Mommy Nurse Wife and 25!

I'm baaaack

2007-05-23T03:38:00.000-07:00

Hey everyone out there! It's bee a while since I've posted anything but I wanted to say a quick HELLO to everyone!!!!

Guess what I did in the last few months?

-I took a 3 week vacation at our timeshare in Myrtle Beach.
-I became a CEN.
-I cut back my hours to 24.
-I lost 3 pounds (which is a lot when you're 4'10")
-I started therapy for my OCD.

And I wrote a really funny story, so I'll post it when my kiddos take a nap :)

Burritos

2006-11-07T03:22:00.000-08:00

I am realizing that we workers of the ED see a side of
humanity that most people aren't privileged to
experience. On the last weekend I worked we had about
5 patients who were a bit shy in the hygiene
department. You all know what I'm talking about don't
you?

The patient usually will come in one minute away from
gun point by a family member or friend who insists on
an ED visit. In my experience, this patient also will
arrive via rescue because he is unable to ambulate and
hasn't been out of his bed/recliner/futon for 6+
weeks. This is the patient whom the EMTs will make
what Donnie refers to as a patient burrito; they wrap
the patient and whatever he is wearing/laying in in a
neat little package for the receiving RN. There is
usually a faint odor of something horrible in said
burrito which is usually not fully experienced until
the burrito is unwrapped to apply a johnnie. Once
opened, an emaciated body lays ahead bearing a pair of
slippers, PJ pants, and once white now yellow tee
shirt. The patient has greasy hair which hasn't seen
water or shampoo for months, long yellow fingernails
with some sort of brown substance underneath (if the
patient is demented, you can bet there's some poop
involved), and teeth which are one step away from
complete and total rot. And of course, my least
favorite part, the feet. Once the slippers are off the
week old socks need to come off as well. And with the
sock comes the old skin cloud which in turn leaves a
film of skin flakes on the bed just like a coat of fresh snow.

Every time I have a patient in this condition it makes
me more sad than I can express. Usually these
patients are at home, alone, and unable or unwilling
to care for themselves. Or, they are at home, with
family, but are just not taken care of in the manner in
which a person should. I really donÂt know if I feel lucky to see this side of people or if itÂs just one of those downfalls of my job. If you work at a normal job like the bank, a school, or a construction site you donÂt really bump into someone who has been laying in his poop for 36 hours. So I feel like it is sort ofprivilegeege to take care of these poor souls, I think ignorance is truly bliss in this case.

The Trick-or-Treat Quandry

2006-10-31T17:32:00.000-08:00

So here's a new skill I have to learn as a parent.

How do I manage NOT to eat the entire contents of my daughter's Halloween bag tonight after she's in bed?

Hmmmm...

HI out there!

2006-10-30T15:34:00.000-08:00

Hey ya'll, I know I'm being a total shit and neglecting this blog. Sorry.

But, in my defense, daylight savings is a bitch when you have two little kiddos who are on a very tight sleeping schedule. The theme of this week is "time-outs" and "let's see who can get the kids to bed the quickest before one of them is hurt by a parent."

Cheers!

Wahoo Doggie!!!!

2006-10-22T20:52:00.000-07:00

Yay, it's Change of Shift!!a

Not a good sign

2006-10-17T05:38:00.000-07:00

Someone please tell me that the future is going to be OK when your 2 year old makes this statement to her grandparents;

"If I want it, I will get it."

Oh Dear God what am I in for with this girl?

Help please!

2006-10-10T20:54:00.000-07:00

Hey, BTW, anyone have any good ideas how to make a home-made chicken costume? Both of my kids are going to be chickens for Halloween and I want to join them. We're going to be The Bird Flu!

Happy but then sad

2006-10-10T20:42:00.000-07:00

Last night was one of those nights I left the ED feeling really happy. I liked my job, I was thinking about how much I love being a nurse, and feeling really happy with how things are going.

Tonight is one of those nights I leave-no run from--the department and never want to show my face there again. It was so busy, with very sick (and might I add, heavy) patients. It was one of those nights when I felt I was just putting out fire after fire but not really taking great care of my patients. I hate that feeling.

So, alas, I sit here, exhausted and unable to go bed because I'm wired from work. I'm hungry but really don't want to eat because I'm on South Beach Phase One and the food is boring. I want to sleep but my insomnia is back in full force and I can't yet face tossing and turning for the next 4 hours. So I'll read my favorite blogs and hopefully eventually wind down. Maybe I need to pick up an after-work hobby. One of my nurse friend plays Diner Dash when she gets home, maybe I'll try that.

Check it Out

2006-10-07T04:28:00.000-07:00

Yay! It's time for a new Change of Shift

PB Boob

2006-10-03T18:44:00.000-07:00

I sometimes feel that my life would make a great sitcom. Today I was leaving the house with my one year old in my left arm, my bag slung over my shoulder, a water bottle mashed in my right armpit, and I was carrying my breakfast for the car. It was a Thomas Lite English muffin (my favorite) with peanut butter. Yummy. Right as I was getting through my back door everything started to slip and I had to scramble to catch everything and not sacrifice my food. I took a few more steps and noticed that the peanut butter was melting off the muffin down my hand. Then I thought, "wow, that could have been ugly if it got on me." I then, just as a precaution, checked myself to see if I had, in fact, been peanut buttered. I looked down at my clean (OK, somewhat clean, I'm a working mom after all) black V-neck and saw an English muffin peanut butter outline on my right breast. I'd been hit.

So at this point, I've got the kid in my arm, the car doors opened, the two year old out the door, and a boob full of peanut butter. I thought, "Well, I could just grab a baby wipe in the car and clean myself off OR I could go ALL the way back in the house to change." What would you do?

Yeah, I actually did go back in a change. But it was only because I was on my way to a new playgroup and didn't want to make a complete ass out of myself right off teh bat. I swear, if I was on my way to Wal-Mart or work I would have had one wet boob and a smile on my face. I can't even imagine what my neighbors thought when they saw that spectacle from across the lawn :)

Yummy

2006-10-03T18:42:00.000-07:00

Anyone watch Dancing With the Stars tonight? OMFG Mario Lopez was sooo good. HOT!!!

(And, yes, I am not ashamed to admit that I watch it, it's a fun show!)

Stand Tall!

2006-10-03T08:51:00.000-07:00

A part of me can't wait to stop stooping over. With little kids I feel as if I do it all day long every day. You stoop to pick them up. To rid the floors of
toys. To change a diaper, wash a face, give a hug, tie shoes, pull up the pants, pick up the cup that was hurled from the highchair, kiss goodnight, fix an oowie. I love my kids very much, and enjoy this age, but I also can't wait to look at the world with a nice straight back and un-bent legs. What a feeling to be
upright and not cromagnum man!

I'm baaack!

2006-09-26T03:43:00.000-07:00

Hey ya'll I'm still here. I just got back from my yoga workshop in Asheville NC. I will write about this wonderful trip I had soon, but now I am exhausted as it took us 20 hours to get home instead of the 4 hours we were promised. Sigh.

Thought for the day for anyone who wishes to pass the time...

If you were a patient, would you want YOU for your nurse???

If these stretchers could talk

2006-09-17T08:41:00.000-07:00

It is my observation that you can put people into two catergories, A)Those who love codes and B) Those who hate them. I am in the "A" column...I love a good code.

The first code save I was witness to happened in my senior internship at Dartmouth ED. 47 year old male decided to have his chest pain checked out randomly one day after having intermittent pain x 2 weeks(much to the dismay of his wife, a cardiac nurse). He came in, was placed on the monitor and within seconds his eyes rolled back in his head and we went into Torsades. My preceptor and another nurse promptly shocked him and brought him back to life. It was one of the coolest things I had witnessed in my life. I was in love.

After I became a nurse I became ACLS and PALS certified immediately (not only because of my love for that stuff, working in ICU it was required). Four months after that I became an ACLS instructor. I love it.

So you can imagine my excitement the other day when we had an interesting code. 90 something year old woman who was in the ED with nausea. She was tiny, about 80 lbs soaking wet, with diabetes, a cardiac history, and a bilateral above the knee amuptation, in addition to other medical problems. She was what we all call a train wreck. She developed chest pain, then SOB, then went semi-unresponsive in a matter of minutes. We moved her to a critical care room and hooked her up to the monitor. Not good. We all know that second we look up at the monitor and see those large and ominious tombstones. Not good.

But then, a PVC. And then another. Then a couplet. Bigemeny. Trigemeny. V-tach (with pulse). Shock. Tombstones, pulseless. V-tach, pulse. Shock. And so on and so on. It felt like we were in the megacode testing section of ACLS and someone was trying to trick us. We gave Lidocaine, Atropine, Epi, Retavase. By the end of it she was on Amiodarone and Heparin drips. It was a really good test of our teams skills.

But the whole time it felt like torture to me, and I had a flood of those old feelings from the ICU come back to me. These old, frail, sick people who are dying and we just can't let them go (usually because the family just isn't ready). When in that situation I usually feel very torn, as if I'm in a war and torturing someone for information. It's a very challenging situation for me because I know if it was my mother or father or husband in that situation I wouldn't let go of that hope that they might come back either...But I also know that most of those patients in that situation are ready. And for me, a situation like this is one of the most heart-renching and difficult situations we face at our jobs. When to draw the line between playing God and just letting things be as they are.

