Farewell to the Floor

As I prepare to transition to a different nursing setting, there are lots of things I will not miss about float nursing. I don’t need to detail those – I’m sure, after reading this blog, you can think of a few! I am really excited about starting in Employee Community Health next week and working with a new boss and coworkers.
 
 But there are things I will miss, like my favorite patients. 
 
 I know, I know – you shouldn’t have favorite patients. But sometimes, you just hit it off with them. Sometimes, taking care of a patient is a treat. Like “I’m getting paid to do this?!”
 
It doesn’t mean that you treat patients differently. All patients need to be assessed and cared for; they all deserve a parity of time and effort. But nurses are people and “click” better with some than others.
 
I had a patient like that the other night when I was on Ortho – the lovely and gracious Isabella. She had just had a bone in her arm removed due to cancer (her second cancer in 5 years – she has terrible luck!) but her dark eyes were as bright as if nothing had happened. Her English was inflected with an Italian lilt as she told me all about her family and her dogs. Indeed, her family when I met them were just as delightful. I told her all about my dogs and we discussed marriage and family. We could have been friends in another life…
 
To be honest, I very rarely have patients that I do not get along with or connect with in some way. Even if they have dementia or are extremely anxious, patients will often respond well to kindness and solicitude. When I do have interpersonal tensions, it is more often with family members, particularly if the family member is having trouble adjusting to some terrible and difficult truth. In that case, I can only be supportive, not critical. But spending an 8 hour shift with a favorite patient is a rare and wonderful thing.
 
I will also miss giving showers. I sometimes think showers are the best medicine. You see people go from sick, pale, sweaty patients with their hair sticking up  – to clean, warm, happy and well groomed people. Showers are transformative!
 
The strangest thing I will miss is emptying JP drains. I don’t know why, but those little grenade-like bulbs are fascinating.  Really, drains of all kinds are cool. I will  also miss hanging fluids – flicking the bubbles out – watching the fluids drip into the patient and make them feel better.
 
I will miss getting meds out of the Pyxis and punching them into med cups. (I will not miss occasionally dropping them on the floor, the dirty table, or the patient’s gown!)
 
I will miss navigating the twisting windowless corridors, the hidden staircases that I have just started to find, and the “back roads” of the hospital. I will miss walking through now-empty units that have been converted to offices.
 
I will miss the weekend potlatches that I occasisionally lucked into – cinnamon rolls and cakes and soups, oh my! And the chocolates that I occasionally enjoy when (usually recovered!) patients decide to treat the nurses. Whichever patients bought us Stam chocolates have my eternal gratitude. 
 
I will also miss my favorite parts of the hospital. For instance one unit has a beautiful Christian Lassen painting. I might have to go to that unit just to visit it!  Many have gorgeous flower arrangments. And of course several feature plaques with pithy sayings. I will close with one that was on my unit last night:
 
“It’s not what you look at that matters. It’s what you see.”

Easter Weekend

Again, I had to work Easter Weekend, just like last year. But guess what folks… this is the last time (for a long time) that I will work 12 hour shifts on a weekend!! Yay!!

I will start with Thursday, because that’s when we played handbells at the Maundy Thursday service. I really enjoyed the piece we played (What Wondrous Love) – beautiful and mournful and  exciting, just like Easter. I really love being part of a church that celebrates all these traditional elements of spiritual holidays. In college, I probably would have seen such things as archaic, but now I have grown into it!

On Friday, we had our 3rd surprise party of the year for our friend Chris PR – his first ever!  It was not what you would expect of a surprise party. Well, there were decorations, and wine, and cake and icecream, and dogs and good friends:

But our activities included Bananagrams and puzzling:

Yes, we demolished that 500 piece puzzle. And of course, the always fun “giraffe kissing”:

 

Finally, amongst med school partiers, no birthday is complete without sharing around the Peak Flow Meter:

So as you can see, a good time was had by all!

Saturday was Chris’s day off but I was working a 12 hour shift on bone marrow transplant. So what did my sweet husband do? Bring me lunch!! Right after that he got a call… one of his patients was ready to have her baby! Everything went well, he got home at 3AM and went to church the next day, napping intermittently. He’s something else! On Sunday I was again working a 12-hour shift on a hematology/oncology floor. After that I came home and had leftovers with  Chris before he left for his overnight shift.

Easter Monday, now… that was a good day! My mom ran the Boston marathon and did SPECTACULARLY, and this after she had suffered some crippling Achilles tendon pain. God healed her and she was able to run a 3:40! I am so proud of my mom and her 8:30 miles.

I also got to visit all of my church ladies. As a deacon, I was assigned several people to visit, and chatting with them has been so  fun and rewarding. This time, I delivered a bunch of Easter flowers that our church gets for them every year.

Well I could go on and on, about how one of my ladies fed me delectable chocolate chip meringues, or how we had Faith Fillers last night and wise ladies from Bible study tackled heavy questions like “how to influence your husband to faith” and “what is heaven like” and “why shouldn’t people live together,” or about how school is almost done for this semester. But instead I will just say… praise the Lord! He has given me a wonderful life and most importantly the ultimate gift of His Son’s sacrifice. I am so thankful and whatever may come,  I know He is in control. Happy belated Easter to all of you!

