Tag, I'm it

SEVEN weird and crazy things about me, tagged by Veralee

7. I cry at Hallmark commercials

6. Ask me to name any song from any musical and I most likely can, and then I will sing it for you without being asked

5. I used to believe God made the wind blow with me when I sang

4. I get ear zits from my stethoscope

3. I've eaten a goat eyeball

2. I enjoy wound care

1. I sigh in my sleep

Digressions

I was riding home from work last night on the bus. Not an unusual occurrence, I know. The bus and I, we're good friends. We have an understanding, you see; it arrives on time, I arrive on time. But sometimes one of us doesn't hold true to our agreement. When that happens, I feel more like how a dog feels when it chases a car. You know you'll never catch it, but you simply must try. But I digress.

So, I was riding home from work last night on the bus. And two "gentlemen" were sitting behind me. I use the term "gentlemen" loosely because they didn't seem all that gentle and were certainly not men. They were more like rough hooligans. But I digress again.

Yes, last night, I was riding home on the bus, from work. And two rough hooligans were sitting behind me. They were, I might add, talking at the top of their lungs for the whole bus to hear, whether they wanted to or not. And trust me, no one wanted to listen to this conversation. I was privy to "hiding-pot-and-smoking-paraphernalia-from-the-police 101." I do not lie. Nor do I digress. So, if you're in the market for this type of information, see me after the show. And as a preview, I'll leave you with this little jem: dealers don't like when you pay with singles.

Needles and shaking hands don't mix

I see a worried mother, standing outside her daughter's hospital room. Tears are beginning to well from her lacrimal ducts. "What's wrong?" I ask, responding to the silent plea for help that is blasting across the open space of our ICU.
"That nurse is being needle happy with my daughters arm," she snaps at me.
I look into the room. It's one of our newer nurses. She's a good nurse with killer instincts, but like all of us, we have to practice on someone before our butterfly needles slip into veins with ease. It's so easy to take sides. Yes, I want to say, how dare that nurse poke your daughter so many times. You're tired and scared and helpless and all you can see is a nurse inflicting pain and it's too much. On the flip side, the poking is necessary, practice is necessary and only through it will experience be gained, making a good nurse a great nurse.

So I can't pick sides, I know both too well. Instead I say, "let me see how I can help." I walk into the room. The daughter is crying, the husband is crying, the mother is crying. The nurse looks up. "Could you please help me?" her eyes and her mouth ask me. I see now the purpose of the poking. Not for an IV, but we're aiming for the artery in the wrist to test the blood being pumped out from the heart rather than the blood returning. These are much harder and make me nervous. I feel a movie moment coming on, where all you can hear is the beating of my heart as four sets of eyes focus beseechingly on my face. The pressure is on. I gather my supplies. I take a deep breath to calm my racing heart. The pulse of the girl preparing to be poked matches my own. I clean the site.

This is no big deal, I've done this a million times before, I've never missed, I can do this, I can do this, I can do this. Somehow, having a traumatized audience watching over your shoulder makes all of those rationalizations fly out the window. My hands are visibly and uncontrollably shaking. Adrenaline is a weird thing. I'm sure the mom is freaking out at this point as she sees the shaking hands with the sharp pointy needle heading towards her daughters wrist. I hold the tip of the needle against the skin for a brief moment to steady my aim, then push through. "Oh fuuuuu....." is all I hear.

And then, bright red blood pulses steadily through my syringe. I feel euphoric, relief floods through me much like the blood is doing in the syringe. Funny the metaphors you find in a traumatic situation. The specimen is sent, I'm hailed as a hero and the rest of the day nothing can truly go wrong enough to take away that feeling.

Mother Duck vs. Crows

Nature is sometimes cruel. I was driving home this morning into my underground parking and I saw several crows circling above. Probably some dead squirrel carcass, I think, how gross. Instead I hear low pitched chirpings and see an anxious mother duck with her 12 ducklings trying to shield them all with her body. I almost started crying as I saw the crows hopping towards her. There was no way those fuzzy little ducklings were going to make it all the way to adulthood. And where was that absentee father to help out? I just wanted to scoop them all up and carry them to safety. I honked my horn and waved my hands at the crows like a madwoman but I only managed to scare the ducks. The crows just stared at me malevolently, biding their time. It made me really hate crows. And then I had to laugh at how I assign human, malicious feelings to animals. And then it made me really want Christ to return all the more so we don't have to see the evidence of sin even in creation. And then I cried.

