Chaos

From yesterday’s Daily Prompt.

As I write this, “Lose Yourself” by Eminem is playing on my Pandora Radio. It reminds me of the chaos that was in my mind and in my heart this morning when I started work. On days like this I ask myself the same questions. Did I really choose the right profession? Has my burn out returned? Have I become desensitized? Why can’t I win the Powerball and retire?

I am a peri-operative nurse. My day begins at 0430 when I wake up feeling sorry for myself because it’s the ass crack of dawn and no one else is awake at that time but me. I get ready for work and my jeep/broom takes flight to get me to my 0600-1530 shift four days per week. My job is to prepare patients for the Operating Room. I review their history and physical, labs and diagnostics searching for red flags to alert anesthesia providers and surgeons about that may prevent the patient from getting into the operative room safely. I do a physical assessment, a care plan and a preoperative check list. I also initiate IV access and infuse Lactated Ringers and medications while they wait. On a rare occasions I’ve transfused blood before sending the patient to surgery. There is much critical thinking and hustle involved in this type of nursing and my time as an Emergency Room nurse prepared me well. My department opens at 0600 and we hit the ground running. By the time the first cases go in the OR at 0730, all twenty nine rooms in our area are full.

Chaos is inevitable when there are sixty OR cases in a day and two RNs called out. Of course I didn’t realize we had the call outs and I saw how badly my assignment sucked. It’s really fun being pissed off ten minutes into the shift and then try to put on a happy face so your patients don’t think your crazy said no nurse ever. I started my morning with two patients to get ready by 0730. One of them was not told the right time by the surgeon’s office and arrived way later than she should of. Put your foot on the clutch, drop the gears and move your ass nurse. My other patient was febrile, very sick and most likely septic. After much ado her surgery was cancelled and we took her to my old stomping grounds, the Emergency Department.These two patients were very kind and for that I was thankful. I took it one task at a time with each patient, expressed gratitude for everything that went right and drudged through it.

The two surgeons I worked today with are nice but not my favorites to pre-op for. They can be irrational, unrealistic and pushy when they change the order of who gets surgery first and all of their patients are train wrecks and take forever to get ready. Their lack of understanding for exactly what we have to do to get these patients ready safely puts me on edge as does everything I have to say to explain this to them. Sometimes I feel like I’m Charlie Brown’s teacher. Wa wa, the patient arrived late doctor.  Wa wa the patient has 20 medications to reconcile and they were not put in the computer by Pre Admission Testing doctor. Wa wa. I’m having trouble establishing IV access doctor.  Wa wa. I’m moving as fast as I can and trying to bite my tongue because I’m about ready to tell you to get off my ass and then I’ll get in trouble for my mouth. Wa wa wa doctor I know you are not listening to me trying to tell you I’m trying to get your patient ready safely. Yes doctor I’ll hurry.

My patients were sick today and I fought an uphill battle getting my patients ready until I got all of my patients into the operating room ,went to lunch and carried out the rest of my crap assignment. No wonder why I had heartburn when I left work today. Through the course of the day I realized that all of my coworkers were equally as miserable. Not that I like misery loves company, I felt justified because my feelings were not alone.

Days like this happen to every nurse on the planet and sometimes I want to punch that little girl who decided to become a nurse when she was four right in the back of the head. Other days I couldn’t think of anything else I’d rather do for a living. Very rarely do I tell my family exactly what happened during my work day because I leave it at the door of the hospital and don’t bring it into my house. When asked by my family how my day was, my answers are either, good, bad or busy. We all somehow find a way to survive and keep up with the flow to get through the day. Sometimes I wonder how I managed to get through days like this. The answer is simple. I am a nurse. I can do it.

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Music

This is a Daily Prompt from six days ago. This is the first time I have responded to one of these and it took me several days gather my thoughts. I have a lot to say about Music.

Music has always been that song that comes on the radio that makes you feel so good. It could be a new song that you know you’ll love forever or an older song that you haven’t heard in awhile that immediately makes you smile the moment you hear it.

