Bathroom Privacy

If you are with my family, and you feel as though you are going to say something very, very rude, do not go into the bathroom. Do not, I beg you, go into the bathroom shut the door, and enjoy several comment free moments. Because, if you spend more than the Correct allotted Time you will then be faced with every single person asking you about your bowel habits, or telling you about theirs. Did you know that pepperoni give mom gas, and diarrhea? Did you know that there are those among you who suffer from constipation? Did you know that there are others in the party who feel that rich food is just not worth it? Did you want to know?

I'm just sayin'.

In Which Son Two Smashes His Thumb

Son One and Son Two were vigorously debating whether the door should be open or closed, and Son Two smashed his thumb in the Door. I, of course, was not home, not that my husband was doing anything wrong, but still. I was actually at the dentist having a root canal. Did you know that there are people who cannot be properly numbed by novicaine? You do now. I spent the entire two hour appointment with the tears leaking into my ears and holding my own hands down. The chirpy receptionist came in and asked how much longer we would be, as my husband was on the phone and thought my son had a broken thumb. Note: this is a good way to split without paying your co-pay.

So, we trooped off to my very own hospital and had it x-rayed. Note: the PICU nurses are not well known in the ED, and we did not receive any extra love. No un-love, just no love. The radiologist will read the x-ray in the morning, and in the meantime, he has no obvious fracture. But he is three, and he said to me "Mommy, the ban-aid is not working" meaning it was still hurting. I, who spend a lot of my professional life sticking children with needles and otherwise causing them grief, was moved to tears.

We are home now, and he has had a dose of Tyco (tylenol with codeine) and I have suddenly realized that my mouth hurts.

While I was at the hospital, I realized that I have a Pavlovian connection between Diet Coke and being in that building. I began craving the Diet Coke as soon as I passed through the metal detector and was not able to not think of it for more than a few minutes the whole time we were there. Everytime we made a move- from ED to x-ray, from x-ray to the ED, then over to the cast room, I was calculating if we would pass the vending area, and fretting that I had only a $20 in my pocket, and thus would need to get change. I got home and downed two cans.

Lazy is as lazy does

I need to cultivate my laziness, obviously. I came in to a bust ass assignment, another nurse with a B.A. assignment, and the Co- worker from Hell who had a single, settled patient who would have been out of ICU and on the floor except that the floor was swamped. Ahem. In the first two hours of my day, I drew central and peripheral blood cultures on a screaming fighting BITING child who was small, but mighty. ( No sympathy from nurses who care for adults, I know, but, still. He BIT me.) Then I drew a few more labs that the oncoming doc wanted. Then I noticed that my other patient hadn't had his morning x-ray, and gee, seemed to have lots 'o clonus and weird over all tone, plus a tendency to sort of drift off and stop breathing. He gets a neuro consult and a stat CT of his head, and mom of said baby is crying and crying and crying. Both patients are on triple antibiotics, so timing is tight, both only have one IV and no real hope of getting another without a central line.

Kid number one, the biter- ( actually, I admire his spirit. He is like a little David going against the incomprehensible giants. I mean, he's had a brain insult, he's two, and people keep poking him)- begins to vomit. A dire sign in our neuro unit. Plus, I get the happy task of pointing out to the docs that they were not notified last night when the patient was spiking a temp, although the nurse who took the temp did write it down on the chart. Luckily for Biting David, he was not septic and dead within the hour, but we're still very worried about him. We discover that grandma made him eat breakfast before she left, and then when mom couldn't find his breakfast tray, she went to the cafeteria and bought him breakfast, which he ate, and you just can't fit that much mother love into one tummy. Too much tummy pressure, not head pressure. I change the bed and go about my business.

Lazy co- worker has given pain meds once. She is reading People magazine at the desk.

While I am down in CT with the baby, who is obligingly breathing on his own while off the unit, another nurse comes in. Lazy nurse declares herself charge nurse. I come back, and she:
a) helps me settle my patient and reassures mom of patient
b) volunteers to stick little Biter for the new labs that ID has ordered STAT
c) takes her ass to lunch

If you have been following along you have chosen "c" which, although it is the wrong thing to do, is the right answer to our little quiz. Nurse who has come in is a traveler who is not renewing her contract, and thus is reading her magazine at the desk.

