Adventures In Nursing: I'm Here To Help

I've had a lot of long days at work recently. Thankfully, this weekend wasn't too bad.  It's nice when there's enough work to keep me busy, but not so much as to send me round the bend, or make me feel like I haven't been able to do the best job possible.

So, I'll share a little secret: Nurses are people.  We're human beings with actual feelings.  Granted, when we walk into a patient's room, we do our best to set aside our own prejudices and judgments and become advocates for the people who depend on us.  That's something I take very seriously considering my patient population is largely made up of vulnerable adults.  But just because we're professional doesn't mean we can't be hurt.

Nurses put so much of themselves into their work.  It's not just a job for the vast majority of us.  So, when we're abused by our patients, especially when patients pepper that abuse with insinuations about the quality of care we're providing, it tends to sting.

A long time ago I learned to put my foot down.  I'm there to help, and I will do everything in my power to try to meet the needs of my patients.  But I draw the line at becoming their whipping girl.  It's not that I don't understand that they may be frustrated or upset.  I truly do!  But that doesn't mean I should allow it to continue when they take it out on me.

This weekend when one of the best nurses aids I work with ended up in tears because of a patient's repeated verbal lashing, I talked to her about it.  I explained to her that just as she expects to not be mistreated by the staff, we also expect to not be mistreated by her.  I informed her that she'd made my aide cry and I left her to think about it.  Had the patient continued to berate the aide, I would have changed her assignment.  I really will not allow myself or my staff to be treated that way.

I was really happy to find that she later apologized to my staff member.  She explained that she's (understandably) angry about a number of changes that will affect where she lives.  I get her frustration.  In fact, some of the staff are frustrated with those changes as well.  When she opened up to talk about it, she found that the staff was actually really understanding and supportive.

There's something truly satisfying about being able to be assertive and actually achieving some kind of understanding.  We all have bad days.  It's just that we're there to help!  We're on their side.  And that's so much easier when we're not treated like the enemy.

Just Your Everyday Nurse

I'll tell you a secret: I want to be appreciated, just like most people.  Don't get me wrong.  I don't need flowers and chocolate, or constant pats on the back.  I just like to think that what I do matters.  Whether it's cleaning my house for my family, or trying to find the right medication for a patient to control their pain, I want to make a difference, even if only a small one.

I was wondering why is it that so many nurses are burned out when so many of us love what we do?  Sometimes I think it can be the job itself.  It's often long hard hours, even if it's only an eight hour shift.  It's family members or patients who are resistant to care.  It's coming on shift, getting report, and realizing that you have to deal with 10 problems before you can even begin your actual routine.  Some days or even weeks are just plain hard.  But I think those are usually balanced out with good weeks, gracious families and patients, and the support of incredible coworkers.

Some places are harder to work than others.  There is no substitute for a place that makes you feel like you're part of a family, cared about, and doing good work.  Honestly, I think we nurses will put up with a lot if we still feel like we matter to management, like they appreciate what we do, and like they care.  Even if there are problems, we'll stay loyal to a job where the powers that be are at least trying to find solutions that will benefit everyone.

When nurses are overburdened, overworked, under appreciated, and have no voice, it is almost always the patients who will suffer.  We nurses put all of ourselves into our work.  It's not just a job, it's who we are.  Maybe the reason we burn out is that we often give everything we have, to make sure that our patients receive the best care possible, not matter how overwhelmed we are.  We take care of people.  That's just what we do.

This past week was nurses week.  If you know or love a nurse, please tell them how much you appreciate what they do.  Because when the job is hard, it's sometimes that encouragement that helps us keep going.  

Adventures In Nursing: Who's Side Are You On?

When it comes to this very simple question, the answer is always simple: My patient's. I'm their advocate, and I am on their side. My goal as a nurse is always to do what is in their best interest.

Of course, every nurse knows that sometimes the biggest challenge to working in the patient's interest, is a patient themselves, or their family. In my field it seems that sometimes people just want things done their way. Whether it's a routine they've had at home, a medication they're sure should be a certain dose, or a bad habit they don't want to end, it can be hard to convince them that there's a reason to change.

