Holiday Nursing

Holiday Nursing

Memorial Day Weekend 2009: I am standing at my front screen door on Friday afternoon watching my neighbors across the street pack their car. I see sleeping bags, tents, cooking supplies and coolers of food. Camping supplies. They are going camping. They are smiling. Of course they are smiling, they are about to go out of town on a holiday weekend. I, on the other hand am not smiling because I don’t have a holiday weekend. My three-day weekend will be spent working in an inner city Emergency Room because I am a nurse and that’s what I do. On top of it, this was my first summer back in school after 15 years. I was earning my BSN. Our vacation wasn’t until August and I had decided against the pool membership thinking it was too much money, when it really wasn’t and I should have just spent the money. So here I stood on the Friday before Memorial Day weekend, getting ready to work my three twelve hour shifts in a row, do schoolwork and look at my husband, children and the rest of the world who was off this weekend. I was miserable.

The above scenario is what nurses experience year after year if they are at the bedside working in a hospital inpatient area or the Emergency Room. Their job is 24/7, weekends and holidays included. Typically in a hospital the six paid holidays of the year are Memorial Day, Independence Day, Labor Day, Thanksgiving, Christmas Day, New Years Day. Sure they committed themselves to do this when they decided to become nurses but it doesn’t make it any easier when you want to be home with your family. It doesn’t make it any easier watching your loved ones at home for days at a time enjoying their holiday weekends. I try to put on a happy face but deep down inside I am grumpy a little and lash out when I feel someone isn’t being considerate to my melancholy feelings of working the holidays.

On the other side of it, we nurses are there on holidays for our patients because we chose to embark on a career of caring. We leave for work before sunrise and return home after sunset or we leave for work at sunset and return home at sunrise. We are there to watch the cardiac arrests role in the door and to tell the families we couldn’t save their loved one’s life. We are there to prep patients for the surgeries to get the cancer out of the body immediately knowing that this could be this person’s last holiday season. We are there to watch amateur drinkers puke their guts out in the ER because they’ve had too much to drink on New Years Eve. To them it’s an emergency. To us, it’s a pain in the ass. We are there to encourage a wife to accept her husband’s decision to die a week before Christmas because he’s tired of his cancer. We are there to watch child protective services take away a schizophrenic woman’s children the night before Thanksgiving because she refused to take them to a family homeless shelter for the night. We are there on Labor Day weekend when everyone else is outside in the sunshine cherishing the last moments of summer before the kids go back to school. We are there late on a Saturday night on July 4th, when the city hosts it’s yearly firework display and there’s a heavy metal concert going on at the stadium at the same time and people are coming into the ER drunk, angry and violent. We are there on Memorial Day weekend when everyone is off and excited for summer to come. We are there on Easter Sunday when everyone is dressed in their Sunday best and off to church and brunch. We are there on Valentines Day when we’d rather be on a date with the love of our lives. We are there on Superbowl Sunday hoping someone at home records the Superbowl because we aren’t sure we’ll be able to stay awake to watch the second half when we get home. We are there on Mother’s Day and Father’s Day thinking of our own parents and thanking our spouses for giving us our children. Our coworkers become family. We bring in food, enjoy each others company as we try to make the best of it until we can go home to our families. We risk our lives to drive to work in the rain, sleet and deep snow because if we call out we won’t get paid and we’ll screw our coworkers over.

We know how to shake off the sadness we see in our patient care everyday and especially on the holidays. It’s part of that exterior shell that starts to grow around our hearts during nursing school and hardens more and more as the years of nursing go on so the sadness can’t hurt as bad. We aren’t there to be verbally abused or to take on unnecessary nonsense at work during a holiday though. That part of the job truly crushes our spirits worse than watching sadness.

I transferred out of the Emergency Room three years ago to the Perioperative world. I smile every Friday when I leave work because I don’t have to be there on weekends anymore except for an on call Saturday shift three or four times per year. My department works Christmas Eve and New Years Eve and days before and after weekday holidays. Even then there’s turmoil. If you really want to piss off a veteran nurse, give a nurse with far less experience than you Christmas Eve off and don’t take into account that this baby nurse was off last year and the year before when you the old hag nurse were where else but at work.

The best thing about working holidays is the day after or the Monday after the holiday when the rest of the world has to return to work and school but you the nurse are there in your pajamas with your cup of coffee, smiling and waving to your family as they leave the house for the day. Bye bye now, see you later. You, the nurse won’t be going to work today. Instead you’ll take your coffee and go back up to bed with your dog.  Today is your holiday and aside from touching the lives of those you care for, this your reward for working the holidays. It’s one of my favorites.

