nurse moxie

Things I Mostly Like

March 18, 2010
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First things first. IVF got me pregnant. I am almost 11 weeeks. This is fantastic and we are beyond thrilled. I have never been so incredibly in awe of the human body (However, that does not mean I will not be signing up for labor/delivery or OB nursing anytime soon. I’m not that awed). Also medical science. I mean, I saw a picture of my baby (ie blastocyst, to be technical) before the stuck it back in me. How amazing is that!?! That was not available 50 years ago. I am so grateful this technology gets to help people who would have been childless go on to become parents (some of time) and I am ever so grateful that it worked for us.

That being said, we will never be repeating the process. Mainly because how incredibly sick it made me. And I know I shall look back at this time when it is over and be like; well, I got through it and look; our baby! But now, it just sucks.

OHSS, borderline hyperemesis, horrid constipation, this kid is really making me work. I can’t wait to have my first moment as a parent where I look back and think of all the time I spent puking at work, having paracentses (is that a word? I had more than one paracentesis) only to have our kid yell about how much he hates me because I won’t let him play with scissors or set his hair on fire.

Anyways, I’m grateful, but being a nurse at this time is rough. Tons of pregnant nurses do this, and I keep telling myself that, but damn, it’s hard. I feel like a whiny baby, but for reals, it’s hard. My coworkers are very helpful (mostly) so I have lucked out there, but between school and work and now a new job, it’s been, well, a ride.

I’ve chosen to take a registry position at the hospital I thought I was going to work at after I graduated. I cut my hours in my current job (still benefitted) but will be making my pay with a different gig. I always thought it would come down to this eventually, since I like a change-up in nursing and I’m excited, but it sucks the opportunity is just throwing itself out during finals week. But I really want to do this. I can work in higher acuity areas and I get to have more autonomy than I do now, and I want that experience, especially for the future. I don’t know how long I’m gonna do it or how long the job will last, but I’m going to give it my best shot to get the most out of it and make it work.

I don’t know what my life will be like as a mom (other than the usual incredibly hard things about being a parent) but I’m glad I get the opportunity to find out. October can’t come fast enough.


One Year In

December 27, 2009
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I’ve been thinking a lot about death lately, as I usually do. As I mentioned previously, I see a lot of death where I work. Most happen to be the of the “going gently into the good night” kind, but I’ve had my fair share of trying to save people from death’s door since I started as nurse almost a year ago. In that department, I haven’t had too many miraculous saves, I’m sad to admit. And the ones that went on a bit longer, made me really think about all this technology and resources we use to keep people alive. Being in the mix really makes you think (here’s something interesting on it from the NY Times).

My friends and family and some acquaintances pepper me with questions about this aspect of my job, more so than any other. People do not want to confront their own mortality and since I confront other people’s on a day-to-day basis, it must be depressing, no? People are not made to watch that kind of suffering right? How can I stand it? And the truth is, I can stand it more than I did a year ago, for better or worse. Do I feel horrible when I lose a patient I care for, especially ones that I have cultivated long relationships in treatment? For sure. I’m human. I’m not above crying with a family or saying goodbye with them.

But here’s this thing that I do; I don’t take it home with me. I’ve been able to kind of cultivate my own survival technique by leaving my relationships at the hospital. I don’t attend funerals or wakes or sit shivas. This would be too much. Many nurses I work with can do that sort of thing, and they can deal with it. I know my limits. I see far to many unfair situations at work where I just want to scream for these patients, the cruel tricks that disease and life plays on them sometimes. To watch hope and promise drift away as disease progresses and treatment options become vexed. There are no words, little comfort you can really give to the patients and their families then. Sometimes pain killers, sometimes education, most times nothing.

But this not to say that I find my job depressing as a nurse. This past year I’ve gone through a lot of changes and transitions. More than any other profession I have held, I am pretty much thorough defined by being a nurse. This is both confusing and amazing to me. I’ve never been much of an authority on anything in my life, and now my friends look to me to help them answer questions about medication and changing their c-section bandages. I walked two friends through birth in the last year (and I’m not even and ob nurse) and held my friend’s mother hand as she died from her battle with cancer. In what other job could I see a complete cycle of life like the ones laid out before me like they have this year? Not many, I tell you.

