I couldn’t work at one point because my hands were covered in blood. But wasn’t that what I had asked for, what I had wanted.
I wanted a good bloody night, a code, septic shock, something. I wanted to do all the things I do one last time. And that is exactly where I found myself. I intubated, placed an arterial line, placed a central line. I was in that pt’s room for hours, hovering over that body, doing bloody things, giving a lot of orders.
I’m going to miss this. I love this.
It’s extreme stress. To have a life under your direction. Complete responsibility.
It‘s addicting. The adrenaline rush. It’s also exhausting.
My back hurts. I didn’t set the bed at the right height.
I told the family I had little to no hope and most likely they were going to die. Hours later they did. We did everything we could. I did everything I could.
I had wanted so many more experiences like this. There weren’t as many as I had wanted, as I had hoped. But there were enough. They will stay with me forever. This has been an interesting time in my life, an extreme time, a surreal time.
I have a few nights left. As much as I’m ready for them to be over, I’m not.
Be careful what you wish for…
Thursday, December 15, 2011
Thursday, December 1, 2011
Awake
I should be sleeping right now, but I’m not. I worked last night and I’m back on tonight and here I am, sitting up, awake.
My pager went off a bit ago and a text from a friend let me know there’s a high probability for a chaotic night at work.
Last night was not so chaotic. It was a slow night. I had 3 patients. Only one of which was somewhat sick. I slept most of the night, not restful sleep, but sleep none the less.
I’ve thought a lot about the ICU the last few days. About the parts I like and the parts I don’t like. I find the parts I like heavily outweigh the parts I don’t. I don’t like the nights; that’s about it.
All I’ve really known is the ICU. And I love it. I will miss it. Sometimes I feel so used by God in working in critical care, I feel like I’m doing what I’m supposed to be doing. I wonder if I’ll still feel that way. I wonder if I’ll still feel used. Maybe I’m partly having second thoughts.
I am excited for a new adventure, to learn new things, to work in a new arena, to experience a new perspective. I suppose there is a part of me though, that is afraid of what I’m losing professionally, fearful that what I’m gaining won’t outweigh that which I’ve lost.
It’s funny how we tend to define ourselves by various things. I’ve grown to define myself by my work, by what I do, by my service in the healthcare profession. But I have lost myself to my work and you can’t really be who you are when you aren’t sure who you are anymore. And how can you know who you are when you’ve lost yourself?
In truth, I’m moving more for personal reasons: to be closer to family, to have a better schedule, to re-engage in life again, to have a life outside of work, to “find” myself. I don’t regret that. But I do wonder how that will affect me professionally.
Due to staffing issues, my schedule has been quite horrific these last 10 weeks. Time is a personal resource we shouldn’t waste, you can’t restore it. Those 10 weeks are gone. They’ve left me feeling exhausted, irritable, and disengaged. Sometimes I fear that I will never feel rested again. Yet here I am, sitting up, awake.
My pager went off a bit ago and a text from a friend let me know there’s a high probability for a chaotic night at work.
Last night was not so chaotic. It was a slow night. I had 3 patients. Only one of which was somewhat sick. I slept most of the night, not restful sleep, but sleep none the less.
I’ve thought a lot about the ICU the last few days. About the parts I like and the parts I don’t like. I find the parts I like heavily outweigh the parts I don’t. I don’t like the nights; that’s about it.
All I’ve really known is the ICU. And I love it. I will miss it. Sometimes I feel so used by God in working in critical care, I feel like I’m doing what I’m supposed to be doing. I wonder if I’ll still feel that way. I wonder if I’ll still feel used. Maybe I’m partly having second thoughts.
I am excited for a new adventure, to learn new things, to work in a new arena, to experience a new perspective. I suppose there is a part of me though, that is afraid of what I’m losing professionally, fearful that what I’m gaining won’t outweigh that which I’ve lost.
It’s funny how we tend to define ourselves by various things. I’ve grown to define myself by my work, by what I do, by my service in the healthcare profession. But I have lost myself to my work and you can’t really be who you are when you aren’t sure who you are anymore. And how can you know who you are when you’ve lost yourself?
