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!

Empty Eyes

Today I was pulled in many directions but my mind kept coming back to the man with the sad eyes slumped shoulders and the look of despair on his face. He admitted he was depressed, he admitted that he would like to go to sleep and never wake up. He informed me that life had become more of burden than he could bear. His eyes were sad but void. They were void of any emotion except utter dismay. I guess that's good to just have any emotion but this gentleman.....this gentle man was closing in on the end of his rope. I could see it in his demeanor, I could see it in his body language and I could almost feel the despair that radiated from his soul.

His mother brought in into the ED to be evaluated for his depression. He admitted that he wanted to end his life by any means that would be the quickest to do so. His mother constantly interrupted his speech giving me his answers that he would start to tell me but she would finish. I gently asked her to let him tell me what was going on when she promptly told me she was well equipped, even better than he was, to tell me what he was feeling. I looked at him and asked him if he felt that was true. He shrug his shoulders and nodded as he said, "I suppose so." He had no opinions that were his own, he had no feelings that were his own, he was totally dependant upon this woman who called himself his mother. His mother told me he has had a series of unfortunate incidents that have lead him to this depression. She told me he's been homeless, hasn't eaten and was generally not able to take care of himself. I couldn't help but notice the meticulous way she was dressed in a pink suit with her hair recently coiffured. She wore a stunning diamond broach along with small but very classy diamond stud earrings. Her nails were freshly manicured and her perfume was perfectly applied and not overpowering.

After I spoke with both of them, I explained at length what would occur in our efforts to get him the help he so desperately needed. I explained to both of them that he would have his belongings taken away from him for his own safety. I stated that if his mother stayed with him I would not have to lock him in a room to protect himself because he felt the strong desire to kill himself. I explained that he would be medically evaluated and then placed in an appropriate place that could help him adjust medications and give him some counseling.

As I stood to take him back to his room I made the assumption that his mother was going to stay with him. She moved toward me and said, in full earshot of the patient, I am not staying with him, you will have to lock his room. I have way too many things I have to do to stay in the hospital so long. You may call me if you need me. With that, she kissed her son on the top of his head and left.

Stoically, as if he were a dead man walking, he followed me to the padded room that he would remain in until proper placement could be provided.

This man has only left my thoughts fleetingly the entire day.

It's About Time

I can't believe it's been more than a month since I've written. The only excuse I have for not writting is because I just haven't made any time for myself. I've been busy helping my daughter get her practice up and running and I've been trying to settle into my job. The former is actually frustratingly fun; the latter has been trying to say the least. At every turn I am met with opposition. At first I thought my opposition would come from the "company" but they have embraced many of my ideas, it's my fellow co-workers that have given me the most trouble.

I thought I knew a lot about people, but this job has taught me that I don't really know anything at all. I've learned that people, for the most part, can't recognize the sign of the times. The hospital business, and it's just that, a business, are directed to make money. The bottom line in any business is the capital. Another part of business is not employing people that are not needed and that sometimes a reduction of staff is a necessary evil.

When our ED went to EMR, I saw the writting on wall that the department may not need 2 secretaries in the ED at all times; in fact, we could do with just one most of the time. I like these people, over the years many of them I have grown to care about in a way more than a work relationship. In thinking that, I developed a plan that would give the secretaries some more jobs since a lot of their job is not taken over electronically. I have tried to designate some jobs that used to be done by nursing to the secretaries; for instance, in the ED when we hold patients because there is no rooms available in the hospital, it has always been the nurse that made up slips of paper to remind herself of what needed to be done at what time, (IE: Labs, EKG, activity, tests, etc.) This is something that the secretaries on the floor do all the time. Do I think that doing that stuff is beneath me? Heaven's no! But it is something that can be given to the secretary to do which will give her another task that will attempt to keep her valuable to the department and give us some justification as to why we need the secretaries we have. THIS is he writting that they can not see; as if it is written with invisible ink.

Oh well, maybe it's just me being pessimistic. Perhaps they have a secure job; I don't know. I can't imagine learning how to do more things could possibly hurt...and it can only help.

"While others say don't hate nothing at all except hatred." Part 2

I guess I don't take advice well sometimes because there are things that I hate. More importantly, I think these things should be hated and spoken out against when the opportunity presents itself. No, we don't have to get on soap boxes to preach to be an advocate of what is right and stand up for things that are not right. Given time, every situation presents itself to teach and/or learn a lesson from. I'd like to share with you a few things I hate, and I will not apologize for hating them.

