The look on her face, something was wrong.

It wasn ‘t her vital signs, they were perfect. It wasn’t her dressing. She was laying on her right side, her left arm over the blanket, the telfa dressing on her bicep dry and intact – not a speck of blood on it.

It was the look on her face.

She looked anxious.

She didn’t have a pre-existing permcath.

This surgery – it was her first. This wasn’t a revision done on a fistula worn out from years of work.

I’ve seen this kind of look; the distant stare, the mouth partially open, an effort to keep the bottom lip from quivering and triggering tears. My daughter had it when someone she loved broke her heart and moving forward took monumental effort.

I was looking at someone trying not to break.

I couldn’t walk away.

Stepping over to the side of the stretcher and squatting down, I took my mask off for a moment and looked her in the eyes.

“Having dialysis is going to be like going to the grocery store. In order to keep food in your fridge, you go to the store. You’re going to go to dialysis to keep your kidneys happy and the next day your going to go out with your friends for lunch. In the evening you’re going to read more pages of that book you started. “

I pulled my mask back up and paused.

She nodded her head. I saw the furrows in her forehead disappear.

Five minutes later her friend showed up to hear the discharge instructions, provide a ride home, and company.

The scared look on her face, it was gone.

Like it does for all of us, I know it will return. but I was happy she left without it.

You would have thought…

Wednesday – crazy busy. By the time I got to the last two surgery patients, I was obsessively checking their charts and online orders for accuracy of consents and thoroughness of things like pre-op antibiotics and entered H&P’s ( History and Physical).

See, things were getting blurry having gone back to back with patient preparation. Compartmentalization skills are a necessity — you have to be able to move on once a patient goes to the Operating Room. However, if there is no down time, like about ten minutes to prep for the next patient, information from your last patient is still in the forefront of your mind. Hence the obsessive rechecking of information.

Thursday – easier.

Friday – discharged a patient by going to the Recovery room and doing my phase of Discharge care from there. Then on to helping with a patient from the floor that needed a central line before going back to his unit post surgery.

* Note – Recovery room RN’s Rock big time !!

I was on call Sunday so unlike everyone else I wasn’t like ” Oh, I want to get out of here and start my three day weekend.” Being on call means you need to be able to stop what you are doing immediately and come to work.

I did have family coming to town Sunday evening and I was to see them Monday, that’s nice, but I didn’t have a three day weekend coming my way. Frankly, I was getting annoyed at everyone moaning about having to work their whole shift .

So, Friday over, Saturday comes and I run around doing errands, laundry, yardwork, etc… Like it has been for every weekend I’m on call, I knew I was going to get called in. Saturday was the only day to catch up on things not done during the week.

I woke up at 0700 Sunday morning, showered, and ate breakfast. I had a pen and paper by my phone — ready for that call from the hospital supervisor.

0900 – No call

1100 – No call. I watered the plants on the porch then sat down to read. keeping my phone close.

1200 – Feeling bold , I went grocery shopping. I was in and out in fifteen minutes with two weeks of groceries.

2 pm – Still no call. By this time I was sure this was going to be a day where that call would come at 7:00 pm when I was completely wound down and ready to get in pajamas and watch a good movie.

Getting called in to work became a figurative beast lurking outside my home. I was cautious with every decision I made. Paint my nails ? What if I’m called in ? Do some stretches? I’d surely sweat and have to go in stinking. It was almost 4 pm before I realized I’d been home for four hours and not removed my sneakers!

When I passed the 7 pm mark with no phone call from the hospital , I exhaled and at the same time grumbled a little.

I didn’t enjoy my Sunday. I technically had a three day weekend, but in body only, not in mind.

In my mind I was prepping for what might come.

Owning your day. That’s what makes it special.

So, when anyone asks me tomorrow if I enjoyed my three day weekend, I’m going to say ” I did not have a three day weekend.”

Politics, Sex, and Religion

When asked about one of those forbidden topics

” So, I have specific instructions from your surgeon and also, on the pages that follow is some information about recommendations post hernia repair.”

Sitting up in the stretcher opposite of where I stood, his color was good, his breathing even and unlabored. A recent check of his dressing confirmed no drainage and well intact.

With a smile on his face, he raised his hand like a confident school boy sure of the answer.

“Yes?” I expected him to tell me he needed to use the restroom.

“When can I have sex?”

“Well, let me read your instructions from the surgeon.”

I thought it was a good save.

” May remove the dressing in 48 hours.”

” May shower in 48 hours.”

” Ten pound lifting restriction.”

” No strenuous or vigorous activity.”

” May resume previous diet.”

” Keep follow up visit”

I couldn’t read his expression to the information I’d just read.

