Last week I mentioned that I planned to apply for another position at the hospital. I worked on my resume, wrote a great cover letter and submitted it on time. Then, I didn't hear anything. I called the manager of this department and left a message. Still didn't hear anything. 10 days later she finally called me at work only to tell me that unfortunately she was not even going to interview me, because I was not Critical Care staff, and that was where they were getting their pool of nurses from. I told her that I was very surprised at this because as mentioned in my cover letter, I had over 10 years of Critical Care expertise, and while I was now Recovery Room staff, I have a flexible schedule that allows me to work 12 hour shifts. As well, other team members of her Response Team had personally approached me and suggested I apply. She said she was sorry, but at this point, I did not qualify. I was pissed off but suggested she keep my resume on file.
An hour later, I was at the job posting board looking to see if there was anything new. The physician who runs the Response Team saw me and jokingly came over to tell me not to bother looking, there was nothing worthwhile for me. Let's just say he caught me at a vulnerable moment. I was still pissed and told him that I had just been turned down for his Team, and that I was "a little miffed." Of course, I said this with my face feeling all flushed and I'm sure my eyes were getting a little watery. (A terrible response when I feel frustrated at something I can't control in my personal life.)
He actually tried to offer me a position in one of the step-down units that needs experienced nurses but I told him that I was looking to try something new, and had been really interested in the Response Team.
Anyway, to make a long story short, the hospital just called wanting to set up an interview for the Team. I'm guessing that having had a good working repore with this physician he spoke with the manager on my behalf and they decided to at least offer me an interview.
Turns out that this would have been scheduled while I'm in Europe, so we'll see what happens. Hopefully an interview will happen when I get back.

Nightshift

I'm working nightshift for the next few weeks which is probably not such a bad thing in that I can get a lot of stuff done during the day with regards to packing and cleaning and such. The other night, I took some pictures in the Recovery Room. It was nearly 3am and it was very, very quiet. On weekends, I work alone, and let me tell you, it can be a very lonely (sometimes creepy!) place.

Tootin' My Own Horn...

Two weeks to go until we move! We are living amidst a mountain of boxes, bubble wrap and general chaos. The kitties know something is up. They both enjoy playing King of the Castle on top of the boxes.
This weekend I sorted through all 8 of my Junk Drawers throwing away old bills, receipts, movie stubs etc. In amongst all the junk, I came across a letter sent to be by one of my patients' daughters. Coincidently, this patient died exactly 4 years ago to the date of me finding the note. So, at the risk, of tooting my own horn, I'm going to share it.
Dear Dr. G,
I am writing to express my heartfelt gratitude for the deep compassion abd excellent care, my father and I recieved from your staff.
My 85 yrs. old father, LW was a patient on your unit and died on Oct 15, 2002. It was an incredibly sad & difficult time for us. Yet admidst all this, Ramona, the nurse on duty, provided exceptional care to my father & emotional support and common sense to me. She did everything to maximize my Dad's comfort in a most professional & competent manner. Both she, and MM, the chaplain, inspired in me courage with their gentleness, goodness and compassion.
Thanks to their interventions, letting my Dad go, was hard and sad but not traumatic. My 22 year old daughter left the unit with me aftermy father's last breath-no longer afraid of death.
Thank you all, and congratulations for the outstanding care you provide.
Sincerely,
BI
It's not often that family members or patients take the time to write notes, and I'm glad that I still kept this one. It reminds me, that I did chose a career that directly affects people's lives, at their most vulnerable times in their lives, and hopefully I can make those times a little easier for them.
Finding little notes like this somehow re-inspires me.

Working nightshift this past week has completely messed up my inner clock. I thought I had done well with 'turning myself around' this weekend but I was wrong. It's 3am, and here I sit in front of my computer, wide awake. Don't get me wrong...I have already slept. In fact, I went to be at 9:30 but an hour ago I found myself lying in bed, eyes wide open, with Mao curled up in my right arm as per usual. So now, I'm awake, and both cats are awake, and Greg gets to make like a starfish in our bed.
This afternoon we went to an engagement party for some friends of Greg's. Greg has known Elvi (short for Elvira) (she is a very pretty blonde, in case you had just conjured up a vision of a Gothic Vamp!) since grade 7, and the party ended up being somewhat of reunion and a lot of fun. It crossed my mind earlier that when these guys were in Grade 7, I was already in my second year of University. Sometimes, it freaks me out a little when I play that 'Age Game.' Like, I remember watching the Lunar Landing on our 12 inch coloured tv, back in '69. I was 4, Greg wasn't even born. When I was in Grade 7, he was 4. Of course, now our age difference isn't a big deal, the gap is narrowing and most days I don't really think about it at all. But, every once in a while it does occur to me.
Twice in the past week people have made comments about the Bungalow we are moving into next month. Comments about retiring in this house, and how good it will be that there are so few stairs. And then, my imagination gets the best of me and I think what if I get old and decrepit and Greg will have to help me with get up those four stairs with my walker...or maybe we'll have to get one of those Stair Chairs...or build a wheelchair ramp.
But why am I thinking about this at all? Because it's the middle of the night and apparently I've got nothing better to think about. And god knows I don't want to fold the pile of laundry that Mao is now lying on, and doing dishes would be too noisy.
Anyway, I realize that I'm kind of going on about nothing, so I think I'm going to play some Mah Jong now.
'Night.

