Medic/Nurse's Blog

Did Anybody Miss Me?

2010-05-27T12:21:00.000-07:00

I've been gone a long while, did anybody miss me? I kinda fell off the earth for awhile, due to some health issues.

I never thought I'd be the one to have to say it, but here's the bombshell that's kept me busy: I have Rheumatoid Arthritis. Its not 100% sure, but its looking more and more like it. Its been a very rough couple of months as I struggle with adapting. Even on my good days, I'm not a good patient. I HATE this side of the stretcher with a passion. Right now its affecting my ankles, knees, and wrists the most.
So, that's why I haven't been posting much lately. I'm still reading, still in the loop as best I can be. However, there are many days when I still can't type very much. I do have some posts in the works, but they will be slow in coming. The grieving process for my old life is still consuming much of my time as I struggle to adjust to this.
I'm currently still working and running calls...just at a slower pace. Before this, I didn't have a stop button, and rarely even slowed at all. Now, I feel like life is in slow mode as I am forced to rest and relax.

Physical Agility Test

2010-01-24T21:28:00.003-08:00

So, Tomorrow evening I take a physical agility test so I can join the local rescue squad. For the most part, I think it is well designed. Its geared toward things we actually do in the field, and not firefighting.
Step one is loading/unloading a cot plus patient from the ambulance
Step two is 10 mins of CPR
Step three involves carrying a patient and STRETCHER up and down a flight of stairs.

Now, all of these make perfect sense to me. Except the stretcher part. I specifically asked if it was a stretcher or if I could us a Reeves sleeve, stair chair, backboard, or some other device. I was told it has to be done using the stretcher from the ambulance.
Maybe I'm spoiled, but I have NEVER carried the entire stretcher up a flight of stairs before. I've hauled many a patient down many flights of stairs, and never found it necessary to carry the entire stretcher up a flight. Maybe up a few outside stairs, but that's it. Reeve's sleeves, stair chairs, backboards, sling chairs; I've used these and more to carry patients down stairs.
So, does anybody else carry their stretchers upstairs? Is this reasonable?
I'm having a hard time even thinking about how its supposed to be carried without injuring the rescuers. Wheels up or down?
So, opinions please. Is this done routinely? Is this a fair test?

21 and Desperate

2010-01-19T21:06:00.000-08:00

WARNING: This is another graphic post, read only if you have a strong stomach.

Remember, this is not a real case, rather a blend of what I have experience. Any similarities to a real situation are totally coincidental.

Blood pooled underneath his head, congealing in blobs that looked liked cooked tomatoes. The clumps of brain matter looked similar to grains of rice mixed in. The single bullet wound between his eyes spoke of a desperation so deep I couldn't fathom it. It also spoke of a young person's rashness, and deep scars. His eyes were open, staring blankly into the gap between the trees. His hand still curled around the gun used to take his own life.
His close friend was about 3 miles back on the two-track leading deep into the woods. He stood there sobbing "I can't go on, I couldn't stop him, Is there anything different I could have done?" He told of a tale of what he thought was a happy lark into the woods turning into a witnessing of a tragic end to a young life. A young person driven to taking his own life. Driven by desperation, by pain, and by tragedy to selfishly end his own life. Seemingly, it was a sudden, rash decision; one made out of the quick decisions of teenage years. But, we'll never know if he really wanted to kill himself, or just made a rash decision. He did it right, and there is no going back now.
The EMT who beat me on scene was valiantly performing chest compressions while her tears mixed with the pooling blood. "He's one of my son's friends, I coached him in Basketball, He's such a talented kid" she gasped out as I came up.
His Mom was further down the road, stopped by Police before she seared her memory with her son's mangled body. She was also sobbing, crying for her bright young son. She kept repeating "He never told me he needed help, I would have gotten him all the help under the sun, if only he would have told me". I recognized her, couldn't place her right away. As I went further, I remembered...She was the sister of the Mother of another recent tragedy in this small town.
As I looked at his body, it was obvious that any efforts we made would be futile. Brain matter was splattered for a large radius, and the back of his head was missing. I ran my strips, and called the time as the EMTs on scene collectively cried. This was a very small town, and they all knew him. Fathers, Mothers, Friends, all stood as witnesses to the tragedy, the end of a bright young life. Even the Police Officers stood unabashedly crying as they recited stories of him being the one who stayed out of trouble, and helped others.
It was a scene I won't ever forget. Later, we assisted the coroner in transporting the body to the hospital for x-rays then to the morgue for autopsy. As we carried him out, the other workers still onscene formed a silent line, a tribute to a community's pain.
That night, I came home late, exhausted yet unable to sleep. I went to the fridge to find something to eat. Several prepared dishes awaited my selection, yet all contained tomatoes, and most had rice as well. For the first time, I couldn't stomach them because of the similarities. I had cereal for dinner and cried over the desperation of one young man.

Desperation in Haiti

2010-01-18T16:00:00.000-08:00

So, as you all know, Haiti is facing a tremendous disaster. My thoughts and prayers are with the rescuers and aid workers as they battle the clock there.
The time is quickly running out for finding anyone alive under the rubble. Any trapped are going to perish of hunger and thirst in the next few hours, if they haven't already. Medical aide is being slowed and hindered at every turn by red tape and simple logistics. There is only ONE airport to bring ALL of the aide into. This will continue to hinder relief efforts for many days to come.
Even if they survived the initial quake, the survivors are still facing tremendous odds. Infection, disease, starvation, and thirst lie in wait for them all. Even simple wounds can be quickly deadly in a dirty environment with the stressed bodies of the quake survivors. The pictures coming out are incredible, with people with huge head wounds, mangled skulls, open fractures, and more still alive. Without timely aid, some of which is already to late, many of these will die in the next few days of infection.
The decomposing corpses, lack of sanitation, and lack of clean water will also provide hazards. The risk of disease outbreak is very high with this lack of basic sanitation. Diseases we have never seen here in the US can quickly kill hundreds weakened by malnutrition and injury.
These are just a few of the immediate risks faced by the relief workers in Haiti. I'm no expert, but I know they are facing HUGE challenges. My thoughts and prayers are with them as they work.

Technology Issues, Part 2

2010-01-17T20:40:00.002-08:00

Apparently Technology and I have an ongoing battle. This girl is not quite as techno-savvy as I thought! My smart phone and my Internet have both crashed in the past weeks, and have both been down for awhile. I currently have a phone again. However, my Internet is still slow, albeit it works now!
Of course, this happens right after I promise to write more posts! I have more posts in the works, so stay tuned.