To smoke or not to smoke...

The hospital where I work just became smoke free. No smoking in the hospital, around the hospital, under the hospital, above the hospital. All space occupied by the hospital, all property owned by the hospital, no cigarettes allowed. While some may rejoice in seeing the dingy little hovels where the clear paned glass had turned a lovely nicotine brown removed from the hospital premises, those who looked to them as a haven from hospital woes aren't as thrilled. But seriously, if you are a health care worker and you smoke, well, this little order won't stop you. Think about it, not only are you bombarded with education (we practically throw "quit smoking today!" packets at every patient that walks in the door) but you've also withstood seeing firsthand evidence of what smoking can do to you in the patients you care for. So, where there's a will there's a way, and I stumbled across the way this morning. Across the street from the hospital, there is a little grove of trees that screen you from the all seeing eyes of the hospital's many windows. And behind these scrawny little trees is a make-shift garbage bag ash tray with several hospital employees furtively inhaling and exhaling as quickly as possible before their shift begins. I catch an eye and the look is of sheer desperation, a silent plea to not report this misdemeanor. I won't, but maybe someday when they're my patient, I'll make sure they're educated on the perils of smoking. Because they must not know.

End Game

We stare at each other, gridlocked.
"Please let go, I don't want you to hurt yourself." I plead.
"Well, then stop hurting me." she retorts. I'm slowly prying her fingers one by one off of the arterial line. I look at all the tubes we have her hooked up to, the oxygen mask, her incisions. If I didn't know I was in the hospital, I guess I'd think everyone here was trying to hurt me too. As I'm filling with sympathy, her hand gripping my wrist lunges at me. I instinctively jerk back, but not in time to prevent getting two long scratches down my hand. I think I see some drops of blood pooling to the surface. My 72 year old, sweet-as-could-be patient, just drew blood! I manage to loosen the last of her fingers from the A-line and without loosening my grip I tie her arm down to the bed with a restraint. The next hand quickly follows, though I stay far out of reach from those dagger like nails. Once securely fastened, I ponder this paradox. I tell her we're not trying to hurt her, and now she's tied to the bed like a criminal. I have a feeling she's not going to trust me again. I go to call the doctor and scrub some Purell on my hands. The stinging I feel reminds me of the battle just fought. Well, score one for the 72 year old, I think.
___________________________________________________________________
Update: This patient was suffering from delirium, which is pretty common in older patients in the hospital, especially when medications and lack of sleep are involved. She is now doing fine but remembers our little adventure, and thankfully no longer thinks I'm trying to kill her.

When Patients Attack

"Help! Help!" My patient croaks from her freshly extubated throat.
"What's going on, what's wrong?" I ask my once perfectly sane patient.
She glares at me with all the menace she can muster.
"You know what's going on," she accuses.
"Where are we right now, {insert name here}?" I ask, wondering if this is the dreaded neuro status change.
"I know where we are right now, don't talk to me like I'm stupid."
"I don't think you're stupid {inserted name}, I just want to make sure your head is doing okay." Wrong choice of words.
"Well, that is not.... that is so rude to say my head is not okay. You are just not a very nice person. I want my lawyer. Now. And the police."
I try to smile reassuringly. "{name} you're in the hospital, you hurt your head, you don't need your lawyer."
"I don't trust you!" If looks could kill, I'd be in the morgue.
"Why don't you trust me?" I try to get a reasonable dialogue going again.
"You smile too much." She states, perturbed. I gulp down another grin.
"You can't hold me here against my will!" She starts to panic and I try to keep her from hurting herself as she becomes entangled in all the different tubes and wires we have her connected to. She grabs her arterial line in a vice like grip and I can just envision the bloody mess, not to mention dangerous blood loss, if she manages to pull that out. I grab her hand as she grabs my wrist with her other hand. For a 72 year old woman who's been laid up in a hospital bed for several days, she's surprisingly strong. And while I don't want to hurt her, I can see in her eyes she doesn't care one whit about hurting me. We are locked in place. If I pull, the A-line could go. If I let go, it's coming out anyway. Just as I'm hoping for some innocent passerby to see my predicament and help, my patient makes the first move. To be continued...

