A day in the life; a day from hell

I am in the middle of a four-day stretch. For those of you who work in hospitals like I do, you know how exhausting that sounds. For the general public: imagine cramming Monday through Saturday into four days.

Now that you have that in mind, let's begin.

0531: alarm. I have nine minutes of snooze time. Nine minutes. I feel like I went to sleep five minutes ago.
0540: get out of bed now or you'll never make it to work on time.
0600: shit, move your ass or you will have to drink the hospital swill instead of real coffee.
0625: out to the car. snarf power bar.
0653: time to clock in.
0700: report. These guys are a mess. All four of them. Going to have to start paging as soon as I'm out. Hypoxic felipe over there, confused felicia in here who is also hypoxic, this felicia in here shouldn't be too bad. And that felicia over there is going to surgery so hopefully she'll be gone awhile.
0800: med pass. Let's hope none of these felicias give me a fight about taking their meds. I'd rather not have to pick spitty capsules off my scrubs today.
0900: the one felipe's oxygen is definitely low, his blood sugar is through the roof and I can barely wake him up. Awesome. Too bad I can't talk to the doctor since he isn't returning my pages. Hopefully he'll be here for rounds soon.
1000: finally getting around to this dressing change. Hopefully this thing we MacGyver-ed will be enough until the wound nurses get here. That stuff needs attention bad.
1100: felipe's oxygen is still low. Finally talked to the doc on rounds. Too bad he's mad at me about something so he didn't want to talk to me, just wrote down a list of things for me to do STAT and set it in front of me. excellent. Oh by the way: finally got orders for the blood sugar. Good luck with the oxygen, though. Fortunately I had the wherewithall to put that felipe on continuous pulse ox because he falls asleep and his sats drop to the 60s, so that's fab.
1200: post-it tasks complete STAT at MD's request. Felicia over there needs pain meds and IV antibiotics. Just found out apparently the doc went to the director of nursing and complained that I am terrible and undermining him all the time. K. Both my felicias who left the floor come back at exactly the same time of course. Frequent vital signs, the one is confused so now I have to convince her to take her pills. Challenge.accepted.
1215: ah well, I tried. I'm just a bitch who's trying to choke that felicia with her anti-seizure meds according to her. I don't have time to fight you today my dear. I chart "refused". Surgery felicia's blood pressure is high. Excellent. Time to treat that.
1230: more insulin for my felipe with the high blood sugar who I can still barely wake up. At least respiratory therapy is on board now. The wife wants to go over labs and why he's so tired all the time and why he's so swollen and why we are changing this, and that his blood sugar is good at home so why is it so high and what else are we doing and how long is he going to be here. Let me go get the computer and we'll go over everything together.
1315: felipe's wife is telling me his CPAP has been broken for months. Maybe that's why he's so lethargic, his body is just so oxygen-deprived. Could also be the blood sugar though. She agrees and thanks me. It's all making sense. The Doctor didn't go over any of that in rounds, she says.
1420: shit I forgot to page the other doctor about surgery felicia. She wanted to come see her.
1430: surgery felicia's MD is here. As long as vitals are stable she can go home. Yay, patient says. Oy, now I'm going to have to figure out how to do a proper discharge at 5pm. Hope she doesn't have any complicated meds!
1500: lunch. finally.
1520: better get back out there. Need to check that guy's sugar again.
1600: felipe's blood sugar is still super high. Another nurse is on the phone with that doc, can I talk to him? I whisper. "OH GREAT" I hear over the phone. I roll my eyes and tell him about the high blood sugar and can we maybe treat it again. "Yea fine, I was just going to go take care of some personal things but yeah that's fine". So I get to put in your orders again. Excellent. Can I confirm the 10 units IV then? "YES JUST PUT IT IN". Hangs up. Eye roll.
1645: surgery felicia can go home. Oh by the way, she needs medication teaching about a shot she has to give herself twice a day that she's never done before. Cool. The patient is surprised by this. Doubly excellent since I have to be sure she knows how to do the shots and have her teach it back to me. And pharmacy closes in 90 minutes.
1720: On the phone with the pharmacist. Copays are going to be really high. This felicia is on a fixed income. Excellent. I hope we can actually do this, she says she's going home regardless.
1725: Bug runs across felicia's table. turns out it's a bed bug. Perfect, been taking care of her for two whoooooooole days. Patient is super upset and crying now, I reassure her that it's not her fault and begin teaching about what to do when you get home with cleaning. Surgery felicia is super overwhelmed. Asks me to come back to teach her about the shots.
1730: Nursing director wants to talk to me about what happened with the doctor and what he said. We had a previous incident, which is why he hates me so much I guess. I tell her maybe I can do it in thirty minutes? have to do 1800 med pass.
1800: wound felicia needs pain meds, felipe's sugar is still high, more insulin, surgery felicia is really getting antsy because she wants to go home. I just got the meds, turns out half of them are filled wrong or missing. They're closed. FACK. The discharging MD isn't even here anymore. Awesome. Guess I'll have to pull out her night time doses and go over the discharge meds really carefully and HOPE that she gets everything squared away tomorrow. Maybe I'll see if I can call her in the morning if I have a minute.
1820: frantically trying to get the medication schedule for surgery felicia right so she understands. She did great with the medication teach-back so I feel good about that. She's standing in the door waiting for me to come in. Fuck. I have to go talk to the director.
1825: director's office. She starts talking about what the MD said about me, that I don't do what he asks exactly when he asks, that there's a hierarchy and I should know my place, and that I don't know how to assess a patient. I have about 93 other things I need to be doing right now and I am so frustrated to hear this that I actually cry. How embarrassing. I never cry. Must be PMSing.
1840: better start this discharge, surgery felicia is REALLY getting antsy. Felipe's oxygen monitor is alarming. Hang on, have to go check. NOOOO CONFUSED FELICIA'S BED ALARM IS GOING OFF STAY IN BED DUDE.
1842: felipe is fine for the minute. so is confused felicia. thank god. I do NOT need a fall at shift change. Just have to make it to shift change. Discharge papers. aaaaaaaand GO.
1920: OH MY GOD I NEED TO BE IN REPORT BUT I'M STILL DOING THIS DISCHARGE.
1925: finally done. she seems like she gets it. I apologize profusely to this super nice night RN who is putting up with me being a HALF HOUR late to report.
1940: done with report. Everyone survived. Now I have to chart. Didn't even print one strip today fuuuuck me. Notes. make sure all my assessments and vitals are correct and in there. My brains is going so slowww. I bet my blood sugar is like 4.
2030: finally done. holy shitballs it's late. oh my god my legs hurt. Did I pee today? I think I'm hungry? who cares I'm too tired. still trying to wipe off mascara, thank god this corner is dark no one can see me I am such a hot mess.
2033: send email to director thanking her for sitting down with me and backing me up. Especially as a traveler I appreciate the hell out of that. Ugh my god I need to get out of here.

