Humble.

That patient I worked on last night that I felt so wonderful about doing so much for? When I left, they were comfortable, no more signs of pain, family was so happy we got this worked out.

They died a hour after I left.

I ended up with four extra hours of paperwork, only 3 iffy hours of sleep and woke up completely miserable, pissed off and hating the world. I got that message and the air went out the balloon.

Lesson #2 of nursing: Humility.

Want you to know that YES, I AM THAT GODDAMN AWESOME.

I think I should have learned my lesson by now about "doing (someone) a favor". Tonight was a repeat lesson but also an awesome experience.

The head MSW calls me and says "Could you do me a favor and go out to start the admission on this patient. They've had a very sudden turn for the worst and the family wants us in ASAP. Just do a tuck-in." A tuck-in is basically the admission RN going out to eyeball the patient and get basic information about them.

Nuh-uh. Not this visit.

I arrive at a beautiful facility (out in the middle of God's country) to find the patient in full blown respiratory distress and showing physical signs of pain. Being as this patient got this way in a matter of hours (less than 24 hours mind you) the facility really did not start anything major by way of comfort medications. I freeze up only for a second before that strange energy that all nurses get at one point or another kicks in on me and I just whirlwind the room. With a whole family present and staring, I finish the assessment, the recommendations, have orders called into the physician, initiate a new plan of care, and teach the family about the signs and symptoms of dying. This happens in under 2 hours.

I also find out that this patient's doctor thinks of hospice nurses as a group of well organized serial killers with access to narcotics. Oh Fun. The upshot to this? One of the more adamant family members happens to be a nurse as well. So when we wait after 4 phone calls to the doc's office for an answer on my recommendations, this fellow nurse is on the standby to do what I like to call a verbal surgery on the doc's ears. Not only does the doc agree, but I get my highly ambitious order for pain medication. Oh fun turns into "OH JOY!".

When finally I call in for one of our agency's nurses to come in and continue care as my shift is ending, I sit down long enough for my body to scream "WHAT THE HELL WOMAN?!". I'm exhausted. I can't move my legs to save me since I've been running around so much. My voice hurts from asking, answering, calling, ordering, summarizing...you name it. I pushed myself into close to 4 hours overtime, it's well past midnight and my eyes are almost to the point of bleeding but I wanted to get this out because it was a helluva night.

And I want to end with this, as a thank you to the phenomenal staff at this facility: Yes, we are nurses and yes, WE ARE THAT GODDAMN AWESOME.

Rule One: Laugh. Or you'll die much faster.

I went to a facility today to do an admission on a patient. I spoke with the nurse who didn't know the patient well and could not give me much information. I spoke with the patient who was very tired from their day and could not give me much information. I went to the desk and found the chart of the patient so I could wrangle some information from it ... then realized we were talking about reading doctor's handwriting and could not get much information beyond a squiggly line. Patient's doctor walks up to me, asks what I think the diagnosis should be for the admission and I say, with confidence, "I think [the patient] qualifies for CHF." Doctor pauses for a second before looking at me strangely and says, "They have pulmonary fibrosis." He flips open the chart to a random piece of paper stuffed somewhere in the beginning of the binder and points to past medical history. My response: "I'll be damned, they DO have pulmonary fibrosis!" At this point, the doctor laughs.

And to everyone’s surprise, so did I.

Plan of Care (For lack of a creative title)

If you are starting at this entry, then you are starting at the beginning of these posts. And I apologize in advance for the insanity that will unfold before your eyes.

The story thus far:

Yesterday, during the course of a conversation, I said some random thing that triggered this thought in my head: I've been a nurse for a whole year. 365+ days I have had the title of registered nurse printed after my last name. In all honesty, I almost quit this profession at my old job working as a floor nurse at a hospital. Between the stress of the patients, the stress of the job and the expectations around me, I nearly fled. Well....I did flee in the end, but not out of nursing. I went out of the hospital and into the field. Literally. Once free of the hospital walls, I found a little niche of nurses tucked away in this specialty know as home hospice nurses. And I found my own little cubby hole of a career here.

So why am I blogging about it now when a year has already past and the interesting stuff has already occurred? Because, my friends, the interesting stuff NEVER STOPS. Whether it makes you go bald from yanking your hair out or you shave your head from enlightenment, this little job known as nursing grabs you by the hand and drags you through some of the strangest, weirdest, horrifying and beautiful things you have ever seen.

This blog is for, and dedicated to, all those first year nurses out there in the world who feel like they made a mistake by joining the ranks. First of all, deep breathing helps. Secondly, Ativan helps pretty wonderfully too. But most of all, you didn't make a mistake.

You, like all us nurses, were never told exactly what you signed up for.

So here on this blog is a little wisdom I want to impart upon you.