TGIF...

I've never been happier to see the end of a work week.
It has been super busy in the Recovery Room. With summer vacations being over, the surgeons are all back full-force working on the backlog of patients awaiting their operations.
The days were hectic, and patients were generally very grateful that a)their surgeries were finally over b) that they were alive and c)that there was a hospital bed assigned to them.
One patient stands out this week because she was the most obnoxious, manipulative, rude, passive-aggressive Wench that I've ever come across in sixteen years of nursing. I was very nice and accommodating to her, although, I must admit, when she wasn't looking, I was rolling my eyeballs around so much that it hurt. And, as time passed, I would really have liked to have given her a good swift kick to the head (only I'm not limber enough.) But, let me reitterate: I was polite to her...at no point did I intentionally antagonize her. I have witnesses!
This woman has had a significant chronic illness since she was 8. So, she has been in and out of hospitals since then and let's just say, that she knows her way around hospitals probably better than any doctor or nurse. Because of this illness, she has abnormal muscle tone, so this surgery was the second blilateral browlift that she has had in a few years. (Ummm..not sure but the surgeon might have actually overcompensated the browlift so he wouldn't have to deal with her again...her brows were perfect semi-circles located quite close to her browline. She kind of looked like she was going to have a permanent SURPRISED! look which, I must admit, was incredibly comical.) (And, she had little beady eyes) However, comical she was not.
This woman gave me such a hard time when she found out where her bed assignment was. In our hospital, the plastic surgury beds are shared with the orthopaedic unit. She felt that the nurses would not be able to handle her condition adequately, that she needed to be assigned on a unit with neurosurgical patients. So...she would rather be sharing a room with a head injured trauma patient, that someone with a broken bone. (OK>>>WTF?!) I tried assuring her that the nurses were well aware of her condition, and would be able to handle it. She threatened to pull out her IV, find her clothes and leave the hospital if she was being forced to go there. She wanted to speak to the Hospital Administrator. Then she started the spitting. She spat and spat and spat some more, and I was so grossed out! She told me she was having an asthma attack and if she were at home, she would take her puffer. Uh...Ya...right. I didn't hear a single wheeze, but I humoured her. I got her a brand new puffer, and a brand new aerochamber ( a plastic thing that makes it a little easier to take puffers)
Then I called her surgeon, told him I was having a problem with her, that she didn't want to go to her assigned bed, and also needed a specific kind of pain medication for her, because "nothing else worked for her" and that she was being rather difficult.
Anyway...blah-dee-blah-dee-blah...long story short...she refused to sign the Leave Against Medical Advice form without "Her Lawyer present" but left anyway and took the freakin' bus home...Highbrows and all.
I had a funny feeling about her, so I filled in all kinds of forms, wrote myself an email about her and called the appropriate Hospital Higher-ups. They, of course ignored my phone message, until.....
...Yesterday, she decided to return to the hospital to file a complaint about me. Apparently, I have given her HIV from a dirty aerochamber and she was demanding bloodwork to be done! Can you friggin' believe that?!?!?!?!
The Patient Advocate to whom she was complaining to, recalled my message so suddenly she had the heads up! There was no reasoning with this psycho woman and she eventually made her way to the CEO of the hospital! OMG!!!
In a way, I'm impressed because I would have no idea what the $2 Million Man looked like, and she had the balls to sit in his office and refuse to leave until she had her wishes met! I can only hope that he might sympathize with a lowly nurse upon meeting the likes of her.
So, she had her HIV test.
But I'll bet at least $2 Million that that won't be the last time that she wreaks havoc in Ontario's hospital system.

