Saturday, June 23, 2007

In Which I Yelled At God...and Apologized After There Was a Thunderstorm.....

* If I could ask God just one question:

Why aren't You here with me?

("Someday We'll Know", The New Radicals)


I'm going to say it.

Yes..... I'm going to say it.



Didn't Ya tell me, Lord? Didn't You tell ME, yes ME, in Your Bible, that You WOULDN'T FRIGGING PUT ANY MORE FRIGGING BURDENS ON ME THAN I COULD ENDURE?

LET ME QUOTE YOUR OWN WORDS, OKAY? Just to refresh Your memory:

It says in the Bible---AND I QUOTE:

"Every test that you have experienced is the kind that normally comes to people. But God keeps his promise, and he will not allow you to be tested beyond your power to remain firm; at the time you are put to the test, he will give you the strength to endure it, and so provide you with a way out." (1 Cor. 10:13)

WAY OUT? WHAT WAY OUT? I don't see any frigging dang way out! So what's the deal, Lord?

First ---THREE, yes, THREE of our beloved patients have died in a short period of time, patients we loved dearly. First, our beloved Lew died in my arms. Then, a second beloved patient died at home alone after putting a pot of beans on the stove. But the latest, most agonizing death was that of dear Mrs. Turnwater.....

Mrs. Turnwater finally died a miserable death. She kept bucking the ventilator machine and was in continual torment and misery to the end. They couldn't medicate her enough to put her out of her misery without the tranquilizers lowering her blood pressure so low that it would kill her. And every organ in her body was failing. Heart, lungs, kidneys.....

So after considering all factors, and the fact that Mrs. Turnwater herself had written out an Advance Directive stating that she did not want to be "kept alive on a ventilator" if the situation was hopeless, the family made the agonizing, guilt-ridden, and ultra painful decision to "pull the life support". DO YOU THINK THAT WAS FUN for them LORD? Couldn't You have allowed her to die peacefully and painlessly in her sleep? Couldn't Ya, Lord?

And the hospital staff did just as Mrs. Turnwater's family directed. They took the ventilator breathing tube out and unhooked Mrs. Turnwater off of all the drugs that were keeping her alive. They were going to attempt to transfer her to a Hospice bed in another part of the hospital, in the hopes that she could remain alive long enough for her large family to say goodbye to her in a peaceful setting instead of the horrible, noisy, tube-entwined ICU.

But she died before they could even get her to that bed----in the hall of the hospital.

Mrs. Turnwater died in misery and pain, with a tube down her throat, gagging and struggling against it, and there wasn't a dang thing anybody could do about it. And her family had to watch that, Lord! Yes, they had to WATCH EVERY MINUTE OF IT.

Then, as if that wasn't enough Lord---those three deaths----You had to put MORE burdens on me. Yes, YOU DID---- YOU DID, LORD!

Even though I was praying. And I prayed, Lord, loud! You KNOW how loud I can pray when I'm upset..... And then I also did what AA recommends recovering alcoholics do when they're in trouble. I contacted other recovering alcoholics about my deepening depression and ever-darkening mood.

I wrote emails to a couple of really good friends in AA (in a town I formerly lived and worked in) , who are recovering alcholics like me--- to ask about "how to get out of these dark moods that a sober alcoholic in recovery faces".....

And the responses I got, Lord? You know perfectly well what responses I got.


Okay, and about that nurse, Lord? She was a bright and funny girl!!! A joy to be around! And she was a nurse I used to work with. I liked her and and You dang well know it, Lord!!!!!!! So thanks a dang lot! What on EARTH in her life could have been so painful that she couldn't have reached out for help? WHAT? But..... I KNOW WHAT PAIN is.....that's just it----it's simply FRIGGING PAINFUL to LIVE ON THIS EARTH is what it is! SO LORD, AND I ASK YOU----WHAT MORE DO YOU WANT FROM ME, LORD? HUH? HOW MUCH MORE DO YOU WANT ME TO HURT??? AND HOW MUCH IS IT GOING TO TAKE FOR YOU TO STOP THIS?

PAIN I know. Boy, do I know pain.

And if that wasn't enough of additional misery for me to face this week---WHAT ELSE HAPPENED???? YOU KNOW DAMN WELL WHAT HAPPENED, LORD......

My beautiful, beautiful mockingbird family. The mama, the daddy and the four precious little babies......

One by one, night after night, ALL FOUR FRIGGING BABIES WERE PICKED OFF BY SOME PREDATOR, PROBABLY AN OWL. And then one night, the LAST TWO were taken....

I cried each day as the numbers of babies went down.....EACH DAY I CRIED, LORD. And I know you heard me.....because I called to You. I called out in agony to YOU every night--- and I cried out to YOU to protect those precious, innocent babies from night predators!!! Look at them, Lord---look how sweetly they slept at night!!!!! And I BEGGED YOU FOR THEIR PROTECTION!!!!!



Goddang it, did ya have to take my little birdies?????.... Count 'em, Lord---COUNT THEM.......

Four were born:

Then there were three:

Then there were two:

And then......and then......there came the day that I bawled my eyes out, knowing!, and climbed up onto the chair and found this:.......

Okay, God, wasn't it YOU who said in the Bible that the birds would "not worry about their next day" and that humans should follow their lead?

Let me quote it for Ya, Lord, so that You know that I REALLY DO read the dang Bible: Matthew 6:19-34 says (and he was on of Your biggest buddies): "I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more important than food, and the body more important than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?"

Well, Your Word must be true Lord, because guess what? THE DANG MOCKINGBIRDS ARE ALREADY BUILDING ANOTHER DANG NEST ON MY BALCONY!!! And I don't want them to because everybody knows that predators will hunt as long as there's a food supply, dammit! You think I want to go through that heartbreak again????? Haven't I been through enough? And so again I ask, LORD---HOW MUCH MORE PAIN ARE YOU GOING TO ASK OF ME?

