I'm trying to stay professional but...

After Mari passed away I went back to work in the orchards counting bugs for the summer.  It was good to mix it up a little bit, I was feeling a little emotionally overwhelmed.  I got into nursing school that summer and couldn't wait to get started.  Honestly those two years are kind of a blur (I fell of the face of the earth for two years, sorry friends)...not many specific stories stick out until I got to do my last quarter of clinicals in the ER on night shift...all the crazies come out at night...

One night a man came in who was soaking wet, clothes and all.  Apparently he decided he was going to swim across the river.  Not a little river, a really big ass river.  Our friendly local police brought him to us to get checked out.  We got him hooked up to the monitor and his heart was racing.  We went through all the classic questions if someone has a funky heart rhythm and they can still talk to us.  Then I asked him, "sir, have you used any drugs tonight?"  He responds without missing a beat, "well yeah, but it was just two lines of coke."  Well, guess what...that still counts.  His heart eventually settled down, clothes dried out, and we called him a cab.  Adios River Man.

On a cuter note, we got a sweet little old guy (you will learn I have a huge soft spot for cute oldies, and even for sassy not-so-cute ones) with a GI bleed who had to wait in the ER for a bed to open up.  So we started his blood transfusion and let him hang out with us.  I went to talk with him and held his hand (hand holding is automatic with cute oldies) and his hands were really cold, so I said "oh, cold hands!"  He smiles at me and says "warm heart." :)  I hope I'm a cute oldie someday.

During this quarter was the first time I did CPR on a human, not a mannequin.  It's not for the faint of heart.  He had been coded for quite awhile in the ambulance and we kept at it for awhile in the ER then called it.  It's not Grey's Anatomy...ribs are broken, bodily fluids are everywhere...I'll just leave it at that.  So to all of you reading this...if you have an 90 year old grandparent or parent who is still a "full code" please talk this over with them.  Maybe give them some meds, a little shock to give them a chance....but please please, no chest compressions.  It is probably their time to go and letting us thump on their chest isn't the way to go out.  Sometimes we can do too much in healthcare, and coding a 90+ year old is the perfect example of TOO much.  (Alright I'm stepping off my soapbox)

We had a young homeless guy brought in by EMS who seemed either really drunk, or really high.  He couldn't get it together enough to do a breathalyzer, but the 10+ attempts were pretty entertaining.  We didn't know anything about the guy, and he definitely wasn't going to help us out, so we found his wallet and got his name.  Luckily he was in our system so we knew a little background.  He was a type one diabetic and an IV Meth user living on the streets.  I was assessing him with the ER doctor and the patient starts sticking his tongue, drooling, & grabbing his stomach and talking about "the baby."  The doctor asked me to check a blood sugar since this guy acting so out of it.  I checked it, and it was 19!!  (Normal is like 60-100)  I don't know how this guy was still functioning (well sort of functioning).  I grabbed my preceptor and she came right in and started trying to get an IV.  His veins were shot since he was an IV user, but eventually she found one up by his shoulder.  We gave him some IV dextrose and then the real fun began.  He started to perk up...then he stands up, and starts pulling down his pants.  I said, "I think he's gunna pee!"  Thankfully we had a urinal in the room and we shoved it down there and he fills the thing to the brim.  He sits back down, we ask him if he's hungry, he nods.  So we grab a few sandwiches and juice.  He eats these in about a minute, we ask if he wants more, he nods again.  We grab two more sandwiches and he eats those too.  We left him alone for a little bit & I hear the drawers in the room opening and closing.  We go back and he's stumbling around the room looking for needles.  We ask him to stop, and lock up all the needle drawers.  He still hasn't said a word to us, and he is still pretty out of it.  While we are locking the drawers, he starts farting.  Not your average fart.  This is what my older brother would call a "cosmic fart."  This thing went on for seriously 10 seconds.  It was insane.  I look at my preceptor, who is about to loose it too and I said, "I'm trying to stay professional, but..." and we just burst out laughing.  I don't think I've ever laughed like that in front of a patient, but it was 4am...and we just couldn't help ourselves.  The patient didn't seem to notice.  Then our friend (who still hasn't said a word) starts unpacking his backpack.  I seriously think they should have a show that reveals the contents of homeless people's back packs.  It was wild.  This guy had maps, needles, papers, books, hats, clothes, insulin, blankets, it just went on and on.  We stayed in the room just to see what he was going to do with all of it, but then he just loaded it all back up, held out his finger for us to re-check his blood sugar (it was normal) and he walked out.  So random.