Did I mention that there is no ward clerk, and that the phone rings incessantly?

Did I mention that there is another nurse with an assignment as bad or worse than mine?

Did I mention that I now seem to hate almost everyone over the age of twelve?

Poor Baby

Remember the baby? The one that I so cockily predicted would be fine in a few days? She was trying to die as I left today. Of course, I stayed late and watched the other patients untill things were settled. She is hovering around 88% O2 sat, and she is very very sick. There is no easy answer, here. There is no easy cure. This is RSV.

Knitting. Uhm, none? Maybe a little on the sleeve of the EPS before I fall alseep. Which I would like to do, soon.

THe picture? a sea anenome I met at Point Pilar.

They still die

But they are better deaths. Oncology, that is. The Oncology floor nurses do a great job on the end of life situations. I am planning on a transfer to that unit, when and if, a day shift job opens up. Of course, once I submitted transfer paperwork, my boss got very complimentary about my work. It will be a hard switch for me. The meds are hellishly complicated, precisely timed. And dangerous. The kids are all bald and swollen. The hope that the kids will live is like a flock of butterflies over the unit- so many more of them do live, now. Back when I was misdiagnosed with leukemia, in the early 1980's, it was a death sentence. Now, not so much. Lots of kids live to grow up, and isn't that what we all want?

But lets talk about me, here, because, after all, this is a blog. I will have to learn to take vital signs only every four hours. I will have to remember to bring their food trays. I will have to get used to awake alert, and oriented as the norm and not the exception. I will have to learn that I can get off my chair at the end of the bed and that the kid will still be alive without me staring at them, their monitor, and their drips. Plus, that flock of butterflies, each one a real hope of living to grow up.

Breathe, Baby

Breathe- that was my patient's task today, and she failed. All day, we did the oxygen ramp up- mask at 8 liters, Non rebreather at 8, then 10 liters. Non rebreather with albuterol- nope. NRB with racimic epi- nope. Meanwhile, Dr. Napoleon is strutting around asking who'd like to make a bet that the kid "eats some plastic" before morning. Blessedly, Dr N goes home and Dr Gestalt comes in. Dr G takes one look at my struggling, crumping patient and asks for Respiratory to bring a vent, X-ray to come for a stat portable chest x ray, and could I please draw up some versed, fentynl, and vecuronium? I do and a 4.0 cuffed endotracheal tube slides down nicely. She is now a paralyzed, sedated, intubated baby, and her sats are quite nice. If all goes well, she will heal, she will rest, and in three to four days she will be extubated, get better, and a few more days she will go home. I wish her mother knew all this, in the same way I do.

It is now, of course, well past the time I should be going home. The next nurse looked a bit overwhelmed, and why shouldn't she? My life was a no lunch, no breaks, no peeing kind of day. May she do it with more grace than I.

Knitting- uhmm. Haven't. I have a yen to crochet an afghan for Son Two's babysitter. Son One's teacher is getting a seaman's scarf.

Blog Wall

Ohhh, I've done it! I've hit the wall on posting! Yes, I now officially feel that I have nothing to say. Not that that will stop me.

Infuriating day at work. Was asked by manager to attended a bi weekly meeting that focuses on reducing pressure ulcers , was enthusiastic about this. Then was told that I would have to change my schedule and attend on my day off, or, alternatively, count my attendance as my lunch and breaks. In any case, there is about four hours of work to do before the meeting so that the charts and patients are ready to be reported on. Every other floor has a manager that is doing this- and why not? Our corporate entity supports it, our hospital risk dept supports it, and it's the right thing to do. Its wrong to let sick people get bed sores. And yet, when I cheerfully bounced into my Evil Managers office to report on the meeting and ask for the out of staffing time to do a good job on this, I was absolutely shot down. Weird.

Also, The Nurse Who Does Nothing was forced to take care of my patients while I was at this meeting. He did, Nothing. No vital signs, no, turns, no meds, no nothing. ANd I'm the problem. I'm being harsh, here. I'm sure that if they had stopped breathing he would have bagged them. I think. NWDN comes in every day at 11, has no assignment untill 4, and really, does nothing. He has actually gotten a tear in his eye when forced to take an admit last week. I don't know how he does it.