So what happened, Lord? What happened to Your promise of not putting any more burdens on me than I could stand?

What in the hell happened?

My patients, my friend, my sweet baby birds.....


And what do You care?

This is how You care:

I'm craving a drink is how You care.....

Many recovering alcoholics will describe in AA meetings how the haunting and deadly "call of alcohol" sounds to them. To some, it sounds like a beautiful woman beckoning them. To some, it is like their own rational thought telling them that it "won't hurt just this one time....".

But to me? I'll tell ya what it sounds like to me, Lord.

It sounds like a good lookin' bartender. He's standing there at the bar, holding out his gorgeous muscular arm towards an empty barstool--- and he's talking to me. That gorgeous guy is saying:

"Hey there, Bo! Thought you'd never come back, honey! Sit down and have a drink, baby, cuz I got just the ONE for you! It'll fix everything. Yeah, it'll fix everything, Sugar! You won't have no more worries or troubles because good ole Mr. Booze is gonna act like the Calgon Man in all of those Calgon advertisements ----and take you away from all of your troubles!"

You know what, Lord? I realize that You gave me strength. Yes, you gave me certain strengths.

You gave me a strength for defending weak, sick patients. Hell, I am strong as an ox when it comes to defending the underdog---especially if they're a weak and ill patient. I can defend them all day long without breaking a sweat. I can beat the hell out of anybody who would try to hurt them.

Poor people? Yes, I can defend them. I've been poor myself at times. And I WILL defend them.

Non-insured, defeated, hopeless, and uneducated patients? Yep---I can whup anybody's ass who insults them or ridicules them. These people deserve to be treated as well as anybody else---and I will stomp the living shit out of anybody who ridicules or dismisses them as "unimportant".

Friends who are broke, scared, or feeling lonely? Yep, I'll defend them, too---I'll calm their fears , sit with them when they're afraid, and I'll loan them my last dime.

The miserable? YES---especially the miserable and downtrodden people who used to come to my ER's. Yep, I defended them, too. I took care of them with all the strength I possessed. I loved them all and prayed for them when they died. Everybody in any of the ER's I worked in knew better than to treat one of my patients like crap.....

But ME, LORD?????????


Because I cannot protect my own stupid self, Lord, and so you better LISTEN and LISTEN GOOD. Because I need some help right now.

I am in a fix and I'm going to say something to You that I never thought I would. I'm going to sass You and it hurts me to do it, but here it goes:


(And no I'm NOT afraid of that thunder and lightning storm you just started outside my window......)

(....well, maybe just a little bit...... It was kind of weird how it started right when I yelled at You. Okay, I'll shut up now....I was finished anyway.....)

* * * * * * *

Whatever happened to Emilia Earhart?

Who holds the stars up in the sky?

Is true love once in a lifetime?

Did the captain of the Titanic cry?

Someday we'll know if love can move a mountain,

Someday we'll know why the sky is blue,

Someday we'll know.....

("Someday We'll Know", The New Radicals)


Tuesday, June 19, 2007

I'm Honored to Have Made Grand Rounds!


I am very excited and honored to be included in the current edition of Grand Rounds 3:39, which Geena has put together over at Code Blog: Tales of a Nurse.

Thank you very much, Geena!

There is some very good reading in this Edition, and I recommend a look-see!


Saturday, June 16, 2007

Inquiring Cows Want to Know.....(And a Just Added Update on "Code Blue" posting)...

* (Scene: Day 12 Since Discovery of the Eggies ) *

Tra la la.....Just another buccolic scene in Podunk's pastures, the stupid cows standing around, doing what stupid cows do, minding their own business.....and then suddenly.....

One stupid cow says to the other stupid cow: "What's that noise I just heard?"

The other stupid cow replies: "What noise?"

First stupid cow: "THAT noise, stupid! It's..... well, I think it's gossip in the fowl world, I tell you! I hear that woodpecker tapping it out in Bird Morse Code! Something IMPORTANT is going on! "

The other stupid cow, eyes widening in a dawning realization: "You don't think? don't think...that Bo's mockingbird babies are finally hatching do you?"

First stupid cow: "Shut up and let me listen to the woodpecker's tappings......OH LORD THAT'S EXACTLY WHAT IT IS! Call a RED ALERT!!"

Other stupid cow (after spitting her cud out onto the ground):

"Red Alert! Red Alert! All available fowl midwives to the balcony of Bohemian Road Nurse, first hanging flower pot on the right! THIS IS NO DRILL! I repeat---THIS IS NO DRILL!!!"

* * * * *

(Next scene, in Bo's apartment and her balcony ..... )

(Picture me in a panic, running around my apartment like an idiot, not knowing what to do.)

"Buy the cigars!"

"Somebody boil some water!"

"Pack Mama Birdie a bag for the Bird Hospital!"

"Good Lord, I think it's happened!"

Yes, it was true! The Blessed Event had finally happened!

And, phew, it was touch and go there for a minute, as I was worried about each and every one of the four eggies as it got closer and closer to "hatching time"! I was practically chomping at the bit.

In fact, on Day 12, I had "a feeling". Because Mama Birdie seemed more "serious" in her brooding. And she had sat on that dang nest till I thought her feathery little butt was glued to it. And impatient me wanted to LOOK in that nest so badly that I almost felt like going out there and unconsiderately lifting up one of her "butt cheeks" (do birds have "butt cheeks"?) and saying to her: "Uh....excuse me Ma'am, but do ya mind? I've gotta look under there..."

But I refrained from doing that. I simply waited till she got off the dang nest for awhile.

And then I looked:

BABY BIRDS had been born! THREE out of four eggies!

As I looked in wonder at the three babies, I noticed Mama Birdie and Papa Birdie up on the roof, just a few feet away, talking to each other.....

