The FMLA is a combination of good and bad, I think. From the perspective of motherhood and having babies…

I remember when my daughters were born- I had worked through each pregnancy right up to the day each was born, literally. Early in each pregnancy I went to Human Resources to tell them of my pending leaves, which I had planned on lasting about four weeks. I was told my job would be safe, probably, and that if not, I would be brought back to a similar position with similar pay and benefit. I managed pretty well- taking the four weeks of leave and returning to the same job in the same unit on the same shift. Had any of these factors changed, especially the SHIFT, I would not have been able to return to the job.

There were no laws protecting jobs back then.

A pro-business group is touting a national survey that says a majority of Americans think the 15-year-old Family and Medical Leave Act needs tightening to eliminate misuse.

The poll by National Coalition to Protect Family Leave, a broad-based group of organizations such as U.S. Chamber of Commerce and National Retail Federation, said that although more than 70 percent of Americans said the current system is “mostly fair,” nearly half of the respondents said they had firsthand experience of misuse by co-workers.

Survey respondents are also concerned about whether the misuse of FMLA would jeopardize public safety. More than 60 percent of people said they would be more likely to support FMLA reform, provided that “the staffing of hospitals is impacted when unscheduled FMLA leave is taken” and “vulnerable citizens, such as children waiting for a school bus or people in need of emergency 9-1-1 services, are left to themselves.”

Now, employers must guarantee the positions will be held for up to 12 weeks, same pay, same status, benefits and no loss in seniority. The problem with this when you work in nursing is fairly big…that’s 12 week of working short. That directly effects patient care. And when you work with a lot of women, this isn’t a rare occurrence.

One year, we had 5 co workers who were pregnant, all within the same time frames, and all of whom took maternity leaves at around the same time. It was a substantial burden to cover their shifts- even with the best pre planning. My employer wasn’t allowed to hire others to fill the open slots; they had to force many others to work overtime or, bring in agency nurses and aides at extremely high pay rates. The Agency option didn’t cover much- since those who work for such places can pick and choose their shifts, we were not able to cover even a tenth of the openings. Women like me, who had little kids at home, were made to work many double shifts and a day off was almost unheard of.

It certainly didn’t feel very FAMILY like to me! In fact my family rarely saw me during those times. Sure the pay was awesome, but nothing can replace being with your kids when they are small. I had to get sitters for the double shifts I was made to work- since my X worked evenings. There went most of my overtime pay…My family suffered because of this law, IMO.

Then, a couple of the new Moms decided they didn’t want to return to work after being at home with their newborn babies. I don’t blame at all- babies are precious and really need their Moms to be with them for the first year if not longer. But, for me and many others, this wasn’t an option in our lives. Needless to say, we had to work another five weeks or so of mandated overtime until the newly hired staff were trained. This scenario played out three other times at the facility I work at. It wasn’t a one time thing.

So I think the law has some good to it…but I also believe it creates a burden not just for the employer, but the employees left behind to pick up the slack. In nursing, the slack is patient care. Is this a case of unintended consequence? When a law designed to *protect* one group of workers infringes upon the lives of another group? The irony of it all is this is about FAMILIES. While one family is allowed to bond and not have to worry about employment, another family is temporarily torn apart due to their employment.

I wanted to remind folks who come here that I work the weekends.

I skip and hop to work Saturday morning at 6am and work until 10pm; go home and sleep for a few hours- get up at 5am Sunday and drag and pull myself back to work for 6am for another 16 hours. Go home again, sleep for another precious few hours so I can be at work on Mondays at 6am…usually I get out at 2pm, but today I’m suffering from

WORK DERANGEMENT SYNDROME.

I’m still working and will be until 10pm. I am exhausted and more than ready for some REAL SLEEP- like 20 hours of it! The posts up from the weekend and today were all done on the fly- posted ahead of time and published at times I thought would be good. I’m not ignoring comments- I just haven’t had time to respond.

I will be back sometime tomorrow. After I sleep.

An post over at the WSJ Health Blog caught my eye:

Nurses are beaten and abused, pinched and punched by deranged and demented patients.

The rough treatment of nurses by some of the people they care for isn’t an issue that gets much attention, but it should, Illinois doc Ben Brewer writes this his WSJ.com column. “Nurses get assaulted all the time at work,” he writes. “They get assaulted in small and large ways at every hospital and nursing home in the country.”

The subject comes up occasionally in the medical literature (see this study, for example), but for the most part everybody assumes it happens and there’s not much to do about it. Nurses are the infantry of the health-care system.