So amongst all of these feelings the daughter was there, crying and talking to her mom. Saying "oh mom, oh mom," while we're pushing Retavase. And then, we helped her understand that it was time, and since she didn't want us to intubate or press on her chest, we needed to stop. And we did. And she passed away.

Eventually the daughter left, the funeral home came and got the body, I cleaned the stretcher. Within five minutes there was another patient in that very same bed where another person had just passed away. The next patient was a happy, healthy 60 year old with a TIA. He was laughing, making jokes, and had a lovely wife and daughter at his side.

Not only thirty minutes ago I been struggling with my internal debate over letting someone go or carrying on with the code. How quickly we can shift gears and move on huh? The new family had no idea what had just gone on, the magnitude of what we had all just experienced, and the work day forged on.

This happens every day. Maybe not as dramatic as this but to some degree. We go from CPR to suturing a little girl with a lip lac. We put people in 4 points and then start an IV on a pregnant woman with hyperemesis. We are constantly switching gears, moving on, and to me that is just amazing.

So the new family, the TIA family, commented on how good the room smelled upon their arrival. It was funny because to me, that was the lingering smell of death, to the daughter, it smelled like brownies. If only those stretchers could talk huh?

Awww

2006-09-14T16:24:00.000-07:00

I am about to cry.

Lily just paid me $10 (Monopoly money, of course) for "doing a good job, momma."

Makes my heart want to explode with love and joy :)

My story

2006-09-11T08:22:00.000-07:00

Everyone has his or her own version of this story...Here's mine.

I was in my senior year of college, on my way to becoming a nurse. It was a Tuesday morning and we were starting our rotation on the Psychiatric Unit at Dartmouth-Hitchcock Medical Center. My only experience with psych patients to this point had been from behind the thick glass of the nurses station in my local ED where I worked as a CNA. I was scared shitless.

We were getting our tour of the unit when someone spotted the World Trade Center on TV. We all instantly recognized it but it did take a second or two to realize that something was wrong...the damn building was smoking. We paused for a minute or two, and continued on with our tour.

About halfway through our day my nursing instructor called us all to a meeting. We sat in a circle and began discussing what was going on in New York City. I can remember trying really hard not to cry but wasn't successful. I was crying for all of those families who didn't know where their loves ones were. I was crying for those poor people who were trapped inside those buildings. I was crying because my mother was flying to Florida the very next day. And I was crying for the firefighters.

At that point Donnie and I had been together only a few months. We fell head over heels in love instantly and had a special connection. I had only known this man a short amount of time and my heart was breaking at the very thought of him being in that situation as were other firefighters. I couldn't stop thinking of the wives, children, parents, and partners of the firefighters whose loved ones were on shift that day. What were they going through? The pain and worry was overwhelming.

We were dismissed early that day. As you can imagine, the images of the Twin Towers collapsing was just a little too much for the patients on the psych ward to handle that day. Why no one shut off the TV on the unit is beyond me...Perhaps it was for the same reason we all didn't shut off the TV, we just couldn't.

I remember getting home that day and finding my roommates on the couch (I lived with three other girls). They didn't move from that spot for hours. I, on the other hand, didn't even pause my day. I picked up my books and a snack and headed off to the library to study. After that, I worked on a care plan. I went through the motions of my daily life like that for 3 days. Only for a few minutes did I actually sit down and watch the footage, and that was only to be social with the girls.

Friday morning I packed up my car and headed home. One of Donnie's best friends was getting married that weekend and I told him I'd be his date. Right outside of Concord, NH there was a song on the radio. It was a Bruce Springstein song with voice overs from the tragedy. People were crying, screaming, commenting on what had happened. It was a beautiful piece of work. It was also the one thing that broke my shell. It finally hit me what had happened at that moment and I couldn't handle it. The flood gates opened and I started to cry. And cry and cry and cry. So much that I had to pull over to the side of the road.

I had gone through the motions of being sad but before that moment I hadn't really meant it. I think it was all too much for me to handle so I just kept busy to avoid dealing with my real feelings about the whole situation. Yes, I did cry and yes I was sad but it didn't affect me until that moment. Then I let me guard down and truly felt what had happened.

I learned a very important lesson that week. I am so good at keeping busy that sometimes I don't ever take the time to stop. I don't think this is a problem that only I face, I think it's sort of the norm in the American culture. I know it's something that I have to work on and I am trying.

So now, here I sit, five years later. Married, 3 kids, 2 jobs, and a different person than I was when those towers were hit. It's amazing what can happen in 5 short years, and it's even more amazing how quickly five years can pass. I can't even begin to think what the next five have in store for us...

:(

2006-09-11T03:44:00.000-07:00

Sad this morning.

Pat (my bro in Baghdad) called me yesterday and I missed his call. Sad.

9/11 today. Too sad for words.

2006-09-08T20:24:00.000-07:00

So tired.

Must
sleep but can't
tear myself away
from the Internet.

Deep breath and PUFF

2006-09-07T20:58:00.000-07:00

I've been thinking about how much of a pain in the ass (hee hee, literally) it is to give our cocktail. You know which one I'm talking about right? The three shots in the bum of Haldol/Ativan/Benadryl we use to chemically sedate patients who are out of control. You've got to draw them up, label them somehow so you can document what went where in the body, don gloves and THEN step into a room with a person who is usually psychotic and pissed off and shoot them up when they're at their angriest. It's like sticking a banana up the nose of a bull during a bullfight...it just aint right.

So here are my proposed new methods of infusing Ativan (or insert your favorite med here) into the world without actually having contact with the patient.

1. Ativan blow darts. Man o man would we have fun with this one. Anytime a patient is getting rowdy just suck in some air and puff in the general direction and WHAM, they'll go down like one of those elephants who has escaped from the circus (Note to self, must spend hours of practice on aim on my children during the "witching hour").

2. Ativan rectal gel. We do it was valium, why not Ativan? Just grease up the inside of the patients johnny pants and wait them out. In my experience psych patients really like to talk and talk and talk, so just let them do their thing while the jelly works its way up. This could also be a handy payback joke to the local paramedics. Just a little on the ambulance seat and you're golden.

3. Ativan cool mist. I envision a switch behind the desk where you can simply turn it on and watch the calmness wash over the patient. This can also double as the "Cool Your Jets" Room for fellow nurses, physicians, PAs, and NPs who are just having a really tough day. Or any family member who needs to simmer down. Or anyone from administration. Or, well, I'll stop there because I think this one could go on and on. Why not just put an Ativan mist in every room in the hospital? I'm SURE that would increase our satisfaction scores.

4. Ativan laced Turkey sandwiches. Because everyone who is in our department wants breakfast/lunch/dinner this would be a very easy way to sneak in some sedatives. Note to self, LABEL laced and non-laced varieties or nursing staff will be incompacitated.

Those are my top 4 choices. If you think of more, please don't hesitate to write me and share. Some day, our fantasy may become a reality. Though, we'd really have to come up with some pretty strict policies on when you can use these, because I have a sneaking suspicion that if we had Ativan blow darts it would be way too much fun to resist using at least a few times a shift :)

Wa-hoo!

2006-09-07T20:41:00.000-07:00

Hey everyone, it'schange of Shift!

Sharpie

2006-09-06T20:57:00.000-07:00

I can't even start to tell you guys how happy that I am home and not at work anymore. I just left there and it was sooo asshole and psych night. Everyone we took care of was either wanting to kill himself or a complete a-hole. Annnd, you know it's going to be bad when the cops call and tell you to have the "shots" ready because they're bringing in a "live one."

But, we did have a good crew on so it was OK. Plus, we ordered out and I got this amazing white pizza so that made me pretty happy.

Oh yeah, guess what? My insomnia is totally back. I can go years without it flaring and then all of the sudden it pops back in my life like an old boyfriend looking for a booty call. So now I'm making myself stay up late so maybe I will be able to actually get tired tonight. No matter what happens I'm going to be up around 6 with Sam so I guess it's a crap chute anyway you look at it.

On the bright side, my two friends and I all took over 2 1/2 hour naps this afternoon (so at least insomnia helps me nap :). I put them in their beds at noon, laid on mine and the next thing I knew my clock said 2:17 (I have to be at work at 2:45). So I got dressed (and, oops, I had fallen asleep with wet hair, so did something with that mess), woke the kids, and was out of the house at 2:31...not too bad huh? It was really funny though, I went to wake Lily up and she wasn't in her bed. So guess where I found her? In her closet! She had taken her nap on a blanket on the floor of her closet. Poor kid's going to have f'ed up sleeping habits like I do. Sigh.

PS- Are you supposed to laugh when your 2 year old writes on your new stairs with a sharpie? Yeah, my husband didn't like that either. I've got so much to learn. Double sigh.

So sad

2006-09-04T16:45:00.000-07:00

R.I.P. Crocodile Hunter. The world was a better, and more interesting, place with you in it.

Make-up

2006-09-03T21:15:00.000-07:00

I's sorry to be one of those moms who is constantly telling stories of her kids, but I can't help it! So here's one more.

Lily was putting on make-up the other day before I took her to the gym's child watch. As we were walking down the stairs she said to me, "Momma, I'm pretty with make-up." Then she stopped short, looked up at me and I swear I saw a light click on above her head, and she said "Boys going to be there?"

