Unwanted visitors.

Why do people think just because you have a driveway are allowed to drive up it. And then they think they can come up on your porch, knock on your door, and tell you that you are going to hell if you don't listen to them?

I met those people with a broom in my hand and told them to go away and don't come back.

You would think the days are gone when people would feel safe walking up to a stranger's door.

Next time it might not be a broom I hold.

How would they like it if I knocked on their door and told them they were wrong in everything they thought and believed. Church people have been doing this forever. It is time they stopped. It really isn't safe.

Hospice Angels

I don't believe in heaven or angels. I believe in the earthly angels. I've met them many times. The best ones work for hospice.

On this mother's day our hearts are heavy. Tonya's mother died April 23. She was in a hospital bed in the middle of our living room. Facing a wall of windows looking out on a yard full of daisies and beautiful green things.

What a lady she was. Always had polished fingernails, always dressed in fine clothes.

She decided it was time to die. She said so. She said she was ready. She talked to the hospice nurse like she was planning a business deal.

We watched her slowly letting go, giving directions to her children, look there for this, look there for that, be sure you check on this.

I saw a slight hesitation as she opened her mouth for her first dose of Ativan and Morphine to ease her pain and difficulty breathing. We kept her comfortable and clean. She left us like a lady.

Wow! If we could all choose to go like that wouldn't we? Shouldn't we?

A family sent a loved one to the ER with respiratory distress. I watched as he struggled to breathe. I watched as he was intubated and put on a respirator. Not good. Traumatic, intrusive, so sad.

Hospice is the way to do this. The angels come to usher us out of this life when we are ready. May we all know when that time is and may we let our families know what we want.

Happy mother's day Arlene. Here's to a strong and brave lady.

The Teddy Award

No, this isn't about those skimpy nighties. This is about the true Teddy Awards. I will write the original here:

It is not the critic who counts: not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again...who spends himself in a worthy cause; who, at the best, knows, in the end, the triumph of high achievement, and who at the worst, if he fails, at least he fails while daring greatly.

I believe we nurses deserve a Teddy Award. I believe we should be made to feel like what we do for our patients matters. Sometimes it just isn't enough to pat ourselves on the back and feel good inside about what we did that shift, about what happened and how well we handled it all.

Something is just wrong when the CEO brings food down to our break room and then says "Now bring those satisfaction scores up."

We truly spend ourselves in a worthy cause. We go limping home and try to rest and heal our sore spots and get ready to do it all again.

We wash off the blood and the gore and try to get the charcoal out of our clothes, and the thoughts of that homeless person we shuffled from one part of the hospital to another.

There are days it really feels like a strategizing game. Move this one here and that one there and get the admitted patients up to make room for more coming in.

Yesterday I passed the exam and am now a Board Certified Emergency Nurse. I feel great about it. It will get me no raise or promotions. But I did it.

I love what I do. I want to do it better every day. And I want some God damn kudos instead of having things I didn't do pointed out every day.

So everybody on my team gets a TEDDY AWARD, whatever that might look like. I love all of you.

The Power of One

When there is no one in your life to encourage you and tell you that no matter what, you are good, you matter, there is a reason for your life, and that you are loved at your most unlovable, you will seek out those affirmations anywhere you can find them.

We must seek everyday to build a team of support around us. And we must in turn be there to give others that support.

When we fill our circle, strengthen the walls, and nurture our garden of friends, no one and nothing will be able to make us feel inadequate, unloved, unneeded, unimportant.

And we will not fall for the empty promises of what comes after death. We will not need to give up on this life and this world.

I am looking out my window on a rainy day, feeling melancholy and being okay with that. Rainy days are good for that. I feel loved and happy. I only hope I make other people feel that way too.

Remember When

We had a few rare moments last night at work to stroll down memory lane.

We remembered when nursing meant something more to us. Evening back rubs with warm lotion for our patients was better than a sleeping pill.

Patients checking in the night before their surgery so we could do pre op teaching and do that dreaded enema and bowel prep under our watchful eye and aide. We taught you to deep breath and cough and told you what to expect when you got out of surgery.

You knew that your primary care Dr. would be there for you in the hospital. You felt safe and secure because your Dr. knew you and your needs. Now you are placed under the care of a stranger, however competent he or she may be.

Remember when you got one bill? I know this is a stretch for some of you younger ones. Now there is confusion over who got paid by the insurance company and who do you owe.

The paper work is overwhelming to say the least. Sign here to say you understand that there is no smoking on this campus. Okay. Sign here to say you understand that you will be responsible for anything your insurance does not cover. Duhhhhh! Sign here to say you understand that you will be receiving a separate bill from radiology and lab. Sign, sign, sign.