"I told you she was going to start this crap again," I think I heard Mama Birdie say....

I fretted about that fourth egg. She had lost a fourth egg in the last batch and I was highly worried about this egg. So I waited patiently, all night long.....

So today, on Day 13 Since Discovery of the Eggies....

I looked again....

FOUR BABY BIRDIES!!! The fourth egg had hatched! Yahoo!!

And then I guess I must have woke them up----because the babies started moving and two of them started wanting to be fed. That's always a good sign!

And then I thought to myself, awww shucks......

I'll just leave the little family alone, to get to know each other....

....after one more pic.......

(I think she's getting right tame, doncha think? Because that's not a "zoomed" picture. I was actually only about 6 inches away from her, as I stood on a chair in front of the plant. Guess she came to the conclusion that I'm gonna take pics come hell or high water and must figure that at least she can "supervise" this time.....)

And then it started raining again.......and so right now Mama Birdie is sitting on her new babies, keeping 'em dry and warm....


* * * * *

(Added later, an update on Mrs. Turnwater, from my previous blog posting called "Code Blue.... ")

Things are not good. When it became ICU "visiting hours" time at the hospital, I went over there to the hospital and checked on her. All of her family is there with her, having driven in from various towns, including her executive daughter from Dallas.

It is as I feared. She will probably not last long, although she is giving it a good fight.

Her blood pressure right now is horrifyingly low, mostly between the 50's and 90's systolically. She is on the ventilator machine which breathes for her, and has reportedly been "bucking the vent" , which in hospital slang means that she struggles and fights against it---which (although it is necessary to help her breathe) is very understandable because who would want a damn tube down their throat?

It is very horribly uncomfortable and frightening to be intubated, and patients cannot help but gag and be restless when ventilated. When a patient is in this horrid situation, the doctors mercifully order paralyzing and tranquilizing medication in order that the patient not only be prevented from struggling and "fighting" the ventilator, allowing the machine to deliver the necessary oxygen to their lungs---but also so that the patient becomes sedated and calmed in order that they "don't mind" the discomfort. This always works and makes for a much easier time for the patient. But, unfortunately, in Mrs. Turnwater's case, every time they have tried this process on her, the tranquilizing medication seems to cause her blood pressure to go even lower--- which in her current state would be lifethreatening as the tranquilizing medications seem to be causing her blood pressure to fall too low to support her heart and other body organs' functioning. Which is bad because Mrs. Turnwater's kidneys have also begun to fail.

The good doctors and nurses are fighting a losing battle--- and they know it. But still they fight on, as we speak.......

Jenna has maintained constant contact with the family, and the family has thanked her over and over, recognizing the fact that had Jenna not been with Mrs. Turnwater at the time she lost consciousness, Mrs. Turnwater would not have lived long enough after passing out to have been "coded". Basically, Jenna saved Mrs. Turnwater's life.

But still, as I told you in my previous post about the survival rate statistics for Code Blues on the elderly, Mrs. Turnwater is most likely going to die soon. I hate to be that blunt, but it's a fact that we must prepare for and face.

But I did not say that to Mrs. Turnwater's family. I only told the family that we are continuing our prayers for them all and are here for them if they need us. I told her daughter to feel free to call my cell phone at any time, no matter what time of day or night. But Mrs. Turnwater's daughter did admit to me that the doctor had pulled her aside and discussed with her that "things did not look good"---so the daughter is attempting to prepare herself psychologically for the worst. And it breaks my heart...

I am calling upon the Angels of the Lord to hover close to this patient and her family, keeping them all wrapped in their loving arms during this time---and also for all of us who love her and are struggling with our own sadness. Because we all love Mrs. Turnwater.

I don't think I remembered to mention this before, but Mrs. Turnwater is a retired nurse. During her career she helped multitudes of patients---- and I hope like heck that we, in turn, can do as much as we can to help her in her hour of illness and need.

I'll keep you all informed....


Thursday, June 14, 2007

Code Blue.....

Though I keep searching for an answer,

I never seem to find what Im looking for,

Oh Lord, I pray that you give me strength to carry on,

'Cause I know what it means,

To walk along the lonely street of dreams.....


("Here I Go Again", Whitesnake)


Things are worse. The rain keeps coming and so does the sadness...

As you know from my last posting, we sent Mrs. Turnwater to the hospital. She was admitted, diagnosed with pneumonia, and has not been doing well.

Today Jenna, one of our home health aides who works part-time at the hospital, was helping Mrs. Turnwater take a bath and get into her robe. (Today was one of the days Jenna just happened to be working at the hospital, and she had been assigned to Mrs. Turnwater's ward.)

She said that Mrs. Turnwater was very glad to have her as her nursing assistant today (as all of our company's patients are when they're in the hospital, as it's so nice for them to have a familiar face to help them while in the uncomfortable environment of the hospital).

And then it happened.

Jenna was helping Mrs. Turnwater hobble over to a chair next to her bed after her bath, and Mrs. Turnwater suddenly grabbed Jenna with both arms, pinning Jenna's own arms. Then Mrs. Turnwater went unconcious and limp.

Jenna instinctively grabbed Mrs. Turnwater as best she could with her own restrained arms to prevent Mrs. Turnwater from falling onto the floor. This caused Jenna to lose her balance--- and they both tumbled sideways onto the bed. But Mrs. Turnwater's grip on Jenna did not loosen for some reason. And thus, Jenna couldn't reach the Code Blue button (which is on the wall in almost all rooms of hospitals). So Jenna screamed out for help.

"Help me in here!" she hollered out desperately to anybody nearby who could hear. "Code Blue! Code Blue!"

The staff came running---and then formally called the Code Blue. The Code Blue team arrived in seconds.

