Measure twice. Cut once.

“No. I’m not sure you should.” I looked her square in the eye, giving her the I’m serious look.

Her smile got bigger , dozens of creased lines surrounded her eyes. She’d put eye shadow and mascara for the occasion.

“O.K. This EKG is done. I’ll be right back – need to show it to Anesthesia.”

” I’ll stay here.” She plopped her arms down over her belly and sighed.

I returned with the report signed, hearing on the way back that todays surgeries, more complicated than expected, continued to darken her surgeon’s mood.

“Okay. He should be out soon.”

She was my fourth patient, by far the most spirited, and with an amazing attitude about the decision to have both knees replaced at the same time.

The doors between our department and OR swung open and here he came, scrubs wrinkled so much he looked like he’d slept in them for three days. His jaw slack, his shoulders down, I felt some empathy usually only reserved for patients. I stepped quickly to the bay. I had one chance to make sure he signed everything on the chart.

“Okay. You ready? Your up next. We’re doing both knees so I don’t need to use this skin marker on either leg. Any questions?”

She twisted her mouth then opened it slowly before speaking.  I took a deep breath in.

I am not responsible for everything the patients say. I am not responsible for everything the patients say.

“No, but I want to give you some advise young man.”

He raised his eyebrows. “And that is…?”

“Measure twice. Cut once. Advise we quilters give each other. You could use it too.”

My eyes bobbed back and forth between the two of them. She said it so matter of fact.

He cocked his head then dropped his eyes down for a moment.

Then he let out the biggest laugh.

“Darlin’ you just made my day!”

 

 

 

We didn’t see his type often.

He walked in, chin up, thick belly, arms cocked at his side, gave me a smile, a mischievous smile, and I thought , oh well, every now and then, you gotta take care of someone you know is going to be different.

“Hi David, I’m going to be your nurse. We need to get your weight and height right over here.”

He gave me a ‘You must be crazy’ look, but he did comply. I jotted the numbers down and led him along with his female escort to his pre –op bay.

Paperwork completed, I closed the curtain, giving him privacy to change.

A small adult cuff fit his arm, Yay!, the O² saturation probe picked up fast, and I thought things were going well until the woman with him asked for help.

“Susan, we need to find a channel he likes, like fast!”

I started pushing the channel up button as quick as possible. I didn’t want a meltdown on my hands. He started to scowl. His face turned red. I flipped to high channels then back to low one. Panic was making me inconsistent. Why does the hospital need sixty-eight channels? I just passed a really hard test. I can’t believe how nervous this is making me.

Finally.

Channel 18.

The cartoon channel.

Crisis diverted.

Four year olds are cute, but I’ve changed my mind about being ready for grandparenthood!

 

I Passed.

Almost two years ago I posted about my failure to pass a specialty nursing certification exam.

It hurt.

Six months later I took it again with the same results. I physically felt like less of a person, less of a nurse.

Over the years, I’ve been repeatedly recognized for the quality of my work. Still yet, I wanted to pass that test. I wanted closure on the dogma that correctly answering at least 140 out of 185 questions legitimized my knowledge in the surgical setting.

So, yes, I took the exam again.

And I passed.

The joy is tempered by the fact that it took me three attempts. Fortunately, it didn’t deter the response of my coworkers.

I’m most thankful for the one coworker that said, “ I’m so proud that you didn’t give up.”

Yeah… just typing that sentence makes me smile.

I’m glad I didn’t give up!

 

Compassionate Doctors on Twitter led me here:

March Moment

“I don’t like needles.”

Twenty-one. Probably his first. Unless he’s donated blood.

“Thanks for letting me know. Most don’t. We use lidocaine. Just like at the dentist. It ‘ll make it less painful.”

“If it hurts at all, I’m going to punch someone.”

I waited to hear a laugh. No laugh.

Twenty-one. 6’4”. Long reach. Sculpted biceps.

Hmmm.

“I’ll be right back.”

brrinng brrinng

“Hello. Anesthesia. I have a patient that I need help with starting his IV.”

____________________

This is the only time I have bailed on a patient.

Dear Daughter

Dear Daughter,

At least thirty-eight random people (patients I’ve readied for surgery) know where you live. 

I can’t help it.