I've been a nurse, I've been a patient, and I've had both parents and children in the hospital. It's the same in every unit. There are either the patients and families who realize that you're all on the same team trying to make things better, or they've decided that only they know what's right and that the medical staff must be fought every step of the way. As a patient, parent, and family member, I know which one of those I'd rather be. As a nurse, I understand that the family members who fight us, generally do so out of genuine concern for their loved ones or bad experiences they've had.  In those cases I do my best to show them that I will work with them, and that I'm there to help.

Personally, I have no other purpose than to do the best I possibly can for my patients and I am blessed by meeting their needs and caring for them.

Huh.  That's pretty much how I feel about being a mom, too.

Adventures In Nursing: It's Just Too Much Work!

On days that I work, I decided I wanted my blog to reflect how my career outside the home has shaped who I am. Being a nurse isn't just a job. It's one of the main ways I identify myself. I am a nurse.

My first real job was in (what was called at that time) a sub-acute unit.  In a perfect world there were four of us and we never had more than nine patients.  Of course, it wasn't a perfect world.  I could have 18 patients on a really bad day.  All of whom needed scheduled meds, treatments, PRN pain pills, therapy, calls placed to doctors, labs drawn, and time.  My time.  On top of that there were admissions, discharges, and not much in the way of help.

This daily routine of meds, treatments, doctors, and charting was supposed to happen 3 days a week, for 12 hour shifts.  Since I was a new nurse, it often ended up being four or more days a week, 14 or more hours per shift.  I was exhausted and stressed out.  I worried that I would make mistakes that would leave my patients at risk.  Sometimes I'd wake up and call the desk at 3 AM, asking them to make sure I'd filled out the lab slip for something due the next morning.

Eventually I left that unit.  I enjoyed doing other things.  And now here I am back on (what is now called) a Transitional Care Unit.  Some days we're slammed with admits.  Some days we're slammed with trying to get everything finished from the admission parade from the day before.  We want to provide the best care possible for those in our care, and I promise you that we work really hard to do that.  I think sometimes that it would be nice if we could have more nurses and support staff with whom to share the work load with.  But I also know that's unlikely to happen.

Then tonight I thought about the nurses who've gone before me.  Women working in hot uniforms, long sleeved dresses that made the physical parts of their job more challenging.  So many nurses have worked so hard in conditions I can't even imagine.  I think they would be grateful for how much we have at our disposal. The things I take for granted.

I wish I were a bit less stressed at work.  I'd like to be able to take the time to really focus on each task at hand and know that at the end of the day I crossed all my t's and dotted all my i's.  I'd like to have made a difference in someone's day, even if it was just encouraging a co-worker.  

As much as the job I do can drive me crazy (and believe me I'm exhausted right now!) I still love what I do.  I love seeing our patients go home feeling better and moving better.  I love getting to know the families, and their stories.  I love that I get to work with some incredibly knowledgeable professionals who never hesitate to share with me and help me grow and learn.

But some days I do call my bestie in California and ask her to remind me why I ever gave up being 19 and working at Disneyland.  Then she reminds me how much cooler it is to be a nurse.  Even if some family member has decided I'm incompetent and possibly the anti-Christ while another family member has decided I'm an angel sent by God to help care for their mother.  It's still a cool job where I (hopefully) get to make a difference.  Though I may dissolve into a funky puddle of stress if I have too many more days like I've had this week.  *oof*

The Calling

There is a certain image of nursing that lives in the minds of many people. The lady in the clean white dress or scrubs, taking a blood pressure, or patting a hand. But in reality, nursing can be really messy business. We're not too good for toileting, changing dressings on wounds that would make some people pass out, vomit, blood, or just about anything else. We see it and do it all. Nursing is actually very hands on, physical work.

There's a lot about that kind of work that I love. I enjoy helping to figure out how to treat a wound and watching it heal. I love seeing nursing interventions help a person put on weight, or have fewer behaviors. I love watching the things we do make people's lives better. But that's really not my favorite part.

Today our nurse manager was off. And there were care conferences that needed to be attended by someone on the nursing staff. Since I didn't have a patient load (I was a support nurse, taking orders, doing necessary paperwork, etc.) I attended the conferences. One of them in particular I felt like I really did some good. It's hard for people, especially those who are smart and have always been independent, to come to the realization that they can't do everything anymore and that they need help. I get that. Getting old is hard, and it's not for sissies!