Even though the holidays have ended, it’s still New Years weekend and nurses everywhere are at work, wishing they could be home. I wrote this today to honor all of my nurse sisters and brothers that have worked this holiday season and are at work right now to thank them for what they do.

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A Year in Colors

I picture each year as a clock with colors. The year itself is written in the center of the clock. There are no other numbers. January is at twelve o’clock and the months go counter clockwise. Every year I look forward to each color and the time periods they represent and the possibilities they present.

January, February and March are bright yellow. Yellow represents the light of hope and dreams of the new year. The slate has been wiped clean and it is time to start anew. I don’t make New Years resolutions, I just make a list of things I want to do and I do them. If I find myself getting off course, I try again.

April, May and June are green signifying new life, growth, renewal and the season of Easter. Winter turns to spring as the ice begins to melt. Humans and animals emerge from hibernation, plagued with cabin fever from a long winter, eager to get outside. Green is everywhere. New grass grows and plants and flowers are in bloom adding color to dull branches of winter.

July, August and September are orange. These are longer days with suffocating summer heat, time spent out doors and colorful sunsets. I enjoy that feeling of freedom I get when I put on my favorite summer cloths, shorts, tank top and flip flops. My favorite part of orange is spending a long day on the water, soaking up sunshine, making mental notes of every detail, inhaling the smell of the water and being thankful that I am there.

October, November and December are blue gray and the darkest days in my year. There is a chill in the air as the sky darkens early. The colder it gets the more I smell people’s fireplaces when I walk my dog in the cold night air. I cook hearty meals and enjoy early pajama time when I can. I often feel like I’ve been hit by a train during this time period. My life becomes consumed with my children’s back to school and fall school activities. Fall flies by and pretty soon it is black Friday and the chaos of the holiday season begins. The quick transition between fall activities and the holidays is what makes this time dark for me. I often feel like I don’t have time to catch my breath before the ridiculousness of holiday shopping begins.The meaning of Christmas has blown out of proportion by retail stores and the emphasis on the birth Jesus Christ is lost.

My last blog post was on October 18, 2015 during the darkness of the blue gray time. Fall activities were going at full force and occupying several evenings of each week. My days at work were busy and we were swimming in my son’s college applications. Soon it was Thanksgiving and the beginning of the holiday season. With each added responsibility, my mental clarity, creativity and desire to write deflated like a tired balloon days after a birthday party. I spent my downtime watching television and reading. This year wasn’t as bad as some though and I somehow managed to get through the holiday season without a temper tantrum.

In early December I attended a holiday brass concert at a local cathedral here in Baltimore. The music was moving and uplifting and the scent of the incense of the cathedral reminded me of the many Christmas Eves I spent in midnight mass when I was growing up. My heart was suddenly filled with the desire to attend midnight mass on Christmas Eve. I was determined to attend this year and I did just that.

As I sat in the wooden pew, admired the decorated alter and waited for mass to begin, I thought of my grandmother. My grandmother cried every year during Christmas Eve mass because her own mother died of a massive heart attack while walking home in the snow after Christmas Eve midnight mass when my grandmother was only nine. Despite her own pain, my grandmother always managed to make Christmas special for us and I hoped that six Christmases after her own death she’d be proud to find me in church on Christmas Eve after a long absence.

I inhaled the familiar, comforting smells of incense of the Catholic Church. I pictured myself being present at the birth of Jesus Christ. I sang in celebration and listened carefully to the Priest’s sermon, savoring every word. It’s the best Christmas gift I’d ever given myself and it gave me the faith to believe all things are possible in the upcoming year.

I have no regrets of the year 2015. I’ve learned valuable lessons, tried new things and built a foundation for things I’d like to continue in 2016. Today, December 31, 2015 as the blue gray darkness of December fades into the bright yellow light of January 1, 2016, I’ll carry out my hopes and dreams of the new year by remembering what the angel said to Mary prior to Jesus’s birth, “Do not be afraid”.

Happy New Year.

Seasonal Dishes

Yesterday my husband, my mother in law and I took a random drive to Havre De Grace, Maryland for lunch. We were surrounded by the spirit of fall. As we drove north on 95 we noticed the amber, red and brown earth tone colors of the leaves on the trees. When we arrived in Havre De Grace and walked to the restaurant, we zipped up our jackets when we noticed a slight chilly breeze in the air coming from the Northern point of the Chesapeake Bay.

