God, I love that. I especially love it when I've already accomplished everything I wanted to do tonight (organize utility room shelves, wash and rehang curtains, finish laundry, vacuum, clean bathroom) and have had dinner besides, so the rest of the night is gravy.
And it's raining, to ice the cake. And it's supposed to rain all day tomorrow, too.
Max is indoors on his bed, snoozing damply and waking up with the occasional *boof* when he hears the neighbor dogs bark. You can, if you look closely, then see the wheels turning in his head: is it worth it to go outside in the wet and pretend to be Braveheart, or should he stay here inside, in bed? Bed wins.
The guy I took care of for the past two nights, the one with the crazy electrolyte imbalances (potassium of six, anybody? Calcium of three-point-eight? You go!) has transferred up to the floor. The other guy, the one who had his entire throat rewired, will be with us for a day or so more, but at least I don't have to be the one checking four pulses with a Doppler every hour and hoping the flap stays viable.
I feel so sorry for people who have complex head-and-neck dissections, or folks with really complex plastic surgery. It's never for a benign reason that you get a flap; it's always because you have to have a breast or two removed, or (God forbid) your entire tongue, and you get some new architecture on your face into the bargain. No matter how good we get at plastic surgery, a jaw that's rebuilt from leg bone will never, ever look like the one you were born with.
Add to that pain and fear and general anxiety that you've got a nurse coming in every hour on the hour, smearing light-blue conduction gel on your new face or new chest and checking for the swish-swish of a good pulse, and you've got hell on wheels. There is not enough Ativan in the world to make me willing to go through that, yet I ask if of my patients every night. They can't even *sleep*, for the love of Mike, and yet we expect them to get better.
You can, eventually and with enough support, get used to not looking like yourself. I imagine you can get used to having tattooed-on nipples (though I'd hate to have to) after a while. It's what we put them through in the meantime that kills me a little every day. I want to let them sleep, to feed them decent food rather than the weird stuff from the hospital kitchens, to touch them without gloves. I'd like to touch them without hurting them once in a while.
People go through hell before they heal.
Sometimes I wonder if the advances in surgery and technology really make it worth it.
With all of that, and with the continuing revelations that the people I work with on nights are ka-ray-zee, I've decided to take the job in the new neuro unit. It'll be back to all brains, all the time. I have to cast back six years to the last time I did brains and spines exclusively, and it seems at this distance to have a nice rosy cast to it. I'm sure there'll be parts that suck, but at least I'll be doing things that are less painful and invasive.
One of the unit managers came to me last night, envious that I'd gotten the offer to work on the new unit. Apparently, my current manager doesn't know my long-standing reputation as a rabble-rouser/pain in the ass, but everybody that does is excited that I might actually have something to do with how the new unit's laid out and run. As the other unit manager said to me, "Make sure you work it so we can see all the beds from the desk, okay?" Like I'll have anything to do with that, but it's nice that she has confidence in me.
One of the newly-minted neurology attendings asked me if I planned to take the job on the neuro CCU. When I said yes, he sighed "Thank GOD."
I guess it'll be okay. If it's not, there's always the general CCU to go back to, or I could conquer my mental block about telemetry and go work for CVCCU (note to self: cute male nurses on CVCCU! Wahoo!). We'll see.
In the meantime, I have Fritos to eat and a dog to scratch. *Boof!*