Thoughts on Casey Jones

I have had the song “Casey Jones” stuck in my head the past two days. This is the only Grateful Dead song that I own; I bought it after hearing it on classic rock stations. Besides the reference to drug use (“Ridin’ that train, high on cocaine”), the song is all about the disaster in which Casey Jones, a railroad engineer on the Cannonball Express who died in a crash in 1900. The parts of the song that have stuck in my head are “Casey Jones, you better watch your speed… Trouble with you is the trouble with me, got two good eyes but we still don’t see.”

Based on my Wiki-research, Casey Jones was not, as far as anyone can tell, a drug addict – in fact he may have been a teetollar! He was a good engineer with a few rules infractions for speed, normal at that time as the railroad companies were always pushing their trains to arrive on time or early. He was a family man with three kids, just trying to do well at his job. The accident that happened may or may not have been his fault; no one knows for sure. But ultimately, he was a hero who chose to stay on the train and apply the emergency brakes, with the result that he was the only fatality.

The song and story show me that speed can be killer (and I’m not talking about the drug although that’s also true). Rushing is dangerous. Rushing through life, through work, causes us to take shortcuts and lose sight of the meaning and intention of what we are doing.

I think God is reminding me of this because I have recently had a few over-committed days. Many times I will look at a blank day on my calendar, and – quick! – try to fill it up with activities, instead of allowing God to own my time and guide my decisions. And what’s the result? Things fall out! The grocery shopping or laundry doesn’t get done. I never have time to make that phone call I meant to make.

In medical settings, rushing can be VERY dangerous for a variety of reasons, and that is why you will very rarely see doctors or nurses running anywhere except a code. Usually, we have more of a “speed walk” going to prevent both panic and falls.

Speed forces us to take shortcuts. Shortcuts may endanger patients. As it says in the song, “We got two good eyes but we still don’t see.” How many times have we missed something that, if we were rushing, we would have known was serious?

Because speed isn’t everything. Integrity is. We have to take time, take responsibility, take a breath and prioritize.

Casey Jones didn’t see the signals, if there even were any; he turned the corner and saw the caboose and knew a collision was imminent. As it says in the song “Come round the bend, you know it’s the end…” He stayed on the train because that was his responsibility.

In nursing, we don’t abandon our patients who need us, even if it’s lunch time, even if shift is over. Even if we are really really busy. No, we find the time, make the time, to pay attention. In life and nursing we prioritize. Time is a gift.

How are you using your time?


I’d Like to Thank…

After my pleasant shift yesterday, fate had it in for me. Any day in which you have to ask “is this what x bad symptom that I’ve never seen before looks like?” is a tough day.
But I got through it to my oscar watching party with some help from my fellow nurses. Who am I kidding? A LOT of help.

First of all, a big thank you to everyone who answered my endless questions “where are-”

Thank you nurse that took care of one nearly fainting patient when I was taking care of another.

Thank you PCAs for helping so much with baths, bathroom, vitals, and everything. I’m sorry I was always running out of the room to answer phone calls.

Thank you to those that covered while I took a 20 minute lunch… And not rolling your eyes too much…

And thanks to the (float!) resource nurse who offered to take a blood sugar to make my day better.

Thanks to my patients for being (mostly) patient and chill.

Thank you HUCs for putting that patients sandwich in the fridge for me.

Thanks to the charge nurse for advocating and wasting with me and giving me a sweet admit at the end.

Thanks to the services for being polite and responding quickly to my incessant pages.

Thank you God for getting me through…

Thank you!!!

Lunch in the Time Warp

12 hour shifts are timeless.

In all honesty, I would rather work 8’s. I quite enjoy my 3 8-hour evenings a week more than I would enjoy 3 12’s. Why, you ask? It comes down to quality of life. After a 12 hour day shift, I have maybe 4 hours of productive off time before I have to fall into bed and be ready for the next day. Whereas with 8 hour shifts, I have 8 hours, that’s TWICE AS MUCH down time, to read/run errands/do laundry/spend time with my husband.

(Sure, mathematicians, I get paid 2/3 as much but money isn’t everything…)

But when I am working a 12 hour shift, I really don’t mind it. I find myself in a time warp. I know I’m going to be at work all day (or all night) and I may as well accept it. The day streams by in its series of neat boxes; medications, treatments, vital signs, lunch, repeat. Before I know it, the next shift nurses are swarming like – something loveable and friendly that swarms – to get report and I can go home.

Today the time warp was nicely broken up by lunch with some float colleagues. As floats, we don’t see the same people day after day. We get to know nurses on different floors but it takes a little more effort to build friendships when both the people and the territory change every shift.

