A visit with an old friend...
A book friend, that is. So, like a lot people I know, I read in bed before falling asleep. And before Michael can make a comment about how I fall asleep before reading 3 pages of anything, I'll just out myself right now. Since I can't stay awake long enough to read more than 3 pages, I usually read books that I've read before like Harry Potter or Calvin & Hobbes. But this time as I was perusing the book shelf, my eyes fell upon "Are You There God, It's Me, Margaret." What fun to reread that book, a book I have read a hundred times since 4th grade. It's the original book I purchased from the Little Professor bookstore that used to be next to Giant but then became the pizza place which then got bought out by Giant when they expanded in the late 80's. Not that you care about the bookstore or Giant.
Anyway, the book has a huge cherry KoolAid stain on it and is a bit dog eared from being so loved. It was fun and silly and I'm so glad I picked it up. I just love rereading some books; it truly is like visiting with an old friend. I'm also rereading "Island of the Blue Dolphins" which Mr. Paone read to us in 6th grade. Scott will probably remember that. Before that it was HP and the Half-Blood Prince. I'm not sure which book will be next (I can guarantee it won't be a new book until the end of August when I'm on break)...maybe some Little House books. I just looooooove the Little House books. Like, love so much that when I commented to a boyfriend that I wished I had a new set and was bummed that my parents didn't get it for me for X-mas he bought me a set. And then I kept it when he tore out my heart and squished it flat. Normally, I would have burned and/or thrown away such a gift but not the Little House books. That would be sacrilege. Just thinking about it makes me want to wander over to the bookshelf and pick up a book. I think I'll start from the beginning. Do you have favorite books that you like to reread?
7.27.2009
I win!
My first patient on my first day back on the ward was positive for C. diff and had scabies. Woo! I swear to Ogg that I would bathe in Lysol if I could.
On a completely unrelated note, Michael and I have been trying to take advantage of some of the many things that sunny Kali-for-nee-ya has to offer such as the San Diego Zoo, the SF MoMA and the garlic festival. Pictures of a baby cheetah out on a walk with a zoo keeper and warthogs and camels will be forthcoming. I rather enjoyed our time at the zoo but perhaps the July 4th weekend was not the best time to partake of its offerings. The MoMA was great; we saw the Ansel Adams & Georgia O'Keeffe exhibit and loved it. Usually I find the audio tour to be quite helpful but not so much this time. And the garlic festival? Well, I'm pretty sure I still reek of garlic but since Michael probably does too and neither one of us can truly smell the other, well, I wouldn't come visit us for a couple of days. I doused myself in perfume this morning before going to class. But it was so worth it. See what you're missing by not living out here? Or at least visiting? (hint, hint, nudge, wink)
My first patient on my first day back on the ward was positive for C. diff and had scabies. Woo! I swear to Ogg that I would bathe in Lysol if I could.
On a completely unrelated note, Michael and I have been trying to take advantage of some of the many things that sunny Kali-for-nee-ya has to offer such as the San Diego Zoo, the SF MoMA and the garlic festival. Pictures of a baby cheetah out on a walk with a zoo keeper and warthogs and camels will be forthcoming. I rather enjoyed our time at the zoo but perhaps the July 4th weekend was not the best time to partake of its offerings. The MoMA was great; we saw the Ansel Adams & Georgia O'Keeffe exhibit and loved it. Usually I find the audio tour to be quite helpful but not so much this time. And the garlic festival? Well, I'm pretty sure I still reek of garlic but since Michael probably does too and neither one of us can truly smell the other, well, I wouldn't come visit us for a couple of days. I doused myself in perfume this morning before going to class. But it was so worth it. See what you're missing by not living out here? Or at least visiting? (hint, hint, nudge, wink)
7.22.2009
Where have I been...?
Apparently not hanging around here sharing the mundane details of my life. Thank goodness for a little respite, huh? Well, as always, I have been up to my eyeballs in homework and weekly quizzes and/or exams. You know, the usual. I've since finished my pediatrics rotation and the nursing research class (evidence-based practice is your friend. So are librarians, by the way, so make nice with all the librarians in your life) and am now on to critical care. We're not on a critical care unit the whole 5 weeks but will rotate in a few students at a time/day plus hopefully we'll get to spend some time in the ED, OR and some of us will go to the wound care clinic. I'd like to do that but I have a weekend rotation and wound care is only open M-F. Boo. All I can say is that I better see some good stuff because if I get stiffed again like I did in maternity I'm going to be seriously pissed off.
To sum up peds, all in all it was a good rotation. The hospital was great (location was sucky but we can't have everything, now can we?), staff were awesome, clinical instructor was mostly good but sometimes weird and, well, weird, and my group of classmates was pretty solid. Peds is an interesting place because they try to make the floor feel inviting to kids and their families and parents (mostly moms, tho) are pretty much camped out for the duration of their child's stay. Sadly, some kids don't have parents who can or will come and stay with them. Some parents don't have employers who are understanding and will fire them if they don't come back to work, some parents don't have a partner or a spouse to help out and may have other kids and home to take care of and some parents are absent for some other reason. I saw a fair number of kids who were in foster care because of neglect. I had one patient last week whose parents give consent over the phone for procedures but have nothing more to do with their daughter. She has a rare syndrome that causes developmental delays and she requires total care. Her parents put her in a home and have no contact with her. Her only visitors at the hospital have been 2 of the caregivers at the group home where she lives and they come to see her twice a week.
You know, it's hard to keep an open mind sometimes when it comes to other people's behavior. If I've learned nothing else while in nursing school, I've learned that you don't really know what people's lives are like outside of the hospital and you don't know what is going on that may interfere with their care for themselves or a family member. As a result, you can't be too quick to judge. But this girl's situation broke my heart. It is an unfortunate fact that some parents can't deal with a child who is "atypical" and this won't be the last time I encounter a situation like this.
On the other hand, there are some parents who are total rock stars and stay with their child for the duration of the treatment (sometimes for months at a time), who learn all about the diagnosis and treatments, who rally behind their child and support her/him all the while trying to hold their own shit together. It's an amazing thing to see and I think it's what I'll miss most about pediatrics. But for now, it's back to adults and all the challenges that come with treating them. I'm hopeful that this will be a good rotation.
