Badge Day

I bathed for nothing today. On my day off, I like to take a break from trying to look good. I don't bathe. I wear old, comfy clothes and don't comb my hair. Today, even though it was my day off, I showered, washed and blow-dried my hair. I carefully put on full make up and even ironed my top. I did this because our replacement hospital passed it's final inspection this week. Almost a year late, we are moving.

What does moving into a new hospital have to do with making myself look presentable? We have to get new badges and that meant a new photo. If I have to wear a photograph of myself around my neck, I want it to be a good one. Today was new badge day.

I ran into a coworker at the security office. Like me, she had done her hair and make up in preparation for her close up. Even if we don't look that good everyday, we want people to know what we can look like.

When it was my turn, they asked me if I wanted to keep the same photo. I didn't know that was an option. My current photo is great. Of course I said yes. My photo was downloaded onto my new badge and I was done. I got all gussied up for nothing.

Moving day is March 25. They're making us spend time in the new hospital to get used to it and find our way around. It is very different from our current hospital. The new hospital is big and modern with very long hallways. The artwork is gorgeous and would look nice in my home if I could find a way to steal buy it.

Our old hospital is cramped, old and embarrassing to be seen in, but the circular design is efficient and easier for the nurses. The patients will prefer the new hospital with the big private rooms, but the nurses may not be so happy with all of the walking. I hope that my hips hold out. I'm not getting any younger.

But They Were So Dirty

The label on the pillows said, "Spot clean only." They weren't kidding.

Minty Fresh Bottoms

My excuse was that I wasn't wearing my reading glasses. I don't know what the excuse was for the nurse who handed me the bottle. At least she was wearing her glasses. Anyway, what happened is that I washed diarrhea off of someone's bottom with mouthwash. It made the patient very unhappy. Minty fresh bottoms are not a good thing.

---

The shift usually starts out with an argument. Today's argument was over staffing. We were told that one of our patients wasn't to be counted in calculating the nurse to patient ratios. Yes, it's true that the patient was dead, but still, one of the nurses had to be assigned to the dead patient.

In spite of being dead, dead patients are quite a bit of work. The paperwork is heavy and we were expecting family to come and view the body. I can't believe that anyone would argue that dead people aren't to be counted in the census. But I guess if the staffing is illegal, people will argue anything they can think of to make the staffing legal, at least on paper.

I am curious, though. California's law is that there must be one nurse for every five patients. I wonder if it's okay to assign more patients if some of them are dead? :)

Locked Out Again

Late Sunday night, I was sitting on a sidewalk by myself in a bad part of town. I passed the time by eating oranges. It wasn't long before people driving by would stop and ask if I needed help. Someone came out of their house and crossed the street to see if I was okay. I was okay. I had just locked myself out of my car again. I was using my lunch break to wait for Auto Club.

The last time I locked myself out of my car, I started a new protocol for getting out of the car. I had to check my purse twice to make sure the keys were zippered inside and whisper to myself, "keys in purse." That worked just fine. My keys were in my purse, but I left my purse in the car. I now have a new protocol. I can only lock my car with the remote. That should work, but it is annoying having to squeeze my keys in my purse and zipper it up after I'm out of the car.

It is nice to know how many nice people are out there, though. I probably looked like a homeless person sitting on the sidewalk, yet total strangers offered their help. Later, I switched to standing hoping that I would look less in need of help. But I stood as far back from the street as possible and kept my arms crossed and head down. I was worried that I might be mistaken for a hooker, again.

Life Is a Bitch

Dear, sweet Kelsey passed away. His cancer was growing rapidly and he had a GI bleed. He stopped eating solid food for two days. He drank only water and a few sweet pea leaves. He wouldn't touch chicken, beef scrambled eggs, cheese or any of the usual foods he loves.

He kept getting weaker until this morning he tried to stand up and collapsed. He had slid into a place not reachable by me. He was clearly suffering and not responding to me.

I did what I do for end-stage patients. I gave him a large dose of morphine. He relaxed and his breathing was no longer labored. I sat with him, petted and massaged him and told him how lucky I was to have him. After four hours, I had to leave for work, so tearfully, I asked my parents to come and stay with him, so that he would not die alone.

They came and took over the death watch. I have the greatest parents to help me out in times of crisis. I cried all of the way to work. I didn't cry at work, I was just a zombie and barely made it through the shift. On the way home, I cried on the drive home. I didn't know what I would face at home.