Knitting- oh, hell. I've done nothing except a few useless rounds on the EPS sweater. I want to go to bed, but have to wait a few more hours untill Son One and Son Two come back from their wonderful afternoon activities with daddy. Then I can force them into bed and go myself. Sleep is wasted on the young.

Not Dead

But not alive, either. I am finding myself more interested in the unconscious, the semi conscious, and the unaware. Not by choice- my interest, I mean. I'm talking about people- children, really- who cannot swallow, eat, move much, speak, sign, or otherwise communicate, but are still "in there". SOme of them breathe on their own, some do not. Not every person in this state has given me the feeling that they are in there, locked into their body somehow. Some people seem merely vegetative. I don't judge. Every patient get spoken to, warned of my intentions to wash them or turn them or put meds through their G tube. Every patient gets TV or music or videos. We dim the lights at night and turn the lights on during the day, even for those whose brain injuries have most likely rendered them centrally blind. ( This is blindness not because the eye has failed, but because the brain has been injured and cannot interpret what the eye sees. Or, perhaps, has no connection to what the eye sees.)

Some children are just as unresponsive to the world and yet still have such pesence. I have puzzled over why this is. There are the outside cues, like photos of the child when well, or at least less sick. A lot of bedsides are festooned with these heart lacerating photos. Some children's beds are decorated with toys and stuffed animals that they seem unaware off, yet are ritually and tenderly arranged by family and nurses. But some of the children with the most stuff surrounding them are the most gone, and I do not get that mild electricity that signals someone at home.

I do not know who, or how, or why. I only know it is so.

Out of my mind

It's really ungracious of me, I know. Everywhere, there are orphans and people whose families are truly evil. Mine is just whacko. I am so disoriented that I just flipped off the dog. She won't pay any attention, I know. My family is visiting and they refuse to go home. Also, they want to know why I knit so much. I don't know, to keep from speaking my mind?

The sleeve from the eco wool sweater.

Support The Bottom

That's what it says on the bottom of the turkey roasting pan. Wouldn't it be nice if that's what society did? Support the bottom> Feed the hungry, clothe the cold, treat the sick, you know, all that stuff. Listen to the lonely. Smile at the tentative. Anything.

Pouting because I lost the blog again, when my laptop crashed. Hopefully, fixed soon. Currently forced to use the clunky desktop with the weird clicky keyboard and the flikerey monitor. Also, have 11 people to cook for tomorrow, and a turkey skulking in brine in the cooler. Should I wash the kitchen floor before, or after? Or both?

Is status a bitch, or am I?

Our hospital recently created a lovely web site for each unit. Pictures, profiles of the docs, the whole nice thing. There's even a list of nearby restaurants and hotels, for family from far away. And on this site, under the smiling photos of each they list the names of our esteemed surgeons, our intensivists, dieticians, pharmacists, secretaries, physical therapists, respiratory therapists. Then there are the pictures of the nurses. We are smiling, too. Our names are not listed. We are "staff".

Why do I care? I don't know. Don't I know that nurses are seen as glorified waitresses? Yeah I do. Didn't I hope for better? I did.

A Bad Day Knitting...

is better than a good day at work. In fact, a whole lot better. I have very little tolerance for the whole knitting as spirituality thing that's going on. I don't begrudge any one any peace they find, but for me, it's just yarn. I like it. It soothes me, it amuses me, and I get to have some thing to show for my time. But today, cynical ol' me managed to eke out a life lesson from the knitting. Remember the first Turkish sock? I was thinking to have the second be different, but the same colors. But, I found I didn't want to knit it. I didn't like the new pattern, it didn't have the fun 4 stitch variation of the first. I ripped back. It was going in the wrong direction. So, O started again, at the toe, and did the pattern I wanted. It is so much better. So, onward to life! Rip back when it's wrong, stay up too late and knit when it's right! Tomorrow: work.

Nice

Can I believe I had two nice days at work? Not crazy busy, just nice. It makes such a difference when I work with nice people. The staffer actually apologized to me when she phoned the unit to say that the secretary was sick and she had no replacement to send. A staffer, apologizing to a nurse? Never happened to me before.