Seriously!!!! She's 2 and already asking about boys. I'm bidding on a chasity belt on ebay as we speak.

GD Sudafed

2006-09-03T21:05:00.000-07:00

Now I have that stinking cold that everyone else has. I am NOT a good sicky because all I do is whine. It's not even a bad cold, just annoying. Everytime I leaned over to start an IV my nose fountain would oven up and I'd be caught in that embarrassing dilemma...Let it drip or wipe it on my clean gloves.

So when I was sitting at the desk trying to pull off that snot-suck-up-the-nose maneuver the ED Doc said "You're not pregnant are you?" I replied with a quick, and very professional, "Fuck no" (in a quiet voice so no patients could hear, of course) she ran to her bag and brought me Sudafed. Now, let me tell you a little about me and Sudafed...it makes me a hyper crazy wired person. And for you out there that know my baseline, hyper/crazy/wired is a scary scary scary thought. For those who don't know me, I have a considerable amount of energy at any given time, and at my best am usually a bit wired and crazy.

Anyway, so now I'm at home with a perfectly clear nose and I am WiREd!!! I've already been laying in bed for an hour tossing and turning and cursing that G.D. Sudafed. So now, I've taken an Ativan and I'm patiently awaiting it to kick in. Once I'm done writing this I'm going to do some yoga and hopefully that will do the trick. If not, I'm off to clean my windows and vacuum. If I can't sleep everyone should be up, right :)

The Staples Lady

2006-08-31T03:59:00.000-07:00

Seriously.

The day after I wrote about how young I looked I was at Staples buying bubble envelopes for the stuff I'm selling on e-bay. I was in scrubs, since I was headed to work right after I did some errands. At the cash register, the lady who was ringing me up said "Dear, are you a nurse?" to which I replied, "Yes I am."

She looked me up and down and said, "My goodness, I must be getting old because you don't even look old enough to drive a car."

See what I mean???

Fit to be tied

2006-08-28T20:46:00.000-07:00

Sometimes I tell my patients that I'm a lot smarter than I look...Because, well, I am. If you don't know me here's my description:

I'm short, bleach blonde, and have the face of a twelve-year old. Seriously. I can't even start to tell you how many times I hear "Oh, you're my nurse" when people realize I'm not the candy striper. So when people are surprised that I'm not a total moron I always use one of two lines A) As above, I'm smarter than I look or B) Trust me, I'm a professional. Both get a good laugh and breaks the tension (but you have to know when to use them b/c they can be inappropriate if used incorrectly).

So, back to my point. I'm starting to think maybe I am pretty stupid because tonight was one of those moments of clarity where I realized we have a pretty dangerous job. I mean, I always acknowledged the fact that the ED can be a little wild and crazy, but I guess I never have felt scared or nervous. Tonight I didn't feel scared either but I realized that this guy on the stretcher in front of me could kill me if the police and security weren't pinning him to the bed. It's just funny when that happens you know? When you get a moment to hover above yourself and see things in a different light, from a different perspective. I still don't feel scared or nervous, but I do think there's a certain vunerablitiy (sorry about the spelling) to the ED which is maybe why I'm drawn to it, why we all do what we do. That excitement, the adrenaline all of that crap, it's great isn't it?

Author's note:
Sorry that this makes no sense, I'm very tired but can't seem to wind down after my shift. I'm sure I'll read this tomorrow and delete it because it's just non-sensical rambling. Thanks for listening though...

My pre-teen two year old

2006-08-26T16:17:00.000-07:00

Get a load of this one you guys:

This afternoon I was trying to get Lily in the house and asked her many (many many) times to come inside. So, finally, she said "Coming momma...jeez." And then,

"I'm coming momma, be quiet."

I can't believe it, I have a teenager already :)

Toots

2006-08-25T20:45:00.000-07:00

Hi everyone, I'm still here. Just been busy...doing what I have no idea, but I've been doing it well. So there.

So we took the kids to the Museum of Science on Monday for a nice little day trip. We had a lot of fun and it was really great to get out of dodge. On the way home my step-daughter was playing with this fart noise maker thingy she bought in the gift shop (how that is educational I really do not know) and was making the thing make tooting noises. The first time she made it toot it was funny. The next time it was funnier. And then, before we knew it, we were all laughing so hard that my belly was about to explode. Even Sam, who's one, was belly laughing everytime there was a toot.

And it was so great. We had spent the whole day at the museum and had a great time, but what I will remember for the rest of my life is laughing with my 3 kids and my husband in the car over tooting. It just makes me so happy...

Never Argue with a Woman

2006-08-19T08:55:00.000-07:00

One morning the husband returns after several hours of
fishing and decides to take a nap. Although not
familiar with the lake, the wife decides to take the
boat out. She motors out a short distance, anchors,
and reads her book.

Along comes a Game Warden in his boat. He pulls up
alongside the woman and says, "Good morning, Ma'am.
What are you doing?"

"Reading a book," she replies, (thinking, "Isn't that
obvious?")
"You're in a Restricted Fishing Area," he informs her.

"I'm sorry, officer, but I'm not fishing. I'm
reading."
"Yes, but you have all the equipment. For all I know
you could start at any moment. I'll have to take you
in and write you up."

"If you do that, I'll have to charge you with sexual l
assault," says the woman.

"But I haven't even touched you," says the game
warden.
"That's true, but you have all the equipment. For all
I know you could start at any moment."
"Have a nice day ma'am," and he left.

MORAL: Never argue with a woman who reads. It's likely
she can also think .

So here is the big news.

2006-08-14T09:29:00.000-07:00

The night after I wrote Pee in Pants I woke up with a cry-hangover (most of you women know what I mean; the fatigue, puffy eyes, emotional exhaustion) but had to get up for an 8:30 appt with my personal trainer. Exercise is the #1 thing in my life that can instantly boost my feelings and remove my chronic fatigue. So no matter how bad of a night I had just experienced I was not about to miss my appointment to have my ass kicked.

So I got there and she took one look at my puffy-eyes and near-tears and looked concerned, but I told her I didn’t want to talk about it and just kick my ass, please. So she did. And about halfway through my work-out she asked me if I’d come work for her. That I had the right background, I have a holistic and healthy outlook on life, and the right personality to make it in her profession. She is planning on a move which would make her business larger than she could handle alone. My knee-jerk reaction was “Hell no” because I’m a nurse and not a trainer. But after giving it some thought, and some coercion on her part, I was convinced that it’s something I can do. I also told her that one of my secret fantasy jobs was to be a yoga instructor, and she told me that she would support that and incorporate it in her business when the time came. The best part: she offered me exactly what I am making as an RN, and when I become certified and have my own clients, more.

So I had a long talk with Donnie and we both thought it was a great opportunity. The next morning, out of the blue, my friend Terry left me a message on my machine. She was inviting me to a three day weekend in NC, a yoga workshop, and asked me if I’d be interested in opening a yoga studio with her. Out of the blue this came just 24 hours after I’d had that offer from my trainer. Odd.

So I hemmed and hawed about it and decided that this is too much fate happening all at once and I have to follow this new path that has been placed in front of me. I have told my boss that I’d like to reduce my hours and I will be giving up my supervisor’s position. Once I told her I instantly felt as if a weight was off my shoulders. So now, if all works out as planned, I’ll work part-time in the ED and part-time as a trainer. This means I can always pick up more work in the ED if I need to, but have the flexibility to give to my new job. Also, down the road when my trainer job becomes full-time, I’ll be home every night of the week. That means when my kids are in school I can be home with them every night!!!

So, I am very excited about all of this. It’s very very scary, but I think that the universe is trying to tell me something and for once I am going to listen

Dammit!

2006-08-11T17:06:00.000-07:00

My wonderful daughter loves to slam doors (Really though, who doesn't??). But her habit has gone on so long, and so strong may I add, that her door is now coming off the hinges. So today, after almost shutting her brother in the door, the door started to really come loose. She called me in, looked up at me with her beautiful bright blue eyes and said, "Dammit!" then added,

"This dammit door is broken."

I think we reeeeallly need to cut back on our swearing.

Is THAT bad?

Is it even worse that my reaction to her saying this was laughter? I am such a bad mommy it's not even funny!

PS- I have exciting news to share with you all but no time to write of it now. I hate it whem my favorite shows do this but I'm about to anyway:

To Be Continued...

WOW!

2006-08-05T20:56:00.000-07:00

An actual conversation with my husband last night.

Husband (while studying my face):
"Wow, you really do look 26."

Me:
Silence

Husband:
"Really, you're aging."

Me:
Sound of a shotgun loading.

Husband:
"I don't know why it's such a big deal, everyone gets older. So are you."

Me:
Out the door, looking for a new husband. He still TODAY can't understand why this was not OK to say to me. WOW!

WTF?!?!

2006-07-30T07:50:00.000-07:00

I forgot to share this with you all:

We got new life insurance policies recently and our blood work/pee test was this week. The insurance lady measured me TWICE and I am now officially 4 feet 9 inches. I think the tape measure was rigged...

