Hasta Luego

To all my faithful readers... I can't imagine there are many of you left out there.

Just a quick hello and "see you later" (not exactly goodbye).

Blogging is just not happening in the midst of my busy life right now, and I'm "giving up" on it for now.

I appreciate all the thoughts, feedback, and smiles you've provided. I hope to check in on your blogs when I get a chance... you've always been a source of inspiration and encouragement.

So, for now, hasta luego!

Still Here.

If there has been a lack of writing as of late, it hasn't been for lack of things to say, just the time in which to put the words to "paper" (or screen, as it were).

Status: MIA

Hope to be back in full force soon.

Working Hard, Even When You're Not There

Vivid dreams of a terrible shift... working, working. So busy, patients everywhere, bad heart tones in every room. I must have been in charge... I found myself running from one room to the next, putting out fires, starting IV's, calling docs. Remember struggling for a while with IV lines that were hopelessly tangled, and not compatible with our pumps, so I must have dug up an ancient pump from somewhere and figured out how to get the IV running and attached to a pole. Ran to another room to help with an IV, and a newer nurse was poking her with a 20 gauge... thinking, "What are you doing?! We need an 18 gauge!"

In the midst of it all, my kids were there with me, except it was my friend's kids, but they were mine, and the baby was so small, and I had to hold him while he slept. It really pulled at my heartstrings as the chaos swarmed around us.

So strange.

And I haven't even worked my first night this week.

And on a BUSY night...

Finally, a busy night with the pedometer, and I feel somewhat vindicated.

15,367 steps!

That's 7.03 miles!

My dogs are barkin'... time to put them to bed.

MAGNETism

I am ambivalent about my hospital's claim that we are seeking Magnet status. You can find more information about this designation here.

At times, I feel inspired to aid in the effort, certain that if we can find enough like-minded colleagues to work towards positive change, we can make it a better workplace. I am often proud to acknowledge that I am part of such an esteemed institution, that we can provide professional, highly-specialized and complex, but heartfelt, individualized care to a high volume of patients. I assume that my fellow nurses choose to stay because they, too, appreciate the high expectations and abundant opportunities inherent to a large teaching facility.

However, there are also times when I am discouraged by the ridiculous processes and mindless functions of the executives and managers who spend so much time talking in circles and sitting on committees that accomplish nothing. How can we effect change if those in leadership roles care more about the statistics than they do about the people "beneath" them who are daily offering their blood, sweat, and tears at the bedside? I wish I could say that we have a cohesive team from top to bottom, but I am constantly reminded that this is simply not true. There are an abundance of petty battles being waged at any given point, with very few satifactory resolutions made.

To my fellow bloggers: Do you work for a Magnet hospital? I would love to know... how is it?

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A few other random thoughts:

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It was an incredibly busy weekend. Low staffing didn't help: it would not have seemed quite so out of control with a few more warm bodies present, but we made do (as always) with what we had. Now that all the holiday celebrating has ceased, we have settled back into the normal routine... busyness as usual. Today feels like I'm recovering from a marathon: achy head, sore shoulders, heavy eyelids, sore throat. I still didn't manage to get a pedometer for Christmas, so I'm not sure how many miles it was this weekend. It felt like at least a marathon's worth!

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As a charge nurse, I often step into the room for the actual delivery, to make sure that there are enough hands available and that the newborn can receive any extra care if necessary. Sometimes I miss having a close bond with one patient and seeing her through the entire experience, but it is thrilling to be present for so many of those most magical of moments. Within an hour and a half the other night, I witnessed a natural (and naked) birth that was documented by a professional photograper and videographer, the birth of an undiagnosed Downs Syndrome infant, the birth of a first child after days of labor and hours of pushing, and the birth of a sweet babe with a previously diagnosed cleft lip and palate.

Sigh... our bodies are so amazing. And sometimes they betray us, but that's a post for another day.

Bone Tired

I am not even kidding.

When I finally get myself a friggin' pedometer, I am totally going to get on here and brag. I must have walked/run at least 8 miles last night.

And when we're already crashing a patient who's bleeding out, is it really necessary to clue me in on the fact that the patient who was 8 cm when she got to triage is (oopsy) also BREECH?

So what if I'm in charge? At that point, I just don't wanna know.

Realized at 5:00am that I never ate lunch.

Too late now. I'm sure I'll make up for it at a later date. You know how we nurses like to enable each others' eating habits at the holidays!

Off to bed... I feel a coma coming.

Food for Thought

How not to make friends with the Neo charge nurse: give her a 28 weeker, 30 week twins and then 30 week triplets over the course of about 4 hours.

Huh.

I'll try to remember that one next time.

Probably best not to mention the 26 weeker with a bulging bag at this point, huh?

I've been busy.

From the Merriam-Webster Dictionary:

Main Entry: hi·a·tus
Pronunciation: hI-'A-t&s
Function: noun
Etymology: Latin, from hiare to yawn -- more at YAWN
1 a : a break in or as if in a material object : GAP b : a gap or passage in an anatomical part or organ
2 a : an interruption in time or continuity : BREAK; especially : a period when something (as a program or activity) is suspended or interrupted b : the occurrence of two vowel sounds without pause or intervening consonantal sound

Can the word "yawn" be contagious when read?

As the day charge nurse aptly put last night upon my arrival, "Everything was going okay until 4:00pm, when the skies opened up and started raining pregnant women!" Well, the day nurses this morning came on to a very nice board, due in large part to the fact that we delivered the whole flood of patients that were left to us, along with another wave that followed.

Note to self: do not EVER make comment to departing shift based upon the current census on the floor along the lines of "Well, it must have been a good night (or day, as applies to situation)... you're all just sitting around." The fact is, we got our butts kicked and then did it all over again a couple of times and right now we're sitting here staring at each other because every ounce of energy we may have had is completely gone.

On that note, nighty-night!

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.