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!




Wednesday, December 16, 2020

December 16

Well, that was fast. I got the email from work last night that we've got vaccines and just need to sign up. I responded to the email that I was interested, filled out the survey and signed all the consents, and am just waiting for the response email with a link to schedule a time to get it. 

I'm nervous and excited. Obviously there's the possibility of side effects, as with literally any medication or vaccine out there. But having followed the CDC and other countries' data and recommendations, and trying to keep myself as educated as possible on this process, I can firmly say that I am getting this vaccine as soon as I can. 

Because there might be side effects. Maybe. But you know what else has side effects? COVID. Up to and including death. I've watched more than enough young healthy people stroke out or 60 year old people desaturate and be brain dead on a vent or grannies gasp for air on a non-rebreather a week after their family get together, and I'm at the point where I will do literally anything to make this pandemic stop. 


***

In plant news, a friend of mine gifted me this newly rooted sansevieria. Isn't it pretty? I have just the spot for it, too. When I find the right plant stand, it will live next to our drawer side table in the office. The drawers sit next to the desk, and all of our electronics are on top of it - printer, router, etc. The plant and stand will be perfect to hide cords and cables!





Tuesday, December 15, 2020

December 15

Our hospital is on the list for COVID vaccines. Soon, like within the next week soon. I can almost see the light at the end of the tunnel. It's still far off, and although things are still getting worse and will continue to do so for the next few months, I have hope. I laid in bed this morning and tried to identify that hopeful feeling - I think it's just relief, honestly. Pure, exhausted, relief. Like the kind that you see when marathon runners lay down just past the finish line.

I know this isn't the end of COVID. Not even close. But it's a start, and I've felt lighter today than I have in a long time.

This won't be forever, and I can look forward to that.


***

Our office renovation Phase 1 is finally complete! We installed our new fancy desk, hung curtains, and arranged the plants. It's a usable office, and a very happy place for me - it's the sunniest room in the house, and will be full of plants eventually. Phase 2 will be one entire wall of bookshelves, with a little nook for reading (that's the spot of orange you see behind the armchair - everything purple will be hidden behind the shelves). I'm so excited! 







Sunday, December 6, 2020

December 6

Obviously when you start sentences with "the new grad nurses these days," it's hard not to sound A) patronizing as hell, and B) like an old fart. It's hard sometimes to remember back to when I was a new nurse at the tender young age of 24, but it's true and I was. I'm absolutely positive that the old fart nurses shook their heads at my antics back then, but here we are today and I guess it's a rite of passage to get to the point where you just shake your own head at the youngsters?

Anyway, one of the things I wish I could scream to the new grads from the parking garage rooftops is to PICK YOUR BATTLES.

Seriously.

More and more, I see a large portion of the new grads getting into a pissing contest with the malingering psych patients over stupid stuff. Like yes, you can and should set boundaries with them and stick firm to those boundaries. But getting butthurt that a longtime bipolar off-their-meds-by-choice meth and crack user is a twitchy bundle of profanity and saltine cracker wrappers? Tweakers gonna tweak, and there's nothing you can do about that. This is the life you chose when you decided to work ER - it's 10% acutely sick people that you can do something about, 40% nursing home based chronically sick people you're never going to fix, and 50% complete bullshit of all varieties. End of story.

And the other thing that kills me - when they try to out-argue these people. You're gonna lose your job before you beat these people in an argument. As I try to educate when I precept, when you're dealing with someone who will willingly shit their pants in the lobby to get back to a bed sooner, you will NEVER be able to shame them into any sort of better behavior. If they're willing to take off all their clothes and lay down naked in the hallway on the way back to the room because you won't promise them dilaudid and phenergan and benadryl waiting on their arrival, then you definitely aren't going to be able to have any sort of rational discourse with them. If they'll be willing to fire you as their nurse, unfire you, threaten to call the news on you, then offer to call the news because you're so awesome, then fire you again, then leave a 5 minute rambling voicemail to the patient advocate in which they forget they're leaving a voicemail and in that voicemail both accuse of you of stealing their crack, denying they have crack, and also saying you're the best nurse they've ever had*, OBVIOUSLY you can't out-crazy them.

Just pick your battles, and ignore the crazy by either rolling with it or removing yourself from the situation.

*THIS IS A TRUE STORY FEATURING YOURS TRULY

***

Also, look at the baby plants I have! Basil on the back left, dill and parsley front right, a tiny pothos propagation hidden back right, and a cosmos seedling front left that I got for free from the nursery because they said it looked sad.


Please ignore the yellow sticky traps and fungus gnats, unless you have advice on how to eradicate fungus gnats in which case HELP ME!