Priceless

2006-07-30T07:46:00.000-07:00

Presents for son's 1st birthday: $100.00

Cake for birthday party: $25.00

Photos for son's 1st year: $30.00

Discovering (right before he turns one)that your father-in-law thinks your son's middle name is Devon when it is actually Kevin: Priceless

Kenol

2006-07-29T16:14:00.000-07:00

It’s funny to watch these kids grow up. I am seeing more and more of my dad in my little man Sammy every day. A few weeks back I caught Sam staring in the trees as the wind blew through the leaves. He was in a world of his own watching them sway back and forth. Again I noticed him doing it a few days later, and since then I’ve seen him do it almost every time we’re outside.

Now, here’s why it’s really special. Any of you out there who know me really well know that my family is extremely close. I consider my parents two of my best friends in the world, and regard my brothers the same. I love them all for very different reasons and for the wonderful people they are.

My dad is one of the most interesting, creative, and kind person I know. In fact, my mom always told me that if I was lucky I’d grow up and marry someone just like him, which I did. So to see these little things crop up in my little guy really makes me happy. I hope that he’ll end up being as courageous as my dad, as gentle and kind, and as quirky. I can already tell that Sam is going to be very affectionate, into nature, loving, and happy.. It’s so cool to be able to see these things this early in his life. Makes me happy.

Welcome Jacob Owen

2006-07-27T15:27:00.000-07:00

Just so you all know, had a much better day today. Got a whole 5 hours of Ativan induced sleep and felt great in the AM. I went to my trainer at 8:30 and when I got home my long lost friend Allen came over. Then I had a really good in service at the hospital and got to meet my new nephew Jacob!

Congrats Stacey, James and Aidan. And a big shout out to Stacey who pushed a 9 lb 10 1/2 oz baby out vaginally and lived to tell the tale!

Pee in Pants

2006-07-27T15:24:00.000-07:00

Tonight was one of those nights in which I left work upset. I’m not going to elaborate, but I’m raw right now and I’ve been crying for about an hour straight. My eyes are red and puffy and I have snot pouring from my nose.

Despite how upset I am, I am very appreciative for two things. The first is my mom. I am so lucky to have a mother who I can wake up at midnight to talk to me. I am lucky that she is a nurse and knows what it is to be a nurse. I am even luckier that she was a former ED nurse IN this department so knows the unit like the back of her hand. I am so lucky that I have her, I can’t even really put it into words right now how grateful I really am.

The second is that I still have my sense of humor at a time like this. I was in the bathroom, washing my face, and went to blow my nose and all of the sudden I peed a little bit in my pants. PEED IN MY PANTS!!! I have never ever in my life done such a thing. So, now I’m sitting in my bathroom, puffy eyed and snot faced with pee in my underpants and thinking, “Well, now that I’m getting old I guess it’s time that my bladder function starts to go. Guess I’ll have to re-name my blog Mommy Nurse Wife and Pee in Pants at 26” and then I had a good chuckle and felt better.

I think I’d be OK right now if I wasn’t so goddamn sleep deprived, I really do. Tonight I just got pushed over the edge and feel vulnerable and I really think it’s because I’m very low in the sleep department.

So, I’m off to take a Benadryl or Ativan or something that will help me sleep and call it a night. It’s 1:08 AM right now and the kids will start getting up at 5. Luckily I have a wonderful husband who gets up with them and I’ll be able to sleep until 7 or so…hopefully.

Cows and money

2006-07-25T20:36:00.000-07:00

I usually don't watch the news but for some reason this morning I happened to catch it. Man, is the news depressing. Stories about dead bodies being found and this person molesting that person, robberies, stabbings...just so sad and too much for my little heart to absorb.

But here's what really gets me right now, which is also the reason I can't stomach the news. My brother, Pat, is in Baghdad with the Army and I can't stand the thought that he is THERE! I see things blowing up left and right and horrible things happening and I keep thinking that Pat is seeing this shit right up close. He's in the thick of it. He is such a brave person I can't even comprehend what he has been doing over there. And this is his 2d tour!

Many of you know that I don't like to talk religion. Just causes too much fighting. If you really want to get in it with me then bring it up sometime, but be ready because I'm passionate about what I do believe in. I really don't care what other believe, as long as you believe in something. If you want to worship cows, chocolate pudding, Buddah, God, the weather, Dansko clogs, Tori Amos, water, or money...it's all cool to me. But what I'd like, is for anyone out there who can, please send a little love to my brother Pat through your higher power. I do every night when I go to bed and I can't get him out of my mind tonight. I feel like I'm on the verge of tears just thinking about how proud of him I am and what an amazing person he has turned out to be. And how truly scared I am for him being in the middle of this mess.

And Pat, I'm sure you're not reading this but if you are, keep up the good work. Like you told me on Saturday you've only got 120 more days to go...peice of cake brotha! I love you!

Two of the best men on Earth; Mike and Pat (AKA Brother 1984 version and Brother 1982 version)

Can anyone tell I love food?

2006-07-25T20:26:00.000-07:00

Every night on my way home from work I try to talk myself out of gorging myself on food when I get home. It always seems that on the drive I'll crave a certain food and think of it to the point of obsession. Some nights it's cookies, other it's chips, but most of the time on my way home I crave Original Goldfish. And guess what...they're are NEVER any left in the house.

Want to know why? It's because if there is a bag anywhere in my reach I will eat the entire thing in one sitting! So I usually only buy the cheddar kind for the kiddos so I won't eat them (they're just sub-par in my book), but when I get home from work I glare at them in the pantry because they sit there and mock me in their stupid orange package which should be blue.

So I want to know, does everyone else out there pig out when s/he gets home? And if so, what do you eat? My standard post-work snacks are as follows:
-A 100 calorie bag of popcorn with sprinkle cheese on top.
-Granny Smith apple with PB
-graham crackers

A cute story before bedtime

2006-07-23T20:50:00.000-07:00

I am so tired. We were down an RN tonight; sick patients...ran my ass off for 8 hours straight. I did get to scarf an english muffin and pb at some point when my blood sugar must have been 22. I know, cry me a river, I just wanted to complain.

And, to share this story. A few nights ago I was playing the "eat two more bites" game with Lily because she wanted dessert. So she put them in her mouth, chewed, and I was satisfied so started to talk to others at the dinner table. Not even a minute later she asked for a napkin and I gave her one, stupidly thinking she was cleaning her hands and mouth. Well, it took me a minute but I realized that she was pulling that trick...you know, the food in the napkin trick. WTF? She is 2 YEARS OLD, not old enough to know how to be sneaky like that. Seriously, that kid is way to smart for her (and my) own good!

But she's pretty cute huh?

Superstitions

2006-07-23T08:38:00.000-07:00

This is an addendum to my previous post about OCD.

After a long discussion with my mom (who has to wear the same cap every Friday or all hell breaks loose) I got to thinking whether or not these compulsions are just compulsions or if they're superstitions...Or a touch of both.

Those things in which we believe deeply are the actions in question. Here are some examples:

1. You can never say the "q" word. Ever.
2. If you mention a frequent flier, s/he will be in that day.
3. In the ICU, at night, if there is a light on in a room you may not turn it off.
4. We may never have an empty tracking board. The last patient can not be erased.
5. If you mention something horrible, like an AAA, you will have a patient with that.
6. When someone is close to death, open the window.
7. Patients always die in room blank.
8. Never schedule nurse A with Doctor B. The s&^t will hit the fan.
9. If a bed is turned down and the admission goes elsewhere, do not re-make the bed.
10. Counting a death toll until you make it to 3.

What do you guys think? Superstitions or compulsions? Both? Am I the only crazy one out there?

OCD

2006-07-23T07:52:00.000-07:00

I have a personal theory that all nurses have a touch of Obsessive Compulsive Disorder (OCD).

I know for sure that I do. I can remember back to being 10 years old laying in my bed at night worrying that the stove was on or the front door wasn't locked. I would lay there until I would HAVE to get out of my bed and check. Then I would get back in my bed after assuring we weren't in danger of a fire or break-in, and worry that I really hadn't seen that the stove was off or that the door was locked and have to get back up and check on it. I thought this was normal.

And about the same time I also became obsessed with order. Mainly the order of my room. Everything HAD to be in its place. The figures on my dresser, my books, my clothes, they all had a designated place and remained there unless used. One day, my friend Allen locked himself in my room and told me he was moving 2 things. I can clearly remember standing outside my door having what I now realize was a panic attack waiting for that door to open. As soon as it was opened I burst in the room and within ten seconds realized that two toys on my bookshelf had been reversed. I fixed them, then was OK.

This continued into college where it lessened a bit while living with roommates. When I met Donnie and moved in with him it also lessened because I wasn't yet at home in his house. I have since made this house my home and now my OCD is back in full force. I can not sleep at night if the cushions on the couch are crooked, if the toys are not in their place after the kids are in bed, or any of the rugs are not at a perpendicular angle to the wall. If there are things out of place, or even worse, things are homeless, I hide them in a drawer, cabinet, or throw them away because I can't stand to look at them.

It also followed me to work in the ICU. I was OK at first with all of the new things I was learning and experiencing, but once I got a little comfortable it came back on strong. When I moved to the ED it also lessened but as I am now coming to recognize, it is back at work with me now like an old friend.

I figured this out a few weeks ago when I caught myself straighting the tape dispenser and the stapler. Then I couldn't stand to look at the pile of paper on the desk and couldn't think of anything else until it was in the recycle bin. So in the past few weeks I catch myself doing it more and more. It really doesn't interfere with my work but it's just something that I have to do.