We chose to eat at Laurrapin, a contemporary American cuisine restaurant that uses fresh ingredients from local Maryland farmers and the Chesapeake Bay. The décor of the restaurant furnished a cozy ambiance of mustard and brown painted walls, copper tabletops, hardwood floors and paintings by local artists.

We ordered the fried eggplant appetizer. The eggplant was covered with goat cheese, basil and a touch of fresh tomato marinara. My entree’ was a generous portion of baked Rockfish on a bed of succotash with kidney beans, lima beans, zucchini, brussel sprouts, and onions. My accompanying glass of white wine gave this dish a hearty, earthy taste. It reminded me of the Top Chef Boston episode where the chefs went to Plymouth Rock to cook Thanksgiving dinner using only the ingredients and utensils that the pilgrims and the Indians used to prepare their very first Thanksgiving feast in the New World. I have a tendency to inhale food when I’m enjoying it and there were moments I had to force myself to chew slowly and let all of my taste buds savor each bite before I swallowed. Dessert was a fresh apple crumble with a hint of caramel sauce and a freshly brewed cup of coffee. It was the perfect ending to a delightful seasonal dish.

Afterwards we did some window-shopping at the various shops in the historic district. We discovered there was an Oktoberfest going on so we took a gentle stroll through that, enjoying the music, people watching and inhaling the scent of various sausages and beers that the vendors were selling. As we made our way to the dock we inhaled the clean sea air and watched a few sailboats floating by allowing the beauty of the golden autumn sun shining upon us to complete a perfect fall day.

Food For Thought

I spent several hours from morning into early afternoon cooking. For some, cooking is a chore to be done to provide nourishment. For me, cooking is so much more.

My cooking has evolved throughout my nineteen years of marriage. Even though I grew up in a family that valued good food, my mother was not the most patient teacher when I asked her to teach me how to cook during the year that my husband and I were engaged to be married. After I got married I followed the recipes from friends and cookbooks given to me as bridal shower gifts. I frequently called my brother who had recently graduated from culinary school and was working as a chef for what I called a “culinary consult”. I also called my grandmother. My grandmother made the most beautiful lemon meringue pies. I thought since I’d watched her make those pies since I was a little girl that I could make one tool. The only time I attempted to make a lemon meringue pie, I ended up calling my grandmother in tears because the meringue fell. She just laughed and asked, “Well honey what did you do to it”. I realized then that I was not a baker and should stick to savory meals.

Over the years my cooking abilities have expanded from “I hope I get this right” to “I can do this dish”. My husband and I enjoy cooking together. We watch cooking shows and consult each other with ideas for meals. I grew up in a Sicilian family watching the women in the family cook. He grew up in a Scandinavian family watching the men in the family cook. With our different back grounds, we’re a perfect match in the kitchen and we work well together.

In the years since I’ve proclaimed myself as a writer, I’ve learned that engaging in other creative activities besides writing actually enhances creativity. Although I’ve returned to my cross stitch after a fourteen year hiatus and I occasionally enjoy my anatomy coloring book, cooking is my favorite creative outlet. There’s much to be said about the acts of planning a meal, refining a recipe, chopping, measuring, sautéeing, stirring, simmering and tasting. It requires focus and concentration and provides a wonderful feeling of accomplishment when the meal turns out delicious. Sometimes when life is stressful, focusing on a cooking a meal is a therapeutic distraction within itself.

Last year my husband gave me a compliment that I never forgot. I was on the phone complaining to him in the craft store about an assignment that our son had for his English class. He had to write poems and design a homemade notebook to put the poems in. It had been a busy week for the family and I just didn’t have it in me to help him design a notebook. My husband said, “Let me deal with this. You have the ability to think on the fly in the kitchen, not in a craft store”. Some women would have considered that a sexist remark. Not me. I knew exactly what he meant and because of that, whenever I look at a difficulty recipe and wonder if I can pull it off, I remember what he said and know that I can.

As a third generation American born Sicilian, I grew up knowing that a family meal was a sacred thing and the person who cooked the meal, cooked it out of love. I have carried those beliefs into my own kitchen and those that I cook for will always get my best.

Some weeks I only really have time to cook on the fly and get a meal on the table quickly because everyone is busy but other weeks I do have the time to try new recipes and plan different meals. Last week was an emotional and eventful week for our family and I’ve been running around for days. Despite my need to sit on the couch and relax, today I decided to cook. I approached my stove at nine o’clock this morning. In the course of a few hours I had made a long over due pot of sauce for a friend, breakfast sandwiches for my family, I put a brisket in the slow cooker and made a batch of my grandmother’s chicken soup. I was focused, organized and moved easily from one meal to the next. I also managed to jot down notes for this post. Everything I cooked today was successful and I am pleased. I finally did get the chance to relax and watch my favorite football team play their home opener. Oh and by the way, I don’t do dishes.

