Guilt

Why do I feel guilty when I want to do something for me? Why is it that I have to do one thousand other things before I can feel ability to do one thing that I want to do? Why is it that I have to feel that all the ducks are lined up in a complete row before it's okay for me to do something that I might want to do that is out of my ordinary routine or something that might put me in a "nirvana" state of mind?

I have grown so tired of looking for tools to do the things I need to do before I do the desired tasks. I have grown tired of looking for the shovel before I can shovel the shit to get it out of my way so I can do something; only to find that the shit I shoveled stinks and I have to wash that down with soap just to be in the same universe as the smell. I am not sure how much longer I can take being this "person" who fixes all wrongs and makes the world a better place to walk. I have grown very weary.

Lately, while I have been driving from here or there, I've been dreaming what it would be like to just take off and see where my gas tank will leave me stranded and then see how far it is I can go with just my feet. I have been dreaming about how just walking out into the spance of nowhere sounds so much better than being here to shovel shit and make it smell nice.

Will I dare venture out into the unknown or will I forever remain behind the door that is my home? What is both comforting and unsettling is that I know the answer before I even ask it. I shall remain home behind the door of home and settle for what this house dishes out because I know that the grass is rarely greener on the other side.

I keep thinking of a Bob Dylan line that tells me to "strengthen the things that remain." The things I have before me are truly the things that I love, they are my reason to continue to do what I do; they are even my reason for me to cry behind these words. I can't shake them, nor do I want to. What I want is time for me. Is that too much to ask or should I give unceasingly never asking for what I want? What is it I want? I want time. Time is something you take, it is not something given. "Take the Time." How can I take something that is not mine; is that not stealing? "Steal a few moments for yourself." Is that not a selfish thing to do?

For the first time in a long time I have stopped what I was doing and sat down to write what was on my mind NOW. I am tired. I am weary.

Por la amor de Rios

While at work today I had the opportunity to sit for about 30 minutes with a person I consider a good friend. In fact, she's the only one at work who really knows that I write this blog or even how passionate I am about writing in general. Our conversation started of in generalities as she told me about her sister and how she wishes she had an outlet like I have in my writing. It was just an off the cuff remark which led to other remarks which led to tears.

This woman was sharing something with me that was very personal to her. She was allowing me inside to feel something she carries that she hides from most everyone. I was touched, deeply and gratefully touched that this person would share something with me that was so intimate to her.

Nope, I'm not going to share it with all of you, but I will share my reaction. I wanted to hold her in my arms and tell her all would be okay, but unfortunately time marches on and things change as do we and the ones we love; so my words would have been a lie and I would never want to do that to her. I don't want our relationship to be so superficial that all I can say is "it will be okay."
I didn't know what to say to her, but I did understand, in my own way, what she was going through and how it impacts her life.

I will tell her now, in these words, that although life is not forever it is all that we have. If you could choose to spend one hour with those you love or an eternity with those you don't.....which would you choose?

Hey......that's not her job

I can't tell you how many times I've heard "hey, it's not my job," come out of the mouths of some employees. It was amusingly refreshing to hear, "hey, that's not her job," come out of the mouth of one of my fellow co-workers. I kind of shook my head to clear out the cobwebs to make sure I heard what I had heard. "So tell me, what exactly is her job?"

I grew up in the 50's and 60's in a Union household. My father was a strong union man along with my brothers. The men older than myself worked physically demanding jobs and come home with dirty faces and hands only to shower, enjoy their family and head out to work the next day to the same dirty job they toiled at the day before. They, like most of the men their age, had a very strong work ethic. My father was a firm believer in, "if you don't work, you don't eat." His union association, as was most union officials at that time, was to make the work environment more humane. "The unions did a wonderful thing back then," my father would tell me, "they made an 8 hour work day instead of a 12 or 16 hour work day. They made a 40 hour work week, they did a lot of good things. Now, the people want different things. They want a 12 hour work day so they can suck up overtime and put the rest of the country into unemployment."

My father, to a great extent was correct. The unions did some amazingly wonderful things. They allowed a worker to have security in a job, yet have a family life as well. Unions were good. Please, don't skim over the word "were" because it was placed exactly where I wanted it to be placed.

Having been a member of a union for several years, I chose to leave the union and go into a management position. My reason for leaving the union was not financial because trust me, I did not gain a great deal monetarily. My reason for leaving the union was not based on extra perks because I did not receive any. My reason was to improve the work place. That sounds like an oxymoron doesn't it, but it is the truth. What I see now is that the union protects workers who do not work. The union protects the employee who is habitually late or absent, who habitually talks on the phone, who habitually pawns off their work on others so they can sit and read the news in the newspaper. To top all things off, they union has developed this "brother/sister" kinship that implies that one cannot turn in a family member for less than productive behavior. The vicious cycle begins there because that, by the mere nature of the beast, makes the employees who are not "seeking the protection of the union" do more work.

