Wednesday, August 25, 2004

Welcome to Stepford.

Be afraid.

It's just after noon now, and already today I have made breakfast for my boyfriend and done some sewing. Not only did I make breakfast, I made *popovers* for breakfast. Unfortunately, I was distracted by scrambling eggs as I took them out of the oven and so didn't pierce them quickly enough to keep them from sagging over sideways and collapsing.

We dubbed them "flopovers". They're still good.

After breakfast (sausage, eggs, flopovers, and a fruit salad with strawberries, pineapple, and blueberries) I pegged the legs of a flare-legged suit I bought on sale. Then I cuffed them.

When the nice guy from the fire department showed up to inspect the sprinklers in the apartment, he found this domestic scene: David on the couch with a cup of coffee, reading an article Dad wrote about reindeer being sold for meat in the 1920's. The cat at his feet, purring. Me sitting at the kitchen table, hemming a pair of slacks.

Very unusual.

Of course, twenty-four hours ago I was suffering with a sore throat and stuffy ear and general malaise. This sudden domesticity is probably just a symptom of the cold I've got.

Sunday, August 22, 2004

Baby, I can't hang upon no lover's cross for you

The local PBS affiliate is running its annual pledge drive now and has a Jim Croce retrospective on. I had completely forgotten about Jim Croce's existence until tonight. Now I'm afraid that David will decide I'm too much of a dork to hang out with if I tell him that I really, really like Jim Croce.

The only drawback to the man's music is that I turn into a blubbering mass of sobbing uselessness every time I hear one of his sad songs. Which, frankly, are most of 'em. I think it's a consequence of growing up with a seven-years-older sister who listened to Croce during the peak of adolescent angst. Looks like a trip to Amazon is in order, just to get this out of my bloodstream.

In other news, I have one patient who's waiting to die at the moment. I've described dying before as being a lot like labor in that eventually the process takes over and the person is no more than a vehicle for the process. What I haven't talked about is the long, long period in the waiting room (as it were) while you all wait for something, anything, to start happening.

We're at that point right now with this patient. Her husband is worn very, very thin, and the hard part is just about to start. Unfortunately, she's not with us in any real sense of the word; she hasn't spoken a coherent word in a year or more, since she was mugged for her purse in a grocery shop parking lot. So it's harder for him; he has to make her come alive to everybody in an attempt to reassure himself that she actually was like that.

All told, I prefer the easier business of a stiff drink and Jim Croce and self-examination to thirty minutes in a room with someone whose loved one is dying.

Thursday, August 19, 2004

The night before the morning of

Goin' in to work tomorrow, yes I am.

I've spent a very productive couple of days cleaning out and rearranging cabinets, buying groceries and making brisket and coleslaw and mashed potatoes, and spending Quality Time with David.

A note to the culinarily intrepid: do not eat at Big Time Bob's Burgers without a supply of diuretics on hand. The burgers are magnificent but have so much salt in them that you'll swell up like a pufferfish. I swear.

Did you know that some people go to the hospital for a hobby? We have three frequent fliers, two of whom are the equivalent of He Who Must Not Be Named for nurses. The third is rapidly approaching that status.

People who hospital for a hobby are uniformly crazy. There's no other explanation. They're not sick, exactly--they might have weird orphan diseases, yes, but other people with the same disease putter along fine for years without constant visits to El Schwanko Hospital Du Jour. Mostly they're addicted to painkillers that are expensive and difficult to get outside of official channels. I'm sure that Dilaudid is easy to obtain if you're, say, a roofer or a diner waitress, but most of our patients don't fall into the easily-connected-with-roofers category.

I mention this for two reasons: one is that I'll have to deal with, again, a patient who's on rotation through the nursing staff. She's that bad--nobody wants to assign her to the same person two days in a row lest the nurse's head explode. It's either that or I'll get floated to the cardiac floor; either way I'm not looking forward to my assignment.

The other reason is that Arlene is scheduled for yet another knee surgery tomorrow. You'd think that somebody who'd been literally run over by a motherfucking TRUCK and who'd had to have her knee replaced, oh, six times as a result would be grumpy. Or martyred, or at the very least addicted to heavy painkillers. Arlene is not. Instead, she sends me funny political cartoons and reminded me tonight that she was coming in. I have to remember to take her Jon Stewart tape back in to her.

