Monday on Tuesday

Yes, the day after a holiday sucks on so many levels. People who can't take it (or imbibed too much) take off.

Otherwise, it seems like any other Tuesday. Except today didn't seem like a day after a holiday or Tuesday. Today, after our regular weekly meeting, (which was blissfully short) had a terrible pall.

One of my favorite interdisciplinary team members, C. is dying. Dying as we had our meeting, and were talking about our current crop of rehab patients. It reminded me of one other time where I went into report and the boss told us, "As we speak Mr. Warhero is dying." He was right: Warhero died that night. To me, how small and insignificant the meeting seemed today.

I finally left the meeting (after our chaplain prayed for him/her) and it got a little better. I buried myself in a project or two. As a result, I had to look at the way things have been going over the past few years. Thankfully, they are getting better.  C. helped us to get where we are. C. helped inspire other folks in his/her discipline to do the same.  We are not where I want us to be for our little group in the Hotel Rehab (I thought we'd be there three years ago...) but we are closer.

I was sad for so many things when C. retired last year, due to health reasons. Sad that I could no longer go down the hall and see him/her. Sad that we'd never get to work together and get your rehab program where it rightly belonged. Sad that I knew this day would eventually come.

'Twas a pity it came so soon. Godspeed you on your journey, C, and may the angels greet you and lead you to paradise. You've earned it.

Memorial Day

I thank those who have gone before, leaving families, friends, babes in arms, children who would never know them except through photographs or home movies or stories told from the grieved spouses, siblings, brothers, sisters, parents and friends.

That sting of a lost loved one in the war was a pained expression I saw every year in my family. My grandmother next door wore it, some days with bearing and dignity, other days, with much distress.

These are a few of  the quotes that sum up what this day means to me.

I remember those brave men and women who answered America's call today and every day. I hope you will, too.

Until next time...

Hope turns to sadness

This patient's journey to us for rehab was long and arduous. One day you're minding your own business and start having these unusual pains. They find out you have this terrible condition.

The doctors save your life, but it was rough. You seem to be getting better when all Hades breaks loose. You go back to the OR, get almost triple digits of PRBCs, and abdominal washout and have all sorts of complications. You lose so many things. But you are here with us, so you are hopeful.

You come to us, are barely here a week, and we have to send you to World Renown, because we aren't staffed (in surgery or anywhere else) to resolve your latest issue. Unfortunately, we have seen this scenario before. You have a problem even World Renown can't fix. They send you back.

They leave us to tell you the bad news. You cry and yell. But to me and the other nurses, you are nice. You're not sure of what's going to happen, but I tell you, that no matter what I'm here with the staff for you to help give you some control in your room; to help you do what you need to do.

It is bittersweet. I have seen this before, and while the characters change, the stories all end the same. I just hope we can make some good memories before the clock runs out.

Stay tuned.

It's beautiful outside, but it's sad

This past week's been a doozy. I'm hoping I never repeat some of it again.

Work was work. We had our yearly inspection and I survived. The inspection team had some new and some old folks, so it was interesting to watch them.

Outside of that, one of my mother's in-laws died. I hadn't seen her (or any of her kids) in ages. I like this family, so it was pleasant. The crazy relative didn't show up for the wake. Still don't know if he/she is alive or dead. 

I was just getting ready to go to bed when another relative called me. Her son didn't answer calls as usual that day, so she went to the apartment complex where he lived near her. No one answered when she knocked and one of the neighbor's let her know she could see inside the apartment from outside, since Max left the curtains open when he worked from home. (He had a job that could be done remotely, and hadn't worked in an office in years.)

When they looked in, Max appeared hunched over his desk. My relative watched, but Max didn't move. She knew Max was probably dead. While it wasn't a surprise (Max had problems), it was sudden.

So, since Max's family (girlfriend and teen child) was out of town and she didn't have a key, she had to call the police to break down the door. She found Max dead. He was in his early 50s. It was sort of a circus arranging the apartment, having the police roaming around, lots of questions, and waiting. Happily, things calmed down before I could get dressed and leave.

Now, we're just waiting for Max's family to get back to complete the arrangements, and for the medical examiner to do his/her part.

Stay tuned...

It's Tuesday

However, for some folks, it's Friday. Forever. One of our retirees came in for the last time and left today. Sadness.

Tuesday for me means patient appointments (if someone doesn't cancel them at the last minute) and meetings. Fun meetings where people who insist that it start at one time (0800) casually stroll in at 0815 and throw off the folks who have to come in at 0830 from another site for a short report.

