Peacock Feathers for Margaret


This is Margaret.  Margaret is one of my hospice patients.

Margaret loves to chat about her past life as an “desert rat.”  She talks about how her dad would collect snakes to sell.  A rattle snake was worth 20 dollars.  She talked about a dress she made that she was very proud of and said her mother was the best in the world.  Margaret has multiple middle names.  One of her names means “sewer.”  She has dementia so carrying on a conversation can be interesting but she does love visitors and socializing.  She also loves to listen to the radio.  One day I started singing a nursery rhyme and she happily joined right in.  It was a wonderful discovery that I could say/sing something she could relate to or remember.  Margaret said she couldn’t go to school but her friend brought her books back from school and lent them to her.  She loved books and dreamed of being a librarian.  She’s blind now so I read her “Daily Bread” to her that is delivered from her church.  She really enjoys it.  She likes to hold things so I bought her a teddy bear from Goodwill.  It’s very soft so it won’t hurt her extremely fragile skin.  She can’t get out of bed anymore but she’s near a window.  There’s peacocks out that window and they make a noise when they hear her singing.  We think they think she’s a peacock.  If you heard her singing you’d understand!  :)  She has a vase full of peacock feathers next to her bed.  I have some now too from the owner of the group home where she lives.  They are on my mantel and they remind me of Margaret.

 *

This is a little bit of what it’s like to be a hospice nurse.  I don’t know why I’ve been so blessed to be a part of my patient’s lives.  I appreciate it though.  I hope  that if you ever have a chance to sit with someone who is in their final stages that you do.  The moments that you share are truly priceless.  Life gets stripped down to the important things at this stage.  Material things don’t matter anymore.  You see beauty in the every day things.  You appreciate what you’ve been given and every day you wake up is a blessing to cherish.  You connect with loved ones.  You give love and receive love in a way that is truly magical.  When my patients grab my hand and tell me they love me I believe it.  I know they do- I can feel it.

Hugs, FeeFee

“Normal day, let me be aware of the treasure you are. Let me learn from you, love you, bless you before you depart. Let me not pass you by in quest of some rare and perfect tomorrow.

One day I shall dig my nails into the earth, or bury my face in my pillow, or stretch myself taut, or raise my hands to the sky and want, more than all the world, your return.”

~Mary Jean Iron

Week 3 - Favorite Things (7)

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kids (puddles,cute boots,love,life,laugh,fun,summer,kids,girls)

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Watching TV with bestie - Imgur

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Baby names to cross off your list


I sometimes follow this blog called Fresh MD : http://www.mothersinmedicine.com/2009/05/baby-names_11.html

It took me here today and I had a really good laugh.  For my nurse friends, you will like this!  Baby names to avoid if you are in the medical profession. 

You would think I would get sick of nursing/medical humor but I do not.  It cracks me up every time! 

feefee nurse cute! (annette)

new love


HPage0There’s a new love in my life and this song/video is it:

http://www.youtube.com/watch?v=9_ZXtevJJlM

I love this remake of the Sarah McLachlan song Silence by esOterica.  Unfortunately, the rest of their music isn’t doin it for me.  Too heavy. 

Here’s a good Sarah McLachlan song I like too.  I heard it driving home with a friend after my first day of nursing clinicals 11 years ago and it will always remind me of that day and the patient I had.  This grumpy old man who hadn’t showered in ages- he let us get him in the shower and give him a good bath.  All of the nurses at the nursing home were shocked.  It was a good day.  The first nursing bath you give someone will leave you soaking wet and laughing.  I’ve seen many a new nurse do the same thing and feel the same accomplishment since. 

http://www.youtube.com/watch?v=nSz16ngdsG0

sarahMclachlan

Journal


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You have reached the pinnacle of success as soon as you become uninterested in money, compliments or publicity.
— O.A. Battista

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The greater part of our happiness or misery depends on our disposition, and not our circumstances.
– Martha Washington

butterfly-wikipedia

How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant of the weak and strong. Because someday in your life you will have been all of these.
— George Washington Carver

purple-butterfly

The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.
— Elizabeth Kubler Ross

 

