Updates and musings from one momma nurse

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Thursday, December 13, 2012

Unsolicited Advice

On the way out of Library Storytime with a tired toddler, a stranger initiated conversation.

"Before I get on the elevator, I'm going to tell you a secret."
....
"Chamomile tea."
...For what?
Nods in direction of the kids. "Babies."
*puzzled look*
"You can put it in anything. Milk. Whatever. I had four babies, and the last two were twins."

Elevator doors open, ending our brief conversation as awkwardly as it began.

There you have it. The secret to babies is apparently chamomile tea.

Monday, December 10, 2012

Irony

Today, I had the potential opportunity to sleep in an hour or two, because I will be going in to work a bit later than usual.

Guess who was up at the usual time?

That's right; the two girls who normally have to be dragged cajoled coaxed carried out of bed were both awake and READY TO BE UP RIGHT NOW long before the sun.

Wednesday, November 21, 2012

Kid Stories

It's been a while since I've recapped kid stories on here. With the girls getting older, they are both giving me more blog material but less time to blog! Ironic.

Bright Eyes (14 months) moved up to the toddler room at her daycare. One major change from the infant room to the toddler room is the naptime arrangements. Cribs? History. Cots! She doesn't seem big/old enough to be sleeping on a cot, but I hear that she's doing well with it, and has taken great naps for them.

The other day, Sweet Pea laid down on the floor, and Bright Eyes toddled over and started rubbing her back, just like her teachers do for her at naptime.

We've had tear-free dropoffs up until this week; part of the benefit of starting daycare at such a young age. Well, days 1 and 2 in the toddler room broke our streak! On day 3, however, she barely waved at me as I left. The secret? I dropped her off at a mealtime, and apparently a plate of food is interesting enough to engage her so I can slip out!

Bright Eyes is also making progress with her communication skills. She often waves and says, "Hi!" She's recently added "mama" to her reportoire (though sometimes it is MAMAMAMA!) and seems to associate it with me. She is picking up signs pretty quickly now, and uses "more", "milk" (our sign for nursing), "please", and "sit" appropriately.

I asked her one night if she wanted to read, and she looked around, grabbed a book, and sat in my lap and opened the book.

When I hold up a shoe, she holds up her foot for shodding. She also likes trying to put her own socks on.

Silverware is fascinating to her! She once used a spoon to try to eat a saltine cracker.

Sweet Pea (5) has made big strides with reading since just before her birthday. She had known letter sounds for a long time but didn't seem to be able to keep all the pieces of information in her head and put the sounds together into a word. Now she can look at a word, sound it out to herself, and read it to me. So neat to see!

One nice thing about the girls being the ages they are is that the baby/toddler books that Bright Eyes likes are great for Sweet Pea to practice reading. Win-win!

Hmm, how about some quotes? Sweet Pea has had many that have cracked me up. Going to C&P from FB.

"I love you a hundred much, Momma."

(I voted early. Took the kids with me. Once I'd cast my ballot..) "But won't the other one feel bad?"

(While listening to music in the car) "If I could snap, I'd snap to this beat!"

The sun was streaming down from behind some clouds.) "Is that yellow cloud Jesus?"

"Who was the first one to think of cupcakes? You're older than I am. You should know! When were they first invented? 1968?"

(I was explaining that God loves us all the time, no matter what. She was incredulous.) "Even if you say the word 'booty butt?'"

I love eavesdropping on the girls' room at night through the monitor. One recent fussy night, I heard, "Bright Eyes, I am going to give you five chances, ok? Now GO TO SLEEP."
 
(While walking through the grocery store parking lot)
"...And if you step on the yellow lines, they will catch you on FIRE, and then you will have to stop, rock, and roll!"
 
"Do you see that orange star over there? It looks like the one they followed when Jesus got born."
"Sweet Pea, that's a street light."
"Well, it looks like a star."

Thursday, October 4, 2012

Conflicting Values

"I watched my mother go through Alzheimer's," confided my elderly patient. "My dad had some form of dementia, too. I'm already fumbling for words, and that terrifies me. I'm 90 years old and realistically, I only have one or two good years left before I start battling big health problems. Stroke, heart attack, dementia; it's just a matter of time, and I do not want to go through that! Do you know of anyone who can help me with an assisted suicide?"

Well, what do you know? Four years in this place, and this is the first time I have ever been asked that question.

In the few seconds before I answer, I am doing a rapid mental assessment to determine whether this patient is at risk for self-harm. That will affect my next move. My gut says no.

How do I feel about assisted suicide? Is that pertinent to this conversation? I decide my own values and opinions need to go on a back burner. I tell the patient this is a new question for me and that I'm not sure where to go with it, but that I will do a little digging and get back to him.

First step: Document the conversation in the chart and give the charge nurse a heads-up.

Second step: Call the chaplain for ideas.

Third step: Leave a note for the physicians to pass along the chaplain's suggestion.