This also affords me the unique position of being eternally grateful for the things I have. Never before have I been confronted with so many misfortunes/horrible circumstances/bad life decisions than when I go to work every day. My life’s hardships pale in comparison. So what if I’m infertile? At least I’m not staring down an oncologist telling me that I have stage IV anything.

Do I feel I make a difference in people’s lives? Sometimes, whether they like it or not. I certainly didn’t start out doing it for the thank yous. Sometimes one comes my way, and I relish it when it does.

After a year in, this is still what’s happening with me:
1. Mistakes. I guess I may continue to make these my entire life from what I’m told.
2. Learning: Mostly from said mistakes, but in other ways too; from other RNs, from school, from patients and their families.
3. Taking it Personal: This happens less; but I’m only human.
4. Loving my job.


New Resolution

November 23, 2009
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Today I’m going to start living my life by the messages in the Dove chocolate wrappers. So today, I ate five and they all said (the same thing! What a coincidence!) that happiness is its own reward. So I guess that means I will watch Stark Trek a bunch of times today and then blow off my research paper for pathophysiology. Because that will make me very happy. And I then will feel rewarded.

I rocked my chemotherapy recertification despite the fact the hospital kept scheduling the review classes at 8am immediately after I worked the night before. I was so very proud of myself that I remember most of it.

Also, it’s good to have nursey friends when you need to get shots in the ass.

That is all.


Clomid is…

November 18, 2009
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Effing me up.

Case in point: Not only am I watching Sisterhood of the Traveling Pants 2, it is making me cry.


Moonlighting

November 10, 2009
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To complete the continuum of oncology nursing I provide, I have started moonlighting as a hospice nurse. It is possibly one of the most worthwhile things I have decided to do since getting my license. People constantly say things to me like “how can you stand it?” “isn’t so sad?” “aren’t you just depressed all the time?” and my answers are no, no and yes (but not because of the nursing I’m doing, it’s because I am infertile and it’s kind of permeating everything I’m doing nowadays). Many of my patients move from active oncology treatment, to palliative care and then to hospice, should their treatment options become exhausted. And now I can follow them on their journeys. I consider myself privileged to do this. And when my patients pass on, I am so relieved that they have found peace, even if their loved ones are experiencing pain that I can do nothing to ease. But I am relishing this time in my new role. It is helping me feel better about my life now, oddly. A fellow nurse and myself are studying for our hospice certification. I’m hoping by next summer I can also be oncology certified if I stay at my current position.

More studying. Yay.


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Hard Decisions

November 9, 2009
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So, I was talking about hard(ish) decisions the last time I was rambling on. Here’s our first one:

Should we spend $790 on an IUI cycle (of our own money, no insurance yet) or spend that money on:
A) Christmas
B) Property tax bill
C) Car repair
D) Save it for something catastrophic

We are now officially onto the part of our lives entitled “How Bad to Do Want a Baby.” We will have new insurance coverage starting either January or March. My husband wants us to do Clomid and natural trying on our own until our new insurance kicks in. My RE says that she doesn’t feel that Clomid alone with help us, but doesn’t rule out the possibility of it happening with Clomid (of course). She feels we will be wasting time until we start with invasive treatment, because by then I will be 34. She wants us to have as many tries as possible with IVF before I turn 35.

I also had been feeling like I could be pregnant this month. But all BFN on early testing.

I have no idea what we should do.


Redo

November 3, 2009
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How did I end up here?

I’m thinking back my early college days with my husband (we’ve been together eleven years – can you believe it? I can barely most days). Young and in love, living together. You get the idea. My only thoughts about babymaking was how to avoid it altogether. And we did a good job. I was on the pill – I had been since I was fifteen. But right around the time I was to graduate, I started feeling really nauseated and sick all the time. I was throwing up, having horrible headaches, sore chest. I could not figure out why. So of course I saw my doctor and we surmised it was because of birth control. So I tried a three or four different birth control pills (there weren’t as many options as there were now, no rings or patches or implants) and they all made me feel the same way. So we figured it my body reacting to the hormones. Sometimes it happens, my doctor said. Your body just says no more, you react differently after things go along swimmingly. So no skin of my back. We went the non-hormonal route.