See, when I meet them, they change, and they’re lying there after I’ve put them on the monitors, started IV’s, etc., I make casual conversation. I want them to be a little distracted. I don’t quiz them on the discharge planning I’ve initiated. I mean, they’re going to go under general anesthesia in under an hour. I don’t need to add test anxiety to the list of their issues.

So, sometimes the “You born here?” “You a native?” “I hear an accent” results in me hearing them say,” I’m from New York” “Was born in Brooklyn” “From Long Island” and that’s when it happens…

I miss you.

And, as if to feel a little closer to you, I spit out your address.

“My daughter lives there.” (I like to tell them Manhattan. It’s cosmopolitan, which I think you are. ) “She’s at 31___   East _______ “

May can’t get here fast enough!

 

Code Purple

It  means our ER is saturated.

_______________________

I came across the link below posted on Facebook by a coworker.  The author is Jennifer Kawaski ( The Magenta Emergency Nurse ). Look her up her on WordPress.

She walks the fine line between saying it like it is and not stepping on too many toes of  the more sensitive reader!

https://www.huffingtonpost.com/entry/dear-america-you-need-to-be-nice_us_59407687e4b03e17eee087cb?ncid=engmodushpmg00000003

 

Truth

Not Hitting the Snooze Button

Instead of sleeping in on a Saturday morning, I followed up on an invitation from a friend to attend an in-service hosted by Central Florida’s Case Management Association.

The focus was Heart Health: The Latest in Thrombosis Care, Exercise Impacts on the Heart, and Heart Healthy Eating

I’m a heart patient.

My work history includes Workers Compensation Case Management.

And this free in-service included, can you believe it – FREE, included breakfast and a gift basket raffle.

How much better can it get?

Well, let me tell you…

Hospital Case managers, insurance case managers, case managers that worked in Rehab settings, some in Home Health agencies — a melting pot of healthcare professionals linked by their chosen specialty.

Around me I could hear everyone discussing the topics, sharing ideas, and, of course, having some good old fashioned fun when the Exercise Impact speakers had us all up out of our chairs and stretching. (I wore heels. Bad choice.)

I may not do Case Management anymore, but attending this in-service, learning, and just as important, seeing the camaraderie among the people in attendance, made me happy I started my Saturday the way I did.

Now tomorrow…I’m gonna sleep in : )

 

A Very Good Read

This is the first time I have reposted something since starting this blog four years ago.

I have a good reason.

While walking through Barnes and Noble, I noticed this book pictured below. I read it a year ago.

That little gold sticker on the  right reads, just in case you can’t  enlarge it, here, let me help you,

Finalist for Pulitzer Prize

____________________________________________________

I don’t look for these books, they find me, Death Be Not Proud, Before I Go, Being Mortal, and now When Breath Becomes Air — stories that don’t glorify death, only bring to light the questions intersecting life, death, and meaning.

When Breath Becomes Air crossed my daughter’s path (a lover of Hiaasen and Palahniuk), not mine, she mentioned it to me in the same easygoing manner she would share her yoga schedule. Little did she know how much of an impact reading this book who have on me.

Atul Gawande and Carol Cassella are the only other physician/ writers of who’s work I’ve read; Gawande —philosophical and earnest in taking his own experiences and finding the common threads we can all relate to; Cassella , in my opinion, a master of upmarket fiction  who creates stories with characters and themes that jump off the page and hold you captive.

Kalinithe’s memoir, completed by his wife when cancer took him, is a lyrical retelling of his entrance into residency, the day he learned of his diagnosis, and how the blending of his calling and his cancer gave him a perspective he was driven to share until the very end. Kalinithe explained early on that he chose neurosurgery because “the brain is the crucible of our identity and medicates our experiences of the world.” Little did he know that lung cancer would spread to his brain and be one of his last teachers.

I don’t have a fondness for stories about people dying. I am a hopeless romantic who could watch Rob Reiner movies all day. It could be the “doctor becomes patient” thing I find intriguing. William Hurt did this well in a 1991 movie, but, it was fiction. While reading When Breath Becomes Air there is no getting up and categorizing the plot as a well-crafted or full of witty dialogue you want to share with friends.

I feel blessed to have gotten to read this book. Right after “courageous” the word “generous” comes to mind, courageous not because Mr. Kalanithe pushed hard to keep working, keep helping people, courageous because he was willing to put his fears and insecurities on paper and leave them for all to read.

And generous, that’s self-explanatory once you read the book.