Now, let's move in the direction of the non-productive employee who has all the bad habits mentioned previously; combine that with the productive employee who states, "I can't believe you [management] haven't fired him. He's always late and when he gets here the first thing he does is take a smoke break, eat lunch and call his friends." Let's investigate why he still works there. Well, he has a union that will not allow him to be terminated because of some misplaced loyalty. They are making sure he keeps his job and continues his ways and in the meantime YOU are picking up his slack. Don't thank management for that, thank your union. Management can have stacks upon stacks of unsatisfactory documentation on him, but the realization is that it will probably take at least a year or two to terminate an employee that is in the union. Of course, there are circumstances that are not negotiable like stealing (if you can catch him red-handed), HIPPA violation (if you can prove that it was him and not someone else who stole his password in an attempt to look up medical records) and of course if you are down right physically violent with another co-worker or patient (and of course that has to be witnessed as well). But, don't fear union workers, your brothers and sisters didn't see a thing when push comes to shove.

Whatever happened to a person's word? Whatever happened to the truth? Whatever happened to a good day's work for a good day's pay?

Hmmm...where did that post come from?

Truth

What is truth and how does one find out who is telling the truth in a sea of lies and deception? Can I believe what my eyes are seeing; or are they seeing a show put on for my benefit? Have some become so adept at their craft that the lie can seem be a truth in the presence of one and that same person revert back to the lies and treachery that surrounds them when one who has the power to discipline and judge is out of site?

The pendulum has swung full circle; those that I thought were telling the truth maybe indeed be the ones speaking lies. I watched as grown adults played their game with me; but not with each other. These adults spoke to me in the vein that I would believe their words but their words did not coincide with the picture I was seeing.

I have to stop and take inventory; but is taking inventory a judgement? I am in a position where I have to make a stand. I have to determine who is telling the truth and whose mouth is spewing lies; or are both parties mixing enough truth with enough lies to make them both believable?

A long time ago, in a science class far, far away (sorry Star Wars), I learned that matter changes if it is watched. Everybody knows they are being watched. It's no secret, I have not hidden the fact that things are going down in this department that I don't like. Have the people changed their behavior for my benefit? Yep, I think they have.

Here is my problem. Why can't the people who are in charge control what is happening? Why do I have to change shifts to identify a problem? Is there a reason that some are unwilling to approach a worker who is falling behind, or does everyone think we should all just get along by letting everyone do what they want.

Should I stay or should I go????

Today, I read the post from Disappearing John, whom I love to read, that said he was leaving the blogosphere. From what I gather, and I don't even pretend to speak for John, is that he is fearful that his blog may ruffle the feathers of the powers that be and result in a termination via the HIPPA law.

How disheartening but he is right. By the mere fact that we are medical professionals, we are looked upon (or should I say "ready to be pounced upon") for breaking a HIPPA law. Without mentioning exact names, birthmarks, tattoos, piercings, etc... or changing the names to protect the innocent and not so innocent there is no possible way to distinguish one patient from another because, trust me, if you think you are working in a unique atmosphere, you are wrong.

I can understand if I said, "Joe Fufutyfey" came into the ER at "Oh my God" Hospital and gave an exact blow by blow detail of events, well hell, that's a no brainer; that's a no no. But, if I don't mention my name, the name of the hospital, the name of the patient, the exact sequence of events, and change a few things here and there that do not affect what is meant to be said, is there a problem?

I'd like to think that if a lay person were to read my blog, and saw themselves in that blog as....let's say.... a person who abuses the EMS system to get into the ER while the dying patient may be waiting in the lobby.... steps up and says... hey... I never thought of that, that might be a good thing. It might... (and that's a big word there, "might") change their behavior. The situation I just described is NOT unique to where I work but is a major problem across the nation.

There are other major problems as well. Let's talk about the patient who has a penile discharge but throws in, "oh yeah, I have chest pain too," to get himself to the back quicker. If you think it doesn't happen everywhere, you are so wrong. We could talk about every patient who comes into the ED with a child who is "bleeding to death" only to find that you can't find the cut. These are the patients that take time away from those who need our immediate attention.

I'm sure you've always heard it said that the squeaky wheels gets the attention. What about those patients that are too weak to squeak?

Okay, I've rambled enough. Just thought I'd vent.