Our coordinator called some of them on it. I don't really think it will stick or embarrass anyone enough to show up on time. It's the Hotel way, and they (the Hotel "team") aren't going to change for anyone. Even if it is terribly inconvenient and they are the first people who think the meeting is going too slowly.

I'm all for locking the doors and deducting the time from their pay, but unfortunately, management doesn't feel the same. We should ALL suffer together.

Just another reason why I hate team building exercises. A few divas always screw it up.

On the ropes

This guy is back again.

Things got better. But time is not his friend. He's getting older, and now he's sicker.  We can flush him out, but will have to wait to see if he will make it through the latest crisis.

He's a guy we like: friendly, funny, loves his doggies (big ones and small ones) and his wife.  He has good friends who've been there with him and her the whole time.

Now, we pray. That he gets up that hill again, before the avalanche takes him out.

My mother really was a saint

Momma had coal black hair and eyes just as dark against her Celtic skin. Yes, she looked like those black Irish ancestors sans the blue eyes that Granny had.

She suffered lots of stress in her life: getting married "late" (at 25), not having kids right away, and when she had them, she nearly died.

Momma was stubborn, though. (Dad loved her for that.) After nearly dying and losing her first baby, she kept going until the rest of us were born. She finally was where she wanted to be: a mother of four children, just like all of her siblings (except for her old maid sister Maisie). Granny was pleased with all 24 grand kids. Momma was her baby, and she finally had her own brood of kids. Gramps and Granny absolutely loved being overrun by little (and big) kids at their house.

But, the happiness was short lived. In the prime of her life, Momma found out she had a terminal disease, something she would not get now, but then, they didn't know how to prevent it.

Momma died in her 40s. We were very sad. One of Momma's friends ran a local newspaper and published a long, sweet unofficial obituary for her, which I still have here somewhere. I couldn't bear to read it more than once, so I put it away.

However, I cannot imagine being a child who would have to write this obituary. We had much sadness in our home, but we were loved so much, and so rich in comparison.

I mourn not for the dead lady, but for her children.

A revelation

 Nothing is covered up that will not be revealed, or hidden that will not be known.--Luke 12:2

Diseases and disorders can be eye-opening, in more ways than one.I always thought that a relative had a common neurological disorder. No big deal. You see it, grow up with it, and you deal with it.

Life has a habit of throwing curves, and this relative sure suffered them lately: deathly illness, recuperation, and it seemed, a return to health.

Recently, the relative went for a consult. Normal, I thought. Done at the advisement of the old boss, since "It's a good thing to do." Now, I learn it's not normal, but now it's even more different. The oddities that stood alone put together all make sense.

I almost wish I could put the genie back into the bottle, but it would have gotten out sooner or later, anyway.

More later...

Back to work and...

"She never gives out/She never gives in/She just changes her mind.
 She's always a woman to me."
 Billy Joel, She's Always a Woman to Me (The Stranger, 1977)

Q. is a character. A short, thin, sassy, color-coordinated one. So much so, that she put those color extensions in her hair to cheer up the patients. She put red and green in for Christmas. She put football team colors in during football season. Other colors for baseball. And there was always purple, because it is her favorite color.

Q's laugh, high-pitched and resounding, could be heard all over the unit. One regular patient told me, "I know Q's here whenever I come, because I hear her." She'd fly into a room and give patients she knew a big hug and tell them, "C'mon Mr./Ms. So-and-So, you need to get up and see those therapists. They're waiting for you."

She would also clean them up and get them ready for relatives, trips to x-ray, or only to roll out in their wheelchair or stretcher on the unit. She had her favorite patients, and she'd tell you who they were. She was known to negotiate to get the ones no one else wanted. And when she was done with them, they wanted her as their nurse every day.

One day, Q. told me in the hallway, when I was done with one of her patients appointments, "RehabRN, I really have a pain in my side." I told her, "Q, you'd better check that out. Don't hurt yourself."

In a couple of days, Q. was at work and she told one of the staff she was having chest pain. Since she didn't fit the profile of a heart attack victim, staff still worried about her because she didn't like to complain. R., the staff member she told, took her to the ED down the road, so she wouldn't have to go alone.

