Sunday, July 25, 2021

July 25

This past 4th of July holiday was awful. Not to celebrate, mind you, but if you were sadly at work like I was then it was just the worst. We had more traumas and CPRs and critically ill people than I've seen in a long time. Our trauma surgeon on call was fortunately one of our favorites - a generally nice woman, extremely competent, and not prone to getting flustered or yelling at staff. She, however, also had a terrible night.

We had multiple severe traumas all at once, and the surgery department nearly activated a mass casualty incident because of it - a super serious call that wakes up all the hospital administrators, OR backup teams, supervisors, and whatnot. She decided not to activate because fortunately (unfortunately?) two of the traumas were declared deceased fairly quickly. Had they continued to draw large amounts of resources, the MCI would have been activated. Anyway, it was still a terrible night and exhausting and just so bloody and tiring.

As you all may know, I'm a very well known shit magnet at work. So around 4 am (3 hours after my shift ended) I go to leave, and waved goodbye to the rest of the trauma nurses and staff. The trauma doc looks up at me from her computer and goes "OH SHIT. This was YOUR fault! I didn't even put it together until now..." Apparently my black cloud reputation has filtered down to the surgery staff.

RUDE.

So anyway, I'm at work the other day and right around 7pm we activated an incoming trauma. We're all standing in the room waiting for the patient when the trauma doc arrives and she immediately notices me, looks at the clock, and goes "you're leaving right? Please, for the love of god, tell me you're leaving. I'm still traumatized from you being here over the holiday." When I shook my head no, she sighed and goes "Shall I just call time of death now? Or we gonna do this?"

What can I say, y'all. I don't know whether to be offended or take pride in my disastrous little personal black cloud.


Wednesday, July 21, 2021

July 21

YOU GUYS. My plant life and ER life collided in the very best way this week. A patient came in, and she recognized a few of us that took care of her a while back. She happened to work at the nursery down the street and when she was discharged she asked if any of us wanted a free plant. Obviously I said yes. 

So she comes back an hour or so later with a little tray of plants, and now I have my very own philodendron micans and I love it so much. Look at this adorable little plant in it's adorable little planter!






Saturday, June 26, 2021

June 26

We recently had a very drunk middle aged dude come in for an MVC, because of course he was shithoused, high, and driving extra fast. As people do. Anyway, he dislocated a hip out of socket and it was decided that we needed to do a conscious sedation after his CT scans to a) reduce his hip and b)shut him the fuck up because he was literally nonstop screaming at the top of his lungs. 

His belly was distended when he first came in to us so obviously we were concerned about internal bleeding, traumatic injuries, etc. After reviewing the CT though it turns out he was just gassy. Like, ALL the gas in his entire body was concentrated in his stomach. How that man wasn't constantly burping up stale beer air is beyond me. The trauma doc went from being super concerned about internal bleeding to very concerned about gastric rupture, in addition to his actual traumatic injuries. 

A belly full of gas + intoxication + sedative medication is just a beautiful recipe for aspiration, so before the conscious sedation could take place we needed to decompress his stomach. I was somehow the lucky one who got to drop the NG tube on a 250 lb screaming drunk idiot. There's no easy way to do these on a cooperative patient let alone a flailing one and also I hate doing them. But it was me, the patient, and about ten other people in the room waiting for me to place the tube so sneaking out wasn't an option.

I managed to easily get the NG tube down with holding help and a fair bit of luck, and OH MY GOD YOU GUYS. Normally we have to inject a bit of air and listen via stethoscope to confirm placement, but not this time. Oh, not this time. As soon as the tip of the tube got into his stomach, it was like one of those whoopie cushion cartoon farts. Air started rushing out of the tube so fast it was causing turbulence in the room. I started laughing. The trauma doc started laughing. The other nurses started laughing. The patient was not laughing, but you can't win 'em all.

The cartoon farty noise went on for at least thirty seconds. I was laughing so hard by the end of it that I had to leave the room to go wipe my eyes. I'm not lying when I say this is literally the funniest work moment of 2021. It's up there with the legendary pinkeye situation. Which also contained comedic flatus, so I think the moral of this story is that I'm a teenaged boy and farts are the funniest thing on the planet.

