Dums Saved Me!

Thank goodness I found a bag of DumDums in my pantry. I don't think they expire. ::whew:: Without them, I probably would have been the crazy bitch in the neighborhood giving away raisins & cough drops, cause that's all I have. And I don't think parents would approve of me giving Ricola away as a candy.

Sick, Healthy, & Quitting..

Random Church Sign #21

Ok these church signs just crack me up. They're usually cheezy as can be, and they're always prominently displayed. I've never seen them anywhere else other than here in the bible belt.

Most recently: God answers Knee Mail

.. sorry, but that sounds kinda dirty, lol.

Today I am Thankful For...

1. Cheesy/cool friends
2. Ballistic Brownies!!!
3. AMC movies from the early 30's
4. "Ugly 13" afghan
5. On-Call to sleep in when it's freezing
6. Caramel Highlights
7. Legwarmers
8. Little Sisters
9. Fond memories of being a spectator at my own college graduation
10. Having the clarity to have the IGDAF mindset when drama is amidst.

Cheesetastic <3!

I went to a cheesetastic roller skating 80's theme party Sunday night. My friends are completely awesome!! Love to the other KD.. because only SHE could come up with something this silly and make it so wonderful!!

I think I can pull off 80's maybe a little too well! Thumbs up for the costume; thumbs down on the skating skills! (WAYY down!)

Thankfully, i'm not too injured. One bruise to my left hand. Way less than I anticipated, actually!

I gave in and turned on the heater last night. I'm just so tired of being cold! I had promised myself I'd wait until 11/1 to turn the heat on - but when I woke up the house was 55 degrees. I can't handle this cold! (And I'm wanting to move somewhere cold?!) Thanfully, wherever I go they're gonna pay my heating bill. (It's so expensive to heat my old drafty house!) - Sleeping on my couch in my office because it's the warmest place in the house! ... More on the brain, but it's TIRED!

Saturday Afternoon

I took this picture at M&D's house 10/06. I call it "The Lone Golden Leaf"
It may not be Ansel Adams photography, but I love how poetic it is
that one leaf is golden, while the rest are still in full green summer wear.
..and yet they'll all turn at any moment.


Played in the yard today. I absolutely love my chipper! It has a vacuum feature, so I got to clean up the 50 million leaves that have been raining off the trees... I really need to do something with my ginormous mulch pile, but even with my lack of action, it still looks good. I had intended to do some composting, & turn it into a vegetable garden... maybe someday... far off in the future!

I'm just barely finishing cleaing out my closets & purging my junk, and it occurred to me - Kara's party is tomorrow - it's 70's/80's theme dress. .. I think I might have to make a quick run to the Goodwill! I've got a box of shoes & clothes to drop off, & I guess I'll see if I can find some cheesetastic legwarmers or something while I'm there!! It should be so much fun - I wish my camera still worked!

I'm tempted to go buy a video camera .. My (regular) camera broke after Oktoberfest. It's under warranty, but the receipt is completely lost. *cry* I'm sure I can work it out, but I still want a video camera. Besides, with a nephew coming, I'm sure I'll *really* want a video camera (trying to justify a purchase!)

I Guess it's Therapy?

311 is still around. I did *not* expect that after 2 days off she'd still be hanging on! And, of course, she's mine. One patient I had over the weekend expired early this morning... she's one I did NOT expect would pass. She gave up on living, the girls told me. She refused all treatments, and said goodbye to her family. I don't have a lot to say on her, because I hadn't seen her in the last 2 days. People can deteriorate quickly in my world.

But they don't get better quickly. 311 still isn't better. And she wakes from her sleep only when touched, to moan and cry. The night shift RN told me she'd scream "It HURTS" whenever she woke. Today, each time she woke, she would shout at me, words diffuse - garbled through her oxygen mask, and gurgling lungs, "I'm not going ANYWHERE!" I don't understand it. I broke down. Walked out of her room and the eyes welled up. I can NOT stand to watch the torture. I got the MD to order morphine for her. It's a small dose, but a dose nevertheless. Today I gave her Ativan and Morphine. All I can do is give her the prescribed treatments, and continue to show compassion. I honestly didn't think she'd make it through the day... and yet she continues with her shallow, gurgling respirations. Fiesty one, she is!

It was pretty much insanity on the floor all around. EVERYONE was so busy, they couldn't tell whether they were coming or going. I freely admit patient care suffered because of it. (I know none of us were able to give care and attention to our patients the way we like to!) And to top it off, we got 3 postpartum couplets to our floor today. (We're still nursing-home central right now.) Yes, our unit is truly a "Womb to Tomb" floor. Today showed the full spectrum. I had patients from 3 hours old, to 94 years old!