Time Changes All Things

Eighteen months ago I took a new job and thought I'd be able to change the world. I thought that I knew what my fellow co-workers wanted and I could provide that for them and in doing so promote a better attitude toward patient care. I was excited and zealous. I thought my ideas, which were really their ideas would be welcomed with open arms and we'd sail off into the sunset forever at peace with each other.

Oh, how wrong I was. Each and every idea, change in the regular routine, change in procedure was met with great obstinacy. Eighteen months ago, I thought that if I wanted to invoke a change in the department, I'd have support because I was attempting to do the things that had come from their own lips. Twelve months ago I came to the realization that I'd have to do it alone or just quit trying to change things and recognize the obvious; that some people just want to bitch no matter what the situation. Many people are happier being the bearer of bad news or the town crier who constantly calls out, "It won't work....it won't work...it won't work." I chose the road where the top of my head hits the wall on a daily basis creating a headache and enough brain damage that enables me to carry on in my attempts to make the place I work a better place.

Six months ago I learned that if you are persistent and consistent that change is inevitable and, like me or not, you will know what to expect from me. In my humble opinion, in an effort to poke fun at my methods, one of the management team members made bracelets that said, "WWWD" meaning, "what would Woman do." I chuckled not because she was attempting to poke fun at me and I thought it was funny; but I laughed because something HAD changed and she saw it. She recognized that when I was at work, things ran differently than when she was it work. It a strange way it was both flattering and irritating.

This past week and a half, I have been training a person to be a part of the management team; a member of the shift that makes up little bracelets that say, "WWWD." He states he has many of the same ideas as I do, and I think he might, but I'll reserve all my comments until I've had time to evaluate more completely.

Today, while I sat at the desk watching the person I was training I overheard two of my co-workers talking. The one said to the other, "I like working with Woman, I wish she worked afternoon shift all the time." The other one replied, "Yeah, it is nice. I think it is because everyone is on their best behavior." The first worker then stated, "Hey, at least you know where she is coming from all the time; she doesn't make it a secret and she doesn't pick and choose who to say things to and who not to say things too. If she sees it, she says it. I like that."

Okay, I tried my best to eavesdrop more but I got busy and didn't get to hear the rest of the conversation but what I heard I liked. Here was a department that fought me tooth and nail 18 months ago and today "likes" working with me. I was humbled.

Just when I thought change had not occurred, I woke up and it was there. It was good.

Now, please don't think that everyone likes to work with me because they don't. In fact, before I started to train on afternoon shift a few of the day shift people who work some afternoons told me that the off shift was "dreading" my arrival. Hmm... maybe that speaks volumes too.

Packing a Lifetime

For weeks I've been picturing how I will re-decorate my youngest daughter's room when all her things are moved into her apartment. A scenario plays through my mind as to the color scheme or the wall hangings or what exactly do I want this room to reflect when I move some of my things in to make it my sanctuary. The room will be void of a bed and bedroom furniture so I'll have a lot of room to move things here and there until I am pleased with the placement of each thing I want to bring into this "domain." I've been excited about painting the walls and putting up new curtains, or blinds or whatever I want for quite some time.

Today I decided would be a good day to take the walk up the stairs to look around and try to put things into perspective. Since she's across the country at an international event, I thought I might even pack a few things to help her (and me) get started.

I opened the door to her room and scanned the scene. Yep, she has to be one of the messiest people I know; well at least when it comes to her room. I started to clear out the long dresser that is against the wall since I know that this particular dresser will be the start of a good bonfire when we get out our weenie roasting sticks to cook hot dogs on a cool fall night. I don't know why it surprised me to find most of her drawers empty since she's been moving for what seems like months. I took the remaining clothes from the drawers and folded them neatly and placed them on the chair.

I took in a deep breath as I looked around the room once again. I looked at the television, the Rock Band Drum set and two guitars, the amplifier that is attached to the Fender guitar, the name tag hanging over her mirror from last year's Comic Con Event and I felt the stuffiness begin to build in my sinuses as the tears started to flow down my cheeks. I tried to look passed those things and thoughts only to have my eyes rest on her stuffed animals in the corner of her room. I began to look intently at everything in her room; not one dust bunny escaped my eye. I looked from her diplomas that hung on the wall telling me she was an adult to the PlayStation 3 that told me she was still a child. Before I realized I had moved across the room to her dresser my fingers were gliding along her grandmother's laminated obituary notice that has not moved from her dresser since the day she received it almost 10 years ago.