Wednesday, June 23, 2021

June 23

Hello! I've been away from blogging these past couple of months because it seems like there's no time! I've been wildly busy with work, gardening, sitting outside in this Texas heat in order to socialize with people, and also spent a very wonderful TWO WHOLE WEEKS with my family in May. 

After nearly a year of not seeing my folks, it was so incredible to just spend time with them. We had no agenda, just family hanging out. We are all vaccinated, and it was just wonderful.

My garden is also doing so well. It's a little less fun to go poke around in it now that the Texas heat has reached a million degrees daily, but such is life here.

I've got a couple of nursing related posts cooking too, so keep an eye out for them in the next week or so. Since this is ostensibly a nursing blog. Right? Anyway, here's some fun pictures of all the stuff. 









(non-garden pictures are from my trip to Maryland/Virginia to see the folks. I'm debating getting a little less anonymous and letting my face show on this blog, but maybe that's a bad idea. I dunno. We'll see!)



Thursday, May 13, 2021

May 13

I've had more foot-in-mouth moments over my decade+ of nursing than I can count. Somehow for all my momentary embarrassment I've never been truly shamed by them because damn if they don't make hilarious stories. 

So I was at the charge desk last night when I hear an old pepaw going "nurse? Nurse!? Hello?" I looked over to find two of the new grads just sitting there ignoring him, so I got up and walked in there myself. I called them out on it but that's not what this particular story is about so let's move on. 

"I heard you calling, sir, is there something I can do for you?" I asked. The room was dark, so after he wanted to be repositioned I asked if I could turn the lights on. He responded with "well, you can leave them on for all it matters...I'm blind!"

Oh man. Oh, buddy. At least he laughed about it.

Wednesday, April 21, 2021

April 21

Good lord y'all, springtime got away from me there. It's been a busy few weeks since the last post. 

Work is...work. We're pretty firmly out of the winter COVID surge and back to our normal baseline, although the number of positive tests has been creeping back up the past week or so. I'm not sure whether or not I need to feel crushing panic and anxiety again like I did in the winter, but I'm cautious and hesitant to let myself feel too optimistic OR terrible. I've been feeling like things are better with vaccinations, but there's so many people out there who are just refusing to get one that I fear we'll never actually move past COVID.

I've been going to therapy which has been immensely helpful for me. I think part of the ability to not get paralyzed with anxiety and depression has been directly related to this, and the other part is the fact that springtime is fully upon us. The better weather, being outdoors in sunshine, and digging in my garden has done so much good. I honestly feel like a better person than I was six months ago, at least when it comes to dealing with all the shit going on.

We've had a couple of awful deaths in the ER recently, and normally that would send me into an ever-increasing cycle of anxiety but this time around it's been more manageable. Here's hoping I can continue to improve on my coping skills!

In other news, I get to see my family again in ONE week! I haven't seen them for nine months, and that's the longest I've ever gone in my life without them. But next Thursday I get to see them, finally. Both of my parents will be fully vaccinated by then, my brother and his fiancee are both vaccinated (one with both shots, the other with his first - although he had COVID late last year so hopefully still has some protection from it), and the couple of people I'll see have also been vaccinated. It's encouraging. We're still obviously going to be safe, and socially distance from the general public, but it will be amazing to just be in my parent's house again after so long.

Someone has to keep my plants alive while I'm gone though, so I'm gonna have to write up a watering schedule for my husband. Here's some pictures of my garden!


*more to come later today after I've taken some updated pictures







Updated: here's the full garden pictures!



Thursday, March 18, 2021

March 18

 Y'all, I did a charge dayshift on Tuesday. DAYSHIFT. I'm honestly trying to remember the last time I worked a real, honest to god dayshift from 7a-7p. I can't think of it in the past 5 years, so question mark if it ever even happened? Maybe a partial dayshift when I used to pick up at home hospital, but that was 7 years ago so...