I wish for simplicity for us and our patients. I wish for comfort and caring for our patients. I wish for less stressed nurses and an atmosphere of kindness and love. I wish for no more added paperwork. Let's do some take aways for a change.

Remember when we loved what we did?

For the sake of a clean shower door.

I am always interested in knowing how people hurt themselves. Maybe so I can be more careful in life and avoid those same mistakes.

This one is priceless.

A man wants to have a clear shower door instead of an opaque one. His wife agrees if the husband agrees to squeegee the door after he showers.

The man agrees and the door is installed. The wife discovers his trick. He always showers first leaving her to squeegee the door after her shower.

One day he was headed to the shower and she decided to beat him to it. She fell and broke her ankle.

Now she won't be taking showers for awhile with her cast on so guess who gets to squeegee the shower door?

She smiles when she hears the squeegee sound now I bet.

Are they listening?

I've been working some overtime lately on purpose. ER has been slower than usual. I have had more time to actually spend at the bedside with my patients. I really enjoy that.

I talked with a German lady and found myself mesmerized by her accent. She told me stories of her travels and compared things with living in Germany.

One thing she talked most about was getting around in the different cities. In Germany, you don't really need a car. You just get on a bus and go anywhere you want.

Freedom means going where you want without having to drive there.

This lady was very sick when she came in. And much better when we had our conversation. I saw her color get healthier and her eyes brighten as she told me stories of her travels. This is my favorite kind of nursing. The human kind.

Listening is cheep medicine.

Flu Season

We are all being bullied to get the flu shot. If we don't, we have to wear a mask during our shift. How crazy is that. I'm a nurse taking care of sick people and I have to wear a mask. I think we are going to frighten people walking around all masked up.

If we really "care" about our patients, lets keep children under 12 out of the hospital. And make the visitors wear masks too.

Here's the funny part. We ran out of flu shots the second day they were offered. We are so far behind the ball now it makes no sense to even get the shot.

Can you imagine a true Pandemic? We could never make enough vaccine to take care of everyone.

Some more stupid stuff: We have monitors that you can print out your patient's vital signs. We are being told that we have to chart every vital sign because the print outs are being lost. Now that makes sense right? Lets not fix the problem of medical records losing a legal part of a chart. Lets punish the nurses and make them spend time charting five minute vital signs in the computer.

So if you have the flu or anything else wrong with you come on in to the ER. Your nurse will not infect you because she or he will be wearing a mask. But you will be exposed to other patients with viruses galore.

Junk Food Taxing

While I don't care if they tax junk food, I think the real money is in religion.

We could do a lot with the money we would get taxing churches and religious organizations.
They influence a lot of people regarding who to vote for and what they believe is good and bad in the world.

I think anyone who spreads so much hate and discrimination should have to pay for it.
They push their way into our schools and government facilities, blatantly stand up and pray to Jesus at football games and put the nativity scene on the court house lawn.

The Christians forget what separation of church and state was created to protect us from.
The very thing that Christians are doing now. . . .Proclaiming that their God is the only one and everybody else is going to hell.

Give me freedom from religion. And make the churches pay taxes and turn off all those lights in Andice Texas where the Baptist and the Catholic church across from each other battle to see who can light up the sky more.

And let me introduce you to my God, The Flying Spaghetti Monster. May his pastaness lift you up and carry you through a happy day.

Cleopatra is alive and well.

While she is known for so much more, Cleopatra is also the Queen of "Denial".

Nurse to elderly man--I see that you are a Diabetic.

Elderly man to nurse--What makes you say that?

Nurse--You are taking Metformin.

Elderly man--Oh, I don't have Diabetes. I just take that to keep my blood sugar down.

Coffin corner

I read in my time magazine an article on the recent plane crash in the ocean. It was said they were flying in their "coffin corner". Too low, too slow. It sure gave me a creepy feeling and made me think about, what else, my job.

It is very hard for me to think about making money off people who are sick or injured, although I couldn't live without my paycheck. But the pressure is on when my health care organization sees fit to cut "corners" to save money in this bad economy.

This is our "coffin corner"-----

The first to be canceled or cut are the very people who save lives. Nurses.
The next are our clerks, who if they aren't around, the nurses left have to answer phones, put in orders, make calls for DR's. and answer call lights. (One less nurse out there taking care of patients)

We do not have a shortage of nurses in this country yet. We have them knocking on our door to be hired. There are no openings. Productivity, patient numbers, steers the need. What we have are older (45 to 60 year old nurses) however experienced and skillful, who are "flying lower and slower" than we used to.