Friday, November 27, 2020

November 27

 Look at my adorable new birds nest snake plant! And isn't this 3D printed pot the best? I'm happy just looking at it. Right now it's living in it's temporary home, but when our office renovation is finished it will live on our new fancy desk. I'm pretty excited about it.

***

In hospital news, it's bad again. We're holding most nights because there's no ICU or medsurg COVID beds available. We're regularly seeing people stagger into triage with O2 sats in the 50s, and we see whole families of people who check in for COVID symptoms. It's going to be a long winter.

Sunday, November 15, 2020

November 15

It's 0200 and I can't sleep, so after rolling around in bed for a few hours I finally decided to get up, have a cup of ginger turmeric tea, and kill some time. So here I am!

It's been a beautiful few weeks of fall here in Texas, so last weekend my husband and I drove a few hours to Dinosaur Valley State Park. It was an absolutely perfect day. The sun was shining, the weather was crisp, and the dinosaur tracks were cool as hell. I'm excited to come back there one day in the summer and go swimming. Anyway, here's some pictures!








***

COVID has me scared again. I'm guessing that's why I can't sleep right now, but it's hard to drift off when the realities of things are bouncing around in my head. Our ER is understaffed due to high volume/sick coworkers/people calling out when they get overwhelmed. Every shift is busy and more often than not we're holding dozens of patients because there's no beds in house. Everyone has COVID. Nurses in various departments are calling safe harbor because it's so packed, and everyone is really sick. It's exhausting. I didn't expect people to actually listen to science and wear masks, stop going out to bars, and having giant family gatherings - but it's just disheartening and exhausting to deal with the fallout from it day after day with no end in sight. 

My immediate solution is to take ALL THE HIKING DAY TRIPS and also BUY ALL THE PLANTS and also RUN ALL THE 5Ks. So far, so good.

Friday, November 13, 2020

Coping Mechanisms

I've really been working on my stress relief these past few months. One of the perks, and also downsides, of having a blog is that you guys get to read about my struggles in real time. When I'm having a rough go of it, I tend to overshare - when I'm actually updating, that is. Obviously this year has been incredibly tough so I've been sharing quite a lot.

Anyway, I've been in a much better place recently when it comes to my anxieties with COVID, burnout at work, ER in general. I thought that maybe I'd share the coping mechanisms I've been using, in case it helps anyone else.

SPOILER ALERT: THIS BLOG IS ABOUT TO BECOME A CRAZY PLANT LADY BLOG

Ya heard! Y'all, I got into gardening and plants this year. Like, I'm already a crazy cat lady so it's a little alarming knowing that I have two obsessions now, but it's 2020 so I'm not apologizing. 

My mom has always been a master gardener, but pretty much the unofficial country version of one. She can grow a garden without a second though, knock out a season's worth of tomato canning in a weekend, choose the most complimentary plants for a flower bed, and have fresh cut flowers on the counter all summer long. It's amazing. She's also got the most adorable little plant hanging from her kitchen window, and I found out recently it's almost 45 years old. I didn't know plants could even live that long! I've always loved that little plant, and it was the inspiration for me deciding to buy a similar little hanging pot and start my own houseplant. 

When COVID hit back in March and we went on lockdown, my husband and I started a little vegetable garden. We put in two raised beds, and later added a third. We did below average with our first season, I think - some plants thrived, some immediately died, but most others seemed to grow but not put out any usable vegetables. I absolutely loved the process of planting and tending, and then using our own homegrown stuff but it was a little disheartening how much of our garden wasn't producing. After lots of discussion with my mom, we decided that I needed way more flowers to help promote pollination. It seems that all of our plants started the process of fruiting, but since we had no pollinators everything sort of stagnated. 

Fast forward a few months, and I've BECOME THE CRAZY PLANT LADY. Once I decided to get more plants, it just took off. I bought a darling little hanging pot which holds my first real houseplant - and I look at it every day and love it. But that was just the beginning! I've got a whole section devoted to plants on pinterest, a long list of pottery to buy for plants I don't own yet, and a notebook that I'm using to keep track of where I plant things, important information about each plant, and what goes wrong (or right!) so I can adjust next time. It's so, so therapeutic.

I have seedlings growing for rainbow chard currently, and I'm working on baby basil, dill, parsley, and mint to grow inside over the winter until I can transplant them outside. I just put in a flower bed with a whole bunch of easy to care for perennials that will look SO GOOD next year when they bloom. I have plans for our patio and where I'm gonna put stuff to make it a little plant oasis. My entire bathroom windowsill is full of plants, and our office windowsill will also be a plant haven once we're done renovation.

