Wednesday, March 31, 2010
Fortunately, our nurse manager is great and runs interference, and I haven't had to do it.
So the other day, she comes racing triumphantly downstairs, waving a letter and looking for me. Someone had written an email to administration about an encounter we had had. She hands it to my manager, and asks for me to be called over "because we need to talk about this--this is the THIRD letter we've received about GuitarGirl!"
My manager reads through the email and calls me over, laughing. He asks the clipboard nurse if she read the letter all the way through. She starts looking uncomfortable. He hands it to me.
Although the letter started out rather humorlessly with "I am writing to address an incident in room [number] of your Emergency Department on [date]," this was not a complaint. This was a letter effusively thanking me for my "Herculean efforts" (that's a direct quote) in disimpacting a young lady's badly impacted colon after the resident was unable to do it. The writer complimented me on my sense of humor and the way with which I put the patient and her partner at ease in a difficult, painful, and embarrassing situation.
I remember this incident. This poor young woman had been in a car accident and had had multiple surgeries on her leg in the last few weeks, necessitating lots of narcotic pain medications, which had backed her up something awful. I skillfully birthed a load of poop out of her butt (I remember saying, "OK, it's kind of like popping a big, poopy zit!"). After the initial blockage was out, a torrent of poop followed and actually flew off the stretcher and hit the wall behind the bed (fortunately the med student who was assisting me and I were well out of the way). Needless to say, it was smelly and messy, but I quickly cleaned up and put the woman and her partner at ease.
As we read the email, the manager and I started laughing--and so did the clipboard nurse, although it seemed she was reluctant to admit that this was not a complaint, it was a good letter!
Of course, she had to find something to chastise me about: at some point in the letter, the writer quoted me as having used the word "shit." She mentioned that that language isn't appropriate in the workplace.
I can't win.
Tuesday, March 23, 2010
Sunday, March 14, 2010
Hubs and I had been trying to get pregnant for about a year, and I was
mystified by our lack of success. Finally I made an appointment with a
fertility specialist. I had to have a saline hysterosonogram to
determine if the fibroid I have was preventing pregnancy.
Yup, it is.
The fibroid was pushing my uterus out of shape, preventing any embryo
from implanting. So my chances of conceiving are low, my chance of
miscarriage is high, and even after surgery to remove the fibroid, I
would still need fertility drugs and intrauterine insemination because
of my age, and my chance of conceiving could be as low as 30% because
The surgery involves laparotomy, and would require an extensive
recovery period with at least 8 weeks off work.
Not fun news to get. My husband and I have been talking it over, and
we've pretty much decided not to have the surgery. I might try one
round of IUI without the surgery, and if I conceive and miscarry, so
be it. And we may start looking into adoption.
So, you can see, things have been pretty stressful so far this year.
I'm kind of taking it easy and waiting to see how things pan out.
But things are looking up! Right now I'm holding my sweet 9-day-old
niece so her parents can get some well-deserved rest. She has
delicious milk breath and is making faces at me. Welcome to the
world, baby Audrey!
Thursday, March 11, 2010
Early Monday morning, my husband woke up with excruciating abdominal pain and bloating. He was nauseous; he thought it was gas from the big meal we ate the night before. The pain was unrelenting--he suffered for two hours without relief. Finally, thinking it was pancreatitis, I convinced him to go to the ED. He was reluctant, as he's self-employed, and needed to call his sub to cover all of his clients for the day. But I insisted, so off we went.
Thank goodness it wasn't busy yet. I was already in my scrubs for my shift, which was to start at 11:30 am. They whisked him into a room, got an IV and some morphine in him and whipped out the old beside ultrasound. I was sitting across the room and I could see it: his gallbladder was so full of stones that it looked like a bag full of marbles. It didn't look inflamed (the wall of the gallbladder was not thickened), and the attending offered to let him go home and follow up with surgery in a few days.
Nope, I said. It's got to come out. And, one of the best surgeons in the hospital was available to take it out the next morning. Snip snap, I said. That thing is coming out ASAP!
So my husband was admitted to the hospital. Fortunately, he was able to have a private room--but it was on a floor that's notoriously understaffed--and when it is staffed, it's all brand-new grads. So guess who got to be his private nurse? Me, that's who.
We got him all squared away, and then the phone calls started. His mom, worried. His dad, worried. His sister, frantic with concern about the general anesthesia because he's a bad asthmatic. I told her that the anesthesiologists know all about asthma and would take care of him. She was less than reassured.
That night when I went home, our dog was really confused. Every time someone left, they didn't come back! She was very needy and withdrawn at the same time. I felt awful for her.