Visiting family

2009-12-20T12:22:00.003-08:00

So, I'm sitting in my parent's living room enjoying the family. We had an early Christmas celebration this year due to some of our work schedules. Having a couple of people in the EMS/nursing field in the family makes scheduling holidays difficult. Also having the family scattered literally across the country makes getting together difficult. However, despite all this, we managed to get everybody together for an early Christmas celebration! So, no deep post today, I'm simply enjoying my family and will be going out to build a snowman shortly.
I do have a post in the works about EMS 2.0 and another one about EMS vs Nursing education. Keep checking and they'll be up eventually!

Beaten by technology

2009-12-16T13:37:00.004-08:00

OK, so technology has totally gotten the best of me at the moment. I wanted to submit my post below (AIDS part 1) to Emergiblog for Change of Shift. I've actually tried for the last three editions.... But, somehow, when I click on the "contact me" button on her website, I can't get through. I think its because I use gmail and I don't have my Windows email outlook set up properly. I used to be able to scroll over the link, get her addy and send it her way....but, somehow I can't do that anymore.

I also wanted to comment on AD's post about his blogroll, and request being added there. But, my computer won't let me do it. I don't know if he has comment moderation on and hence has about 10 posts to sort through, or if its my computer.

So, I am attempting to communicate with the greater world and maybe get some readers. But, attempts at mastering technology are defeating me at the moment. Any hints, suggestions, tips are much appreciated!

Freedom to be New

2009-12-16T12:41:00.004-08:00

I am still a new medic. I got my license in January 2009, and was cleared to run by myself sometime in the April region. I then moved multiple times, and have not been practicing since September. I have been an EMT for almost 6 years now
However, many in EMS keep mistaking me for "experienced". I know I have some nursing experience under my belt, including my years as an ER/Trauma nurse in a large level 1 trauma center/inner city ER.
But here's my problem with this: I am NOT an experienced Medic. Things that make me a good ER nurse do not make me a good Medic. I have always been of the opinion that in-hospital and out-of-hospital care are two separate things. Similar, yes; even over-lapping in their fields: but 2 different worlds. It takes a different mind-set, different set of skills for me to operate in the field. This mindset helped me do well in Medic school, by setting aside my experience as a nurse and focusing only on what I had done as an EMT/and what I was learning.
So, here's my problem: people in EMS keep calling me "experienced", giving me preference on calls, even sending me out by myself into difficult situations "cause you can handle it".
I have nursing experience, I'm not the most experienced, but I do have some experience and feel fairly confident in my skill set. But I'm not an experienced medic. I haven't yet done a field tube (wasn't required in my program, I've done tubes in the OR, but not in the field). I haven't even run a wreck requiring extrication (once again, been in EMS for 6 years, and all my patients have self-extricated! Weird I know). I have also never run a code in the field (again, been in EMS for 6 years and my white cloud has prevented me being there for one!). I have run many, many codes in the hospital. I have also run ALS mega-codes until I could do them in my dreams (literally). But I have never run the actual chaos of a code in the field.
I would love to have the experience of watching an experienced medic run a code in the field. I would love the opportunity to drop a tube with an experienced medic peering over my shoulder to help me. But I'm not being given these opportunities. I'm sent out by myself, expected to function at a high level.
I'm getting ready to start at a new squad, and I'm already facing this conundrum. Already they're talking about a shortened preceptorship "since you know what you're doing". I don't want it shortened, I want help. I guess I want the pressure off, I want to be able to be "the new guy on the block". I want the freedom to mess up, to be told that I'll do better as time goes on. I want the freedom to have someone show up to back me up (volunteer system) since I'm still new.
Any thoughts? Hints? My nursing experience does help me a little (cyanosis is still cyanosis, in-hospital or out-of-hospital), but not much. I'm still a new medic and want to be considered that way.

AIDS part two

2009-11-30T00:35:00.000-08:00

He was very well dressed, down to the neat pressed suit coat and silk tie. He carried an expensive tooled briefcase and a Blackberry prominent on his hip. He checked in at the front desk, and sat in the waiting room. When I first saw him, he was a ripple of fashion in a world of stained tee shirts, flip flops, and worn stained jeans. He sat and texted and emailed until he was called. He looked the picture of a well put together executive.
I took him back to triage, and quite another story emerged. He had just been to the AIDS clinic to get his next round of cocktail meds. “I can’t accept the insurance at my new job, because then they’ll know about the diagnosis, they aren’t supposed to….but….they just fired another employee who signed up for the insurance and told them he had the dreaded disease.” He said he went to the free AIDS clinic in the city as “the only way I can hope to stay alive for long”. They had taken his blood that day, and called and sent him to us with a dangerously low blood count. He cried big, heart-wrenching tears- “I guess this might just be the end…I always wanted to be old, but I’m not going to get the chance”.
His story was more tragic than most. In his teenage years, he had been struck by a drunk driver one night while driving home from a business conference. During the ensuing days and weeks in the ICU he had received many, many units of blood. One of those units wasn’t properly screened, and he had contracted HIV. He was beating the odds so far, had made it to middle age without too many complications. He looked fairly healthy, but then he took off his jacket and rolled up his sleeve for the BP; and another story came out. He had the tell-tale end stage purple lumps, he was almost nothing underneath that coat, and a strong wind could carry him to China if he wasn’t careful. His mouth was all sores inside, the tongue eroding, the gums bleeding. He told the story of sleepless nights, incessant coughing, and massive diarrhea.
Despite all this, he had remained optimistic. He had managed to not only keep his job, but hide his diagnosis. He said his coworkers wondered sometimes, wondered why he never dated, wondered why he left at lunch each day. He said he had never dated “cause I just couldn’t take the chance of giving this horrid disease to someone I loved, I just couldn’t do it”. He left at lunch each day to go swallow a massive amount of meds in private, and try to eat something nutritious, even if it didn’t look good.
He was at the top of his company, when I saw his name I recognized him as a prominent business man in the city. He lived in one of the nice houses, in a nice neighborhood. He said he had just “had to move, cause my old neighborhood learned about me, and nobody would talk to me anymore”. He loved kids, and said “so far, I’m allowed to play with the neighborhood kids, and even eat with people again”. He wasn’t sure it would last, but stated he was enjoying what he could while it lasted.
I took him straight back to a room, with his WBC count of almost nothing he didn’t need to be exposed to the contagion rolling around the waiting room. I went back later to check on him.
I found him, almost nothing under the blanket, crying on the phone. I left him alone for privacy, and came back a few minutes later. He said that the doctor was admitting him for intensive treatment of his massive pneumonia, “but it doesn’t look good”. He called his work and told them some excuse so he wouldn’t have to show up the next day.
2 days later, I was perusing the obituaries when I was shocked to recognize his picture. The picture was taken before the disease had gained so much ground, and he was a different person. The obituary only said that he died of pneumonia, no word of the true cause. I heard he had a large funeral, with most of the people in attendance ignorant of the courageous battle he had fought, totally alone, for over 25 years. The disease had won again, had won in secrecy and stigma.

