Thankful

So we are into the month of November. Where at the end of the month we celebrate giving Thanks here in the USA. On social media on Nov 1st people start putting on their timelines Day 1: I’m thankful for…. and so on.

Well…my turn. I’ll say one thing that sums up everything. I’m thankful that I am a nurse. Why?

I make decent money that I can get by, have a roof over my head, etc. It also gives me a chance to see the country and travel (as a travel nurse). But I’m also thankful that I am able to witness people struggle with drug addiction (alcohol, crack, etc). It reminds me that it can happen to ANYONE, at any given time-for any given reason (though some are more prone to addiction than others).

3) I’m thankful that I am able to witness people (young and old) die. Die from disease, die from traumatic injuries. It reminds me and makes me thankful for today. Tomorrow is never promised to ANYONE.

4) I’m thankful for witnessing people try to conquer Cancer. Giving them good news or bad news and witnessing the support that my patients receive from staff, from their family, from their friends, from they church members (if they belong to a church). It makes me thankful for all the people in my life. Even when I tend to be anti-social, I know I can reach out to friends.

5) I’m thankful to witness people with mental illness. Be it in a depression episode. Be it in a manic episode where they cannot control the random, rapid thoughts that go thru their heads. I’ve work with people who laughed at those patients. I told my co-workers that it’s not funny. Can you just imagine being in their head and how crazy that must feel? So I’m thankful that I am able to see it and thankful that I am not dealing with it.

6) In two months, I have the opportunity to go overseas to Madagascar and donate my time, my skills to those that need it. I will spend two months volunteering. Two-three months of not being paid back here at home, etc…to lend my services. I am thankful that I have a job that allows me to give back. I am lucky. Blessed. And privileged.

7) Just general older patients. Seeing them get by and get around and I’m thankful that I have that possibility eventually. Though I predict that I probably won’t live past 50 or 60.

Yes…I’m thankful for my job because my job makes me realize that I’m thankful for EVERYTHING else in life!!

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Hmmm- Is Nursing a Talent?!

Is nursing a talent?

This is, evidently, the thought that went thru the mind of Michelle Collins of “The View” (according to one of her now deleted tweets). I really go back and forth on this statement. Is it a talent? If it is a talent, can’t all careers be a talent? Or are we just truly that special?

I do know that I have worked with some co-workers (nurses, doctors, techs, etc) that should NOT be in the healthcare field. They are in it for the wrong reasons. But does that mean SOME nurses have talent and others don’t? So then we think about-what classifies something as a talent? Does that vary person to person? If so, was Collins in the wrong?

I think about my first couple months off of orientation as a staff nurse. On this day I had a student nurse with me. I was showing her what I did, she gave medication with her instructor, she asked me questions. This is a teacher aspect of nursing. I remember getting a report and one of our patients was end of life.

How do you approach someone who is at the end of their lives? This is not the first time for me. I used to work on Oncology and Palliative Care units as a tech, I also worked in the Emergency Department. We dealt with death all of the time. End of life is what I seem to do fairly well-Palliative Care probably will be where I end up in the long run of my career. I think I help my patients transition comfortably.

But back to the nursing student with me. I asked her a few questions 1) how are you with death? 2) have you come across someone who has died? 3) have any one in your family passed? 4) are you okay with dealing with this aspect of the career? If not, is there anything I can do to make it better for you to process it?

Back to the patient. I knew her. I had her as a patient before. When I had her previously, she was awake and talking. I never saw family visiting her (this is common). When we walked into the room, I had the student nurse evaluate the situation. She was sitting up in the bed, but pretty much non responsive. Her family (whoever they were) decided that they wanted her on tube feedings. Why? Perhaps they were in denial? Perhaps they didn’t understand how close their loved one was? Perhaps they were hoping for a miracle? I do not judge why-if they are around, I just try to help them with the process.

The student nurse stood back while assessing. I could tell, she was not that comfortable. She didn’t know what to do. At first it was difficult for her to engage with the patient. How do you engage with someone who is not talking back? With someone who is not looking at you? With someone who is not talking, eating? With someone who Cheyne-Stokes breathing pattern? Someone who is clearly not going to make it to the end of our shift. Her legs are mottling. Even newborn healthy babies respond in some way to contact.

We step out of the room, and I asked her how she felt. She said that she was overwhelmed but okay. I reviewed the situation with the doctor and in the long run-he called the family. The family still did not come in. For whatever reason, I do not judge.

I knew the mission of this particular patient. But before I spent time with her, I wanted to introduce myself to my other patients for my shift. I did just that, quick visual assessment. Introduced myself, made sure they were not in any distress, made sure they were not in pain, etc. Basically making sure they were vital, stable, and happy.

Upon returning to the room, nothing changed much other than her breathing slowed. I reviewed this with the student nurse. It’s one of the signs. I reminded the student that, as far as we know-someone’s hearing is the last to go so it’s okay to talk to them. She did but you could tell it was awkward for her.

I approached my patient and I brushed her forehead, held/rubbed her hand and told her “it’s okay to go, everyone here is going to be okay. It’s okay to be comfortable. You don’t have to suffer any longer. Your family is going to be alright.”

I rubbed her leg and repeated that she was free to go. “Just relax.”…”Just let it all go Ms. ____.”

I could tell…we could tell- her shoulders relaxed at that moment. As if a big weight has been lifted from holding her down. Then she passed away within a few minutes. She was not alone. She was comfortable. She did not struggle. She appeared to be in no pain.

