lies

there is something about being lied to on a daily basis that has made me stop trusting a thing that people say.

case in point.  i had this patient awhile ago....8 months pregnant, accidentally stuck her hand through a window and severed an artery.  almost bled to death on her front porch.  upon arrival to the ED, they almost did a C-section in the trauma room, which is NOT DONE (i know, i know, the TV show ER lied to us all).  they finally got a blood pressure on mom in the 40s systolic, so they ran her to the OR and did the C-section there.  after a ridiculous amount of blood...like 16 units PRBCs and 9 of FFP, everybody was still alive.  baby ended up doing pretty well in the NICU, and the patient came to me in less than 24 hours from when she was almost dead.

she had some problems, to say the least.  drug and alcohol issues, didn't have custody of some other kids...that kind of stuff.  but when she told me that her issues were in the past, something made me believe her.  and when she teared up every time she talked about her baby, she was genuine.  she didn't even want to go home on narcotics, such was the dedication to the idea of changing her life.  i don't usually drink the kool aid about that kind of stuff, but with her i did.  i was convinced that she was going to change her life, and when she got discharged i was hopeful for her.

a few days later one of my pregnant coworkers saw her in the OB clinic waiting room.  she was falling out of her chair, dropping things, eyes half closed...obviously on something stronger than percocet.

i guess i shouldn't be surprised.  it still makes me sad, though.  i wanted better for her.  i wanted for her to prove everybody wrong, for her to prove to the state that she can be a good mom.  for her to be able to keep her baby, to fight her addictions.  but i guess she just doesn't have it in her.

now that i think about it, i don't think that she was lying to me as much as she was lying to herself.

it's an age old question: how do you give your best on a daily basis to people who most likely will never change the behaviors that brought them to your door in the first place?  or do you just do your job and stop caring about the rest?

i want to believe that people can wake up one day and say 'enough is a enough', stop living out destructive behaviors and making poor choices, and completely turn their lives around.

i WANT to believe it.  i'm just not sure i actually do anymore.  

run and tell that.

a while ago we had a visit from some governmental friends.  while they who will not be named were in the house, we had an unauthorized dog running around the floor, a patient trying to bathe themselves with cavi wipes, and a patient elope to mcdonalds playland for 3 hours because "nobody told me that i couldn't!!".  cue widespread panic and cover ups to ensure that we didn't look like morons and get dinged 234098234 times for violating like all the policies we have.

and while our visit with 'the man' went fine, it always ticks me off when they're around.  mainly because we have to spend more time worrying about timely charting than about actual patient care.  and because i have to hide my coffee.  but now they're gone...let the use of unauthorized hand lotion begin!!

in which i am traumatized by camp nursing.

so i do this thing every year where i work a 70 hour week and then head straight to kids camp and be their nurse for a few days.  every year i dread it, and every year i leave happy and feeling like i did something good.  for the past few years, i have soothed the hypochondria of children and put on some band aids.  this year, i expected more of the same.

that was, until, the very first night of camp.  when a mere 5 hours after the kids arrived, i heard the horrific screaming that only comes when someone is very very hurt.  my suspicions were confirmed when people started yelling for me, so i followed the noise to the kid writhing in pain on the ground with a very obviously broken arm.

now i'm a trauma nurse.  but i don't work peds, and i'm not a first responder.  the fractures that i see are all splinted or ex-fixed or at the very least, covered in some way by the paramedics.  i'm definitely not used to seeing such a little hand just hanging there, especially when it's attached to a terrified little kid.  i would like to say that i launched into nurse mode, but i actually think that it was more like mom mode.  i grabbed the crying child, pulled him into my lap, and held on for dear life.  the arm was bleeding, and even when i was asking him if he remembered falling on anything, i was pretty sure we were dealing with an open fracture.  and instead of my nice shiny sterile hospital setting with all of my supplies, i'm sitting in dirt at the bottom of a hill with a first aid kit that somehow doesn't have gloves.  and this is my fault, because i was the one who "restocked" the first aid kit....just not very well, apparently.

i honestly think gloves wouldn't have mattered anyway, because the kid wouldn't let me do anything to his arm.  i had nothing to splint it with.  the open area was all the way underneath the arm, where i would have had to twist it to look, and he was having none of that.

so there we sat.  in the dirt.  at the bottom of a huge hill.  him in my lap, his broken and bleeding arm laying on top of my intact one as i acted like a human splint.  i held his hand on the broken side, and we waited.

i have never been so relieved to hear sirens in all my life.  we packed him up in the back of the ambulance and went to the hospital, where the xray showed a both-bone open fracture that needed to go to the OR right away.  i stayed until his mom got there, then went back to camp.

i talk about being this mighty trauma nurse who's seen everything and is not phased by anything, and that night it just wasn't true.  sitting on the side of a big hill, in the dirt, with a crying and terrified child in my lap...it was SCARY.  none of my supplies, no resources, no higher authority than myself...everyone looking to me to decide what we were going to do.  you would think that someone who loves to be in control would be thrilled with such power, but i wasn't.  i was out of my depth.

so once it was finally over, i called my nurse bff and cried.  and then i felt better, and went on to nurse another day.  a day in which i had to deal with this:

it turns out that it's a bad idea to wrap a t-shirt doused in lighter fluid around a piece of wood to make an "olympic torch" and then run with it through camp, as one of the counselors learned the hard way.

such.  big.  blisters.

i hear both 'patients' are recovering well, and after a week i finally have too.

hats off to those who make a living listening to the panicked screaming of people who are healthy one minute and broken the next.  i have officially learned that is not for me.