MIA

2009-11-24T20:19:00.002-08:00

Folks, I have been rather behind in posting recently. (just a newsflash, in case you hadn't noticed!). In between moving long-distance, settling in, starting a new job, learning a new role, getting a kitten, fulfilling all the license requirements for the new state, etc, etc, etc...I just haven't had much time for posting!
I will try to do better in the future, although I can't promise much. A post a week would be wonderful, but we'll have to see. I can say there are some posts in the works about professionalism, EMS versus Nursing, etc. If I still have any readers, feel free to comment on anything I post!

The Many Faces of AIDS, part 1

2009-09-19T14:39:00.004-07:00

Notice: this series of posts will highlight the personal side of one of our country's major health problems. Please note that these are in NO way portraying real people, but are a combination of my experiences. If you think you recognize someone, you are wrong, these are not real stories.

She was wasted, emaciated, almost nothing on the stretcher. Friends, family members all piled at the bedside, all concerned about her. They had pictures from a month, a year, several years ago. All these portrayed quite a different picture: laughing, dancing, normal weight, friends and family all around.
Today, she was crying, covered in sores, odd lumps present here and there. She said that her family had brought her in "because they are all worried about me". History was hard, if not impossible to obtain with all of them around. The family painted a picture of declining appetite, declining weight, declining energy, "she just seems sick all the time".
I asked for a little privacy so I could get a urine sample. The family willingly filed out to the waiting room while making it clear that they would be back, they weren't abandoning her. Once gone, she dissolved into tears.
In bits and pieces the story came out, she was born in poverty in the inner city. While attempting to earn a college education she had run out of money. Her minimum wage job wasn't paying enough to allow her to finish school. There just weren't enough hours in the day for her to work enough to pay for school. So, she turned to what she knew would make her a little more money. She stated it started out slowly, but quickly it trapped her. Selling her body became more and more easy, and made more money. She finally made enough money to finish those last 2 years of school. She graduated top of her class, with a degree that ensured she would never have to stoop that low again.
She left that city, went to another one, got a good, well-paying job. She never turned to the streets again, thought she was done with that shameful period in her life. But, the deed had been done, and there was no avoiding the consequences. After a time, she moved back to her hometown and continued to work at her new profession. She had money, friends, influence, and even a new boyfriend.
But then, the weight loss started, the frequent infections. She knew that her old life was coming back to bite her, but didn't know how to tell her family and friends. She was scared of what they would think of her stooping so low for those 2 years. So, she avoided the issue. She told them she was getting back into shape, that the cross-country move was to blame for her frequently being sick, anything to get the attention off of her increasing sickness.
Now, she was lying on our gurney, sick, scared, and broken hearted. She told me she knew it was AIDS, she said "I just know I caught it in those 2 years, but I don't know how to tell them". I stayed with her until the sobs quieted, and tried to offer reassurance. But deep down, there wasn't much reassurance to offer. The signs were all too obvious, and the stigma all too deep.
We ran a few blood tests to confirm what was already obvious. We arranged for her to be admitted to the hospital for the first round of medications. We helped her break the news to her family, who solemnly shook their heads and filed out of her room. We answered questions, and tried to reconcile them. Hoping, hoping that she would have someone left to support her through the ugly days ahead.
I sent her upstairs, and sent her family after her. I sent the chaplain up after them, hoping to break the cycle of social stigma. I didn't see her again for awhile.
4 weeks later, a familiar name flashes across my screen. I quickly ask to have her again, to follow up on what I had started. This time, the scene was so different. She was even sicker, but alone in the room. A small heap under the bedclothes was all that was left. She sobbed again as she told the story. The tests were indeed positive, and confirmed her worst fears. Her family and all her friends had immediately abandoned her, even her roommate had moved out while she was at work one day. She had lost her job due to being unable to work from the illness. Her boyfriend had left town and wouldn't return her calls. She was facing the horrible truth, all alone.
We saw her fairly frequently for the next few months as we tried to curb the spread of her illness, stop the insidious slide toward the grave. She was always alone, scared, trying to find her footing alone in the world.
About 8 months after that first day, we got an EMS call. "Unknown female, unresponsive, initially pulseless, revived after one round of CPR and a defibrillation. Now unresponsive, pulse of 100, BP 60/40, ET tube in place, 2 min ETA, blood glucose 200". For some reason, my mind flashed to her as soon as I read the report. As I readied the room and summoned the other personnel needed, I mentally reviewed her case. Sure enough, when the Paramedics rolled in, it was her. She was down to less than 70 lbs, and had obviously not been able to care for herself in sometime. EMS reported a very dirty house, and indications she had not moved from bed for some days. Nobody knew who called 911, but she was alone when EMS arrived.
We tried our best, but her fate was sealed long before she arrived. She died soon after arriving despite our best attempts. She didn't die alone, but she died without any family or friends by her bedside. The horrible grip of the viscous disease finally won.
We attempted to contact family and friends, but no one would come, no one was willing to be associated with her. We finally sent her body to the morgue, alone. The disease had won again, and social stigma had taken another victim.

LOA Reasons

2009-08-19T06:51:00.002-07:00

Hi to my few readers :). I just wanted to drop a quick post to explain my lengthy absence. I have been very busy, I am preparing to move clear across the country. I have moved twice since May to short-term rentals in anticipation of this job opening up. Now, I'm preparing for a 3000 + mile move, and a major job change. So, in a nutshell, I've been simply to busy to post for awhile :). I haven't gone anywhere, and will be back!

Life Lessons, Number 1

2009-04-16T06:56:00.000-07:00

This is the first of a series, titled Life Lessons; although perhaps it should be titled "things my patients taught me never to do".

Number 1: Never, ever let your dog chew on your tracheostomy tube. If by some chance your dog does, please discard it immediately. Do not, and I repeat; DO NOT continue to use the tube anyway. Especially do not continue to allow your dog to chew on it, and continue to use it.

