Saturday, May 30, 2009

Butt Out, Obama.

Why is my President getting involved in affairs of private commerce? The last time I checked, my American brothers and sisters were still overseas in a war zone. Hey Obama! Get involved in that. That, after all, is your job. Even I am starting to get a little bit pissed, and other than being a staunch Republican, I don't usually get into politics. And I am a simple kind of girl. But I equate this to my going into work and saying "Nope, I am not going to see patients tonight because I have X, Y and Z to complete for school." But I don't do that, because I know what my job responsibilities are while I am on my emploter's dime. Obama never learned that lesson, apparently.

Is this what you wanted, America? Is this the "Change" you were looking for? The American public made a huge mistake.

Friday, May 22, 2009

Whatever


Hate My Life @ Yahoo! Video

Ummmm. Do you notice a trend? I post videos when I am too busy to write or when I have nothing to say.

Yesterday, at the gas station, as I was walking in to pay for my gas, some guy asked me if I would give him money for cigarettes. Not food. Not gas. Cigarettes! Beggars have gotten ballsy!

In the meantime, finals week is rapidly approaching, and because of the $1K electric bill, I have been working weeknights in addition to my weekend shifts. I don't think the black circles will disappear from under my eyes any time soon. I have literally been going about 48 hours between chances for even a little sleep. Go to school all day, then head straight into work, then get finished with work and go straight to school. I'm exhausted. And everyone says "Just wait until med school!" Seriously? By then, I will not be working 70-80 hours per week in addition to a full-time class schedule. I do not plan to do this to myself then. So med school? Not scared.

Saturday, May 16, 2009

Good Tunage


I saw this and thought instantly of my son and of my mom.

Tuesday, May 12, 2009

Electric Nazis and the Landlord from Hell


I. Am. In. Hell. I have had to resort to 60-hour workweeks again in addition to my crazy school schedule because of bills. I am a sort of magnet for drama. The therapist I saw after my mother died once told me that I have the tendency to get bored because my mind is capable of handling a lot at one time, and so sometimes I dramatize a little to entertain myself without realizing it. Back then, I would have to stop myself from over-reacting to little bumps in the road. Well, that was years ago. I can assure you that with motherhood, marriage, my career, and my rather ambitious educational endeavors, I am not bored. Not me, my mind, my heart, my soul.....All of the parts of me are challenged on a daily basis. And yet still, drama. Drama, drama, drama. Here is the latest:

We moved in to the property where we now reside back in November of this past year, right? Well, we have had trouble since. Trouble with neighbors and the general functionality of the house in which we live.

My absolute fave incident had to be the day I had my wisdom teeth cut out. As our luck would have it, despite best-laid plans, about an hour after Evan was dropped off at school, the school called saying he was vomiting. Yuck. But I had to have the procedure done, and John had to be there. I arranged for the sick childcare at work so John could take me. But we had to go. So John picks up Evan while I am in the shower. John and Evan are in Evan's bedroom changing Evan into pj's while I am in the next room getting ready. Apparently, Evan started projectile vomiting all over his room, so John shouts for me to help. The next thing we know, the neighbor from upstairs comes downstairs and is banging on our door, raising hell that we "jolted" his wife awake. I tried to apologize and explain that our son was ill and John needed my help. Before I could finish, he started talking about our "dumbass kid". Oh. Oh no. I called the landlord then and there and told him that if he did not do something about them, we wanted out of our lease.
But as if that wasn't enough...

We get a bill in the mail last Monday. Electric. $163.89. We have been paying about $200 monthly since we moved in in November, which is a pretty substantial electric bill for an apartment. I figured it was a little cheaper because we haven't been using heat. Sweet. Until the next day, when we get another bill. For...wait for it...$1,029.96. Ummmmm. Seriously? No way. I immediately get on the horn to the powers that be at the electric company. I pay my bill every month, in full, before it is due. What in the hell could this possibly be about? Well, as it turns out, they claim to not have access to our meters, which are under lock and key. Who has the key? The landlord. I didn't even realize that they couldn't read the meters. I mean, if they can't, how did they read it when the electric was first turned on in our name in November? So something is not right here. We start talking to our neighbors and find out that the upstairs neighbors got a bill for over $2K, and the neighbors across the hall got one for $1600. The neighbors upstairs aren't married, and thus have different last names, and so their solution was to turn it off in his name and turn it on in hers. But John and I cannot do that. I had no choice but to pay the bill.