I saw that tears were starting for the student. She removed herself from the room. I stayed, turned off the tube feeding, put her head down and went out to call the doctor to pronounce. I left the oxygen on until the time of death was called.

After I hung up with the doctor, I went to the student (who was in the break room). I asked her if she was okay. I asked if it was something in particular.

She looked at me and said (as she’s wiping tears)-“you read about it all of the time but you do not expect to see it happen. You hear that it’s okay to tell them to go but to actually see it is…WOW!” And she thanked me for the experience. This did not shock me. I have had this experience many times before. As a nurse or as a tech, I had always told my end of life patients that it was okay to go and I’d witnessed them go by the end of the shift.

Is that a talent? Or just mere compassion? caring? Can compassion be a talent? Can everyone do it?

I don’t necessarily think it’s talent but I certainly don’t think everyone can do it. Be it, the end of life process or the birthing process or the psych process or the trauma process or the teaching process-one nurse cannot necessarily do another. But hear me out-I don’t think Miss Colorado was in the wrong for doing what she did. I actually applauded her and shared the clip (before this The View fiasco). I was proud of what she did. Nurses are important. Police are important. EMTs are important. Doctors are important. Teachers are important. We are all important. I cannot sing-thus I don’t have that talent. I cannot do standup comedy-thus I don’t have that talent. I can, however, help the process of dying-is that a talent (I know that not everyone can do it)? or a calling?

Is it a matter of potato, patato? Does it really truly matter? Or is it the context of how the ladies on the View (quite frankly, I was more offended by Michelle Collins and followed by Raven than I was Joy Behar) presented it?

Either way, I stand by my previous blog post-I hope this social media publicity sheds light to the real issues facing nurses and healthcare. I hope that there are adequate staffing ratios so I can do my nursing talent/calling and spend that time with my dying patient as I was able to do with the above patient.

Her, like a lot of other patients, remain with me. I think of them often. This is not a job that I leave at work.

#NursesUnite

#compassion, #joybehar, #michelle-collins, #nursing, #palliative-care, #talent, #theview

It’s Not About You, It’s About the Patient

Stethoscope and a silhouette of the heart and ECG. 3d

Do people realize that if you offer help to others, there is less stress for everyone?

I work in the healthcare field, now as a nurse. I tell everyone, PLEASE, do not get into nursing for the pay because it’s a highly stressful job (or can be)-not to mention you’re dealing with people’s lives. It’s not a production line at a factory.

My personality is that I have to help. I am not one to sit down and stare at my smartphone while someone else is running around. I’m not one to chat on the phone while people are admitting someone or discharging someone. I get up and ask everyone “do you need help?” Most of the time people say “no”. But I think it’s important to lend a hand. I think the stress level overall, would decrease if everyone took part in that. Not just for the stress level. Not just to keep you from being bored. Not just to help that other nurse or tech. But for the patient.

If someone is in pain, why should the patient have to wait until their nurse is ready to help them? If I’m available? Or someone else?

I suppose it stems from a situation when I was in the hospital as a child. I had a bone graft taken from my hip. This was the night after the surgery (as in less than 24 hours). So it was tender and painful. I was young. It was in the middle of the night. I called for the nurse and my bed positioned where I could see the nurse’s station. I rang and someone answered (now looking back I believe that someone was a unit clerk). They said “someone will be down shortly”.

Okay, not a big deal. I’ll wait. But I waited and waited…and waited. When time went by (granted it could have only been 5 minutes) no one came. When I saw a 2nd person at the nurse’s station. I rang again. I told them, like the first time that I had to use the bathroom. The person on the other end repeated what they did the last time.

So I sat there, and waited. In the middle of the night. It was quiet. I was thinking about peeing. No one came. I decided to take it upon myself. I rolled over to roll off the bed, sat up. It was painful. Hopped on my good leg, hopped to the head of the bed to unplug the IV pole. Used the IV pole as a brace and hobbled to the bathroom. Whew! I made it.

When I was finished, I hobbled back. I did not even bother to plug in the IV pool. As I picked up my legs, carefully on the surgical side. Went to pull up the blankets, someone came in and asked what I was doing? “I just came back from the bathroom, I had to pee.”

She said something to the effect of “why didn’t you wait?”

My going to the bathroom, is minor at a young age. Now that I’m older and think of my patients. An older lady that has had kids, thus a weak bladder-having to use the bathroom. Or an older gentleman where we gave Golytely to prep them for a Colonoscopy, needing to have an explosion. What about the middle aged man, that cam in with chest pain…calling because he’s having that experience again? Or someone with COPD who feels like they cannot breathe, and gasping for air? I just think of myself as those people-what it would feel like to be them. Then realizing that there probably someone else that could have helped them.

Yup, virtually every hospital that I have worked it. As a policy for workers NOT to say “That’s not my patient.” But I notice a lot of workers (everywhere) have that mentality. I just tell my co-workers, what if that was your loved one? Would you want them waiting?

I am not a charge nurse. I left my permanent job because I didn’t want to be charge nurse. I didn’t want the added stress of people coming to you with problems, or trying to make everyone happy with their assignment, etc. But when I offer help to my co-workers, I often hear “are you charge today?”. I say no and follow up with why? “Oh, because your asking people if they need anything?”

Again, what if it was YOU or your loved one waiting to be assisted? Waiting for pain medication? If you have time, and your caught up? Why not help someone else? It’s not a big deal and who cares if they don’t do the same. Remember it’s not about you, it is about the patient.

Link to my GoFundMe site for my medical mission trip Jan 10-March, 2016: http://www.gofundme.com/PAdamsMedical

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