This patient came in with a tracheostomy tube that was approx 1/3 the length it had been, the end of it was jagged and sharp. She had a tracheoesphageal fistula from continuing to use the sharp tube. That fistula was discovered when the patient attempted to drink liquid potassium supplement, and then coughed it all over the night shift nurse! Now, you really don't want anything down in your lungs, but especially not liquid potassium!
The patient had been living with a family member who made no attempts to help her, get her medications, or even feed her properly. She was diagnosed with aspiration pneumonia (no surprise!) and eventually sent to a nursing home, under care of Adult Protective Services.

94 years old

2009-04-15T06:30:00.000-07:00

She was 94, frail, but still mobile with the assistance of a walker. She had called us with a nosebleed that she couldn't get stopped. She lived in a large, 2-story farmhouse that stood on what was obviously previously a working farm, but was now a housing development.
When we arrived, it looked like a small massacre had happened in her home, with blood all over the floor, the walker, the bed, even across the room. She removed the tissue for a moment, and the blood squirted across the room. I was the preceptor on this call, a situation that doesn't happen too often. The probate member rightly decided that this lady needed the hospital yesterday, and started making preparations to hustle her down the hill to the waiting ambulance. While he was moving furniture, I took a moment to look around the room. It was the living room, but obviously had been transformed into an all-purpose room at some point. There was a bed, a couch, a desk, a table, everything she needed was in that one room.
The patient interrupted my musing, stating nicely "you know, I really don't want to leave, do you think all this fuss is really worth it?" The probate member immediately starting listing all the reasons why she could bleed to death if she decided to stay. After politely listening to him, she turned to me and stated "I just don't want to leave this place, for I'm afraid I'll never come back". She turned to survey the room, and look out the window at the mountains visible. "I was born in this house, I raised my 6 kids here, I had 2 kids die here, I lost my husband here. I just want to come back here, and die peacefully here one day. Sorry, you all are nice, but I don't want you to come banging in as I'm in the business of dying".
The probate was lost at this spiel, and started trying to quickly load the patient onto the stretcher. She paused for a moment, "wait a minute, young man, I need to grab my pocketbook." He was impatient, found the pocketbook quickly, and then hustled her onto the stretcher. By now the bleeding had finally slowed, so the urgency was less, but still the probate hurried her. I held up my hand for a second, and he paused. She was crying now, and softly told me "I love it her, all my kids live in the neighborhood, they don't farm like I used to, but they all have good jobs. Can I come back?" I held her hand for a moment, and reassured her that most likely she would be home before dark.
At that moment a massive figure appeared in the doorway. I instinctively ducked, for he had come in silently and I had no idea who he was. "MOM! How are you?" he gently called out, as he moved in to hold her hand. She turned to me, "this is my oldest son, and he comes over and cooks and cleans for me, allowing me to live her". He was gentle and carefully with her, and even tried to help us carry her out of the house. He reassured her that he would be at the hospital to pick her up "just as soon as I get some decent clothes on". We locked the door behind us, and gave her the key. When I climbed in the ambulance she was crying again. She caught my hand, pulled me close, and whispered around the tissues "Thank you for listening to me dear, I really do go on a bit about the house, but I'm getting older and if something kills me, let it kill me there". She patted my arm, smiled, and sat back.
Later in the day, I heard the ER got the bleeding to stop and sent her home in the care of her son. They commented on the care he takes of her, and her love for her family and her house.

He said "Uh Oh"

2009-01-31T10:28:00.004-08:00

He was young, way to young. 19 year olds are not supposed to be dead. Instead, he was supposed to be healthy, innocent, free, dreaming, imagining himself invincible. Now, he was tangled in a web of poor choices, poor decisions, bad rearing, inner-city crime, and violence that I couldn’t even begin to wrap my head around.
It was a horrible tragedy, never should have even begun. He had plans, dreams; he was going to escape the web that bound his entire family. He had scholarships, colleges, roommates, all lined up. An escape route planned, now thwarted by someone else’s twisted self.
I couldn't even begin to imagine the blasé attitude of those on the scene. To stand there and watch him get shot like that, by someone who was laughing. I couldn’t even begin to wrap my brain around it. Mom, siblings, girlfriend, friends; never stopped the other guy. In fact, they all initially helped make up a story about him shooting himself
EMS was called for “a guy not acting right”. Initially, he acted like he was drunk and high. Everybody else there was, so why not him? Except he didn’t smell like alcohol. Toxicity screens later proved, and 1 friend onscene said; he was totally sober. He had shown up at his childhood home, simply attempting to get in touch with his family, keep connected to his roots. They couldn’t stand the thought of him bettering himself, and shot him in the head. The poor EMS providers, they initially began trying to treat him as a drunk/high patient. Then, someone noticed the bullet hole in his head. Police were not even on the scene at the time. Then, the gunman scared them all by showing up and telling them what he had done while brandishing the gun. EMS quickly removed the patient and fled to the ambulance, while having to listen to the jeers and callous remarks of those who had stood there and watched the whole thing. PD soon arrived and dispersed the crowd so they could pull out and leave.
He was initially awake, but slightly confused. During the twelve minute transport, he quickly became unresponsive. I was the trauma nurse, me and me alone. Supposedly there were to be 2 of us, due to his condition. However, due to staffing, it was only me. Plus I had 4 other beds with sick, sick patients. Stressed already, my heart rate accelerated when I saw him; pale, thrashing, confused, mumbling. By the time we got him on our stretcher, be began posturing with his arms. He looked up, looked in my eyes and said “Uh oh”. Those were the last words he ever said, and I was the only one who heard them. Heard his last words as that bright, beautiful life was snuffed out in a senseless act of violence.
His eyes slowly rolled back as his limbs stiffened and then curled into posturing. Soon, they straightened out into even more ominous posturing. His BP sky rocketed, and his heart rate plummeted.
We worked as hard as we could, using all the resources we could. A second nurse stuck her head in, and was soon sucked into the activity.
We ran him to the CT scanner; while the neurosurgeon started scrubbing for the OR. I stood at his side, in a lead apron, and pushed Mannitol in as fast as I could while they scanned his head. Quickly, quickly we worked.
He briefly started to improved, then crashed again. Before we could get him to the OR (8 minutes door to OR), his heart rate plummeted again as his brain herniated.
The OR team was standing ready as we crashed through the doors. They were joking as they attempted to remove his skull fast enough to save him. It was all to no avail, he died on that table. He was spared the horror of a code due to the bullet in his brain. His CT looked like “brain mush” as one CT tech put it. Saving his heart wasn’t going to fix his brain problem. The OR team continued laughing, joking, as they cleaned up the mess.
I wanted to stop them, tell them of his last words, his dreams and aspirations, and the abrupt end of them. This was a talented, bright young man destined for brilliant success killed in senseless inner-city violence.
We called his Mom, who had watched him get shot. She said “another one dead?” totally apathetic. She never came to see him, and nobody else did either. We were the only spectators of the end of that bright, young life. We wheeled him down to the morgue, and left him there, alone, dead dreams crashing down around him. I was certain that if I stayed and listened, I could hear them slowly falling and crashing around his stretcher. Hear the cries and echoes of those who would never know of his brilliance, his friendship, his healing touch. For he had planned to be a doctor, he was headed to medical school. He had scholarships for all the way through.
Meanwhile, we went back to attempting to save those who did not want to be saved; leaving him, alone, dead-the one who wanted to live was gone.
It felt like such a failure, although we couldn’t have changed anything. Those words echoed and reechoed for days: “Uh oh,” “Uh oh,” “Uh oh,” words of desperation, words of hopelessness, words of one caught in a tangled web.