Our patient wanted to know why, if she felt ready to walk, we wouldn't let her. I was able to explain it in a way that made sense to her, which was good. But more than that, I was able to help her understand that all her feelings about what was going on were normal. It is normal to be frustrated when things aren't going the way you want them to, when your life has been turned upside down. I felt good about being able to reassure her that her life and her care were still her own to direct, that we were here to help, and that she was allowed to have whatever feelings came. Because sometimes just having staff understand what a patient is going through helps the patient relax and trust us enough to really make incredible progress. And that's my favorite part. When I can help someone feel listened to and understood.

It's really wonderful to get to help people become active and independent again. It's an incredible blessing to me to be able to benefit from the stories, experience, and spirits of those I take care of. So many have come back to thank us for what we've done for them. But really, sometimes I wish I had more time to thank them for what they do for me. From marriage and parenting advice, to the simple joy of seeing someone benefit from something we've done, caring for them is a true privilege.

"Then the righteous will answer him, 'Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?'

"The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.
Matthew 25:37-40

Life Doesn't Have To Make Sense

Today was Piper's 7th birthday. Seven years ago my little girl came crying into the world with four pushes. And today, instead of celebrating with her, I was at work. Now, Piper was fine with that. We'd made plans to have cupcakes after I came home, and we're going to have cake and ice cream and presents tomorrow when I'm at home. But it bothered me to be away.

I have learned over time that I'm not as good at work if I'm resentful of being there. So on days like this, I give it to God, sure that I can do some good through Him, and certain that I can learn a lot from the wonderful people I help take care of.

At noon, I admitted a woman we've had before. She was fine about coming back to us, well aware that she'd had surgery and needed our help. There were only a few problems. First of all, she didn't think she had time to be admitted because she was certain that she was due in court at any moment. She wasn't even sure she had time for lunch until I assured her that I wouldn't let her miss the appointment. She also didn't think we could transfer her to the bathroom, or that the room across the hall wasn't really the one she should be in, or that we had a toilet. In fact, how could she get down to the second floor (we're on the first floor)? My patient while totally lucid as to her own condition, was completely confused about everything else.

I think she's going to get along famously with our other very confused patient, who spends a great deal of her day laughing. I absolutely love it. She's so happy! I think her laugh might be great to record and play for the Trick or Treaters at Halloween, but for something one might think would be annoying, in fact she just makes everyone smile. It's like she has a special sight for joy, and can pick it out of any situation. Even if she doesn't understand anything else that's happening.

My two confused patients really made life interesting today. Instead of dealing with just the plain old hustle and bustle of a busy Transitional Care Unit, I was navigating one patient through the complicated legal system while showing her around her own room, repeatedly, and laughing at the wonder of all things with the other.

Life doesn't always make sense. In fact, it really doesn't have to. We can find joy, wonder, and interest even in the most mundane. Sometimes it will be scary. A big move, an injury, an illness, life can throw all kinds of things at us we don't expect. But we can find peace in God and a smile in the midst of it. And even in the simplest of things, like going to work when I don't feel like it, God can teach me things if I'll just let myself be taught.

Rise in the presence of the aged, show respect for the elderly and revere your God. I am the LORD.
Leviticus 19:32

Fairness

I know I'm being absolutely ridiculous. I feel like pouting and being whiny because I had to stay home sick from work and I think it's awful to have a whole day off and have to actually spend it sick.

I couldn't figure out what was wrong with me last night. My patience level was so low and I just wasn't myself. I needed help getting my med pass finished and I was crampy. When I woke up violently ill this morning it finally dawned on me.

I was actually feeling a bit guilty for skipping work until I got up and tried some housework. Just 10 minutes of it left me totally exhausted. I'm wondering if I'll need tomorrow as well. I don't want to take it because I need the hours and certainly the money. At the same time, I don't want to push it and I certainly don't want anyone else to get sick.

Being sick makes it feel like pregnancy is slowing down. And that just stinks.



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Now playing: Aimee Mann - Driving Sideways
via FoxyTunes

Just So, Sir

Every once in a while I get a patient who is unique. Really, every shift I have patients are unique. But the kind of patient I'm talking about doesn't stand out because of their life story, but more because of their expectations.

Tonight I took care of a retired military man. A life based on schedules and doing things just so has left him with a very strong sense of how things are to be done. The law may say that I have from 1530 to 1630 to deliver meds due at 1600, but for him, if the book says 1600 he darned well had better have them in his hand at 1600.

