Monday, May 19, 2008

Toys In the Attic

For those of you too young to remember Aerosmith before they got sober, toys in the attic is a euphamism for crazy.

I don't know what it is about dialysis patients. They can be so crazy and controlling sometimes. Maybe it's all the grief and loss. Maybe it's the metabolites building up in their brain. Whatever it is, it's never a dull momement in Dialysisland.

The other day I had a patient whose husband created drama as I was leaving one night. The patient was a little hypotensive after treatment, which is not all that uncommon, but when she got to her room she told her husband she had chest pain. He came roaring out of the room demanding to know what had happened to her, and later insisting that she was allergic to one of the meds I had given her. Before I was able to get to the bottom of it, word had already spread throughout the unit that "that dialysis nurse gave her a medication she's allergic to."

By the time I arrived at her bedside the charge nurse was there trying to damage control and was fuming. I stayed with the charge nurse, trying to get to the bottom of what had really happened. I wanted to make the charge nurse understand that I was there to clean up whatever problem I might have created and that I wasn't going to dump the situation in her lap and then leave. Together we looked at the patients' record. The med I gave was prescribed by the nephrologist and had been given to her before. We checked her list of allergies and the med I gave her was not one of them.

About an hour later as we began to unravel what had happened, we realized that we were the victims of a drama king and an attempt at staff splitting. By teaming up with the charge nurse to solve the problem, we stopped the patient's husband from performing a "divide and conquer" episode with us. I'm glad I made the decision to work with the nurse and function as her ally. As things calmed down she relaxed and we were able to talk through what had happened. I could tell she was relieved that I stuck by her against the evil one and worked as a united front against him. Everything was documented thoroughly. We could feel a lawsuit in motion and thought we'd better have things written down. The next time I saw her she gave me a big smile and a wave. That made me feel pretty darn good about how we got through that difficult situation together.

Today I had a problem with my dialysis machine and was doing what I could to keep it running. Meanwhile the patient noticed I was spending a lot of time punching buttons and began a running commentary about it. "How come the other nurses don't have this problem? You don't know what you're doing. They need to get someone up here who knows what's going on." Stuff like that. I mostly ignored him and went about my business. I learned long ago that dialysis patients have lots of time on their hands and use it to invent new games to try and rattle the nurse. I've learned to deal with the crazy.

Today it took me 12 hours to run 2 patients. That's really way to long but actually it's an improvement over what I was doing before. It's going to get better. Even with all the playground games I already love this job.

Monday, May 12, 2008

Time For A Cool Change

Pinning was awewsome. Graduation was awesome. My family was awesome.

It is an interesting place to be; ending one kind of life and beginning another. In the past my life changes came on like a freight change. They were sudden and dramatic. This one is smooth and calm. It feels like moving in slow motion and it's very nice.

I have the uneasy feeling that I'm supposed to be doing something. People tell me this is normal after graduation. I still have this amazing feeling that whenever I do something fun I can keep doing it until I don't want to anymore. I can enjoy myself without guilt.

I still have to take the board exam. I had planned to spend an hour a day reviewing stuff to get ready for it. I can't quite get myself to do that yet. I just want to enjoy doing nothing for a little bit longer.

Then there's the unpleasantness of having to actually work.......full time. I haven't worked full time in 2 years. I'll be hating it for a while but eventually I'll adjust.

Meanwhile I am spending way too much time on YouTube and I Can Has Cheezburger, but what they heck. I worked hard for it.

Wednesday, May 7, 2008

I Feel Love

This weeek is filled with graduation frenzy.

My family arrived yesterday and we have not stopped partying since they landed. Last night we went out with my classmates. I've never been out with them in the evening; just lunch here and there. It was a big deal because I rarely stay awake past 10 p.m. The ideal bar for me would be one that has last call at 8:30 p.m.

Today was the pinning rehearsal. The pinning committee had put together a couple of slide show presentations. They were trying it out to see how it would work and we were all mesmerized. Our instructors saw that they could not get our attention once the slide show started so let us watch the whole thing. There were lots of photos and video of us from the past two years of nursing school. Lots of smiles, hugs, busy moments, etc. Each student also created a couple of slides thanking friends, family and whomever for helping us get through. So, yeah, all of us were riveted, waiting for our slides to appear.

Tomorow is the actual pinning. There will be plenty of Kleenex for all.

Friday is graduation. I'm pretty excited because miraculously I was able to keep my grades up and I'm graduating with honors. Yay me!

I'll write more once all the celebrating is over. For now I'm having a great time with my family, soaking up the love from my classmates and marveling at having made it through in one piece.

Peace out.

Thursday, May 1, 2008

Adapt......Or DIE

Boy, the stuff they don't teach you in nursing school.

I spent a day working with another dialysis nurse. As she hooked up the dialysis machine to the shower she said "Oh by the way. Call the manager and tell her you need a special plumbing adapter for this."

Special adapter?

Okay so I called the manager and she said she'd have someone drop off a kit at the hospital the next time I was there. A kit? I expected to find a charming little kit, maybe with fur lining and rhinestones and it would play music when you opened the lid, and a teeny little adapter inside. Instead I found this.

Inside are no less than 20 different plumbing adapters.

That's a penny on the bottom row second from the left.

I'm calm today, but when I saw this thing I just about shit a brick. What the hell am I supposed to do with all these?

Apparently what I am to do is attach an adapter to the dialysis machine and another adapter to the faucet or shower and couple things together until I get a tight seal. The one I saw the nurse use was a perfect fit for the dialysis machine and the shower head so only one piece was needed. No coupling required.

Wait it gets better.

So the other day I decided to put on my big girl panties and run a couple of patients all by myself. I get to the patient's room, introduce myself and get him all warmed up in preparation for dialysis. He's a new patient, just started dialysis a couple of days before, and so was a little edgy and nervous about the whole process. I fire up the dialysis machine and drag the hoses into the bathroom. I get out my sparkly new kit and begin trying out different adapters.

None of them fit. Oh sure, I could get one to fit the shower hose and another to fit the dialysis machine, but could not get them to fit each other.

Oh boy.

I called my manager and she said to call the machine tech. The machine tech said he could send someone over with the correct part and it would only take about an hour or so.


I cooled my heels in the cafeteria and played games on my Blackberry to relieve the tension. I had to get out of the room because the anxious patient set to whining and saying "well, how come the other nurse came in and hooked me up right away?"

Because I'm a lame-ass buffoon and they sent me here as a joke. April Fool!!!

The machine tech arrived with the correct adapter and threw in a pipe wrench for good measure. Thanks Dude. Much hillarity ensued and about three hours later I ran the patient and all was well with the world.

I took a lunch break and went to run my second patient and things went even further awry, but I'll save that story for another day. I'll just tell you that I spent 20 hours running two patients and I'm still trying to recover from that disaster.

The really awesome part is even with all the time I spent there that day, I still made more per hour than I did as a medical transcriptionist.

It's going to be fine. I just have to get over the hump.