Fourth step: Return to the patient and let him know what steps have been taken.

Do I have opinions on the issue? Absolutely. I have some strong opinions that would fall under the category "Sanctity of Life," and assisted suicide is no exception. Did my patient ask me to share those opinions? Absolutely not. Should I withhold care, or shy away from researching answers as I would do for any other question asked, just because my patient's values do not line up neatly with my own? Again, I say, absolutely not.

My patients deserve the same level of care no matter who they are, why they are there, how they treat me, or what they believe. That is my duty as a nurse, and it is my honor and privilege as a human being providing care for other humans.

Monday, September 10, 2012

Peaks and Troughs

The normal patient load on my particular unit for my shift is 5-6 patients per nurse.

One shift, I started with six patients. Four units of blood, two blown IV sites, one home care set-up, and two late discharges later, it was an hour after the "end" of my shift and I was just beginning my charting. I clocked out about 2.5 hours after shift change.

My next shift (a few days later), I started with four patients. By a few minutes after 9, I had passed all their morning medications and charted all my assessments. When a new patient transferred to my unit, I tucked him in, charted on him, and made the appropriate calls. I had time to eat lunch. I had time to pump.

It's amazing what a difference one or two patients can make!

Another thing that made that latter shift stand out in my mind is that that was the day I was asked to precept a capstone nursing student this semester. (I gladly accepted.) Can't wait!

Sunday, August 12, 2012

Advice From a Patient

"Listen, honey. Get yourself a boyfriend, and have as many kids as you can. That way, you'll have someone to take care of you when you're old like me."

Sunday, June 10, 2012

Compliments

I round the corner with a patient's breakfast tray, headed to put it with the other dirty ones. A visitor lingers behind me.

"Your hair is really pretty."

I am perplexed by this approach, but thank him, and continue on my way.

He keeps going.

"The color is just, wow, and I like the way you have it up in that ponytail. It looks really nice. I saw it earlier and wanted to make sure I said something."

I excuse myself, head to the nearest med room (which has a lock on the door) and call the charge nurse to find out who he is and whether I should be calling security.

Her verdict: sweet
Mine: creepy

What say you?

Monday, April 16, 2012

Dual Employment

"You have two jobs, Momma. You take care of people, and you take care of us."

She may not have figured out yet what she wants to be when she grows up, but her assessment of what I do is right where I hope to be!

Friday, April 13, 2012

Process of Elimination

"Oh, no, Momma!" says the 4 1/2 year old.
"What's the matter, darling?"
"I don't know what I want to be when I grow up!"
"Oh, that's ok, honey. You don't have to know that right now." (I was nearly 22 when I figured it out for myself.)

She starts ticking them off on her fingers, "Ice skater? No. Fire fighter? No. Police? No."

Sometimes you have to know what you don't want to figure out what you do want, right? She's on her way!

Wednesday, March 21, 2012

Compassion

I take a deep breath. Exhale slowly.

Comfort care.

New milestone in my nursing career.

Knock softly. Push the door open. Introduce myself to the family.

Patient unresponsive. Introduce myself to him anyway. They say hearing is one of the last senses to go, don't they? Might as well include him as much as possible in his own care.

I have other patients to tend to, but I try to check in on that patient and his family more frequently than I might normally.

What can he sense? Does he know where he is? Does he know his children are by his side? Is he comfortable? Does he feel loved?

I've known the family for six hours, and I already know more about this patient and his relationship with his children than I do about some others I've had all week. He is fiercely independent. He looks out for his children. He is well-prepared. He has a great sense of humor. He will be missed.

I enter the room with small doses of medications to keep him comfortable. I check the identification and clean off the IV site. Before I give it, I notice his breathing has changed. I put aside the syringes and pick up my stethoscope. His peripheral pulses, which had been decent when I first came on shift, are now difficult to detect. His breathing is labored. I don't have to use the stethoscope to realize that his heart is going into ventricular fibrillation.

I make eye contact with his daughter. "He's close," is all I need to say. I quietly step out. As I close the door behind me, I can hear his children sob.

A hug and condolences. Is that all I have to offer this grieving family? I can only hope that my attempts at gentle care of their dying father will help them eventually look back on this time peacefully.

May I not walk away from this experience unchanged. May God grant me the foresight to value my relationships with my own family. May I remember to work a little less, and hug my girls a little more. May my family always know how much I love them, not only in what I say, but in how I treat them. May I treat all my patients with the dignity, compassion, and gentleness they deserve. And someday, when I am on the other side of the equation, may the nurse taking care of me or my family member do the same.

Tuesday, January 24, 2012

Spirit of Nursing

This week has helped me remember why I love nursing.

Patients and their family members remembered me (and my name) even when I'd been off for a day or two. They were glad to see me. They vented to me. They reached out for hugs. They called me their angel.

One of the aides told another aide she liked working with me.

Good days at work make it easier to leave the girls in the care of near-strangers at the crack of dawn.