Feelings Ahead

For the first time in months, since winter grasped us in its clutches, I feel like myself again. I finally feel like myself again. I’m not sure if it’s the weather improving or the fact that I’m actually moderately comfortable with my role as a nurse, but either way I’ll take it. 

I, like most girls my age, was scrolling on Pinterest the other day and I came across a post the said, “Wanna be less neurotic? Think about death more”. Morbid, right? 

Well it turns out that that is damn good advice. My hometown has been hit by some serious tragedy and death lately, and I don’t think I’ve ever been more grateful for family, friends, and a job that drives me completely insane. (On a side note, I’ve been consumed with watching Investigational Discovery for 24 hours a day. That’ll spark your thoughts on death, in case you were wondering.) Anyway, lately the little things have been particularly important to me. Walking to work in the cold air, getting a run in on the only two warm mornings we’ve had in what feels like ages, my dad’s voice on the phone, and my sweet boyfriend’s smile all seem a little more rose colored lately. I’m no one of importance, but I have things that are important to me, and they make me feel alive. 

Advertisements

Check Your Pulse.

Reach down to your wrist, and feel your pulse right now. 

That faint thump, thump, thump you feel? Be grateful for it right now. Say to yourself, “My heart is beating. I am breathing. I am alive.”

And say it ten times more. Look out your window and appreciate the weather, rain or shine, snow or sleet, wind or fog. Put your feet on the floor and feel alive. Stop complaining about that inch of snow you have to scrape off your car, and for the love of God, quit complaining about the cold. Be glad that you can feel the cold. It means you’re alive. Be glad for every moment you feel is stupid, insignificant, and pointless. Because it’s not, and no moment of life is stupid, pointless, or insignificant. Precious. Life is precious.

The world is an unfair place that does not care if you’re twenty two or one hundred and two; life can be taken in the swiftest moment. I pray that my fellow Madison Central  alum felt no pain and that justice may seek the person responsible. 

Check your pulse. 

Read it. Or don’t. Whatever.

As of lately, I’ve been wondering if I have chosen the right path by becoming a nurse. I’ve had many tearful and heartbroken mornings when I feel completely wiped out and broken down by the situations I’ve seen or the absolutely ruthlessness of the hospital setting. To further my uncertainty, many people who I’ve gone to school with my whole life are now pursuing bigger things in life, such as PhD’s and family life. I’m guilty to say that my first thought was, “And I’m just a nurse. What good is that?”

And after this thought I became upset with myself. I remembered all of the sleepless nights and tears that I cried in nursing school. I remember laying in bed at night and hoping that I could make a difference to people. I remember sitting at a patient’s bedside as a student nurse, holding a patient’s hand because he was scared. And it dawned on me how important my career is.

Nursing is hard as hell. As a nurse, you are expected to juggle as many patients as you can, sometimes without safety even being a factor. I work on a medical floor, where this is especially true. The majority of my patients are chronically ill and are well acquainted with the hospital setting. As a nurse, providing quality care to these patients is a complex and challenging task. On my floor, a nurse can have up to six patients. On a good night, the call light rings for pain medications and sleep aids until around 2300, when the patients all groggily drift to sleep. On a bad nights, nurses get their asses handed to them. When coming on to shift, three different call lights are alarming for patients in agonizing pain or wanting another cranberry juice, the house office administrator is calling to tell you to send one of your nursing assistants home, and you see your assignment only to realize you have three incontinent patients who are confused from hepatic encephalopathy. While elbow deep in poop trying to help your tech get a patient clean, another unit is trying to call report on your next patient, who is a 22 year old male with cerebral palsy with no IV access because he’s an awful stick. Oh, and don’t forget about the bolus they just put in for him to have STAT. The other nurse forgets to tell you that he is completely pitiful, with family members who clearly do not care for this boy who has his limbs so severely contracted that he resembles a pretzel. In between trying to start an IV and draw blood cultures, you find five minutes to sneak to the bathroom and cry because of how shocked you are by this patient’s condition. And the shift isn’t even half way over.

Reflecting on nights like this makes me outraged that I have thoughts like “I’m just a nurse”. My career choice is an extremely an important one. It is not glamorous by any means, but it is necessary. It not only gives back to others, but I grow as a person for each life that I interact with. Is each night easy? No, of course not. But if it was easy, everyone would do it. I sleep knowing that I give 110% to my patients each night, whether that is enough or not. Some nights I’m cranky and tired, and begrudgingly do my work. Other nights, which are rare, I come into work with a sense of duty and privilege that drives me to provide top of the line care for patients. I’m working on how to channel this attitude more frequently, but it is a work in progress. Ultimately, I hope to be one of those nurses people look at and say, “Damn, she’s a strong nurse. I’d let her take care of me”. I have a long way to go, but at least I’ve got the idea in mind.