On a busy floor with a number of patients who have various degrees of acuity, sometimes doing things on one man's schedule is more than we are able to accomplish. Some of the other nurses have become a bit frustrated with the exacting standards of this patient and I can understand that. But tonight, I decided I would try to win him over. I brought him each set of medications at the exact time they were due. I listened to what he wanted and explained in plain English if I was or was not capable of providing it and why. I called him by his last name, or I called him sir (something I generally do anyway). I made sure to ask if there was anything else he needed and let him know that I was just a call light away, every time I left his room. I attempted to anticipate needs, and check in. As long as I stayed on top of him, he didn't give me any trouble at all. It was actually very satisfying when he asked if I would be his nurse again tomorrow.

Every patient is special. Every one is a special gift from God (even if I don't always see it). Every person has something that I can learn, and offers me a way to serve. And each one needs something that I can provide. Some need to be left alone. Some need to talk. Some just need their medications on time because everything else seems so wildly out of their control.

Once again I am shown the powerful gift there is in service, and that there is a vulnerability just beneath the surface of even the most controlling patient. They are vulnerable adults, after all, and it is a privilege as well as a duty to care for them.

2nd Night On

I started my new shift last night and it went really well.  I was finishing up assessments that were as yet, uncompleted.  I finished the work and got to go home early.  I thought  that would mean some extra sleep for me, but it just didn't happen.  Bridget ended up sleeping with me, but not until after 1 in the morning.  It took me that long to get her to sleep.  Then Ciaran woke up inconsolable at 4 something in the morning and I ended up bringing him downstairs and letting him watch Baby Einsteins until he fell asleep on a blanket around 7.  That's when Dominic got home and I crawled back into bed for a couple more hours sleep.

So, I've cleaned the kitchen, done a load of diapers, finished school with Piper, showered, dressed and gotten all ready.  Tonight will be my second night on.  I'm tired, but still okay.  We'll see how I feel in a few more days!

I Must Be Crazy

I have accepted a new shift at work.  I will have seven days on and seven days off.  I start my week on tomorrow.  I'm happy to have a regular shift again as it brings with it some financial security.  At the same time, it sounds exhausting and a little scary.  We need it, though.  Pray for me!

Service

I was feeling a little annoyed at a patient tonight who was convinced that people were trying to kill him, and to escape, tried to run me over with his wheelchair.  Then I spoke to a patient who said how grateful he was that the staff provided such good care, and I was reminded again, how much of a blessing my patients are to me, how much they humble me, and how much I learn from them.  Tonight I calmed restless spirits, I held the hand of someone who was dying, and spent time talking to someone who was lonely.  And I'm so grateful that I was allowed to.

"34"Then the King will say to those on his right, 'Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. 35For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.'

 37"Then the righteous will answer him, 'Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? 38When did we see you a stranger and invite you in, or needing clothes and clothe you? 39When did we see you sick or in prison and go to visit you?'

 40"The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.' " Matthew 25:34-40

One of Those Days

In my work I've met women who deliverd a stillborn baby 40 or more years ago.  Sometimes I discover this through simple conversation, perhaps when they ask me how many children I've had, and I include Sarah.  They are always amazed that we spent so much time with her and took so many pictures.  They weren't allowed to do that.

Back then women were told that it would be easier for them to never see the baby.  The babies were taken away without being held, memorialized, or photographed.  Sometimes husbands were told to go home and take down the whole nursery.  So these women just suffered a major loss and returned to a world that ignored it completely, with no actual reminder of their child at all.  I don't believe for a second that it was for their own good, but was more comfortable for others.

The modern world has cut itself off from death.  Especially childhood and infant death.  Even now, when grief is better understood, people have so little understanding of what it's like to live through.  Once again on my message board the issue of stillborn pictures has come up.  A number of us have a picture of our lost baby in our avatar or signature.  I've always found them precious and the sweet tasteful pictures chosen to display are not something I could have ever called disturbing and don't understand how any feeling woman could tell a mother that a picture of her baby is!

You can guess which side I'm on with this issue.  I'm sorry if a picture of my daughter reminds someone that life isn't perfect.  But I guarantee it was harder for me to lose her than it is for someone to see her picture.  And I don't think anyone has the right to tell me which picture of which of my children I display.