Now, I have fed the dogs, the boys are at a field trip, and I am blogging. How nice life is. Last year I bought a lot of those instant firelogs, and now I am studiously burning one a night. Our 1917 house has no central heat, and we are thinking we will put a gas log with a blower in the fire place. I need to get rid of these logs, and having one flicker away every night is very pleasant. I'm also baking brownies. Nice how seamlessly my reentry into family life can be when work is pleasant.

Still knitting the EPS sweater. Just bought Knitting Way by Linda Skolnick.

Clean Laundry

...As in, I want some. I know how it works, natch, I just don't want to do it. I just want to HAVE it. Sort of like a flat stomach, a clean house, and a balanced check book. Hmmm.

Spent the first of two days off obsessing about work, cleaning, folding, washing, with intermittent knitting. I'm doing an EPS sweater (see www.schoolhousepress.com for all thing Zimmerman/Swansen). I think I will do the yoke as a Box the Compass from Meg's book. In a nice dark brown of Cascade Eco Wool, from the best yarn store in the East Bay, Creative Accents. (sadly, no web site. It's a hands on place, in San Leandro.)

In other world news, I went to Target and spent less than $50. I shall check my temperature and take two tylenol, just to be sure.

Odd

This from May: google the word failure, no quotes, and hit "I'm feeling lucky"

I will not be staying late tonight

Did you vote? Did you vote NO? (Californians, that is.) I was so damn tired after work. I picked up the kids, drove thru for food and odd plastic toys, and carried the sleeping three year old into vote. Did anyone let me cut in line? A nurse in her uniform, carrying sleeping child, 8 year old in tow, well, no. So what, I voted anyway.

Worked so hard today that I briefly wished for some kind of slip and fall in the parking garage- nothing serious- the kind of thing where you get six weeks off. Maybe my gall bladder will act up. A girl can dream, can't she?

Overstaffed, under-wanted

OK, work today. Very sick kid, not getting better, not responding, still vented. Busy, Busy Busy. It takes two people to turn him in the bed, one to watch the ET tube, one to do the turning. And, he can't take it. He's too fragile to turn, can't keep his oxygen sats up, has to go back onto his back. Where he will probably get a bedsore, but there's not a whole lot to do about it. And so, I'm busting ass, all day, with this patient and another one, and we get an extra nurse at 11. Aha- I think, I'll give the second, less sick kid to the extra nurse, and then when the sick kid goes to CT, for a scan, I can go with the transport nurse and RT, and Doc, and it will all go well. I mean, I'm suctioning his airway, giving his meds- at least two an hour, blood gases to see if the ventilator is adequately oxygenating him, the works. He keeps waking up and fighting, and I hate that. It must be so damn scary for him.

An hour after the other nurse takes my patient, The charge nurse- who has not offered me one break, one chance to sit down, one chance to go pee- the charge nurse tells me to take the other patient back, the assignment is too cushy and a nurse needs to go home or go to staffing to do paperwork. Yeah. And, since it was my great idea, I need to be the one to go home, unless, like an idiot, I want to walk back into the not so sick patient room and explain that yes, I will be their nurse again, for an hour, and then they'll have the other one back- it just seems too damn disruptive.

At the last moment, before I punch out, I have an idea. I go eat lunch. Then I punch out.

Knitting: Turkish sock number two, not matching. More of a life partner kind of thing. And, a nice sweater made of Cascades Eco wool, of which there is only an inch or so.

Lazy

L A Z Y I ain't got no alibi!!!! Behold the bitter nurse chant. Actually, I had a lovely day. I waxed the kitchen floor, I cast off the sock, and I took a monster good nap. Pictures tommorow.

oops, the sock

Forgot to show you the progress on the sock

Back at it

Worked today. Had about six hours before I could pee, eat, or drink anything. There was no amount of time management that could have ameliorated today. The manager was all excited by how busy it was. What can I say? My back hurts, my feets hurt, my head hurts, and I'm wicked tired. I also worked with this whiny manipulative BABY of a nurse, and that sucked.