Brewer rolls out one example after another. The young nurse with the long scar on her forearm, where the surgeon went in to fix tendon damage after a patient violently twisted her hand and bent back her fingers. The ICU nurse with a deformed finger and nerve damage from a patient’s bite. The nurse who got punched in the ear.

He notes that patients are restrained less often than they used to be, but he suggests that more frequent use of restraints probably wouldn’t do any good. “Usually it’s the one you don’t see coming that gets you,” he writes.

Yea? Let’s talk about this rough treatment:

Nurses and aides are:
Hit
Punched
Kicked
Bitten
Pinched
Held semi captive by hair pulling
Picked up and thrown
Targets of objects being hauled across rooms- everything from a simple hair brush to entire hospital beds.

…and otherwise roughened up and abused by our patients.

On a daily basis.

Read the rest of this entry »

The mother of one of my patients (a Marine) pointed me to this article this morning. She was quite upset with the portrayal of wounded soldiers and Marines in the manner presented in this story…and her words resonate strongly:

“Be grateful they have memories of their battles. I would give anything including my own life for my son to remember.”

TEMECULA, Calif. (AP) - He was one of America’s first defenders on Sept. 11, 2001, a Marine who pulled burned bodies from the ruins of the Pentagon. He saw more horrors in Kuwait and Iraq.

Today, he can’t keep a job, pay his bills, or chase thoughts of suicide from his tortured brain. In a few weeks, he may lose his house, too.

Gamal Awad, the American son of a Sudanese immigrant, exemplifies an emerging group of war veterans: the economic casualties.
[...]
“The wounded and their families no longer trust that the government will take care of them the way they thought they’d be taken care of,” says veterans advocate Mary Ellen Salzano.

How does a war veteran expect to be treated? “As a hero,” she says.

Not all soldiers and Marines will agree with this. A great many of them would prefer not to be known as heroes. My work is with profoundly brain injured young people- teenagers, young adults and we serve some wounded Marines now. You learn a lot about human strength through the struggles these families must endure. And like my patient’s Mom says- theres a fine line between garnering sympathy and expecting the government to fix every problem, vs. taking charge of your own problems and working towards a solution. The battle of recovery can be optimistic or pessimistic. Most people find a balance- they mourn what they have lost, yet they are also grateful for what they have.

Every morning, Awad needs to think of a reason not to kill himself.

He can’t even look at the framed photograph that shows him accepting a Marine heroism medal for his recovery work at the Pentagon after the terrorist attack.

It might remind him of a burned woman whose skin peeled off in his hands when he tried to comfort her.

He tries not to hear the shrieking rockets of Iraq either, smell the burning fuel, or relive the blast that blew him right out of bed.

The memories come steamrolling back anyway.

“Nothing can turn off those things,” he says, voice choked and eyes glistening.

You know, when I read lines like this, I lose respect and sympathy…does that make me cruel or cold? I don’t think so. Mr. Awad should realize he is lucky to be alive. He should visit with some of my patients- who are alive, but who have lost it all. My patients who have little to no recollection of their personhood- or their family and friends. They who have lost portions of their brain yet manage to breathe and who are kept alive by machines.

When the time comes for the machines to stop doing the work, many of my patients continue to live, but they are never ever going to be the person they were prior to their injuries. As mean as it sounds, the Mom made reference to the sad thought she had- where she wishes her son would be able to express feelings and suicidal ideation. She would give almost anything for her son to express his thoughts, to cry, to have emotions and to feel anger.
She hasn’t heard her sons voice in 5 months. Chances are very high she never will hear him speak again either.

He stews alternately over suicide and finances, his $43,000 in credit card debt, his $4,330 in federal checks each month - the government’s compensation for his total disability from post-traumatic stress disorder. His flashbacks, thoughts of suicide, and anxiety over imagined threats - all documented for six years in his military record - keep him from working.

The disability payments don’t cover the $5,700-a-month cost of his adjustable home mortgage and equity loans. He owes more on his house than its market value, so he can’t sell it - but he may soon lose it to the bank.

“I love this house. It makes me feel safe,” he says.

Awad could once afford it. He used to earn $100,000 a year as a 16-year veteran major with a master’s degree in management who excelled at logistics. Now, at age 38, he can’t even manage his own life.

Sometimes people take advantage of post traumatic stress syndrome and all the havoc it can wreck. Other times people blame their already present problems and use a newly DX PTSD as an excuse. It’s very difficult to differentiate from the real honest life altering problems PTSD can create. Is it up to our government, the VA and military, to cover the expenses of those who are taking advantage? I think not. My patient’s Mom was extremely irate about this because, again, she would move mountains to hear her son complain about his finances.