I started talking to a couple of other loss moms who posted, and learned their stories.  It's amazing that even when the situation is radically different from the one we found ourselves in with Sarah, so much is shared.  From the devastation of getting the news, to leaving the hospital with empty arms.  And sometimes when I hear someone else's story, it just brings my own back, along with all the feelings.

I'm so grateful for those who are willing to share their stories and their pictures.  I carry them with me in a way I can't explain.  We're not supposed to bury our children, but too many of us do.  And while I don't believe we are required to crawl into a hole and bury ourselves in our grief, I also don't think I'm required to pretend that my daughter never existed just to make someone else more comfortable.

Where, O Death, Is Your Victory?

Several weeks ago, B. was admitted into our Transitional Care Unit.  B. was dying.  When I went into B.'s room, I expected to find a weak, pitiful woman.  Instead I found a pair of bright blue eyes, and a smile that radiated joy.  We talked.  We talked about her medical issues, and how well she'd been doing in her home, and how long she might have.  I discovered a woman who prayed faithfully, loved her God, and was excited to go home, and meet Jesus.

In the next room we had a woman nowhere close to death, who argued with us over changing her pad, convinced that we would charge her for putting on her call light, and who accused us of stealing her medication.  She wasn't senile.  She was just mean, and according to her family, always had been.  The staff disliked going into her room, as one could count on being abused from the moment of entrance to the moment of exit.  She was hateful, and spiteful, and tested my convictions.  I knew that I was commanded to treat her as I would treat my Lord were he to be lying sick before me.  I had to fight my human nature to remain kind in her presence.
B. and my other patient were like night and day.  B. radiated the love of God, and you could see the presence of the Holy Spirit within her.  You could leave B. feeling renewed, even if there had been much to do with her.

B. died this evening.  She waited for her family to leave, and then took the hand of Jesus, and went home.  She lived a long and good life, and while I'm sad to see her go, I'm so excited for her.  For she is not dead, but lives.

For the perishable must clothe itself with the imperishable, and the mortal with immortality. 5hen the perishable has been clothed with the imperishable, and the mortal with immortality, then the saying that is written will come true: "Death has been swallowed up in victory."
"Where, O death, is your victory?
Where, O death, is your sting?"


^{1 Corinthians 15:53-55}

Thank you, B. for showing me which kind of patient I would one day prefer to be.  Give my love to Sarah, and pray for me, as I will you.  Death will have no victory tonight.

This Is Hard

I've officially decided that this mommy business is hard.

Sure, I should have guessed this 8 years and 1000 diapers ago, but I've just decided it today.

Today I woke up at 5 am and tried to convince a sleepy baby that he really did want to nurse again.  Not just because I was going to work, and he'd miss me, but because I don't want to go too long between feedings for fear of my fertility returning.

Today at work I found out one of my residents died.  And another was readmitted from home.  I can't say too much about it, for obvious reasons, but I will say that I was left angry and sad.  I also found out that someone I had gone out of my way for, left.  She said that no one had come to see her, on the day that I was working.  And I'd spent most of my time with her.  So, many things were frustrating.  I think most nurses tend to have a sense of perfectionism with their work.  It's important work, after all.  And it's frustrating to be unappreciated, or have hard work undone.   Hmmmm....sounds like being a mom, actually!

I came home after stopping at the drug store.  The kids weren't dressed.  Daddy said I hadn't left clothes out for them.  But I had.  I'd told him the night before, exactly where they were!  Honestly, even if I hadn't, we live in a 1000 square foot apartment.  I'm pretty sure he could find the closet.  If not, Reagan could show him!  ( Love you, honey!)  He did, however, keep everyone fed and got a load of laundry both into the washer and then the dryer.  Bravo!

So, I set about my work of taking laundry out, cleaning the kitchen, cleaning the parts of my breastpump, taking care of the kids, feeding the baby, changes, bath, food, de-cluttering, zone housework, etc., etc, etc.  It made my feet start to scream obscenities at me!

And the kids are playing, making noise, while the throbbing in my head just gets worse.  I'm trying to keep everyone happy, and my feet are killing me, and I realize I haven't even attempted to get any schoolwork done with Reagan.  Thank goodness he's reading the Indian In the Cupboard, and is fascinated enough to have at least done that!