Most days are just like this. Minus the bullshit with the doctor. Most days I don't cry. I go to work every day, I put my head down. I don't complain, or at least I try not to. Some days I just gotta. I call it 'venting' but let's be real: I'm whining. I have always been resolved to advocate for my patients, no matter how much flack I take. If I have to page a million times or call the pharmacy back again, or stay an hour past my shift I will. If I have to take a beating from a physician because he thinks I'm incompetent, so be it. I'm not, but if he wants to think that I'm not going to change his mind. I will say that I'm the reason your patient didn't go into DKA, that they didn't go into respiratory failure, that his wife knows what's going on.

Some days I just have to sit in my car and cry like I did tonight. Even when you know you've done nothing wrong, when someone wants to make you feel small sometimes it works. What's the point, I think. I'm killing myself every day only to be shot down by some asshole. I don't need an award or a cookie. Well, maybe a cookie, but the point is: I don't do what I do for the recognition. At the end of the day if the people I'm taking care of are still alive, and they know what's happening, they feel secure, that's all I care about. To hell with the rest of it.

My legs ache. I'm too tired to eat. I should drink some water. Better get to bed, it's already 10:15. I have to be up in 6.5 hours. Time to do it all again.

Things you don't see...

I get a lot of crap for "not doing things" at work, directly or indirectly. There are a multitude of things that nurses do for people that go unnoticed.