But coworker hang-outs are totally worth it! I can’t express how relaxing it is to chat and commiserate with other float nurses. We can discuss the idiosyncracies of our different floors, complain about switching between days and nights, and share notes on all our mutual float friends that we rarely see.

I am very thankful for my job because, from what I read, a guaranteed 30+ minute lunch is not common in many nursing environments. But it adds so much to job satisfaction. That chance to step away from the craziness of the floor, leaving my patients in another nurse’s capable hands, eat, drink, go to the bathroom, and talk… After a good lunch I can return to work refreshed ready to run my behind off for the rest of the shift without any problem.

Thank God for nursing lunch!

Reminders for Family Members

Yesterday, I floated to a unit where people of all ages are recovering from a variety of problems. Strokes, falls, car crashes, medical issues… this unit helps people get back on their feet. As I sat in the nursing conference room, people were discussing family members that had fallen or been in accidents.  Falling is unfortunately frequent up here this time of year – it is cold and slippery and dangerous to walk outside!

When I got off work I received a call that one of MY family members had an unfortunate accident and had to go to the hospital.  As I learned the details through texts and phone calls, I couldn’t help wishing that I could be right there, at the bedside, supporting, helping, and advocating.

So, as a family member and a nurse, here are my thoughts on that relationship.

1) Family members are a really important part of nursing care especially on a general care floor. The fact is, no matter how good of a nurse you have, he or she can’t be in three rooms at the same time, or watch every little change in the patient’s condition, or know everything about that patient right away. Family members are really important as advocates for the patient. Does your family member look different? Are they in pain? Do they take their pills whole or crushed in applesauce? Families are important partners in the process.

2) However, “advocate” doesn’t mean “be rude.” I understand a little rudeness – you’re stressed! you’re coping! – but please try to be a polite advocate.

3) Asking questions is good. It may annoy some  nurses, but it’s a good chance for education. I find it helpful to be asked questions. And sometimes, that can help nurses catch things that otherwise would slip through the cracks. There are a lot of people working in medicine; people make mistakes; questions help catch mistakes.

4) There are some things where you do have to step back and let nurses do their jobs. For example, and every case is different, getting a patient up to the bathroom. We really don’t want patients to fall, and we don’t want family members breaking their backs. So let us help them get up to the bathroom.

5) Be patient. Healthcare is an enormous affair and lots of different people are involved – doctors, nurses, aides, respiratory therapists, nutritionists, chaplains. We really are trying to put your family member, the patient, first. That means you may have to tell the story a few times to several different people just so we all get on the same page.

6) Lay aside your professional status (doctor, nurse, lawyer) and be a family member. Sure, if you as a professional know that something is wrong, speak up. It shouldn’t be used to intimidate people. Rapport and camraderie are important in the teamwork setting of healthcare.
As for nurses, it’s really important for us to remember that every patient is someone’s loved one. A wise nurse aide once told me, “Treat all the ladies like they’re someone’s grandma and you’ll be fine.” Also, we are meant to be patient’s advocates, and if they don’t have a family member to help advocate, we need to pick up the slack.

Hopefully the nurses taking care of my loved one will treat her like I would treat their loved one; with the utmost care, respect, and patience. Hopefully they will understand if I call the nursing station tonight to check on her and ask a few questions. We do what we do because we care, both as family members and as nurses.

Get well soon!

Of Squash and JP Drains

This evening we made a delicious butternut squash soup that our friend Lisa sent in a box – squash, spices, coconut milk and all. Tasty and fairly easy! The only hard part for me was preparing the squash by getting the seeds out. I hate trying to scoop the stringy gunk and tiny seeds out of the hard squash out with a spoon. It just feels yucky to me, fighting the squash to wrest out the slimy vegetable “entrails.”

I know, I know, it’s a vegetable. How bad can it be? But it IS! I remember my parents doing this to pumpkins in my childhood and I thought it was gross then too! Squash and pumpkin innards have this smell I associate with decay.

Once they’re cooked, I have no problem. Sweet, plush, carmelized squash. Soft as butter. Purees like a dream. But when they are hard with a slimy mess of stringy membranes and seeds… shudder.

You know what I don’t mind? JP drains. Little grenade-shaped shells of plastic connected by tubing to people’s insides, draining all kinds of fluids. Fine, I won’t describe exactly what they drain. But I don’t mind emptying those things. Doesn’t bother me a bit.

Hopefully people who turn pumpkin into pumpkin puree all day feel the same way about that as I feel about JP drains.

And this relates to Lent how, you ask? Well, I’d like to think it has to do wth “vocation” or calling. I am called to be a nurse, to care for people. To empty JP drains. Other people, presumably, are called to be squash de-seeders. (Or perhaps supervise the machines that de-seed squash). Others to be teachers, others to be pastors…

You get my drift. We all do things that other people find inconceivable because they are ours to do.