In truth, I’m moving more for personal reasons: to be closer to family, to have a better schedule, to re-engage in life again, to have a life outside of work, to “find” myself. I don’t regret that. But I do wonder how that will affect me professionally.
Due to staffing issues, my schedule has been quite horrific these last 10 weeks. Time is a personal resource we shouldn’t waste, you can’t restore it. Those 10 weeks are gone. They’ve left me feeling exhausted, irritable, and disengaged. Sometimes I fear that I will never feel rested again. Yet here I am, sitting up, awake.
Tuesday, November 29, 2011
Meet People Where They Are
You have to meet people where they are. You just can't make any progress until you do.
Sometimes it’s hard to understand where someone is. Sometimes when you get to that point, we tend to stop listening. We get so focused on trying to get the person to where we are that we can’t hear when they tell us where they are.
When you don’t meet people where they are, they can’t hear you. Walls come up, defenses set in, the conversation becomes a stalemate, or worse, a battle. No progress is made. Both parties walk away frustrated and the original goal of coming to a common understanding is not met.
People truly don’t care how much you know until they know how much you care. You have to listen. You have to hear where they are. You have to be present for the person you’re talking to. In truth, listening gives someone all the power, all the control. When you hear what they are saying, you hear where they are, you hear what they need, what they want; then, and only then can you help them.
Communication is so extremely important; especially with healthcare. It is our responsibility as healthcare providers to educate, to explain, and to equip families and patients with information so that they can make appropriate choices, so that they can do what they need to for themselves, for their patient, for the peace they are so desperately groping for.
When we argue, when we fight, when we don’t listen, when we dismiss, we lose, the pt loses, no one wins.
In truth, it only takes a moment.
Then Jesus said, “Whoever has ears to hear, let them hear.” Mark 4:9
Sometimes it’s hard to understand where someone is. Sometimes when you get to that point, we tend to stop listening. We get so focused on trying to get the person to where we are that we can’t hear when they tell us where they are.
When you don’t meet people where they are, they can’t hear you. Walls come up, defenses set in, the conversation becomes a stalemate, or worse, a battle. No progress is made. Both parties walk away frustrated and the original goal of coming to a common understanding is not met.
People truly don’t care how much you know until they know how much you care. You have to listen. You have to hear where they are. You have to be present for the person you’re talking to. In truth, listening gives someone all the power, all the control. When you hear what they are saying, you hear where they are, you hear what they need, what they want; then, and only then can you help them.
Communication is so extremely important; especially with healthcare. It is our responsibility as healthcare providers to educate, to explain, and to equip families and patients with information so that they can make appropriate choices, so that they can do what they need to for themselves, for their patient, for the peace they are so desperately groping for.
When we argue, when we fight, when we don’t listen, when we dismiss, we lose, the pt loses, no one wins.
In truth, it only takes a moment.
Then Jesus said, “Whoever has ears to hear, let them hear.” Mark 4:9
Wednesday, November 23, 2011
Relax
I went to the dentist today. Going to the dentist doesn’t bother me. At times I have even found it to be relaxing. I’ve even almost fallen asleep.
Today was no different, really. I laid there, my mouth wide open. People had their hands and tools in my mouth.
Then I started thinking.
These thoughts were triggered by a patient I had recently who has some mental disabilities. We suctioned his mouth and explained why. “Oh” he had said, “like the dentist”. “Yes”, I smiled, “like the dentist”.
So, there I was, laying in that chair, with peoples hands in my mouth and all of a sudden I realized how little control I had over what was going on to my body, of what people were doing to me.
Relax? Everything’s fine? My hands are tied down, there’s a tube in my lungs, I can’t breathe, I’m scared and you want me to relax?
I’ve never really been in the hospital. I’ve never been the patient. I don’t know what it’s like to sleep in a hospital bed or wear that ugly gown. I don’t know what it’s like to have a foley in my urethra or stickers on my chest or a probe on my finger. I don’t know what it’s like to be inubated. I don’t know what it’s like to have an arterial line placed, a central line placed, a PICC line. I don’t know what it’s like to experience the things that I do to people all the time. I don’t know what it’s like to lay in that bed.
But I know what it’s like to lay in that chair. And as I laid there today with those hands and tools in my mouth, swalloing with my mouth wide open, aware of my surooundings but not being involved with them, I started to think about what it must be like to be intubated.
