Tuesday, March 30, 2010

Q&A of sorts

Dear bloggy friends,

I am have having trouble wrapping my head around some things from my patient's death. Maybe you guys have some insight into helping me see things a different way. A fresh perspective/insight may be helpful.

One of the things I that has been on my mind popped up when I heard the doctor say to my patient's wife, "I'm sorry, ma'am, but there's nothing left for us to do. He's going to die". My problem with this is how we as healthcare workers determine the line of when to stop lifesaving treatments. When the patient doesn't improve quickly enough? When their insurance stops covering treatment? When the unit gets over-crowded, When the patient's "quality of life" isn't going to be the same as before, even if they do live? What makes us think we can determine someone's fate? Who are we to be the dictator of someone's lifespan? I am not the Creator God, nor do I want to be. I shouldn't choose when a patient lives or dies, and I shouldn't listen to other people's orders of when a patient lives or dies, right?

This weekend, there was a point when the doctor ordered more vasopressins to increase my patient's blood pressure, and as soon as I went to give it, he stopped me and said, "No more. We are not doing anything else for him". After he said that, he walked to the patient's wife and said that she would lose her husband today.

I have witnessed miracles, and seen people walk out of near-death situations unscathed; maybe this is the reason why I struggle with other people, such as doctors and nurses, calling the shots on someone's life. If we listened to doctor's all the time, many "miracles" would be dead right now. Heck, if we listened to my grandmother's doctors and nurses, she would be dead right now. I guess I just think that every has their chance of a miracle if they hold out long enough.

I guess I just want to know what my role in this is. What does God expect from me as a nurse when it comes to healing? How do I know when to listen to the doctor and stop treatment? How will I know what to do, and if it is the right thing to do? Who am I to determine someone's lifespan? At what point do you determine that someone's life is no longer worth saving?

Sunday, March 28, 2010

Death

This weekend I lost my first patient. He passed away near the end of my clinical shift. I spent the morning caring for him, and trying to do my best to keep him comfortable and stable, but he didn't make it. He died of a sepsis from a catheter infection.

I have only ever seen a person die once; my fiance's grandmother. I was hesitant to blog about this experience yet because I haven't had time to sort through my thoughts, but it is something that I want to remember, so blogging about it is a must.

Around noon, my patient's condition was becoming very unstable. He was in multiple organ failure, and the physician decided there was no medical treatment available to help him. Keeping him on the ventilator and pumping him full of medications was just prolonging the inevitable. The nurse in charge called his wife, and she came quickly. She made the decision to change him from a full code to a DNR (do not recusitate). His blood pressure fell quickly when his wife arrived. We were getting ready to administer a vasopressin (a medicaiton to increase the blood pressure) when the wife changed his code status, so we let him go. He passed away peacefully holding his wife's hand. It was the saddest thing I've ever seen.

I had to step out of the room and shed a few tires as he passed away. I couldn't bear to hear the wife whispering to him about the house they just bought in Florida, and the 45 years they spent together. It broke my heart into 10,000 pieces knowing that she walked into the hospital as a married woman of 45 years, and walked out a widow. I cannot imagine her grief. She plans to scatter his ashes on the beach in Florida. I hugged her as she left the hospital; she didn't want to let go of me, and I didn't make her. I just let her cry, and cry, because I know that's what she needed. None of the other nurses hugged her, and it made me very sad that they have become so hardened to death.

Seeing someone die is one of the strangest, creepiest, most peaceful and beautiful things in the world. One moment a person is breathing and living, their soul one with their body, and the next they are flat-lining and dead, their soul moving on to another place. His death was peaceful. His eyes never opened, which I thought was weird. He looked at peace, which was relieving for me.

The patient tech on shift showed us how to do after-death care, which wasn't as creepy as I imagined it to be. I removed an arterial line and stitches for the first time on my newly-deceased patient. That was kind of fun (removing the line and stitches, not the dead patient part).