Anyway, DAYSHIFT. One of the new dayshift charge nurses got hired into the position, trained for it, completed orientation, signed up for her shifts on the next schedule, said schedule got finalized and released, and then she resigned two days later having accepted a job elsewhere. This nurse is a dumpster person in general, so while I'm not sad to see her go I am annoyed that she screwed all the other charges over. Like, why even bother signing up if you literally know you're leaving? Ugh.

But anyway, that's why they needed coverage help. So me, being the poor sucker that I am, agreed to a dayshift. BOY HOWDY is it different from nightshift. For starters I had to be there during the daytime. Shocking, I know. But I am a permanently midshift type of person. My brain becomes functional around 9-10 am, and firing on all cylinders around 11a. Which makes me perfect for mids, and capable of nightshift. But when my alarm went off at 0515...not my best moment, and many regerts. 

I also have the reputation of being a true shit magnet, and all the nightshift people thought it was hilarious when I showed up for report at 0645. They laughed their way out the door with warnings to dayshift about me. It was a beautiful two hours of nothing happening, and then promptly at 0900 it was like someone threw a grenade made of critical patients into the department. I shit you not, there was a STEMI and two Code Strokes AT THE SAME TIME. I activated two of them at once with the emergency page system, and they had me on hold for a second because they were already activating the first one from triage. Then we had a trauma come in, and then there was rumors of a CPR arriving, and at that moment the triage nurse called me and kindly asked me to fuck off back to nightshift.

But the crowning moment of terrible day was when I sent a very, very sick looking lady to one of our trauma rooms because I thought she might die any second and it turns out that BONUS FUN she was also covered in bedbugs. Like, crawling over her. I thought the primary nurse was going to kill me.

Then 7 pm rolled around and honestly it wasn't so bad because the day flew by but I don't know if I'm cut out for that early life. Consistently being awake at 0515 sounds just terrible. But it was very nice to get out of work and have a couple of hours at home to wind down. Who knows, maybe I'll do it again sometime?

***

Look at my garden! I got most everything put in, and we're building a third bed which will get the cucumbers, more tomatoes, and more squash/zucchini. Plus I impulse purchased a couple of strawberry plants yesterday, so we'll see how those go. 



Thursday, March 11, 2021

March 11

Can you believe it? One whole year since the WHO declared COVID a pandemic. One entire year. Shit's wild.

Things are getting better here in Texas. Our positivity rate in the hospital is down to single digits and trending in the right direction. Our ICUs have beds on the regular now, as do the other inpatient floors. More and more people are getting vaccinated. My husband, sister, and brother-in-law, as well as most of my immediate friend group, have gotten both their shots. Other friends have appointments soon. We're still not comfortable hanging around inside, but fortunately the weather is getting nicer so we're able to gather outside. 

Overall, I think there's lots of reason for optimism. The only catch is that yesterday Texas eliminated the mask mandate - our governor seems to think that people did such a good job at mask wearing and not making poor choices that they can now be counted on to voluntarily make those same decisions...

It remains to be seen how this will affect us. Many businesses are continuing the mask requirements, but many more are not. It's too early to decide if we're fucked again or if we've made enough ground against COVID that this won't ruin us, but all I can do is let y'all know how full of rage I will be if this wrecks yet another year of my life because people can't act right.

***

In other news, look how well my garden seedlings are doing! Another few days of hardening off and they'll be ready for planting. I am so excited!



Sunday, February 21, 2021

FeBRRRRRuary 21

Remember that time one post ago when I was like "this is the best snow day ever!" and we had a cozy fire and cheese board and I snuggled with the cats and the husband while watching the snow fall outside? Yeah, the power went out like two hours later. And then came back on for an hour, and then flickered off again for an hour. We got a notification that there would be rolling blackouts for a while, breathed a sigh of relief when the power came back on, and then promptly realized the pipes on one side of our house were frozen. 

I'll spare you the play by play, but the short story is that we were without power for around 36 hours total, intermittently from late Sunday night to Wednesday around noon. The "rolling" blackouts were more like regular blackouts. Our house got down to 45 degrees at its coldest. We didn't regain running water in our main bathroom until Thursday.