Truth be told, I don’t want to know what it’s like to be intubated, to wear that gown, to lay in that bed. But I do want to relate to those patients, those people whose mouth my hands are in.
Today was no different, really. I laid there, my mouth wide open. People had their hands and tools in my mouth.
Then I started thinking.
These thoughts were triggered by a patient I had recently who has some mental disabilities. We suctioned his mouth and explained why. “Oh” he had said, “like the dentist”. “Yes”, I smiled, “like the dentist”.
So, there I was, laying in that chair, with peoples hands in my mouth and all of a sudden I realized how little control I had over what was going on to my body, of what people were doing to me.
Relax? Everything’s fine? My hands are tied down, there’s a tube in my lungs, I can’t breathe, I’m scared and you want me to relax?
I’ve never really been in the hospital. I’ve never been the patient. I don’t know what it’s like to sleep in a hospital bed or wear that ugly gown. I don’t know what it’s like to have a foley in my urethra or stickers on my chest or a probe on my finger. I don’t know what it’s like to be inubated. I don’t know what it’s like to have an arterial line placed, a central line placed, a PICC line. I don’t know what it’s like to experience the things that I do to people all the time. I don’t know what it’s like to lay in that bed.
But I know what it’s like to lay in that chair. And as I laid there today with those hands and tools in my mouth, swalloing with my mouth wide open, aware of my surooundings but not being involved with them, I started to think about what it must be like to be intubated.
Truth be told, I don’t want to know what it’s like to be intubated, to wear that gown, to lay in that bed. But I do want to relate to those patients, those people whose mouth my hands are in.
Monday, November 21, 2011
Walking In To Work Tonight
Tonight is the 5th of 6 nights in 8 days. I really hate nights. Some people were built for them, but I’m just not. God definitely did not design me for that. I’m so looking forward to having a “normal” schedule, of being awake and alert and alive during the day, of having a life again.
I parked my car and was walking in to work tonight and realized that there
aren’t many more nights that I would be walking into this building, to do this job, in this place, at this time in my life. Everything just seemed so surreal and for a moment it was like life was in slow motion. I became acutely aware of the impending changes coming.
Raleigh has been so very good to me. I came here for many reasons and chasing many things and I feel as though I received everything I wanted and so very much more. I will forever and always be thankful for this beautiful time in my life. I have received so much professionally, personally, and spiritually. I have grown, I have healed.
Sometimes life is what we make it. Sometimes life is what we allow it. Most the time it’s a little bit of both. I think part of maturing is realizing this fact to be true.
The other night I came to work and I passed a pt’s family member in the parking garage. I asked them how the pt was. “Not good”, they told me. “Fix them”, they said, “make them better”. I knew there was little to no hope for this pt. And here this family member was looking at me to make it right, to fix them, to give them back what they want. The pt died a few days later. I did not fix them.
I spoke to another family member for a long time. It was a good conversation. We spent a lot of time talking about Nashville. They had lived there in the late 1940’s. They asked a lot of questions about the pt’s future and what the outcome would be. It was sweet. They were sweet. That pt will mostly likely get better. I did not fix them either though.
I wanted to work in critical care so I could save lives, be a hero. I wanted to save people. I know now that it has nothing to do with me. I do not save or fix. I am no hero. I’m just the person that’s here, that’s involved in the decision making, but in reality it has nothing to do with me. Some people die and some people don’t. I love what I do; even more so now that I truly understand how little it really has to do with me.
My niece called me today. She got a shot in her bottom. She told me she cried. We laughed on the phone. She’s funny. I’m glad someone was there with her.
I would love to recap all of my experiences over the past 17 months, to revisit all the ways in which I’ve grown. But it would take forever and the list would still be lacking. All I can say is that I will forever be indebted for my time in Raleigh; it truly has made all the difference. And I am so much better for it.
I parked my car and was walking in to work tonight and realized that there
aren’t many more nights that I would be walking into this building, to do this job, in this place, at this time in my life. Everything just seemed so surreal and for a moment it was like life was in slow motion. I became acutely aware of the impending changes coming.Raleigh has been so very good to me. I came here for many reasons and chasing many things and I feel as though I received everything I wanted and so very much more. I will forever and always be thankful for this beautiful time in my life. I have received so much professionally, personally, and spiritually. I have grown, I have healed.