Thinking that part of this fiasco is the landlord's mistake, I call him and tell him about it. I explained that, for the first time since we moved in, my rent would have to be 1 week late because I had to pay this enormous bill since he failed to provide a key to the meter reader. In other words, dude, even though you messed up and jilted your tenants, I will pay the sucky bill, but in exchange, I need you to give me one week. Nope. He wants us out. Which is fine. I want out. I am tired of the noisy neighbors and the bugs that crawl through the gaping holes in the screens because we cannot use our non-working a/c and thus must leave the windows open. I'm tired of trashy neighbors stealing my towels from my dryer downstairs when I turn my head for a second.

But then we start really looking at our lease. Boy was I stupid. It appeared to be a standard lease, and the day I signed it, Evan was running around like a madman and I was just trying to get home. But it is anything but standard. This asshole actually has it in his lease that we are responsible for repairs to electrical, plumbing, appliances, and even the roof if it leaks. In other words we got hosed again. So now we are looking for a new place...again. But not before I got my digs in:

We were leaving the house. There is already a "For Rent" sign in the front yard because one of the units upstairs is empty. Well this young couple pulls up and asks if I know how many bedrooms the empty unit has. "Two," I say. "Two pieces of crap."
"Really? You don't like living here?" the guy asks.
" Well, my electric bill was over $1000 this month. I make really good money, and I cannot afford this piece of crap." I tell him. This is when John walks up and pipes up about the bugs and the neighbors and the lease he makes people sign. The couple wanted to know if we knew of anyplace else around here for rent. We directed them to a place around the corner that has 1 bedroom, which we would have rented if we didn't have a child. They thanked us for our honesty. I doubt they will even inquire about this apartment. I figure that was my good deed for the day. At lkeast I could save them, if not myself.

For the First Time in a Long Time


I cannot believe Mother's Day has come and gone. I am that busy. But for the first time in quite a long time, I did not cry. I worked and slept and worked some more instead. And I absolutely treasure the little bead necklace Evan made for me in his first grade class. It is hanging on the rearview mirror of my car. But now I feel guilty. I was so busy that I did not stop and honor my mother's memory.

Sunday, May 10, 2009

Swine Flu B.S.

(* I found this pic on the internet. LOL)

I have had the sniffles and a sore throat for the past couple of days. I am obviously not feeling well, and as I cruise the halls of the the hospital while working, and encounter other healthcare professionals, I have heard nothing but the following: "You don't have the pig flu, do you?"

No. I do not have swine flu. Stop asking me. But I do have a patient whom we suspect does, and I will go no further than that. But let's talk about the pig flu, shall we? It has, thus far, caused no abnormal symptoms, save for the standard flu symptoms. And while the global death rate for influenza of which we are accustomed climbs into the thousands and thousands, at last check, swine flu has only caused a couple of hundred deaths worldwide. So why are we freaking out?

Well, this marks one of the first instances where we can catch an illness that has morphed from animals. (Not the first. Remember avian flu???) But everyone is in a dither about this. Everywhere I go on campus, there are signs posted on doors, windows, walls, about prevention of the swine flu. Seriously. Even my husband is not exempt. I mentioned that we had a suspected case, and he practically wanted to red-bag my clothes and burn them when I got home. I wanted them off as soon as possible just because I was dealing with influenza, and I have a child and husband at home who have not had the wealth of vaccines I have had due to my position in healthcare.

Maybe it is just me. I don't get worked up about MRSA or TB or influenza. I use precautions when dealing with these patients because I want to protect my other patients and my family by not becoming a vessel of illness. But most of this stuff is just common sense. Wash your hands, especially after touching something that a gazillion others touch, like door knobs, light switches...Make your loved ones and friends throw away their dirty tissues instead of laying them around. Sneeze or cough into a sleeve of tissue, then wash your hands anyway. Stay away from hospitals if you can. We try really hard, but hospitals are full of sick people. Those of us in their employ have someone in infection control to ensure we are protected. We try to protect visitors and patients too, but some people just do not listen. (Case in point: the suspected TB patient who SNUCK out of her room for a smoke!) Do not, by any means, be the idiot who has your 2 year old cruising the halls barefooted. No doubt, they are treading on c. diff and MRSA and VRSA and streptococci and anything else you can think of that settles to the floor of a busy ER.