NREMT-P Coming to your town!!!

2009-01-01T15:10:00.004-08:00

I did it! I am officially an NREMT-Paramedic, and I have the card and patch to prove it!

I passed every one of my practical stations on the first try. I was still sick with mono, but I made it to the exam and passed every single station! I was proud of myself :)

I took the written exam 3 days later, and passed it with 82 questions in 45 minutes! The National Registry posted the results about 5 hours later on their web site. I wasn't expecting the results for several days, so it was a pleasant surprise to see it that day.

I received my card in the mail about 10 days later. I spent awhile jumping up and down and showing off my patch like an excited little kid :)

Now, I have sent off the stuff required to receive my state certification and am awaiting the card. I can't wait to start precepting at the rescue squad. I get so tired of sitting in the back and being unable to do the things I can do in the hospital. Last night, we joked about raiding the post office and grabbing the card so I could work a cardiac arrest that we were headed to. There were only 2 of us, and both were EMT-Basics, so it would have helped to be able to use my ACLS skills. Fortunately for the patient, the PD arrived before we did and found him merely intoxicated. He went to jail, and we were cancelled before we got to the scene.

Just for Laughs

2008-12-12T15:52:00.002-08:00

Today I went in to work for a few hours, the first time I had been back since the mono started. Lets just say it didn't go to well, and I won't be trying that again for awhile. I need to recover a bit more before I try that again!
However, while at work today I saw something that made me laugh. I work at a large academic center and frequently bump into, consult with, and care for patients of prestigious doctors. Today, I happened to look up and see on of our world renowned neurosurgeons and one of his fellows (also fairly well known) walking down the hall together. Actually, they weren't exactly walking, they were both quacking like ducks, flapping their arms, and chasing each other down the ER hallway. In front of patients, staff, and visitors! I turned to the nurse next to me and asked "is that Dr. S0-and-So quacking like a duck? She quickly assured me that it was indeed the prestigious neurosurgeon on his way to see another brain-injured patient. After a good, long laugh at the situation we both had to admit that he is one of the most cool doctors either one of us has ever been privileged to work with. His sense of humor never fades, and while he tolerates nothing less the than absolute best for his patients, he is always willing to go the extra mile and explain something or help out in any way. And yes, even willing to quack like a duck to make the work day less tedious!

Mono, Ugh

2008-12-07T21:40:00.004-08:00

Well, apparently I am not "just a little sick", unlike what I told everybody. Apparently I have mono. Let me just say this, MONO IS NOT NICE!!! I have been sick for a week already, and am feeling only a very tiny bit better. I hope to feel better son, as my National Registry Paramedic exam is on Saturday. What a way to study for it!

Sick

2008-12-06T20:04:00.003-08:00

My apologies to any readers I may have, as my posting has been rather non-existent lately. Between working, visiting family for Thanksgiving, and studying for my Paramedic National Registry Exam, I have been rather busy. Then, I got knocked off my feet this week by a horrendous cold/flu bug. Nasty fever, nasal congestion, sore throat, headache, and sore neck. This is day 4 of this bug, and I can actually lift my head off the pillow for about 15 minutes at a time. After 15 mins, I am totally exhausted and nap for awhile. I have actually called in to work sick for 2 days in a row. I have never called in sick before! I worked on a broken foot before, and insisted on a walking cast so I could keep working. But, today I decided that if I can't stay awake long enough to even drive there, I won't be doing them much good! This morning, it took me 3 hours to drink a cup of tea and eat a banana in between naps.
So, that's my excuse for not posting much lately! While I'm recovering, check out this guy's website: www.rayfowler.com Make sure to read his lecture notes on "Top 10 issues in EMS for 2009". He was one of the speakers at the EMS conference I attended, and this lecture was really insightful, and I have several thoughts on it that I will post at some later date. In the meantime, I hope you and your families are enjoying health, each other, and the holidays!

Home

2008-11-16T18:27:00.001-08:00

I just arrived home from a great and very educational EMS conference. I thoroughly enjoyed learning so much and talking with other EMS providers. I have many stories, including competing in a competition while there. However, right now I'm off to bed for a good long sleep.

CONGRATULATIONS TO ME!!!!!!

2008-11-10T10:35:00.002-08:00

YEAH!!!!! I have just (15 mins ago) completed my Paramedic program!!! I am now officially a Paramedic graduate!!! I am so excited!!! Now for a few days off, a fun EMS convention with friends, and then hit the books for some study for the NREMT.

Congratulations to me, Congratulations to me, (cue silly music and me dancing in front of my envious classmates)

4 beds...A day in my life

2008-11-02T17:12:00.005-08:00

A day in my life at work as an RN:

I thought I would share a quick snippet of a day with you all (whoever reads this, apparently I don't have a site meter? If someone would help me with that, I would appreciate it. However, I am not sure I actually have any readers).
Anywho, this is a picture of a moment in my day. A picture that changes constantly as patients come and go,and needs increase and are met.

Background: It was a busy day, 30 people waiting in the waiting room, all the hall beds full. We are short again, every nurse has 4 beds plus the hall beds. We had 1 tech for all 80 beds, so pretty much all he did was transport patients upstairs. Our acuity was through the roof, again, so all of us were running around, so nobody had much time to help each other.

So, with that background, here is a snapshot of my 4 beds:

Bed number 1:
Exceedingly cute little old lady (92 years old!) who lived by herself! Cute LOL daughter present as well. She had bilateral pulmonary embolisms, with one being a saddle emboli. She was fairly dyspenic, with saturations in the upper 80s on oxygen. She still needed more blood drawn, the resident wanted something or the other; and she needed report called to the step-down unit upstairs. Oh, and she kept having R on T phenomena that resulted in runs of V-tach without a pulse. Code cart was between her room and room 2.

