snowflakes, or anthrax?

so, it's been warm here for a while, and then suddenly this week the weather
turned to freezing. i was walking to the gym yesterday morning (yes, i've
returned to the gym--hired a personal trainer and all) and there were a few
flurries coming down from the only slightly cloudy sky. i should qualify my
next thought with: i was nearly drunk tired. i had dragged myself out of
bed after three days on to go meet with my new personal trainer. had i not
had an appointment with her i could have slept for hours more. i wouldn't
have trusted myself behind the wheel, or doing anything that required any
mental skill. anyhow, as i noticed the flurries, i thought "hmm...that's
beautiful. but i wasn't really expecting flurries...maybe it's ash. or
anthrax spores. did i really just think that? well (on the next block now)
there are still flurries over here, so it must be snow...it just seems weird
to be flurrying..hmm..." so there you have it, direct from the mind of one
overly exhausted, apparently paranoid, emergency department nurse.

just a job...

this weekend i worked three days in a row. i also agreed to go in two hours
early on my last day because they were anticipating being severely short
staffed. not the end of the world, but by midnight on sunday, i was dead
tired. there was this guy i had been working with for most of the night who
required a lot of attention. the oxygen saturation of his blood without any
supplemental oxygen was pretty low, so they had him on a machine that forced
air into his lungs every time he breathed in. pretty fancy stuff. anyhow,
he was hungry, so i would let him take it off for a few minutes at a time to
eat, and wipe off the dried spit around his mouth at the same time. he told
me i was one of the "nice nurses," when it was taking a long time to get him
a bed on one of the units (due to a clerical error) we joked that he just
wanted to stay downstairs with us. when his iv came out, i found him a
nurse who was better at iv's than me so he wouldn't have to be stuck more
than once. at the end of the night, i went over to the other side of the
emergency department to wash my hands and find the head nurse to see who my
relief was going to be. as i was walking out, i said "i'll be right back."
in my exhaustion, as soon as i found the head nurse, i found the guy who was
relieving me, said goodnight, and left. when i was gone, i remembered that
i never said goodbye. if i've spent a lot of time with a patient, i usually
like to wish them well, either when i leave or when they go up to the floor.
i felt horrible. not because i think that i held any great place in this
person's life, but because i feel like when i stop saying hello and goodbye
to patients, i start dehumanizing them. "they" collectively become my job,
not people who are having a rough day, are not well, and need help. it's
just not the kind of nurse i want to be. i think i've figured out while
working at this hospital that i am more interested in public health and
policy than in bedside nursing, but at the same time i certainly don't want
to treat this like a stepping stone. we'll see...

sweet...

i went back to work today after having 6 days off. it was, oddly, good to
be back. i loved having time off, but at the same time i like to fill my
days with something. when i am not working i am often overwhelmingly
tempted by "drama in the daytime" on tnt, and the gilmore girls on abc
family. i love that stuff.
anyhow, one of the aspects of working in my emergency department is that we
are often crazy busy. the smart, older doctors have mostly figured out that
if they hand us orders, call us their "favorite nurse" and tell us a little
about the patient it is far more likely that the medications will be given
sooner, the iv will be placed stat, and the labs sent right away. one of
our attendings has been there for more than 30 years, and i can never turn
him down. i don't know how anyone can--he just cares that much. anyhow, he
pretty much has me in the palm of his hand, and as long as i stay aware of
that i'm comfortable with it. tonight, i was going to call up to one of the
units and give report on the patient he had been working with all day. i
stopped him to ask him if it was ok to transport her without oxygen. before
i could ask, he stopped me with "i have been off since 8:00 pm and i'm still
here." basically, don't talk to me. then (i think he felt bad) he asked
what my question was. realizing it was something simple, he fell over
himself for the next 10 minutes apologizing, telling me that i help him a
lot, and i can always ask him things like that, and making sure that i knew
that he didn't mean i shouldn't ask him things. it was actually really
sweet. i've known for a while that some doctors have me wrapped around
their little fingers, but it's nice to get a little recognition back and an
effort on their part to make my life a easier.
on that note i am sufficiently wound down, and i am going to go to sleep so
i can get up and go to work tomorrow.