Little Girl

After leaving my CNA job, I went to work for a home caregiver agency.  I was in school full time so I was paired up with Mari who needed me to come for an hour in the morning and a few hours in the evening.  I was so nervous my first day, going to some strangers house to take care of them.  I didn't know what to expect.  I had heard horror stories from other caregivers about houses being totally dirty and other family members expecting you do to all their dishes and cleaning.  You are there to care for one person, the person who needs help with their laundry, food and dishes.  You aren't expected to be the house maid.  Luckily I arrived at Mari's house and found that she lived alone in a very cute (and clean) house with her little dog Sugar.  She let me in & I fixed her breakfast and started a load of laundry.  She loved poached eggs with a piece of toast and a boost.  I was supposed to serve her meals on smaller plates to encourage her to eat more.  The big plates can be overwhelming.  When I first started I didn't really know what had happened to make Mari need my help, she seemed fairly able, but as the weeks ticked by I learned more and more.

Mari started showing me pictures of herself from a few years back.  She was curvy with big hair, big makeup and she still had the big personality.  She was without a doubt "fabulous" and she had all the clothes, products & pictures to prove it.  She told me she had been married, divorced the guy, then decided to remarry him!  She didn't care, and told me "it felt right."  When I met her, she was a skinny-mini and got tired very easily, but she still had the sparkle in her eye.  After a few weeks Mari told me she had cancer, but that's all she really said about it.  After talking to her niece, I found out that it was lung cancer that had started to spread over the last few months.

Every day I would come over, Mari would have QVC on the TV...and she had packages delivered almost daily.  Finally I spoke with her niece who asked me nicely to please change the channel from QVC because Mari was spending ridiculous amounts of money!  Her credit card was linked up and all she had to do was call and enter a code.  I asked her why she shopped so much and she said "well I'm bored."  We found a old western channel that she liked a lot and the shopping slowed down a little :)  She would buy the weirdest things.  One day a package of these wind spinner things that go in the yard arrived.  There were about four of them and they looked like roosters.  Mari wasn't feeling very good that day and she always kept the living room so dark...so I set up these wind spinner things in the yard in her line of sight from the couch and we opened the front door, let the sunshine in, and watched these ridiculous little things spin around in the yard for a couple of hours.  Mari smiled at me and said, "this was one of my best purchases."  :)

 Mari started needing radiation for a cancer lesion on her wrist that hurt.  You would think going to radiation wouldn't really be the time for a fashion show.  Guess again.  Mari made me show up two hours early to help her pick out her outfit which always had some sort of sparkle on it and was topped off with a fur coat.  Then there was hair and makeup which took about 45 minutes to an hour.  We would go to radiation, her little dog Sugar always came along, never without her bedazzled leash and collar.  I would usually pow wow with a dietician at the oncology center about ways to help Mari gain weight while she got her radiation.  Afterwards she always wanted me to stop at McDonalds for a cheeseburger and a vanilla shake, even if she only ate a few bites...Sugar got the rest :)