There’s another twist. This dedicated Marine was given a “general” discharge 15 months ago for an extramarital affair with a woman, also a Marine. That’s even though his military therapists blamed this impulsive conduct on post-traumatic stress aggravated by his Middle East tours.

Luckily, his discharge, though not unqualifiedly honorable, left intact his rights to medical care and disability payments - or he’d be in sadder shape.

Hmm…Problems in marriages are forever present; and yes the separation of wars and battles can amplify them. An act of infidelity could be called impulsive…but a longer term “affair” cannot. We make choices, and we know the possible outcomes of our actions for most choices we make. Mr. Awad is trying to pass the buck here, and I’m pretty shocked his therapists have helped him along. In my opinion he is certainly taking advantage now.

Divorced since developing PTSD, Awad has two daughters who live elsewhere. He spends much of his days hoisting weights and thwacking a punching bag in the dimness of his garage. He passes nights largely sleepless, a zombie shuffling through the bare rooms of his home in sunny California wine country.

Few anticipated the high price of caring for Awad and other veterans with deep, slow-healing wounds.

Awad needs to just deal. He needs to get a grip and stop blaming everyone for his own problems, and especially he needs to stop expecting the government to bail him out. He’s lost much, yes. But he’s brought a lot of this upon himself. Whether he was rational or not isn’t in the running here- hes become a loose cannon in his own battle. He can change his course if he wants. He can become the man he once was- he has all his parts and most importantly, he has his brain, his mind. So many others do NOT.

Millions of fine men have seen much worse than he has; millions of men have been to war, come home, canned their battlefield memories and moved on with life. Some suggest repressing those memories is not a good thing. Maybe. But men have the ability to do this and do it well. My own father was a WW 2 veteran, who saw a lot of action, he saw entire ships blown up and men’s bodies strewn across the oceans in bits and pieces…he lost many friends. He also bared witness to the horrors of the concentration camps as they were found in the days right before that war ended. He didn’t dwell upon the sights and scents; he didn’t speak of these things often. He got on with his life, enjoyed that life and made a good name for himself.

Compare the young Marine who lost half of his brain to an IED in Iraq…who is alive, barely and whose body is merely a shell of what he once was; he who cannot look around because his neck is paralyzed. The once strong and handsome young man who had a beautiful and sexy girlfriend- that he bragged about to his buddies and shared tales of lust over. When he sees her picture, the only reaction might be a tear. The young man who has no control over his bodily functions, who cannot eat orally, who will never walk, talk, make love, dance or drive or have children. Never mind the career, the house, the worries about finances, the dreams he had of his life…and God only knows what his nightmares might be like now.

Mr. Awad needs to stop taking advantage of the problems he calls insurmountable. The mind is a terrible thing to waste Mr. Awad; but it’s even worse when its taken away from you. He really needs to meet my Marine patient and his Mother - and take stock of what’s truly a loss.

They grow so fast.

Pepe…as his name appears to be at this point.

He’s losing his black coat and it’s growing in brown…which is his true color. Soon enough he will be a true Chocolate Golden-doodle. I wonder how big he will get? If he’s anything like Taz, he will be HUGE.

I’m sitting outside right now, snapping pictures of my puppy and sipping a spiked apple cider. And thinking about work. Last weekend was pretty rough. A favorite patient of mine coded, and we “saved” him… and I just heard he died today. It took him a week to do so. Sometimes I ask myself, when these codes happen, should we do it all? Is it worth it? Of course, legally we have no choice in most cases. We have to not only do it all, we have to do more. And the life is often saved but only for the short term. We’re pretty invasive too, when someone codes. It’s not a pretty sight; heck it’s not even as cleansed up as a show like Grey’s Anatomy makes it appear.

It’s not easy working with the population I work with. Sometimes it’s a NUT HOUSE at work. I swear Full Moon Madness comes each month like clockwork. A few of the patients are not in comas or other states of altered conscience…usually they are coming out of a horrific brain injury and this is very challenging to deal with. We get beat up, kicked, picked up and thrown, spat at, hair pulled…you name it, we get it. I cannot recall a weekend where I have not been bruised, badly, at work.

When it’s not the patients, it’s the staff I work with. Someone is always in an uproar about something. I have little patience for the bullshit too. I don’t get into stupid gossip sessions and bitch breaks. I rise above the politics of the place (most the time lol) and just do my job…and a lot of the time I do much of my co workers’ work as well. Many of them are half my age and I run circles around every one of them. There is something different with younger people and their work ethic, that is for sure. I don’t like it at all either. Lazy takes on a whole new meaning these days. So does entitlement. Thankfully I don’t need the ego building bulloney so many people seem to depend upon from their careers…I KNOW I am highly skilled and above well tuned into what I have to do.

