Prompt / Thank you Miss Hill!

The Friday Reminder and Prompt for #SoCS Dec. 29/18

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The dreams they tell, I don’ t always think it’s the anesthesia. I do wonder, but I say nothing out loud.

” There were three of them, big playing cards, just like the movie Alice In Wonderland, you know, the mean  Queen of Hearts, flat card body with her square  head on top and the Jacks lined up behind her, but no heads in my dream, just life sized cards falling out of a window. And me, down below, thinking I could catch them. Then the luau started…”

Now he’s waving his arms left and right. I reach quick for his swinging IV tubing and turned to the CRNA for the remainder of report.

” …and he got some Ketamine due to sensitivity to the Propofol and Fentanyl”

Aah, good old Ketamine.

” You girls are so pretty with your crowns on… hey, my dream, what does it mean?”

Vital signs good, abdomen soft, no pain.

“Sir, I think you should ask someone else…after your medicine wears off.”

Last post for 2018

Gratitude by Oliver Sacks, this is how I need to enter into Christmas Day, sharing  the joy of having gotten to read this book compliments of parents who have such a respect for literature that they purchased it for me months ago and gave it as an early Christmas gift.

Dr. Sacks, professor of Neurology at NYU, wrote a collection of neurological case histories, his last book being a memoir where he revealed his vulnerabilities when faced with the return of melanoma and the numbering of his days.

He doesn’t speak of his impending death with pathos or overt drama. Although other publications chronicle traumatic childhood experiences, he brushes over them and leans into what he learned, not what he endured. Despite his luminous medical and writing career, he is humble and writes this memoir in a way that everyone can relate to.

On the inside cover there is a quote,

“It is the fate of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.”

I have a tendency to believe that physicians, in general, are prone to be more self-absorbed than most. (Theirs is a demanding profession. I understand some of the need for elevated self-love and unwavering confidence.)

Dr. Sacks, through his writing, demonstrates that you can have an analytic mind and still help people understand what it means to be human.

I get the title.

Come on in 2019, I’m ready.

2:45 am

Though tall in his frame (6’2’) and broad shouldered, his face was jaunt and his color slightly off — like that of the gastric patients of twenty years ago whose surgeries left them with multiple vitamin deficiencies. The dark shadows weren’t just under his eyes; they circled around his orbs giving that eerie look mimicked by many on Halloween. But it’s not Halloween, it’s December 24^th.  His bariatric surgery and following cumulative two year weight loss of 300 pounds began Christmas Eve of 2015.

He gave me a genuine smile, no facetious twist at the corner of his mouth, when going on to report that this was his third Christmas Eve surgery. Today’s goal was to fix his inguinal hernia.  The significant weight, surgery, and following weight loss had affected the integrity of his mesentery. Under the loose skin that sat in folds low on his waist, a piece of his intestine was poking through causing pain that forced a change in his plans to travel for the holiday.

When the tech came to do the abdominal prep, I stepped away and reviewed his history again. He had eight out of the twelve listed complications related to bariatric surgery.

He said his knees were shot from the weight he carried for 10 years so he was under pain management for that

But he lost the weight.

And I think that’s all the average person will see.

So something doesn’t feel right about this to me. I can’t explain it. But it just doesn’t feel right that this is all people will see.

Two hundred pounds gone.

It Should be.

Compassion isn’t cool anymore…or so it seems.

Very few of the people listed in TIME’s Most Influential of 2018 are known for charitable work, or serve as role models. Who’s getting followed by millions on social media? Movie stars and singers, political figures who name call via tweets, online celebrities whose only quality seems to be performing outlandish stunts.

And it makes me weary.

Deflecting the course humor about the #MeToo movement, about the Wall intended to keep out people — people seeking hope on new soil, and openly derisive attitudes about anyone who doesn’t fit the consumer market ideal (tall, thin, blond, athletic, blissfully happy heterosexual couple with Abercrombie dressed toddler walking through park with Labrador type family), yes, this brings me down.

Now, I do like Labradors and Abercrombie’s clothes (can’t buy them, they’re too expensive, but I like them), and I have fantasized meeting Mr. Wonderful and having those walks in the park, but…

Let me get back on track here

The meaning of compassion is to recognize and have concern for the suffering of others.

It’s a virtue.

In any country, in any language, it’s described as a virtue. It involves an empathetic response and an altruistic behavior. It’s not pity.

My well is low on witnessing compassion at work, hence the reason I haven’t been able to post much. I’ve been hearing, and I mean literally, more “I have to look out for me” or “Don’t worry about getting that for them, they’re going back to surgery soon”.

I ignore it. I do what feels right to me.

I am so grateful for all who read my posts, give me feedback, or share experiences.

I’m going to open my eyes wider. There are angels among us at work, I know there are, and I need this blog to continue to be a place to share positive and / or humorous experiences. That is my New Year’s resolution.

Thank you for reading this!

Kudos From An Unexpected Place

Dear Susan,
I wanted to let you know that we published a list of Top Nurse Blogs on our website (at blog.nurserecruiter.com/top-nurse-blogs ), and that we were very happy to include “Don’t Curse The Nurse” as well. ___________________________________________________________

I just posted last week about stress and the heart. I didn’t want to post just how much of it I was sure was coming from work because I love what I do.