Of Palms, Cancer, and Orchids

This is a post full of odds & ends, things that have been happening in my life.  Yesterday was Palm Sunday, one of my favorites, where we all process in the aisles and wave our palm fronds, celebrating Jesus as conqueror, celebrating the beginning of Easter Week.

Celebrating in the full knowledge that things are about to go from good to bad to worse.

***

And speaking of worse…. I went back to Jo2G last week, my first time back on that unit since my patient coded. It was a good night but not an easy night. For one thing, my assignment kept changing – my transfer never came, my post-op went to another unit, and instead, on a surgery unit, I got 2 patients with cancer.

One was a lady who had been on hospice for end-stage pancreatic cancer. She had come for a second opinion and had looked so pale and weak that the doctors had immediately decided to admit her. She is now in renal failure and probably will not leave the hospital. I held her mother and spoke kindly to her husband and did everything I could to relieve her pain.

My other patient, meanwhile, had metastatic prostate cancer and was admitted for severe pain from a bone metastasis. He is a fighter – still a full code, on his umpteenth treatment regimen, running his office supply business from the hospital bed as his girlfriend looks on adoringly. Once we got his pain under control, he was as happy as a clam. He will go out swinging.

This floor always challenges me, makes me think about serious things, like death and dying and mortality, and how we squeeze out the joy from each precious moment we have here on earth. I prayed for both of my patients after I left, that they will find meaning and joy in their remaining time. A prayer I could ask for all of us, because we are all terminal. Teach us to number our days, that we may gain a heart of wisdom (Psalm 90:12).

Note: As usual all patient details have been so dramatically changed that they are pretty much fictional

***

That was deep and hopefully not too heavy, although I meant every word. Now on to my latest book list – Books with Matte Covers. These are all real books, not library books, that I have been given or borrowed or otherwise obtained through more or less legitimate means.

Nothing Daunted, by Dorothy Wickenden – I love books that allow me to time travel. This one lets me time travel with two delightful society girls that take on a rural Colorado school (think Christy in Colorado) with not one but two romantic twists. It’s very good (thanks Mom!)

She, by H. Rider Haggard – How have I missed this book all my life? It influenced Tolkien, C.S. Lewis, and no doubt J. K. Rowling… and it certainly reminds me of Heart of Darkness. A great book from the 19th century, this follows two adventurers to the dark shores of Africa where on a quest to solve an ancient mystery, they find a mysterious white witch, Ayesha. (Thanks, Clementses!)

Born To Run by Christopher McDougall – The tale of Mexico’s running natives, the Tarahumara, a crazy gringo who hangs around them, and a couple long-distance races. This book almost makes me want to run, and run without good tennis shoes, because bad tennis shoes are the key to no-injury running… but not quite. I’d rather just read about it.  (Thanks, Hills!)

The Rivers Ran East, by Leonard Clark – the early 20th century tale of an adventurer who sets out to find the 7 Cities of El Dorado. Joined by a gruff Peruvian, and then by feisty American… does he find them?! You’ll have to read it to find out! (Thanks, Mic!)

The Orchid Thief by Susan Orlean – The author dives into the story of an obsessive (Aspbergers-y?) fellow who faced criminal charges after working with some Seminoles to steal orchids from a Florida swamp and turns the story of a rather unlikeable fellow into a deep exploration of ethnicity, flower-culture (not horticulture but the culture of the people who do it), and of course orchids. Have I mentioned that if I get a tattoo, it will be of an orchid? (Clementses!)

The Night Circus by Erin Morgenstern – the story of two magical young people caught up in a fantastic circus with everything a circus should have. Have you read this? If not, go read it. Now. (Clementses!)

Periodic Tales by Hugh Aldersey-Williams – A nonfiction book about the period table that discusses many of the main elements and the author’s unorthodox chemistry experiments to obtain said elements. If you like rocks or chemicals, you should read this. (The Clementses rock!)

***
So – Easter Week is upon us. Peace to all of you as we approach the end of this holy season of Lent!

Across the River

Every year, Chris and I do something fun in March/April. In 2012 we went to Arizona and enjoyed a spiffy weekend at the Phoenician. Last year we went to beautiful Napa Valley. And this year?

Wisconsin!