Work has been busy as hell too…I go in every weekend and run almost all day…my day is 16 hours long and when I stop at 10pm, I usually hurt all all over and feel emotionally drained. For quite a portion of this past spring I worked 12 hour shifts in the Physical Therapy dept…this was a requirement for my schooling. I found that I missed the nursing though, so eventually I started helping in my former nursing dept unit. Now, I’m back there- nursing units, every weekend. In spite of the negatives that do happen, I find myself truly content and satisfied with this work. With all it’s bad parts- nursing- the good is always present. There is nothing like hands on, nitty gritty nursing work to keep a person humble and in check of becoming to big for themselves. The endless tasks that must be done, for me, are what keeps my patients comfortable, pain free and able to heal. Sure, the work is back breaking and I’m never caught up. My feet KILL me by the time my weekend is up. And the pay sucks all in all…But when one sees the real fruits of their labor all the pain of this work is very worth IT. I wouldn’t do anything else for a living.

Which leads me to the thought: Do I really want to be a Physical Therapist? I always thought I did. I have dreamed about it. I respect the work they do and some of it is more important than nursing. I would sure as hell make a lot more money. But I’m not sure I would be…content. And this is very important to me. What good is life when you’re making lots of money- but the manners and ways you earn that money are not fulfilling? Money means nothing to me. Being happy and content DOES.

After work Sunday evening I’m heading back to Maine. Where I will be pondering this, and a few other deep things spinning ’round my head. Life offers us all so many choices and chances; sometimes we’re always looking for more, more when it’s the last thing we really want and need. Damn this cidah must be really spiked tonight! Have a good week.

Who hasn’t had to deal with

MISERABLE

ROTTEN

BACK STABBING

EGO FONDLING

GOSSIPY

DRAMA QUEEN:shock: AND QUEERS:roll:

types of people at work and in everyday life??

CERTAIN mortals have the power to sink hearts and sour moods with lightning speed. The hysterical colleague. The meddlesome neighbor. The crazy in-law. The explosive boss. A mélange of cantankerous individuals, they are united by a single achievement: They make life miserable.

Hmmm….I know a few people who have the ability to make my mood go APESHITTIN pissy in about 2 seconds flat…all I have to do is SEE them and downhill it goes from there.

You call them jerks, dolts and nitwits. Psychologists call them “difficult people.” In fact they are difficult in so many ways that they have been classified into species like the Complainer, the Whiner and the Sniper, to name but three.

Yea? I call them assholes and shitheads. Right in their faces. And I don’t care WHO they are and what special position of power they think they hold over me. PFFT. No need to beat around the bush with these losers. Just tell them to shut up and go away.
(Works for me anyway…):shock:

But in an age when no problem goes unacknowledged or unaddressed, living with such people is no longer the only choice. Instead, an industry of books and seminars has sprung up, not to help the difficult change their maddening ways, but to help the rest of us cope with them.

Bulloney. Who needs to read a damn book or go to some dumb ass seminar just to learn how to tell someone to go F OFF?? People spend WAY too much money and time on this silliness. Really.

The lessons include common sense (talk it out and put yourself in their shoes), character by character tactical road maps and something that the victims of the difficult don’t want to hear: they might be the problem.

Puleeeze. Bore me no more here. Tactical road maps?? THIS ISN’T the Israeli’s and the Pallies, people. This is you and assarts who make you’re life miserable. JUST. TELL. THEM. OFF.

Whatever the reason, “difficult people” gurus are in demand. That is perhaps because everyone knows at least one person who can set the blood boiling. They can be found in corporate offices, on co-op boards, in church choirs and on university faculties. They are the office Cassandra who predicts doom for every project her team initiates, the intimidating boss for whom nothing is ever good enough and the unreasonable receptionist at the motor vehicles office.

Difficult People Guru’s are probably very difficult people themselves. But they manage to pass out advice and make money on it- who knows if they’re right or wrong and WHO CARES??? We don’t need to pay someone to grow us some balls! People have become to soft and sensitive and unable to be frank, blunt and honest.

Yet, some scholars say, the problem is not the difficult people themselves. It is you.