And it worked for all these years. No real scares, even though it seems like every after school special would start out with our exact situation. But we put things on the back burner. We both went back to school late. We had contemplated trying during my last few months of nursing school, but I was afraid to get pregnant right into my job. I have always had regular cycles, most 28 days. I thought once we got into it, it would be fine. Maybe a few months, but we’d get pregnant. After all, we’ve been doing this for eleven years. We should nail this, right?

Well, here we are, many months later, no sign of a baby. I went from being relaxed, to mildly concerned to full on panicked. I went from Taking Charge of Your Fertility and peeing on sticks to your basic fertility workup to clomid in about a year and a half. Because I am thirty-three. And in the words of my reproductive endocrinologist, “not getting any younger” (Uh duh, thanks for the update). And there was a point I can clearly remember in my ob-gyn’s office about a year ago where I thought I would not be able to handle an infertility journey. I remember looking at a Mirena ad and thinking about the irony.

Now I think we’re on that journey. And I am not a person that is handling it very well. I try to remain hopeful, but realistically I know that my husband and I will have to be making some hard decisions, searching to see how far we want to take along this path. It is lonely and isolating much of the time, and physically draining. It is hard to explain to people who don’t know the road.

But at the same time I need to embrace the unpredictability of life. As I read other’s journals and stories on their paths to children (and no children, sometimes) I realize I could get knocked up by IUIs, IVFs or if the universe is really feeling funny, the good old sex that is currently not working for us at any point.

But I’m going to just focus on the old Al-Anon saying of one day at a time for a while.

And I just want to take the time to say that my November work schedule is stupid and depressing.


You Can Go Back Again

August 25, 2009
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So I am sitting at a desk in a dorm room the same school I started my undergraduate career at 15 years ago writing this blog entry. It’s an eerie feeling, I’ll tell you what. I’m trying to remember my first night of college away from my family and I’m having a hard time remembering it, to tell you the truth. I would like to have said I was so happy to be here, but I think in reality I was really sad. I didn’t really know anyone here at the that time, my roommate mainly spoke Chinese (I went through like 7 different roommates my first year of school I think) so I hadn’t really connected with anyone yet. I was in a tiny, tiny town in the middle of the Christian right having lived in a large liberal city for all of my life. I was discombobulated to say the least. But all of my other friends went away to schools that were large, fun, expensive. I didn’t have much money. I picked the school because it was the cheapest I had gotten into. And I was so sure I had to go away. Everyone in my class did, so off I went.

And I felt alone when I got here. Like I do now. I’ll be home in a couple of days and I won’t have to be back on campus for the rest of the program, but I miss my husband because we have a hard enough time seeing each other as it is. I’m the only person in my program that doesn’t have kids again. And it sucks because we’re trying desperately to have them. And our insurance won’t pay for infertility treatment. Ha! Gotta love that one. That fact makes me feel a little lonely again too. It makes me wish I knew someone so I could get a drink or something. Instead I’m here. Typing away listening to the girls above me giggle and laugh on the first night of school of the new semester like I didn’t do lo those many years ago.

But beyond that, I’m excited to be a part of the program (it’s newish – they didn’t have nursing as an undergrad option back when I went) and to be back working on nursing. I want to know more. I think it may help my mindset these days. Work has been very hard lately. It took a good vent session on the phone with a friend and nice bit of reflection here alone in a cornfield to make me realize it’s not nursing work that gets me down, it’s all this other minutiae that takes away from it that drives me nuts, and it’s also my personality to a large extent of what’s making it very difficult for me right now. And I have to come to terms with it, because that’s nursing, and that’s everywhere in every job. And as far as myself goes, I realize I just need to juggle other things and other jobs because I’m that type of a personality. It keeps me from feeling this way. It’s my distraction. I’m not used to having one job only. I thought it would be so awesome for me, but instead I think it’s boxing me in and making me crazy. So I’m hoping to get a registry position or something to help break that up. And to keep with school and do a little art when I can.

I was thinking about this blog a lot too. Because I do like it but obviously I don’t do it so regularly anymore. I never really write any patient stories here and of course the things I have written that correspond to patientsĀ  or anything patients have said is totally fake and made up so as not to violate HIPPA, but still this being out there is making me super paranoid. It would not take much effort to connect me the person to this blog, and although I feel like I haven’t really written anything negative about patients or my employer, well the way the world works makes me think long and hard about it. Besides I feel like only two people in the world really read it, and I have their phone numbers so I can probably just tell them about my life.