Bed number 2:
Another cute little old lady with her partner of 60+ years by her bedside. You could feel the love between the 2 of them. He carried out her every wish, while she just held his hand and stared into his eyes with love. This LOL was extremely sick, with a dissecting aortic aneurysm from her aortic valve down to her renal arteries. She had come in with sudden onset of "ripping" chest pain radiating to her back. Classic for this presentation. She had a known small abd aortic aneurysm that was supposedly stable at 3.1 cm.. Today, she had an aneurysm measuring 7.5 cm down her entire aorta. She diminishing pulses in her left leg, and very poor perfusion throughout her body as it was shutting down to compensate. She also had a BP of 180/86 and the MD refused to lower it cause "I don't think this is acute". Herald a continuing argument with the MD to try and get this LOL some immediate help before she died. She also needed another EKG, some fluid, and some more blood drawn. Oh, and reassurance to that loving husband. When the surgeon finally showed up (he took his time since the ER MD told him this was "non acute"). When he finally showed up, she got immediate BP lowering, and rapid transfer to the OR to try and save her life.

Bed number 3:
Extremely obese patient who cannot walk due to a weight over 500 lbs. Seems while having a relationship with her husband (also over 400 lbs), she fell out of bed. He managed to avoid falling on her, how I will never know. She had some small lacs that the PA student was suturing, and some bruises that would heal. No broken bones, fortunately. Oh, and a extremely needy husband who would walk into my other patient's room to drag me out and ask about getting a taxi ride home. Before you flame me, I treated them with care and compassion. Also, being overweight myself I did not judge her for her weight.

Bed number 4:
Patient with Guillan-Barre syndrome after the flu vaccine. She came in with leg weakness that over the course of 4 hours spread to include the entire body. She became unable to swallow, and was developing respiratory failure by the time I transferred her upstairs. After much care and time from me, the annoying judgemental PA who works with the hospitalist team comes to see her and write admission orders. The PA decides that this presentation "is entirely psychosomatic and she just needs to get over it. Please feed her now with a full diet. I am calling the shrink, and she needs a regular bed (not even with tele!) and cancel the ICU bed". Herald another argument with her, and a call to the attending in charge of the hospitalist team that day. The attending comes to see her eventually. Meanwhile, I am getting chewed out for not feeding this lady, not insisting she walk to the bathroom, and continuing to place the foley against the PAs orders (but with the ER MD's orders). Finally, the attending shows up and concurs with the Guillian-Barre diagnosis. She goes back to being headed to the ICU, gets immediately placed NPO (just like I did! sorry, miss PA!), she gets a central line, respiratory gets called, placed on Bipap, etc, etc. She got intubated shortly after arriving in the ICU. She also had a million things that needed doing and several family members who needed help understanding the rapidly changing care plan.
(also, before you flame me, I love PAs. Most are excellent care providers, and I am excited to see them show up as they are often better than the residents. However, this one new one needs to learn a few things before being let loose on her own).

So, that is a moment out of my day. I generally love my job, but it sure can get challenging sometimes!

Strange

2008-11-02T17:10:00.002-08:00

Today I cared for a elderly women who had a history of both a frontal lobotomy and a circumcision. I don't see either one of those very often, so it was wierd...

CPR fun

2008-11-01T17:56:00.004-07:00

This story just goes to illustrate the twisted sense of humor ER nurses and Medics develop. When you do this job day in and day out, dealing with people's lives day after day; you find you either have to laugh or cry. Most of us choose to laugh, not at the patients; but as a way to cope with what we see everyday.

Today, had a very septic patient come in. Initially somewhat responsive, verbalized a few words. We RSI her, intubate, and start the septic workup; central line (her veins were horrible), foley, EKG, labs, pressors, fluids, antibiotics, NG tube; etc and etc. While the doctor was using the ultrasound to find the femoral vein for the central line (horrible veins!), she lost her pulse. We initiated CPR, and ACLS, and etc and etc. We ended up coding her for an hour and a half before her family said "enough" and we finally let her die.

During that hour and a half of CPR, we got bored with just compressing and started trying to outdo each other with the quality of our compressions. We do not have capnography in our ER, so we were going by pulse and BP. This was a little old lady, and amazingly we were able to measure a BP during compressions. So, what do the bunch of twisted ER nurses and medics do? We started a competition to see who could perform the most effective CPR.

I am proud to say that I won. I was able to compress effectively enough to generate a radial pulse and a BP of 175/106. I was pretty impressed with myself! In the hospital, I don't generally do compressions since we are so short staffed. Most times, I am running around defibrillating, medicating, etc; while the techs do their awesome work and do the CPR. Today, we actually had some free nurses and not many techs. So, we all stepped up to the plate and did our turn. I am pleased to report that I can still perform effective CPR without tiring too much.

Too Young

2008-10-29T22:36:00.003-07:00

So, the past few weeks at work have been rather rough. Usually patients don't bother me, but I have had a string of patients who have, for one reason or the other, gotten underneath that tough skin and bothered me. Here is the rough version I wrote late one night about one patient that bothered me. Warning: for tough stomachs only, this is not pretty. This was a 17 year old suicide patient, I was the paramedic student who declared her dead on scene from hanging herself. She was a frequent at my ER before she killed herself.