I feel so much less anxious, you guys. It's crazy how therapeutic gardening is, and I love it so much. I always thought I had a black thumb designed to kill any plant I came across, but it turns out I just needed time, a little bit of research, and the motivation. Thanks to COVID, I have all the time and motivation now, and am loving the research. My mom always jokes that everything she tries to teach me I learn about 15 years later (see cooking, time management, the importance of having lots of wine glasses, etc), and gardening is no different. 

Don't be surprised to read a lot more about plants on this blog in the future, because work is really hard and overwhelming right now and I'm trying to focus more on the good things going on. I'll still share anything interesting from the ER because I do still love what I do, I just need to focus on what's making me happy currently. Also you guys would probably rather hear about plants than my other new coping mechanism: running. Way less exciting to write about, and pictures of plants look far better than post-run selfies do.








Thursday, October 22, 2020

October 22

 Man, this month is just flying by. I totally meant to update more often, but then all of a sudden it's been six weeks since I last did and I don't know where the time went. 

I spent a long weekend camping a few weeks ago, and boy howdy was it needed. Four days of hiking, relaxing, outdoors, sunshine, and campfire coffee were the exact things I needed to recharge. I haven't really taken any time off since the summer, and while I didn't actually work less around this trip it really felt like I did. Normally I make the mistake of trying to extend a trip until the very last moment, where I get home and have to go to work the next morning. This time I planned for an extra day at home even though it meant one less day camping. And it worked! Camping was amazing and then I got to have a relaxing day at home to catch up with my cats. Somehow the time off felt even longer because of this.

Anyway, here's some pictures! 









***

But since this is ostensibly a medical blog, let me leave you with a phrase one of our psych patients yelled across the ER recently and which still has me laughing every time I think about it...

"IMMA SHOW HIM MY TURKEY TITTIES!!"

What a strange career I've chosen.

*sadly, I was not present for this event and have only heard tales of it. What I would give to have witnessed it first hand!

Wednesday, September 2, 2020

An Accord

"I'm sorry!" the security guard whispered to me. The security guard who was called to help calm down the grouchiest, grumpiest, Clint-Eastwood-get-off-my-lawn old man ever. This crotchety guy had sprung a Plavix nosebleed while recovering on our rehab floor from open heart surgery, and was obstinate enough that the rehab staff was just spinning their wheels trying to stop the bleeding.

Two hours later, he finally demands to come down to the ER. So now he's pissed off, grouchy, tired from being two weeks post-CABG, and COVERED in blood. He's cussing everyone, horking up giant blood clots, and generally refusing to hold pressure on his nose long enough to at least attempt to stop the bleeding. This attitude has already caused his rehab nurse to wish him gone, the security officer to apologize to me, and the rapid response team to make apology-eyes at me when dropping him off in my ER room.

Maybe I was feeling more charitable than usual, or maybe I'm getting nicer, but he and I somehow came to an accord as I was starting his IV. At first poke, he goes "OHGAWDAMMITIKNEWYOUWEREGONNAMISSIT and accused me of enjoying making him hurt. I responded with "what the hell dude? Why are you cussing me, when I'm already done with your IV? Which I got, by the way." He then apologized for his mouth, and I told him I wasn't sorry for doing my job and that he doesn't need to apologize for cussing, just for cussing AT me. He just sighed and goes "it's been a hell of a month."

We then talked about his surgery, the hospital food, where we've each lived in this country, and general frustrations with healthcare. He was still grouchy and never what I'd call pleasant, but it was clear that he was just fed up with being sick and in the hospital. He apologized again for being a turd, and I was able to gently let him know that acting like said turd will in fact make his stay more difficult, longer, and less pleasant. He seemed to take that to heart, and even managed to give me a little smile and a goodbye wave as he went back upstairs. Whether he continued to terrorize the rehab floor staff, I'll never know. But I hope not!



Wednesday, August 26, 2020

Convenient

I love it when a plan comes together! A nice guy getting admitted tonight didn't get a chance to order a meal tray before the kitchen closed. He asked me if we had "carrots or something else" to eat. Since carrots aren't a standard snack in the ER, I offered him graham crackers and pudding.

The patient next door did order a meal tray, but decided to AMA before it was delivered. When nutrition brought it up he was already gone, but obviously all the nurses descended on the tray to see if there was anything good on it. When we opened it, it was ALL CARROTS!

Imagine that! One guy left AMA like he wanted, one guy got a tray of random-ass carrots, and I got the dessert cookie off the tray as a finder's fee. Everyone wins!


Saturday, August 22, 2020

August 22

This year is really flying by at molasses speed, isn't it? It felt like March and the impending COVID wave was just a couple of weeks ago, and all of a sudden it's almost the end of August. Weird!