I really hope that when my lifestyle catches up with me and I end a drooling idiot in the chronic-care section of the hospital, I can at least be a *funny* drooling idiot. The charming sort of drooling idiot who looks at the clock and says (as a patient of mine with dementia once did) "Somewhere, there's an opera going on." I want to be the sort of drooling idiot that people enjoy seeing come in, rather than one of these understimulated and overfed whackjobs who want *this* dosage of *that* pain medication.

Off to bed. Saving the world takes a lot of sleep.

Wednesday, August 18, 2004

Back from vacations, with a vengeance...

Canada was nice. The Hill Country was nice. Sunday alone in my apartment with nobody talking to me and not having to go anywhere was very nice indeed.

Which is a good thing, as the last two days at work have been Work with a capital W. I'm using words I haven't used since nursing school. Words like "polycythemia" and "hypoalbuminemia" and I'm having to actually look up lab results in my little cheat book to find out exactly what a RDW/WBC ratio is.

In other words, the hospital is full, full, full and we're getting patients that should be going to the other floors. In the last two days, I've had two blood dyscrasias, a huge abdominal surgery, a guy with a major eye problem that I won't go into here because I got thoroughly squicked, and a couple of broken and repinned legs. And toes. Toes with pins sticking out of them.


So today it's laundry, groceries (already done. David used his discount card at the store for my groceries; this must be love), bills and mail and checkbook-balancing, and playing with the cat. Later I might vacuum.

It'll be a nice change from trying to conduct three two-chamber IV pumps to push their contents into somebody who's suffering from fluid overload. It'll be a nice change from having to stock a room with sterile saline and sterile gauze *just in case* my patient's eye decides to pop out of his head. It'll be a *very* nice change from having to adjust traction and readjust pins and so on.

Tuesday, August 10, 2004

Georgia's post on Monday ...

...made me realize how much I've changed, physically, in the last 17 years.

Half my life ago, I had headshots taken by Mom, who's not such a bad photographer, in preparation for going to music school. It was standard procdure then to submit both tapes and photos; I don't know if it still is.

The Jo at 17 has a perfectly unlined face, enormous blue eyes, and lips that take up most of the picture. She has no discernable bones. She's vaguely sad-looking, as though teenagehood hasn't been what the teen-books in the local drugstore and newsstand told her to expect. (*snork*)

The Jo at 34 that looks back at me from the mirror has smaller eyes and thinner lips. She doesn't weigh 117 pounds; her weight now is closer to what people call "that size". She has wrinkles that show up when she smiles or is dehydrated or tired. She looks like somebody who has been through a number of ill-advised relationships, a divorce, nursing school, several deaths, a couple of really hard jobs...and has come out of it happier and with a better sense of humor.

It's funny, how we age. If we're lucky, we see more value in a mobile, lined face than we do in one that's forever frozen into fantasy. If we're lucky, we can count the rolls and lines and curves as badges of experience rather than markers of incipient decay. If we're lucky, we'll celebrate the first grey hair (Hooray! I'll look more like Dad!) rather than flipping out.

It's like the picture over my bed says: "What a relief that as we age we retain our scars on the outside, rather than on the inner cuff."

Wednesday, August 04, 2004

Dull is good. Creative is better.

The most exciting thing I did yesterday was dig a splinter out of Sparky's finger. Sparky is a physical medicine and rehab attending who works with spinal cord injuries. Her nickname is her own suggestion; everybody has nicknames at work.

Anyhow, Sparky came up to me with a splinter in her finger, so I washed it down with chlorahexadine, slapped on a pair of gloves, and popped that sucker out with an 18-gauge injection needle. Took about thirty seconds from start to finish.

We like dull days. Being a nurse on a neuro unit is a lot, I think, like being a cop: long stretches of routine punctuated by absolute frantic insanity. You learn to love the long stretches.

And during the long stretches, we get creative as only a bunch of over-intelligent, high-strung people with an assortment of issues can get.

Miss Italy brought an ancient Polaroid with equally-ancient film, so we took a series of sepia-toned candid photographs and posted them on the walls with appropriate captions. Those joined the brighter Polaroids that Carolita takes on a regular basis. We've also cut questionable pictures out of the fashion magazines provided to the patients and stuck 'em up on the wall.