I didn't get to the patient's room in time, so their bed alarm went off and now the family is mad because it's sounding. 
I was on the phone with the doctor asking for pain relief for another patient. 
I didn't remember to bring you a warm blanket like you asked.
I was trying to get my other patient's wounds dressed.
I didn't put the IV right where you wanted.
I placed it where I knew I could get it the first time.
It seems like I'm coming off cold when you get bad news.
In truth, I have to act emotionless, or I'll fall apart too. I'll probably cry for you when you can't see me. It's called empathy, and I have a terrible case of it.
You're mad because "no one told you what I need?!"
No, the call light message must not have been passed on, and now I'm magically supposed to read your mind. Ok. 
You need answers, so you need the doctor in here RIGHT NOW.
That doctor probably has 10 pages to answer and 23 more patients to see. I will let him/her know, but they probably can't be here right this second.


When I spend two hours on the phone trying to find an oxygen tank so you can make it home safely,

When I can't get you a new pair of socks because I'm Rapid Responding a patient who's tanking,

When your relatives are upset that I haven't given you any pain medication, yet you haven't asked,

When I can't give you what you want,

It's because I want you to have enough oxygen to last you until the home health nurse can come in the morning. It's 5pm on Friday afternoon, I'm trying as best I can.

It's because that patient who was tanking needed me more than you needed another pair of socks.

It's because I want to treat your pain, but I don't want to sedate you. I cannot read your mind, you must ask yourself.

It's because I have your best interests in mind. 

Most days I have no problem at all. Some days I just can't do anything right.

Every day I make sure that I do everything I can to make you better.

Life as we know it: not what I imagined.

I really need to get better at updating this thing. Too much happens when I don't write for several months at a time.

Well... let's start here: Grandad Tom passed away in August. That was pretty awful. Death and funerals are probably two of the things I hate most in this world. I am very glad that he doesn't have to put up with all the pain he had been in the last ten years, or deal with the fact that his mobility was diminished to basically nothing, or that he was home-bound. I'm glad he doesn't have to go through any of that anymore. I am sad that he's gone though. I still think about him a lot, and hope that he's watching over me. Still miss you every day, Grandad.

So there's that. Grandma is coping, kind of, which breaks my heart even more sometimes. It's not that she doesn't want to, it's that her memory is fading. Losing time and faces is much more sad to me than death. Dementia is a slow, terrible way to become a shell of who you were. The more I think about that kind of stuff, the more I keep saying that being a grown-up is the worst. Because you realize everything, you internalize it, you understand how terrible things can be. Ignorance is bliss.

The other fairly large development in my life is that I decided to put school off for another little while. For two reasons: school blows, let's be real. And, I just want to be 100% sure that being a nurse practitioner is what I want to do for the rest of my life. So, I am "quitting life" as I've been telling people, and taking an epic trip starting at the end of my six month lease. Which, HOLY CRAP a six-month lease is so expensive. Ugh. Money will be tight, but at least it will only be for six months. Oy. 

I've never been one to just "let go and go where the wind will blow", but that's what I'm going to do. 

I've also tried to make peace with the fact that I'm going at my own pace. I'm not in a relationship, which kind of blows sometimes. I don't own a house, I don't have a baby, I don't have any of the things that are supposed to make us "adults". I'm starting to be OK with that. I don't need to fit into some box that a 25-year-old woman is supposed to fit into. I have a great job, a decent head on my shoulders, and dreams to go places. So that's what I'll do. I don't need to be "making investments" in a mortgage, I need to be investing in education, in broadening my horizons, in creating stories for my future kids/grandkids/nieces/nephews to marvel at when I'm too old and attached to do them anymore. Not having things. Things disappear. Life will too if you don't stop to experience it. 

I don't know where I'll end up, or who I'll meet, but I know that I need some time and some space to really figure out what I want. It's incredibly scary, and totally outside the scared little box I've been living in the past two years since graduation, but I'm trying to live by the phrase, do one thing every day that scares you. I'm sure scared, but I'm also full of hope. Let's see where the wind blows.

Well son of a biscuit!

It has been quite some time! I didn't realize how long it had been since I sat down and wrote something.  I'm sure that zero people care whether or not I update you all on my life, it's more a selfish way to see myself progress and be all, "Oh, look how grown up and mature I am!". It's kind of pathetic, but I hope you'll appreciate my honesty.