Sometimes life is what we make it. Sometimes life is what we allow it. Most the time it’s a little bit of both. I think part of maturing is realizing this fact to be true.
The other night I came to work and I passed a pt’s family member in the parking garage. I asked them how the pt was. “Not good”, they told me. “Fix them”, they said, “make them better”. I knew there was little to no hope for this pt. And here this family member was looking at me to make it right, to fix them, to give them back what they want. The pt died a few days later. I did not fix them.
I spoke to another family member for a long time. It was a good conversation. We spent a lot of time talking about Nashville. They had lived there in the late 1940’s. They asked a lot of questions about the pt’s future and what the outcome would be. It was sweet. They were sweet. That pt will mostly likely get better. I did not fix them either though.
I wanted to work in critical care so I could save lives, be a hero. I wanted to save people. I know now that it has nothing to do with me. I do not save or fix. I am no hero. I’m just the person that’s here, that’s involved in the decision making, but in reality it has nothing to do with me. Some people die and some people don’t. I love what I do; even more so now that I truly understand how little it really has to do with me.
My niece called me today. She got a shot in her bottom. She told me she cried. We laughed on the phone. She’s funny. I’m glad someone was there with her.
I would love to recap all of my experiences over the past 17 months, to revisit all the ways in which I’ve grown. But it would take forever and the list would still be lacking. All I can say is that I will forever be indebted for my time in Raleigh; it truly has made all the difference. And I am so much better for it.
Thursday, November 17, 2011
Moving On
Our choices are guided by various factors and variables. Some push us in one direction while others push us in another.
I can honestly say that a lot of various factors and variables have been prodding me, poking me, nudging me the last few months. This has resulted in some slow, meticulous actions on my part. I wanted to make the right choice, wait until the right time to act, be confident and sure of myself. I wanted to do what was best for me professionally, what was best for me personally.
So, I took my time. Fancied a lot of options. Engaged in a lot of discussions. Fielded a lot of phone calls.
And then I finally said “yes”.
So, I’m moving.
Yes, again!
The seventh time in 39 months.
I’ve accepted a position with the University of Texas Southwestern Medical Center as an Acute Care Nurse Practitioner on the Cardiovascular and Thoracic Surgery Service. So, I’m moving to Texas, to Dallas. I’m leaving Raleigh.
I move in five weeks.
I’ll once again be at the bottom of the totem pole.
I’m only going to be working days.
I’ll get to sleep at night.
I’ll only be three hours away from family.
I’m excited about a new area, about working in a very different arena. But, I will miss critical care. I have so deeply appreciated the lessons it has given me, the opportunities I have had, the things I have seen, the things I have done, the privilege it has been.
I will miss many of my coworkers, my attendings. Especially my boss; he has invested so much in me and I will forever be grateful for him and for the confidence, the encouragement, and the opportunities he has given me.
I am a blessed person. Life just keeps giving to me.
I can honestly say that a lot of various factors and variables have been prodding me, poking me, nudging me the last few months. This has resulted in some slow, meticulous actions on my part. I wanted to make the right choice, wait until the right time to act, be confident and sure of myself. I wanted to do what was best for me professionally, what was best for me personally.
So, I took my time. Fancied a lot of options. Engaged in a lot of discussions. Fielded a lot of phone calls.
And then I finally said “yes”.
So, I’m moving.
Yes, again!
The seventh time in 39 months.
I’ve accepted a position with the University of Texas Southwestern Medical Center as an Acute Care Nurse Practitioner on the Cardiovascular and Thoracic Surgery Service. So, I’m moving to Texas, to Dallas. I’m leaving Raleigh.
I move in five weeks.
I’ll once again be at the bottom of the totem pole.
I’m only going to be working days.
I’ll get to sleep at night.
I’ll only be three hours away from family.
I’m excited about a new area, about working in a very different arena. But, I will miss critical care. I have so deeply appreciated the lessons it has given me, the opportunities I have had, the things I have seen, the things I have done, the privilege it has been.