I hate: racism, discrimination, ridicule, and spousal abuse.
I hate that people hate fat people and ask to be moved to different seats just so they don't have to sit next to a fat person.
I hate that people defend others when they make fun of fat people because "they are fat because they are lazy."
I hate the people find racists jokes funny.
I hate that people laugh when they are told jokes about lesbians, faggots, or dykes.
I hate that as a people, some feel intimidated to stand up for what is right because they are afraid of being ridiculed by those that find it easy to find fault in others.
I hate that people feel at ease critizing others before they have walked a step in their shoes.
I hate that it is easier for people to be apathetic than compassionate.
I hate anti-semetic remarks.
I hate that people don't take personal offensive when others are being called Kikes, Niggers, Honkies, Faggots, Dykes, Beaners, Wet Backs, Dagos, WOPS, carpet munchers (just to name a few).
I hate that people are not color blind.
I hate that people take man's inhumanity to man as natural and not a thing to speak out against.

I really hate, that at one time or another, that I have probably been one of those haters that I just mentioned; and may God forgive me for that sin.

In reality, what Bob Dylan says in his lyrics "It's all right Ma, (I'm only bleeding) is true.

"If you could see my thoughts and my dreams, you'd probably put my head in a guillotine."

But it's all right Ma...............................ALL OF US ARE BLEEDING.

"While others say don't hate nothing at all except hatred."

It's all right Ma (I'm only bleeding)

Darkness at the break of noon
Shadows even the silver spoon
The handmade blade, the child's balloon
Eclipses both the sun and moon
To understand you know too soon
There is no sense in trying.

Pointed threats, they bluff with scorn
Suicide remarks are torn
From the fool's gold mouthpiece
The hollow horn plays wasted words
Proves to warn
That he not busy being born
Is busy dying.

Temptation's page flies out the door
You follow, find yourself at war
Watch waterfalls of pity roar
You feel to moan but unlike before
You discover
That you'd just be
One more person crying.

So don't fear if you hear
A foreign sound to your ear
It's alright, Ma, I'm only sighing.

As some warn victory, some downfall
Private reasons great or small
Can be seen in the eyes of those that call
To make all that should be killed to crawl
While others say don't hate nothing at all
Except hatred.

Disillusioned words like bullets bark
As human gods aim for their mark
Made everything from toy guns that spark
To flesh-colored Christs that glow in the dark
It's easy to see without looking too far
That not much
Is really sacred.

While preachers preach of evil fates
Teachers teach that knowledge waits
Can lead to hundred-dollar plates
Goodness hides behind its gates
But even the president of the United States
Sometimes must have
To stand naked.

An' though the rules of the road have been lodged
It's only people's games that you got to dodge
And it's alright, Ma, I can make it.

Advertising signs that con you
Into thinking you're the one
That can do what's never been done
That can win what's never been won
Meantime life outside goes on
All around you.

You lose yourself, you reappear
You suddenly find you got nothing to fear
Alone you stand with nobody near
When a trembling distant voice, unclear
Startles your sleeping ears to hear
That somebody thinks
They really found you.

A question in your nerves is lit
Yet you know there is no answer fit to satisfy
Insure you not to quit
To keep it in your mind and not fergit
That it is not he or she or them or it
That you belong to.

Although the masters make the rules
For the wise men and the fools
I got nothing, Ma, to live up to.

For them that must obey authority
That they do not respect in any degree
Who despise their jobs, their destinies
Speak jealously of them that are free
Do what they do just to be
Nothing more than something
They invest in.

While some on principles baptized
To strict party platform ties
Social clubs in drag disguise
Outsiders they can freely criticize
Tell nothing except who to idolize
And then say God bless him.

While one who sings with his tongue on fire
Gargles in the rat race choir
Bent out of shape from society's pliers
Cares not to come up any higher
But rather get you down in the hole
That he's in.

But I mean no harm nor put fault
On anyone that lives in a vault
But it's alright, Ma, if I can't please him.

Old lady judges watch people in pairs
Limited in sex, they dare
To push fake morals, insult and stare
While money doesn't talk, it swears
Obscenity, who really cares
Propaganda, all is phony.

While them that defend what they cannot see
With a killer's pride, security
It blows the minds most bitterly
For them that think death's honesty
Won't fall upon them naturally
Life sometimes
Must get lonely.

My eyes collide head-on with stuffed graveyards
False gods, I scuff
At pettiness which plays so rough
Walk upside-down inside handcuffs
Kick my legs to crash it off
Say okay, I have had enough
What else can you show me?