Let's see... lots of things have changed since last I wrote. I am officially a day-shifter. I'M NOT A VAMPIRE ANYMORE WOO!

Which, I've only been on days for a week now and I am still in that HOLY-CRAP-THIS-IS-SO-UNCOMFORTABLE mode. It's a complete 180 from nights. There are humans around...all the time. New orders to get through... all the time. New notes to read... ALL THE TIME. It's cray. The first day kicked my ass, but it FLEW by. And I mean FLEW. So the faster pace is helpful for making the day pass. I am still missing my fellow night-shifters. They're pretty rad. Getting used to this whole thing will be a challenge, but I think it's coming at a good point in my life. I try to live by the philosophy that you should never get too comfortable because then you get complacent. I never ever want to be complacent.

I also decided shortly after my last post that I am actively pursuing graduate school. I love my job most days, but some days I find myself acting extremely cynical and jaded. I think a lot of that, toward the end of my time on nights, was related to not sleeping. I basically quit sleeping the last two months I was on nights, which was MISERABLE. I also decided that I can't be a bedside nurse forever. It's just so stressful, especially since I have this empathy "problem". Call me a baby, but I would really like to have a job where I make decent money and not have to work that hard... Is that terrible?

I just get so stressed out when my patients are teetering on the edge of going to ICU, or when they're having problems at home.

Por ejemplo, I took care of a patient the other day that, when I came on, was having a fight with their significant other. Come to find out, this significant other had an alcohol problem and the patient didn't feel safe going home since there has been some alleged abuse in the past. This person was visibly upset, we did some safety planning, and I walked them out to their car. The patient hugged me and said "thank you so much for everything you've done", when I had only been taking care of this person for literally an hour, but I worried about this person for the rest of my shift. I wanted to be sure that this person was going to be okay, and I will never know unless I see them again. Dealing with that kind of stress--being responsible (at least partially) for another human's life is a stressful thing. It takes a toll for sure.

We'll see how that changes as I am back on a normal human's schedule of sleep. I just read a blog of one of my classmates who is a nurse in the PICU, which basically prompted me to write another post. I have the greatest respect for nurses who work with kids. Sometimes when I'm at work I get so upset because of how unfair life can be for an adult. I think I would just come home and cry every day if I took care of sick kids. They didn't do anything, they're barely getting started in life! It's amazing the heart and soul Peds nurses have.

Speaking to the "getting jaded" aspect of this job--people ask me a lot how I can do what I do. It's "gross", and "so hard" and all these things that people think it is. Usually what I say is that if you can't ever detach from the people you're serving, you'll drive yourself crazy. That being said, the element of detaching makes me feel kind of heartless sometimes. I rarely cry in public, and never ever at work, [mostly because I hate people seeing me cry] but it also has a lot to do with the fact that I have built this wall that I put up when I go to work or I will cry. A lot. Empathy is a double-edged sword for shiz.

The other thing I tell people is that things that "classically" make people sad or cry don't really affect me anymore. It's the tiny little things that get me emotional--when the wife of an eighty-something little old man who is confused as hell and ripping out IV's, cursing at everyone who is trying to help him and telling everyone to leave... when she is telling him "I love you, I've loved you for sixty years, I'm not leaving you". When the teenage daughter of a patient dying from cancer doesn't say anything, just climbs in bed with her parent and holds them because she doesn't know when they will breathe their last breath. Just because she doesn't have any words left to express how much love she has for them. On Thanksgiving Day. When a patient tells me they're this close to giving up because they don't have anyone to go home to, that they don't feel like their life is worth living anymore. That. That gets me emotional.

The other thing I've started doing is volunteering with an organization in the area called MOCSA as a hospital advocate. It's definitely difficult, but I really like doing it, it's incredibly rewarding. It's been really eye-opening too as far as how common (unfortunately) sexual assault is, and how enlightening it is to know that there are people out there working tirelessly to end it. It's also really nice just to be a support. I don't have to worry about lab values, whether this person can teach-back something I'm trying to get across. I hold hands, I talk with people when they're in crisis. That's why I became a nurse, that's why I volunteer with these amazing people. We help people in crisis. Warms my black little heart.

So moving on from all that jazz... I know I said in my last post that I was going to get a cat--SCREW THAT. I traded that notion in for this little beaut.