I gingerly placed the obituary back onto the dresser as I remembered packing my mother's things into boxes after she died. I packed her things alone not even a month after she died because my father couldn't bear to look at her clothes hanging next to his for one more minute. I asked my sisters several times to help me pack her things, but they declined. They told me that since it was "my" dad that was having the problem dealing with my mother's death and having her things around, then I should be the one that did something about it. Not having the emotional strength to argue, I packed her things. I remember clearly opening 6 paper bags and writing the names of her children on the bags; each of us having our own bag. As I packed, I would think, "Mom and my oldest sister loved these things," so those types of things I would put into her bag; each bag filled with special things that I thought the child and parent shared. Her clothing was packed in boxes to give to the city's homeless or to others who could wear them. With each and every piece of clothing I packed her scent infiltrated my senses and permeated the room.

My youngest daughter came home from wherever she was and found me in my mother's room packing and crying. She sat on the bed and without a word she started to help me. I didn't have to tell her what the bags were for because she seemed to know instinctively. The silence was finally broken when she said, "These smell just like Grandma, nobody smelled like Grandma." I couldn't speak, all I could do was nod. She scooted across the bed to me and hugged me. We held each other for what seemed like hours and we cried.

Finally releasing myself from her grasp, or allowing her to be released from mine (I'm not sure which way it was) I tried to compose myself and wipe the tears from my eyes. After multiple fruitless attempts at trying to refrain myself from sobbing, I told my youngest daughter that we were done. I couldn't do it any more. I had to stop. My body was aching from trying to stop my shoulders from shuddering. I was emotionally exhausted.

Once again, I am emotionally exhausted. I stopped packing because I can't do it alone. I can't bring myself to put her things into boxes to carry across town to her new place. I should be happy but I'm not. I'm selfish. I want her here with me. Yes, today I am the baby and I'm not ashamed to say that I'm acting like a child. Maybe one day I'll grow up and be able to pack a lifetime into a box without crying; but it's pretty obvious that today is not that day.

Look at me, I'm a big girl now.

She was born on April Fool's Day; two full months before she was scheduled to arrive. Her tiny body was just a bit larger than my brother's hand as he held his precious package close to his heart. I can only imagine what was going through his head as he held his daughter close to him and looked over her small body complete with a feeding tube inserted into her nose to help give her added nutrition since her sucking abilities hadn't quite matured yet. Her mother, recently released from the hospital from giving her life was always close at hand. As any mother of a newborn child, she fretted; but I assume that her fear was far worse than that of a mother's who had delivered a full term child. I'm sure her parent's can tell you how long she was hospitalized but I can only tell you that since this precious package from God was born to two loving, caring nurses, the doctors felt comfortable releasing her into their care prior to her weighing 5 lbs.

Her parents, being the proactive people they are, notified the local EMS personnel that they were bringing their premature baby girl home complete with apnea monitor. They wanted the local EMS to be prepared just in case anything were to happen to her and the EMS, in their professionalism, brushed up on their Neonatal Advanced Cardiac Life Support "just in case."

Truthfully, if a stranger were to look at her they would probably whispered what an "ugly baby" she was due to her prematurity; but I thought she was absolutely gorgeous. She developed slowly, but not as slowly as one would imagine. The doctors were pretty confident that she would be fine but she may have some "developmental delays." In my mind that seemed only logical and to be expected; we prayed she wouldn't have any neurological problems.

On July 4th of the year she was born, we had a huge picnic in the back yard. Family from out of state were in attendance and the festivities were wonderful. When it became dusk, her parents made their apologies for going into their home early. Essentially they live in my back yard, but they needed to bring their 3 month daughter inside for apparent reasons.

Suddenly, I heard the shout of a man in desperation. My brother was calling to me as I was outside. "Help, she stopped breathing, help me." I ran into the house; my brother, who was naked and covered in soap was holding his lifeless child in arms giving her rescue breaths. I took my niece from his arms and saw that she was now breathing but having periods of apnea. 911 was called, my brother dried himself off and got dressed and I kept biting my niece to keep her stimulated to breath. Where was her mother? She was trying very hard to pull herself together as any mother would who had competent people around her to help her child. Later she told me that if she was alone she wouldn't have known what to do. I told her she would have sucked it up and did what she had to do until someone else could help her. I was and still am confident of that fact.

911 arrived and took immediate control. They were prepared....well prepared. God bless those men who took the parents of this premature infant seriously enough to brush up on whatever they needed to brush up on. Prehospital attention ran flawlessly; my brother rode in the squad while I drove my sister-in-law to the hospital. The squad called in to the hospital prior to arrival that they had a 3 month old pre-SIDS baby in route that was having periods of apnea and her heart rate was beginning to decrease at times. The squad arrived before my sister-in-law and I did and were filled with fear at what we might find.