My parents left a letter for me taped to the door into the house. They said that Kelsey stopped breathing at three thirty-five and never woke up. His death was peaceful surrounded by his loved ones. My parents took his body to their home. I would have preferred to bury him in the back yard, but if he is cremated, than we can someday be buried together.

Kelsey was my best friend. He was a rescue dog who needed a home when I needed a dog. I tried to be a good guardian to him and he was a sweet, gentle platinum blonde Golden Retriever who followed me all around the house. His hair was the same shade as my hair which pleased me. Children should look like their mothers. I didn't just lose a dog, but my son and best friend. He was only seven years old.

Update, 2/21/08:

I wrote this post after washing down three xanax's with a beer. I couldn't walk without bouncing against the walls and furniture, but somehow managed to write this post, such as it was. I cleaned up the typos today, but left the rest of the post intact, despite my desire to rewrite it.

I was out of my mind with grief. There were a number of people I could have called, but how do you talk when you can't stop crying? It made more sense to write. I reached out into the Internet in pain and people wrote back to comfort me in my time of need. It means more than I can express in words to receive all of your kind comments. Thank you all.

A Woman Driver

Pulling out of a parking lot, I tried to accelerate, but something was wrong. Looking down, I saw that my car was in the wrong gear. Quickly, I stepped down on the clutch and moved the stick back into place. Suddenly, I was thrown forward as my car came to a complete stop. The car behind me almost rear-ended me.

That's when I remembered. I drive an automatic. My clutch foot had slammed down on the brake.

Today's ditsiness, I blame on work because they made me come to work seven hours earlier in the day than usual to attend a class. Why does everything have to be on day shift's schedule?

Sleeping On A Cold, Hard FLoor

Kelsey hasn't been doing well. On Friday, he developed an upper GI bleed and wouldn't eat or drink. He also couldn't walk without assistance. I didn't expect him to make it through the weekend. I had no choice but to go to work, so I gave him a shot of morphine to make him comfortable. He got too much and was pretty much unconscious. I put a thick down sleeping bag on the couch and picked Kelsey up and put him on top of it.

In a quiet rage over the unfairness of having to go to work and take care of sick people when I had my own sick, precious Kelsey who needed me, I left for work. We were short two nurses, so it was another night where I ran in circles without a break for nine hours. Several times, I was tempted to scream, I quit, and leave.

When it was time to leave, I took a xanax before driving home to brace myself for what I might find. Kelsey could have bled to death, overdosed on the morphine or drowned in the pond while I was away. I came home to find him standing next to the couch. With some coaxing, he drank some water and ate a piece of chicken.

I've stopped his pain medication. I suspect that the tramadol ate away his stomach lining. He's eating and drinking and is able to walk okay again. The bleeding appears to have stopped.

I want to spend as much time as possible with Kelsey, so I haven't been blogging much. I have also moved downstairs, because he has problems with the stairs. I've been sleeping on the floor for almost a week now, but it's not as miserable now. Lindsay loaned me a king size futon mattress, so there is room for everyone to sleep together.

I Voted

With the election a week away, I still had plenty of time to mail my ballot. This morning while drinking tea and reading the paper, I discovered that the election was today, not next Tuesday. It's not easy going through life ditsy.

It was too late to vote by mail, so plan B was to vote in person. There was just one problem, I threw out the paper with the address of the polling place on it.

Plan C was to get in my car and slowly drive around my neighborhood looking for a sign. It was small and way too discrete, but I found the sign at a local school. Getting out of my car, I followed the signs. It was harder than it sounded because some of the arrow signs were spinning in the wind.

Once I found it, there was a new wrinkle. Their records showed that I was voting by absentee ballot. They took my word for it that I didn't send in my ballot and let me vote in person.

They were surprised to have a Democrat voting. Apparently, my neighbors are Republican. Considering the modest nature of my neighborhood, that took me by surprise. I associate rich people with being Republican. Anyway, I'm glad that I got to vote. I want Hillary to be our next president and Obama to be vice president. If you voted differently, that is an example of one of the great things about this country. We get to vote for our leaders, with the exception of the Bush-Gore election.