The next morning, hubs had his surgery at 11 am. After some confusion about where he would end up after the surgery (I had to call my friend in Patient Relations to figure it out for me), I found him in the inpatient PACU, miserable. His 02 sat was low, even on oxygen, so he was getting frequent nebulizers. He had received a lot of pain meds and was super sleepy. His elderly parents were there, fretting, until I sent them home.
I spoke with the surgeon. Apparently, the surgery had started out as a laproscopy--but then had to be converted to a laparotomy due to the size of the gallbladder. It WAS infected--and badly inflamed, and so huge they couldn't get it out of the little incision. So they had to widen it. He had two small incisions, another long one, and a drain in his belly. So much for going home the next day.
Poor hubs. He had never had anything worse than a mild flu bug before this; he'd certainaly never been in the hospital. Miserable, in pain, not allowed to eat, on awful antibiotics--and unable to urinate for eight hours after surgery. And you know what that means. Foley catheter.
And who put it in?
Not the floor nurse.
Who re-sited his IV when the potassium rider caused it to infiltrate?
Not the floor nurse.
Who noticed that the IV antibiotics that were hanging up there were expired?
Not the floor nurse.
Thank goodness I had four days off in a row. I was able to be with him for most of the time. I communicated with his colleague, who was covering his work, I communicated with his family, I communicated with his doctors.
Finally, on Thursday evening, they asked if we wanted to go home. YES! I said. I want him at home where I can take care of him.
And that began the next round of misery. The first night it was like having a new baby: He was up to the bathroom every hour and a half, and that required me to help him out of bed, rearranging pillows, helping him to the bathroom, helping him back into bed. Managing the medications, and the fiber and the antibiotics--and the new low-fat diet.
Finally I had to go back to work. His parents came to stay with him that day to help him with anything he needed.
It's been a long slog, but he was back to work on a part time basis after three weeks and then finally full time as of two weeks ago.
Wednesday, March 10, 2010
As you know, my mom passed away in October. It wasn't unexpected, but it still sucked. My sister (who lives in North Carolina, and who at the time was 6 months pregnant) and I had to scramble to get the estate straightened out, get Mom's apartment ready to sell (holy shit, old people save SO MUCH CRAP!!), and deal with some minor issues (when my sister and her hubs were staying at Mom's for the memorial service, they used the shower, which leaked on the lady downstairs and ruined her ceiling and closet and she wasn't happy).
Then in January, my elderly dog started having seizures. Grand mal seizures. It was horrifying. We took him to the vet after the first one, and he said he thought it was probably a brain tumor, because the dog had also been having some neurological issues with his back legs and walking. We put him on phenobarbital, which of course made him dopey and barely able to function. But he was my sweetie pie, and I didn't care as long as he was comfortable and able to eat, drink, pee, and poop normally. He was 14 years old, and had seen me through being single, and nursing school, and dating idiots, and other crises and I loved him very very much. He kept seizing even with the phenobarb, and his walking deteriorated to the point where we were carrying his back end with a sling (which he hated). This was not easy, as he was a large dog (90 lbs). We also had to deal with a weekend during which our elevator was out of order, so my husband and I had to carry him up and down four flights of stairs twice a day, with him barking and howling in displeasure the entire time. It was not pleasant.
Then one night he woke us up at 3 am. He was howling and couldn't get up. He had slipped off his dog bed and was lying on the floor, but couldn't move enough to get comfortable. He drank water and ate a bowl of food hungrily, but we couldn't get him to relax enough. He was panting and miserable, and we made the decision to call the pet ambulance and take him to the all-night vet to have him put down.
Of course the minute the vet techs showed up with their cool sling, he got up and walked to the door. But he fell at their feet, and we still took him in anyway. He ate a banana (his favorite food) in the ambulance, and then another one as the vet was injecting the propofol to put him to sleep. He finally relaxed against me, his head against my shoulder. His body was so relaxed, he felt like a puppy again, the sweet boy I remembered from years ago, not the aging, arthritic, pain-plagued elderly adult he was. I kept my arms around him as she injected the phenobarb overdose, and I felt his heart stop.
I'd never had to put a pet to sleep before; this was my first dog ever. Even though my heart was breaking (and it still is--I'm crying as I type this), I knew we had done the best thing for him. He was never going to get any better. The vet confirmed this by saying, "It was time. You did the right thing." Now, I know they probably teach vets to say this in their first year of vet school, but man, it made me feel better. So, thanks, midnight vet, for being kind to me and my sweet boy at the end.