it's always the good ones...

there is some sort of murphy's law/perfect storm/cruel fate phenomenon that makes the really bad things only happen to wonderful people.  

as a rule, i would say that i like most of my patients.  but lately i have been REALLY liking them, and have had this groove going the past couple of weeks.  they keep giving me wine and candles and raining complements on me, and it is both creepy that things are going so well and also amazing.  

but the more you care about people, the worse you feel when things go wrong.

i had this lady last week.  young, pretty, with an awesome family and little kids.  so of course she has some rare genetic disorder, and of course this means that she has perfs her bowel and requires a permanent ostomy.  and she's sad, and she's anxious about it, but she still is doing everything that she needs to be doing and trying to have a good attitude and being all around gracious and inspiring.  

so i was surprised, but also not surprised, when i came into work yesterday to discover that she eviscerated bowel through her suture line and needed to go back to the OR.  she did great, but ended up in the ICU postop.  

i kept running into her dad in the hallway during her surgery, and i just felt so awful for them.  and then her sister came down after surgery and cried on my shoulder, just so incredibly frustrated and worried and sad.  it made me feel so helpless, like i should have done something more.  like i should have been able to prevent it.

so i went up to the ICU last night after my shift to see her.  and she looked good, but also exhausted and broken.  being that she's such a good person, all she kept saying was what a good nurse i was and how i have a gift.  

just not the gift of being able to prevent this, i guess.  

sometimes this job just wears on you.  it's exhausting watching bad things happen to nice normal people and not being able to do anything about it.  and while it's flattering when they think i'm amazing and feel well cared for, the truth of the matter is that i can do very little for them in the grand scheme of things.  i can make it feel better, but i can't MAKE it better.  

and while that's definitely something, sometimes it just doesn't feel like enough.

 

omens

so i was fired from a patient within an hour of being at work on a monday.  

she was completely insane.  my offenses?  well first i asked her to put her gown down because she was flashing the hallway.  then i had the audacity to ask her to use the call light before she got up out of bed and set off the bed alarm.  and the final blow was when i tried to assist her into the chair and reminded her not to use her nonweightbearing foot.  

what commenced was a screaming/swearing fit so loud that it sent the doctors running out of the back room and to my rescue.

apparently i'm a "bitch with an attitude".  well if the shoe fits, i suppose...  

i kindly removed myself per my patient's request, and then thanked jesus for sparing me from hours of torment with this psychotic woman.

this may not bode well for the rest of the week...

AMA: you're doing it right.

this one comes courtesy of cardiac nurse bff.

so they got this patient on the floor who was regular.  this guy is a classic manipulative patient in a 'sickle cell pain crisis' who required a PCA, yet spent the majority of his time off the floor out smoking or trying to scam people.  he apparently would get a few hits of dilaudid then disconnect himself from his pump and disappear for an hour, only to return to get some narcs and disappear again.  everyone was fed up with him and his alleged "pain crisis" and the doctors finally gave him an ultimatum.  if he took himself off of his PCA and left the floor one more time, it was going to be considered leaving AMA and he wouldn't get his prescriptions for all of his pain meds upon discharge.  they patient apparently agreed to this, and then went MIA from the floor again.

when he finally got back, the intern went to go talk to him and, wouldn't you know, the patient refused to go AMA.  after much bargaining, threatening, and the like, the intern finally caved and told the patient that he would write him a prescription, but he was still considered AMA as per the original agreement.

so at this point in the story, i'm pretty much livid.  THIS IS WHAT IS WRONG WITH THE WORLD.  entitled people making your life a living hell to the point that you just give them what they want so they will finally go away.  but still, not ok.  shame on that doctor for giving in, i thought.

so the patient signed the AMA papers and the intern handed over his prescription.

it was for tylenol.

and the intern for the win!!  it's about time that someone took it upon themselves to not give in to manipulative, drug seeking bs.

and THAT is how you do AMA.

youtube and a nurses week shout out

first of all, a very happy nurses week shout out to all my people.  go enjoy your dry cake and keychain, or whatever it is that your hospital graces you with.  secondly, i saw this ecard today and almost peed myself, as we got a 'youtube gone wrong' admit a few weeks ago.

the kid was young, like maybe 18, and had decided to jump out of a moving car and try to do some sort of tuck and roll so he and his homeboys could get rich off of being an internet sensation.

...turns out no one really wants to see you give yourself a grade IV spleen lac.  well fancy that.  

HAPPY NURSES WEEK to all...remember that we are fabulous even if no one else appreciates it.