How can you say no to that face?!

Yeah...screw cats. Bambi is pretty much the best and I love her to pieces. I adopted her in October and she has been so much fun to have around. We are still getting used to each other, and she's neurotic as hell, but she cracks me up and gets my ass moving, which, if you've seen my ass lately--it's like a shelf. 

I also started taking piano lessons again, which has been really really great. It's really nice to have someone help you achieve your goals musically, and it's always nice to have things to occupy my time so I don't, you know, keep eating my feelings or spend money. 

One last thing--my "older brother" Andrew and his magnificent girlfriend Chelsey just got engaged and I am so so so so happy for them! I'm so very excited to have Chels be a part of the insanity that is the Pirotte family, and I'm so happy that Andrew has found someone to spend his life with. She's leaving KC though, which makes me kind of sad, but again, SO HAPPY! *Sigh*.

All in all, I can't complain. I'll be able to see my friends more, I'll be able to travel more (even though my budget will be a little tighter--IT'S GOING TO HAPPEN). My next project is trying to find someone to share it with. We'll see how that goes. With the current state of affairs in the mid-twenties-marriage-and-baby-bonanza, I'm about 8 lightyears behind, which basically equates to me dying alone. 

So I'll just keep being 25 (almost) and drunk.

Happy as a Pig in...

Well, I am sitting here in my Rat Cave. That's what I've been calling it. Not with any love, mind you.

SO... I havent written anything in quite some time, so I figured that since I am sitting in my living room covered with boxes, QuickMix-ing it up on Pandora, I had a little time to reflect, because seriously: packing is just ruinous to one's happiness.

So my current apartment on Holly Street in Kansas City is an absolute bust. I love the apartment, and I would have stayed, except there are rats. Yes. Rats. Large, pooping, pink-tailed, disease-ridden vermin. Running around in my house. Makes me want to vomit just thinking about it. I won't get into all the gory details, but basically I have backed my property manager into a corner, and won't be paying any fees to leave this dump. Thank GOD. And now, I get to move downtown! Woo!

I hired a moving company to get all my shit from A to B, which, will be a little pricey, but SO WORTH IT. And I am fortunate enough to be able to afford it. I feel bad asking people to help me move, especially when I moved not two months ago. Oy.

I will be moving downtown, and I have decided to get a cat. I consider myself a dog person, however, I just love animals in general, and there are plenty of kitties out there that need homes and love, and I am not prepared for the amount of energy it takes to make a dog happy, and I am certainly  not willing to keep a dog closed up in a cage the entire time I'm at work. That's just mean. When I have a house and a yard (someday...), I'll get a dog. Maybe. I just need a snuggler. Because sometimes you just need a good snug.

Lots of things are changing! I started working at KUMed, which was one of the best decisions I could have made. I love everything about my job. Some days I get frustrated but don't we all? I feel like I have way more purpose than I did at LMH, and I am definitely getting much more involved here than there. I'm on the Practice Council, which is really cool. Being able to make decisions that positively affect the patients are really fun! Not to say that LMH was bad, because it was completely the opposite. I think it was a perfect way to start my career. I learned a lot, and got the basics down, and now that I'm at KU, I feel completely prepared for a challenge.

For example: I had my first code last week. It was extremely scary, but I proved to myself that I can handle myself in an emergency without falling apart, and it was made extremely clear that my coworkers are freaking amazing and I definitely would not have survived without them. It's so nice to be making permanent friends at work. I can certainly say I am a happy camper; very grateful.

As for the rest of the world and its happenings, I cannot wait until election season is over. It gets worse every day: the mudslinging and lies. On both sides. Absolutely disgusting and makes me want to up and move to somewhere else... where I would encounter the same problems. Politics are just ridiculous, and I absolutely despise them. Why can't we all just get along?

So screw the debates and candidacies. Do what you think is right and at the end of the day, that's all you really can do. People will judge you for the decisions you make, but you can't make everyone happy, so you might as well make peace with that and keep chugging along. Be thankful for what you have, never forget where you come from, and do good.
Don't be concerned with winning or losing or getting ahead or falling behind. Just do good.

Don't Worry, Be Happy

Well, this is a change from the last post. Enjoy, and be inspired!

Just be honest.