Jenna was immediately shoved out of the way, and she took a place in the corner of the room, fearfully watching the Code Blue Team try, valiantly, to save Mrs. Turnwater's life. Jenna became so upset at the traumatic scene that she couldn't help crying her eyes out, watching the Code Team's efforts as they did all the things that are done in a Code Blue, "intubating" Mrs. Turnwater, shocking her heart area with the defibrillator, and shooting umpteen life-saving drugs into her IV in order to attempt to bring her back to life.

As a veteran ER nurse before doing road nursing, I will just go ahead and tell you the "real" truth about Code Blues.....

It is not the glamorous, exciting situation that you frequently see on medical TV shows where the Code Blue team members move as fast as lightning in a gloriously coordinated ballet of tasks which seem to always end up with the patient returning quickly to consciousness--- with TV viewers getting the impression that the patient was never "really" dead" at all---only appearing unconscious for a few minutes. In the TV shows, the patient is usually "saved" and brought back to life.

That is not how it happens in real life. In real life, a Code Blue is a last ditch effort, an absolutely desperate attempt to save a person's life who has just died in front of you. The Code Blue team will nervously and courageously try those certain ACLS protocols they have been taught for Code Blues (based on the particular way the person's heart is delivering it's last few, ineffective and quivering beats--- while in the meantime their body is continuing to "die" as that quivering heart no longer delivers oxygen to the patient's brain or body)----- and most of the Code Blue team members are as frightened as shit.

ACLS protocols are very difficult to learn and memorize, and one trained in them must know them so well that they can change from one protocol to the other at the drop of a hat in the middle of a Code Blue if the patient's status changes. Sometimes they must change protocols 5 or 6 times in a Code Blue....sometimes more....

And the reason most of the team members are nervous is because they know......

They know that the statistics for bringing somebody back to life from performing a Code Blue are very poor. The statistics for "survival rates" for Code Blues are pretty bad. In some hospitals' statistics, out of all the Code Blue's they perform, their survival rates can range from only 37% to 57%, depending on the age and illness of the patient. And the survival rates for the elderly are extremely dismal. If I remember correctly, the survival rates for age 75 and older are only about 30%. And even if they do survive the code, they will most likely die shortly afterwards.

And also, the Code Team members don't move recklessly fast during a Code in real life like they do on TV shows. They try to move quickly, but they move less slowly than the TV dramas show, methodically and thoughtfully, because they don't want to make a mistake while burning their brains up to ensure that they correctly identify the right drug or amount of joules (units of electrical energy) to use with the defibrillator paddles to shock the hell out of the patient with, per whichever ACLS protocol they are following. And the doctor doesn't always "run" the Code Blue. If a doctor is not available, an ACLS trained nurse will make the decisions and run the code until he or she can get there to take over.

Sometimes codes can get very confusing among the team members for various reasons, for example if the team is not used to working together or else the patient's dying heart changes rhythms during the team's interventions, requiring the team members to change protocols in the middle of everything. Things can get crazy then....

I have seen code team members arguing during a Code Blue--- arguing about which drug to use next or which IV drip to hang. I've seen people tossing drug vials across the room, through the air, at each other--- to save the time it would take to run the drug over to the receiver. I've seen patient's IV's "go bad" in the middle of a code, necessitating the team to lose valuable time by having to start another IV. I've seen Code Blue situations so desperate that the team wasn't able to establish a working IV quickly enough and so they were forced to break open the vials of medicine and then drip it down the patient's throat in a REALLY last ditch effort to get the drug into the person's system as quickly as possible.

And when you shock a patient repeatedly with the defibrillator paddles, sometimes the patient's skin gets so burnt that it smells like cooking bacon, filling the room with a sickening, "pork-ish" aroma.

Sometimes the team member who has placed the ET tube into the throat of the patient doesn't get it placed correctly---and the tube goes to the "wrong" place, causing the oxygen which is being shot into the patient to accidentally get pumped into the stomach instead of the lungs----which then causes the patient's stomach to gradually (and horrifyingly) start to blow up as big as a basketball. Then the tube has to be pulled out and re-introduced again....and maybe again.....

Code Blue Teams don't like to lose a patient. I have seen Code Blue teams try courageously to code somebody for so long----not wanting to "give up"----until the patient actually went into rigor mortis and was obviously LONG GONE....

To this day I still have nightmares about certain Code Blues that I have been a part of during those years I worked in the ER....

True confessions here: I am a diagnosed "burn out" of ER's--- and I can never go back. I'm not proud of this fact. Actually, I am very embarassed and somewhat shameful about it---because I was considered very good at it and loved my years in the ER's. It still haunts me even though I know that burn-out happens to many ER/trauma nurses a lot more often that one might think. ER nurse "burn-out" rates are actually quite high. In the end, with the help of counseling, I figured out that I had simply put in the amount of years in ER's and trauma centers that God had allowed me--- and that was that. And I was going to have to accept it and let others continue on in my place....

Anyway, poor little Jenna witnessed the whole Code Blue of Mrs. Turnwater--- standing there in the corner, quaking in shock and fear, all the while crying her eyes out. Nobody paid attention to her. Hospitals are notorious for not paying attention to "lowly" nurses' assistants. Unfortunately, nurses' assistants are not always treated very well a lot of the time.

The doctor and the Code Blue Team were able to intubate Mrs. Turnwater successfully and got her heartbeat and blood pressure back. After stabilizing her, they promptly sent her to the ICU.

I don't expect her to live through the weekend.

We will watch and see.....

Later, as it was the day for me to do payroll, and when her shift at the hospital was over, Jenna stopped by the office to turn in her timesheets and mileage reports for her job with our company.

She was still crying hard.

I took her gently by the hand and made her sit down in a chair. Belinda and Jane-Anne then grabbed their own chairs and gathered around in a circle around Jenna---because they knew what I was about to do. And they knew, too, that it was necessary.