And I can recognize that this is sort of crazy. Who gives a shit if the stapler and the tape dispenser aren't at a 90 degree angle to the wall? I do. So a few months ago my mom pointed out to my while I was having a panic attack in the car ride to Myrtle Beach that feeling this anxious all of the time is not normal. It was such a weight off my shoulders to hear that. Until then I really thought everyone felt this way. So off I went to my PCP and discussed all of this anxiety and my compulsions (Which, as you all can predict has gotten worse than ever after having kids) and he put me on Prozac.

I felt a lot better in the beginning but am back to my old habits now. They are much better, but still present. My PCP said this is something I will have to deal with for the rest of my life and now I can really see that's true. My anxiety is much better on the meds and I am a little more relaxed at home with my compulsions (Donnie wouldn't say so, but whatever).

But my whole point to this long and boring story is that I think because I'm a nurse it adds to my underlying OCD. We all have our "quirks" and by being compulsive and methodical it helps us be good nurses. Am I way off base with this or do others see it? One of my good friends, and a nurse whom I respect deeply, cleans each and every phone practically as her coat is off. My mom has to write with a blue, fine tip, BIC pen. Another nurse I know can't work until the med room is clean. A lot of nurses, I have observed, will put the exact same things in his or her pockets at the start of shift (and yes, this is for practical reasons but it's also from a comfort standpoint. How many times in an ED do you really use Kelly clamps for God's sake? (And if you use them a lot, should I carry them with me????)) My friend M. has to write out the staffing for the next day on the whiteboard at the same time each night. I knew one nurse who always had to twist a knob on the wall each and every time she walked past it. ..oh wait, me again. Man, I AM nuts!!!

So, sorry to blab on about this. It is actually really therapeutic to put this all down in writing so thanks for listening. And, you other crazy nurses out there, if you exist, just think of silly Cassie arranging the stapler and tape dispenser while you methodically do your own rituals!

26 and old

2006-07-21T20:43:00.000-07:00

What a night! We went on diversion at around 1800 tonight and by the time I left (at 2300 on the dot!) we had two patients in the department. One was on his way out the door and the other on cocaine who had just threatened his neighbors (and neighbor's minivan) with a sword.

Oh yeah, and just so you all know. FOUR patients presented tonight within a hour of each other...All female, all with abd pain over their umbilicus, a "burning" in quality, with acute onset, all with nausea none with vomiting. Odd. Then later, four complains ear pain. What the heck is going on? Things are supposed to come in threes, not fours! Odd odd odd.

And by the way,

In 19 minutes it is officially my birthday. This year I turn 26. Everyone keeps saying "you're such a baby" and things like that but I'm feeling REALLY old this year. I think it's because I'm on the downward slide to 30. 25 is OK because you're only half-way there. Now I'm really on my way. Just feels different, you know? Usually birthdays just feel like another day for me, this one is feeling different. Don't like it.

Pink is cool!

2006-07-17T16:26:00.000-07:00

Hey Everybody check out the new color scheme in here. How great is it?

AND, I figured out how to put in links on the sidebar! Thanks to Kim at emergiblog for helping me out with that!

However, I think I lost my sitemeter which I will restore a quickly as I can. Thanks to everyone for your patience while I am going through these changes!

With Deepest Regrets

2006-07-17T15:51:00.000-07:00

Ok you all, I get it, I can't spell. I'm going to work on that very hard. Sorry to ruin your day like that :)

I need a good night of sleep

2006-07-15T15:15:00.000-07:00

I am in the process of getting Lily tucked into bed right now. I am amazed every night when I put her to bed at what a professional staler she is at the young age of two. Tonight, here is the complete list of requests (and I promise that I am not exaggerating).

"I'm hungry, need grapes."
"I need juice."
"Need new water momma."
"Need medicine, teeth hurt."
"Lip hurts."
"Toe hurts, need band-aid."
"Me no like this shirt, need new shirt."
"My room too hot, need fan."
"No fan too big, need little fan."
"Need to kiss Grammy."
"Want to kiss Sammy."
"Kitty is looking at me under door."
"Need pink baby (pacifier)."
"I peed in diaper, need new diaper."

And wanna know the crazy thing, even though the needs change, this happens EVERY SINGLE NIGHT! And even crazier is that we do EVERYTHING she asks! Well, for about ten minutes, then we read three books, sing a song, listen to her snow globe, give kisses and stop listening to the requests. If we didn't, we would be up with her for hours trying to put her to bed.

But the best thing about tonight was this:
Lily is going through a phase where any time she gets any sort of injury she NEEDS a band-aid or she'll die on the spot from pain. So tonight, as I'm putting on her final band-aid of the night, on her non-injured toe I might add, she looks up at me and says, "Momma, no pick it."

What does that say about my picking fetish? I think I've gone too far...

Playgroup

2006-07-14T21:04:00.000-07:00

Today at playgroup Lily was watching her friend get his diaper changed. When the diaper came off she looked at me with wide eyes and said,

"Look mommy, BIG penis!"

I can only hope she was comparing it to my son's and not my husband's :)

Who chokes on Lasix anyway?

2006-07-13T09:50:00.000-07:00

So last night was a new one for me...I saved someone's life. I recognize the fact that I have been a part of saving a life before. Doing cardioversions, helping (or as I learned in the ICU, convincing the doctor to perform) intubations, initiating Dopamine or giving Adenosine, the list goes on and on. We all do it, this is our job.

BUT, last night, I was giving a patient his pills and at that moment where I usually hold my breath until s/he swallows and says "It went down," I couldn't exhale because it didn't go down. Instead, he sat bolt upright in the stretcher, eyed bugged out of his head, and he turned that scary shade of bluish/purple which I have learned to loathe. He was choking, no doubt about it.

So, I encouraged him to cough, which WAS NOT happening, and when I realized he was choking I got behind him in the stretcher and did the heimlech. At the same moment I gave the old heave-ho I thought to myself "holy shit, this dude is big" (I couldn't even really get my midget hands wrapped on top of one another, so it was a modified Cassie-style maneuver) and let go after one squeeze. I came around off the stretcher, while screaming for help of course, and he was starting to exchange a little bit of air. I was cheering him on like I was at the Super Bowl, "Come on, cough it up, come on. Rah rah rah." And with every passing second he did get more and more air through and finally managed a cough. Then he didn't stop coughing for the next fifteen minutes.

So today I've been thinking--When you have those shitty days where you feel like you can't do anything right, you will have one of these great moments right around the corner where you'll know you made a different. And all I had to do was make my patient choke on his Lasix. Piece of cake.

Just wanted to share

2006-07-12T10:06:00.000-07:00

Are you pregnant?

2006-07-12T09:56:00.000-07:00

A patient asked me if I am pregnant last night. It seems to happen about once a month since I've had Sam. At first I was really upset by people asking me that, now I'm getting a bit better and not crying when it happens. The thing is, I'm petite. I am 4'10 5/8" and I weigh 129 lbs. There's not a lot of wiggle room in there for extra fat. If I gain 10 lbs it's like 40% of my bodyweight (right, that math's right huh? :)

And I do have a mommy belly. I keep telling myself that if that didn't exsist neither would my two little friends. But no matter how much I tell myself that I still feel like a horrible, fat, cow.

And I work out like crazy and eay well. I have a wicked sweet tooth which is really bad somedays and really OK others.

So here's why I am writing about this today. When will I ever be OK with my body? I keep waiting for the day when I wake up and feel OK in my own skin. It has been very altered from having 2 kids in 18 months, I know that, I just can't make myself feel that.

It bothers me so much that I have actually contacted plastic surgeons to see how much I need to save to pay for a tummy tuck. How crazy is that? For the amount of money it would cost we could take a family trip, buy a new car or a boat, or invest some money.

So there's no real story here, just me venting while Donnie's at the firehouse and both kids are sleeping. Because, God knows, I do not want to say this shit around my daughter and step-daughter because I tell them what beautiful women they are and to be proud of their bodies. I just wish I could believe it myself.

If you don't like pee, don't read this.

2006-07-10T16:06:00.000-07:00

You know, I was really dreading potty training but it's turning out to be a hoot! I constantly have funny Lily stories about this process. Though she is fully potty trained during the day, here were some of the good 'ens that have happened in the past few weeks.
#1:

Lily: I peed!!" (This is usually our cue to shout and clap; everyone in the room is obliged to participate).

US: "Yay!" "What a big girl!" "All right Lily!" "Way to go!"

Lily: "...on the deck."

Though she is fully trained during the day, for some reason right after supper she likes to go on the back deck and pee. Tonight she took it a step further and actually peed AND pooped on the deck. I was trying soooo hard not to laugh when we talked about how this isn't OK. All I could think of is my neighbors, happily cooking supper, looking out their window and see little Lily squatting on the deck outside pinching a loaf. That's my girl.

#2:
Today, in the bookstore, she told me she had to pee very loudly. Which is ten times louder than she usually is because A) we're in a bookstore and B) people in public usually don't scream about their bathroom habits making this comment seem that much more loud and inappropriate. Plus, there was this young couple looking at wedding books talking about prenups who glared at her. Which really pissed me off, but they're young yet, they'll be there someday.