One day I came over and Mari was too weak to get up.  The hospice nurse came over and said that we were probably getting close to the end.  I remember I had checked her blood pressure and it was low, but I had called my mom and said "is this too low?"  It's crazy to think about working in the ICU now and how little I knew back then and how scared I was.  What a difference a few years make.  I was just starting my spring break so I stayed with Mari 24 hours a day.  The hospice group got her a hospital bed and oxygen, and I learned which medications to give and when, then kept Mari clean and turned her every few hours.  Lots of her friends were able to come and say goodbye...Mari and I spent about a week watching endless movies, taking naps, painting nails and talking about life.  She always referred to me as her "Little Girl."  She never had any kids, her niece tells me I helped fill that void even it was only for a short time.  Pretty amazing :)  I found out after Mari passed away that she had kicked out multiple caregivers until I came along, I would have never guessed...she and I hit it off from the start.  On the night she passed away, her best friends, her niece and I were all at the house.  We knew that she was getting close to leaving us, I had just given her feet a massage and she held out her hands and we all gathered around her.  She was hanging on for something, we weren't sure what...until Sugar jumped up onto her lap.  Mari passed away about a minute later.  It was, and still is one of the most moving moments of my life.  It's when I first realized that death can be beautiful, and peaceful.  I didn't know it at the time but Mari helped me discover my passion for end of life care.  What a gift to pass away at home surrounded by family and friends, and be so comfortable and calm.

Mari's manicure...there is a diamond on her thumb...she showed it to everyone who came over :)

I think about Mari often.  Her niece didn't know what to do with her belongings so I helped her take some of it to goodwill, and I ended up with a few special items.  My red couch is from Mari and it is my most treasured piece of furniture.  I also have these spoon holders that you put on your stove top (to place spoons and other utensils while you're cooking), there are four of them, one for each season.  Today I changed out spring for summer...thought of Mari and smiled :)  My crockpot is from Mari, so every batch of spaghetti is extra special.  So Mari, wherever you are out there....thank you for being my friend, and thank you for showing me that nursing was the perfect career choice & helping me find my passion.  I know you're breaking hearts up in there in heaven :)

xoxo, Your Little Girl

My utensil holder..summer :)

My favorite red couch :)

Who Pooped?!

So after passing my test, I headed out to find my first CNA job.  I interviewed at a skilled nursing facility in town.  The woman that interviewed me was really nice and she went on and on about what a "family" they were there.  They offered me the job on the spot & I accepted.  The woman who interviewed me quit a week later...that should have been my first clue.  It wasn't all bad, but it was and still is the hardest job I've ever had.  I usually took care of about 20-22 residents, by myself.  I never had a partner like I was supposed to.  I'll never forget trying to lift these big men and basically falling over them when I transferred them.  Here are a few of my favorite resident stories from my 5 months as a CNA in a nursing home...

There was a woman there who could just sense that I was new, young & naive.  The trifecta if you will.  I could never figure out why she was always asking me for water, and juice, and soda.  Like all the time.  I always gave it to her of course, who am I to dehydrate the woman?  Finally her nurse informed me that she was on dialysis and on a strict fluid restriction.  Lesson learned, always ask the nurse before giving patients food & drink....and never trust dialysis patients...

Then there was sweet Pam who would sit in the hall, day after day and say "help me, help me, help me please," in the sweetest little voice.  A sure-fire way to never be ignored.  Every single person who walked by would say "what can I help you with?"  Pam would always reply: "Well, I don't know." 

There was Beth who made me hand wash and hang dry all her undergarments every single fricken night.  I mean, I'm all for taking care of clothes, but lets get real...I had butts to wipe.  Then I would have to take her mini water bottles that her daughter supplied her with and I had to empty some of the water out of 5 of them, and funnel in the mini ice chips from the cafeteria.  It drove me a little crazy, but she gave me candy every night...only after the hand washing of undies and funneling of ice so I guess it was worth it.  She also called me her sunshine--that was nice :)