I wanted Jenna to be able to sit down and tell us about it----and have an opportunity to "get it out" in a safe environment. I wanted her to be able to tell her friends (we, her co-workers in in the road nurse company) the things which she couldn't say at the hospital---- where they are so busy that they frequently ignore nurses' aides and don't consider their feelings. I wanted Jenna to have an understanding place to be able to tell us how traumatic her experience had been and how sad and shocked she was. And about how helpless she felt when she couldn't reach the Code Blue button. And about how worried she was about the patient.

Mostly, I wanted her to know that we were there for her and that we understood how much pain she was in---because we happen to know that she loved this patient very much. And so, she did tell us and she did get it out. But pain like that isn't easily gotten rid of.

Because when she left the office, she was still crying.

After she left, I quietly collected the rest of the employees' time sheets, finished my payroll duties, and faxed the data to headquarters. Although the day before "payday" is usually a happy and boisterous day, the rest of this day in the office was subdued all the way around---for everybody. The sadness and pain in the air was so thick you could have cut it with a knife.

We know that the chances of Mrs. Turnwater coming out of the hospital alive are practically nil.

And so, I trudged back to my apartment at quitting time, not even stopping at the store for my evening meal ingredients (usually junkfood anyway), tired again, feeling beaten, and again dripping wet from walking through one of the everlasting start-and-stop rain episodes.

When I checked the computer, I noticed that I had received an email from an ER doctor friend, a guy I used to work side-by-side with in an ER for years.

In the email, he stated that he'd seen a baby mockingbird in his back yard "practicing" flying--- and that it had made him "think of me".

That cheered me up a little bit.

And also when I got home, I checked on my own Mockingbird Family, of course. And I saw mama birdie sitting on the nest, protecting the eggies from the rain--- on the official Day 11 Since The Discovery of The Eggs....

(I told them this morning: "Don't make me come in there....")

Because, as you can see, the eggies have not hatched yet. What are they waiting for? Engraved invitations?

Sigh....soon....maybe soon......

And so I will sit and knit tonight. Thankfully, the weekend is coming soon and I will be able to get some rest and "re-charging" then. Please pray for my patient in the ICU tonight.....

Thanks for being there for me, guys----because you are MY safe place. Where I can "get it out". You are the ones who I trust to be there for me when I need good, understanding friends who will let me rant and rave about troubles.....

Thank you for being there.

(And in regard to the picture at the top of this posting....Yes, it's true. You CAN really see "Spiderman 3" around here for 99 cents at the matinee. That little theater is in one of the tiny towns which my company services, about 20 miles from the office. Jane-Anne and I were in that town today putting up signs to advertise a Blood Pressure Clinic we're hosting next week and I couldn't resist snapping a picture in order to gloat at my sister, who lives in Dallas and has to pay about $8.50 to see a movie.....)



Tuesday, June 12, 2007

Storms Clouds Over Podunk Hospital.....

And the rains continue.....

And I've spent far too much time up at the hospital for my liking....visiting our poor little sick, hospitalized patients.

Lately, I've been getting home from work so exhausted that I can barely get out of the Jeep and carry my groceries up the stairs before collapsing in my "knitting chair".

And today I had a particularly embarassing moment when I arrived at my apartment complex because I clumsily dropped a big fat tomato out of my shopping bag onto the parking lot pavement----and the stupid thing rolled away from me, causing me to have to chase it 40 feet down the sloped parking lot.

And have you ever chased a damn runaway tomato down a sloped parking lot? It is most definitely NOT the most dignified action to be seen doing. One is required to squat down and run, bowleggedly, down the pavement, trying to scoop up the damn rolling tomato between one's knees while exhibiting an utterly ridiculous duck-waddle run---

....which is a body movement quite nicely conducive to the subsequent splitting of the middle seam of one's scrub pants right up the middle of a certain area of one' really isn't exactly the "picture of glamour" that one wants their neighbors to see, if you know what I mean....especially when one is wearing neon orange panties that one knows one should have thrown out two years ago because they're....well....holey.

(Okay, I never was one to shop at Victoria's Secret, okay? I think undergarments are utilitarian clothing which nobody should ever see and have a chance to judge---if it just wasn't for that damn tomato.... )

Anyway, runaway tomatoes aside, today it rained so hard that I fretted for an hour at work, worrying about the Mockingbird Family. I fret because they are in that puny little nest, hanging precariously in that potted plant, blowing to and fro in the wind on my balcony---and the thought of the pot falling haunts me.

And when DON'T I fret, these days? Things with the patients just seem to keep going from bad to worse....

I sent another patient to the hospital, the third of our patients hospitalized in a week.

This time, it was the home health aide who called me from the patient's house. (It's the patient who lives on that large cattle ranch where the cattle almost stampeded me that time.) The aide said that when she called the patient to tell her that she'd be there shortly, the patient just mumbled weakly into the phone: "Help me, me....."

Jenna knew that wasn't a good sign--and so she sped up and got there as fast as she could.

When Jenna arrived, she found the patient in respiratory distress, running a fever of 103, and coughing up thick yellow junk. Of course, Jenna called me immediately, her cell phone fading in and out due to the faraway location in ranch country. (The patient had lost her cordless phone somewhere in the huge ranch house---it's a ritzy one, kind of like that mansion on the "Dallas" TV show.)

"Bo, Mrs. Turnwater is in trouble for SURE," Jenna cried into the phone. "What should I do?" And then Jenna described what was going on with the patient. She told me that the patient confessed that she'd felt "bad" and had "run fever" for 3 days but hadn't wanted "to worry anybody". She'd lied to her busy executive daughter on the phone about it, saying that she felt "just fine" every time her daughter had called her in the last few days. Her daughter lives in Dallas and the patient didn't want her daughter driving from Dallas "for nothing but a plain old head cold".