I believe there is a certain amount of truth to this. It’s all in how we perceive these idiOts, these low life JERK OFF’s who so annoy us. I also think if people had enough confidence in themselves and didn’t live under politically correct rules of people-to-people engagement, we would be much more upfront with others. I have gotten into trouble for telling people LIKE IT IS…for being BLUNT, HONEST AND UPFRONT. I’m still standing. I still have my job (16 years now…) I still have my friends. LOL…
I’ve told them ALL off too- bosses, Presidents at my work, Board Of Director types, cops, town selectmen, Senators, friends, family and yes even my dog and cats.

But psychologists say people exhibit difficult behavior because they have a need that is not being met. Understanding that need — a colleague may be snappish, for instance, because his personal life is in turmoil — helps take the sting out of his or her actions, they say.

Bite me. Excuses. That’s all this is. I could care less what problem Joe Blow is having at home- when he’s at work he better be doing his fair share without complaint…and he better be doing it right! If he needs to blow off steam, it’s ok on a break or something. BUT don’t come to work and treat ME like SHIT cause I will bite back. There are exceptions to this of course…I worked with a lady who was being hit all the time at home and she had the bruises to prove it, fresh everyday. She was a BITCH.
I confronted her and told her off…and she just fell apart and let it all out. She never had a better friend after this, and her work ethic grew ten fold over the next few weeks.

Workplaces are competitive environments comprising individuals with disparate styles of working and communicating. With so many temperaments thrown together, every office is a powder keg.

Yea? It’s all the bosses fault when things get like this. Straighten out the boss and this shit don’t happen.

People skills are important. So long as we don’t allow others to control our moods to the point we can’t function. Those who hold power over us think they can manipulate us into behaving certain ways. NOT IN MY WORLD. I don’t tolerate this bullshit. No one should. There’s always a better job. Or better friends. Or whatever…no one needs to be in the company of those who make them miserable.

Another December 25th has come and gone again.

Christmas is what we make it. It’s not always about being with family and friends- although that is preferred by most. Sometimes it’s about personal sacrifice and giving to others what they cannot give to themselves. For those of us who work on this holiday- we don’t complain or get negative. We keep our spirits up and remember: It’s not about us.

There’s nothing like working the holidays. In my line of work someone (more like someONES) has to be working 24/7/365…and this will be my 12th year that I’ve spent my Christmas day- a double (16 hour) shift- choosing to care for those less fortunate than the rest of us. It’s a sacrifice- to me, my family and friends. But it’s always worth it.

We get paid triple time today. Not too bad- it’s like working 6 shifts instead of two. We have the same numbers of staff working- the ratio doesn’t change just because it’s a holiday. The doctors are here; the nurses, aides, housekeepers, maintenance guys. In most healthcare facilities doctors and bosses get this day off and take on the coveted “On Call” status. Not where I work. Management laid out a policy years ago: If it’s your scheduled day to work, you need to be there. Secretaries and similar support role staff get the day off but no one else. The VIPS of my facility were at their desks today.

Our patients have the same needs and requirements today- it doesn’t change just because it’s a holiday. Nursing care doesn’t stop or become less important just because it’s a holiday. Meds and treatments still must be given; baths and showers and ROM must still be done; trach cannulas need care and tube feedings must be given and central line flushes are still necessary- these medical needs don’t stop just because it’s a holiday. Vital signs and arterial blood gas levels must be monitored, and ventilator rates have to be adjusted. IV’s still run on holidays too.

What does change, because it’s Christmas, is the attitude of those of us who are here. We’re more festive. We come to work decked out in holiday print scrubs and we bring in gifts for co-workers; each of us agrees to cook a part of a meal we’ll all enjoy.

The doctors always bring in GOOD coffee - the crap they provide up here SUCKS - and this year we got the really good stuff from our MD’s. Our patient’s families tend to be around a lot on Christmas- and they bring in trays of shrimp, boxes of donuts and platters of cheese and crackers. Some bring gifts for their favorite nurses and aides. The unit is decorated but only to a certain point: Most of our patients have seizure disorders and little things like Christmas lights often trigger epileptic episodes which quickly become life threatening for them. So we don’t have lights. We also have to keep in check the very real possibility of items being medically dirty- infection control rules over most everything else. Little Santas and Elves and garlands and the like are not to be seen on these units- they collect dust and germs which are not at all good for the population who resides here. It’s cheerful but not overly done.

We make the best of it on Christmas. This afternoon, we broke up into two groups. Each group sat down in a private conference room and ate a dinner that was really good: Work provided prime rib and each of us brought in various crock pots and pans full of potatoes, gravies, stews, veggies, casseroles, sandwiches, rolls, pies, cakes, cookies and drinks (non alcoholic of course). We had desserts- so many it was hard to pick one to devour. A couple hours after we all ate, we broke up into the groups again. Outside we went to the field in front of our building…to play a game of rough and tough touch football. That’s a tradition here. We strip out of the work gear, don play clothes and go get dirty and have some fun while we’re at it.

