 year degrees in the world. We learned the art and science of nursing by taking care of patients 24 hours per week, and preparing for at least 2 hours before every clinical the night before by reviewing labs, nurses notes, meds, care plans and meeting our patients. For us diploma dinosaurs, critical thinking is something that was developed over the years, not crammed into a four year course.

Anyway, it was great that after 30-odd years a group of friends who "grew up" with each other fit right back together without skipping a beat. Naturally, we scheduled two more get-togethers sans spouses before we said goodbye.

Renewing old friendships: priceles.

I'm Back (Part 1)

Like the proverbial bad penny, I'm back after a 2 month sabbatical. Where have I been you wonder? For one thing, I celebrated my 30th wedding anniversary with Mr. EDnurseasauras in a lovely warm climate for a week. Aruba was beautiful, everything I could have wanted in a relaxing vacation. The second hut from the top in the second row from the right is where I spent most of my time gazing at the water and taking in the sights.

And there were many. Although Aruba does not have clothing optional beaches (and this was a VERY nice resort) Mr. EDNurseasauras and I were treated to the vision of Naked Girl every afternoon. Hubby missed her first appearance since he went to work out. Very concious of keeping up with his exercise program since his Near Death Experience last November. Anyway, he didn't believe my Naked Girl story until he saw for himself the next day. It was pretty funny watching groups of guys walk by and do a double take, then find a reason to stick around for a good long look. So predictable.

We had our own Near Death Experience on a jeep tour around the island. Our driver was one of the clients! This stuff would never happen in the US, yet we bunch of sheep just went along with it. To her credit, the gal who was driving did a great job. We all survived the 45 degree rock climb and return ascent with the loss of nothing more than a couple of buckets of adrenalin.