"Hang up," I told Jenna. "And then pack her an overnight bag while I call the paramedics. Sounds like pneumonia for sure."

Didn't I just go through this the other day I thought to myself ? While also adding into the back of my mind the thought that our patients are dropping like flies....

I called the paramedics of that particular county (one about 25 miles away from where our office is located) and they told me that they'd head on out there immediately. I instructed them to bring her to Podunk's hospital--- NOT the even podunkier little teeny hospital that is out in that direction. The patient's doctor works out of my Podunk and I wanted her to be treated by her regular doctor.

I called Jenna back and waited on the phone till the medics arrived. To mine and Jenna's shock, when the paramedics measured the patient's oxygen saturation, it was 79--which is VERY bad. If Jenna had not had an appointment to see the patient, or been sharp enough to identify the patient's condition correctly (thus causing her to call me), I shudder to think what would have happened. Because her next nurse visit was not for another couple of days....

Thank God for Jenna's keen assessment abilities....

Needless to say, the patient was taken quickly to the hospital--- and just as quickly diagnosed with pneumonia. She's there now, admitted to a room which is near to our other two hospitalized patients, both of who also have pneumonia--- as well as the original problems which caused them to be hospitalized in the first place.

Jane-Anne and I made a trip to the hospital later and checked on all them. They all looked terrible, which depressed us greatly. Pneumonia can be deadly to the elderly.

Anyway, I came home after another busy day, drenched from doing the duck-waddle run through the rain to catch that stupid tomato.

I immediately ran to check on the Mockingbird Family. Sure enough, mama bird was sitting fast on the nest, guarding her eggs from the rain. I snapped a sneaky picture of her sitting there (from my crouching position behind my couch) , smiling at the sight of her little brown head peeking out from the fern fronds.

The rain lessened later, enabling her to leave the nest for a minute or two, and so I was able to snap a quick picture of the eggs themselves.

My beautiful, beautiful little Eggies.....

So, it is officially Day 9 Since the Discovery of the Eggs (and I am excitedly expecting them to start hatching any day now!

Also, during my fretting I've done more "Worry Knitting".

I finished Belinda's baby blanket:

And I finished the machine-knit camouflage blanket for Jane-Anne (and hand-crocheted a border for it):

And I started another sweater for Jane-Anne's future baby---a black one which I will make into a "baby biker" sweater. I've made such baby biker sweaters before---I try to make them look like the typical adult "biker jackets". (If I do them right, they turn out fairly cute.)

(I've even sold some in the past, in biker stores.)

The trick is to use a zipper closure instead of buttons, and to sew on certain leather & stud trims and biker "patches".

Anyway, I guess what I'm doing mostly these days is fretting, knitting, "expecting" baby mockingbirds----and trying to keep out of the rain----and from chasing tomatoes.

I'll keep y'all informed...



Saturday, June 09, 2007

Ceci ├ętait ma cour de jeu, or: You Can't Go Home Again....

This used to be my playground,

This used to be my childhood dream,

This used to be the place I ran to,

Whenever I was in need of a friend,

Why did it have to end?

And why do they always say don't look back...


("This Used To Be My Playground", Madonna)


Lately it rains every five minutes. I haven't seen a dang cow on it's feet in three weeks.

In addition, there's other aggravations. Patients keep lying to me, I had to fire another secretary (because she stated that she "couldn't remember if she had punched holes in some documents" or not), and I missed the 10:15 am deadline for ordering the Deluxe Breakfast at McDonalds.

(When that secretary made that statement, I will tell you here and now that I was VERY proud of myself for not YELLING the following phrase, simply stating it in a relatively calm voice, asking acidly: "Couldn't you have just LOOKED at the piece of paper to SEE if you'd punched the holes in it or not?" )

(You think I'm kidding but I'm not. She REALLY told me that. Don't worry---she's not out of a job. The company owners simply "reassigned" her to a simpler job in one of their other businesses because she's part of the owners' large family since she's living with Jane-Anne's brother, who also works for the owners' family...)

(Lord Jesus.....20 years old and "couldn't remember" if she'd punched holes in a document or not!!.....)

And now I need a new secretary.

Okay. There. I got my "whining" out.

I feel better now.

Anyway, I'm as stressed out as a long-tailed cat in a room full of rocking chairs. I've got problems galore and so I'm doing as I usually do when I'm stressed out---I knit, I cuss, I fret, and I bug the Mockingbird Family, whose dang eggs are sitting in their little nest, snugly nestled there like blue-with-brown-spot jewels, teasing me to death by not hatching. (See Mama Birdie sitting there? Broodin' away......) (I can only get these "brooding" pictures by hiding on my living room floor, shooting the pics from a crouched position behind the couch, through the balcony door's glass...)

Anyway, one of my ongoing problems is that my patients sometimes don't do certain things which they're supposed to do---like informing us nurses of Important Details--- and then it lands them in the hospital, which is bad for them for two reasons:

1)* It's always bad to be in the hospital because it means you're really sick. And they do uncomfortable things to patients in the hospital --- like not allowing them to eat the things their doctors tell them they're not supposed to eat. And the TV clickers don't always work in our piddly little town hospital. And they can't get any sleep because the night nurses wake them up at 3am to take their vital signs, who are then followed by the lab techs who arrive at 4:00 am to draw the morning bloods. Oh yes, and also, they can't get Moon Pies, buttermilk, and other Texan delicacies in the hospital.

and the second reason:

2)* I live right across the street and so I will frequently show up, striding into their rooms wearing my biker jacket to sanctimoniously say : "I told you so, dammit."

Anyhoo, I've got two patients in the hospital this weekend. One because she indirectly (and reluctantly) FINALLY confessed to me what was going on with her.