I was scheduled 7a-7p today. (Which really means 7a-7:30p). I clocked out at 10pm. ::ugh!:: It really was one of those days! I looked at the schedule for tomorrow, and *groan* they are beginning student rounds for the semester. I have two 1st semester nursing students assigned to me for the AM, and two more assigned to me for the afternoon. Their instructor came up and said they have *NO* patient care experience, and they have a high level of anxiety with dealing with patients. Holy Moley! Please let me not teach them bad habits, or do anything that might otherwise get me in a lot of hot water!) Two nursing students to one nurse is a LOT. Let's pray that tomorrow is not a repeat of today.

I told my manager today that I am serious in planning to leave/Go PRN. I'd tossed the ideas with her in the past.. so this isn't NEW per se, but it is the first time I sat her down, told her I've spoken with recruiters and have had offers. I appreciated her reaction. Some of the clinical crap is completely lost with her, but she is a respectable manager. I told her that I was going to put her name in for references, and to expect phone calls soon. (I thought I owed her the courtesy of telling her). I hope that I can stay PRN and pick up hours.

So today, prime examples of things I'll miss when I'm away...

- Dr. M: "Wow, you got your hair done! You look all sassed!"
- Me: (later in the day) "Dr. M, your wife must have you well-trained! Your first words to me was regarding a new haircolor. I've had it about a week, and you're the first that's mentioned it. She's got you VERY well-trained!"
- Dr. M: "Well, it's not that. It's just I've learned as a gynecologist, there's not a lot of things I can say to a woman that doesn't get construed for sexual harrassment. I mean, really, I can't exactly say 'Wow, your clitoral ring looks new!'
- Me: "Since when have you stopped to care about sexual harrassment?"
- Dr. M: (giggle, blushing) "True!"

- Dr. C: (looking for a tube to otoscope) "I found one behind the bin"
- Me: "Eew, that's old and filthy, and probably used!"
- Dr. C: (shrug)
- Me: "You mean to tell me that the infectious disease doctor is going to use a dirty used otoscope?! Do you at least want an alcohol pad for that!?"
- Dr. C: (scrubbing tube with alcohol pad) "No one has ever died from a
used otoscope!"

There are some people in this world you'll never be able to duplicate!!

That's enough for today. <33>

Petty thoughts on Pettiness...

So I was talking with one of my online friends tonight (<3 Nikki) about some of the things I get frustrated with. There's a lot of pettiness that people make big deals out of. I'm kinda getting fed up with petty stuff. I'm needing to distance myself from any high school bullshit drama right now.

It's been feeling like nursing-home-central at work this past week. Yesterday I nearly cried; it was such a difficult day. Today, thankfully was a much better day, but I still had a rough crowd of patients.

I had 3 goals today:
1)Stay awake.
2)Don't Cry.
3)Keep 311 alive
till 7pm.
I was pretty successful in my goals.
I shed tears,
but they were tears of laughter.

So, without being all HIPAA-y... let's talk about 311. She's been riding on my mind a lot. Little old lady. When I say old, I mean OLD. Nearly pushing a century. Sick. Aspiration pneumonia, and breathing like shit. Also (+) for MRSA in Nares, Urine, and Blood. She's completely septic. She's not going to get better. She WILL die; there's no question about that in anyone's mind. To me, it's just a matter of when and how she dies.

The poor lady was "with it" completely until the last couple days. Last night she mostly became nonresponsive. She moans, cries, and panics when she's moved or touched. She's edemetous, with hands swollen and puffy like the Stay-Puff Marshmellow Man. Her skin is tight, splotchy, and bruised to all hell. She's incontinent of stool, and on so many antibiotics, she's got heavy diarrhea. She needs to be turned regularly, because she cannot move on her own. She carries the smell of the dying- even after a bath. She's had agonal breathing, in an attempt to get more air in. I've suctioned her several times. She panics, moans, and sometimes pleads, "no..please no". Suctioning isn't pleasant, but it often opens a clogged airway. It's what needs to be done to sustain life. She is a DNR.

DNR. Do not Resucitate. It doesn't mean do not treat. So treating the illness is what we continue to do. We pump her with antibiotics. We turn her regularly to keep her skin on her bottom intact. We poke her swollen hands & arms with needles repeatedly, looking for veins to draw blood samples for her daily labs. When her IV site blows, we put a tourniquet on, and start a new IV. We feed her through a tube that goes directly into her stomach. ...If she stops breathing, we cannot help her. But in the meantime, we are obligated to continue to treat her, doing everything in our power to prevent her from getting to the point where she stops breathing. This is where it hurts. She is going to die. It is certain that she will not be able to survive all these ailments that are attacking her.