Anyway, we went to the bathroom and she did her buisness and as we were leaving she looked at the first woman we saw, a complete stranger mind you (she gets that from my BTW. I 'll talk to anyone, anywhere. I'm totally that girl in line at the supermarket who brings up how much I love the cheese in the woman's basket behined me. It's super annoying, I realize, but I am powerless)-and said "I peed!!!" The lady looked taken aback and then said "What a big girl!" I was super happy she had that reaction because when you come out of the bathroom there is a cafe directly outside the exit. Not the place to be screaming about peeing on the potty when people are having a scone and coffee. But she is 2, what do you expect right?

#3:
Well, that's about all of the funny stories I can muster right now. I could always tell you about when Lily pees in the potty and her broter comes to the potty before I can get to it and dumps in on the carpet. But I won't. Don't want to be too gross right? Heee heeee.

Dead Man Working

2006-07-09T21:39:00.000-07:00

There are two stories out there in the media which have taken up permanant space in my head, mainly because I can't figure out if they're true or not. You be the judge...

Story #1:
This is a story of a man working in a New York office who died at his desk on a Monday. The problem was that no one noticed he was dead until Saturday. Apparently, the man was first to the office in the AM and last to leave in the PM. Therefore, no one thought it strange when they passed his desk at quittin' time and he was there. My question to you all is could this really happen? We've all seen dead bodies. They look, well, dead. Hard not to notice. So is it really possible that for a WEEK his co-workers walked past him slumped at his desk and took no notice? According to my research the story was published overseas but never here in America. Seems fishy to me. Anyone who has extra time on her hands here's his "name" if you want to research it more: George Turklebaum (even the name sounds fake).

Story #2:
Apparently, in India some dude's skull fell off. He had a previous burn and the tissue just died and subsequently part of his noggin fell off. (http://news.yahoo.com/s/nm/20060705/od_nm/india_skull1_dc)

Seriously, you can't even make this stuff up!

So here's what I've been thinking about for this one. What a social faux paux to have this thing decide to fall off at any time. I've been having visions of this man passing supper at the table, running on the track, doing a crossword puzzle, meeting the in-laws, etc etc etc and PLOP. Oops, excuse me, don't mind my skull just falling in that soup. My bad. What was he doing when that final piece of skull let loose? How cool would it be to BE there at that time. My feeble little mind can't even comprehend what a dream that would be.(AND, if that was my skull, you know I'dve already picked that sucker off:)

Milestones

2006-07-09T10:49:00.000-07:00

My little man Sammy, who is 10 months, had 2 huge milestones this week.

July 5th he took his first steps.
Today, July 9th, he said his first words besides the usual mamma and dadda babble. "Uh oooh."

Do you think that his first words are a sign of what's to come with him? That he's only 10 months and already realizes that he's a little terror. I knew having a little boy was going to be so different from a little girl...

Serious coccyx pain.

2006-07-04T09:00:00.000-07:00

It happened AGAIN.

Patient A:
Coccyx injury over a year ago. Fell, re-injured said body part. In ED for pain control.

Patient B:
Coccyx injury almost a year ago. Re-injured said body part this week. In ED for pain control.

Came in back to back. How wierd is that?

My Anniversary

2006-07-04T08:33:00.001-07:00

Today is the 4th of July. It is also my wedding anniversary. It got me thinking about all that has happened since I met Donnie the summer of '01. A lot has happened in a short amount of time. For all of you that don't know, here are the clifnotes of my life the last 5 years.

2001:
Donnie and I meet in a bar where I work as a cocktail waitress. We spend the next 10 months falling in love over the telephone, writing letters, and spending weekends together while I finish my last year at nursing school. The last semester in school I get to do my senior practium in the ED at Dartmouth. One day I get to fly (twice) with their chopper, DHART.

2002:
Graduate from nursing school with my BSN.
Start first nursing job in the ICU.
Get engaged on the top of Mt. Washington.
Start 401K.

2003:
Get married to Donnie July 4th. We got married at Popham Beach at 7 am with about 40 of our family and closest friends. My brother, Mike, announced that I am pregnant while making a toast to Donnie and me. Previously, this was only known by our parents. Oops. Funny in retrospect, not in real time.

2004:
Lily is born January 26th after two weeks on bedrest in the hospital. The next year is all about learning how to be parents and still keep a marriage afloat while mentally and physically exhausted.

November, pregnant with Sam. Lily is 10 months.

December, get offered Unit Coordinator job in the ED. Ponder taking it, then take it. What the hell did I get myself into. I went from being comfortable and experienced in the ICU to new and inexperienced in a new department where I am now a supervisor. Holy shit.

2005:
Start in the ED in March. Holy shit.

Sam is born August 15th via c-section #2. Easy, happy baby. Lily is 18 months old when Sammy is born. Whoa...and we thought we were tired before.

2006:
Buy first house (BTW, why didn't anyone tell me how stressful THAT was going to be?). Buy a timeshare. Open ROTH IRA, invest money in the stock market. Feel OK with my role in the ED (most days). Donnie gets promoted to Lieutenant

Today:
Now we have three jobs between the two of us, three kids (I have a stepdaughter who's 10 BTW) a house, a timeshare, money, and we STILL manage to be in love and very happy. So today, July 4th, on our nation's birthday I am feeling very happy and content. It's a lot that Donnie and I do and deal with but aren't we lucky that we have it. And it all came from a girl picking a guy up at the bar.

28 days

2006-06-30T06:57:00.000-07:00

This is an actual conversation I had with my husband the other day.

Donnie:
"We were watching TLC the other day at work, some show about female things, did you know that women don't have their periods for 6 days, it's actually 28 days long."

Me: (And those of you who know me, this is said in my dead serious but sarcastic voice coupled with a straight face. Yes, the same one I use on patients every day I'm at work)
"Wow, really?"

Donnie:
"Yeah, the whole cycle actually lasts for 28 days. I guess that's why most women are so f-----d all of the time, because every day of the month they're having some sort of hormone changes."

Me: (Same face)
Dead silence.

Me:
More silence (cue crickets chirping in the background)

Me still today:
Shocked and silent.

Really, what do you say to that? How is it that a well educated man, who's 35 with THREE children didn't know that? I blame the public school system.

Things that make you go hmmmm

2006-06-29T08:56:00.000-07:00

Here's one thing that blows my mind about the ED. How do people know why kind of special of the day we're having? There is no sign outside, no menu, no airplane flying overhead with a banner attached...so how do the patients know that they're supposed to complain of the ailment that day?

Last Saturday it was finger lacerations. Sunday was a migrane day. Tuesday we had a pedi clinic. Last night it was abdominal pain.

But not only abdominal pain, it was three very similar cases. All in their 80s, with dementia, female, and doting family members. AND they all came in within two hours of eachother. Actually, now that I'm thinking about it, we got two women- each in her 70s- with end stage COPD on Sunday night within 5 minutes of eachother, both in respiratory failure, sitting side by side in our critical room.

And we all know this is true. It happens more often then we actually think or talk about but I really think it's an interesting phenonomen. There are the obvious reasons for the obvious situations. I'm sure the double respiratory failures had to do with the humidity we've been having lately. There's always more suicidal patients around the holidays, more CHF at Easter, Monday's are always busier after a holiday weekend. Those things you can count on. I'm talking about the odd things, like 6 people slicing their fingers at 6 pm on a Saturday.

What cosmic forces are out there coordinating this stuff? I don't want to even think of broaching the topic of religion vs. spirituality (those who know me know my true and very stong opinons on both) but this is really a funky thing we experience. With all of the things that can go wrong with the human body, why do they all seem to happen at the same time to our patients who have nothing in common?

This, I know for a fact, is bad.

2006-06-26T17:38:00.000-07:00

(Disclaimer for all of you non-medical peeps out there, please DO NOT read on if you're grossed out by puss or blood, this is not the entry for you to read OK? If you do read on, you were warned and I don't want to hear any complaints about the contents of this entry. Got it???)

This, I know for a fact, is bad...
I was turned on at work yesterday. For ALL the wrong reasons.

I have always known I wanted to be an ED nurse. Just something I felt in my gut. Yesterday, around 1900 I had actual confirmation that I'm doing the right kind of nursing. Because yesterday I watched my first pilonidal cyst (for you non-medical sort, it's an abscess in your butt crack) be lanced and was so fascinated that I have been thinking of it all day long today.

Don't get me wrong, I'm not a pervert or anything, but I do love to pop and pick things...a lot. I have scars all over my body (including an incision on my knee from surgery) that were wounds which should have healed but never allowed because of my wandering hands and now remain scars. I can't stop myself, if there is something to be picked or popped I'm all over it. Just ask Donnie what a "treasure" is in our house.

Which is why you can understand why I was so excited by this cyst. It was like a soda can exploding after its been shaken too hard, just so breathtakingly gushy and gross. Then the surgeon put pressure on either side of the incision (as if popping a zit) and MORE came out. I let out a moan. It was great.

Is that bad? Or do I just need a lot of therapy? (Retorical question, of course. I really really really don't want to hear the answer to that question).

The Bridge

2006-06-26T15:29:00.000-07:00

Today was one of those days that I can identify with that woman who threw her three small children off of the Golden Gate Bridge (Well, except that she was schizophernic, details, details, details...). I worked last night, managed to get to bed by midnight or so, up at 6 (Donnie's at work today). Pretty good night in my book.