That’s how I’ve spent my day today. It’s almost time to go home. My kids spent their day with their Dad and his family…and tomorrow morning they’re joining me and we’re heading to Maine to the beaches and then to Bar Harbor (yes, in December!!). My kids and I will be spending several days together without anyone else… I’ll be back in the area Thursday to prepare for our BIG ASS New Years Party- at the lodge. We have no idea how many people will show up…it will be well over 200 though. I’m working next weekend- and after my shift ends Sunday evening (New Year’s eve)- it’s MY turn to party.

Heather and Kim will be posting here starting tomorrow…be good to them or I’ll kick your asses.

Recently I wrote a post or two about my total disrespect for those who think places like the Heart Attack Grille are not bashing the nursing profession. This past weekend at work there were some discussions about those TV programs that portray medical people in a way that isn’t quite honest and truthful as well. A few weekends ago, we experienced an event that led me to my ranting post about those sexy non nurses serving up lots of good things to some people…and how I think it is wrong to use my line of work for such things.

Read the rest of this entry »

Sometimes I wonder why I chose nursing as a career. It can be the most thankless, brutal, physically challenging work. The pay sucks; the hours suck. We have to give up our holidays and work swing shifts all the time, often without enough staff. The tasks we do, every day, seem like a part to an endless journey where we don’t see the light at the end of our patients tunnels.

The mundane tasks I perform every shift I work can be frustrating. Nursing staff look at the patient in terms of what their DX is; how much time they will require and who else will be on the assignment; we look at the meds and treatments before we see the person. At times, the patients become the sum of their injuries and we lose sight of the humanity that exists within.

I’ve been here before- being bored, unchallenged. Always, something happens that reminds me why I chose this work over so many other more lucrative and productive fields. I could have been a teacher. Or a doctor. Or an engineer. But I chose nursing because of the difference it made in my life one time.

Working with young adults who made bad decisions is tough. Knowing the histories of these people can really upset me. I often wish I could go back in time, just a few weeks, to warn these kids of what is in store for them if they continue down the roads they so often choose to take. It’s always the boys too- who tend to get into accidents. For every female patient we admit who has been involved in an alcohol related accident, we admit 7 males. Usually they were not only drinking, but doing some form of drug as well.

When I look at the pictures of these kids- recent high school graduates so many of them- I see the potential for a future husband to some lucky-in-love girl; I see a father to some awesome children; I see a person with so much potential. The smiles and happy surroundings seen in so many of these images are in stark contrast to what I see laying in the hospital bed in front of me. A young person, in some stage of coma; battered and bruised beyond recognition. Attached to machines and tubes. On multiple forms of life support. Alarms that go off constantly; lights always on, staff constantly checking their vital signs. What an existence.

They are all of high acuity- and require intense nursing care. At any moment any one of them can go into a code situation.
The fragile human body can only take so much. But the human spirit can take a lot.

When you’re in a coma you are alive. There comes a time when you wake up to dark and unknown surroundings. You can’t speak; you can’t open your eyes; you can’t move. You are in pain. You feel every poke and prodding; you experience a full array of feelings- emotionally and physically- and you have no control over anything. And you hear everything that goes on around you.
When you’re in a coma, you’re often hooked up to so many machines that make noises, you cannot sleep. Strange as it sounds, one can be asleep yet not. I know because I have been there.

A young man came to my facility about 6 months ago- he had been thrown through the windshield, tossed 200 feet and his body slammed into a tree. The car followed him and pinned him to that tree. He broke every bone in his body; he lost the frontal portions of his head. But he lived. He went to a Boston hospital for the initial care and two weeks post trauma he was admitted to my unit. He’s been in a coma since impact.

He has been under my care every shift I work. I have watched his wounds heal. The infections have gone away. The casts are gone and he’s been living in suspended animation ever since. No amount of sensory stimulation seems to have helped him. His level of coma is deeper than most. This never matters.

We always assume our comatose patients can hear everything, feel everything, experience everything. Because those who have been in these states, and who wake up from it, tell us what they heard, felt. Every shift I worked with this kid- I always orientated him to where he is, why, what happened to him, what his condition is; more than this, I always shared the latest news with him. I took risks when I shut off the trach humidifier so that he could hear what I was saying to him; reading the sports sections of local news papers and news from his local town. I placed special headphones over his ears (no small feat when their head is covered in dressings and full of stitches- or when they have no scull) and played his favorite music. After I finished his cares, I would rub small amounts of his preferred after shave stuff on him (in spite of my hatred of these smells). I would add flavoring gels to his lip ointment so that he could taste things. And everything I did with him- I would tell him ahead of time…and warn him when things would hurt.