Apparently not hanging around here sharing the mundane details of my life. Thank goodness for a little respite, huh? Well, as always, I have been up to my eyeballs in homework and weekly quizzes and/or exams. You know, the usual. I've since finished my pediatrics rotation and the nursing research class (evidence-based practice is your friend. So are librarians, by the way, so make nice with all the librarians in your life) and am now on to critical care. We're not on a critical care unit the whole 5 weeks but will rotate in a few students at a time/day plus hopefully we'll get to spend some time in the ED, OR and some of us will go to the wound care clinic. I'd like to do that but I have a weekend rotation and wound care is only open M-F. Boo. All I can say is that I better see some good stuff because if I get stiffed again like I did in maternity I'm going to be seriously pissed off.
To sum up peds, all in all it was a good rotation. The hospital was great (location was sucky but we can't have everything, now can we?), staff were awesome, clinical instructor was mostly good but sometimes weird and, well, weird, and my group of classmates was pretty solid. Peds is an interesting place because they try to make the floor feel inviting to kids and their families and parents (mostly moms, tho) are pretty much camped out for the duration of their child's stay. Sadly, some kids don't have parents who can or will come and stay with them. Some parents don't have employers who are understanding and will fire them if they don't come back to work, some parents don't have a partner or a spouse to help out and may have other kids and home to take care of and some parents are absent for some other reason. I saw a fair number of kids who were in foster care because of neglect. I had one patient last week whose parents give consent over the phone for procedures but have nothing more to do with their daughter. She has a rare syndrome that causes developmental delays and she requires total care. Her parents put her in a home and have no contact with her. Her only visitors at the hospital have been 2 of the caregivers at the group home where she lives and they come to see her twice a week.
You know, it's hard to keep an open mind sometimes when it comes to other people's behavior. If I've learned nothing else while in nursing school, I've learned that you don't really know what people's lives are like outside of the hospital and you don't know what is going on that may interfere with their care for themselves or a family member. As a result, you can't be too quick to judge. But this girl's situation broke my heart. It is an unfortunate fact that some parents can't deal with a child who is "atypical" and this won't be the last time I encounter a situation like this.
On the other hand, there are some parents who are total rock stars and stay with their child for the duration of the treatment (sometimes for months at a time), who learn all about the diagnosis and treatments, who rally behind their child and support her/him all the while trying to hold their own shit together. It's an amazing thing to see and I think it's what I'll miss most about pediatrics. But for now, it's back to adults and all the challenges that come with treating them. I'm hopeful that this will be a good rotation.
6.30.2009
Hater...part II
Wow, straight off of the whole financial aid pain-in-the-ass-ness and here I am being subjected to automated call center hell just so I can make an effing doctor's appt. Whatever happened to just calling the doctor's office and making an appt. with a human being and being off the phone in, at most, 2 minutes? Gah. I hate everything.
8 minutes and 37 seconds later I have made an appt. It seems like sometimes advancing technology creates more work and takes more time to complete a task than just putting a schedule book in the hand of a single human being at the other end of the line. Durr.
Tomorrow I'll find something nice and wholesome to say about, I don't know...something.
Wow, straight off of the whole financial aid pain-in-the-ass-ness and here I am being subjected to automated call center hell just so I can make an effing doctor's appt. Whatever happened to just calling the doctor's office and making an appt. with a human being and being off the phone in, at most, 2 minutes? Gah. I hate everything.
8 minutes and 37 seconds later I have made an appt. It seems like sometimes advancing technology creates more work and takes more time to complete a task than just putting a schedule book in the hand of a single human being at the other end of the line. Durr.
Tomorrow I'll find something nice and wholesome to say about, I don't know...something.
6.21.2009
Procrastination nation...
More like procrastination household but I love me some Stphn C0lbert. There are a million things I should be doing right now but I'd rather sit here with my coffee and the internets instead. I should be making appts with the dentist and GP, calling the stupid FAFSA office about my pin, calling financial aid at school, sorting mail, shredding credit card offers we don't need, running the weed whacker, buying some tomato stakes from Lowe's Depot, doing a hundred things for school, call for an appt to get the oil changed and the tires rotated on the car...you get the picture. Serious life maintenance + school work = a crapload of things to do. And now it would appear that I may be coming down with a sinus infection which will throw a monkey wrench into my plans to get it all done. Durr.
In other news, the pediatrics rotation is coming along. I absolutely hated it the first day because I didn't feel in the least bit competent to do my job but it's gotten better. It's just a very overwhelming rotation. Not because you're taking care of sick kids (let's face it, the only healthy hospital stay involves maternity) but because their ages vary, their parents may or may not be present, their parents may or may not be really involved with the kids' care, vital signs are different at different ages, med dosages have to be calculated and at this hospital, the place is overrun by residents and their attendings so there isn't much elbow room. You have patients who have been on the ward for weeks and months and some who just pop in every now and again. There are a lot of congenital disorders and chronic diseases and it's a lot to remember. Honestly, I just don't know how MD's do this. So many signs and symptoms can be indicative of so many disease processes and they all manifest differently in kids. Hell, vomiting and diarrhea alone can indicate umpteen conditions.
For now, tho, I'll spare you the sad stories. You can go over to 6YearMed for that. There are some uplifting ones as well but I need to hang on to those for myself. As with any hospital experience, uplifting and happy moments are like gold.
More like procrastination household but I love me some Stphn C0lbert. There are a million things I should be doing right now but I'd rather sit here with my coffee and the internets instead. I should be making appts with the dentist and GP, calling the stupid FAFSA office about my pin, calling financial aid at school, sorting mail, shredding credit card offers we don't need, running the weed whacker, buying some tomato stakes from Lowe's Depot, doing a hundred things for school, call for an appt to get the oil changed and the tires rotated on the car...you get the picture. Serious life maintenance + school work = a crapload of things to do. And now it would appear that I may be coming down with a sinus infection which will throw a monkey wrench into my plans to get it all done. Durr.
In other news, the pediatrics rotation is coming along. I absolutely hated it the first day because I didn't feel in the least bit competent to do my job but it's gotten better. It's just a very overwhelming rotation. Not because you're taking care of sick kids (let's face it, the only healthy hospital stay involves maternity) but because their ages vary, their parents may or may not be present, their parents may or may not be really involved with the kids' care, vital signs are different at different ages, med dosages have to be calculated and at this hospital, the place is overrun by residents and their attendings so there isn't much elbow room. You have patients who have been on the ward for weeks and months and some who just pop in every now and again. There are a lot of congenital disorders and chronic diseases and it's a lot to remember. Honestly, I just don't know how MD's do this. So many signs and symptoms can be indicative of so many disease processes and they all manifest differently in kids. Hell, vomiting and diarrhea alone can indicate umpteen conditions.
For now, tho, I'll spare you the sad stories. You can go over to 6YearMed for that. There are some uplifting ones as well but I need to hang on to those for myself. As with any hospital experience, uplifting and happy moments are like gold.