So why am I not scared, other than reasons I just mentioned? There is not one single part of me that does not believe that I do not have MRSA all over me. If I were to get sick enough that they were to test me, I am sure I am completely colonized with it. I have had my flu vaccine, and I wash my hands before entering a room and before leaving. (That's a lot, for those of you who do not realize what it is that I do.) And in between those frequent washes, I sanitize. When someone is going to be coughing in my face, which is pretty much all of the time, I wear a mask. If I am going to get something on me, I wear a gown. When I get something on me when it was not anticipated, I bag my laundry, and either turn it in to the disinfecting gurus at the hospital or I wash it seperately with peroxide, then wash it again, by itself. And I wear gloves pretty much all of the time. My son and husband do not come to visit me at work. Common Sense, really. All of it.

Quit freaking out over swine flu. Because each year, as we get vaccines for new stuff, there will be other new stuff to emerge from which we are not protected. Viruses and bacteria are a clever sort. The morph and evolve too. Are we going to panic about every single one of them? Really? Calm down, says the Respiratory Therapist soon to have a degree in Molecular Biology. It'll really be okay.

Wednesday, May 6, 2009

Thanks, Dodge



I must had it to the people at Dodge. Yesterday, John came to pick me up and informs me that my 6 month old car's check engine light has come on. Huh? What?

So I make an appointment at our local Dodge dealer's service department. Turns out that I have a bad oxygen sensor on my car. But this was the first time I have ever had to have a new car serviced. Despite the inconvenience, it was pretty nice to hear, "I am so sorry for the inconvenience, ma'am. We will take care of it." I kind of like this whole not having to pay for repairs sort of thing.

Monday, May 4, 2009

Tales from Behind The Mist....Of Albuterol


From the "Are You Serious?!" File....

Some true stories from work this weekend.

Phone rings and it is Nurse X: "Andrea, can you come and give the patient in room XXX a breathing treatment?"

Me: "Sure. Whats going on with the patient?"

Nurse X: "I don't know. He wants a Coke. Can you just give him a treatment so he will shut up about the Coke?"


Phone rings and it is Nurse Y: "Andrea, my patient's sat is 85 on 2 liters. Can you come see him?"

Me: "Did you turn up his oxygen?"

Nurse Y: "Yep. To 5 liters." (sounding very proud of herself)

Me: "What's his sat on 5 liters?"

Nurse Y: "I don't know. I left to call you."

Me: "Well, I am in the ER with a full arrest. Go and see what his sat is, and if it still low, put him on a venturi mask at 50% and 15 liters, and I will be there as soon as I can. Do you know how to do that?"

5 minutes later the phone rings. Nurse Y again: "Andrea, I think I broke the venturi mask."

Me: "Get another one and try again. I am still bagging this patient in the ER."

2 minutes later, Nurse Y, again.: "I don't think 50% is going to fix this. We need to go up on his oxygen, not down."

A few minutes later, I head to the room. The patient's sat was 100%. His heartrate was 85. I put him back on his 2 liters and went back to the critically ill patient I left in the ER to deal with this.


Later that night, a full arrest in the ER. We are intubating the patient and I have the nurse behind me at the crash cart hand me an en-tidal CO2 detector to verify proper tube placement.

Doctor X: "That won't work on this patient."
Me: "Well it is habit, so just humor me."
After a few breaths, we get the color change that shows the tube is indeed in the lungs and not the esophagus.
Me: "See, it worked."

After the code, Doctor X comes up to me, and in a gentle voice asks me if I understood why it would not work for that patient.
Me: "Well, it did work. Plus, It is an ACLS standard that tube placement be verified with an end-tidal CO2 detector, and therefore it is the policy of this hospital that we use it after an intubation."

Doctor X: "Well ACLS is wrong. I'm going to write them about that."


Seriously, people. Seriously.

Being Seen


I have had the most interesting weekend at work.

For the first two shifts of the weekend I had the ER, along with some general med-surg floors. I had to confront death head-on for a couple of patients. I lost one battle and am still in the process of losing another.

A 75-year-old man comes in as a full cardiopulmonary arrest. We are doing CPR, and they let the family back. I hate that. Hate it. I have to remain detached and professional to do my job effectively. But this little old lady comes limping back with her family, as we are doing CPR on her husband of over 50 years. They have had this life together, and I feel like we are taking that away from her when there is nothing we can do to save the man. As I watch her cry, I am finding it hard not to cry. The doctor calls time of death and I help her limp to the bedside, where she gives him a kiss on the cheek and crumbles with grief.

