Nursing Voices

Sunday, October 29, 2006

Falling Back... aka the Night from Forever

Anyone else find that the longest night of the year is always one of the slowest?

Just makes that extra hour draaaaaaaaaaaaaaag

A little more.

We did get a good chuckle (ok, that's a blatant lie... we laughed our butts off!) at the three day nurses who all showed up promptly an hour early for their shift. Not feeling a whole lot of sympathy at that point.

Shouldn't we institute a policy of fairness? If the day shift would agree to show up half an hour early, we could split the difference.

Yeah, I know. It'll never happen.

Ugh. My bed calls.

Monday, October 23, 2006

Welcome to OB Triage

Sometimes I'm convinced that the management and physicians have conspired to place a glowing sign at the ER entrance that states (in large flashing pastel pink and blue letters), "All pregnant freaks and their families, WELCOME! C'mon in to OB Triage" To top it off, the sign is only lit during the most inopportune (i.e., already busier than crap) times.

Case(s) and point:

You are 26 weeks pregnant and have been vomiting for four days. You are starting (Starting?) to wonder if something is wrong. When do you come in to triage? 2:00am on a Saturday night.

You are 39 weeks pregnant and twisted your ankle while tripping over your toddler. Yesterday. Oh, and you don't have a car or money for a cab, so you've missed your last four prenatal visits, despite being high risk due to a history of high blood pressure, diabetes and a pulmonary embolus. When do you roll into triage by ambulance (thanks, glad I just paid my taxes so that you could spend about $1000 of my tax money for a ride... oh look, here comes the rest of your family, who got here in their CAR.)? 2:00am on a Saturday night.

You were sitting on the couch naked ('cause that's something I'd admit to my health care provider), 36 weeks pregnant, eating ham (I repeat, while sitting on the couch. Naked.), and your boyfriend took it upon himself to "check" your cervix, only he noticed some green funk down there instead. In addition (as if that were not bad enough), there was something pinkish on your boyfriends fingers when he pulled them back out. But it might be ham. (Gag. True story.) When do you come in to triage? 2:00am on a Saturday night.

You are 21 weeks pregnant and have not had a bowel movement in three (seriously, I'm not kidding) weeks. When do you come in to triage? 2:00am on a Saturday night. (because NOW it's bothering you?)

You are 24 weeks pregnant and have not felt the baby move for "a couple" of days, which concerns you, despite the fact that you weigh almost 400 lbs and probably have a foot and a half of adipose tissue between the baby and the nerves of your abdominal skin. Oh, by the way, you also have asthma and are having a coughing fit but forgot to bring your albuterol inhaler. What else do you take for your asthma? Nothing, just the albuterol, and since you usually feel worse at night, you use it an average of 6 times every night. (Pause, while nurse picks up lower jaw from floor.) And the icing on the cake, you are latex allergic and have a history of MRSA, so you must be kept in contact isolation. When do you come to triage? 2:00am on a Saturday night.

You have not received prenatal care during this pregnancy due to the slight inconvenience of being incarcerated for the last few months, in another state ("It was my boyfriend's dope in the car, I swear!"), and your mother only recently bailing you out. Now you're just curious how far along you are, and "Can we do an ultrasound to find out the sex of the baby?". When do you stroll up to triage? (Are you sensing a pattern yet?) With perfect timing, you, too, arrive in the middle of our "lunch time". (Looks like it'll be a couple of peices of the Halloween candy someone brought in, swallowed whole, on the run, again.)

Yes, there are quite a few legitimate patients who visit the triage unit amidst the chaos. I wouldn't be surprised if most of them get lost in the shuffle.

Hey, at least I still got my health.

Sunday, October 22, 2006


It's been a long weekend on L&D (busy, stressful, all-out-cuckoo?)... you would think that I might be smart enough to come home and crawl right into bed.

But no: I went looking around the internet, and accidentally (or serendipitously) came across an infant bereavement photography website. Couldn't help myself... I started paging through.

And I came across this stunning eulogy that I felt compelled to share. Please be aware, the website also contains photographs of ill and dead infants. However, this father's words were amazing and uplifting in the face of such sadness. I think that it speaks to much of the grief that those of us who work on L&D and particularly in NICU carry with us.

If anyone is in need of a good emotional release, I know it worked for me.

Wednesday, October 18, 2006

Why do we do what we do?

Do you ever feel like a glorified waitress?
I sometimes ponder why we put up with all the baloney. (I'm being diplomatic and politically correct here, in an attempt not to offend those who don't yet know me well enough. Please substitute the actual term I'd like to use in place of "baloney"... use your imagination.)
And does the baloney outweigh the reward?

Would it make a difference if it did?

Men and women enter nursing careers with astoundingly different perspectives and motivations. Certainly, there are enough different nursing fields and forms of practice to satisfy our diverse expectations, but why do we so often "stick it out" in challenging and mediocre work environments?

Honestly, I don't have a global answer for that one and would not presume to venture a guess.
More about the baloney later, I'm sure, but here are a few of the reasons I continue to show up for my shifts (occasionally with bells on):

1. I have to admit, it feeds my family.

2. Most of my co-workers are admirable (if often inexperienced... yes, I do work nights), and we've worked together through those nights from hell, laughed at each others' nutty 5am slap-happy stories, smiled and cried with each other over the joys and tragedies in our personal lives, and managed to keep the unit from completely falling apart at any point to date.

3. The sense of pride and accomplishment when new nurses look to me for help and mentorship... then over time transform into "experienced" nurses themselves.

4. There's nothing quite like the adrenaline rush of a scary or fast delivery. There are those of you who know, it is indescribable.

5. The absolutely unforgettable moments I've spent with close friends who've asked me to be present at the birth of their children, which brings me to perhaps the overwhelming reason I stay:

6. (pause while I sit here and struggle to begin...) I'm having difficulty putting this one into words, but I want to convey my understanding and acceptance of the fact that what I do (help bring babies into the world) is utterly miraculous. I am present at those moments in a family's life that bring both the most anticipated and the most unexpected joy. I also stand by as families experience the most heartbreaking and unspeakable grief. To witness these pivotal moments is both a privelege and a burden, but is definitely one of the most influential factors in my faithful return to the unit, week after week, year after year.

I'll close on that note. There are perhaps innumerable other reasons to "stick it out". Sometimes, it feels as though they are not enough.

Tuesday, October 17, 2006

A Start

I'll never claim to be an expert with my finger on the pulse of nursing issues. With the time I might find to devote to this blog, I can't possibly hope to be as well-informed and widely read as many of those whose blogs I have witnessed. This blog will be primarily for self-expression, exploration and amusement. A place for the rational and not-so-rational sides of me to meet. Congregate. Who knows what might happen? I enjoy perusing the other nursing and medical blogs and would like to think that I might have a unique perspective to offer. Any comments are welcome. I look forward to the communication and fear only that my little corner of the blogosphere will be undeserving of the readers who may venture here. Oops, little too much honesty and melodrama there for a minute. (deep breath) Salad tongs, anyone?