6.12.2009
It's a shame...
That we don't treat our adult patients the way we treat our pediatrics patients. The pediatrics floors are brightly decorated and there are murals and pictures and scales that look like rockets and giraffes and there's so much effort put in to making a stay at the hospital seem less scary and more fun. And yet, we don't do that for adults. There are far more adults in a hospital setting with bland, boring walls that blend into white tiled floors and seemingly little effort put into making an adult floor more appealing. I think it's wonderful that the peds floors are so nice but what about the adults?
That we don't treat our adult patients the way we treat our pediatrics patients. The pediatrics floors are brightly decorated and there are murals and pictures and scales that look like rockets and giraffes and there's so much effort put in to making a stay at the hospital seem less scary and more fun. And yet, we don't do that for adults. There are far more adults in a hospital setting with bland, boring walls that blend into white tiled floors and seemingly little effort put into making an adult floor more appealing. I think it's wonderful that the peds floors are so nice but what about the adults?
6.11.2009
That was a fast 5 weeks...
Well, my maternity rotation is over and now it's on to pediatrics. Tomorrow is my first day on a new ward at a new hospital at a new time and at a place where there is no street parking on weekdays and a parking garage that costs $24/day. On the other hand, it only slightly interferes with my tennis schedule but leaves me free to worship at the church of Kelly on Sundays. Why, hello, leisurely breakfast with Michael and the Sunday Times and a trip to the market followed by tennis and the remainder of the afternoon spent in my backyard. How I've missed you.
Anyway, maternity. There are lots of good things to be said about my rotation but seeing the birthing process from start to finish was not one of them. Durr. It was a great hospital and the labor and delivery nurses were awesome. The midwives were awesome. There just weren't any women in stage 2 labor while we were there. The darned babies would always come out at like, 3 am or 5 am or something. You know, when we weren't there. Seriously, I was about to stand on the street corner shouting to pregnant women about eating some indian food for dinner, having sex with their partners and then coming to us in labor. I don't even know if eating indian food works, but whatever.
Overall, it was good. It was a really different experience to work with women and their families and the fact that there is a constant rotation of patients is nice. There were always new moms and babies when we were there unlike in med-surg where we saw patients who were there before we started the rotation and were still there when we left 10 weeks later. And while there was poop, it was meconium and it came out of the behinds of tiny babies. And let me tell you, it's a lot easier to wipe poop off of a baby than an adult. But that meconium? Yeah, it sticks like crazy to skin. That stuff is like wallpaper paste.
But it isn't always sunshine and rainbows. There are lots of ethical dilemmas and internal conflicts to deal with. Like the 16 yo who already has a 2 yo and encouraging her to breast feed even though she doesn't want to. Internally, you're thinking "dear god, put that girl on Depo, stat!" and you're also thinking "breast feed!" Here's the thing: studies support the "breast is best" idea but it's not for everyone. But just trying it is so important even if it's only for a few weeks. My job is to support mom in whatever her plan is but it's also my job to educate mom and encourage her to breast feed. If she's got her mind made up to bottle feed, well, so be it. If she's on the fence, it's my job to help her decide what will work best for her and the baby. But it doesn't always work out and formula is a nutritionally-adequate substitution. Did I mention the support thing? That's always the most important part.
Then there are the other issues: sending a baby home with parents who may or may not be fit to parent (CPS and the hospital social workers make these decisions but the nurses and MDs alert them based on certain evidence); adolescent moms; moms with histories of spousal abuse. Those things are hard to deal with but all we can do is act within our capacity, alert the authorities when abuse is suspected or evidenced, be supportive and keep our mouths shut re: everything else.
In L&D, you have those issues but also the labor and delivery part. The hospital where I was stationed is great if you want the natural childbirth experience. Laboring women are not on a time clock and the staff are super supportive and let you do your labor thing. But sometimes birth plans have to be pushed aside because of fetal intolerance and moms suddenly find themselves having an emergency c-section. And, man, those moms are pissed. This hospital has a 3% c-section rate and they're only performed if it really is necessary (not just b/c the doc wants to go hit a few rounds of golf on the way home). It's not like in the documentary that R. Lake produced (which was really good, btw). But there was a mom who came in 3 times during labor and 3 times checked herself out against medical advice because she really wanted to have a home birth and did not want the emergency c-section she needed and...ultimately her baby died. She finally agreed to the c-section but the baby had been in distress for so long that she died 3 days later. It's really, really sad. But it goes to show you hard this can be sometimes. You really want moms to have the childbirth experience they want and deserve but sometimes it can't be the experience they planned and hoped for.
But I don't want you to think that maternity is a huge downer experience because it's not. It's a wonderful and beautiful thing to watch families get to know their newest additions and to help moms prepare for going home to raise their babies. And those babies are just precious. It's a privilege to be a part of that experience and maybe someday I'll be back as a maternity nurse. For now, onward to pediatrics.
Well, my maternity rotation is over and now it's on to pediatrics. Tomorrow is my first day on a new ward at a new hospital at a new time and at a place where there is no street parking on weekdays and a parking garage that costs $24/day. On the other hand, it only slightly interferes with my tennis schedule but leaves me free to worship at the church of Kelly on Sundays. Why, hello, leisurely breakfast with Michael and the Sunday Times and a trip to the market followed by tennis and the remainder of the afternoon spent in my backyard. How I've missed you.
Anyway, maternity. There are lots of good things to be said about my rotation but seeing the birthing process from start to finish was not one of them. Durr. It was a great hospital and the labor and delivery nurses were awesome. The midwives were awesome. There just weren't any women in stage 2 labor while we were there. The darned babies would always come out at like, 3 am or 5 am or something. You know, when we weren't there. Seriously, I was about to stand on the street corner shouting to pregnant women about eating some indian food for dinner, having sex with their partners and then coming to us in labor. I don't even know if eating indian food works, but whatever.
Overall, it was good. It was a really different experience to work with women and their families and the fact that there is a constant rotation of patients is nice. There were always new moms and babies when we were there unlike in med-surg where we saw patients who were there before we started the rotation and were still there when we left 10 weeks later. And while there was poop, it was meconium and it came out of the behinds of tiny babies. And let me tell you, it's a lot easier to wipe poop off of a baby than an adult. But that meconium? Yeah, it sticks like crazy to skin. That stuff is like wallpaper paste.