All in all, I am thankful for the experience. Few student nurses get to experience this during nursing school. I was lucky enough to share it was with my best nursing school friend. We cried together, shrouded and bathed my patient together, and walked to the morgue together. We were so thankful to have each other's support during the experience.

I have never been so honored to take part in someone's care. I am working on not looking at death as the enemy in healthcare. As a nurse, I want to save my patients from death- isn't that the point? Actually, no. There comes a point in some patient's lives when death is imminent, and my job is to keep them comfortable and help their transition to the next life to be as painless as possible, so that when death comes, it is peaceful. During the dying process, a person is at their most vulnerable state, and it is such an honor to help someone through that stage in their life, as they literally put their life in their hands. I love my profession, and I am thankful for being able to care for my patient as he passed on yesterday. Without saying a word, he taught me so much.

Thursday, March 25, 2010

21st birthday

Happy belated birthday to me. It wasn't a big deal, really. I kept forgetting it was my birthday.

I took the day off work and school. I felt that I deserved it.

My parents got me a sweet new camera, with which I took the following photos, since my mom fell in a sinkhole at the beach and got sand in my other one.

Hello, Mr. Moon.

Wait for the one that you can't live without.


Sunset outside of Olive Garden.



My 1st legal "big girl drink" (as my fiance calls it). Happy birthday mudslide (yum).



It was a relaxing birthday. Here's to many more.

Friday, March 19, 2010

I am going to miss my neurology patients. My heart is in midwifery and neurology; orthopaedics is stinky.

Thursday, March 18, 2010

Stream of consciousness

I secretly love embarassing my Korean sister. She is super conservative and modest; she shares nothing private. I am pretty much the opposite, around my house anyway. Sometimes I like to do things just to get her reaction. I think sleeping nude, or at least partially is comfortable. She sleeps in 10 billion layers. She changes clothes with the bedroom door locked, even though no one will come in. I rip 'em off and run around like a banchee (which is why I've flashed my 60 year old neighbor one too many times). She refuses to ask us to buy her pads or tampons, so her mom sends them from Korean. Whole boxes of them. She has a drawer in our bedroom dedicated to them, but she keeps it tucked under a thin layer of clothes. I openly wash my cloth pads and store used ones in a bucket under my bed. Opposites. Yet so much alike, in ways only we know.
I walked through my new clinical site hallway. All I smelled was poop. I didn't know orthopaedics would be so stinky. My patient was the source of the stench. If he smells like that tomorrow I am going to shove a plug in his butt get some of that awesome deoderizer from the Pyxis. Should be interesting tomorrow. I have 2 patients with total hip replacements, just on opposite sides. My other patient was making strange noises when I left. Strange noises freak me out.
My Marine cousin is home. He is proposing to his girlfriend in 8 days. She has no idea, and I'm so happy for them.
I am working midnight shift tomorrow (blegh), and after clinical I was supposed to sleep, but my preggy cousin is supposed to find out her little home-wreckin' peanut's gender and asked me to secretly deliver flowers to her mom in either pink or blue, depending on the gender. I am hoping to do some maternity pictures within the next few weeks/months. Probably in May. If I get a new camera for my birthday, I will try to post some photos.
Yesterday I got a flat tire.
 Today I spent my tex check replacing my tires.
The best part of yesterday was the amazing photo my fiance texted me of the keys to our cabin. It's ours; all ours. We picked out paint colors and are going to paint as soon as we get a day off together. After he picked me up off the side of the road with my flat tire, he drove me out in the middle of nowhere to our pretty little house, and we dreamed. We dreamed about putting the lemon and limes wall vinyl in the kitchen, and painting the living room blue. We dreamed of me taking a bubble bath and him sitting on the side of the tub talking to me. We dreamed of building our bed from Ikea and seeing the lamps on the nightstands. I won't tell you what else we dreamed about.