Q. got the workup and she didn't have a heart attack. She had terrible labs, though. By the time the weekend came, Q. got the news: she had cancer. She started treatment immediately. She went through a short rehab to get her well enough to go home, but she went downhill quickly. She was sent to World Renown for better treatments, but she didn't make it.

Today we found out Q. lost her battle. Her infectious laugh will never be heard again, nor will we see those crazy colors for the patients.

The Hotel Rehab will be pulling out the black bunting again.

It's Friday

And one day, I'm glad is over. My very last paper of grad school is finally done.

But nothing today could be as noteworthy (or notorious) as the school shooting in Connecticut today.

As a mother of a child who could have gone to school there (Bubba's the right age group), I am numb. Numb to think that someone would kill his mother, steal his brother's identity, then go and kill as many as possible in an elementary school.

I could somewhat understand if the shooter chose adults with whom he had a grievance, but he did not. He killed defenseless little children.

Some things I just can't understand...the terror, the grief, the unspeakable sadness for families, first responders, for all the people of Newtown.

I will just pray. For all of them.

Sometimes you're the windshield...

And sometimes, you're the bug, as the song says. Nevertheless, it's Friday and I survived.

It was a busy week punctuated by technical difficulties, rascally coworkers, and stressed out providers who bark orders at you, then apologize later (after you've got a nice case of indigestion).

That was just my side of the house in the beauty of the old, untouched, 70s era Hotel. The new, renovated part of the Hotel is shiny, and the infection control nurse is worried about me. "If you don't have a sink in there where you see patients, what are you going to do?"

Turns out I do have a sink, since I use a clinic room that has one. Problem averted. He/she makes me nervous since one of the therapists tried putting the popcorn machine used by the volunteer group in my clinic room. "No dice." I told the therapist. "We have to move it or it will be confiscated." Thankfully, we found a couple of legal spots for the machine in the renovated Hotel section down the hall. Yes, we'll have to walk, but it has its own spot ensconced next to the nutrition refrigerator.

There was sadness, too. One of our very sick patients got back home and died the other day. He was a sort I wasn't sure would get out of the Hotel. He was elderly and got sick while he was over for his annual check-up. He just bounced back and forth for a while. I was happy to see he was up and motoring around with his wife, who became a minor celebrity on the unit when she was featured in a newspaper story about our town before he left us. They never did hold that "autograph session" I was always teasing them about in the lobby, since we have a paper box nearby.

Godspeed Mr. V.  You fought the good fight. We'll miss you and your "famous" wife, too.

Perspective

One day you get a terminal diagnosis, like Mr. X. Madge, our NP, briefs the staff by saying, "Mr. X. may complain of a sudden pain and that will be it." Lots of people are worried, about you, but we do a pretty good job of bluffing sometimes.

You finally realize that maybe you should go to hospice, because, even though your siblings love you, they just don't know if they can take losing you by themselves at home. As usual, for some people, the Hotel becomes their home for many reasons, as it did for Mr. X.

Our docs get ready to send you to the hospice unit. You say you're okay with that and wheel around in your chair. Your relatives come and even bring your little dog, Fido, who's missed you ever since you've been gone on this odyssey of one life-threatening event after another.

That day, your sister comes for lunch and brings you the biggest burger from Burgers-R-Us nearby, which you tell us are the best ever (just like the sign out front says) and you eat your lunch out on the patio.You go to bed, telling staff you're happy, after a wonderful, sunny day.

Early the next morning, Sasha, the night nurse, finds you. Unresponsive. Gone. She wept and wept. It was her first death on the unit.

She wept for all of us.

We'll miss you, Mr. X., your family and your little dog, too. Godspeed...

Packing

So much to talk about, so little time...so a bit of my day in a nutshell.

I literally was packing a patient's belongings today, and it made my heart ache thinking about it. I packed up stuff for a patient who is on the express train to the hereafter. You know it's heartbreaking when the boss says, "Can you look for his cell phone? They need some numbers only he (Dad) had to make calls for the funeral." Happily, I found it amid all the stuff, but packing and sorting all the toiletries, t-shirts, therapy items and treats was hard. I liked him. He was one of my best patients ever.

We moved people around again. If only the transportation fairy comes to our unit and takes us to the sister unit for a remodel. Maybe Santa Claus will visit next year...

Finally, before I left I was packing supplies to distribute to my rooms down the hall on the way out. A couple of my more macabre coworkers thought I was smuggling out a urinal for a novel "beverage container".

No recycled beverages for me, thanks.

Off to bed...one more day to study...stay tuned.