Do you know of Elizabeth Kubler Ross?  I learned of her in nursing school.  A remarkable woman.  Firstly, she became a doctor (Psychiatrist) in the 1950’s which was an accomplishment in itself for a woman.  (Interesting fact: In recent years, nationwide, more women than men have applied to medical schools, according to statistics from the Association of American Medical Colleges.)   Her greatest contribution has been her work on death and dying patients and her development of the stages of grief.  She wrote a book “On Death and Dying” and encouraged the movement of hospice work http://en.wikipedia.org/wiki/Hospice_careecause  which was basically unheard of in her time because she was appalled by the neglect of care for the dying patient.   That book, her firstof 15 , is still considered to be the “master text” on the subject.  I’ve read a lot of quotes that she has written and it just seems to me that she had such great insight.  She said:

In Switzerland I was educated in line with the basic premise: work work work. You are only a valuable human being if you work. This is utterly wrong. Half working, half dancing – that is the right mixture. I myself have danced and played too little.”

and, “It is not the end of the physical body that should worry us. Rather, our concern must be to live while we’re alive – to release our inner selves from the spiritual death that comes with living behind a facade designed to conform to external definitions of who and what we are.

and, “As far as service goes, it can take the form of a million things. To do service, you don’t have to be a doctor working in the slums for free, or become a social worker. Your position in life and what you do doesn’t matter as much as how you do what you do.”

 
She taught at the University of Chicago Medical School.  She died in Scottsdale, Arizona at age 78 in 2004.  She is in the National Women’s Hall of Fame and has won 20 honorary degrees. 

She became interested in death and dying (and what people go through in that process spiritually, emotionally and psychologically) when she was a young girl after visiting a concentration camp.  She saw pictures of butterflies that children (who lost their whole families to the gas chamber and were going to die themselves) drew on the walls and that intrigued her. 

In 1994 she was trying to start a home for babies with AIDS.  She built it on her own land in Virginia  She had bullets shot through her window at home, was called the “AIDS Lady” and “Satan” by born-again Christians in her town.  They said they would not call an ambulance if she were dying because they were afraid of AIDS being brought into their town.  That same year her home and all of her possessions were burned to the ground in an arson fire that is suspected to have been set by opponents of her AIDS work.

Even though she brought more humane, elevated care for the dying patient, she still has opponents who say that her research hasn’t been scientifically based and dismiss her as a pseudo-scientist because she often talked about spirituality.  In the YouTube video below she said that children who are dying (or some that have just gone through a lot like the death of family or other tragedies) develop a compensatory spiritual quadrant while their physical quadrant deteriorates.  She has met 5 year olds that are like an old wise soul who speak like spiritual teachers. 

Remember Ryan White?  His story came about way before I went to nursing school but I remember thinking he was an old wise soul.  He was the 18 year old who died of AIDS and had become a spokesperson for AIDS when it’s trasmission was poorly understood.  He was expelled from school ,if you recall.  He was among the nearly 90% of hemophiliacs treated with blood-clotting factors between 1979 and 1984 who developed AIDS.  When he was granted permission to attend school he was very isolated, had to eat with plastic utensils and use a separate bathroom.  He had numerous threats on his life and a bullet was fired through his living room.  His family ended up moving (basically being driven out of their town).  He died just a few weeks before his high school graduation.  His grave was even vandalized.  What I remember is that despite everything he was going through he had a really great attitude and personality.  Because he spoke out we now have the Ryan White Care Act which finanically supports people living with AIDS who are low income, uninsured or underinsured so they can get treatment. I was (am) so impressed.  I thought he had been given some sort of “gift” despite his illness.  Maybe a gift of tolerance or patience or peace within himself despite it all.  He was also very optimistic. 

Since I’ve been a nurse I’ve had experiences with dying patients that have been so oddly rewarding.  It’s like that patient gave something to me instead of the other way around.  I have had patients who defied death also who have come to have an amazing appreciation for life.  One patient I recall was a middle aged gentleman who came to the ER with back pain.  He ended up having an aortic aneurysm which ruptured right there in the ER. Luckily, one of the top thoracic surgeons was there at that moment, recognized it and rushed him to the OR.  The surgeon told me that he was running down the hall with the patient on a gurney yelling for them to get suite so and so ready for surgery and everyone behind him was saying they can’t possibly save his life.  The surgeon said “the hell we can’t” and proceeded to operate and repair the aorta.  The doc told me it was like a blood bath and the pt.was losing blood as fast as they could give it.  He had something like 20 liters of blood transfused (the body holds about 5).  I swear to you, the entire time I took care of that patient he was smiling despite the pain of major surgery and all that he went through.  I wish we could all have that appreciation for life without having to go through that experience.  (By the way, if that aneurysm had been any bigger the surgeon’s efforts would have been futile no matter what skill he had).