But it isn't always sunshine and rainbows. There are lots of ethical dilemmas and internal conflicts to deal with. Like the 16 yo who already has a 2 yo and encouraging her to breast feed even though she doesn't want to. Internally, you're thinking "dear god, put that girl on Depo, stat!" and you're also thinking "breast feed!" Here's the thing: studies support the "breast is best" idea but it's not for everyone. But just trying it is so important even if it's only for a few weeks. My job is to support mom in whatever her plan is but it's also my job to educate mom and encourage her to breast feed. If she's got her mind made up to bottle feed, well, so be it. If she's on the fence, it's my job to help her decide what will work best for her and the baby. But it doesn't always work out and formula is a nutritionally-adequate substitution. Did I mention the support thing? That's always the most important part.
Then there are the other issues: sending a baby home with parents who may or may not be fit to parent (CPS and the hospital social workers make these decisions but the nurses and MDs alert them based on certain evidence); adolescent moms; moms with histories of spousal abuse. Those things are hard to deal with but all we can do is act within our capacity, alert the authorities when abuse is suspected or evidenced, be supportive and keep our mouths shut re: everything else.
In L&D, you have those issues but also the labor and delivery part. The hospital where I was stationed is great if you want the natural childbirth experience. Laboring women are not on a time clock and the staff are super supportive and let you do your labor thing. But sometimes birth plans have to be pushed aside because of fetal intolerance and moms suddenly find themselves having an emergency c-section. And, man, those moms are pissed. This hospital has a 3% c-section rate and they're only performed if it really is necessary (not just b/c the doc wants to go hit a few rounds of golf on the way home). It's not like in the documentary that R. Lake produced (which was really good, btw). But there was a mom who came in 3 times during labor and 3 times checked herself out against medical advice because she really wanted to have a home birth and did not want the emergency c-section she needed and...ultimately her baby died. She finally agreed to the c-section but the baby had been in distress for so long that she died 3 days later. It's really, really sad. But it goes to show you hard this can be sometimes. You really want moms to have the childbirth experience they want and deserve but sometimes it can't be the experience they planned and hoped for.
But I don't want you to think that maternity is a huge downer experience because it's not. It's a wonderful and beautiful thing to watch families get to know their newest additions and to help moms prepare for going home to raise their babies. And those babies are just precious. It's a privilege to be a part of that experience and maybe someday I'll be back as a maternity nurse. For now, onward to pediatrics.
6.04.2009
Feeling irrational...
When I tell you why I'm feeling irrational, you'll undoubtedly laugh but this is something about which I am very upset. I got a B+ in maternity. A B+. In my book, a B+ is practically an F. An F- at that. Effe menos. This is the lowest grade I've gotten in nursing school and it kills me that I didn't get an A. This sucks. I'm going to go stew in my irrationality and have something with alcohol in it. Boo.
When I tell you why I'm feeling irrational, you'll undoubtedly laugh but this is something about which I am very upset. I got a B+ in maternity. A B+. In my book, a B+ is practically an F. An F- at that. Effe menos. This is the lowest grade I've gotten in nursing school and it kills me that I didn't get an A. This sucks. I'm going to go stew in my irrationality and have something with alcohol in it. Boo.
5.29.2009
I need a break from the internets...
Because if I see one more effing headline about J0n & K@te I am going to throw my laptop and myself off the roof of my house. Okay, maybe just the laptop. See, the roof isn't that high up and I'd probably just break an arm or a leg and that would be unfortunate. But, seriously, I can't take it anymore. Even my beloved Salon has featured stupid headlines about these people. So, if you don't see me on the internets you'll know it's because I boxed up my laptop and buried it in a closet. Someone please call me when it's over and it's safe to surf once more.
Because if I see one more effing headline about J0n & K@te I am going to throw my laptop and myself off the roof of my house. Okay, maybe just the laptop. See, the roof isn't that high up and I'd probably just break an arm or a leg and that would be unfortunate. But, seriously, I can't take it anymore. Even my beloved Salon has featured stupid headlines about these people. So, if you don't see me on the internets you'll know it's because I boxed up my laptop and buried it in a closet. Someone please call me when it's over and it's safe to surf once more.
5.28.2009
Picture time...
We finally got a new camera and we finally uploaded the photos taken thus far. Not that we take very many. That's bad. And we really do need to branch out beyond pics of the dog. Just how many photos of the dog do we need anyway?
Isn't she cute?
Cherries! In my backyard! Now, how am I going to reach those?
Crazy-looking plant from the backyard. Anyone know what this thing is?
Tree? (Come on, I had to. Even if I didn't want to, you all would make me do this for the rest of my life. Also, I don't know what the hell that baby head thing is--there are 2 at the front entrance of Boston's MFA.)
We finally got a new camera and we finally uploaded the photos taken thus far. Not that we take very many. That's bad. And we really do need to branch out beyond pics of the dog. Just how many photos of the dog do we need anyway?
Isn't she cute?
Cherries! In my backyard! Now, how am I going to reach those?
Crazy-looking plant from the backyard. Anyone know what this thing is?
Tree? (Come on, I had to. Even if I didn't want to, you all would make me do this for the rest of my life. Also, I don't know what the hell that baby head thing is--there are 2 at the front entrance of Boston's MFA.)
5.26.2009
No babies!
There were no babies to be born on Saturday night and I'll admit to being disappointed. There was one mom in L&D but she wasn't in labor; she was being treated for a kidney stone. There was one baby in the nursery and only one post-partum mom would allow a student to provide her care. Durr. A wasted evening at clinical.
That being said, there is no schedule for babies and it's either feast or famine, as they say. Unfortunately the famine seems to occur during our clinical hours and the feasts occur at 3 am after we're gone. Also, it's unusual for a patient to refuse student care so there we were doing a big group study session in the family waiting room because there was nothing to do. Maybe this coming weekend?
That's all that's exciting in my life. Hoping to see a birth, studying for exams and the usual life maintenance. And tennis. Lots of tennis. Did I mention that I beat Michael twice?
There were no babies to be born on Saturday night and I'll admit to being disappointed. There was one mom in L&D but she wasn't in labor; she was being treated for a kidney stone. There was one baby in the nursery and only one post-partum mom would allow a student to provide her care. Durr. A wasted evening at clinical.
That being said, there is no schedule for babies and it's either feast or famine, as they say. Unfortunately the famine seems to occur during our clinical hours and the feasts occur at 3 am after we're gone. Also, it's unusual for a patient to refuse student care so there we were doing a big group study session in the family waiting room because there was nothing to do. Maybe this coming weekend?
That's all that's exciting in my life. Hoping to see a birth, studying for exams and the usual life maintenance. And tennis. Lots of tennis. Did I mention that I beat Michael twice?