In recent years, Music has taken on a deeper meaning. It’s having my own brass section in my house. It’s the sounds of my son’s trombone and my daughter’s trumpet that resonate with me year after year as I hear their music abilities grow and evolve. It is the memory of the first time I heard each of them play their instruments in fifth grade. It’s listening to them practice diligently even if it’s getting later in the evening and I’d prefer the house be quiet as I get ready for bed. It’s watching them enter the stage looking like professional musicians in their concert attire and letting myself be carried away by the music they play with their peers. It’s listening to their band directors speak after a concert and feeling in my heart how much the band directors enjoy teaching music at the high school, middle school and elementary school level. It’s every concert, marching band event, state solo and ensemble event, all county honors band and orchestra event, jazz band and all county honors jazz band event that I’ve watched them perform in.  It’s all the awards and recognition they’ve received for their hard work. It’s a band parent being able to train their ears to hear their child’s instrument during a performance. It’s a hope that even though my son will not major in music in college, that he will join an ensemble for fun in addition to college marching band. It’s a hope that my daughter will enjoy band and marching band in high school as much as my son. Finally, it’s the community of band within our community that my family now belongs to because our children love it so much.

Who I am and Why I am here

Who am I? I am “that nurse”. Through the course of her adult and professional life, that nurse realized that writing feels natural to her. In high school, it was that nurse’s father who sat at the kitchen table with her, read all of her papers and taught her grammar and how to properly word her ideas to make her writing flow. At first she was perplexed as to how her father could actually do this eventually she caught on. These skills carried her through nursing school, nursing documentation, writing necessary for life and her bachelor of science in nursing degree. She wrote paper after paper while she was completing her degree and realized that she’d much rather write a paper than take a test. Since then, that nurse has encountered several people along the way who have complimented her on her writing and encouraged her to take it further. That nurse started this blog June 2015 at the suggestion of those people. She has a handful followers that include family and friends and a few fellow word press bloggers.

She’s here because she wants to be a writer as much as she wanted to be a nurse. She wants to reach someone with her writing in the same way she’s contributed to the healing of her patients. She is an avid reader. She observes the writing style of the books she reads and follows her favorite authors on social media. She imagines creating her dream writing sanctuary and becoming a success just like them. She has her enemies though. Insecurity, doubtfulness and sleep deprivation are nasty little voices that arrive out of the blue and know how to ruin the high a writer gets from producing a piece that they are proud of. Insecurity tells her she’ll never learn to write creatively and no one cares what she writes. Doubt tells her she’ll never establish herself as a successful writer. Sleep deprivation is probably the ugliest enemy of all. It is a black cloud that surrounds her Monday-Friday. It causes her to lack motivation, mental clarity and the discipline to write every day and quite frequently invites insecurity and doubt to join in. She knows now that if she really wants to chase those enemies away, she just needs to write, write and write. She pictures herself putting her hands over her ears singing “la la la, I can’t hear you” until she can no longer hear her enemies.

Maybe whoever is reading this is wondering why this post? That nurse doesn’t give up. Today that nurse decided to participate in a blogging course offered through word press entitled Blogging: Learning the Fundamentals. The first assignment was to answer Who am I and Why and I here and to tag. That nurse hopes she did the tags right because she’s not real computer savy.

Lastly, that nurse would like to thank all of those who have taken the time to read her posts.

Friday Adventures 

I went on a little adventure on Friday. What I gained from it is a priceless sense of independence and empowerment. I’d experienced this activity countless times with my family but have had a growing urge to try this alone. I’ve lacked the courage to do so in the past for two reasons: my sense of direction is a few fries short of a happy meal and I didn’t want to be murdered by the Boogie Man. Friday changed all of that for me. I finally went hiking in the woods by myself! 

We have the privilege of living near a state park that has a diverse ecosystem with an abundance of of wildlife, trails, streams and a river that I’ll never get tired of looking at. This place is becoming my new best friend, gym and place of solitude where I can leave my worries, my busy schedule and my job at the entrance of the trail. 

I realized as I was parking my car that I’d forgotten the map of the park that my husband had printed for me so I had to hike the trail relying solely on my memory from the one and only hike I’d taken on this particular trail with my family the weekend before. Fortunately this park color codes the trails. Once I found the turn off for the blue trail I knew I was on my way. 