Whoo-hoo. Sunday night and I'm at work. As I start this post it is 1:13am, and tonight is one of those nights when I won't be able to catch a nap. The OR is still running, they are operating on some poor soul who has a bowel obstruction, and I am watching over a 20-something youngling who had his appendix removed today, and there are no beds available in the hospital for him post-operatively. Welcome to Canadian healthcare. At least he is a very nice young guy who is sleeping quite peacefully. I'll be the one struggling to stay awake.
Weekends when I work, I am the only nurse on nightshift, and it's a dark, lonely place here in the Recovery Room. I am working with an Environmental Service Provider, which is a fancy way of saying Housekeeper. I guess everyone gets to have a politically correct title these days, except us Nurses. Really though , he is here because otherwise I would be completely alone save for the nicely drugged up, sleeping patient I am watching. I hardly think that he would be able to help me if the boogy-man were to come and get me.
Anyway, the ESP is nice enough, but I don't know him very well, and he is well, a little odd. Last night he brought in a pillow for him to rest his head on during nap time. Know what it was? An empty wine bag that he had filled with air. You know when you buy a box of wine and there is a bag inside with a spout so it's like you have a little keg-o-wine? Well, he says you can fill it up with as much or as little air as you like, and it's quite comfortable. (Except for the tin-foil crinkle sound everytime you move your head!!!) He also has a tendency to listen in on conversations and add his two cents worth. So, he knows I've just bought a house, and he thought he would give me an unsolicited tip about driveway paving. The first time he mentioned it, I humoured him. Twenty minutes later he continued his lesson on driveway paving and tarring. Half an hour later, he discussed sealing. Another half hour later he remembered that you have to prime before you seal.
WTF?! I finally had to say to him that I really had no intention of paving, tarring, or sealing my driveway anytime soon, that the driveway actually looked pretty good. At the rate he was going, I thought he might actually want to discuss it all night!
Sigh. OK, I'm mean, I know. He was just trying to be nice.
I'll stop blogging now and throw him a bone. Maybe I'll ask him how to prevent ants from building anthills in the driveway cracks just to get the conversation rolling again...

Warning: Ranting Ahead!

There are days when nothing seems to go right, and today is one of them.
I am normally a very calm, relaxed, respected member of the health care team. For years I worked in an environment where the more stressful the situation, the slower and more focused I became so as not to make a fatal error in a life or death situation. I have become very adept to look at the big picture, prioritize quickly, problem solve effectively, anticipate what the next step would be, and let the doctor know when there was something 'not right with the patient.' And even if I started with "I'm not 100% sure what is going on here, but my patient is not looking right, and something is going to happen if we don't stop to really figure out what we're missing." I was always respected, and I always knew that I was a good advocate for my patients.

I am so upset right now, I am fighting tears.
I had a patient today who was 75 yrs old, weight 37 kilos (~100lbs) and was Iranian so she didn't speak english. No problem, we have non-english speaking patients every day. The anaesthetist gave me report, and basically just joked about how tiny she was and left the Recovery Room. She woke up screaming and moaning like nothing I'd ever seen before! She was grimacing and trying to hold her back where the incision was and writhing around in the bed in absolute agony. I gave her quite a bit of morphine trying to get her pain under control, but was a little nervous because she really WAS small, and a knew I was giving her a shitload of drugs. I thought I'd better take another look at her Anaesthetic record, maybe I had missed something.
Well. What I missed, was that she didn't get enough analgesia in the OR! Basically, this woman, who had back surgery, had as much pain medication as you would give a cat during surgery.
The drug he chose to give (Fentanyl), is very quick acting, but with a shorter duration than morphine (which is a GREAT drug!) This other drug, is also good precisely BECAUSE it is short acting. It's a great drug for short procedures, like when you are putting in central lines, or breathing tubes. Not when a tiny dose is the only pain relief given during a general anaesthetic! This woman woke up, and it was like she'd had surgery with the local witch doctor.
So, I spoke to the doctor, and basically said that I felt that she did not have adequate narcotics during the OR, and now she was in excrutiating pain. I'd already tried to top her up with morphine, but it wasn't working because she was in SO much pain. I needed something else. His answer: let's sedate her. I repeated to him, that I did not think it was a sedation issue, she needed something else for pain.
He came into the room, basically told me that HE was the doctor and I was a nurse, what did I know, did I want to tell him how to do his job? I again said, Fentanyl is a short-acting drug, it's out of her system now and she's in pain. He then (The Fucker) said "Oh did she TELL you she was in pain? Last I heard, she didn't speak english! I responded by saying that as far as I was concerned, moaning, and crying, and holding your back and grimacing where the INTERNATIONAL SIGNS for pain! His response? She doesn't speak english and clearly she has Cerebral Deficits !
Can you fricken believe that?! The only person with Cerebral Deficits was That Jackass! Then he tells me that fentanyl is the same drug as morphine and that I was wrong in saying that it had a short half-life. I said that "I, and my collegues must all be wrong then." He said we were.
I know that he feels that I was disrespectful towards him today, but this is not the first time I've had to wonder about what he's doing in the OR. Truth is: I don't respect him. He's lazy and sloppy. And even more truthful: he's the kind of person who's gotten by in life based on their good looks and charm. And he's a shitty Anaesthetist who's lives people put into his hands every day.
What I wanted from him, was for him to acknowledge that he did not use the most effective drug, or that he could have used other drugs in conjungtion, that he was not considering the patients post-op pain intra-operatively, and did not deal well with it post-operatively. He was arrogant, and belittling. And I know he is incapable of learning from this.
Anyway, this story is droning on and on. I could go into more detail, but then you'd probably think that I was the one with the Cerebral Deficits.

Right after that Fun-World Interaction, I went to lunch and broke the crown on my tooth. That, my friends, was the highlight of my day.

Good thing, I love my dentist.

Oh. And I had a good hair day.