But on the other hand I read a lot of medical/nursing blogs and I find it so helpful to have those voices out there. It definitely helped me in nursing school to know I was not the only one taking the crazy pills. But these things can be misconstrued completely. That is the climate right now. So I’m up in the air if I will vent, continue blogging, or turn this whole thing into a rant on how much I hate my insurance company right now and about how much AT&T sucks. But I’m sure there are better blogs out there that address those topics. So I guess I have to think on it some more.


Six Months, Really?

June 12, 2009
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And when I say really, I mean…really.

I feel the six month mark. In my body I feel it. Physically I’ve been kicked, I’ve been bit, sucker punched. I’ve moved 500lb+ patients, dead people, people kicking and screaming, wailing patients who don’t want MRIs, coding patients failing about, and agitated patients in drug withdrawls. I’ve run around like a chicken with my head cut off, passing meds, dropping NGs, putting in foleys, starting IVs, talking to patients families on the unit and on the phone, getting in doc phone calls before 10p if possible, troubleshooting tele hookups, drips, PCAs, trying to find meds, and starting TPN (usually all between the hours of 7p-11p, when I first start shift).

In my mind I feel it too…I’m starting to find my groove a little practice wise. Got my routine (which would probably never work for anyone else) down more, my bad days aren’t so devastating, and I have gotten quite adept at trying to wrap my head around all my patients disease processes. Don’t get me wrong, I still get stumped and I still ask for help. I don’t see that ever stopping. But things like cancer treatment phases and chemo cycles and internal radiation implants are no longer textbook concepts for me. I know what to watch for, what to do if things go wrong. Am I perfect? No. But I do a lot better with it. I will say I still suck at not knowing phone numbers. I know the important ones but the respiratory pager that switches hands like five times overnight always drives me batty and I think I still constantly drive everyone nuts asking for it over and over again.

For awhile I was constantly overcome with classes and tests and certifications for work, but I’m through that now. So I decided to go back to school in September, starting an RN-BSN-MSN program locally. I really had wanted to give myself some more time and experience on the floor, but with the economy being so bad I’m afraid my hospital will yank their awesome school reimbursement from us. So I want to get in as soon as I can and use it before I lose it, so to speak. But anyways, I’m looking forward to it. I need like 47 things to juggle and bitch about it, because that’s how I am. That’s how I know I’m alive.

I can remember first starting and just feeling like I was constantly being hit with a mack truck and wishing it was a year from now so I could have experience not feel everything I was feeling. I’m halfway there. I’ll keep you posted if I have some sort of piece of mind about it then, but I’m not holding my breath.

Anyways, she has a much better six month mark wrap up. Per usual.


Posted in Nursing Work

On My Own

March 17, 2009
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Tonight is my last night of “preceptorship” although I have pretty much been on my own for the past three weeks. I theoretically always have my preceptor as a backup, but I’ve been making an ass out of myself and learning to get out of my messes and mistakes pretty much by myself this whole time.

Some nights I’m really sure that I will never be able to do this myself. Other nights I think can – almost. I was woefully under prepared by school for this stuff most days. But I am not alone in that thought judging by every other new nurse I’ve talked to about it. There are some things that I do as a nurse that makes my stomach turn inside, but it’s part of the job and I have no choice. Everybody has that too, so I’llĀ  learn to deal with it somehow.

There is a real part of me that thinks once I have some experience under my belt I will need to find another nursing job. I think maybe two jobs part time may be the way to go. I can see myself getting burned out on this floor after awhile, but after talking to some of my new grad friends, it seems like that’s kinda what people are feeling. I guess just like anything, I’m constantly in search of jobs and what to compare them to. I realize the grass is not always greener, but I am just one of those people that needs the change up in life. I still have my design job, but I give so little time to it now, that I wonder how I would ever have the time to do more than what I’m doing now.

I had a really nice stretch of six days off, but unfortunately I spent most of them on my back due to the fact that I happened to throw it out on my last outing at work moving a rather large patient. My mom made me some cupcakes for me and left them out on the coffee table, and since I pretty much camped out on my super uncomfortable couch doped up on vicodin, that’s all I ate for like, days. Now I am facing going back to work tonight and am praying that patient is gone. Somehow I doubt it, but a girl can dream.


Posted in Nursing Work
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