The other one didn't tell me that her doctor had sent her to the hospital---- but I found out anyway. (Small town, ya know? And hell---what did she think---- that she could "hide" it from me?")

(I'll deal with her later....)

The first incident happened Friday afternoon when a patient called me with that tell-tale guilty and defensive sound in her voice. She stated: "I just don't know why my son won't leave me alone. He keeps wanting me to go to the hospital for some reason. But I'm telling you, Nurse---that I just CAN'T leave this house for any reason. My 16-year old granddaughter lives with me and I've got to keep an eye on her. There's no telling WHAT naughty things she'd do if I were gone."

After a little careful questioning (in which I can frequently descend into a mode of hardcore criminal interrogation which sounds more like the mean cops on the "Law & Order" television show), I dragged it out of her that she had gone to the hospital's lab to have a Holter monitor removed--- which is the end part of a test in which her doctor had ordered that she wear a heart monitor continuously, while at home for 24 hours, in order to see what was going on with her heart. And I was pissed off because I hadn't even know that she'd been ordered to have the dang Holter test in the FIRST damn place....

"WHY on earth did you have a Holter monitor test and WHY didn't you tell our nurse about it when she was there the other day?" I grilled.

"Well....uh....I didn't really think it was important," she hedged. "I mean, these know how they are.......always ordering tests. Ummm... he only did it to see why I was getting dizzy every now and then....and...well, I might have had some palpitations or something last week..."

"Do WHAT? You get dizzy now and then?!?" I thundered. "And palpitations??? You never told us that! What in the hell is going on that you didn't us something important like that? Geez-oh-Man, next you're going to tell me that you haven't taken your diuretic pill like you're supposed to."

"Well, I can't take that Lasix pill before I go to Walmart!" she explained in an irritated voice. "Public bathrooms are always so dirty----and that horrible pill makes me have to pee every 5 minutes! And sometimes I can't make it to the bathroom! The last time I took that stupid pill on shopping day I accidentally made a big pee-puddle right in the middle of the Baggies aisle! I was utterly mortified!"

After a little more of my questioning, she admitted that her son was repeatedly instructing her to "go to the hospital".

"Why would your son tell you to go to the hospital?" I asked.

This story was getting stranger and stranger. Because it sounded suspiciously like the kind of stories my patients tell me in a roundabout way to "confess" something that they knew darn well that they should have told me two days ago.

Or three weeks ago.

And my patients do frequently experience "guilty conscience" attacks which cause them to eventually (and reluctantly) confess everything, albeit in their own sometimes humourous ways--- and sometimes dangerously late for the problem at hand. Podunk lies deep within the Bible Belt, and so I guess the closer it gets to Sunday (like on a Friday afternoon) , the more it causes them to get the urge to get the truth out so that they don't have to sit in front of the preacher on Sunday morning knowing full well that they are "hiding" something from Nurse Bo, whose wrath is sometimes worse than that of any fire and brimstone preacher...)

"Um...I don't know..." she wavered at my questioning. "He may have....uh...talked to the doctor this morning. But we won't know till next week because the doctor's office closes at noon on Friday. So there's nothing to worry about right now as it's way past noon. And I told you, I don't want to leave my granddaughter in the house alone over a weekend..."

"Hang up right now," I told her in an ominous tone. "I'm calling the damn doctor to see for MYSELF what in the hell is going on...."

"I TOLD you that his office closes at noon on Fridays," she stated defiantly. I knew she thought she was "safe" simply because the doctor's office was closed.

"I know his office closes at noon on Fridays," I told her with a definite smugness in my voice. "But don't worry---because I am the Doctor-Finder. I can find a white-coated doctor in the dark during a snowstorm. I can find a doctor if he's stuck in a crevice on top of Mount Everest. I can find a doctor no matter WHAT time of day, no matter WHAT time of night, no matter WHAT the circumstances...."

"Okay, call the damn doctor then," she stated resolutely, knowing it was useless to argue with me.

(Ask me sometime about how I "found" a doctor in the Men's Bathroom of a Psychiatric Hospital---it's a good story, and that doctor learned to never avoid me again. I did get "counseled" by my superiors for running in a hospital corridor, but by God, when I want a chart signed, I WANT THE CHART SIGNED.)

Anyway, this is how I find doctors in Podunk:

I called Beulah, the hospital's telephone switchboard operator.

"Beulah," I said. "Would you find Doctor Milton for me, please? Tell him it's me--- and tell him that it's about Mrs. Dimsy."

In 3 minutes the phone rang and it was Doctor Milton. He didn't even allow me to explain before launching into an angry diatribe.

"Goddammit, where the hell is that woman?" he demanded. "I'm up here making rounds at the hospital and I've been waiting for her. She had a Holter that showed rapid a-fib, SVT, and God knows what else. This morning I told her son to get her up here as fast as he could."

And then he added, in a smaller voice:

"And Bo, um.....send her through the ER, okay? But whatever you do, don't tell the dang ER doc that I said that. Just pretend that you sent her because of palpitations or something. They'll call me when she gets here anyway."

"I won't tell," I said, laughing inwardly to myself.

And I wouldn't tell on him---because I know how grouchy that ER doctor is. If the ER doctor found out that Dr. Milton had sent a patient through the ER (unnecessarily adding to the ER doc's patient load) when he could have simply "directly admitted her" to a bed in the hospital, bypassing the ER altogether, that ER doctor would throw a hissy fit the likes of which we'd never hear the end of for about 4 days. It irks our ER doctor to death that the local docs' favorite phrase is "Send her to the ER..."

So I called the patient back. I told her I was sending her to the hospital---but that I was going to insist she go by ambulance. She lives out in ranch country, 45 minutes away from the hospital, is a fairly ill woman, and I was very worried about her newly discovered heart condition. And I didn't trust her son to drive her because he is a known drug/alcohol user and has been known to pass out, drunk as a skunk, in the neighbors' front yards.

