Staying Focused When Things Feel Overwhelming

When you are a nurse, you face the conundrum of providing care to those outside your job. Equally I suppose doctors get the same: "Oh you're a doctor...well my leg has this rash....". They may feel impelled to offer advise based on their education and oath, yet, the day-to-day job they have has its own schedule and stressors, much like nursing. I read the works of Robert Wicks. He has a book out re: secondary stress and about how it effects the caregiver by just being a caregiver and what it means to decompress and rejuvenate oneself. Giving of oneself when you have little reserve, unless someone is spiritually grounded, is difficult and demands extreme focus and positive thinking. It involves being SURE to be good to oneself first and maintaining that throughout care giving------else one loses oneself.

The Envy Of Close Families

I have always been envious of families who are close and loving with one another. Most Jewish families seem to be like that. Family is first. Still, there are many others who enjoy this closeness, people who talk to a sister or brother or mom every day. My own family seems to always be impatient with each other, a trait gotten/learned from my Dad. My mom taught us anger and how to hold on to it. It is a shame when your family endured difficult times coming up and that now as we are older, the competitions seem to continue in one way or another, like sibling rivalry. I am different from my other family members. I can avoid panic and generally am not impatient. I give cards and gifts for birthdays because I think it is important. But that is my choice. I just had a stressful week dealing with a family member with regards to my Dad. The positive: I had quality time with my 88 year old Dad and that is never measured in money, nor can irritants erase my love for him and my sadness when I realize my days are numbered with him, and he will go to be with my mom.

Health Care Today

I feel the need to ventilate about two health care-related topics: 1) the way in which our system rushes you from one unit to the next or one facility to the next and, 2) the lack of the ability of health care workers to provide empathetic care and time with patients. Let me start with the first and lead into the second.


I just experienced the 'flow' of a family member through 'the system'. She had an extensive 8 hour reconstructive surgery which landed her in ICU. With blood pressures in the 70s over 40s, she bought herself an overnight stay. She was transferred to an ortho floor after 4PM. The following 6PM she was being shipped to a rehab facility. The ambo was en route at the same time an occupational therapist was cutting at and adjusting her full-torso-front-to-back two piece-brace. I had just finished giving her her first bed bath. I found erroneous leads and tape all over her. There were blisters and breakdowns in many places from pressure or tape or teds or SCDs. Now here's the kicker. Why, does a c-section patient get to spend 4 days in the hospital and a fusion patient (me) gets to 'spend the night"? This family member had at least 40 screws and umteen rods along her entire spine. It was a 100% spinal reconstruction.
I have first hand knowledge and experience of the lack of adequate hands-on and often empathetic care simply by being a nurse. Our system is to blame for this. Being a patient in a hospital governed by  insurance monopolies is not where anyone wants to be.

Nursing is the 'next-to-the-hardest job' I have ever had or done.

It is only to be surpassed by teaching...to which I have given 7 years of my 32-year career. Today, I had two mothers hemorrhage. For any OB nurse out there, it is a nightmare. To any lay person, they cannot stand the voluminous amounts and colors of blood being birthed. While their baby lays in a crib, the life is flowing out of them. Their significant other is either asleep from a 'hard night' or they are on the computer or cell phone. I am cross-matching blood and calling doctors and techs and the blood bank. How dare they lay and not know of what is going on. How dare the doctor who doubts your nursing diagnosis. Lay the clots on a hampton so you can calculate the blood loss. Save all the peripads and laps and 4X4s. Get the methergine, the hemabate and watch the father lay there and put it on facebook and text his girlfriend. Assess the baby at regular intervals (peak assessment- new term as of today). Yes, it was tough. Charting (yes the infamous EMR) had to wait and be 'late-entried'. Yes my other patients were delayed and yes, I felt morally and ethically lowest on the totem pole because THEY were not getting equal attention with less emergent issues.
Teaching you ask......... try teaching high school vo-tech nursing and geriatric aide, grades 10-12, in a lower, socio-economic area, where only a handful of the TOTAL number of students I had, did I know had what it took. I had 5 lesson plans-a-night to prepare, five different levels of classes: Pre-nursing I, II, and III- and Geriatric Aide, I & II. I had kids who wanted to be something and I knew they never could do it. I had kids who, by the age of 17 and on drugs with two kids who desperately (though emotionally and socially they could not, even though intellectually, they could have) wanted to be a nurse. I had special ed inclusions. I had ADHD kids. I had roosters in my hen houses. I had it all. What made it worse was that my Principal was a playboy. I spent much of my time in his office with disruptive or disrespectful students than I did with teaching. He would come on to me after classes. BUT...I was not interested. I took my KIDS to the 1st, 2nd, and 3rd place wins in the state competitions. I had a classroom with a 3-bed instructional area I would spend hours in, after class with students. They were to excel; no one was to stop them..no matter who did them wrong, whose boyfriend was untrue, whose father was missing-in-action....it didn't matter to me. I wanted it for them and made them believe. It was hard because there is a fine line between being a parent to them, or friend, and being a teacher. I had a knife 'shown' to me once. I had pills offered to me more than once. I brought in cow's tongues from the butcher to teach the digestive system and about the fungi form taste buds. I brought in social workers, took them to the Wyman Park Medical Museum. I had them watch surgeries and made them dress in all white for graduation. I would even walk the bus row on the way to the nursing home to have them take out their hoops and piercings-not on my watch. And you know........they wanted it, craved it, and needed someone to tell them, make them, be the best they could be and LOOK and ACT the part. I will always miss them. Them and my Geriatric Aide students I also taught through a nursing home conglomerate. I would train them to pass the state's tough exams only to have them thrown to the wolves with 15-50 (yes I said 50) nursing home residents to care for. But I taught them character, chain-of-command and legal documentation. They were the package and I, their ribbon. I loved them all...high school and women and men of all vocations and cultures. Let them stand tall for they were exposed to what health care really is. Oh, and did I tell you that it was for three years straight that I took 1st, 2nd, and 3rd in the state, and that one year- I had a kid place 4th in the United States. Yes ALL those long hours were worth it. But students are hard to get out of your mind...they are an appendage of you. Your patients need your best for 12 hours, 8 hours and then you go home. With teaching, you are up until 3 grading papers and doing the next day lesson plans. On Saturdays you are grading papers. On Saturday nights, you pull a 12 hour night shift as a nurse to keep your skills and license up. On Sundays you sleep and, in the afternoon, you rise to have some time to breathe and reinvest your thinking. I was proud to show my own two kids something. They turned out great. God bless us all..................................