But it could have been so, so much worse. We were already prepped with lots of non-perishables and water storage, as well as the means to convert non-potable water to potable. We are very fortunately not suffering from busted pipes like so many are. My husband bought a generator during early pandemic times, so we had that up and running - thus we didn't lose anything from our refrigerator or freezer, and an LED shop light was able to brighten our entire living area. The generator also powered a tiny electric space heater in our bedroom, so while it was uncomfortably cold it wasn't dangerously cold. Our kitchen has a gas stove so we were able to cook hot meals. And in the most selfish move possible, I ran an extension cord from the generator to the heat lamp over my vegetable seedlings and houseplants. I have spent this winter nurturing these tiny plants from seeds and they have helped my mental health so much. As stupid as it sounds that I devoted a precious resource to take care of plants, I would have been devastated to lose them.

As for our hospital, it fared much better than most. We never lost power and while there were some ruptured pipes it was nothing that shut down the overall hospital - we lost the OR for a day, and some other various units had flooding issues. But we weren't shitting into kitty litter like Dell Children's staff were in Austin due to a total loss of water. So honestly, it doesn't matter how bad it was at our place, I consider myself fortunate.

We knocked on a few of our neighbor's doors to make sure they were okay and didn't need anything. Blessedly they are all fine as well. Once our power came back on, we even went over to my sister in law's house and threw snowballs at their kids - it was the best of snow days. Things are back to normal for us, and the weather is supposed to be a balmy 65 degrees the early part of this week. We're going to be fine.

BUT - there are a lot of people who are not fine, so if you have a good thought to spare please send it our way. If you have the financial ability, you can consider that as well. There are a lot of people in need right now, and anything at all is appreciated - here is the link to a good compilation of places to donate to if you feel so inclined. Dallas-Fort Worth and Waco are the biggest metroplexes near us, but there are people in need all over Texas.

Stay safe, y'all. And if you live literally anywhere but Texas, thank your fucking lucky stars that you're not a part of ERCOT on our little isolated power grid island. Because in a shocking spoiler twist no one could have POSSIBLY seen coming...decades of lack of regulation and a "don't mess with us" attitude led to a very preventable crisis and I'm OVER IT.


*Let this be an unofficial ad boost for Champion generators, the real MVP of this past week.

Sunday, February 14, 2021

February 14

Last I checked, I was a resident of Texas. Warm, sunny, mild-winters Texas. So imagine my surprise when I looked at the weather forecast last week and saw that it was going to be below freezing for DAYS on end! The AUDACITY. Doesn't the weather know we here in central and north texas aren't prepared for that nonsense? 

 Anyway, it's currently snowing outside and it's been below freezing for a long time already and not supposed to even get above freezing again until Friday. FRIDAY! I do love me some snow though. I even bought a pair of real winter boots early last year and then felt real stupid about it since it immediately became spring and I put them in the back of my closet because it was a thousand degrees outside. But then fall and winter coincided with COVID, and all of a sudden our summer socially distanced driveway beers with our friend/family group (a total of 7 people, many of whom work from home and became our outdoors sanity bubble) turned into cold weather wool socks and hat and parka while still sitting outside freezing to death driveway beers. I've never been so happy to own ridiculous winter boots. I'm going to put them on today to go roll around in the snow like a child. I can't wait! 

 We also beat the rush and went grocery shopping last week, and prepped ahead for a fancy valentines dinner that we picked up yesterday. So today? Snow fun, then hot chocolate on the stove like mom always made me as a kid, and then fuzzy sweatpants and a FANCY charcuterie board for dinner. I know it's 17 degrees outside, but damn if this isn't a good day.

***
And look at my plants! Our HVAC system is very uneven so a couple of the upstairs rooms are way too warm to be comfortable. We're hopefully getting someone in to look at it next week. But in the meantime, it's a perfect greenhouse! Check out my vegetable seedlings!



Sunday, January 31, 2021

January 31

I just sort of realized that I've been doing charge now for 8 months. It's been interesting! COVID has really been a wild ride in terms of learning how to manage a department. Most days I feel like everything is on fire - shit really has been wild. But I think I'm somehow - miraculously, blessedly - doing a decent job at it. I've heard from multiple people that they like working on the nights when I'm in charge. I think that is a huge complement, honestly.