The next night, another full arrest comes in. That is what these patient's are to us. The full arrest in bed 18 or 8 or wherever they land. Not a name. She comes in already intubated, so the task of ventilating her falls to me. I am tweaking the vent to find a way to ventilate her that works best with her natural patterns of ventilation. I have my back turned to the door, turning knobs on the vent. I turn around for some unknown reason and see this sweet guy from housekeeping there behind me. In that instant I assume he is at work until my eyes take in his street clothes. He looks at me with these wide eyes, and I just know. I ask him if it is his mom, and he just nods. He stays in the room while we do all sorts of medical procedures to the woman. She is nude from the waist up for an EKG, and all I could think of was my relationship with my son, so I reach over and cover her breasts with a sheet. Later I go down to the smoking area for a much needed break for coffee and a Marlboro Light. He is down there smoking too. Before this, he and I would joke about college football. He would tease me about my hatred of Florida. He was always quick to offer a smile. Before that, I don't think either of us were very aware of what the other does in the hospital, other than these huge badges that go along with our picture badge that is designed to quickly reveal to patients just who we are. Mine says "Respiratory Therapist" in bright green. His says "housekeeping" in pale blue. But that night, in his grief, he saw firsthand what it is that I do. Never again in his eyes will I be the joking girl who loves Buckeye football.
We are sitting there talking. Once again, we are just two people down in the smoking area. There is no whoosh of a ventilator in the background or a beep of a monitor. He looks at me and gulps down tears as he thanks me for all of the hard work I do, not only for his mom, but for all of the other patients I see on a nightly basis. I get choked up by that. Because every night, I whisk in the room in response to a call that someone somewhere in the hospital has stopped breathing. I do my job and slip quietly away unnoticed by the patients' loved ones. I stay under the radar. They will never remember my name like they will the nurse who takes care of their loved ones. Or the doctor charged with their care. They don't know that I am the girl who stands over their family member, with my back breaking and the hot exam lights forming beads of sweat on my brow, breathing for them when they cannot. I am fine with that. I know what I do, and somewhere inside of me, despite self-criticism, I know I am good at my job. That has always been enough for me. It is okay to be the unseen. But that night, I was seen. And the reality of what it is that I do for a living settled with a big thunk somewhere inside of my soul. I see hundreds of patients nightly. I never remember names-- only faces. In that instant, a myriad of faces come back to me. I worry myself daily if I have been a success at the tasks I have undertaken. Did I do well on Exam X at school? Will I get into medical school? Does my time away from home to pursue these goals I have set for myself do harm to my husband and son? Am I truly making a contribution to this world in which we live? In that instant, the housekeeper from the hospital gave me my self-worth on a silver platter, showing me that this is who I am. That I have touched lives, even when I didn't realize I was doing anything more than earning money to support my family. And for some reason, at that point in time, my thoughts went to my mother. Is she watching me now? Does she see the hard work I do? Is she proud? What is this work I do really about? My confrontation with the housekeeper had such an impact on me. I am still the nineteen year old girl who lost her mom too soon to lung disease. And I have been battling lung disease ever since. It will not win. I am too tough to allow that to happen. It is like the housekeeper took a large mirror and held it to my face for me to see, saying "Here. Look at her. This woman, who works hard to fight for the lives of others. This woman who is capable and tough and smart, who can do whatever she deems fit in life, who will reach the dream she has set for herself, who is Pauline's daughter and John's wife and Evan's mom. She is you." I need to be thanking him.

Dealing with the Aftermath

While my professors were really nice about the whole wisdom teeth ordeal, I missed MIDTERM WEEK! I have so much crap to do that I have no time to even breathe. Grrrrr.

Friday, May 1, 2009

2 Less Teeth


I let them do it. I was nervous, and it was a good thing that the sedative works quickly or I would have probably chickened out on this. I looked the surgeon square in the face and asked if he was "prepared for an airway emergency". He gave the nurse the "Do you believe this one" look, to which I responded, "Hey, you know what I do for a living, right?" After that, the last thing I remember is him telling me about the patient he had to trach in the chair. Next thing I know, I am awake and giggling uncontrollably, and the wisdom teeth are gone. Apparently Versed is to blame for the giggles, though I have never seen it have that effect on any of my patients.
Everyone has told me how painful it is to have these boogers removed. I have been pretty sore and not feeling well because I have been taking a low-dose narcotic painkiller. But I have refrained from those for over 24 hours, and now I am feeling the aftermath. But to be honest, after the pain I was having before they were removed, I think this is an improvement. Plus I have the psychological benefit of knowing that I have no more wisdom teeth to cause any problems. All 4 are gone now. I just know that the plan is to work tonight, and I want nothing in my system for that. I have bought a fricken enormous bottle of ibuprofen just for work. I still cannot eat solid foods though. That's okay. The hospital cafeteria has a wealth of frozen yogurts and Jell-O, soups, puddings, etc., to choose from. I'll be a-okay.