On the other hand, I carped so much to the doc about how I could not turn my kid with out his oxygen saturation dropping that she carped to the pulmonologist and he bronched the kid at the bedside. Where we found a little piece of ballon right above the carina. Acting tlike a little valve, and occluding the airway. He went to the OR for a rigid bronch where they could remove it, and he was much less work after this. But, of course, it was time for me to go home. SO, I get the satisfaction of being part of finding out why this kid was so sick, and maybe now he will get better.

My turkish sock maically fell off the needles, and so I have a fun filled evening of getting it back on.

Too Curly For Me

When the youngest son, the Charmer, doesn't want to do something, he always gives a reason. It may be a completely nonsensical reason, but it will be, none the less, his final word on the activity. Today, when asked to put the raincoat on, he said quite convincingly, "oh no, it's too curly for me." And that was it. It was a raincoat- not a boucle sweater. But none the less, too curly.

Well, my best friend got on the airplane today, back to work in her ICU, and tomorrow I go back to work in my ICU, and our parting words, after the kind of long, hard hugs that almost help say goodbye were these: "I'm very curly about leaving you".

Here is the little tree she bought as a souvenir, packed by moi so that it cannot be damaged en route. When you work every day with people who have been maimed, twisted, harmed, damaged, and half destroyed by random and non random accidents, missteps, mistakes and bad luck, it is hard to let your loved ones go out into the world.

PITA

The scarf knitter? Pain In The Ass. It takes two balls of eyelash to make a respectable scarf, and I only have one ball of each. Also, immpossible to do stripes. Brings out the worst in eyelash, as mistakes cannot be seen untill the whole damn thing unravels. Argghhhh. There is no shortcut on the road to hell.

Not Proud

There's a whole lot of fun fur here. All the floofy yarn I ever bought, thinking of whipping up a cute scarf as a present for a ward clerk, or a preschool teacher, or whomever. Well, a few rows into those things, my cells begin to cry out for oxygen, and then the stuff lurks around . Enter the Sew Easy Knitting Machine, although my bestest friend Mary swears it is just like the Wonder Knitter of Christmas 1980. We cranked a few balls of yarn before returning to a few more normal projects, such as Turkish Socks. If I can only concentrate long enough on the plastic cranking thing, I can rid my house of these dust bunny balls of yarn. And never buy another ball again.

Three Woman Socks

Oh, Happiness. Three days off work (5 days before I have to go back! Yeah!), and I have recovered enough brain cells to do colorwork. I got Fancy Feet by Anna Zilborg, which, BTW, I like much more than Knitting For Anarchists, and immediately cast on. But, of course, I couldn't just follow a pattern. I used the garter stitch square cast on from Lucy Neatby's Cool Socks, Warm Feet, and I think I'll use her after thought heel. See? Me, Anna, and Lucy- three women.

The yarn is Finngarn, I think. I'm trying to alternate hot and cool colors. I have to dye some to get orange as I have no idea where I got this stuff, or why, but I suppose I was swatching for something. I have some pale yellow that should overdye nicely. HOw excellent . I just noticed that my unshaved legs to not show in the photo.

We're carving pumpkins tonight. I had four of the kind grown for carving, and they were what I expected. They smelled like I thought pumpkins smelled. The heirloom one that was a deep, deep orange had an intoxicating scent. Cutting into it released a ripe melon smell that made me want to stand up and go cook.

Dusty, Crabby, Bored

Cleaning the living room. I hate the dog hair. Not enough to vaccuum regularly, but enough that it totally bugs me. Hmmph. Above, a view of the floor and the piano. Don't you feel like a better houskeeper already? See what a service I supply?




To avoid turning really crabby, I focused on a different type of fluff: Much better. Doesn't Kelly the dog look guilty? She actually always looks like that. One of her charms.

Fishy Happiness

We built a modest fishpond in the back yard. (Why can't the term "Back Garden" catch on in this country? It's so much nicer, but it sounds stupid for an American to use the term. It's certainly not large enough to be a yard. I think we measure at 23' x 30, or something pathetic like that. When the older son first saw my mom's Midwestern house, he looked out the back door and said "Mom! Grandma has a park in her backyard!")