Tuesday, March 16, 2010

I change my blog layouts like I wash my school uniform... almost weekly! However, I wanted something to reflect my current state of mind: positive, cheerful, and wanted to keep it that way, which meant I really wanted to love the way my blog looked. I think I like it, and I should after changing it about 20 times tonight.

Don't be surprised if it changes again, though.

Spring break

Things I learned on my spring break...

...That my tuition assistance from my job that I recieve for school is being cut becuase I am not a full-time employee. That's around $7000
...How to cook salmon
...How to overcook salmon
...That my fiance loves our cat more than me
...That my dad doesn't give a hoot about my well-being. I'm okay with that
...That Ireally miss seeing my fiance, and it's going to be great when we get to wake up to each other every day
...That bad things happen when I forget to take my happy pill
...That my fiance thinks I'm some super-fit chick who can hike up a moutain, go for a 6 mile bike ride, and do the deed in one afternoon
...That I am getting married in less than 7 months (!)
...That there is such thing as too many BJs
...That I have a super weak bladder (thanks babe, for making me laugh so hard I peed myself in bed, again)
...That I really missed my best friend
...That seeing your fiance's boss after you did IT in their house is really awkward
...That my fiance has a fear of hand-washing dishes
...That my schedule for next semester is going to be really great, I think. I am taking pediatrics and OB (!),a among some other nursing school BS classes
...That you should always check how much fiber is in something before you eat it. I ate a bowl of Bran Buds for dinner and other bowl for breakfast. The following 4 days were misery. 13 grams of fiber in 1/3 cup, baby!
...That you can actually find a dress for $99 at  David's Bridal on their "$99 sale". I got this for the Trash the Dress pictures we are doing the day before our wedding. It's much prettier in person
...That my baby brother isn't a virgin
...That you're automatically accused of clogging the toilet when it starts flooding the floor, even if you were just taking an innocent pee
...That seeing co-workers at the gym is pretty awkward

Sunday, March 14, 2010

The winner's continued

The next winner I dated broke up with me when I tried to hold his hand. We dated for a whole 2 weeks or less. A few years later he asked me to a formal dance in highschool. After I said yes, he told me he was gay (explains why he didn't want to hold my hand!). We went together anyway and had a great time. He later turned into a gaytastic man-slut, but I loved him anyway. Senior year in highschool, he was killed in drunk driving accident. He was the drunk driver.

I think the next winner may be the best yet. He stole my first kiss at the trashy movie theater in town. He literally stole it, cause I never showed any interest in kissing him, but he stuck his face on mine anyway when I wasn't paying attention. He charmed me into liking him; yeah, one of those. He bought me a used Train CD for my birthday. A month later he broke up with me over instant messenger because I wouldn't have sex with him. I later found out he was cheating on me with his ex-girlfriend. She was dumpy and fat and she screwed him often. Who wouldn't want that?

I saw him a few months ago working at Blockbuster. He was getting ready to take a smoke break. He never smoked in highschool. He told me that he got kicked out of the Army, but never said why. I didn't ask; I didn't want to know. He said he was living with his parents and really liked working at Blockbuster. After I left the movie store, I cried. I cried because I was sad for how he wasted his life. He was a brilliant dude, not always in the best ways, but brilliant nonetheless. In highschool he used to hack computers, but he could have used his brilliancy to his advantage and make a sucessful career from it. We took highschool biology together, and I studied and got a C+. He drew pictures and made paper airplanes and got an A. He was that kind of smart. And he wasted it. My fiance and I were in the mall the other day making a payment on my wedding band at Zales and we saw him. He opened up one of those cheesy little kiosks that pretends to sell something fantastic. Smokeless cigars. Yep, that is what he invested his life savings into. And he hasn't made a profit from it. Smart one.