5.20.2009
You know what's funny...?
Being asked to address "sexual activity of the pregnant woman and her partner" (male in this case) on an exam and having to list sexual activities on the test. Yes, that's right, I had to write down sex positions on an exam. How many people can say they've done that?
The other funny thing is that our maternity book provides little pink and blue figurines in sex positions to provide a visualization of the position. Hi-larious. Even better than that is in our geriatrics book there are color illustrations of the elderly getting it on (this is in the coping with the aftereffects of cardiac events chapter). It's like it's straight out of the J0y of Sex. Full on nudity, I tell you. They're really funny, too, b/c the man always has his hand on the woman's breast no matter what position they are in and both their eyes are always closed; they look like they're asleep. Older people have active sex lives, as do pregnant women and their partners, but it's just so amusing to have it laid out there so explicitly in a text book. It's like the kama sutra issue from C0sm0 but for pregnant women.
Being asked to address "sexual activity of the pregnant woman and her partner" (male in this case) on an exam and having to list sexual activities on the test. Yes, that's right, I had to write down sex positions on an exam. How many people can say they've done that?
The other funny thing is that our maternity book provides little pink and blue figurines in sex positions to provide a visualization of the position. Hi-larious. Even better than that is in our geriatrics book there are color illustrations of the elderly getting it on (this is in the coping with the aftereffects of cardiac events chapter). It's like it's straight out of the J0y of Sex. Full on nudity, I tell you. They're really funny, too, b/c the man always has his hand on the woman's breast no matter what position they are in and both their eyes are always closed; they look like they're asleep. Older people have active sex lives, as do pregnant women and their partners, but it's just so amusing to have it laid out there so explicitly in a text book. It's like the kama sutra issue from C0sm0 but for pregnant women.
5.19.2009
Springtime explosion...
It's very much springtime here and headed quickly toward summer. The trees are green, roses are blooming and grasses are starting to turn "golden" as the state motto goes.
The produce at the market is once again bountiful and delicious but my daily allotment of time to spend in the kitchen has been overtaken by school as usual. Still, I'm finding time to try new recipes per my "try 3 new recipes a month" goal. So far this month I made caramel chocolate matzah crackle and mock spanish rice. Next up will be this yummy quiche. What's not to love about hashbrowns and a cheesy quiche all in one dish?
As for gardening, I have purchased a bit of everything in the herb department and will be transplanting everything later this week into a large pot. I also have some tomatoes and a pepper plant to transplant. Unfortunately I already killed the cilantro. Don't even ask me how I managed to do that. Unlike Alissa, we don't have bunnies around here to eat our veg but we do have a rotten brat of a dog who likes to tear around the yard like a maniac and I swear to Ogg if she touches my potted plants I'm going to sell her to the monkey house.
I'm excited to note that our cherry tree has actual cherries on it and I can't wait to pick them. Most of them are out of reach so I'll have to enlist Michael to do the picking. Our landlord told us that peach trees only bear fruit every other year so we should get peaches this year. I'm not so sure about that since the tree looks a bit sickly but who knows? I'm no expert on fruit trees so we'll see what happens. I'm been thinking about buying a citrus sapling but haven't decided which would be best. They're not cheap and I don't want to buy more than one at this time. What do you think: lemon or lime? Lemon is good for fish, garnishes, lemonade, yummy desserts like these lemon bars, hummus and well, almost anything but limes are good too. Limes for guac or spritzing over mexican dishes or limeade. Maybe the lemons would be better?
It's very much springtime here and headed quickly toward summer. The trees are green, roses are blooming and grasses are starting to turn "golden" as the state motto goes.
The produce at the market is once again bountiful and delicious but my daily allotment of time to spend in the kitchen has been overtaken by school as usual. Still, I'm finding time to try new recipes per my "try 3 new recipes a month" goal. So far this month I made caramel chocolate matzah crackle and mock spanish rice. Next up will be this yummy quiche. What's not to love about hashbrowns and a cheesy quiche all in one dish?
As for gardening, I have purchased a bit of everything in the herb department and will be transplanting everything later this week into a large pot. I also have some tomatoes and a pepper plant to transplant. Unfortunately I already killed the cilantro. Don't even ask me how I managed to do that. Unlike Alissa, we don't have bunnies around here to eat our veg but we do have a rotten brat of a dog who likes to tear around the yard like a maniac and I swear to Ogg if she touches my potted plants I'm going to sell her to the monkey house.
I'm excited to note that our cherry tree has actual cherries on it and I can't wait to pick them. Most of them are out of reach so I'll have to enlist Michael to do the picking. Our landlord told us that peach trees only bear fruit every other year so we should get peaches this year. I'm not so sure about that since the tree looks a bit sickly but who knows? I'm no expert on fruit trees so we'll see what happens. I'm been thinking about buying a citrus sapling but haven't decided which would be best. They're not cheap and I don't want to buy more than one at this time. What do you think: lemon or lime? Lemon is good for fish, garnishes, lemonade, yummy desserts like these lemon bars, hummus and well, almost anything but limes are good too. Limes for guac or spritzing over mexican dishes or limeade. Maybe the lemons would be better?
5.12.2009
First day on the maternity ward...
Admit it. You're here to find out about the babies, aren't you? I must tell you: they are cute. Precious, in fact. Wee bitty things that you want to munch on and smell their little baby smell. It's true. Those tiny feet and that hair that reminds me of the baby ducks Judy used to hatch in her kindergarten classes. OMG, total cuteness.
But first, the hospital. It's a small facility in the Mission but has free parking in the garage on weekends (score) but the cafeteria is closed on weekends (which is either good or bad depending on how good their food is). The nice thing about weekend night clinicals is that the traffic is generally pretty good unless there's a Giants game. What's especially nice is that this hospital tries to avoid medical interventions during L&D as much as possible and has a 3% c-section rate (c/s). 3%. That's totally unheard of. They do c/s if they need to but they don't permit scheduled c/s which I think is great. They have mostly nurse-midwives on staff but there are OB-GYNs around, too.
It's a nice facility and the post-partum rooms are relatively roomy and have a pull out couch for family. They do "couplet" care so the baby rooms with mom and the nurses care for mom and baby simultaneously. The NICU is a level 2 so really premature babies and really sick babies get transported across town to the other facility which is a level 5. There were 2 babies in the NICU this weekend and they were tiny. The nurses are nice and our clinical instructor is great. Also, this part of the hospital feels less contaminated by MRSA and C. diff than med-surg floors which was nice. I came home Sat. night and didn't even take a shower before going to bed. Normally, I'm in the shower within 3 minutes of walking in the door. Still, I never wear my scrubs in the house.