I will miss many of my coworkers, my attendings. Especially my boss; he has invested so much in me and I will forever be grateful for him and for the confidence, the encouragement, and the opportunities he has given me.
I am a blessed person. Life just keeps giving to me.
Friday, November 4, 2011
Killing and Saving
I have been so worried about killing someone; fearful that I would do something that would result in death, fearful that I would inadvertently take someones life. Last night I had a patient, they were sick, but not in acute distress. The labs didn't match the patients appearance. They were sweet, alert, oriented. They were sick. I treated the problems and they looked better. But as the night progressed, the labs weren't improving. The patient seemed to be clinically getting worse, despite physically looking better. What was I missing? What didn't I see? I ordered some tests, ordered more labs. I watched close. I realized, after all these many months, that I've been afraid of the wrong thing. I am more likely to not save someone than I am to kill someone. Maybe you think that's semantics, but it's not. It's not the same thing; it's very different. One is doing too much and causing something to happen. The other is not doing enough and not causing something to happen. Ignorance is not bliss; it's a liability. The patient looks fine tonight. They have much improved. My initial thoughts were right, some numbers just hadn't peaked yet. This has made me think about some things differently, though. |
Friday, October 28, 2011
Flying High
The man sitting beside me has good veins. It's funny, the things you notice when you choose to.
I'm on a plane today. Flying cross country; partly for business, partly for pleasure, completely for me.
I worked yesterday. I worked during the day. It was good, really good. I haven't enjoyed a day at work like that in a really really long time. I talked with lots of families: reassured, educated, laughed, hugged, joked, encouraged. I felt like me. I intubated this young patient; I'm really getting good at that.
I wish everyday were like yesterday. It was what I had hoped and dreamed it would be.
Lately, it has mostly been not what I had hoped and dreamed. It has been rough, exhausting, and at times disappointing. I realized the other day that I love what I do, but I hate my job. How does that even make sense?
A lot of it is the hours, okay most of it. I know that will eventually change. Things happened this year that cut our staffing in half and now there are two of us attempting 24/7 coverage. It's not working out too well. Eventually, there will be five of us again. I won't be switching back and forth between nights and days. I might even feel "normal" again.
I suppose that's the fear though, that I'll never feel normal again. That I'll always be tired. That my life will never know stability and consistency again. That I won't ever have a schedule that makes sense and is conducive with the rest of the living world. I miss sleeping at night and waking up early to meet the day. I miss having routine. I miss going to church.
The woman behind me is coughing. I'm wondering why. Does she have a cold, a virus? Is it just the change in weather? Is she covering her mouth? Or is she spraying millions of bacteria molecules into the air?
I need more sleep. I need more days that dreams were made of.
Tuesday, October 25, 2011
Best
Sometimes, even when you do your best, you just don’t do the best job.
Tonight is night 5 in 6 days. I’m exhausted. I haven’t slept very well the last few days. The pt’s have been really really sick. I’ve had a lot on my mind and I’m just not quite “on”.
I needed to call a service for a pt consult. It’s late. I’m waiting and waiting. The doc finally calls in and I give him report. I can honestly say that it was one of the worst pt reports I have ever given. Here is this doctor at home, responding to a phone call in the middle of the night, and I’m the one he gets to talk to. I don’t start at the beginning, he’s confused, I start over, I’m embarrassed and in the end he says he’ll just see the patient in the morning.
Sometimes I just need to let things go. It wasn’t my best. It’s okay.
I’m still watching the pt. They’re okay. It really is fine.
I suppose even now, revisiting the whole situation I realize how silly it is. Is it even worthy of a blog post; talking about my best not being my best.
Stress haunts us in many ways: worry, anxiety, embarrassment, fear, the desire for perfection.
Let it go.
Tonight is night 5 in 6 days. I’m exhausted. I haven’t slept very well the last few days. The pt’s have been really really sick. I’ve had a lot on my mind and I’m just not quite “on”.
I needed to call a service for a pt consult. It’s late. I’m waiting and waiting. The doc finally calls in and I give him report. I can honestly say that it was one of the worst pt reports I have ever given. Here is this doctor at home, responding to a phone call in the middle of the night, and I’m the one he gets to talk to. I don’t start at the beginning, he’s confused, I start over, I’m embarrassed and in the end he says he’ll just see the patient in the morning.