There just aren't enough hours in the day for me to be a cookie baking, homeschooling, craft making, field trip taking, soccer  mom, who works outside the home.  Just trying to keep this many balls in the air is exhausting!

So, I officially declare this  parenting stuff hard.  Still,  I wouldn't trade it for the world.  Maybe for a nice long nap and a cup of  Chai tea that isn't too heavy on the cinnamon though.

Wonderful Work

Last night I went to work again.  I have picked up 5 days for this pay period which is a bit more than I usually work.  Apperantly there was a problem with staff sleeping in the room which is supposed to be for moms to pump their breastmilk.  So it had been totally emptied.  A bit frustrating when I needed to pump.  But after requesting that a table and chair be put back, it was taken care of very quickly.  In fact, our director of housekeeping went above and beyond.  There is now a table and chair, a basket of flowers, and a bunch of sweet baby magazines.

It felt so good that they did that for me (I'm the only pumping mom at the moment).  Here I am, torn between working and being with my baby, and they found a way to make me feel supported in doing something for Ciaran even when I'm away from him.  To help with the sleeping problem they've posted a big sign surrounded by baby pictures that makes clear that the room is for nursing moms and to stay out.

So, last night I worked on the Transitional Care Unit.  I like that one a lot.  There's been an intestinal bug going around work, so we weren't getting admissions, and the census was light.  I spent almost an hour with a patient of mine who is a nun.  I love those nights, where I really feel like I'm doing something good.  Like God is allowing me to use my calling to help people in more than one way.

So, today I'm with the kids and way behind on my housework.  Time to get going and get it done.  All in all I'm feeling very good about everything though.  And sometimes it's hard to feel good about working, even part time.

There is something about doing something that you love, however.  And it made it that much easier to be at work knowing that I'm supported in the choices that I'm making for my child.

Back To Work

Tonight I went back to work. It was my first time back in almost three months. I hadn't been back since my last bleeding episode with Sarah. I was asked about her almost immediately. I wondered if I'd be okay at work. I didn't cry on her one month birthday, but I made up for it over the last couple of days. Lucky for me, the nurse role quickly took over and I was busy and did fine.

I've often thought that working with the elderly is such a gift to the caregiver. That it's a blessing. I had a resident last night who was lashing out at a nurse's aid. And I went in to help. I just kept holding her hands and reassuring her that she was all right. At one point she began getting angry with me, her grip tightening on my hands, but I just kept looking in her eyes and telling her that we were going to help her. Looking that deep into the eyes of a person who is confused always brings to mind the passage in scripture that reminds us "And the king will say to them in reply, 'Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me.' " It's like I looked into her eyes and could see Jesus.

Taking care of a confused elderly person can be as frustrating as taking care of a toddler. Thinking of that scripture reminds me that Christ is there, and renews my patience. So, as we put this woman to bed, and she's clutching my hands, suddenly her face softened and she said, "You really are sweet." And that was my blessing. I have residents who teach me about History and faith. But sometimes I think it's the one's who are farthest from reality that teach me the most. They bless me with compassion. I can tell you honestly that I don't think I bring much to their lives. But they bring so much to mine. I was glad to be back at work and glad to be doing what I do. That doesn't always mean I'm little miss Mary Sunshine about going to work. But at least I picked the right profession.

If anyone can, please pray for Jennifer's dad. He's going downhill fast from the cancer, and we need a miracle.

Total Nurses Post

I had a resident the other night, whose case is bothering me. He's a deceptively young looking 90 year old African American male. He is pleasant, cooperative, and completely alert and oriented. He was hospitalized several weeks ago at a local area hospital after being seen for dyspnea upon exertion. X-rays showed lower lobe infiltrates, and he was diagnosed with pneumonia.

He is currently receiving care because of a stage III wound to the coccyx. What I don't understand is how he ended up with the wound in the first place. He's mobile, using a walker only for balance. He has no sensory deficit, and can feel pain. He's capable of making position changes without assistance. So how did he end up with a serious decubitus?

I did a little more digging into his habits and behaviors by reading his chart and talking with him. He receives meals on wheels which he wont eat at times if he doesn't like the food. Since one of his diagnoses upon admission was dehydration, I'm wondering if there isn't a dietary issue here as well. Perhaps more protein needed? Also, since he has been widowed, he doesn't like to sleep in his bed. There is a practical side as well as it is easier to toilet in the night quickly if he doesn't have to get all the way out of bed. But I suspect the psych/soc issue is a pressing one also, as he still misses sleeping next to his wife. This means that he spends pretty much all day AND night firmly on his bottom.