So, my assignment for the evening was to do the well-baby assessments. I assessed every newborn on the ward and changed diapers and talked to moms about feeding. Newborns are funny little things. They really don't like to be messed with and absolutely hate having their temperature taken. All but one of the babies was eating well and I changed some very wet diapers. I got a rather full meconium one just 2 hours after birth. Good lord, that stuff is sticky. And I managed to avoid being sprayed in the face. Did you know that diapers come with little lines on them that change color when the baby wets in them? What a brilliant idea! Except when the pee just runs up their backs it's kind of useless but still. I'd be remiss if I didn't mention that some of the adult diapers have the same thing. Which is nice for the same reason and allows you to preserve their dignity a little more.
This weekend I'm on post-partum duty so I'll be assessing moms for lochia and breast stuff. The week after I'll be doing a turn in L&D and NICU. I hope someone gives birth while I'm there but I have no control over that. Chances are I won't see a c/s birth but maybe. Either way, it's all really neat. They want us to do the teaching with the moms but for all the reading and classroom discussion on breast feeding, I still feel like I don't know what the hell to say. I know what I'm supposed to say but it seems so weird to teach someone how to do something I've never done before. Then again, I've had to teach someone how to clean his colostomy bag and I sure as hell don't ever plan to have one of those.
All in all, it was a good weekend and I'm looking forward to going back on Saturday. Stay tuned.
Admit it. You're here to find out about the babies, aren't you? I must tell you: they are cute. Precious, in fact. Wee bitty things that you want to munch on and smell their little baby smell. It's true. Those tiny feet and that hair that reminds me of the baby ducks Judy used to hatch in her kindergarten classes. OMG, total cuteness.
But first, the hospital. It's a small facility in the Mission but has free parking in the garage on weekends (score) but the cafeteria is closed on weekends (which is either good or bad depending on how good their food is). The nice thing about weekend night clinicals is that the traffic is generally pretty good unless there's a Giants game. What's especially nice is that this hospital tries to avoid medical interventions during L&D as much as possible and has a 3% c-section rate (c/s). 3%. That's totally unheard of. They do c/s if they need to but they don't permit scheduled c/s which I think is great. They have mostly nurse-midwives on staff but there are OB-GYNs around, too.
It's a nice facility and the post-partum rooms are relatively roomy and have a pull out couch for family. They do "couplet" care so the baby rooms with mom and the nurses care for mom and baby simultaneously. The NICU is a level 2 so really premature babies and really sick babies get transported across town to the other facility which is a level 5. There were 2 babies in the NICU this weekend and they were tiny. The nurses are nice and our clinical instructor is great. Also, this part of the hospital feels less contaminated by MRSA and C. diff than med-surg floors which was nice. I came home Sat. night and didn't even take a shower before going to bed. Normally, I'm in the shower within 3 minutes of walking in the door. Still, I never wear my scrubs in the house.
So, my assignment for the evening was to do the well-baby assessments. I assessed every newborn on the ward and changed diapers and talked to moms about feeding. Newborns are funny little things. They really don't like to be messed with and absolutely hate having their temperature taken. All but one of the babies was eating well and I changed some very wet diapers. I got a rather full meconium one just 2 hours after birth. Good lord, that stuff is sticky. And I managed to avoid being sprayed in the face. Did you know that diapers come with little lines on them that change color when the baby wets in them? What a brilliant idea! Except when the pee just runs up their backs it's kind of useless but still. I'd be remiss if I didn't mention that some of the adult diapers have the same thing. Which is nice for the same reason and allows you to preserve their dignity a little more.
This weekend I'm on post-partum duty so I'll be assessing moms for lochia and breast stuff. The week after I'll be doing a turn in L&D and NICU. I hope someone gives birth while I'm there but I have no control over that. Chances are I won't see a c/s birth but maybe. Either way, it's all really neat. They want us to do the teaching with the moms but for all the reading and classroom discussion on breast feeding, I still feel like I don't know what the hell to say. I know what I'm supposed to say but it seems so weird to teach someone how to do something I've never done before. Then again, I've had to teach someone how to clean his colostomy bag and I sure as hell don't ever plan to have one of those.
All in all, it was a good weekend and I'm looking forward to going back on Saturday. Stay tuned.
5.07.2009
Back to the grind...
Spring break is officially over and it's back to school for me and my classmates. This session starts with 5 weeks of maternity followed by 5 weeks of peds and 10 weeks of research class concurrent with maternity and peds. My first clinical rotation starts this weekend (Sat and Sun 3-11pm - blarg, it's not the Sat night I care about, it's Sun. At least it's only 5 wks) so by Monday there will be an update on all those moms and babies I'll be seeing over the 2 days. At least the only diapers I'll be changing are those of the neonates.
I really am looking forward to a little change in curriculum. It'll be so nice to do a rotation where (almost) everyone is healthy and excited to be there. But seriously, this class is going to kick my butt. The amount of information we need is massive (I can hear the collective "duh" from all the moms already) and we are cramming a 15 wk course into 5 weeks. Jesus. Let's hope I can remember it all. Stay tuned.
Hefk, I'll be cognizant of where my badge is hanging at all times.
Spring break is officially over and it's back to school for me and my classmates. This session starts with 5 weeks of maternity followed by 5 weeks of peds and 10 weeks of research class concurrent with maternity and peds. My first clinical rotation starts this weekend (Sat and Sun 3-11pm - blarg, it's not the Sat night I care about, it's Sun. At least it's only 5 wks) so by Monday there will be an update on all those moms and babies I'll be seeing over the 2 days. At least the only diapers I'll be changing are those of the neonates.
I really am looking forward to a little change in curriculum. It'll be so nice to do a rotation where (almost) everyone is healthy and excited to be there. But seriously, this class is going to kick my butt. The amount of information we need is massive (I can hear the collective "duh" from all the moms already) and we are cramming a 15 wk course into 5 weeks. Jesus. Let's hope I can remember it all. Stay tuned.
Hefk, I'll be cognizant of where my badge is hanging at all times.
4.27.2009
I've been tagged, too!
So, Gwen tagged me and she already tagged most of the people I would have tagged so I'm with Alissa and I won't bother tagging anyone.
"List 7 things that you love, and then pass the award on to 7 bloggers that you love! Be sure to tag them and let them know that they have won. You can copy the picture of the award and paste it on your sideboard letting the whole world know...you are Kreativ."