My first obstacle was to cross a small stream. I’ve crossed plenty of streams and rivers but this one was different. I was alone. I had to survey the stream to find the safest place for me to cross. It was a tricky little stream with large rocks under water that could be slippery and if I stepped wrong I could fall. I was able to cross the stream and check box that obstacle. 

My sense of awareness changed after I crossed the stream and entered the deeply wooded area. My ears and eyes were in the drivers seat. My ears identified each and every word that nature spoke; the hollow sound of my footsteps on the ground, birds welcoming me, raindrops softly hitting the  fallen leaves and of course the silence. Occasionally I’d hear a cracking sound and wondered if it was an animal traveling through the brush or a branch that had fallen from a dead tree. My eyes focused on my surroundings, the beauty of the forest and the patches of blue painted on various trees indicating that I was on the blue trail. Look for blue. Stay on blue but don’t forget to do a 360 every once in awhile to make sure the boogy man isn’t behind you. 

I hiked along, kept my eyes open for blue, and remembered every land mark I’d made a mental note of from my hike with my family the weekend before. I listened intently to everything nature whispered to me. Each time I changed elevation, the woods presented me with a different flora to observe and a new appreciation for the experience. 

After I was about three quarters of the way through the trail I encountered a fork in the trail. Orange was to the left, blue was to the right. I did not remember this part from my previous hike with my family but I was alone and I had to decide what to do. I chose orange because it veered left and I felt that was to the direction that take me to the main entrance trail. I started getting nervous because I didn’t recognize the scenery but I knew as long as I stayed on a trail I wouldn’t be lost. From a distance I could hear the sound of the flowing river telling me I’d soon pick up the blue trail and sure enough I did. 

I could not contain the smile that came across my face as I approached the main trail that would take me out of the park. I didn’t want to leave but it was time for me to re-enter society, go to the grocery store for the ingredients for the supper that I’d make and then greet my children as they arrived home from school. 

I grew up in an era when kids played outside. I spent plenty of time outside with my brothers and the kids in our neighborhood swimming, riding bikes, playing ball and getting dirty. My family did not however, have an appreciation for the outdoors. We didn’t hike, fish, camp or spend time on the water the way my husband’s family did. 

Each decade of my adulthood has had a different theme. I am now midway through my third decade of adulthood and the theme of this one has been to earn a bachelors degree, change jobs, participate in my children’s extra curricular activities and stand by my husband as he earned a master’s degree. It is in this decade that I have developed a hunger, yearning and an interest in the outdoors. I want to be able to occasionally leave the craziness of life at the entrance of the trail to hike, fish and eventually learn to camp. 

I believe that everything comes in time at the right time. As the decades of my life unfold there will be more time for the outdoors but I know where that trail is, that I can hike it by myself and that when I need to leave society at the entrance of the trail if only for a few hours it’s there waiting. 

Nurse by Day, Painter by Night

Nurse by Day, Painter By Night

Recently I attended my first “Paint Nite”. One of my coworkers sent out a group text message in December with the idea of getting a group together and I’d been eager to try so I jumped at the opportunity.

The venue was a gym that happened to be a large enough to house a little pizza place in the lobby. That was a contradiction in itself, here we were stuffing our faces on pizza, calzone and alcoholic beverages while the gym members were pumping iron and sweating it out on a Friday night. I realized later it wasn’t the best place for a paint night. It was difficult for us painters to hear our hostess because we could also hear echoing sounds from the gym; weight lifters grunting, weights clinking into place and the hum of exercise machines.

I arrived early enough to observe the paint night hosts set up for the evening. There were three rows of long tables and chairs. Each table seat contained an easel with a canvas, a Styrofoam plate with a splat of yellow, blue, black, white, red and brown paint and an extra plate. Under each plate was a paper towel. The paintbrushes were passed out next. There was large fat brush, a medium brush and a skinny small brush. The last thing passed around was a cup of water that would be used for rinsing our brushes.