We took advantage of one of Chris’s rare weekends off and headed out on an adventure. Our first stop was Blaedow’s Bakery in Winona, maker of the best donuts in several counties; I haven’t found anything nearly as good in Rochester! My mouth is watering just writing about it. Chris was particularly excited about his bacon donut.
I was thrilled about my glazed croissant. YUMMY!!! We then drove across the Mississippi River to the Elmaro Vineyard in Trempealeau, Wisconsin. Although the drive had the faint odor of cows, the vineyard is fantastic with a beautiful view of bluffs in the distance. We tried all of their wines that were available for sampling and they were quite tasty. Many northern wines are almost obscenely sweet but they had some tasty dry wines; their Marquette Rose was particularly good. Don’t get me wrong, I do like a good sweet wine. They had a fantastic cheese plate as well. We got one with jalapeno and cranberry sausage, honey butter, a triple cream soft cheese that was among the best things I’ve ever eaten (Le Delice de Bourgone from Lincet), a nice cheddar and a hard cheese, with assorted crackers and some fig jam. It was the perfect lunch. Afterwards Chris made a new friend with one of the vineyard dogs.
We were sad to leave but with a bottle in tow, we headed up to Granddad Bluff in La Crosse where we enjoyed the stunning views out over La Crosse.
Then we headed to the Shrine of our Lady of Guadalupe. This beautiful holy place is tucked away amongst the bluffs in La Crosse, but it is well worth a pilgrimage – even if, like us, you are not Catholic. After walking through the visitor’s center, you hike up a pave half-mile until a beautiful chapel and shrine appear through the trees. We walked the Stations of the Cross and the Rosary Walk. It was a perfect trip for this Lenten time of year, seeing these images of Christ’s sacrifice while walking through his beautiful creation. At the end, we prayed, asking for guidance for the future. 

After that beautiful experience we shifted gears and headed back into La Crosse to try the Pearl Street Brewery, a local place nestled into an old shoe factory. For $5 we got a varied flight.

A bus full of people arrived soon after we started working on this flight, so our experience was a little… flat. The beers were hoppilicious, if you like that kind of thing.

We headed downtown to the Four Sisters for supper (not to be confused with the Four Daughters Winery, another great place much closer to Rochester). The Four Sisters has tasty tapas. We enjoyed a couple of appetizers; Chris had some mussels and I had a portabella mushroom with spinach and a pink sauce. Alas, we were too full for dessert. We took a short walk along the river and headed back to home, drained from a long day of food, fun, and travel.

Even though we didn’t go out of the region this spring, we still enjoyed a fun “out-of-state” trip and were lucky enough to get some sunshine along the way. There is so much to do right in our neck of the woods… we just have to find the time to do it!

One Weekend

When I called in sick last Tuesday, I had great hopes that I would be completely recovered by the weekend. Alas, no such luck. I dragged myself into work – and soon wished I hadn’t.

My patient coded. My first code. Completely unexpected.

He had just had a relatively minor surgery – a couple days in the hospital and then he would be going home. I met him and his son and family friend; they were all very pleasant. I had helped him use the urinal, then left the aide in there to do vitals while I went to go give another patient a medication.

While I was giving this other fellow his vicodin, the voice came over the loudspeaker. “Code Blue, Joseph 2G Room 48.”

Did I hear that right? Joseph 2G? They must mean Joseph 3G. Still, I gently excused myself and went to check. I was sure he would be sitting up and watching TV and laughing…

But sure enough, a crowd of people was gathered around the room. and a red light was blinking. Alarms were going off. While the aide was taking his blood pressure, he had gone pulseless and unresponsive. Other nurses had started CPR, set up the AED and called the code team. Doctors, nurses, a house supervisor, the chaplain and the charge nurse all swarmed the scene.

The code team worked hard on him for nearly an hour – intubating, drawing labs, doing CPR (of course), pushing fluids, pushing epinephrine. I did little things like turning on the computer, silencing alarms, handing in alligator clips, and providing information.  Tragically, he didn’t make it. They tried everything but he was gone. Heart attack? Embolism? We will never know. I felt so bad for his family; there was no way to see this coming. 

The rest of the shift went by in a blur and when I got home I found it hard to sleep. For the next few days it ran over and over in my head like a broken tape. I looked online for other stories of first codes and found them strangely comforting. I was glad I wasn’t the only one who felt lost during my first code.

I then worked Saturday and Sunday nights. Saturday night went fairly well, but Sunday night was a little too busy. Things always get really crazy right around 6-7 am especially if you have 6 and 7 am meds to give in 4 rooms and 2 blood sugars… not to mention all the other things that happen.

But this weekend had a few upsides. One was seeing my husband. Yes for once we both worked the same shift in the same building!! We went down to the cafeteria together on my break. Did I mention he’s really cute in scrubs?

Secondly, another nurse floating to my floor on Sunday night invited all of us to breakfast at Brothers Bar & Grill after the shift. So I drove over and had a delicious Monte Cristo sandwich (french toast, ham, and cheese with raspberry sauce mmm) and socialized with some fun nurses. It was great to hang out and debrief before going to bed.

And last but not least… I got a new job! Yes, back on St. Patrick’s Day, I interviewed for a position at Employee Community Health… and on Monday I found out that I had received the spot! I am really excited to try something new and different. I have LOVED working as a float nurse, and I know I am going to LOVE working in the clinic setting at ECH. I can already tell that they have a terrific team and I am so excited to learn a different kind of nursing. So, no more night shifts with the husband… but a lot more homecooked dinners!

Note: All identifying details of the code patient and floor have been changed. It is pretty much a work of fiction. Except that it happened.