We went right back to her room to find not one single person except my niece and my brother. He told me he had been triaged and used the words, "apnea, cyanotic, rescue breathing, painful stimuli to keep his daughter breathing" yet nobody was in the room. Nobody. Not a doctor, not a nurse, not even housekeeping with a bucket and a mop was in the room; just my brother and his seriously ill child. While my brother continually stimulated his daughter to keep her breathing, I went to the nurses station several times (being the pain in the ass that I can be) and told them that someone needed to get into that room immediately. This child needed some help and needed it now. "We'll get in there as soon as we can ma'am" I looked around and saw quite a few nurses charting and being an ED nurse myself, I understand that when it may look like the nurses are doing nothing, that in fact, they are doing something. I repeated that my niece had already stopped breathing several times since she has been here and nobody was in the room. Essentially I was blown off. I went back into the room and my brother hooked her up to the monitor, gave her some blow by oxygen and continued to stimulate her. I watched as her heart rate dropped from 160, to 150 to....80 and then I went back to the room in my full blown anger. "You get in that room right now, this child is dying!" They were just about to tell me that I was an idiot when they noticed the central monitor. "Who put that monitor on?" each nurse was asking the other as they all rose to go into the room. "Ummm...that would have been us who did that and thank God we did or you all would still be sitting here."A flurry of activity began. The doctor was called to the room stat and we were asked to leave the room. I started to back out of the room because I knew my niece was about to get the care she needed when I heard my brother's booming voice state, "The hell I'm leaving my child with you people. You have done nothing thus far and I'm here to make sure things get done." Of course security was called to take care of this unruly parent who was probably drunk because it was the holiday after all. The doctor went nose to nose to my brother yelling at him (which I'm sure was an attempt to see if he could smell alcohol on his breath) and my brother begged the doctor to hit him. "Please, hit me, just once." The nurses were taking care of my niece as I called up to the neonatal intensive care unit where my niece had just left the month before. I knew they couldn't do anything but I didn't know what else to do. It wasn't but a few minutes later that 3 of the NICU nurses showed up along with one of the NICU doctor. It seemed just there mere presence made things run a bit smoother and when the doctor showed up to explain to the ED staff exactly what this infant had just been through, things started to look up.

My niece finally was admitted to the PICU and placed on a ventilator where here condition was considered critical. I can't remember how long she stayed there but it seemed like a very long time. Her parents didn't leave her bedside until the day that my sister-in-law was told that her father was very ill and dying. Torn apart, she left her daughter's side and she and my brother went to see her father while one of the nurses (who was off duty) stayed with their daughter.

Yes, he did die and the days after that are fuzzy at best. My niece survived and ultimately came home to a loving and supportive family and the days, months and years after her hospitalization went on without a hitch for the most part until a week after her 9th birthday. She was diagnosed with Diabetes. I can't tell you how devastated her parents were and how often they were told, "it could be worse, she could have cancer or leukemia or something."

I learned a lot about diabetes that summer; more than I ever learned in nursing school. I relived all the complication that diabetes could deliver such as kidney failure, blindness, neuropathy, amputation of limbs not to mention that the mere fact that a person who is diagnosed with diabetes at a young age for the most part lives 20 years less than the average person.

With the help of her parents, my niece has come leaps and bounds in dealing with her disease. She knows more about diabetes than almost any nurse that I know; perhaps more than some doctor's know. She knows about basal rates and how to bolus insulin over a longer time period if the food should contain a higher amount of fact. She recognizes her symptoms of hypoglycemia and always carries her "equipment" with her in case of an insulin pump failure. She and her parents have had to fight uneducated people at amusement parks, wave pools, water slides, that her insulin pump is just as necessary as their pancreas, and if she has to remove her pump, then they have to remove their pancreas. To be honest, her parents have been very instrumental in educating schools, amusement parks and other places of interest about diabetes, the need to carry supplies and what an insulin pump is and how it works.

A week after her 18th birthday, she announced that she has been a diabetic half of her life. My heart sunk. To hear it put in that way hit me like a ton of brinks. I don't know why, but it did. I looked down at her wrist where she wears a yellow bracelet that simply states, "Insulin is not a cure." She is very feisty when the conversation turns to stem cell research and I'm sure that her thoughts and ideas are a direct result of the fact that she could benefit from this type of research.

Last week, she graduated high school. Her pump accompanied her to get her diploma and she doesn't seem to mind if others see the pump apparatus she must wear. It is part of her just like another arm or leg. I was so proud of her as she walked like a young woman across the stage to accept her diploma...........and today, we partied.

Yep, that's my niece!