Working with patients who are in a coma can be downright depressing- so much work is involved and often we don’t see any results from the effort.

Sunday my patient woke up.

I noticed his vital signs were more active than usual. His closed eyes were making random movements- I’ve seen this before. I knew something was going to happen- a seizure, or brain storm episode. I could have attached more probes to him; I could have set up different monitors with special alarms to alert us to a physical change. Instead I chose to stay with him. One on one. My co workers were not impressed with me because this meant they had to pick up my other patient. Tough shit, I told them.

I observed him. Things were happening that indicated he was going to wake up. We called his family, who live three hours away.

His fingers moved. Then the arm. Then his eyes opened. Immediately I dimmed down the lights. The doctors came in and started their little assessments, which meant some pain for my patient…doctors can be the worst when it comes to communicating what they are doing. I had to step in and remind them to talk to our patient- and his eyes found me and in spite of having a huge tube in his mouth, he managed to smile. And his hand touched mine. THAT made my day. And brought me to tears.

I stayed with him for the next 5 hours. We decided NOT to do all the normal care activities in order to allow him some time to absorb his new world. His mother showed up mid afternoon, and we left them alone for an hour.

It’s a miracle, when this happens. Times like these remind me why I decided to ditch the idea of a high powered, high income generating career. Against the advice of so many friends and family, I chose nursing because of the difference you DO make in so many lives. Shattered bodies, lives, shattered dreams and plans…can be healed with the skilled hands and touch of a nurse who cares for her patients. Many nurses do not truly care; they complain and whine about this work and become bitter nazi like bitches. I have to fast check myself every now and again to reaffirm my choice. Sunday, I got a reminder I wouldn’t trade for a billion bucks and all the fame in the world. There is no higher calling than to work in nursing.

I’m on a break at work; it’s been a rough couple days here. I’m bitchy and moody and well, let’s just say-I’m not very personable right now. Everyone is staying away and that is a good thing.

We worked short yesterday. When I say “WE”- I mean me and the nurse. And no one else. From 2 pm on. It was Labor Day after all; a nice sunny warm day and you know- I guess they all just felt they deserved THE day off and the hell with work. The hell with the patients and their needs and wants. And who cares about the staff who have a little bit of moral and ethical responsibility- the little inner voices that tell us– work calls. Go in. Do your job. Do it well.

There were supposed to be 7 of us working, which is challenging in itself…BUT TWO?????? Was totally unsafe and it just can’t happen again. We have 20 high acuity, medically fragile patients. Many have heart conditions. Many have seizure conditions. 10 require ventilator support for breathing; they all have trachs which require constant care. I can say without much doubt it was one of the very worst days I have ever had at work. I called the bosses. Most of them were not home…but, of all the big whigs and nurses and aides who I called, I managed to get a message to one of the doctors. Who shows up at 5:30pm to HELP ME GET MY SHIT DONE. A doctor. MD. Took his Labor Day evening and spent it at work, helping me. Bet not too many folks can say they have seen this sort of thing occur.

He got a good first hand look at how hard this work is- made even more difficult by the endless round of tasks that have to be performed. Nevermind spending quality time with your patients. Just keeping them safe- comfortable, medicated, suctioned, fed, range-of-motioned, bathed, toileted, repositioned (every hour or so)…the constant monitoring of machines and pumps; the checking of valves and lines and tubes and collection bags…the Doc was good natured about it all and he was a BIG help. He called a couple of his friends up to work- they cleaned the kitchen and dining areas and took out the trash (one set of tasks that are usually done by nursing staff)…And they were a set of eyes on those patients who are able to be out of their beds.

Kim and Channy showed up a little while ago…they brought me some Dunkies coffee and Taz- who is staying at work with me tonight. He’s in the back room with me right now…and when I get back out to the unit he hangs out in the living room area with the patients who are up and about. They love him as he is so entertaining. I have permission to let him stay here with me; he had to pass several state physicals as well as specific work rules before he was allowed to roam the premises. He cannot enter any of the actual medical units though. But it’s great to have him here- he makes me smile with his endless licks and happiness.

There are enough of US here today and into tonight. We’re hoping to get in a break later where we can go out to the front field and play a game of touch football. We do that to blow off some steam. The long day is more than half over and it’s much better than yesterday!