And if my thought-dreams could be seen
They'd probably put my head in a guillotine
But it's alright, Ma, it's life, and life only.

The Variety Column

Blogging makes me sane. Then why have I only blogged 3 times in the month of February? I must be insane.

Blogging releases tension. I have felt very tense in the last month. Could it be because I have not blogged as much as I should have been?

Some people are never wrong? I'm glad I'm not like them because I am always right so I don't have to worry about being wrong.

You know you've broken the color barrier when you have to stop and think if the person you are talking about is black, white, yellow, gold or purple.

You know you've lost your sense of humor when you don't find racist jokes amusing.

You know you have found your sense of humor when you tell the person who is telling an obviously racist joke that you just don't "get it" and laugh inwardly as they flop back and forth like a fish out of water as they try to explain the joke to you.

You know that you are not a religious person when you shake your head as other God-fearing church going religious saints tell sinners the exact reasons they are going to hell in a hand basket.

You know there is something a little different about some people when they do not rejoice at other people's misfortune, even if the other person has been less than kind to most people.

Maturity raises it's ugly head when you realize that some people would rather bitch at what is wrong than to try to be a part of what fixes a problem.

Some people are born to criticize; others are born to be criticized; and still others learn to take part in neither.

Some people rejoice and become physically excited from seeing others fail.

Some people search for happiness before they realize that they have moved in a complete circle and found the happiness they so desired standing before them.

Some children never grow up and some children grow up too soon.

Some children think that they are grown when they no longer need their parents; a grown child knows that they will always need their parents.

Some people are beautiful and some are ugly; the intelligent knows where the beauty and the ugliness truly reside.

Some people have made me cry; some people have hardened my heart. This is something I must work on.

God has kept all of my tears and will wash me clean with them.

Yes, I'm a sinner; no I am not a saint. I don't have to be; God did that for me when he died on the Cross and was victorious over sin and death. Thank goodness, because on my own, I can do no good thing.

Thank you for putting up with my ramblings for today.

Yesterday is Gone

There is a woman I work with who thrives strife and dissension. If need be, this woman will resort to lying. What gets the strife stated? Simply asking her to do her job. In some ways, I think I need to relive the incident that allowed her, for a brief moment to make me want to take her shoulders and shake her in an effort to jiggle the neurons in her brain to see if they would settle down to listen to something other than how correct she is and how management is out to "get her." Yep, in some ways I think she displays some paranoid tendencies, definitely some delusions of grandeur, but mostly a grandiose impression of her importance to life itself.

As a staff nurse, I thought had to tolerate her general nastiness because those in charge were afraid of her potential repercussions. They were afraid of having lies spread about them, or half truths along with the fact that if you didn't do as she felt you should do, things were not done in the manner in which they should have been done; in general making the nurses job more difficult.

I bet your thinking that this person is a doctor, or a nurse, or even a person of high importance. She is not. She is a secretary. Now, do I think being a secretary is a low life job? Absolutely not. A good secretary is worth double her weight in gold. A mean secretary or one that thinks her nastiness is good because she is irreplaceable is more like an albatross hanging from your neck.

I have been in my current position 1 year this month. In that one year I have been "taken to task" with the union because of her. Fortunately, most people know how she is and defending her is hard even for a Johnny Cockran type Union Rep. The first problem? Well, let's just say while one secretary was doing all the work, she spent her time going in and out of the department to have cigarettes and in between she had to speak with "all her men," which in reality are just lost souls that need something to do to look busy.

The second issue is much worse. She returned from medical leave. Her return to work slip had no restrictions. I told the two secretaries that stock needed to be put away. The "bad" secretary wasn't doing anything but sitting; the other secretary was busy scanning things into the computer system. Did I ask "bad" secretary to put away boxes? No, I didn't. I would have thought that two semi intelligent humans would have had the knowledge to let the post abdominal surgery (6 weeks post op) do the scanning while the other put stock away. Did it happen? No.

Shift change comes and bad secretary stays and another secretary arrives. "I want the stock put away. Secretary M. are you putting in orders?"

"Well no," she replied, but I'm setting up the day's call list. Bad secretary is talking to one of her men.

"Okay, bad secretary, you make the call list, Secretary M, you put away the stock."

Bad secretary says to me in the most pitiful of voices, "I can't lift anything because of my surgery."