Sometimes the treatment is just as bad as the disease. If it were me at that age & level of sickness, I would want to be left alone. Give me oxygen to help me breathe comfortably, and high doses of Morphine. Spare the IV antibiotics, that sting going in the veins, and give diarrhea. Quit poking for lab values.. why keep score on a battle that's a sure loss? Just be kind, and keep me comfortable.

Comfortable. That's what I would like to see my patient be. What I talked about above..that's Comfort Measures. Keep a patient comfortable before their "celestial transfer." You don't hasten their death, and you don't treat them; you just keep them comfortable, so that they can die peacefully. I talked to the attending doctor about getting this woman's status changed from DNR to Comfort Measures this weekend. The MD tried to get in touch with the patient's children. (The children, by the way, live less than 2 hours from the hospital, and have yet to be seen on the unit - another issue that just further upsets me!) The MD explained her grave condition, and they said that they "need more time" before they decide whether or not they want to withdraw treatment.

It breaks my heart. Please allow me to stop torturing this woman!! Allow me to stop poking her with needles. Allow me to let her lay in peace. Allow me to give her large doses of painkillers. Allow this woman to finish her final days on this earth comfortably.

*sigh* guess that's what's weighing heavy on my mind. It's not that I try to trivialize some other problems that others might be having, but I guess everything else just seems so petty, in perspective. I've spent my weekend torturing a woman, because that's what I'm legally obligated to do. But in my heart of hearts, I know that she needs & deserves to be left comfortable so that she can leave this world in a peaceful non-traumatic manner.

::continuing to put effort into not crying::

Post-Vacay Thoughts

So tired. Worn out. I was off 5 days, & today, my 1st day back, I almost didn't recognize the place! Several new policies in place, & our entire supply room has been redone. I don't know where anything is anymore!

Heard today that drug reps soon won't be able to give samples to MD's. Wow. I knew they were changing the laws to disallow sticky notes, pens, clocks & other branded gifts, but I had no idea that it was also no samples! This will change the way MD's operate in a huge way! And I guess that means no more free samples for us patients, either! Geesh, I was really getting spoiled by that - it's always sweet when your doctor slips you 6 months of birth control (that costs $40/mo) in a bag and sends you on your way!

There was a lot I wanted to talk abotu today -the alst couple days have been very busy, but I just am too tired. Can barely keep my eyes open.... kd.

Dear Baby

Dear Baby Cadigan,
Yes, It is possible to be in love with a boy you've never met. For I am utterly in love with you. I love your mother dearly, and your father too - but you I've yet to meet, and I can't wait for you to be born!
Love, Auntie KD.

Today I am Thankful For...

1. Finding silly squirrels in the yard
2. Vanilla Mint Listerine
3. My homemade scarf
4. Ho heat/no air for a couple weeks now! (= perfect weather)
5. Purging (belongings. Believe me, I don't purge my food!)
6. Pillar candles that glowe once they've burned down
7. 5 day off-stretches
8. Bean sprout
9. My boobs.. I've got good boobs. There. I said it.
10 New lipstick in a good shade.

Sleep deprived thoughts

I originally accidentally posted this completely blank, and while I appreciated the humorous connotations, I actually still have words running through my head tonight. Often I think in pictures. Tonight, it's completely words.

Ahem: husband of patient in room 313: I have already picked the gauge needle I will shove in your eyeball if you don't shutup. It's 18g 1 1/2". Pink wrapper.. med room B. Keep it up, buster! If the Twinkie Defense worked, I'm sure a sleepless defense will!

I thought I was off today, but I got my days mixed up. So I went to work on ONE hour sleep. 13 hours of work on 1 hour sleep royally sucks, but I'm a tough cookie. Came up with this on the drive home. Summation of the day:

I appreciate the silence
In my travels home -
Hearing nothing but my
engine and the heater.
Reflecting on a job
mediorcre-done with
minimal sub-par sleep.
But nobody complained,
and nobody died.
Everything's all right.

Welcome October - Time for Change!

Welcome, October - my most favorite month, and the best time of the year! The weather is cooling down, and humidity is dropping. Leaves will begin to change their wardrobe soon. Forget spring, this is Mother Nature in action!

So, I've said for quite some time that I tend to make major life decisions in the fall. I know what I want to do, but fear is holding me back a bit. This is the time where I kick myself in the ass & get to it!

"Ships that stay in the harbor are safe, but that isn't what ships are for" ~ it was written on the board in Ms. Murray's 10th grade honors English class one day. It's stuck with me ever since.

So, what am I doing about these potential life changes? Really not a damned thing, to be perfectly honest. I tell myself I'm still around to tie up loose ends. But I'm mostly lying to myself - because I *know* how quickly I can change things, reinvent my life. I did it in 2003 when I came here to SC. And once more before that. Both times, I'd left a job, left a bad relationship, & found myself living in another state in a matter of days. I tell myself I just need some time to sort things out, but I lie.