A good life

Death in a hospital is always sad, but it's especially sad around the holidays. There's something even more heartbreaking about watching the outside people enjoy meals and traditions and festivity when there is a person in a tiny hospital room who is saying goodbye to it all, ready or not. But sometimes, you get to spend a few hours of a shift with someone who knows they are dying, with a family who loves them, and who made sure to share jokes, smiles, and wisdom while they're going.

I worked an overnight on Thanksgiving Eve which is usually one of the biggest party nights of the year. Perhaps you know it as this. I recognize it as Amateur Hour because it's the first time all the newly minted 21 year olds are in one place after school has started. High school friends reunion, drinks galore, and the subsequent ER visits because of course - most of the time it's hell to work this night. But this shift was pleasantly uneventful, and it was slow enough that I was cut 3 hours early. Fortunately this meant I got to spend all my time in one room.

A nice elderly gentleman fell while getting into his bath for the night, and hit his head against the tub. He came in "just to get checked out" even though he had no current complaints and experienced no LOC. He was alert and oriented on arrival, and while age had made him frail his wit was as sharp as ever if the jokes he sent my way were any indication. A head CT was done since he was on coumadin, and sure enough he had a massive subdural with a smidge of midline shift for good measure. The ICU was full until more staff could be called in, so I let his family know that they would all be hanging out with me for much of the night until a bed was available.

Every fifteen or twenty minutes I'd check on him and do repeat neuro assessments. Within an hour, he started to have a bit of a headache. Then his blood pressure started to elevate. Then he couldn't remember my name, even after singing me numerous dirty songs that made me blush and his family snort laughing. The neurosurgeon came in and discussed options, and all fourteen of his sons, daughters, in-laws, grandkids, and one next door neighbor crammed into the tiny room. It was bleak - do nothing, and die within a day or so. Brain surgery, and maybe still die. Definitely a long and painful road of rehab if he did survive surgery.

He decided to do nothing. "I've had a good life. I raised my kids and loved them all and helped them start their lives. I buried my wife last year. I can't get out of the house to work on my boat anymore, and it's real tough to be a burden on my kids for the things I'm too weak to do. I know more dirty jokes than anyone in this building. I traveled the world and saw everything I wanted to see. It's time for me to go," he said. "This has been the best of lives and I'm ready."


He died before I went home that night. And it was heartbreaking, but in a good way. Once again I am thankful that I get to be a nurse and to share these moments with complete strangers, which help shape me in the most profound of ways.

The best shift ever!

So I'm home visiting family for the holidays, and I needed some cash money money. I picked up a 6 hour dayshift at Home Hospital yesterday morning because they were shortstaffed. Can we just note, I picked up a day shift. DAY shift. I got up at 0530. I thought I was going to keel over and fall asleep and die any second. It was terrible.

But besides being up at an ungodly hour, I had what may have been the best shift I've ever worked. It was amazing. Seriously. I worked with a weirdly awesome dayshift staff, and all of the ancillary staff was fabulous too. I was given a free cup of Starbucks from one of the EMS guys who came in, because "they gave us an extra" and I just happened to like the kind of brew they brought. The department was busy, but not stupid chaotic. It was busy to where I felt like an actual ER nurse, prioritizing and doing real things but not feeling overwhelmed.

I also had some amazingly awesome patients. The first lady was super nice and got Adenosine, which is my all time FAVORITE drug to give. For real though, I love Adenosine. I love it, so much. It's the most fun ever to give. The lady was funny too, and thanked us profusely even while making us laugh. She also happened to have been brought to the ER by a staff member who was in the gas station at the time she had palpitations - so I got to unexpectedly say hello to someone I didn't think I'd see while in town.

My next couple of patients were all young - below 30 years old - and they all had real trauma issues which were resolved without a lot of hassle. I had a guy who fell off a scaffolding a broke his wrist (conscious sedation with propofol and a super amusing recovery moment of secret revealing), a nice girl who slipped on the sidewalk and hit her head who required a few stitches but had a negative CT, and another guy who hit a deer while driving and came in backboarded but had only soft tissue injury.

I then had an older lady who had hyperglycemia for an unknown reason. She was nice, her husband was hilarious, and their kids brought donuts for the whole staff. Obviously I was predisposed to like her based on their bribery, but she had an easy to spot tiny diabetic ulcer which was the cause of the hyperglycemia. She was compliant with home meds and happened to be best friends with the local endocrinologist, so he discharged her home to follow up with him tomorrow "and also we'll talk about our neighborhood homeowners' association." So that was a nice easy case.

Seriously. Not a single thing went badly. I'm almost afraid to go into work this coming Thanksgiving Eve, because I'll probably have the most awful, horrible, terrible shift from hell. I do, however, wish shifts like this happened more often. Because it made me warm and fuzzy inside, and I felt good about being a nurse. And also a patient brought me donuts, which is always amazing.

ICU vs ER

Overheard on a slow night: Man, there's three nurses back here for 4 patients. It's like the ICU up in here!

[Another reason why I enjoy not being an ICU nurse - I bet all four of those usual patients are 1:1s. At least my hot mess patients get punted away from me after a few hours, to the ICU or ECU.]

The flu sucks.

Hey, guys. It's flu season. Which means for every rational person out there, there is someone else who is all "I won't get the flu shot because every time I get it I get the flu/vaccines give people autism/I never get the flu so why would I get the flu shot?"

People: GET YOUR FUCKING FLU SHOT. It's not rocket science.

Also, an article about why not getting the flu shot is dumb. With links to research. Because, you know, that's important.

*I feel pretty strongly about this. You might disagree. Which is fine. But still, get your flu shot. Because science.