BUT, the baby took a really early nap today. And Lily took NO NAP at all today. Which, as you other moms know, makes for a very loooong and trying afternoon. We had a playdate this afternoon and Lily was really bad; kicking her brother and hitting the other kids (which is mortifying because then I worry that I am a horrible mommy and can't control my 2 year old). I think she had about 45 timeouts total. By bedtime I was damn near tears because I had just had it.

And I know that I am supposed to enjoy my kids, but days like this I feel like the worst mommy in the world because I just can take so much. I just happen to be one of those lucky moms who has a great support system and people to intervene when I get "the look". People who know me well and know when it's time to hide the car keys so I can't go to the nearest bridge...

But then, after they're asleep all of that anger and frusteration floats away and I wish they were awake to play with. What a horrible Catch-22 huh? They make you nuts, and you can't get enough!

PS- For your viewing pleasure...

This photo is pretty great. This was from yesterday morning after the kiddos had taken thier bath. I was changing Lily's sheets and left the mattress on the floor for "gumping" as she calls it. Sammy loved it even more than she did, however, and crawled up on one side and down the other just laughing himself silly. We played with it for nearly an hour. This photo was taken as Lily was jumping and Sam falling off the other side.

The other photo was after the jumping was over and they were taking a breather. Aren't they cute (And look at her tan!! I swear, we put sun block on her).

A quickie but a goodie

2006-06-25T20:46:00.000-07:00

How many perverts does it take to screw in a lightbulb?

Only one, but it takes an ED staff the entire shift to remove it...

Have a great night everybody!

Oh, oops, do I have VRE? Is that bad???

2006-06-24T20:14:00.000-07:00

Tonight's one of those nights when I come home and feel as if I need my own decon shower outside of my house. We had a dialysis patient who was in CHF. No big deal right? Well, when I called the hospital we were transferring him to (we don't do dialysis) they said, "Oh yeah, Mr. X, we know him really well. He's VRE+, right." I'm all, "Um, well, um, I don't know, he never mentioned it."

I hate when patients neglect to mention that they have something contagious. We are really good about the obvious things (For example: cough and fever=mask; open gushing wounds=gloves) but not so good at guessing the others. So that's why, when you got something, TELL US!!! It's not that hard and it keeps other patients from getting said contagious thing and keeps us from taking stuff home. Man o man.

Frozen Peas

2006-06-23T08:25:00.000-07:00

When I was 17 I tore my ACL in my right knee playing field hockey. Then I tore it again when I was 19 playing lacrosse in college. Then I tore it again working out when I was 20. So now, I'm 25 years old and I've had 4 knee surgeries; two reconstructive and two arthroscopic to fix all of the torn cartilidge that comes along with tearing your ACL. So as you can now imagine, I have arthritis and chronic pain in my right knee from all of this crap that has happened.

So put that all into perspective with this 5 weeks of rain we've had this season in Maine (I am one of those people who can always tell when it's going to rain or snow because of the amount of swelling in my knee), the humidity in the air, compounded with a job in which I am on my feet for the majority of the day-4 days a week, and an active lifestyle where I'm always on the go.

I don't want to complain but I think I need to get it out of my system today. This is not the problem that any 25 year should be dealing with, as my neighbor told me, "That's an old person's problem." People are always asking me how I feel about my knee problems and I just tell them that we all have our ailments, this is just mine. Some people have diabetes, asthma, hypertension, asshole personalities, glaucoma, etc etc etc...this is just what I deal with.

Plus, it's really cute because Lily keeps asking to see my "owie" and this morning told me her knee hurts. So we wrapped it with an ace bandage and she got her own bag of frozen peas on her knee and we iced and elevated together while watching the Wiggles (by the way, has anyone noticed that Greg has gained weight this season, or is that just me???). It was really cute and one of those memories that I will always have...my little friend and I hanging out on the floor with our owies. So maybe I'm hurt for a reason, so I am forced to have down time and relax with my little friends and husband. Not too bad of a gig if you ask me...

My Son Sam

2006-06-21T20:21:00.000-07:00

I wanted to share this photo of my little friend Sam sleeping. He looked like this the night I came home from work. It was a bad night where we had to put a 12 year old in 4 point restraints, during which I got three scratches from his dirty fingernails and spat upon. It was horrible, then I got home and saw Sammy sleeping and it all melted away.

The Back Lady

2006-06-21T20:07:00.000-07:00

I was shopping the other day and overheard the lady behined the cash register complaining about the ED where I work. Apparently she had come in to the ED twice in the same day, via ambulance, with a cc of back pain--from what I gathered the end result was a muscle strain. The first time they sent her home, she didn't do what they suggested (ice, Ibuprofen, etc) and then returned only to be sent home a second time. Whatever, really, it happens right? People leave unhappy all of the time, part of the job ya know.

But what really bothered me was that she said it was because she didn't have private insurance that we didn't admit her or take her more seriously. When I first started in the ED they told me this was the rationale for triaging a patient prior to registration (well, that and the whole legal issue of letting someone who's really sick sit in the waiting room, that small little detail) but I didn't believe it. I was truly that ignorant to think people actually thought we cared about what sort of insurance they carried. Whoa was I wrong.

It was not appropriate for me to butt in on her conversation, no matter how much I really wanted, and set her straight. I wanted to tell her that we give the same care to everyone, regardless of their race, ethnicity, insurance (or lack thereof), living situation, sexual preference, economical or social status, and attitude towards us. I wanted to tell her that we HAVE to take care of everyone because of the nature of the ED. We can't turn our noses at people, for a majority of them we're their primary health care.

But I said nothing. Maybe that makes me a coward, maybe it was the smart thing to do. I really don't know. One of my co-workers told me her solution to the insurance/prejudice thing. She just tells them,

"I give crappy care no matter what kind of insurance you have."

Now why couldn't I have thought of that??

The Legacy Continues

2006-06-21T08:11:00.000-07:00

So, one of my co-workers (and best friends) told me that on Tuesday one of the doctors with whom I work had a patient with a creatinine of 32 or something crazy like that. He looked up at the nurses and said "Is that bad??"

Wa-hoo, the legacy continues!! I'm going to be famous someday mark my words:)

I love...

2006-06-19T08:44:00.000-07:00

I have the best husband ever. The kids woke at 5 am this morning. Both of them.

Donnie got home from work at 7:30 and let me go back to sleep. I just woke up now (it's 11:45). I feel like a new woman.

Off to work for 3-11, so that feeling will last for the next few hours until my job sucks the life from me. Or, as the eternal optimist I am, I will look at it with half full eyes. It's going to be a great day. Hope you all have one too!

2006-06-18T17:05:00.000-07:00

Weekend off, trying to catch up on my sleep...

Guess what time the little ones woke today??? Yup, you got it- 4:30. It was a loooong day and now I'm more tired than if I'd worked a double on a holiday weekend. I'm going to watch 24 and go to bed. Hope you all had a good weekend.

Fuzzy Books

2006-06-17T15:20:00.000-07:00

Wednesday, June 14th will go down in my own personal history book as the worst day I've had in the ED thus far. I won't go into details because it's just too long and boring to recap, but the short version is as follows. We had waaaay too many sick patients (by which I mean our acuity was a lot higher than normal), way too many non-sick--but vocal--patients, and not enough doctors or nurses. By 2330 all of our rooms were full, three in the hallway (which is a lot in a 12 bed department) and 9 to be brough in. And we're a small hospital, there's only one doctor after 2200 to see all of these patients! So at 2345 we went on diversion and it somehow all got better. Of course, I didn't end up getting out until 0130 but whatever.

Oh yeah, then on my way home I came across a car off the road. He wasn't moving, or seatbelted, and his foot was wedged on the gas pedal so the tires were spinning. I called 911 and didn't get out of my car until other people arrived at the scene (reminder to myself; call my EMT instructor and thank him for teaching me about scene safety because it kept me from running to the car to assess the patient. Because, come on, I'm young, very blonde, and cute...someone could have had his way with me then killed me and no one would have known. Or his car could have exploded, leaving my kids mommyless and my husband alone. Or the car could have taken off into the woods with me hanging from the window. Or it was an elaborate set-up to rob me of my Mazda Protege-haha. Sorry, I digress...) Turns out that the dude in the car was drunk (shock!) and had passed out at the wheel. So I guess no one was trying to have his way with me. Sigh :)

And this is all what this blog is about because I came home from that night, got into bed at around 0215 and right as I was drifting to sleep Lily (the 2 year old) awoke screaming because her teeth hurt (she's cutting 4 new teeth). It is so crazy for me that I went from taking care of a 650 lb man (I'll write about him sometime) to reading fuzzy books with my daughter in the span of a few hours. I know there are many working mums and dads out there who switch the gears from work to home very quickly, so it shouldn't be anything special that we nurses do it. But to me, it is. We take care of the sick as we would our children, or husbands, or mothers and it's just what we do. Even on those horrible days in the ED when I'm considering looking up the nearest Borders to see if they're hiring, I really don't think that I'm cut out to do anything else. How sadistic is that?

2006-06-12T17:10:00.000-07:00

When I first started in the ICU I used humor a lot with my patients. I began developing this skill when I worked at the video store and was able to size people up within a few seconds of meeting them. I could feel out who was and was not one of those with whom I could joke. So it comes as no surprise that I am slowly becoming famous for my line, "Is that bad."