The Vain Man Who’s Lost His Purpose

You are a vain man and you have lost your purpose. Somewhere in your life, an incident occurred that your vanity would never allow you to admit to others and caused you to lose touch with reality. Since then you have spiraled more and more out of control faster than a tornado can rip through a mid western town.

You’ve had many valuable purposes in your life but your vanity has clouded your vision and removed your ability to see what is in front of your eyes. You had one of the most cherished purposes a man could be privileged enough to have; to be her father, her daddy, the first man in her life who should’ve loved her and protected her, taught her, encouraged her and supported her. Instead, as you positioned yourself high above her and created a world of hurt for her.

From her childhood and long into her adulthood, you’ve turned her simple rights of passage into a viscous arena for your life long game of battle of the wills. You put yourself on a high pedestal, and looked down at her while you made her struggle to achieve the simplest notches on the belt of adulthood when you should have been walking beside her through each journey of her life, cheering her on along the way.

As she grew she became wise to your cruel games and started to defend herself. You’ve been trying to drown her from the very first time she stood up to you. You then realized it was going to be more difficult to play your games than you’d anticipated.

You have now released all of your toxins into the water that she is swimming in. She is swimming just below the surface of the water. Her head is pointed upward and she can see the sky through the water. The sky is gloomy grey and the clouds are going to open up and dump hard, heavy rain at any moment. The current is very rough and the waves are choppy with whitecaps. She is trying to come up for air but she can’t just yet. She kicks her feet and paddles her arms with all her might.

She’s challenged you again and you are trying to drown her. She knows you’ve been trying to drown her throughout her life. She knows how unpredictable you are. Sometimes the sun shines and the water is calm and warm and you let her enjoy her swim. She always falls into your trap and thinks the water is going to remain calm but then you throw her back into a raging sea.

This time she had the courage to make a move in your game that you could not predict, enabling her to break free of your strangle hold. She’s climbed out of the water, cut your rotten umbilical cord and finally turned her back on your vanity, your mind games, your cruelty and the relationship you had with her. The atmosphere is so thick at the height your pedestal is on, you’ve forgotten what a good swimmer she is.

About Nurses

The Diet Coke incident- A mass exodus of bedside nurses.

I read a very interesting blog today entitled “The Diet Coke Incident” on a blog http://www.florenceisdead.com. I’ve enclosed the link above.

It’s an interesting article and I’m not going to summarize it here but it basically elaborates why nurses don’t want to do patient care anymore. I left a very short compliment on this blog but I wanted to elaborate the topic more with my readers.

Although nurses hold PhD’s MSN’s, BSN’s and nationally recognized certifications, we are not considered to be a “profession” by the vast majority. To them we are just a glorified waitress and over time, incidents like “The Diet Coke Incident” leaves nurses bitter, burned out and looking for the first opportunity for a change of scenery.

I work on a perioperative unit in a hospital. My job is to get patients ready for the operating room. I read through their labs and medical history, I do a physical assessment, a care plan and a preop checklist, medicate them as needed and place an IV in them with a limited amount of time all while providing emotional support to the patient and their family about their illness, their surgery and what to expect. It is also my job to use my critical thinking skills while I am reading their medical history and labs to look for any red flags to present to the anesthesiologist and surgeon that may prevent them from going into the operating room safely.

Earlier in the summer our unit was awarded with the highest patient satisfaction scores of the hospital and given a nice party by administration. It was nice to be recognized like that but I can honestly say that my coworkers and I bust our butts day in and day out to get our patients in and out of the OR safely while dodging “Diet Coke Incidents” in effort to keep our patients satisfied with our care.

The general public has no idea what nurses go through during a workday. They think they do because they watch television. They think that just because we are nurses, we have to tolerate abuse. They have no idea that some of us dreamed of becoming a nurse since we were young children or what we went through to become nurses. We had long hours of study, clinical time in the hospital and nursing instructors that would fail you in an instant if you compromised a patient’s safety. As nursing students we missed out on plenty of  fun with family and friends because we had to study, study, study or work, work, work at the part time job many of us had in the hospital as student nurses.