Once in a while we'll line dance in the nurse's station. We sing songs. The only thing we don't do is roast marshmallows, and that only because the fire extinguishers would kick in.

And, of course, everybody has to have a nickname. We have T-Bird, C-Dog, Even Steven, Megace (that's a type of medication used to stimulate appetite), Amiemamie, T-Max (the maximum temperature a patient sustains over a shift), C-Lo (one of the neurology residents), Sparky, Peg Leg, Budgie, Judy/Judsie, Cindy-Lou-Who, Godlike Tim, and Carolita. Some of these people are doctors; most are nurses. It must make for an interesting time for the patients, as we've pretty much given up on formal names on the floor.

All this silliness drives the administration crazy. Pity the poor floor manager who has to put up signs in the break room about whose ACLS is about to expire: the pronouncement at the end of each posting is "Disciplinary action, up to and including termination, may be taken."

We don't take well to things like that. When somebody printed out and posted a picture of a well-endowed domme, complete with whip, just under the "disciplinary action" notice, it came down. We kept putting it up. Finally the administration gave up.

We got a "contract" about "customer service" a few weeks ago. Now, given that our primary mission is good health care rather than customer service, this was rather a shock. Also, given that our floor is the floor on which every VIP that comes into the hospital gets put on, due to the level of that indefinable "customer service" and the quality of care we give, we were a bit surprised. The memo--er, Contract--specified things like smiling when speaking to patients and helping each other out with lifting and so on.

I've worked all over the hospital, as have all my colleagues. The general feeling on every floor is that though we may be weird, we're the tightest group of nurses in the building and the best at what we do. So the Contract was insulting.

We signed it, though, and turned it in.

Three days later The Semi-Bigwigs came for a surprise inspection of the floor. We all, keeping the Contract in mind, walked around with rictus grins on our faces, saying things like, "Thank you, valued member of the health care team!" "No, thank *you*, my esteemed colleague!" "No, truly, you're too good to me!"

Not a word about the Contract has been spoken since.

This is why I love where I work: no matter the reputation we might have as tetchy, strange geniuses, we all pull together--and the other floors respect us. When Beloved John died, we chose a couple of representatives from the floor to go to his funeral. The rest of us planned to stay and work.

Until thirty minutes before the funeral started, when a phalanx of nurses from other departments strode on to our floor and started taking over our patients. They came from every department: cardiology, surgery, PACU, admitting. As a result, every single one of us got to attend John's funeral in our scrubs with our stethoscopes still hanging around our necks. By mutual unstated consent, we didn't remove the badges and doodads that mark us as nurses when we walked into the church, either.

Not a bad group to be a part of. Not a bad thing to do for a living.

Sunday, August 01, 2004

General pains in the ass, or things I hate to do...

At work

I hate having to hand an attending's head back to him after he's bitten mine off in the nurse's station. Note to attending physicians who "know the protocol" and have "never had a problem like this before": if you really knew the protocol, you wouldn't have done the damnfool thing that caused you to have a problem.

And if you make your problem my problem, one of us will end up regretting the encounter. Hint: it won't be the short redhead with the bad attitude.

At home

Thank you, Nice Man From the Polka Club, but no, I don't want to go out with you. At all. I'm busy enough with work, boyfriend, travel, boyfriend, work, boyfriend, hobbies, boyfriend, and so on not to have any free time.

No, not even five minutes for a cup of coffee so you can get to know me better. Really.

And I'm washing my hair tomorrow. On Tuesday I'm joining a convent.

On the road

Yes, I'm returning from Canada. Yes, I was only here for four days. In Banff, actually. At the Banff Centre. Visiting a friend who's at an arts conference there. No, I didn't leave my bag unattended. Here's the list of what I have to declare. Passport. Government-issued ID. No, those are earrings. Yes, that is a small jade figurine for my sister. Because it's cold in Seattle and I thought my father would like a sweater. Alpaca. Yes, that's an animal product. No, no fruit. No, no wood with bark on it, either. No, no cheese. [Ed. note: cheese ?] Sure. Thank you. Have a nice afternoon.