I didn't even learn her name, but I knew her. Knew her from previous despair-laden visits. Knew her from desperate cries for help before it got to late. Now, it was just to late. Too late to make a difference, to late to change anything. I didn't go to school to learn how pronounce 17 year olds dead, I went to school to learn how to keep them alive. Now, all I can do is comfort Mom, right after I told her the light of her eyes was dead. Dead despite her excellent CPR, dead despite all the attempts to keep her despair in check. Dead, even despite all I could do. It felt like total, utter defeat to walk away. Defeat that said despite all my training, I really can't change the end. I am powerless before something so much bigger than me. The decision was made, and I could do nothing to change it. Her hair flowed away from her head, making ripples on the cold, hard concrete floor. It was black, dyed to have red highlights. It was full of life, full, luscious, it would have bounced against her head as she ran in the sunlight, laughing, playing. Which is where she should have been, dancing, laughing, chasing and being chased. Out in the sunlight, the dawn of her life; not locked in some cold basement hanging from the rafters, despair so thick it engulfed her until she couldn't take it anymore. She had marks on her, repeated marks, marks that told the story of many other despair filled, dark days. Days where she couldn't face the sunlight, couldn't face the joy; but instead locked her self into her despair. Days where the only release from the pain was to hurt herself. Marks hidden well away from prying eyes, the inside of her arms, her upper belly. Marks calculated to hurt, to mutilate, to release the pain; but not to kill. I remembered the marks, remembered trying to get someone to help her. Remembered seeing those marks as the signs of something far deeper. Remembered thinking that if she doesn't get any help, someday it will be more than marks. I just never imagined it would be in front of me. I never imagined I would see the full depth of her pain released in such raw agony in front of me. The green rope was still hanging from the rafters, tattered where it had been severed in haste by a despair-laden Mother. The other piece was underneath, also tattered where that same Mother desperately tore it from around her lovely daughter's neck. Her chest was indented, where that Mother had done such excellent CPR. A desperate effort to save the pride of her life from her ultimate despair. Her tears mingled with her daughters on that face as Mother struggled and tried so hard to save her life. There was a sister, a sister in almost the same shape. The same marks on her arms, the same despair-laden face, the same drab clothes. The difference was it wasn't yet to late to save the sister. Screams echoed throughout the massive house. The screams of a sister recognizing how the despair ate her up. The screams of despair, of hopelessness. The officers stood in silent attention all down the hall way, Witnesses to the destruction of a young life. Silent senitals ensuring we had a way out if something happened. Silent recorders of all that was transpiring, and researchers of what had transpired. The only evidence of emotion was in their eyes, the tortured expressions written there. They to, did not train for this, they trained to try to save before this, before the destruction. The house was massive, beautiful. Furnished with everything a teenage girl could desire. Beside the rope were hanging enough sports equipment for a gym. And yet, obviously something went wrong somewhere. We can only speculate, reminisce about the times we tried. Try to remember what we could have done differently, what might have changed this horrible outcome. Remember how hard we worked, remember how we tried for her, tried to help her. And that is perhaps all that matters. I tried. I tried my best. I tried my best several times. I can't change the entire system. I can't change what was done. I can't change the outcome. But, I can try to change the person, one moment at a time, one try at a time, one smile, one touch at a time. I tried, and I succeeded in doing my best.

Craziness

2008-10-28T10:24:00.004-07:00

So, to my dear friends and family; here is why I haven't returned your phone calls, met you for lunch, or otherwise communicated since March. Here is a typical week in my life:

Friday:
Up early at 0700 for duty at the rescue squad
1000: PT for my broken ankle, learn I may not get the walking boot/cast thing off for awhile yet
1200: Dentist appointment, I don't want my teeth to become like my patients teeth :)
On the way home, stop by the mechanics and learn that my car needs $3000 of repairs
Spend the afternoon studying, and writing a paper
1900: Start my work week, work in the ER of the trauma center for 12 hours

Saturday:
0700: finished with work day (night), What a night! Sometimes this place actually resembles the TV show ER. Sumdood was really busy shooting and stabbing people last night...Oh, and beating up the occasional person. Throw in a code and a couple MIs and you have my night. Plus, we were extremely short staffed. Being up for 24 hours straight is hard on my body!
0800: home at last, that hour drive is really hard when I'm this tired. Now, for some dishes and housecleaning before I shower and fall into bed for 5 hours.
1900: at work again, try to smile but fail miserably when I learn we have only SIX (6!!!) nurses for all 80 of our beds. 9 doctors, 3 PAs, and an NP, but only SIX!!!!! nurses. I just hope to make it through tonight without killing someone! Does anybody wonder why I'm looking for a new job? Plus, my ankle really, really hurts tonight. The Tylenol just isn't cutting it anymore. Why can't I take even Motrin for my broken ankle, dear doctor? I know the research studies, but right now I don't care! I am walking and working on the broken, torn mess I call an ankle, you could at least let me take Motrin!

Sunday:
0730: Off work finally. What a night!!! I had 4 beds, plus the 2 trauma rooms to care for. I am crying as I leave work, I so want to be a good nurse and all I can do at work is run around and pray nobody dies because we don't have any staff. My GSW to the head made it to the OR, but shook me up a bit. He was exactly the same age as me, born on the same day. How in the world is he shot in the head, upstairs in the OR right now getting the bullet taken out? Other than that, a couple of cases of DKA, a massive subarchnoid that was transferred to us, a leaking triple A, a ruptured spleen with a BP of 29/19 upon arrival, and more made up my night. There are 60 people in the waiting room at 0700 this am, some have been waiting for 11 hours to get a room.
0800: Out to breakfast with some good co-workers. They have a few beers, I have some coffee to get me home awake and alive
0930: Home, didn't quite fall asleep behind the wheel. Housecleaning again, than to bed.
1900: Back at work, I cried coming in tonight. Fortunately, our numbers are better than last night, we actually have 9 nurses for 80 ER beds.

Monday:
0700: Off work on time. Last night was better but still busy. The RT said we intubated 8 people in less than 90 minutes time. People are sick, sick, sick lately. I don't think I saw one person who wasn't truly sick.
0800: Home, shower, bed for 4 hours to try to sleep, but the pain in my ankle is so bad I don't get much sleep
1230: Up, try to be awake, I have to swap to dayshift now so I try to sleep only a little on Mondays
Study for awhile
1430: PT for my ankle again. The fall at work on Saturday night did nothing to assist it in healing.
1500: Decide I should cook something for the week, might as well attempt at being healthy. I decide on spaghetti and while it cooks I fall asleep on the couch and burn it. Oh well, I can say that I tried!
Study all afternoon
2100: To the rescue squad for duty group tonight. Check off the truck and immediately get several back to back calls. Most did not need an ambulance, but the cardiac patient and the drunk dude did. You have to love running rescue in a college town, BAC of .44 in a 19 year old does not help him remember to breath!
0350: Finally get to make my bunk bed and fall into it.