They have no idea how long we go without food or a bathroom break and that we are expected to function despite the fact that we haven’t eaten or have had to urinate for several hours. They have no idea what it feels like to be barraged with several different situations going on at once always having to stay sharp and on our game because we are dealing with human lives, or that we put our nursing licenses on the line every time we walk into a patient room. They have no idea what it feels like to hold a BSN and a nationally recognized certification and to be screamed at, threatened with violence, sexually harassed and treated in a way that lets us know that they consider what we are doing for them in the care we provide is insignificant. They don’t know how hard we bite our tongues when we are mistreated so we don’t get fired because we really want to scream at them in retaliation while we are trying to be a patient advocate, create a safe and caring environment, take care of the patient and the family, carry out physician orders and be at the ready if an emergency arises.

I often joke if I won the lottery, I’d walk my nursing license back to the board of nursing and retire. In reality I’d miss the interaction with my patients. I’d miss caring for people through life and death situations knowing that I did everything I could to help them and hoped I made a difference even though I may never know if I did or not. There are many of times that I have a wonderful conversation with a patient while I am getting them ready for the operating room and wish I could continue to chat with them. In these cases it’s a win-win situation; I am able to give the patient the last few moments of normalcy before their surgery by distracting them from the reason they are with me and they are able to make my day by treating me with like a human being instead of a servant, reminding me that this is why I went into nursing to begin with. On the contrary I also get the patients that I care for that I look forward to releasing them from my care so that I don’t have to deal with them anymore and who make me wonder why I went into nursing to get this abuse.

I am a big girl and I have thick skin. I have no desire to ever leave the bedside and I can take a lot of crap from people and set limits in a way that doesn’t buy me a ticket into my boss’s office for a reprimand. Sometimes I might just put that large bore IV needle in a place that hurts because a patient was rude, or make them wait for me to get them that Ginger ale they’ve asked for several times for when it’s convenient for me to get it and not at the instant they demand it. Other times if they are really nasty, I might just go silent for the duration of my time with the patient, going through the motions of my job duties, making sure I provide the same safe, effective nursing care I provide for everyone, just not caring for them from my heart. I have no problem asking a family member to have a seat in the waiting room because I don’t like the way they are speaking to me and they are a distraction to me while I care for their family members.

Nurses are no longer the submissive  angels in white with caps that you see in old movies and on television. We are degreed professionals trained to promote health, prevent illness, and care for the sick, disabled and dying. We too are always striving to learn more about the patient care we do so that we can be the best we can be. In reality, nurses shouldn’t have to experience any “Diet Coke Incidents” but unfortunately they do. Moral of the story, treat your nurse like a human being because they are here for you.

The Bigger Picture of School Supplies

Every year at this time my daughter asks me the same question, “Mom when are we going shopping for school supplies”.

Sometimes this question spins around and around in my head like a broken record that is stuck on a song you just can’t stand! She can be demanding about it and always manages to ask at the most inopportune times; when we may be low on money or at a time when it’s simply inconvenient to shop because we have other pressing obligations to attend to first.

When I was in nursing school I had an instructor that told me I tend to be task oriented and sometimes forget to look at the bigger picture. I never forgot that instructor or what she said because it applies to all aspects of life. When I see myself doing that at work with a patient,  I am usually able to catch myself and refocus quickly. As I tend to the tasks of my own life with two teenagers all over the place, a full time job, a household to run, and the things that I am involved in outside of work, I am so focused on completing the tasks I fail to realize what the people in my life truly need from me.

My daughter is my extroverted child. From an early age she’s demonstrated her ability to think outside of the box. It’s my favorite thing about her. She challenges herself with complicated tasks. She enjoys trying new things and experiencing different types of people. She and my husband appreciate sampling cuisine  that our son and I refuse to eat. She looks into the future instead of dwelling upon the past.

While most kids frown at the back to school commercials and the idea of returning to school, she embraces it. At the end of each summer she looks forward to the school year, her friends and her routine. All week she’s been comparing her eighth grade school schedule to that of her friends, taking mental note of who’ll be in her classes this year, her final year of middle school.

This morning as I sipped my coffee and explored the possibilities of today, the paintbrush moved swiftly and in bright colors boldly painted the bigger picture before my eyes. For my daughter, the act of buying school supplies is something she needs. For her it signifies a new beginning, a fresh start with interesting things to learn, exciting experiences to be had and time spent having fun with friends. It energizes her with hope and anticipation.

We don’t have any pressing obligations today as a family. There are so many things I want to do. I hope I can get to all of them before I head upstairs for the night with my dog and my nook. One thing is certain, we will definitely be buying school supplies.