Last but certainly not least there was Ethel.  One evening before dinner another aide asked me to help her with a resident in the bathroom.  Little did I know the treat I was in for.  I go into the bathroom to find Ethel in her wheelchair, pants down, and poop evvverrryyywhere.  Literally everywhere.  Legs, arms, hair, face...you get the idea.  She was rolling back and forth & back and forth in the poop shouting "WHO POOPED?!  IT WASN'T ME!"  I kept quiet until she wheeled right up to me and shouts: "If you don't tell me who did this, my son will lynch you."  Really lady?  I had already tried unsuccessfully multiple times to remind her that she had pooped...to which she responded "there's no way, I'm a former nurse, the only way I poop is with an enema."  I still have never understood the connection on these two facts.  I'm now a nurse, and don't need an enema to poop, still fuzzy on her logic.  So I finally tell her, "You know what Ethel, I pooped.  It was me!"  She looks right at me, covered from head to toe in poop, wheelchair and all, and says, "you disgust me."  I spent the next hour cleaning the poop out of her chair.

From The Top

After a lot of careful consideration I've decided to start blogging about some of the craziness that goes on at my job.  I'm a Registered Nurse working at a downtown hospital.  I have been writing down stories and quotes for years in a journal, but lets face it...it's hard to keep up with that old school pen/paper business.  I have seen some intense things, met some amazing people, and met some crazzzyyy people.  I love my job...the good, the bad & the gross and I want to get all these stories written down before I get dementia and forget them.  So here we go...ALL the names used in this blog have been changed, HIPPA y'all.  They start when I first began my nursing journey, first stop....Certified Nursing Assistant class.

After spending a year at college thinking I wanted to be some sort of a business woman, I decided to move home to become a nurse.  I thought this was life changing news at the time, my parents weren't the least bit surprised.  First step was becoming a Certified Nursing Assistant (pretty fancy title for all the butt wiping that's involved) and I decided to do a three week crash-course with my older sister, instead of the quarter long class.  In the fall of '06 was the start of my nursing journey.  Our instructor was fabulous and opened my eyes to the world of nursing, and more importantly, the importance of higher education.  She was a shining star who truly believed in teaching CNA's the right way to do this difficult job.  For all the butt wiping, it is very rewarding, and is extremely physically and emotionally draining.  After a week or so in the classroom we were set free to work on "real patients."  We (my sister and I) were in charge of *Dale (all names have been changed remember?  The "*" makes it more legit), Dale was 103 and wearing a Mickey Mouse sweatshirt, a killer combo if you ask me.  We were also in charge of *Lucy (now you get it).  My sister and I had no idea what we were doing.  Dale, fortunately (amazingly) was able to walk.  He was my first ever attempt to put an adult diaper on someone while they are standing (it never works, first lesson learned).  A few lumpy adult diapers later, we were headed down the hall to check and change Lucy.  When we turned her over, I started gagging.  Second important lesson learned, always...always breathe through your mouth at work.  This is when I first learned that the smell of urine bothers me way more than the smell of poop, or stool if we are getting nursey with it.  We got Lucy cleaned and changed after a few 50 rolls over the pads trying to get it right on a bed about 6 inches off the ground (my sister and I are 5'9" and taller).  Other gems from this class that I'll never forget: always brush dentures with paper towels in the sink in case you drop them and they break (they are vedy expensive), never put someones glasses on their dinner tray (the kitchen will throw them away), don't assume every old person is hard of hearing (it can be embarrassing when you figure out they hear you just fine and you are yelling at them).  My sister and I made it through our clinicals without injuring anyone, and after the class was complete I signed up to take my CNA test.

The written test was no problem, I was much more nervous about the skills test.  I had to be watched washing my hands, measuring urine output, and applying Ted Hose (compression stockings).  No big deal right?  Wrong.  The Teds had to go on a mannequin with sticky rubbery legs.  I swear to God it took me close to 20 minutes to get those bad boys on, I even broke a sweat with my hands shaking the entire time.  But thankfully I passed and headed out to apply for my first CNA job...