…I am often struck by how hard everyone is working. Harder than before, it seems. To be stuck in rush-hour traffic in the early morning is to be surrounded by people who are dutifully making their ways to desks and benches and counters and nursing stations and keyboards and cement mixers and cash registers and stools.

There’s no comparison to ANYONE who is stuck in a traffic jam rushing to a desk, bench, counter or keyboard job….vs those who are working in nursing. No comparison. Nursing is hard work- and this work is done 24/7/365- we have no holidays, no Labor Day.
If we didn’t LOVE this work….

Tomorrow it’s back to work. I’ve been off for three weeks and have savored every moment of it. And spent every red penny I had saved too. The schedule is going to be a little brutal- for the next month or so.

Looks something like this-
Saturdays– 16 hour shifts
Sundays– 16 hour shifts
LABOR DAY- I’m laboring for 12 hours.
Tuesday- 16 hour shift
Wednesday- 8 hour normal person shift
Thursday- another 16 hour ordeal
FRIDAY—–OFF

Then this schedule repeats itself for several weeks, minus the “holiday”.

Thatisall. Have a good long weekend all. Enjoy Labor Day- those who aren’t working!!

You know you’re a nurse if…..

You would like to meet the inventor of the call light some night in a dark alley.

Your sense of humor gets more warped each year.

Almost everything can seem humorous….eventually.

You know the smell of different diarrhea to identify it.

You can tell the pharmacist more about the medication they are dispensing than they know.

You check the caller id on your day off to see if anyone from the hospital is trying to call and ask you to work.

You’ve been telling stories in a restaurant and made someone at another table throw up.

You notice that you are using more 4 letter words than you did before you started nursing.

Every time someone asks you for a pen you can find at least 4 of them on you.

You live by the motto “to be right is only half the battle, to convince the doctor is more difficult”

You’ve told a confused patient that your name was that of your coworker and to holler if they need help.

Your bladder can expand to the size of a winnebago’s water tank.

You find yourself checking out other customers veins in grocery waiting lines.

You avoid unhealthy looking shoppers in the mal for fear that they will drop near you and you’ll have to do CPR on your day off.

Your finger has gone places you never thought possible.

You have seen more penises than any prostitute.

If you are not a nurse and have been sent this by a friend who is, its just to help you understand our mind set and questionable mental status/sanity. Most of the time we function in spite of this sick sense of humor, fairly normally and very responsibly.

Believe me, this is how we think, ALL THE TIME. Scary huh??

From Heather….

Adelphia is now Time Warner?
My trusty Compaq laptops were “outmoded” by HP.
My bank (fifth owners) is now managed by Canadians.
The water that fills my toilet is for sale at a price higher than Gasoline.

When the Adelphia dude showed up for his (between 8:00 and 5:00-”our only type of service call”,and be glad we’re telling you which day) “appointment”, he opined that the reason that the service that has involved 3 systemwide reciever technology tradeouts by the company, and four swaps of failed ones by me, as well as routine channel info blackouts, glitches in the digital picture signal, an astounding amount of “paid programming” filling slots that I paid for entertainment on, five channels that inter-cycle the same short repitoire of “B” movies, and an apparently amazing amount of complexity to switch the (digital) public access channel on and off between towns to settle our own petty catfights over funding/pole rent income, subcontracted “maintenance” and installation crews clogging up re-construction efforts, (I could go on for a while)
is that “this area” has always had “problems” because we’re in the mountains.
(yes, one sentance)

I’d like to suggest that Time-Warner-Time.com-AOL-,with an astounding list of other ventures that Mssrs. Hadden and Luce never imagined, now owns Adelphia because their company sucked, and they were in BIG financial trouble due to years of mis-management.It was an easy buyout. I wonder what the golden showers parachutes for pissing on the consumer are THIS time?

And the NEXT time a communications company writes “we have to charge extra to accomodate older equiptment until the (2008?) manditory government switch to all digital service and equiptment.”, ask them who wrote and lobbied extensively for THAT to happen, despite protest and complaint from consumer and watchdog groups. I suspect it wasn’t wasn’t Zenith.

Surprisingly, town landfills have set up new pending fee structures for all those electronics that are doomed to obsolesence- well before the crush is on to jettison them as absolutely useless. This is based on State and Federal guidlines of course.

I’ve been investing in pump organs and learning to repair them. I’m SURE that will be a viable occupation once I get the State approved licence, but I’ll keep the lightning rod sales/installation/repair option on the back burner.

[/retro-grouch]