The first time it just popped out. It was one of those first nights that I flew solo in the ICU and we had a code. When we had worked on the patient for over 40 minutes we were all looking at an asystolic rhythm on the monitor there was a pregnant pause. It was that pause that usually happens at a code when everyone is silently thinking that we just should call it, it's over, and then usually someone verbalizes that thought. Well, in this case, I took one look at that rhythm and blurted out, "Is that bad??"

In hindsight, it was very inappropriate for me to say something so horrible at that time. But what happened was that everyone laughed. It did something that I now realize is very important to keeping your sanity in nursing, it broke the tension that hovers over our head every moment we're dealing with the sick. And it is sick isn't it? That we make these jokes and laugh, but if we didn't we would all go crazy and this job would eat us alive.

So...now I have moved on to the ED. I hear from my old pals in the unit that when something really horrible happens that someone usually says my line in private to the other nurses and doctors. I feel like a celebrity.

Which is when I realized that this line has followed me to the ED. My co-workers are always approaching me with the line. "Cas, your lady in 8 has a K of 9.4...is that bad??" for example, or, "The police are bringing in a man who tried to kill his ex-wife and her dog at the Rite Aid...is that bad?"

It's a great line. So, if any of you out there are feeling sassy some day, try to use it. It's really amusing to watch the person you're asking the question to think that you're a complete moron one second and then realize you're only kidding in the next moment. Just make sure you know who you can say it to, or it could land you in a whole pile of trouble :)

Bed Crisis and the Weekend

2006-06-11T20:52:00.000-07:00

Wow, sorry everyone. Busy week. Here's a recap of the last three days.

Friday: It's been raining for a whole month now. Seriously. We packed up the kids at 8 am (after I worked 3-11 and slept from 1-6) and went to Target and Home Depot just to get out of the house and see new scenery. Home, nap time for both babies, then my nephew's 2d Birthday party. Sleep that night from about 10-6.

Saturday: Husband worked this day (And for those who don't know, firefighters work a 24 hour shift, so therefore, he is gone from 6:30 am to 7:30 the next AM...means I'm on my own with the two tater tots). I packed the kids up and took them to stepdaughter's lacrosse game. Oh yeah, and on the way home from the lacrosse game my 2 year old hit me so hard in the face that my glasses flew off my body and landed on the floor of the car. I know that I am against child abuse with every bone in my body but I swear I have never been so close to hurting another human being in my entire life. Anyway, then my father picked up the tater tots at 2:15 and I had an entire 15 minutes to myself, so I read a magazine before jaunting to work. I worked 3-11. We usually see a patient volume of 55-60 per day, this night it was 71 patients. BUT, we had such an effective and great crew working (and beds in the hospital!!!!) that the shift went well. Oh yeah, then I went out with a few girls from work for ice cream, got home and was in bed by 1 or so, sleeping by 2.

Sunday: Woke at 0600 with the 2 year old. She's getting two teeth and is constantly demanding medicine (She's totally that kid who would drink an entire bottle of ibuprofen if she found it hanging out in the open. I have to watch her like a hawk) and she had 4 temper tantrums before her brother woke up at 7. When my husband got home we packed them up in the double jogger and took them for a walk. En route, we picked up an ice cream cake for my step-daughter's 10th birthday party and came home. Long story short (too late, I know), there were 20+ people at my house including 10 kids, 4 sets of in-laws, and my huband's ex-wife. AND, the party was great...everyone got along and had a good time.

Then the sun came out at 2:15, just in time for me to go back to work. Tonight was unusually slow until 2115 when the whole town decided that it was time to head on in the the local ED. My last patient of the night had just run himself into a tree after drinking "I have no idea" how many drinks (Which we all know is really bad when they don't say "two" or "a couple" and actually admit to being intoxicated.) He told me that I was adorable and if we were in a bar he would totally try to pick me up--would I let him pick me up???? To which I answered, a blunt and direct, "Not a chance in hell" and he laughed.

So now, here I am writing on this stupid blog that I don't think anyone reads instead of sleeping. Sigh.

If there is anyone out there here is my question of the day:

Are we the only hospital out there with a bed crisis or is this a problem that we're all dealing with???

Videos and Gift Cards

2006-06-04T18:36:00.000-07:00

I sometimes wonder if I've chosen the right path for my career. I went to a small liberal arts college in the middle of New Hampshire. My graduating class was 8 students total. We were considered "dorks" in our school becuase we studied a lot a socialized very little. Before I graduated I had three job offers, two being in ICU units. One was at a level 2 trauma center in the adult ICU, the other at a small community hospital with an 11 bed ICU.

I chose the community hospital because of two reasons.
1. I'd worked there for a few years and already knew a lot of people. My mother worked in the ED at the time and I had grown up there. So, I already fit in, and was accepted, a huge hurdle in my opinion.
2. At the big teaching hospital I was told in my interview that their #1 problem in the unit was nurses "eating their young." In addition, one of the newer nurses had pulled me aside and told me to watch my back. Yikes.

I wonder what would have happened if I had gone there instead of where I am now. I know that I would have learned a lot, but would I have come out on the other side a different nurse, or even person, for that matter? I am not the kind of person who fares well in a harsh enviornment and I could see working at such a hostile place turning me off from nursing all together. If that happened, what the hell else would I even think of doing?

Which leads me to this question...almost all of the nurses I know LOVE what he or she does for a living and yet all of them will tell you in the next breath what s/he would do if money was of no issue. So, if anyone is out there reading this stupid blog I want to know-- what would you be doing if money wasn't a factor? Here's what I would do:

I would own a video store. I would have very loyal and interesting clientel who would come in on a regular basis and hang out in my store. We would be buddies. I would work 6 hours a day and spend the rest of the time with my two little friends and my husband. When I made enough money to pay off my store I'd open a little gift shop with fun little things and cool jewlery and notepads and pens, or stupid wall hangings and perverted gift cards and work there a few hours a day. There would be time every day to work out, watch a movie AND read a book, sleep in late (or at least until 6:30 am) AND have supper with the family and play a board game after we ate. Sounds great huh?

But here's the thing...

2006-06-03T08:40:00.001-07:00

But here's the thing...
I left work last night around 11:30 pm, got home and to bed around 1:00 am (because, come on, who can go right to bed after working as an RN...it's just NOT possible). The baby woke up at 2:15 am and then at 5:15 the 2 year old woke up. So today, as you may have guessed, I am sooooo tired. And, so are my kids (And just so you all know, I'm a sleep drill sargent. My kids are great sleepers but with all of this rain and not playing outside and growth spurts they are all over the place with their sleep habits right now. Just one more thing to push me right over the edge).

Luckily my husband didn't have a single call at work last night and he slept like a baby from 9-6:30. I hate him right now.

But isn't it just nutty how you can shift from taking care of a 75 year old woman with a PE and go home to feed the baby and watch The Wiggles? I think that is so cool!

Whew!

2006-06-03T08:40:00.000-07:00

Don't worry everyone, he made it home OK. :)

Supersitions

2006-06-02T20:53:00.000-07:00

I am going to become a millionaire writing my book about supersitions in the hospital. Are these everywhere or just where I work? (Haha, I bet that's a silly question)

When I was in the ICU if we got a room ready for an admission and if that patient never was admitted you could NEVER touch that bed or bad things would happen. At night, if there was a light in an empty room you couldn't turn it off or someone would DIE!!!! In the ED, if our census board is ever blank the world will flip on it's side and we will all float away into the vast black eternity. And we all knows what happens if someone says the Q word. NOoooo!

So you can all understand how scared I was this morning when my husband couldn't find his necklace that he wears every shift to the firehouse. Our two-year-old had been playing with it yesterday and neither of us thought to take it away from her. I was so nervous that I amost couldn't think straight. Luckily, he has a back up necklace that pinched hit for him. I can't wait until 7 am when he gets off.

Can I Start Being Selective???

2006-06-02T07:38:00.000-07:00

I remember this psych patient we had a long time ago who refused to speak to anyone who wasn't Catholic. She ended up escalating and calling us all sinners and refused to speak to anyone who isn't her chosen religion.

It got me thinking...what if we could be selective of the patients whith whom we speak and care for. Just all of the sudden we decide that today we refuse to take any patients with chest pain. Tuesday's are off limits for anyone with a dental complaint. Oh, and I'm sorry sir, we don't accept anyone with grey hair and lacerations today, come by tomorrow and we'll fix you right up.

The ED is a place that is open to all. Our hospital is a small community hospital in Maine and our inpatient units are failry selective of the patients they accept. Med/Surg is great, but is it a daily struggle to get ED patients into the ICU and Behavioral Health units.

But we can not chose the patients we see, nor can we shut the doors when it's just too much like other units can. We must stack them in the hallway, double up family members, run tests from the waiting room and every other creative idea we come up with to see more patients and see them as quickly as possible.

And I love it. How strange is that?

Wow

2006-06-01T09:27:00.001-07:00

I am going to use this space to talk about my life...

I'm 25.
I have a husband who is almost 10 years older than I, and we are in love deepy, madly, and happily. He is a firefighter/paramedic.
I have a 2 year old little girl and a 9 month old little boy.
I work full time in the Emergency Department at a local hospital in Maine.

And I'm fucking exhausted. Anyone else out there with a loaded plate?

2006-06-01T09:27:00.000-07:00