Small moments

I had a patient last night who had been in the hospital for nearly three weeks. Poor prognosis. Family at the bedside since the beginning. I had taken care of him once before, a couple of weeks ago, but this time, report came with the warning that family was beginning to get impatient and rude to the staff. I appreciate those personal notes from report. It means I have the opportunity to change the direction that the relationship they have with the staff around. I may not always succeed at it, but at least I know to include as much TLC and patience as I can in my care for him.

The night started off chaotic, with one discharge, and one transfer and one admission all coming in within an hour or so of each other, and of course that’s when the PICC line on my other patient fails, and so I need to also place an IV before I can administer the scheduled antibiotics. Thankfully, my charge is the bomb. Seriously. This woman is like the calm in the storm, and while I was getting people in and people out, she placed the IV for me and started the antibiotics. (Because frankly, my IV skills are still very new, and I would have been wasting precious time trying something I had little chance of landing anyway.)

So amidst the chaos was this family, and I took every opportunity (between the 3 or 4 code browns that happened in his room that night) to make my interactions meaningful. I reassured him in his confusion. I validated his frustration. I scratched his scalp. I sat opposite his wife, each of us with his hand in ours. I treated him as I would my own family member. I think sometimes that can make a huge difference for struggling families. I think it made a huge difference with this particular family last night.

His wife had been refusing palliative consults. And within a few hours of my shift ending, after I felt like I connected a little, I brought the subject up.

I explained how palliative is not the same as hospice, and how it’s a specialty unto itself, just like cardiology or neurology, and work together and alongside those teams to give the best possible care to their patients. I also went on about our palliative care team, as I had interned with them, and that they are some of the most compassionate and caring medical professionals I know. (And they are all that and more.)

She didn’t say much. But she didn’t cut the conversation short, either. Just nodded and listened. I may not know if they choose to take advantage of our palliative care team, but I feel good that I at least got the vibe from her that she *was* listening. And considering.

And she thanked me. She didn’t have to. She didn’t need to. But I hope that I made a difference for him and his wife last night.

Feeling Broken

It’s been awhile since I posted, and so much has happened in that time. I passed state boards, and began my first job as a registered nurse at a local hospital. I was hired part time, but I didn’t realize that my 12 week long orientation would be full time. Now, I feel as if my body is falling it apart from the demands I’ve placed on it.

I hurt. All over. All the time. When I was in nursing school, I would have bad flares, but usually I was able to get through the day, both a class day and a clinical day, with a little Alleve and I’d recover in a day or two, at most three. Now, I can’t shake the pain. I wake up in pain, I go to sleep in pain, and while I make it through my work day with NSAIDs and adrenaline, I haven’t been able to recover, because before I know it, I have another 12 hour shift upon me.

And so the pain has slowly been building. I’ve been drawing on my reserves to get through orientation and now I have a debt to pay back. And I’m not sure how or when I will be able to pay that back. I need a plan, and I don’t even have that.

All I do have is a date. I get off orientation this Sunday, October 8, and then I finally move to part time, which is two 12 hour overnight (7pm-7am) shifts a week. I’m hoping that I can slowly repay the energy and pain debt I’ve accumulated, maybe with the help of more regular Epsom salt baths. But ultimately, I may need to make an appointment with my LLMD to see what she recommends to manage the pain more completely.

In the meantime, I’m open to ideas.