The tables filled quickly with guests greeting friends and ordering snacks and drinks in preparation for the event. Our Paint Nite Hostess gave everyone time to get settled, greeted the group and our Paint Nite was underway. We started by raising our glasses and repeating an oath that began with several sentences of, “I promise”. I promise not to get frustrated. I promise not to say my painting stinks etc. Our hostess discussed all of our supplies, the paints, the easel and canvas, the water and the brushes and it was time to raise our brush for the first stroke.

We were instructed to use our large brush to wet the canvas with water and then cover the canvas with white paint. The act of stroking the brush onto the canvas with paint for the first time gave me a feeling of exhilaration. At that moment I was nothing else but a painter and all of the worries of the outside world were nowhere to be found in my subconscious mind. The act of stroking the paintbrush from one end of the canvas to the other gave me a new found sense of freedom. Next it was time for blue. The hostess instructed us to paint several diagonal blue streaks onto the canvas and then brush white paint into it. This was our sky. Our hostess encouraged us to add our own flair to the painting by using different colors if we wanted to. I had to laugh at a girl sitting a few seats down. She said she didn’t know enough about painting and colors to deviate from the norm. I nodded my head in agreement. I experimented with a few different colors of the sky and my sky looked like a storm was coming so I tried to get it as close to the blue sky as I could and had some success.

It was time to rinse off our large brushes, dry the brush and dip the large brush into brown paint to paint the branches of the trees. I watched our hostess carefully as she demonstrated and then I watched my friend to my left, took a deep breath and stroked the canvas with brown paint to form branches. Ok I can do this. I didn’t care for this next part though. The hostess instructed us to put white paint on the top of the branches, which I did and it made my branches look washed out. I didn’t let it put a damper on my enthusiasm; I just made a mental note to deviate the next time I don’t agree with something.

With each new structure on the painting, I found myself becoming more comfortable, I was finding my groove. We mixed blue and yellow paint to make two different shades of green, a dark green and a light green. As we put the leaves on the trees, some of the painters used long strokes to paint the leaves. I remembered the scene in the movie Stepmom where Julia Robert’s character teaches the young girl to paint leaves on trees by spackling. I spackled my leaves giving them a fern like appearance. I was pleased with that. I also added random long green strokes to some of the branches to give it some variety.

The final component of the painting was the cardinal birds. The first bird was a nightmare. I realized that I should have worn my glasses because I had difficulty seeing the hostess with her painting to my left and at the other end of a long table. It was also becoming loud in the gym. My first bird turned out to look like a fat red sea horse. The hostess helped me adjust it but it made it worse and I seemed to lose understanding of when to use the two shades of red we had created by mixing red, yellow and white paint together. Inside I was nervous about messing up the second bird. I lived in Saint Louis, Missouri for nine years and grew to love the Saint Louis Cardinals. It took me several minutes to begin the second bird. I finally mustered up the courage to put my first stroke on the second bird. Miraculously my second bird came naturally and I ended up loving it. I added my finishing touches to the bird and the rest of the painting, wrote JAC 16 in the lower right hand and my first painting was complete. I was pleased.

Last year, at the recommendation of a mentor, I purchased a book called “The Artist’s Way” by Julia Cameron. It is a twelve-week program designed for artists of all kinds to recover their creativity from a variety of blocks. One thing I have learned is that in order to enhance your preferred form of creativity, you must partake in different forms of creativity. Last summer I picked up my cross stitch again after a fourteen year hiatus. While on vacation, I cross stitched, read and stared at the lake. I felt my creativity creeping back in. That’s why this paint night was perfect for me as a writer. I have a new creative outlet to partake in. I’ve been curious about Paint Nite for over a year. I recently a purchased paint by number set from my craft store with the intention of trying a painting out if I didn’t get into Paint Nite soon. I look forward to the perfect week in “The Artist’s Way” that I can enhance my creativity by sitting down to paint. My biggest writing block is clutter. When my life becomes cluttered in several aspects, my creativity fades away. It is my goal for January to get rid of clutter, revisit “The Artist’s Way”, write and paint. It is doubtful that I’ll every become a Picasso but why not fill my writing room with my paintings?

 

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.