January, 2006 Archive

January 30, 2006, 11:43 pm

If It’s Grand Rounds You Seek, You Must Take A Peek

This is one of the wierdest ads for underwear I’ve ever seen!

‘Nuff said.

But I wanted you all to “take a peek” over Dr. Barbados’ blog at Barbados Butterfly ,where you can check out Grand Rounds for this week.

Not only was Emergiblog honored with a spot on this week’s list of topics, but I have been asked by our esteemed co-ordinator, Nick of
Blogborygmi fame, to host sometime next month.

I will be ready with laptop and Diet Pepsi in hand.

Now, if I can just convince my husband that this duty requires a new Macintosh 12″ G5 Powerbook with dual processors.

I will then consider my preparations complete.

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4:53 am

When I Die and They Lay Me to Rest, I’m Gonna Go to the Place That’s the Best

UPDATE: One of my readers has pointed out to me that it is a common misconception that juvenile onset diabetes is caused by an excessive intake of sugar, and is concerned that this misconception may have received a boost by this post. Those of us who read medical blogs who have a medical background understand this. Readers who do not may not understand that I am being sarcastic, that sugar intake has nothing to do with causing diabetes. I thought this was a legitimate issue and so I’ve added this update to the post. I appreciate the feedback.

hhhhhhhhhhhhh

Wow, I had no idea that eating Shredded Wheat was a nursing prerequisite! I would have put it on my applications!
How ironic that I used to eat it!

Under protest, of course.

It tasted like horse fodder.

Unless….. you smooshed it all up until it looked like a bowl of twigs, added enough sugar to ensure juvenile onset diabetes and then smothered it in milk, which you wouldn’t drink afterward because little brown shredded wheat things were floating in it.

Ah, memories.

Now you can become a nurse by eating your Shredded Wheat composed of bite sized, frosted “mini-wheats” in a variety of flavors.

Sigh……

Another nursing tradition gone to the resting place of “Cap and Cape Heaven.”

hhhhhhhhhhhhh

My initial experiences as a new RN (back when MTV was just a gleam in a cable company’s eye) were in a Coronary Care Unit.

A CCU is a very different place than any other unit I’ve ever experienced.

Patients would talk to me. They often told me they were going to die. On that exact day.

And they did.

The one thing that the patients found hard to discuss were their “out of body” experiences during codes. This was not a topic that was widely discussed at the time. They were afraid the staff would think they were crazy.

Three patients opened up to me regarding their experiences during the years I worked in the CCU. Here are their stories:

  • Patient One was a young middle-aged female, in her early 40s. This was unusual in itself because young women were not a common sight in the CCUs of the late 1970s.
    • She had had an MI and had “coded” requiring defibrillation three days before. As I did her morning care, she happened to mention that she had felt she had left her body during that time, had followed a light at the end of which was her deceased uncle. Her uncle informed her that, “….it is not your time. Jeremy will meet you here.” At which point she remembers being back in her room.
    • The odd thing? Jeremy was her husband. And he was still alive.
  • Patient Two was, again, younger man in his 40s who had had an inferior MI. As I began my evening care, he asked me how many people had died in the hospital last night.
    • Now that is not a question I get everyday and I asked him why he wanted to know. “Oh, just curious,” he replied.
    • Later he opened up to me and said that last night two of the patient’s “spirits” had come to get him, asking him to come with them. He said they were in the corner of the room. He told them he couldn’t go, his son was a teenager and needed him. They asked three times and then they were gone.
    • Patient Two had been defibrillated three times the night before.
  • Patient Three haunts me to this day.
    • She was not very old, maybe mid 60s and she kept going into unresponsive ventricular tachycardia. She required defibrillation multiple times. I remember standing at the bedside, paddles in hand, while my colleagues worked on her medications and IVs.
    • Eventually things settled down and her rhythm stabilized. She called me over the bedside.
    • “Do you believe in an afterlife?” she asked. “Interesting question, ” I answered. “Why do you ask?” For the record, I happen to be a Christian with a very strong belief in the afterlife, but I sensed this was not the time to discuss it, so I kept the focus on the patient and her situation.
    • What she said next was horrifying. She had been underground, cold, dark and surrounded by dirt, looking out of a coffin. All she could see was her sister’s coffin next to hers. No warmth, no peace. Just coldness.
    • Her sister had already passed away.
    • I asked her if she felt the need to speak to the hospital chaplain. She said yes.

After I left CCU for the challenges of the ICU, I never heard any more stories of my patients’ experiences with death. Unfortunately in the ER, I will never hear them, as most patients are intubated when coded.

I once described a code as having a tug-of-war with God. Every now and then he lets us win.

I like to think my patients are watching the struggle and appreciate the effort we make on their behalf.

Even if we lose.

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January 28, 2006, 12:52 pm

Walkin’ In The Rain

Is it just me or is the recent crop of babies exceptionally cute?

It’s a very dangerous time for me.

My baby is almost 16 years old.

I have no grandchildren on the horizon for years.

I’m at that dangerous age between still being able to have a baby (just barely, I’m pretty sure my ova are using walkers to get to the Fallopian tube and I’d probably have to deliver in a convalescent home) and not having any grandkids to spoil.

The point being that all of a sudden I am in love with babies. Specifically, any and all pediatric patients under the age of one.

I got to hold an 8 month old for about 15 minutes the other day and he decided to carry on a full “conversation” with me.

It was hilarious; I’d ask him triage questions like, “Are you allergic to any medication?” and he’d “talk” for 30 seconds.

What the heck is going on? Is this like some cosmic joke?

One last surge of maternal hormones before they all get taken away? (Sorry, guys, girl talk here).

I guess, for now, I shall live out my maternal instincts through the babies at work.

Just another advantage of being a nurse!

******************************

It was only 4:00 pm. The sky was full of dark clouds. It seemed much later.

This particular year, we weren’t worried about a draught here in California. The rain never stopped. The clouds were just taking a breath before the next deluge.

She walked into the ER with her baby in an infant seat. Not the cheap old-fashioned plastic versions, but the big car seat type that were now on the market. She completed triage and waited to be seen.

*****

She was all of 17; maybe she weighed 105 lbs. A single mother who lived in the big city adjacent to where my hospital was located. Her baby had a fever and she was concerned.

Not only was she carrying a huge car seat and baby, she had the usual accoutrements. A huge diaper bag. A large purse.

The baby had a virus, nothing serious and we gave Tylenol (no ibuprofen back then).

As I gave her the discharge instructions, I noted that a torrential downpour outside and offered to help her carry her gear to her car.

She said, “No thanks!” and pulled out a huge umbrella. “I don’t have a car. We came by bus.”

*****

Not only had that petite little mother carried that baby and equipment on a bus to get to our ER, she had to make two transfers to get to the bus stop outside the hospital. Now she was going home the same way. In the rain.

I asked her if there was anyone who could come and get her and the baby. Usually, she noted, but there was no one else .

She never asked for a taxi voucher, never assumed that anyone else would be responsible for transportation home. She gathered up her equipment, picked up the baby.

*****

There was no way in hell I was going to let that girl and her baby go home in that downpour by a two-transfer bus route.

I told her I would call a taxi. She said, “Oh no, thank you anyway but I don’t have money to pay a taxi.”

I gave her a taxi voucher.

*****

I caught hell for it later.

My boss at the time did not look kindly on giving out taxi vouchers.

Tough.

The look on her face when I told her she could go home by car was priceless.

If we didn’t have vouchers, I’d have paid for it myself.

The baby may have been the patient, but that day I was able to take care of Mom, too.

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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