Expected to do more with less, I struggle as a charge nurse to pick up where others need help and take care of my own patient load while staying prepared for the one coming in who may need all we have available to save their life. And that person deserves nothing less.

May we never be caught flying too slow, too low.

My daughter lost her pregnancy at 10 weeks. We all felt helpless and sad. At least we know she can get pregnant after her cancer battle. It seems the women in this family do best when we have something we can fight against. It is having to accept the things we cannot change that pisses us off.

Tread lightly over the skunk under the porch.

I was watching the birds out my living room window one morning when something caught my eye coming towards the house.

Oh No!!!! All I could do was sit and watch with horror as a hugh skunk crawled under the porch.

I said, "No. That is not a good place to sleep today buddy. We are very noisy around here. We clomp on that deck all day long. Well maybe we could be a little quieter.

The skunk camped out with us for about a week. Caught a whiff of him once or twice but who doesn't have a guest that smells after a few days.

I am going to be a grammy again. My youngest, Marsha is pregnant. I've been missing having a baby in my arms.

I had an emotional break down recently. I am losing another tree. It has to come down because it is falling down and might do some damage on the way down. It surprises me how much love I feel for my trees.

I saw a dead skunk down the road last night. Skunks come, skunks go. It's all that happens in between that keeps life interesting.

Needing Mom

"Our achievements are measured by the people who need us."

It will be another mother's day soon.

When I think of my mother, my continued need for her at my age is so strong. She is always there at the end of my phone and she always knows just what I mean no matter what I'm talking about.

May my need for her only bring her a great sense of achievement.

For in being needed we always have something to do, someone to love, and much to look forward to.

I love you Mom

Hand Prints on the Walls

I am on the other end of nursing right now....A patient.
I had minor surgery on my feet. What is a nurse without good feet right?

The experience was a good one. Except for the pain of course.

There was also a very nice surprise in the OR. A nurse who has been retired and who comes back to work in the OR once in a while was on duty that day. Dee and I worked together when I was a brand new nurse. She taught me how to start IV's.

I barely remember the spinal anesthesia going in. Dee was holding me upright, my head was on her shoulder and we were talking about our grandchildren. It was so good to see her and I felt so safe and well cared for.

This past week has brought back some old memories of all the times we moved as a young family. I can remember cleaning the houses we left behind. The dirty hand prints along the walls where my kids touched them.

Each time we moved the hand prints were higher up of course.

Now I touch the walls as I try to keep my balance walking in these post op shoes. I think my hands are cleaner though. No hand prints to clean off.

I have gained a new respect for walker users. My elbows and wrists are hurting.

Ode to a co worker.

We met when I was 28 and she was 18. We had decided to start nursing school and we hooked up to do some sharing of rides and soon discovered that we would be sharing so much more.

We studied together almost every night. Let me clarify that. She and my husband drank a lot of beer and laughed a lot about the various anatomy courses while I studied. We both got great grades. I just had to work harder for mine.

Janice made nursing school a great adventure from the beginning to the end. We got a 10 minute break every hour in class and we lived for that 10 minutes. There was on instructor who would try to go over that but Janice fixed that. She hid an alarm clock one day under the teacher's desk. When it went off, the teacher screeched and looked right at Janice frowning. We were all smiling at her though so nothing bad happened to Janice.

They learned not to mess with our ten minute breaks after that.

Things haven't changed too much through the years. Janice is still demanding her breaks and getting them mostly. We have both lost our fathers and are taking care of our mothers and still taking care of our children. I traded my husband in on a wife, which I recommend highly if you have the tendency, and I have the joy of having 5 grandchildren.

We are great nurses, great friends, and still up for any funny business that we can get away with and still get laughs and have fun.

Sometimes I'm a Little up tight because I have a charge position and the director expects more from me than in the old days.

It is hard to find the balance between having fun, being part of my friends and co workers behind the scenes shenanigans, and upholding the trust my director has placed in me.

So I will remember the mustang we drove to clinicals in, the nights she spent on my couch sleeping over after all night "studying", my little ones sitting on her lap when they were so young and cute, waiting for the results after taking the state boards and the partying afterward.

I am happy and so glad we have stayed so close all these years. I will be 57 years old soon but when I think of us I still feel 28.

We are what we remember we are. And we were great!

A SET UP FOR FAILURE

You would think that after 38 years of washing my hands in a health care setting I would be pretty good at it. Second nature.

I have a pattern that has been endorsed by nursing schools forever. I wash my hands every time I cross a threshold.

However, they had to find a way to document and observe that we are washing our hands so they created a new way... a way that costs lots of money in new product and a way to deliver that product.