Tuesday:
0600: Up after 2 hours of sleep. Hey, I got some sleep!
Home for a quick shower, change of clothes, and right back out the door 30 minutes later.
0800: Clinicals start in a town over an hour away. These are my paramedic clinicals so I have to look bright, shiny, smiley, and competent. Not happening today, in fact as I look down I remember that I forgot to polish my boots. Oh well... The medic today is really nice and helpful, he knows me from the ER and is very understanding of my exhaustion. He gives me a break on my skills, and trusts me on the calls. Cool!
2000: Off for the day, headed home
2100: Home, study for several hours for my big test tomorrow. Complete my paperwork that's due tomorrow.
0100: Shower, bed for a few hours

Wednesday:
0700: Get up, glad to finally get 6 hours sleep!
0800: Leave for class
0900-1400: Class, big test that I do well on.
1400-1700: Stay at school, not worth driving 2 hours to be home for 1 hour, study hard
1700-2200: Second class, another test that I pass, not as well as the first one, but I pass
2300: Home, finally. Time to do laundry, polish my boots, and find that pesky stethoscope for tomorrow.
0100: Shower, collapse in bed

Thursday:
0600: Out of bed, get ready for clinicals again. I can't keep my eyes open this am
0700: Stop and get gas, I am so tired that I buy not just my 24 oz coffee, but a liter of Mountain Dew as well.
0800: Clean, and wrinkle free I arrive at my clinical site. I try to smile, but that is hard when you are this tired. The medic is nice, and I answer his questions fairly intelligently. He is complementing me when he finally recognizes me for the ER nurse I am. Something about my walking cast being rather distinctive, I am apparently known as the RN/Paramedic student who wears a cast :) So, my preceptor then immediately ups the questions a level, and I still get them right. Yeah, score one for me! I successfully run several challenging ALS calls, including a nice MVC with a head injury, an unconscious person, and a "man down", who had gotten beat up by sumdood and was rather injured. I walk away exhausted, but I learned many things today and I feel more confident about being a medic.

Friday:
I start all over again, up early and stay up for 25 hours straight. You have to love my life!!

So, this is why I haven't returned your calls, or even acknowledged that you live. All I can think about is sleep these days. That, and passing this school so I don't have to do this anymore!!

New

2008-10-27T12:07:00.007-07:00

OK, folks, I'm new here. Actually, only new to posting as I have been lurking for about 5 years now. Yep, I lurked at Emergiblog long before Kim had her own spot. (Hey Kim, was I one of the original lurkers? I don't remember exactly when I found you, but I do remember reading all your archives in under an hour). I have been reading AD for...Oh, I don't remember how long, but a long time. I also read all his archives in under an hour, at that time. I have also read Peter at Street Watch for years, John at Disappearing John since before he was nurse, Student Nurse Jack since before she started nursing school, and many others over the years.
I have only commented sporadically, and always as "anonymous". I would like to change that now, if I can.
However, you folks be warned, I am NOT a women with tons of time on her hands. I work full time, attend school full time, and volunteer with the local rescue squad over 100 hours a month. I will be posting, I promise, just don't expect to much from one women! I occasionally need an hour or so of sleep...
Oh, and I wish to remain as anonymous as I can, so if any of you folks know me, please DO NOT give out my real identity. Thanks in advance!

Grumpy? or Misunderstood?

2008-10-27T11:31:00.003-07:00

She had loud, insistent voice; despite her low oxygen levels and labored breathing. "You will not stick me again, I won't have it!!" Her voice grew shriller as she restated the phrase.
I drew a long, deep breath and sent a quick prayer for patience. I replied sweetly "OK, I have personal policy of only sticking people twice and if I don't get the IV after that, I find someone else to do it." I refrained from adding onto the end of it "But, I'm the person they come find for their hard IV sticks"; although I really wanted to say it.
As I was cleaning up the large amount of trash I had generated, I took a moment to ask her kindly; "Is there anything else I can do or get for you while I'm in here?". I find this phrase often helps prevent repeated trips to the same room for trivial things. She glanced up at me and for the first time I noticed how baby blue her eyes were and how well they went with her wavy light brown hair. I inwardly kicked myself for not even noticing the PATIENT before. Oh, I knew what brought her in; I knew her vital signs, I even knew her lung sounds better than I knew her face.
Now, when I looked at her; I could see the frustration and the exhaustion etched across her face. She had many, many chronic lung problems out of no fault of her own. She hadn't smoked, had taken reasonable care of herself and yet, here she was again with her 5th ER visit in 4 months. She didn't come in until she was really, really sick. In fact, last time she ended up intubated for awhile. This time, she finally called 911 when she no longer had enough breath to tell the dispatcher where she lived. Her neighbor did that for her. She had improved and stabilized quickly with some albuterol, oxygen, and steroids.
She started crying, small tears rolling down her cheeks etched with wrinkles from years of living. "I have been using my home nebulizer 5 or 6 times a day, plus all my medications on time, plus my inhaler; and I still don't get any better!!" "I have a little granddaughter, she's 2, and a brand new grandson; and all I want is to grow old normally and be able to play with them! I can't even walk into their house right now, much less get down on the floor and play with them."
She had been demanding from the moment she could talk, "Get me another blanket", "Don't keep on sticking me", "I'm not a pincushion", "I hate that heart monitor", "Please fix the swelling in my feet", "Adjust the bed for me", "I hate that person, why does she keep calling my phone?" and on and on. Frankly, I was extremely busy, and my co-worker was too (a new RN just off orientation), her patient kept having runs of v-tach and I was needed elsewhere. But, I hadn't taken the time to truly see the PERSON lying in front of me.
I slowly took off my gloves and straightened the bed for her. I squatted beside the bed to retrieve things from the floor (don't ever kneel on ER floors, that's too gross to think about). As I did so, I looked into her eyes and truly listened to her.
She didn't talk for long, but just long enough to let me hear the cry of her heart; a heart saddled and held down by years of chronic illness. "I know I won't be perfect, but I want to stay at my good, and not keep getting bad and coming in here", tears kept rolling down her cheeks. It didn't take long and the tears stopped, and she looked up. "Thanks for staying and listening, nobody ever does, they are all too busy" she said, dabbing her eyes with a Kleenex.
She asked for another blanket, the bed to be adjusted, the lights dimmed, and some ice chips. I found all those things quickly for her, and got another nurse to come try the IV. He is a massive fellow with long, curly brown hair. He walked in and before I could have opened my supplies, he already had an IV in. It was small, but it worked. He smiled at her, said a few kind words, and walked out.
As I adjusted the bed for her, she spoke up again; "thanks for seeing ME, most people only try to fix me without seeing ME under here."
I was smitten, I had done the exact same thing. I had seen her illness, tried to fix it; but had not noticed her under there. Had not noticed that her demands were really a way to try to get attention onto her and off the illness. Had not noticed the very real human soul struggling with being sick again. Had not seen her eyes pleading for some love and attention for HER, not her illness.
Funny thing was, after I took the time to listen to her; she was a new patient. She didn't once call out, didn't ring her light; did just what we asked. Her soul's request for someone to see her had been fulfilled, and she was satisfied. She kept thanking us for seeing her underneath the layers of illness.