So now the issue is, what nursing interventions can I implement to assist with wound healing, prevention of further ulcers, and keeping him healthy and happy? This is a question I'm still struggling with a bit. I passed on info to the day shift (primarily responsible for coordinating care) about dietary consults, etc. But I'd like social services to see him also to evaluate what community services he'd be eligible for in addition to meals on wheels. Also, I think he education. He needs to understand what he's doing to himself by staying in such a position all the time. I'd prefer him to wet occasionally trying to get to the bathroom than get an infection in an ulcer. But I'm not sure how to address the psych/soc issue. I can't tell a man to stop missing his wife.

Somehow this man made me remember why I love being a nurse. Not just the helping, but the figuring out HOW to help. And seeing someone when they leave knowing that they're better for the care they have received. He was the kind of resident you'd love to put in your pocket and take home. He made me remember how strongly I feel that I have got to go back to school!

The Day After

I worked last night, which gave me just a few hours of sleep today. I have learned a valuable lesson with regards to shopping. Buy Stouffers Meals. Just for the days after I've worked. I'm just too tired to cook! But unless I feel like quick trips to KFC eating up the money I've just gone out to earn (no pun intended) I need to plan ahead.

Last night was another night that showed me how much I love what I do. I had a resident who is known to be combative reach out for my arm, and pull me in to hug her. She wasn't elderly in that moment. She was as vulnerable as any of God's creatures can be, and I was blessed to be able to give some comfort. She wanted someone to hold on to while her bed was changed. She needed it. What job could possibly be better? I get to leave home and serve the Lord!

Family Prayer

Wow, what a response to my Quiverfull post. You Quiverfull moms are great. I'm going to keep looking into this. Perhaps it's my ignorance, or my stubbornness, but I'm not totally there yet. I'm really thinking and praying about it, though.

I worked yesterday morning, my last training day. Now I'm free to work in the facility unsupervised. Scary, huh? The more I do this job, the more I love it. I know that God has a place for me in my home with my children, and I have no desire to change that. But I also believe that he has given me a gift in being able to help people. Our elderly are pretty much the forgotten needy, and I truly believe my nursing is my ministry. I think I would have to do it even if they didn't pay me. Getting the help for our family finances while doing something I feel very strongly about is wonderful though. And when I came home Dominic had had a wonderful day with the kids. It's good for Daddy to have time with them too.

We've been saying the rosary together nightly as a family. Reagan makes his first communion this year, so I want him to learn. More than that I want family prayer to be a priority. We take one mystery per night, one decade of the rosary. We talk about the mystery, where it comes from in the bible, what we can learn from it. Then we go through the prayers. Just, instead of doing five decades we only do one. That way the kids get used to the feel, the cadence, the mysteries, but aren't overwhelmed. Karina wants a rosary, but she thinks she should leave it at our house. I guess her mom isn't fond of Catholics. Whatever! I'm going to get some plastic beaded rosaries for each of the kids and a sturdy one with great big beads for Piper. That way she'll feel more included. Everyone really likes it. Maybe it's just praying as a family that they like, but I'll take it.

So, I guess we're Catholic-izing Karina while she's here. While part of me hopes she'll fall in love with the church the way I did, I'm mostly hoping she won't walk away with some of the misconceptions that many of our Protestant brothers and sisters have. I'll settle for that.

Hi ho, Hi ho, It's Off To Work I Go!

So out of the last 10 days, I've worked 6 of them. One night shift and the rest days. I've been so busy I hardly know which way to screw my head on. Dominic, God love him, has tried valiantly to keep the house in order with amazing success, considering his lack of experience. I did come home yesterday to his begging me to take the kids back and let him go to work. I'm totally fine with that.

Bridget is getting into a new stage where she's fighting sleep. It's not as much fun as the newborn stage, but she's still my easiest and sweetest baby yet. I think she was much harder on daddy. He's not equiped like mommy.

I swear my blogging will get better, but you remember how your mother said if you don't have anything nice to say, don't say anything? Well, the kids have been especially obnoxious today and I'm a bit grumpy so I think I'd best keep my mouth shut. Or my keyboard.