The business of dying

I see death often where I work. Not the grim reaper with his scythe and black cape. Less fantastical, but just as traumatic, watching someone take their last breath. Here is something I wrote awhile back after just such an experience...

Rasping breaths, the unmistakable sound of death slowly becoming victor, filled the quiet calm of the room. Loved ones gathered around united for a moment in the face of a common enemy, mortality. Every face showed signs of a different struggle, bitterness, anger, sadness and grief beyond words. You could almost here everyone counting the seconds between each breath, wondering which would be his last, half hoping the struggle would just end, yet pleading for one more breath. Just one more. We're not ready to let go, not yet, please.. quiet prayers lifted up to an unseen God. It never got easier, watching a family go through death. Old, young, expected or unexpected, it was never easy. A cold tear slipped down my cheek, I let it linger. It didn't matter if I was too emotionally involved, I wanted the family to know I grieved with them. How can I not hurt with families, when I already know what they are feeling all too keenly? A breath is exhaled. We wait... It's over.

Mortal Combat

A great and terrible war ravaged the country. Households were being torn apart as young men turned from their parent's ideals, creating enemies between Father and Son. Much blood was shed, with a perpetual call for more. As is the way with most wars, each side believed they were in the right, that God, the true God, was on their side. They would be rewarded in the end, if anyone was left alive to receive it. Yet, those dead and dying men were not hideous, faceless, monsters the "other-side" portrayed them to be. These men were fathers, brothers, sons, loved ones, dear to many. But who would let themselves stop to think on this? It was easier to kill a faceless monster. And still the battles raged on, children becoming fatherless, bothers brother-less and the wide-eyed hopeful lovers became despondent and bitter as news eventually came that their happy ending would never unfold. Unbeknownst to the masses, in spite of man's follies, God uses these mistakes of mortal man for His infinitely good purposes.

Bus rides and Bullets

I used to make up dreams when I was little. Shocking, isn't it? To be fair, my brothers would always have the most interesting dreams, and being the little sister, I had to try and keep pace with them. So I had to lie. Didn't I? Luckily I've outgrown that, I was only five you know. But now, whenever I have a real, legitimate dream, my WHOLE family quickly dismisses it to "Oh, look at Julia, isn't that cute, she's trying to be all imaginative and interesting again." Well people, it's time to put a stop to that! Especially because I do have the weirdest, vividest dreams ever, and it's a shame they're wasted on an audience of one. So, here's one I dredged up from the memory banks.

I'm waiting at a bus stop. I'm always waiting at bus stops in reality, so in dream-land it's rather predictable. It's a busy part of the day, lots of people milling around. I recognize a co-worker and wave hi. We board the bus together. A man, without a face, as dreams often go, boards behind us, and quickly pulls out a gun. I'm always the peacemaker in my dreams, I try to talk him out of whatever he's going to do. I even manage to share the gospel with him. It's all fairly tense. Then he fires and hits my co-worker. Now I go into "nurse mode." I start holding pressure and scream to the bus driver to head for the hospital. The faceless shooter disappears. Justice is not the focus of this dream. I continue holding pressure, but there's a lot of blood. I can feel it, warm and dark. It pulsates out of the wound, I'm sure it hit an artery. My co-worker is still talking to me, and I realize I don't know much about her, where her family is, who her family is. We just work together and we're pleasantly polite, it's never gone much deeper than that. I get personable now, because of course it's perfect timing, with my hands steeped in her blood. She has a daughter, and a grand baby. Now it will be much harder if she dies. We're at the hospital and I'm riding on top of a gurney with her, still holding pressure. Dream travel, I suppose. They tell me to keep holding pressure until they can get to the OR. Her daughter shows up with the baby, they're able to say goodbye. We're in the OR and I'm wearing scrubs and those weird seafoam-green surgical caps. They tell me I can let go now. I lift my hands up and all I can see is a bullet wound that's almost half healed over. I'm ushered out of the OR and the swinging doors close behind me. I know everything is going to be okay now. But my hands are still red and sticky, the adrenaline of the moment still pulsating through my arteries. I wake up with that same feeling. When I see my co-worker later that day, I tell her I saved her life. In my weird messed up dreams. Oddly, it's brought us closer... maybe someday she'll truly be saved, I only hope it won't involve bus rides and bullets.