I do believe that something very positive can come out of one’s suffering but it isn’t always automatically so.  I think one has to be “open” to it.  Besides patients who die at peace with that certain “wisdom” I have seen some patients die in a very sad, unpeaceful way.  I’ve seen people with second chances at life who didn’t appreciate it also.  I wonder what makes certain people open to changing or receiving that “gift.”

I know a lot of nurses who view nursing as just a job.  It makes it a lot easier to be a nurse when you look at it from a mere medical standpoint or a series of tasks to be completed but I don’t think you get as much out of it.  For me, nursing is HARD.  It drains me physically and mentally.  It is a challenge for me to stick with nursing.   I am thinking that this is MY challenge though.  Being a nurse is something I need to do to learn my personal lessons in life.  Having back pain and some other problems help me to be empathetic.  Would I rather be pain-free for the rest of my life and my job easy but not rewarding or fulfilling in any way?  Some days I would say “Yes!” but really, deep down inside, the answer is no. 

Do you know what your personal challenges are?  What are you getting out of them? 

FeeFee

 

sources:

http://en.wikipedia.org/wiki/Ryan_Whitehttp://en.wikipedia.org/wiki/Ryan_White

http://www.youtube.com/watch?v=-ry4iIegZrU  short interview

http://en.wikipedia.org/wiki/Elisabeth_K%C3%BCbler-Ross

http://www.healthy.net/scr/interview.asp?Id=205

http://www.yaledailynews.com/articles/view/17147

Wash your hands


Here is the CDC video on Swine Flu

http://www.youtube.com/watch?v=85sD83aRUIQ&eurl=http%3A%2F%2Fwww%2Eamandaripley%2Ecom%2F&feature=player_embedded

In a nutshell, swine flu or pig flu is very similar to human flu.  Originally, people who were around infected pigs caught it but it can be passed from human to human.  Just like the regular flu, it can be mild or very serious.  It is being advised that employers encourage their employees to stay home if they are having flu-like symptoms to stop the spread.  Obama is encouraging schools to close for confirmed or suspected cases of wine flu.  The NY Times said a toddler (from Mexico) died in TX today from swine flu.  article here: http://www.nytimes.com/2009/04/30/health/30flu.html?ref=health

 

You can track the number of cases worlwide here:

http://www.nytimes.com/interactive/2009/04/27/us/20090427-flu-update-graphic.html

It is even more important now to wash our hands. 

The BEST way to prevent infections is to wash your hands.  It is hard to believe but there are still people out there who do not cover their mouth when they sneeze or cough.  I have had patients cough right in my face!  People don’t wash their hands after they cough into them either (or after they blow their nose) so think about it when you are sharing a keyboard or a telephone with someone or in any public space. 

The right way to wash your hands (First thing you learn in nursing school):

Turn the faucet on. Not too hot.  Not too cold.

Get your hands good and soapy.

Friction, friction, friction- get in between your fingers and around your rings- rub for 20 seconds (or sing the Happy Birthday song)

If in public, grab the paper towel and dry off.

Shut the faucet off with the paper towel.

(In nursing school they used this stuff that showed up under a blacklight on us.  The areas most missed were the fingernails and around rings and then in between the fingers)

This may sound so simple but here are some times to think about washing your hands:

1. Definitely before you put anything into your mouth

2. After you have sneezed or coughed into your hand.

3. After you have blown your nose. (please don’t reuse the kleenex or set it down- it goes right into the garbage)

4. Before cooking.

5. After using the restroom. (tip: In public bathroom, use the paper towel to turn the faucet off and don’t touch the door handle if you can help it)

6. After shopping. (I keep hand sanitizer in my purse and everyone gets a squirt after shopping. 

7. Before putting your contacts in or touching your eyes. (I have allergies so this is a hard one for me when my eyes itch but I do make an extra effort not to touch them when I am at work).

8. If you have touched anything suspicious.  LOL

9. Before and after caring for someone who is sick.

10. Before and after caring for a wound.

Wash your fruit and veggies too. 

 

 

Other infections:

And if you are hospitalized or know of someone who is, please make sure all of the health care personnel are washing their hands. 