Gas

The nurse from the previous shift was livid. Three times she had put the patient on a bed pan and each time the patient had passed gas. The nurse finally snapped and said, "If you're going to pass gas, could you at least warn me first?"

I burst out laughing which got the nurse even more upset. She began defending herself and saying how she had to put her face near the patient's buttocks when she rolled her onto the pan and she didn't like breathing in the toxic fumes. I didn't say a word. I just kept laughing.

When it was my turn to put the patient on a bedpan, she passed gas for me too. She couldn't help it. Old people often pass gas when you try and move them. It's just one of those things. There is no point in getting upset about it. Fortunately, I have long arms and so am able to maintain a safe distance. When it happens, I just ignore it.

At least the patient was confused and hopefully didn't remember the nasty nurse chastising her for passing gas. The patient did chastise me, however. She said to me,'"Everytime you pee, you flush the toilet." She said that water is expensive and it is waste to flush just for pee.

Although it is true that I always flush the toilet, how would she know that? I didn't have time to pee that evening. But then, she also told me that my party was keeping her up and she wanted me to knock it off. I didn't have the heart to tell her that if I didn't have time to pee, I also didn't have time to party. Old age isn't pretty.

At the end of the shift, another nurse overheard me giving report to the oncoming nurse. I mentioned that one of the patient was belching every few seconds. The nurse corrected me and said that she wasn't belching, she was burping. I asked what the difference was. She replied that burping comes from the mouth and belching comes from the butt. You learn something new everyday.

The Faker

It was the beginning of the shift and even more hectic than usual. The nurses had finally finished fighting and were starting to get to work when one of the physical therapists yelled out that someone by the elevator was having an asthma attack. I could have ignored her like everyone else, but I couldn't just walk away. I gave the therapist an oxygen tank and told her that I would get some tubing and meet her there.

It was a long walk to the elevators, but I walked as fast as I could without running. The sight surprised me. A young woman was lying flat on the floor, unconscious. As I kneeled on the floor, someone said that she had been hospitalized with a pulmonary embolus last week. This was not an asthma attack.

He breathing was unlabored, but uneven. Sometimes she just stopped breathing, but as soon as I shook her and yelled at her she would take a deep breath. Her pulse was good and strong. She was not a patient and we weren't in a nursing unit, so we called an ambulatory response team code and no one came. Well, security, the chaplain and a house supervisor came, but no one who could take over came. Usually at this point, I can just get out of the way and let the code team go to work.

A couple of nurses from my sister unit asked if we wanted a crash cart and I said yes. The supervisor worked on keeping her airway open while I broke into the cart to get supplies. We were in big trouble and couldn't wait any longer for useful people to arrive. We decided to call a code blue.

This time I ran back to my unit to tell someone to call a code. As I ran back to the young lady on the floor, I noticed a huge group of onlookers backed along the wall watching with various expressions of horror on their faces. I've never been involved in a code with members of the public watching.

An ICU nurse arrived and started bagging the patient. I'm not sure why because the patient was breathing if you nagged her, but I guess it's just a different approach. If nagging works, I don't bag. I was getting ready to start an IV when the anesthesiologist tried to jam an airway protecter in her mouth. The girl bolted upright and pulled it out of her mouth. At that point, it was decided to let her breathe on her own.

A couple of guys with a gurney arrived, thank goodness, and we all lifted her up onto the gurney. She was wheeled away to ER.

I went back to work. I was way behind now, but did the best I could. My coworkers had little interest in the code, but every one in a while, I would look at the computer to see how she was doing. Pulmonary embolus was ruled out and she was admitted to ICU to wait an see if there was evidence of heart attack. Eventually, heart attack was ruled out and she was discharged home.

When I had more time, I read her medical history. It wasn't true that she was hospitalized with a pulmonary embolus last week. She had just spent the last two weeks in a psych facility. She is schizophrenic and bipolar and two or three times a month, she comes to the hospital with pulmonary embolus symptoms and states that she has a recent history of having suffered from one. Every time that happens, we have no choice but to do a complete work up which always turns out to be negative. She gets psych referrals and sometimes does time on psych wards, but she always goes back to her old ways of pretending to have an pulmonary embolus.

If she just likes being the center of attention, she picked a good way. People with pulmonary embolus do not wait in the ER . She gets everyone's attention immediately. If she doesn't do it for attention, than I have no idea what her motivation is. Has anyone come across this kind of patient?