Oh, yes, I digress. We need to put some trim around the top to hide the black pond liner. The fountain runs from a solar panel , graciously hosted by the neighbors garage roof. The fish were put in yesterday when we noticed mosquito larvae and decided that becoming an encephalitis hotspot would not endear us to the neighbors. Or their garage roof.

On the knitting front, I am overdyeing some bulky something that was once a jacket with fur trim ( yuck) . I'm trying to tone down the purple aqua color to more of a dark purple. We shall see. The yarn- or rather the jacket- was a store sample that was given to me by the store owner when we were friends. But then two years ago, we became unfriends, based on what was, I think, a huge misunderstanding. Just like on Gilligans Island, except no cocoanuts were thrown. ANyway, the jacket got ripped out, as I couldn't stand to wear it, and the yarn has been hanging around for a while. If it still makes me sad, I'll knit a bunch of hats for afghans for Afghans

Alpaca Goodness

Yarn: Suri Dream from Knitpicks
Pattern: Well, follow the directions for Myrna Stalman's garter Farose shawl, but only cast on 5 and use big needles. Use 10 stitches for the center panel. Sawtooth edging from Nicky Epstein's book on edges
Garden: Mine, all mine.

Better

Much better day. We were so short that the manager had to take a patient. Most excellent. She refused my offer of the extra scrubs in my locker, and I had the satisfaction of the patient's mother sneaking over to my bedside and asking- " uhm, is that lady a real nurse? I mean, she doesn't look like one...." Ah yes, most excellent . Also, the ward clerk, who for those of you who are not nurses- the ward clerk is the goddess and ruler of the domain- the ward clerk was supremely helpful in chiding the manager for her lack of gratitude and appreciation of the ward clerks helpfulness. Some posturing, yes, but also, like hey, the nurses always say thank you when I bring them stuff, so you better, too.

My unresponsive kiddo made a small step towards going to rehab- to do what, I don't know, but a step out of the child hell that is the PICU.

Did I mention a week and a half of vacation? MY very best friend, also a knitter, also a nurse, is coming to see me for Halloween.

tomorrow, we have costume parade of the preschoolers, and I am going with a very fine looking cow. A boy Cow, not a girl cow. MOOOOOO

Bitter and Dark

Ok, not a cheerful day, and not because someone died. Actually, it's because someone keeps trying to die, and we won't let him. For months and months, this child has been sick, sicker, sickest. Coded many times. No speech, no vision, no reaction- except to pain- no hope. At least, that's how it seemed to his nurse today. Just endless ICU days and nights, with regular pokes and turns and disturbances, and now and again one of us puts his headphones on, and I don't even know if he likes this music- I hope so, but his parents brought it in. Did I mention the constant diarrhea? I mean, whats worse, constantly leaking stool, or constantly being wiped on your raw little butt? That can't be comfortable. Pain control? Hah. The theory is that he is too far gone to feel pain. If I'm ever this far gone- and I hope not- slip me something, ok? ANyone else out there want to have DNR tatooed on their chest? Damn, it was a sucky day in the ICU.

On the knitting front- nothing.
Does it ever bother anyone else that knitting is now so popular that even mean people are learning to knit?

Husband is working to night. The children are blissfully eating noodles. I may possibly try to spin something

I Lost the Blog

No. Really. I found this really cool backgroundy stuff and links and stuff. I put in the tagline. I filled out my profile. My husband asked about the blog and I said I'm not really sure where it is. He said, "what does that mean?" I said "I kinda hoped you would find it for me. You're the technical expert." Fortunately when he went to blogger the kind folks there had anticipated the totally clueless and had provided a way to recover not only your password, but also your username. That's when I found out that my username and my blog name and my blog's name were all different. Who woulda thunk? Anyway I found the blog .I don't actually expect any readers, but this may force me to write.

So, lessee. I spent the day sick in bed- really sick. Barely able to knit. This evening I perked up enough to finish the hat made from a bulky single from the rainbow batt from www.graftonfibers.com

Tommorow- back to work, I guess, though if anyone with a cold like mine came near my kid in the ICU, I'd throw my body accross their ET tube to prevent the march of the rhino virus.

Picture of the hat tommorow, after I figure out how to work the digital vamera. I know how to get the pictures IN, silly. It's getting them OUT.