Things are going here. Our hospital is on the upswing after COVID really wrecked us in June and  July, when we were up to four entire floors dedicated to it. Now we're down to one ICU/intermediate unit and one med/surg floor. We still aren't allowing visitors in the ER, but the rest of the hospital is slowly getting back towards some semblance of normalcy. 

I've also completed my charge training and had a couple of shifts on my own, with two more coming up this weekend. So far I haven't burned the department down, and have managed to do a decent job - I think. So that's good!

But today is for a more somber post, one in remembrance of a patient who was one of the nicest, most kind hearted people I've ever met. He was a regular in my Home Hospital ER, so much so that he knew the name of everyone there. But not only did he know everyone's name, he knew the names of their kids, when staff members had ill family, were putting themselves through school, and when their birthdays were. He was a relentlessly positive person, who checked in to the ER only after he had asked how each of the triage staff members were that day. He struggled with sickle cell disease and was in chronic pain, but never got frustrated with the long waits or snippy with the staff. Even when he felt terrible, he still had nothing but kind words to say to the staff. On more than one occasion, someone would start yelling at the triage staff about something and he would get up from his seat, walk over, and tell them to give it a rest because we were doing our best. He literally broke up an argument between family members one time before we could get to it because he wanted the waiting room to be a place of healing, not anger.

One of my personal favorite stories about him was a day I was working in triage - it was godawfully busy  and I was taking him and another patient back to their rooms at the same time. He told me he felt bad for how busy we were and how much I was walking back and forth, so why didn't I just let him take himself back to his room so I didn't have to? I handed him his chart, which was really just his little intake paper, and he walked himself back to his pod, dropped his chart in the rack, let the nurses know he was there, and tucked himself into his room with a blanket from the warmer. 

He had an implanted port due to his frequent hospital visits and always let the newer nurses access it. He'd walk them through it, troubleshoot when things went wrong, and never, ever made them feel bad if they missed it. I personally got comfortable accessing ports because of his kindness and encouragement.

One of my mentors at Home Hospital has been there his entire career - and he remembers taking care of this patient when he was only 8 or 9 years old and first diagnosed. It just astounds me that he was able to keep going for so long with such a painful disease, and remain so unfailingly positive. I wish more people were like him. I've thought about him many, many times over the years since leaving Home Hospital, and am sad I won't get the chance to take care of him again. We care about all of our patients, but some of them truly mean so much more to us.


-----

A sincere thanks to Sue in Australia, OldFoolRN, Shash, and Solitary Diner for the comments checking in through COVID. I really, truly appreciate it. One of my favorite things about blogging, and why I've kept at it for so long, is that I feel like I've got an internet family out there thinking about me. Even though I've never met any of you, it's one more positive in this world that so desperately needs it!

Thursday, July 2, 2020

COVID-19 (7/2/20)

Hey guys! I'm still here. Still kicking, and still stressed, but in a much better head space than I was a few weeks ago.

COVID is getting horrible here in Texas. Wear a mask, you guys. For fucks sake, wear a mask.

I had another training shift as charge yesterday, and boy was it a doozy. I kept taking critical lab values, and they were all for COVID. All positive. I took two at a time, more than once. Everyone is sick. Our department is on the verge of getting overwhelmed, and I'm scared. I thought I was scared back in April and May, but this is next level. I don't think we'll get to NYC levels as our population density is much lower and supply chains are less fucked than they were two months ago, but....then again, with the way things are trending we might not be far off.

I took two weeks off, and went to visit my parents in Home State. This was before things got real bad again. I social distanced, safer at home (besides work, of course), zoom friend hangouts only before I visited them. I also got tested for COVID, and while I know it's not 100% my negative test made me feel a lot better before seeing them. I'm glad I did when I had the chance, because while I was on the East Coast all I kept reading about was how Texas has done a complete 180 and was taking a nosedive directly into the shitter.

My first shift back was unbelievably awful. So many sick people, so many non-sick people just out doing their thing, and an astounding number of people who wandered into the ER without a mask already on - and then got pissed at us for requiring it.

I think we're fucked. Really.

But at least my head space is better, like I said before. The time off, lounging in the sun, talks with friends, and then knowledge that I have counseling resources available any time has been a huge help. I never did get into seeing a counselor, but that is still on the agenda - since I knew I had those two weeks off I pushed it back a bit to see if the time away helped. Thankfully it did. But the stress and anxiety are still there, and I'm still working on it.

I'll be updating more often, but I hope you guys are staying well and staying safe. Also, WEAR YOUR FUCKING MASKS, PEOPLE!