Early on I felt as if I was just a warm body at the desk who existed solely to answer the phone and put stickers in books. Now I feel like I'm actually managing problems as they arise. It's been insanely busy over the past few months but somehow I have coordinated things at the last second every time. Initially I was terrified to make an ambulance wait in the hallway, but now I feel comfortable doing that. If I have only one open room and I'm getting three transfers, it's okay to park the young stable patient with a positive cell phone sign against the wall for 30 minutes if I have to - let the granny in afib take the room instead. I've learned to be more comfortable with going up to these patients to explain to them why they're in the hallway for a brief time, and the communication seems to really help. I now get up from the desk to go retrieve a stretcher, or run a med to a room for another nurse, or help clean a room real quick. 

I've gotten past the fear of missing something, and instead tell people to leave me a note on the desk if it's important. I've learned that it's okay if I don't page out a sepsis alert immediately - a three minute delay in the sepsis page means I have had the chance to talk to an upset patient, or run a blanket back to a room, or silence a monitor if needed. I've managed to get away from the desk, which was my biggest hesitation. I didn't want to be the charge nurse who just parked my butt in a chair for 12 hours and became increasingly disconnected from bedside nursing realities. 

The coworkers who tell me they enjoy when I'm charge truly keep me going at this. I am so relieved that I have been a positive influence - they tell me that I'm approachable, realistic, and never make them feel shitty for not knowing something. It probably helps that I drop F bombs like every three seconds, but hey whatever works. 

Hopefully I can keep this up - I want to get even better at being a resource for all the staff. I want to advocate for changes that will help us at the bedside. I want to speak my mind when it will benefit coworkers. Above all, I want to continue growing and being good at nursing and a good nurse.

***

I was thinking about this all today, because it was twelve years ago today that I passed my NCLEX exam. TWELVE!! Can you believe it?! Twelve years ago I was a brand new graduate nurse, afraid to pass and afraid to fail. It really has been a crazy journey, and while it's never been easy it has always been an adventure.


Wednesday, January 20, 2021

January 20

I am so very heartened by the speech from Biden today. He's right - this has been a really tough time, and that may be the understatement of the year. But I am hopeful that things will get better. And to all the little girls out there - let this be a lesson that you CAN make it to the top. Our country has now had a woman in the second highest office. That is something to be proud of.

As for the state of things, let's hope that the vaccine effort will be one of the first things to get better. We need to get COVID under control. Like, yesterday. The ICU is officially completely full at our hospital - as in every physical bed is full, and there are no more rooms left to staff. So what did we do? Converted part of our ER to a satellite ICU. We now have a ten bed unit in the ER, staffed by ER nurses and assisted by a nurse floated from critical care. Shit's wild. I'm off the next few days, but am dreading next week when I'm back.

***

My little snake plant is growing! It's now giving everyone the middle finger. The first picture is when I first got it, and the second is from yesterday.






Friday, January 15, 2021

January 15

My husband and I have a NYE tradition which has lent itself perfectly to COVID isolation - we buy some fancy meats and cheeses and make a big charcuterie board in the early evening, nap on the couch for a bit, and then make a FANCY steak dinner. This year we've learned way more in the kitchen, so he made a bearnaise sauce, I made sauteed ruby red chard in the leftover steak fat, and parmesan red potatoes rounded out the meal. It. Was. AMAZING. And then we watched Anderson Cooper get giggly drunk in an empty Times Square while the ball dropped at midnight. 

And I cried. On the dot, at midnight - well, 11pm our time but you get the idea. Watching an empty New York celebrate with a few guests and random mask wearing people, it just hit all over again just how fucked this past year has been.

I'm living through one of those world-altering events that will be written about for centuries to come - if this planet doesn't implode first. 

