Did some major disinfecting today. My hands still smell of chlorine. Ack!

The trouble with trying to study is that for just about every disease condition or symptom I read, one or more of my patients flash into my mind. I remember their pain and their exhaustion. I remember their sufferings. And their deaths. And the grief that comes afterwards.

I remember being alone in a room with a man who had just been told he was going to die. Despite everything we learned about therapeutic communication and despite being at the top of my psychology class, I was at a loss for words. 

I remember the old lady who died of pneumonia because she and her family could not afford antibiotics anymore. She was the first patient who ever thanked me.

I remember the woman who looked into my eye and told me she didn’t want to die. I reassured her that we were doing our best. A few days later, I came back and she was gone. They said she had a massive stroke and didn’t make it.

I remember the children congested with fluids and yet still bleeding to death.

I remember doing my first postmortem and the surreal sensation of touching the empty shell of a human body, cold as stone.

I also remember the survivors. But I also remember all the pains they had to go through to survive.

And at some point, I don’t want to read anymore. Faces flash back into my head. And sounds: The whooshing sound of the mechanical ventilators that I could hear all the way from the stairs on my way to Station Three; the sharp alarms of pulse oximeters and cardiac monitors and infusion pumps; and the sound of mourning or the absence of it. Tears flowing in silence.  They haunt me every time I open a textbook.

I had done everything within my power. And yet that’s the thing that disturbs me. No matter how hard everyone tries, human suffering is unavoidable. And that there are some kinds of pain that not even the most potent analgesic can relieve.

I know that the most effective way to arm myself against the stress of work is to come prepared. And so I read as much as I can. I buy books on sale and devour as much information as my mind can handle. I try not to think about the Faces when I read. They spoil everything and make me reach for the next non-medical-related textbook I can find just so I can forget about them. But they always come, sooner or later. Because in the end, everything I read has a Face and one day that Face could be someone I know or someone I love.

One day, that Face could even be me. But, quite honestly, I’m not worried about that. I can handle pain and death better than I can handle loss.

Lippincott Manual of Nursing Practice Series: Assessment. (Php150.00, approx USD3.47 at Book Sale)

This was a really good find for me. Personally, I feel that despite the fact that I graduated from one of the best nursing schools in the country, my training on health assessment was somewhat inadequate. It is my opinion that assessment is the most important part of the nursing process, because it is the foundation for all subsequent care.

I love that this book describes in depth assessments and has some useful illustrations, diagrams and pictures to give me an idea of what I’m looking for when I’m doing my assessment.

We’ll see how useful it truly is once I get back to work. :)

jayparkinsonmd:

Philips just released a new iPad 2 app called Vital Signs Camera that uses the camera to measure your heart and breathing rate. It detects subtle beat-to-beat changes in the color of your face to measure your heart rate.

We’re slowly living in the future.

How can one have only one patient with no meds at all and still be tired as hell when they get home!?! D:

I knew I should have had more coffee.

nursling:

You’re a nurse?? That’s cool, I wanted to do that when I was a kid. What do you make? “WHAT DO I MAKE?? I make holding your hand seem like the most important thing in the world when you’re scared. I can make your child breathe when they stop. I can help your father survive a heart attack. I make…

How telling was it that, yesterday, my uniform was stained in blood, sweat, and coffee?

I am so pissed.

I had two post-op patients.

And two patients whose blood pressures decided to shoot up.

And one patient with a serum calcium level of 2.7 mg/dL, exhibiting signs of tetany.

Practically all the meds I had to give today had to be given slow IV push (Calcium Gluconate, anyone?), so I had to stay at each bedside for practically ten minutes.

I was still giving my 8am meds at 9am.

I had to change two diapers, and change one set of beddings because the nursing aide wasn’t available.

I had a hematologist demanding why my blood transfusion was delayed, when I had to come back there every fifteen minutes to flush the line with saline because it would clog every so often even if the line was perfectly patent. (And, yes, I did terminate it after 6 hours.)

Our head nurse was yammering about how we should clean up our mess in the middle of a busy, busy hour when everyone was rushing to give meds on time and throwing away syringe wrappers was the least priority. I muttered “Thanks a lot for the help.” out of earshot. One of our charge nurses ran off to give an enema (a med nurse responsibility), because apparently that’s far more pleasant than staying at the station and listening to that litany.

Unwilling to spend too much time with feeding my patient per NGT, I mixed quite a bit of distilled water into her blenderized feeding. (Yes, I checked for residue before each feeding.)

All my charting was illegible. (The doctors are allowed to do it…)

An infant’s IV dislodged on me as I was giving my end-of-shift meds.

Two of us are resigning by the end of the month, and one has explicitly given the hint that he will be going AWOL because he’s found a better-paying job that requires less hours (and, apparently, you get more respect for it too) and it doesn’t require you to sell your soul to Florence Nightingale.

I have blood stains on my uniform.

Yes, I still hate  that stupid, pointless nursing cap.

And, apparently, someone in the nursing service office read that carrying around a huge, heavy medication tray increases patient satisfaction and is a hallmark of excellent nursing service and decided that carrying the small trays is now forbidden, even if you’re only going off to give one, single, tiny tablet.

I was so pissed off at our managers that I scourged the nearest book store for a book on Nursing Leadership and Management, if only to have a reference to point out that our staffing ratios are bullshit.

Upon finding that I did not have enough cash for the book, I went over to KFC to eat something and de-stress.

Nothing I ordered in KFC had chicken in it, which I suppose is akin to going into a bar and ordering milkshake.

I can’t wait ‘til next year. My resignation letter is going to be so sweet.

I lied to a patient today.

I was like: “Don’t panic, ma’am. This is a standard procedure that we do all the time in this hospital. I need you to relax.”

Which was not such a lie after all because, now that I think of it, I did do that procedure all the time… Back when I worked at the ICU extension.

And, besides, what was I supposed to say? “RELAX, RELAX! DON’T PANIC OR ELSE YOU’RE GOING TO ******* DIE!”

Just potentially messed up my work life by opening my big mouth.

It had to be said, but nobody else would say it.

It’s going to be a long week.