"Pack you an overnight bag and get ready for the paramedics to arrive," I told her. "I'm sending them in a minute. And I know you're worried to death about leaving your granddaughter alone while you're in the hospital. So put her on the phone. I want to talk to her."

I knew that this patient's worrying about the possible consequences of leaving her mischevious 16-year old granddaughter to her own devices for a few days while she was in the hospital could likely put her into a worse heart rhythm simply from her anxiety and worrying.

The granddaughter got on the phone but before I could even begin a lecture, she said in one long, breathless, lightning-quick sentence:


Now then, does that sound like a typical 16-year old who's thrilled at the chance to have the house to herself for a few days? It did to me. So I immediately wrote myself a note to have our nurses do a "surprise" visit and knock on that door every single day during the time Mrs. Dimsy is in the hospital in order to see what the hell is going on over there....

"Right," I told the girl. "And NO BOYS, NO BOOZE---or anything else that you know you're not supposed to be doing, okay? I want you to help her pack an overnight bag. And make sure she's got her hairbrush and false teeth stuff in it. Take off all her valuable jewelry and have her leave it at home. Put plenty of clean panties in there for her. Now hang up, cuz I'm calling the medics."

So I sent the patient to the hospital via the paramedics. I called the ER to tell them I was sending them a patient and I faxed them the patient's medication list and other pertinent details. And I did as the doctor asked and never admitted to them that it was a "set up". They thought that I was sending the patient on my own---- and so Dr. Milton was safe from the wrath of the ER doctor.

Then I called one of our home health aides, a girl who also moonlights at the hospital as a nurse's aide on the weekends.

"Jenna?" I asked on the phone. "Mrs. Dimsy's coming in. Would you do me a favor and check on her over the weekend for me? She's nervous about her granddaughter as usual."

"Sure, Bo," Jenna replied. "And oh---- did you know that Mrs. Janeway's here, too? Got here yesterday, and she's in room 214."

"Get the F___ out of town!" I hollered in shock and surprise.

(Little apology and defense of my bad language here: Usually when something shocks and surprises me, I use the phrase: "Get out of town!" But when something REALLY shocks and surprises me, especially on a Friday afternoon, and especially if it's about a sick patient who was supposed to tell me she went to the hospital but DIDN'T----well, then I'm likely to add the F-word, okay? Bad habit, I know, but sometimes my ex-biker chick habits pop out involuntarily when I'm hit with a surprise piece of bad news....)

(Ok, I've been known to get so mad that I said: "Get the F___ing F____out of town!" but that was only once and it was a REALLY bad day---and I told you before that Texans will frequently heap extra words into a cussin' sentence when it's called for......)

(Hey, at least I admit my sins and apologize for them, right?)

So now I have two patients in the hospital.

And it's Saturday.......

So guess where I'm going in about an hour, after I've showered and then bugged the Mockingbird Family for one picture? Yep----I'll be going up to the hospital to check on the two patients. (And I can't wait to see the look on Mrs. Janeway's face when I stroll into her room with a big grin on my own face....)

(She's probably sitting there in all her glory, thinking she's "safely hidden", happily munching on a banana-nut muffin that she bugged the nurses to get her from the hospital's new lobby "snack bar", thinking smugly to herself that she's pulled a fast one on me by not telling us that she's in the hospital.)

(I've actually had patients who went to their doctor, got admitted to the hospital, came home two days later--- and NEVER SAID A WORD to our nurses about it. In these cases, I not only have a hissy fit to the patient for "sneaking", but then I do my Doctor Finder behavior and have a word with him for forgetting to inform our company that he had hospitalized one of the patients. I usually ask him sassily: "How would you feel if I 'forgot' to inform YOU that something serious was going on with one of the patients?")

(Unfortunately, the doctors are not afraid of me and simply humor me by saying: "Oh, I'm so sorry Bo, I TOLD my office nurse to tell you---but she must have forgotten......")

(I don't believe everything doctors say....)

Anyhoo, I then went out to bug the Mockingbird Family just once, quickly, by taking one picture of those eggs. I am trying to leave them alone while mama birdie broods on her eggs, but it is taking FOREVER for them to hatch. God, I'm like an expectant mother myself waiting for those dang eggs to hatch! Because the way I figure, by my count it will probably be the end of next week before they start hatching.....which seems like FOREVER!!!!

Here's "Day 6 Since The Discovery of The Eggs":

I'm so impatient about these damn eggs that I actually tried distracting myself by cranking up the old knitting machine. It's an ancient "Incredible Sweater Machine" (which is the old version of the more modern "Ultimate Sweater Machine" ) and I threaded the thing up to knit a "camouflage" yarn blanket to match the camouflage sweater I knitted for Jane-Anne's future baby. I used Bernat "camouflage" yarn so that it would be machine washable/dryable.

To my utter surprise, the infrequently used, rusty thing worked--- although I had to do most of the first 3 rows by hand manipulation. So I sanded a "joint" in the middle of the machine (because I've put extensions on the machine to make it longer) and that seemed to help---but mostly I suspect that I need a new carriage because it "sits too low" and the needles are catching on it. I think I can order one from Knitting Today. But it worked alright after a somewhat rough beginning.

Note that the "wrong" side of the knitting fabric is in the front.

So I climbed up under the table to snap this pic of the "right" side of the knitting. I think it's knitting out into an acceptable "camo spots" pattern. (You knitters know that sometimes these varigated camouflage yarns don't "do right" and knit out too "stripe-y" rather than in camo "spots".) But I think I lucked out with this particular project.

I'll hand-crochet a border for the blanket when it's finished.

Oh yes....

Here's a newspaper clipping of a friend that 911Doc over at M.D.O.D. requested to see. (He likes cheerleaders, so I'm indulging him just this one time...)