” So, when can I have sex?”

I adjusted my tone to ensure I wasn’t coming across piqued by his insistence for a more direct response and tried again.

“You have had four tiny incisions made through your skin all the way to inside your peritoneum. Please keep this in mind when it comes to pushing, pulling, lifting, bending, and any body mechanics involved in your recovery.”

He raised his hand halfway though my comment.

” So, when can I have…”

I cut him short.

” When is your post op visit?”

“Miss, its May 20th.”

His smile was so big I could see all his teeth. Deliberating whether I should get into the metaphysical language of the word ‘sex’, I decided on caution and resorted to a steadfast rule learned in Nursing school about forbidden topics.

” Sir, that appointment — make it sooner.”

Oh No! Read the subtitle underneath!

All online ! What ?!

So, as more and more people live longer and have complicated healthcare issues, we now provide an opportunity to get all the required ‘training’ online! My eye started to twitch just reading the simple text underneath the photo.

Don’t lure people into this profession this way !

No career should be promoted as one that you can acquire by computer work alone.

Sooooooo much is missed!

My Anniversary

This is my personal One year anniversary, that is, my one year ‘COVID’ anniversary because this is when I started cancelling things; plane trips ( three to be exact), my gym membership, and hotel arrangements for the U.S Gymnastics Olympic team trials, to name a few.

This is when I started wearing a mask to work.

I’ve come to believe that hospital employees might be wearing masks forever.

It might be a thing, like stopping at the dispenser and washing your hands before entering a patients’ room. And like all things, there will be rebels. The hard-headed ones will come to work with colorful masks until management catches them.

When unmasked ( I couldn’t ignore the pun here), they’ll switch to the standard Level 3 tangerine shaded mask until their supervisor walks away, then Boom! they’ll whip out their bedazzled royal purple linen mask the blends perfect with their navy blue scrubs.

The second time they’re caught, they’ll plead for understanding, claim the coordinated look helps with their stress level.

We’re adjusting. Like everyone else, we each have our own coping mechanisms 😉

Reflection

If empathy is presented to you as a gift and it is not a part of the fabric of the soul, be wary.

It could simply be a metaphorical Trojan horse sent to expose your vulnerable side.

*Yes, this is the results of work events that have my guard up.

My patients continue to fill my cup.

If There Are Any Angels in Heaven, They Are All Nurses — Atkins Bookshelf

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In a beautiful and moving evening vigil to remember the 400,000 lives lost to the Covid-19 pandemic, President-Elect Biden stood somberly at the end of the Lincoln Memorial reflecting pool. Prior to his formal remarks he acknowledged that it was appropriate that a nurse, Lori Marie Key, sing the soaring hymn, “Amazing Grace.” Back in […]

If There Are Any Angels in Heaven, They Are All Nurses — Atkins Bookshelf

It’s all about balance

Nurse A is on left. Nurse B is on the right.

Nurse A gave me a bright red cellophane wrapped ceramic tub, Christmas decorated, palm sized, filled with assorted chocolates and hard candies.

Nurse B saw me the next day waiting by the elevator and approached.

” Hey, I’ve lost a lot of weight and have scrubs that are way too big. Do you or do you know anyone who would want a set of three for only $40?”

She looked me up and down as she said this.

I said nothing.

” They’re a good deal. Set of three. They’re huge on me. I can’t wear them anymore.”

Good thing a mask covered half my expression.

Still love this place.

Reason # 924 I love NYC

What was I thinking

I sat, with the screen behind me – the one sometimes used for people that sign in remote for the meeting; the Nursing Programs coordinator on my right.

” Our upcoming December meeting will be short, bring your units End of Year summaries. The rest is more of a holiday lunch for all of us. Then in January Susan will be the group Chair and in charge.”

I looked around the room at critical care, ER, and floor nurses who juggled five to six patients at once for twelve hour days.

Co-chair. Co-chair. Please mention the needed co-chair.

“We will be voting for a Co-chair.”

Whew! I’ll have a sidekick.

I’ve always referred to Pre / Phase II post op nursing as a boutique job. Yes, there are moments of run run run, hurry and wait, and patients with blood sugars of over 400 that make you go ” Insulin order please, right now !” However, on the average, we’re like that Park Avenue shop with an edited assortment of cute clothes for people size 6 to 10 and coordinated accessories. You get what I mean. The critical care and floor nurses have a wider breadth of work responsibilities and unplanned events during their day.

So…

It’s humbling, for me, to be a part of this group.

My understanding of Imposter Syndrome has increased tenfold with the transition of responsibility looming right around the corner.

I avoided eye contact with anyone, not wanting to reveal just how intense my anxiety was.

We’ll see how this goes.