1. The way dogs look when they're asleep
2. Flannel sheets
3. The yummy way the house smells when I'm baking
4. Beating Michael at anything
5. Harry Potter
6. Reading a new cookbook
7. Fleece pants and fuzzy socks
So, Gwen tagged me and she already tagged most of the people I would have tagged so I'm with Alissa and I won't bother tagging anyone.
"List 7 things that you love, and then pass the award on to 7 bloggers that you love! Be sure to tag them and let them know that they have won. You can copy the picture of the award and paste it on your sideboard letting the whole world know...you are Kreativ."
1. The way dogs look when they're asleep
2. Flannel sheets
3. The yummy way the house smells when I'm baking
4. Beating Michael at anything
5. Harry Potter
6. Reading a new cookbook
7. Fleece pants and fuzzy socks
4.20.2009
Adventures in container gardening...
This weekend the local community garden had a plant sale and I availed myself of the opportunity to do a little gardening. I always meant to do this while we lived in Ohio but we had a problem with raccoons and feral cats so I never got around to it. Now we've got a yard but it belongs to the landlord so I won't be digging up the grass for a real garden. That leaves me with container gardening.
I got 3 types of tomato (green zebra, cherry and regular), 2 types of basil (broad leaf and lemon), parsley, cilantro and an aloe plant. Everything has to stay put for another week or so to mature a bit more (well, not the aloe) and then I'll transplant it all to bigger pots. I'd post a picture of the teeny plants I brought home but our camera is broken but hopefully by transplantation day we'll have a new one. Here's hoping I don't kill everything.
This weekend the local community garden had a plant sale and I availed myself of the opportunity to do a little gardening. I always meant to do this while we lived in Ohio but we had a problem with raccoons and feral cats so I never got around to it. Now we've got a yard but it belongs to the landlord so I won't be digging up the grass for a real garden. That leaves me with container gardening.
I got 3 types of tomato (green zebra, cherry and regular), 2 types of basil (broad leaf and lemon), parsley, cilantro and an aloe plant. Everything has to stay put for another week or so to mature a bit more (well, not the aloe) and then I'll transplant it all to bigger pots. I'd post a picture of the teeny plants I brought home but our camera is broken but hopefully by transplantation day we'll have a new one. Here's hoping I don't kill everything.
4.16.2009
Heartbreaking...
I just cannot focus on the enormous amount of studying I have to do because I can't stop thinking about the patient I had last night. I was a assigned a 17 y.o. HIV positive male who was admitted for cryptococcal meningitis. He was no longer under contact precautions so I was able to go in his room without a mask, etc. (hallelujah for that one--I always have a pt with contact precautions of some sort). He's been in the hospital for about 2 weeks now and is expected to go home sometime next week.
When I first introduced myself he ignored me and the other nurses; he just played videogames until I needed to put a BP cuff and a pulse oximeter on him. He has a history of refusing his medication. Today it was one of the antibiotics he needs to take by mouth--2 of the 4 doses he needs to take in a day. He's depressed (and taking bupropion), stuck in the hospital and bored. And both of his parents are HIV positive as well.
I spent almost and hour and a half with him while he ate some of his dinner and took his meds. He was scheduled to take 9 pills at dinner and an IV injection of an anti-nausea medication. He says that the pills make him nauseous and he doesn't like to take them. He takes a lot of pills. A lot. He's on about 5 anti-retroviral drugs plus the other meds he takes. He said his mom takes her pills 4 at a time. He takes his one at a time over a long period of time. I got him to take 6 of them over the course of an hour and was waiting for the nausea to pass to give him the last 3.
We hung out and watched Mythbusters and the stupid show with the guy who shouts about laundry detergent. You know who I'm talking about. Anyway, we talked about school and videogames and tv shows and why he doesn't like vegetables. He's a nice kid, a good kid, and sometimes he acts like a pissy teenager because...he's a teenager. And maybe, if I were him, I might refuse my meds, too. He tells me just looking at them sometimes makes him gag. But he also knows what happens if he doesn't take all of his ART meds. We talked about the importance of that. And the nurses on the ward have 4 other patients to take care of and can't spend 1.5 hours hanging out trying to cajole him into taking his meds the way a student nurse can.
I got him to take 2 more ARTs before I left last night. I tried to get him to take the last one, the biggest one, the one that can't be cut in half or crushed and put into applesauce, but he was sleepy and didn't want it. But he took the antibiotcs and most of his ARTs so I'm pleased with that. It's hard to do this job sometimes. You want your patients to get better and often times that means just taking all of their medications. And a lot of them take a lot of meds. They're like walking pharmacies, these patients. But they have every right to refuse even if they're minors. But if they don't take their meds, you can't keep the disease in check and/or cure them. In this case, as we know, there is no cure. And he's walking a very fine line between HIV and progression to AIDS by not following the prescribed regimen. He's only 17.
I just cannot focus on the enormous amount of studying I have to do because I can't stop thinking about the patient I had last night. I was a assigned a 17 y.o. HIV positive male who was admitted for cryptococcal meningitis. He was no longer under contact precautions so I was able to go in his room without a mask, etc. (hallelujah for that one--I always have a pt with contact precautions of some sort). He's been in the hospital for about 2 weeks now and is expected to go home sometime next week.
When I first introduced myself he ignored me and the other nurses; he just played videogames until I needed to put a BP cuff and a pulse oximeter on him. He has a history of refusing his medication. Today it was one of the antibiotics he needs to take by mouth--2 of the 4 doses he needs to take in a day. He's depressed (and taking bupropion), stuck in the hospital and bored. And both of his parents are HIV positive as well.
I spent almost and hour and a half with him while he ate some of his dinner and took his meds. He was scheduled to take 9 pills at dinner and an IV injection of an anti-nausea medication. He says that the pills make him nauseous and he doesn't like to take them. He takes a lot of pills. A lot. He's on about 5 anti-retroviral drugs plus the other meds he takes. He said his mom takes her pills 4 at a time. He takes his one at a time over a long period of time. I got him to take 6 of them over the course of an hour and was waiting for the nausea to pass to give him the last 3.
We hung out and watched Mythbusters and the stupid show with the guy who shouts about laundry detergent. You know who I'm talking about. Anyway, we talked about school and videogames and tv shows and why he doesn't like vegetables. He's a nice kid, a good kid, and sometimes he acts like a pissy teenager because...he's a teenager. And maybe, if I were him, I might refuse my meds, too. He tells me just looking at them sometimes makes him gag. But he also knows what happens if he doesn't take all of his ART meds. We talked about the importance of that. And the nurses on the ward have 4 other patients to take care of and can't spend 1.5 hours hanging out trying to cajole him into taking his meds the way a student nurse can.