Innocently, and I do mean innocently, I responded by saying, "Oh, I'm sorry, I didn't realize you still were on light duty." She said she was told she could come back to work a full day. "What kind of restrictions did they put on your excuse?" She replied, "Well, none really."

"Hmmm," I said almost reactively.

The day went on and she began her harassment of me. "What kind of an RN would make someone who has had abdominal surgery lift boxes?" I just rolled my eyes out of her eye shot because that is the furthest thing from my mind. But she kept going and going much like the Duracell Bunny.

Finally the day ends and I am having a meeting with my boss and she walks in and says, "Do I need a light duty excuse or are you going to educate some of these RN's you have that you can't lift after abdominal pain? To be honest, I had to hang my head so she wouldn't see me smirking since my suggestion to put away stock was not towards her, it's just that I didn't mention a direct name initially.

Forward two days. Another secretary pulls me aside and says, "Did you tell the boss that I refused to put away stock?" My eyebrows raised with my response, "No." The secretary responded by saying, "Well bad secretary said you did." I sighed and said, "I'm sorry, I have grown weary of playing bad secretaries games and I will not discuss her any longer."

In the meantime, bad secretary has informed most of the department that they must choose sides, "if you talk to her, you will be my enemy." So mature! I went about my day as usual, asking bad secretary to do things as I needed them and she responded by doing as she was told, but still being her nasty self. About noon she follows me into the clean utility room and says,(complete with finger wagging in my face almost touching my nose,) "I can't believe what you have done. I don't respect you as a person, I don't respect you as a nurse, and I will have your job just like I got rid of that Jew doctor."

I calmly (which infuriated her) told her that she needed to drop this; she refused. I said, "this will be dropped now. I will not have an entire unit filled with patients and families watch you speak to me or anyone in this manner."

"Oh, I'm sure it's not," I commented, "because you leave nothing alone, not even when you know you are wrong. You make things up until you believe what you are saying is true," I said, but even when you believe it's true, and it's not, it's still a lie."

The day went on and she got....how should I say this.... "kinder and kinder" to me. I kept things on a professional level. I will treat her with courtesy; but trust will never lay between us again. I once considered her a work friend, "but that was yesterday, and yesterday is gone."

On My Mind.....

A few days ago I read in the newspaper that an 18 year old man (boy) with autism beat his mother to death using just his fists. I must have read the article 4 or 5 times because it was so disturbing. No where in the article did it mention where this child was on the spectrum and perhaps to most it doesn't matter. It mattered to me, but I am not privy to that information. The article mentioned that 30% of autistic children have violent tendencies; but they failed to mention where that data was documented so I could not research that part of the article.

The mother did not deny that her child had autism but apparently she did attempt to hide his tendencies toward violence. She admitted to a friend (or so the paper states) that she had to hide in a closet with her back to the door while her son would beat and kick the door in an attempt to get to her. The mother would tell her friend that the aggression was the only way he communicated, whether that emotion was happy, sad or angry. I'm assuming that the more angry the emotion the more physical he got, but that is MY assumption, not anything I read in the article.

The mother's friend told the news reporter that the loving bond that mother and son had was like no other. The communication they shared with their eyes and at times with touch was remarkable. The friend felt that this was the reason the mother chose to hide the aggression. The mother, without doubt, had unconditional love for her child.

It's been a few days since the appearance of the article, and I've looked and looked for additional information on the case but I can't find any. Is this a morbid curiosity that can't leave my mind alone? Why is it important that I know?

I can tell you why. Yes, I am extremely saddened at the death of this child's mother and what she must have endured at the hands of the son whom she loved. My prayers and thoughts go out to the family. But more than that, and God forgive me for thinking this way. I am sick to death as to what may happen to her son. He is 18 and for all practical purposes he is an adult who has "committed murder." Does it matter that when he was interrogated by police that he cried out for his mother wondering why she wasn't with him? Does it matter that he wanted and cried out to his mommy? Did it matter that he apparently had no concept of the finality of what had occurred?

My prayers are with Sky Walker, the son, the adult, the child who no longer has anyone that loves him with all his faults and sees past the faults. Will anyone love him unconditionally as his mother did?

I work with a physician who has a son who is autistic. Often times he comes to work looking tired with bruises and scratches on his body. When asked "what happened, where did you get the bruises?, he simply replies, "my son had a rough night." I don't ask him often anymore because I know where those marks come from.

I sit here selfishly begging to forget what I've read, yet others live with the reality of what I only read about on a daily basis. Shame on me.