But you know what? I made it through, and there's the tiniest hint of a light at the end of the tunnel. I've gotten both doses of my vaccine, our hospital has finally stopped elective surgeries so we're not holding 30 COVID patients in the ER every night, my immediate family has managed to either avoid COVID or remain thankfully minimally symptomatic, and my husband and I are making the most of the forced lack of social activities to save our money, educate ourselves on a variety of important life skills, and renovate parts of our house so we don't lose our minds. I also signed up for online tele-therapy, and have my first session in a couple of days - as much as I appreciate the five of you who still read this blog allowing me to brain dump on a regular basis, it seems like it will be more productive for me to brain dump onto a professional brain dumpee. 

My indoor plants are growing, although I'm still fighting fungus gnats on a regular basis. I just ordered a ton of seeds and started to plan out a spring garden, which I am very excited about. I got a fancy little brass planter with a built in light for Christmas, and I think that'll be my seed starter spot for this year. It holds 24 egg carton pieces, so it'll be perfect. 

In my personal life, everything is coming up Millhouse. As to the rest of things...COVID isn't going away any time soon. Our hospital bought a little time by cancelling elective surgeries, but we're still on track for being overwhelmed. We've got refrigerator morgue trucks as backup, extra travelers coming in, and our ICU staff are tripled most nights. Our ER is getting training on a bunch of ICU stuff, like certain paralytics/sedation, vent care, etc - because our other backup plan is to convert a section of the ER to ICU holds. So, not comforting. But, hopefully, one day this will pass. One day.

Saturday, December 26, 2020

December 26

It's Boxing Day. Normally this is the day of the season that everyone gets to stay home in their jammies after an exhausting two days of holiday activity. This year? It's the third day of stay at home holiday celebrating for me. This is the first time I think I've ever had off December 24-26, in, what? Eleven years of nursing? I so desperately wish I could have traveled to see my family. I want nothing more than to wake up and have coffee with my parents, and open gifts around their tree, and see my 94 year old grandmother, and spend time with all my friends, and meet the brand new babies, and snuggle with my parent's cat. I wish I could go to my in-laws' house and watch their kids climb all over their new playhouse, or have dinner with my husbands parents. But I'm not. I'm home, for the third day in a row of this Christmas holiday, and that's just how it is. 

Because I want COVID to go away. I want things to be like they used to, but they're not.

And seeing all the Facebook pictures of big family gatherings, or people posting check ins at the airport, or getting an invite to "stop in and say hello" if I'm in town this year just makes me angry. It's because of this shit that I've been stuck in COVID hell for 9 months now with no end date set. How many 94 year old grannies will we watch die next week in the ER? Will I have to be a part of the decision to NOT intubate someone because it's the last vent in the hospital and someone with a better chance of surviving will need it? Will I be the last person a father of three sees before he dies of a COVID related pulmonary embolism? Will I be the one to turn away the family who just showed up at the triage desk hoping to see their 40 year old sister after her massively debilitating stroke? How many more days will I have to go without that cup of coffee with my family because everyone else is selfish enough to think their actions don't matter?

Friday, December 18, 2020

December 18

I'm vaccinated! 

It's not the end of things, not by a long shot. Our hospital is down to a precious few ICU beds, and we're just now getting waves of the people who caught COVID during Thanksgiving, spent a week without symptoms, and then a week or so being sick at home but not bad enough to come to the hospital and are now 7-10 days into symptoms and crashing. 

It's dire at work. Every day. Our RTs had a discussion yesterday about vent triage - we intubated two people back to back in the ER and someone mentioned that we were down to single digits for available ventilators. But not to worry, "some of those people are going to die soon, so that'll free up the vents if we need them." NOT the reassuring news one wants to hear.

So, yeah. I got my vaccine yesterday, and am looking forward to this being over one day. But that day is not today, and we're going to keep going until it is.


***

My pancake plant that arrived in the mail a week ago looked pretty sad when I first got it - most of the leaves were smooshed during transit, so while it looked great as soon as I took it out of the package it dropped a lot of leaves over the next two days. I was worried the plant wouldn't survive, but then noticed yesterday that I have a tiny baby leaf coming up and more on the way. It's gonna make it! Once it's a little bigger and healthier I'll repot it to something better looking. 

Plant babies! I love this!