I Need an Anti-Emetic…I’m Gonna Word Vomit.

I’m a registered nurse. 

Yeah, I know what you’re thinking, “How do you deal with cleaning poop off people?” and “You just do what doctors tell you to do, what’s so hard about that?” 

To start off: 1) Poop is a normal human process. If you can’t poop you have bigger problems. Like the discomfort of constipation or hepatic encephalopathy from your cirrhotic liver; and 2) No, I do not just do what doctors tell me to do. Orders are…more like guidelines than actual rules. 

I spend 36 hours a week (if not more, depending on whether or not I feel like picking up overtime- a decision usually dictated by the stage of the moon) at the bedside providing care for 5-6 patients per night. I also work the night shift, 1900-0700. On a good night, I pass handfuls of medications to patients who quietly drift off to sleep. On a bad night, I want to gauge my own eyes out with the nearest sharp object. 

Okay, that last statement was a bit exaggerated (I’ve seen patients with eye enucleations. Not pretty). Most nights fall somewhere in between these two extremes and that’s where I like for my nights to be. Busy enough to keep the time flowing, slow enough that my head isn’t spinning. However the past 6 six shifts or so have been almost torture. I say “almost” because I’m an optimist, kind of. 

The moon has been as full as ever, and the hospital fully reflects the glow of that milky white orb that determines so many nurses’ fates. To top it off, our census has been through the roof (good for job security, bad for nurse to patient ratios) meaning that we cram patients into our semiprivate rooms like they’re sardines. 

Recently I cared for two patients squashed into a semiprivate on my floor. The first patient was a well educated man with an extensive infection that had to be treated with just about every antibiotic you can think of. Vancomycin, ampicillin, zosyn, tobramycin, etc. He was pleasant enough, until his confusion set in from the narcotics. His eyes glazed over with a foggy look and he’d wildly inquire about random questions about a business he used to run. His family was trying as well, questioning minute details of nursing care, such as why I would bring him water without ice one time and water with ice the next. I know it’s all part of the whole “my loved one is in the hospital so I’m going to control everything” gig, but come on. Let me work here. 

My other patient in this room was middle aged. He had a genetic condition from birth that required constant care from his now elderly mother, who held his hand as gently as the day he was born. This patient scared me a little at first because he was my first patient with legitimate special needs (being difficult does not count as a special need- if it did, I would specialize in caring for patients with special needs) and I was unsure of how to approach him. Needless to say, when his primary care doctor stated that he needed a urinary catheter to help his bladder drain, my first thought went a little something like this:

Shit. 

Luckily for me, someone else had to come place it. However, this person was not so gentle and pretty much mangled this patient’s genitals with a rubber catheter and didn’t even think twice about it. All the while, the first patient I was caring for on the other side of the room was being bolted awake by his roommate’s desperate screams from having a piece of rubber rammed up his blocked urethra. 

Meanwhile, I’m trying to get to the other side of the room to care with the guy who has the infection. When I finally maneuver past the first family, I discover the infection guy snoring like a log on the other side of the curtain that divides the room. “Huh,” I thought, “His pain must be OK right now.”

So I stepped up to him and touched his arm to wake him. It was time for his medication. I said his name softly only to get no response. So I said it louder and shook him a little. Still nothing. Freaking out now, I’m sternal rubbing this man trying to get him to respond while the roommate is shrieking bloody murder on the other side of the curtain. Still no response from infection man. Fully panicking now, I run to the hall to grab the machine that takes our vitals. I yell at another nurse for help, and she grabs the glucometer to check his blood sugar. The unresponsive patient’s wife is now shaking him when I return, and I thank my lucky stars that he is awake. Albeit confused and irritable, he is awake and responsive. Thank God. 

My other patient on the other side of the curtain had quieted as well. I guess the urologist decided that 25 minutes of trying to cath the poor man was enough. I stopped on his side of the room to bid him goodbye for the day, and tears welled to my eyes as he calmly and gently told me goodbye, as if nothing was bothering him. As if a cold resident who didn’t even order the man a dose of IV ativan before the procedure hadn’t just preformed a traumatic unsuccessful procedure. He was sent home to die later that week. 

I wept for that patient. I cried for his family. I cried for him. I cried for the heartless person who caused him intense pain with no remorse. But mostly, I cried for myself. It felt good to feel human and have human emotions when I had begun to grow a cold crust on my soft heart.

I became a nurse so I could funnel these intensely human emotions into a rewarding career of helping people. Mostly now I feel sad and the weight of the world smothers me. People are mean. People are liars. but most of all, people are human. And I forgive people who shout at me (and even people who throw urine on me). I forgive people who say the worst things that I think about my own self to my face. I’m a nurse. I will carry the weight of my patients until it breaks me down. 

I'm a new nurse going through a quarter life crisis. Enjoy.