Goodbye Smokey

Good-bye Smokey, my cat, my pet, my friend. I had to say,"please put him down now" today. I had no intentions of doing it. I sensed he was trying to clear a hairball over the last few weeks, so we started treating him with hairball cream to his paw. He had been eating, drinking-pretty much his usual self. Late last night however he was wretching again and did not produce anything but seemed to breathe in and choke on whatever did come into his mouth. He had some breathing distress though he was not panicked, so I gave him some chest PT, his breathing settled down, and we fell asleep on the sofa, him in my arms. The next morning he was pulling, retracting, working hard to breathe. I took him to the vet and the vet xrayed his chest. I was not at all prepared for what I would see. I cried as I studied the films with the vet. Smokey had been functioning on 25% of his lung tissue. There was a large pleural effusion showing in most of his chest cavity and there were some tumors. I knew right away, looking at those films, I would have to put him down. He was a beautiful, fiber optically-furred black cat with piercing green eyes. The tips of his long black hairs looked as if they had been dipped in beige paint. Smokey wanted for nothing but to be left alone, be stroked and loved-up once in awhile, and to be no bother. He was happy just to have a home.
After having him euthanized, I sat in my car with him in my arms. I spoke to him, stroked him, and cried. I told him I was sorry. As a nurse, you become angry when you think you missed a diagnosis or signs. The positive from this- a lesson- never assume your cat is trying to clear a hairball if nothing is produced. I took him home and laid him on a quilt in the foyer area so that the other animals could see and acknowledge he was gone. Maybe that was too hopeful. After all, other than his newly shaved foreleg, he looked peacefully asleep. As I lay crying next to him on the floor, petting him, my husband came home from work. He too was shocked and shed his tears.He told me to let him go that we had to bury him. Call it silly, but I buried him with a toy, a little stuffed mouse, and a picture of us. My husband asked where I wanted him buried. I chose to bury him in my closest-to-the-house-garden. He only wanted a home and I was glad to give him one-my adopted, rescued Smokey. Rest well my friend.

Do People Really Think.......

Referring to some twitter comments: Do people really think that they can make a change that is positive through their negative vibes and voices? I mean, I do not believe in sunshine blowing, but I do believe that it does help to keep negative comments and just downright rude comments to yourself. It becomes even more volatile when a negative person has a high IQ and is politically and socially informed. Put intelligence to good use instead of just complaining and insulting. Please!

Feeling 'Dazed and Confused'

Another two weekend days to work and again I am regretting it. The sense of family as caregivers is gone. I miss it. Very few people have the knack to do their work and manage to keep up with everyone's business. I often wonder why it is I have a problem doing that. I know it is not in  my work ethic, and I never was one for idol chatter. I never learned as a family member growing up that sharing was OK or even done. Nine people in a small house and no one really knew 'inside any of the others' heads'. We all went about our rote existences, trying to steer away from unpleasantries at all costs. I am only 53 and I feel weary about the future. Is this what going through the motions of and caring for, then losing your parents, is all about?

Everyday Positive ThinkingThe Power of Positive Thinking