Sometimes I just need to let things go. It wasn’t my best. It’s okay.
I’m still watching the pt. They’re okay. It really is fine.
I suppose even now, revisiting the whole situation I realize how silly it is. Is it even worthy of a blog post; talking about my best not being my best.
Stress haunts us in many ways: worry, anxiety, embarrassment, fear, the desire for perfection.
Let it go.
Saturday, October 22, 2011
Thoughts
We’ve had some really sick people the last few weeks.
The ebb and flow of an ICU is a funny thing. Weeks vary so differently and yet they don’t. Sometimes a patient’s fate seems so grim and they pull through, other times they don’t seem that sick and then they die. The truth is you just never know what the outcome will be.
Sometimes working in healthcare is an incredibly satisfying field. I so deeply appreicate those days, those patients. And then sometimes it’s not. Those days are hard.
I’ve wondered a lot about my role lately, the vitality of it. Wondering if what I do really matters. There is an attending doctor above me and a nurse below me. The doctor ultimately rules and the nurse fulfills the rule. I’m in the middle of all that. I’m what’s known as a “midlevel” provider. I wonder sometimes what that really means.
I enjoy doing procedures; putting in central lines and arterial lines and intubating and even a spinal tap most recently. I appreciate the power of physically manipulating the body and seeing a definitive result; especially when it’s a positive one.
I wonder what my future holds. I wonder what plans God has for me. Where I’ll go, what I”ll do, where I’ll be.
I hate working nights. I hate the life it steals from me. I hate the way extreme exhaustion makes me feel. I hate sleeping during the day when the rest of the world is awake and alive and living. I hate the landscape company employed by my apartment complex.
I love off days when Ruthie and I can go to the park. I love to watch her. She runs so fast and loves it when the big dogs chase her. She likes to play this funny game. It makes me smile. She brings such joy to me.
It’s funny, the things that affect us, the things that mold and shape our daily lives and work in forming who we are. It’s funny how we change from year to year. I am not the same person I was a few years ago and yet I am.
Sometimes life forces us to acknowledge things we couldn’t see before, wouldn’t see before. Sometimes we find ourselves wide awake.
I had the death talk with 3 families this week, all on the same day. The next day all 3 patients died. I took Ruthie to the park. I love to watch her play.
The ebb and flow of an ICU is a funny thing. Weeks vary so differently and yet they don’t. Sometimes a patient’s fate seems so grim and they pull through, other times they don’t seem that sick and then they die. The truth is you just never know what the outcome will be.
Sometimes working in healthcare is an incredibly satisfying field. I so deeply appreicate those days, those patients. And then sometimes it’s not. Those days are hard.
I’ve wondered a lot about my role lately, the vitality of it. Wondering if what I do really matters. There is an attending doctor above me and a nurse below me. The doctor ultimately rules and the nurse fulfills the rule. I’m in the middle of all that. I’m what’s known as a “midlevel” provider. I wonder sometimes what that really means.
I enjoy doing procedures; putting in central lines and arterial lines and intubating and even a spinal tap most recently. I appreciate the power of physically manipulating the body and seeing a definitive result; especially when it’s a positive one.
I wonder what my future holds. I wonder what plans God has for me. Where I’ll go, what I”ll do, where I’ll be.
I hate working nights. I hate the life it steals from me. I hate the way extreme exhaustion makes me feel. I hate sleeping during the day when the rest of the world is awake and alive and living. I hate the landscape company employed by my apartment complex.
I love off days when Ruthie and I can go to the park. I love to watch her. She runs so fast and loves it when the big dogs chase her. She likes to play this funny game. It makes me smile. She brings such joy to me.
It’s funny, the things that affect us, the things that mold and shape our daily lives and work in forming who we are. It’s funny how we change from year to year. I am not the same person I was a few years ago and yet I am.
Sometimes life forces us to acknowledge things we couldn’t see before, wouldn’t see before. Sometimes we find ourselves wide awake.
I had the death talk with 3 families this week, all on the same day. The next day all 3 patients died. I took Ruthie to the park. I love to watch her play.
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