Foam in, Foam out. Since my hands are usually full of things going into a room, and full of things going out of a room, this is not conducive to getting me to wash my hands their way. Therefore, when the spies are watching, they say I am not washing my hands. (not true).

I had the humiliating opportunity to get instructed on how to wash my hands the other day. By a sweet young girl who should have been teaching at my grandson's school. There were two of us in the class. Both of us veterans. We could hardly contain our irritation. Let me go back. I definitely did not contain my irritation.

Here we are, mixing up your medications around a dirty sink next to a garbage can in our med room and they want to teach me how to wash my hands.

My bullshit cup runneth over.

The next day I saw that the hand washing inservice had been cancelled. I'll probably be called on the carpet for harassing the poor hygiene lady. Or maybe she caught a clue and went after real issues.
I can only hope.

"They aren't very nice here"

I heard a wife of a patient bend over her husband and say "they aren't very nice here". It was the end of a very busy 12 hour shift, I was down a staff member and carrying that load plus my own. I had given eye contact to the wife and greeted her when I entered the room which I thought was commendable considering my feet were hurting so bad my teeth were clenched with every step.

I apologized profusely and blamed it on the damn computer I had to chart on. I told them it was a curse that I had to stand there facing the computer instead of them. In my mind I'm screaming at the conglomerate I work for.

"You want patient satisfaction and high scores in that but you cut the nursing staff to the bones. We are the front door to that satisfaction. And the back door, and every door in between."

I also find it interesting and sad that one tired nurse can be the "they" in "they aren't very nice here". My shoulders are strong but I don't want to be responsible for branding the whole place with my inattentiveness in a tired moment.

So I buck up and pledge to be the best "they" I can be today and everyday.

The Universal Sign.

A car stops in front of the ER entrance, the back door opens and we see feet. The tech jumps in to check the man and we see him start chest compressions. The (feet first syndrome). A stretcher is brought to the car and the patient is pulled out onto it. We work on him until our protocols are exhausted but he dies.

The family will remain in my mind for a long time. I watched them go through the shock into the tears and on through to the planning stage smoothly, quietly, and together. When they were leaving, the wife asked if we were all okay.

In all my years I don't remember family members wondering how the death of their loved one affected us.

This day continued with several more critical patients among the non urgent ones.

And somewhere in between things a registration clerk came out of her office grasping her throat. (The universal sign for choking) A nurse saw her and grabbed her around the waist and did what we are trained to do and then went on about her business taking care of her patients.

The clerk was okay but shaking. Just another day in the life of a nurse.

On the porch with Jackson

We were waiting for his mom and dad to get home from Washington D.C.

Jackson- Will you tell me when you see them coming?
Me- I will. What are you going to do when they get here?
Jackson- I'm going to run and say "Mommy, Mommy, Mommy!
Me- And Daddy, Daddy, Daddy?
Jackson- Yes, and where's my present?
Me-Jackson, you should tell them you missed them and that you are glad they are home. And ask them if they had a good time.
Jackson-Yes, and where's my present.

When Marsha and David got home, Jackson went running. I watched, confident in my coaching skills.

Jackson- Running, jumping into his daddy's arms. Where's my present?

What a gift this child is to us all.

Team Work

I was permitted to change my work schedule when Marsha got sick. I was given a charge position in the ER twelve hour shifts on Friday, Saturday, and Sundays. This allowed me to spend Monday through Thursday with Marsha. Her dad came in on Thursday nights and stayed through Friday. David was home on the weekends.

On Chemo days, David's parents took Jackson for a couple of days so I could concentrate my energy on Marsha during those tough days after Chemo.

Tonya came often to play with Jackson. Now Tonya is his, he thinks. Whenever they are together she belongs to him. She sure helped keep the focus off his mom and keep his little life normal and fun.

Jackson is better now but for awhile after Marsha was done with treatments and I would come over he would get cranky and didn't want to look at me. I guess he thought I was going to take his mommy away, which I sometimes did.

We had a great routine going. David's job was to keep working and providing that great insurance. We wanted him to save his vacation days or time off in case he needed to help us.

He sometimes felt like he should be with his wife and that was understandable. Other than a stomach problem, also understandable, David was wonderful and strong.

I recently read in a book a phrase that will forever be in my heart....

"Physical causes are too wrapped up in their emotional results to be disentangled."

David's stomach problems are gone now I think, now that Marsha is well.

It all seems like a bad dream sometimes. But the fear and rage and pain and disrupted life and a loss of direction seem to be my left overs.

But I have not lost a daughter to cancer. I have gained a strong friendship with a kick ass woman who is an inspiration to all who know her.

"Fuck Cancer!"