The next winner earned the nickname "Urinal" from my brother. He was Russian, and my brother couldn't ever remember his name; Urinal was pretty close. We talked for about 2 years. Unlike any of my previor boyfriends, I thought I loved him (before I knew what love was). He was mysterious and kept me awake long into the night talking on the phone and pondering life and humanity (oh, please). He was super quiet, and everyone in our highschool thought he was weird except the creepy vegan goths that played DS in the library in the mornings. I later found out that he had schizophrenia and anti-social personality disorder. He thought he held the key to destroying and manipulating all of humanity. For real. He never did tell me what the "key" was though. Sometimes I wish I knew so that I could... ahem, do it myself! I obsessed over this dude for about 2 years. I think it was his charming mysteriousness or maybe his pale skin and dark hazel eyes, or maybe the long curly hair. Who knows. He started going to college and double majoring in psychology and biochemistry. I texted him on his birthday a few years ago and recieved a phonecall from his psycho, obsessive, and controlling girlfriend/wife saying that I was a "slutty bitch whore", and that I should never talk to her "fiance" again. We never talked again. He cut all of his hair off and is now midly unattractive (I thought men got better with age?), is unhappily married to the psycho girlfriend, and works at... wait for it, wait for it... Walmart! He greeted my dad the other day, "Welcome to Walmart!" Now that's a winner!

The final winner I dated went to my highschool but we didn't meet there. We met online through a friend and e-mailed each other a whole year before we met in person. He was quiet, creepy, and made me feell good about myself. He had long hair, poor taste in music, and wore those aweful T-shirts with sayings like, "Come to the dark side. We have cookies". All the while we dated, he was secretly in love with a homely girl in his band class. He played the trumpet. A few months after we broke up, I recieved a strange e-mail from a girl asking me if I wanted to do bondage photos. She said someone she knew referred me and thought I might me interested. Apparently my ex was addicted to bondage and thought I might be a good candidate. We never talk anymore, but a few weeks ago, he confessed his love to my best friend. Wowza.

The whole point of this wasn't to bash my ex-boyfriends. We all have quirks and faults. I just wanted to see the path I chose compared to the lives I could have had. Instead of staying with any of those guys, I chose to go to college and throw myself into my future career. Where I live, a lot of kids don't go to college. My brother didn't go to college, and that's okay. You don't have to go to college to be sucessful. You just have to give life all you've got. None of those guys did. I am way better off without any of them. The man I am engaged to is ten thousand steps above all of those guys, and dating them made me realize just how lucky I am. My fiance was the first person in his family to graduate from college (as I will be). He has health insurance, a full time job, and soon we'll have a house, which is way more than any of my ex's have. He takes care of me, listens to me, and makes me laugh. We have a great time together. And he's put up with me all through nursing school (bless his heart!). He's a keeper. And I am so darn lucky.

Saturday, March 13, 2010

The winners I've dated

I saw one of my ex-boyfriends the other day, and seeing him got me to thinking, "Man, I've dated some real winners"... Please notice the sarcasm attached.

My first boyfriend was a very sweet guy. We were friends for a long time before he asked me out; he broke up with me a month later on instant messager on a snow day. We continued to be friends throughout highschool, and eventually stopped talking after college except when we run into each other on occassion. He dated a friend of mine a few years later, and come to find out, he never kissed her either. In fact, he still has never kissed a girl to my knowledge. Certain quirks about him make me wonder... maybe he is gay? Like his obsession with his teeth, clothes, and hair. He's a very attractive guy, but he rarely dates women. It makes no sense. I heard a few months ago that he got drunk and jumped off a building and broke something. Real winner, huh?

More winners coming up later. By the way, my fiance is a true blue winner, for real. He's super amazing, and after dating the losers I've dated, I appreciate him even more.

Tuesday, March 2, 2010

I just realized that I have taken 35 classes in college already.

I only got a C in 3 of them. The rest have been A's and B's.

Spring break next week! Finally. I thought this semester would never progress.

It just so happens that my wonderful fiance is house sitting for his boss for the next week and a half, so next week when I am on break we have a nice, big house all to ourselves to hang out and regroup together. I am very much looking forward to some much needed rest. Maybe I'll even get to sleep in.