It’s the bureaucracy and politics that sometimes seep into my work life and steals my joy.

So, this was nice to see on my comment dashboard this morning!

One Liner Wednesday – A day late

Thanksgiving should be a day when the words coming out the mouth are at least half as sweet as the food going in.

 

One-Liner Wednesday – It’s Time

Takotsubu Cardiomyopathy

It’s the Japanese term for broken heart syndrome, an event in which the heart has an acute physiological weakening in response to extreme stress or grief. It can resolve, although sometimes it doesn’t. (We all loved James Garner in ‘The Notebook’ because the bittersweet ending was believable.)

On echocardiogram the heart balloons to a distinctive shape resembling that of a Japanese octopus trapping pot. The pot has a wide base and a narrow neck called the takotsubu.

There are dozens of documented cases, the most significant being the 2004 Honshu Island earthquake. Post this horrendous event; there was a 24-fold increase in the incidence of Takotsubu cases. In almost every case, the patient lived near the epicenter.

It’s unfortunate that we, as a general population, see stress management as some type of ‘Hippy’ trend reserved for Southern Californians or Bohemian artists living month to month. The number of clinical cases reviewed concerning the relationship between hypertension and stress, there are too many to count. If you have any other comorbidities, stress is often placed low on the list of items a physician addresses.

Of course, correlation does not prove causation.

I’m a heart patient and a nurse.  I see the issue from both sides.

I wanted to share this after reading an article about it in The New York Times and reflecting on how I have let stress dance around the edges of my heart.

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The first step is acknowledging there is a problem, right?

Rules of Engagement

Despite having a re-torn bicep and surely some pain, I noticed he bounced when he walked. When I waved him toward the scale for the anesthesia required weight, he slid off his flip-flops before I could stop him.

“Oh, uh, oh, okay. Bare feet. Got it. Let’s get your shoes back on there.”

He gave me a wide grin before responding. “My toes breathe better this way.”

“Do you need to use the restroom before changing?’

“Nope!”

‘Nope’ rang a bell and I searched for recall. Ah, yes. He’d been here a month ago, under someone else’s care, the voice and devil-may-care attitude, unmistakable.

Anyway…I went through my usual intro and explanation of the preparation that would occur in the pre-op area. Not quite un-expectantly, he started disrobing before I could close the curtain and minimize the risk of a side show for anyone walking by.

I had all the healthy nurse/patient boundaries up until I handed him a pen for signing his consent forms.

“Oh, thanks, I hold pens this way.” He took it with his thumb, index, and third finger. “I’m a writer. I like to write this way.”

As soon as he said “I’m a writer” I was taken back eight years.

I KNEW HIM!

A writing class.

I looked at him wide-eyed.

It was a class that opened my mind to the power of putting my thoughts and ideas on paper.

“Woodstream Writers”

He turned his head sharply, gasped, and said “Yes! I thought you looked familiar!”

Way back during that time, I had been tempted to ask him out. He had a charming upbeat personality.

Now he’s my patient.

Oh well.

 

Patients say the darndest things!

“What a nice heroin thump.”

I’m not sure I heard him right.

“I’m sorry. What?”

“You know, like the drug addict on any crime show or movie, the way you flicked my arm before you wiped that alcohol and wrapped the tourniquet … you did it perfect.”

“Huh?”

“The way they flick the skin with their index finger, come on, you know!”

There’s a compliment in that statement, I guess, but I don’t want to retrieve it. I did laugh a genuine laugh.

“Sir, I’m going to remember this moment.”

He admitted to watching way too much T .V.

And his responding laugh was just as genuine.

You’re not getting a car, your getting on my nerves.

You remember the year Oprah gave everyone in the studio a car for Christmas. She waved her arm around the audience, pointing at random people, yelling, “You’re getting a car and you’re getting a car and you’re …”

For a couple of months now, I’ve driven to work, gotten out of my car, and as I walk toward the entrance, I’ve felt heaviness in my chest. (And no, it’s not my arrhythmia)

I dread work.

Not the patients,

Not being a nurse.

It’s the company I keep.

I want to wave my arm around, pointing to certain coworkers, and holler, “You’re a problem and you’re a problem and you’re…”

You get it.

Here’s the thing with transparency, some of it has a negative impact. When I hear peers say “I gotta look out for me, gotta take care of me first” and “This is just a job, I’ll quit if they expect me to do that,” I get discouraged. Yes, they are being honest, but come on — my favorite is “I’m leaving at the end of my shift; I don’t care how many patients are coming out.”

What?!

I feel very alone.

I understand healthy boundaries and the importance of self-care. I guess I should have some appreciation that a peer feels comfortable telling me exactly how she feels, but what if we all get that way? What happens when everyone wants to do the minimum? If I share with them the impact of their comments to me, am I not in a way doing the same, making it about me, not the patients.

It might be time to look for a new tribe of nurses to work with. It’s a drastic step, but one that needs to be considered at this point.