I got him to take 2 more ARTs before I left last night. I tried to get him to take the last one, the biggest one, the one that can't be cut in half or crushed and put into applesauce, but he was sleepy and didn't want it. But he took the antibiotcs and most of his ARTs so I'm pleased with that. It's hard to do this job sometimes. You want your patients to get better and often times that means just taking all of their medications. And a lot of them take a lot of meds. They're like walking pharmacies, these patients. But they have every right to refuse even if they're minors. But if they don't take their meds, you can't keep the disease in check and/or cure them. In this case, as we know, there is no cure. And he's walking a very fine line between HIV and progression to AIDS by not following the prescribed regimen. He's only 17.
4.03.2009
I think I'm ready for a break...
From med-surg nursing at least. This school was a total pain in the arse to get into (b/c nobody returns phone calls or emails) but once you're in they really do take our feedback under consideration. Previous cohorts have done 20 weeks of med-surg nursing, 10 of which are spent on an ICU step-down unit (we won't be doing any work on the ICU--there's too many of us and not enough space and, good lord, those people have tubes and wires coming out of them like crazy). 20 weeks is a lot without a break. So our cohort is doing 10 weeks of med-surg and then we move on to maternity for 5 wks and pediatrics for 5 wks before going back to med-surg. It'll be nice to have a little break.
We're starting week 9 of med-surg and we've learned a lot to date. There's still more to learn but it's very difficult to get exposed and/or try all the skills we learn in lab for many reasons. For example, foley catheters (the ones that go in your bladder and stay there) have to be changed every 3 days. There are 10 students and maybe a total of 25 patients, some of whom may have a foley but many may not. Of those who do, they may not need a new one. And in some cases, it's okay to do something that's just been done for the benefit of learning but many times it's not feasible. For one thing, the waste involved is enormous. For another, the patients are not guinea pigs. But I would love to put in a foley. Maybe in maternity.
Last week I had my first colostomy patient. For all the joking about colostomies they're not funny to the patient. The bags look like those little bags of air that are used to prevent breakage during shipment of the goodies you ordered from amaz0n.c0m. Except these fill up with poop and gas and you have to go in and empty them out and, whew, it does not smell pretty (did I not tell you it was always about poop?). Still, it was cool to see. And you have to be cool about it b/c the patient is not happy to have one. I know I wouldn't be happy about it.
I also had my first experience with a combative patient. The doctors were trying to figure out what was wrong with her and in the meantime she became very combative. For a pretty small 88-year-old, she was strong and fiesty. It took 4 nurses to hold her down so they could give her a sedative before going for an MRI. She was kicking, yelling, biting and hitting; talk about surreal. And this behavior can occur as a side effect of a number of disease processes but it can be hard to deal with while you're waiting for the docs figure out the underlying issue. The pts have no idea what they're doing and if they did, they would be so embarrassed.
Anyway, this patient grabbed some papers the nurse laid on the bed and flung them (yes, she really flung them) right in the nurse's face and then while I held her down so the nurse could flush her IV, she looked right at us and just yelled right in our faces. And then she took a deep breath and telled some more. And...it's not funny. At all. But I mean to tell you that I was about to start shaking with laughter b/c of the un-funniness of it all. It's sort of like laughing at a funeral. Michael will remember how, at my aunt's funeral last year, I started shaking from head to toe from repressed laughter. The cause? My cousin doing a less than stellar version of "In the Arms of an Angel." I thought I was going to die from lack of oxygen. But, see? Not really funny. Except that it is. In a very inappropriate way. Ah, trench humor. This is how we're able to do what we do without losing our sanity.
From med-surg nursing at least. This school was a total pain in the arse to get into (b/c nobody returns phone calls or emails) but once you're in they really do take our feedback under consideration. Previous cohorts have done 20 weeks of med-surg nursing, 10 of which are spent on an ICU step-down unit (we won't be doing any work on the ICU--there's too many of us and not enough space and, good lord, those people have tubes and wires coming out of them like crazy). 20 weeks is a lot without a break. So our cohort is doing 10 weeks of med-surg and then we move on to maternity for 5 wks and pediatrics for 5 wks before going back to med-surg. It'll be nice to have a little break.
We're starting week 9 of med-surg and we've learned a lot to date. There's still more to learn but it's very difficult to get exposed and/or try all the skills we learn in lab for many reasons. For example, foley catheters (the ones that go in your bladder and stay there) have to be changed every 3 days. There are 10 students and maybe a total of 25 patients, some of whom may have a foley but many may not. Of those who do, they may not need a new one. And in some cases, it's okay to do something that's just been done for the benefit of learning but many times it's not feasible. For one thing, the waste involved is enormous. For another, the patients are not guinea pigs. But I would love to put in a foley. Maybe in maternity.
Last week I had my first colostomy patient. For all the joking about colostomies they're not funny to the patient. The bags look like those little bags of air that are used to prevent breakage during shipment of the goodies you ordered from amaz0n.c0m. Except these fill up with poop and gas and you have to go in and empty them out and, whew, it does not smell pretty (did I not tell you it was always about poop?). Still, it was cool to see. And you have to be cool about it b/c the patient is not happy to have one. I know I wouldn't be happy about it.
I also had my first experience with a combative patient. The doctors were trying to figure out what was wrong with her and in the meantime she became very combative. For a pretty small 88-year-old, she was strong and fiesty. It took 4 nurses to hold her down so they could give her a sedative before going for an MRI. She was kicking, yelling, biting and hitting; talk about surreal. And this behavior can occur as a side effect of a number of disease processes but it can be hard to deal with while you're waiting for the docs figure out the underlying issue. The pts have no idea what they're doing and if they did, they would be so embarrassed.
Anyway, this patient grabbed some papers the nurse laid on the bed and flung them (yes, she really flung them) right in the nurse's face and then while I held her down so the nurse could flush her IV, she looked right at us and just yelled right in our faces. And then she took a deep breath and telled some more. And...it's not funny. At all. But I mean to tell you that I was about to start shaking with laughter b/c of the un-funniness of it all. It's sort of like laughing at a funeral. Michael will remember how, at my aunt's funeral last year, I started shaking from head to toe from repressed laughter. The cause? My cousin doing a less than stellar version of "In the Arms of an Angel." I thought I was going to die from lack of oxygen. But, see? Not really funny. Except that it is. In a very inappropriate way. Ah, trench humor. This is how we're able to do what we do without losing our sanity.
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