Hospital acquired infections are a real problem and can be life threatening.  Even if you come in with something that is not normally life threatening- a hospital acquired infection can kill you.  Many hospitals even post signs that say” STOP! Before you touch me, please wash your hands!”  which they post above patient beds or on their doors.  If there’s not one there- make your own!  It’s ok to do that! 

Many types of  infection can be prevented with hand-washing like this one that causes UTI’s, wound infections (chronic and/or surgical) and can get into the blood stream making one very ill: 

“Enterococci are regular inhabitants of the bowel. The genome of E. faecalisis more than 25% exogenously acquired DNA. Enterococci are the leading cause of hospital-acquired secondary infections.

Enterococci have been described as extremely hardy organisms capable of living in many mediums that would certainly kill other bacteria. They normally inhabit the bowels of animals, humans included, but they are found in soil, vegetation, and surface water, probably due to contamination by animal excrement. Enterococci are capable of growing at a range of temperatures from 10-45 degrees Celsius, and can grow in hypotonic, hypertonic, acidic, or alkaline environments. As facultative anaerobes, enterococci can grow under reduced or oxygenated conditions. They are also capable of survival at 60 degrees Celsius for 30 minutes. Enterocoocus faecalisis able to grow in 6.5% NaCl. Enterococci can also grow in 40% bile salts and over a broad range of pH. Enterococci also have a large amount of natural antibiotic resistance.”   from this source:  http://microbewiki.kenyon.edu/index.php/Enterococcus 

Interesting and gross fact:

A physician once told me (this was about 6 or 7 years ago) that he had recently (at the time) read a study that showed the average person indirectly touches at least 6 penises a day!  How can that be?  Well, still today many men do not wash their hands after using the restroom.  Then they put their hands on the table, or grab the phone- and you touch it right after them.  I recently mentioned this to my dental hygienist and she said she wasn’t that surprised because their bathroom is situated in a spot where the receptionist can hear if the faucet is used.  Sure enough, she said at least half the men don’t even turn the faucet on (that means not even a quick little rinsey).   I already knew it was true from being a nurse anyhow.  There’s lot of women who don’t wash their hands after using the restroom too. 

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Je n’ai pas la pêche


“Je n’ai pas la pêche” (“I don’t have the peach”)

This is a French saying for I’m feeling down.   

day two hundred and sixty six. by Allyson Kalie

 image from:  http://www.flickr.com/photos/kaliegarrett/

Everyone has told me that my lay off had nothing to do with my job performance.  When my position ended on my “home” floor I was offered a job on another unit (a position that couldn’t be filled- and I figured out why really fast) but I just couldn’t do it.  I knew we needed the money but this job- it was bad.  I want to give details but I won’t on a public blog.  I tried it for a few weeks but I was so miserable that one day I just could NOT go back.  Because I technically quit the hospital I was not given any severence pay even though I was not fired-  My position was CUT.   I really feel screwed because my director didn’t even give me a letter of recommendation.  (I did receive glowing recommendations from my charge nurses/direct managers).  The lay off came just a few days after a really great evaluation I had with my director.  She seemed excited for me to join the skin team because I have wound experience.  I asked for a class to expand on my tele skills.  It really was an excellent review/evaluation which I have in writing.  I was never reprimanded for anything but received a lot of compliments.  My director said I adjusted well into the role and was well-liked by my coworkers.  Then, a few days later, I was told my position was cut.  I had one week left.  (3 working days).  It is hard to move on from this because it doesn’t sit right with me.   I know there is nothing I can do about it and it isn’t worth pursuing.  Yet it is still hard to move forward.  It pulled the rug out from under me and even all of my coworkers were shocked. 

I’m having a hard time finding a nursing job now and am beginning to ask myself all sorts of questions about myself, my health, nursing and life.  And why this happened to me and if it was for a reason. 

So… this is me giving myself a hug today.  This is an excerpt of a patient letter that was written 3 months ago.  (It was given to the same director who laid me off)

“For me six days in the hospital is just not doable.  I am an active person and spend most of each day out of doors.  Beyond that I tend to be private—certainly NOT your social butterfly.  In a word my 6 days at (hospital name here) were hell, and as I began to deteriorate emotionally I could only watch from afar and curse the darkness…

…Chris takes a place in my heart beside my Aunt Arlene who was a surgical nurse in the South Pacific during World War II.  I have asked myself over and over what I could do for this wonderful girl in thanks.  Nothing adequate.  Nothing appropriate.  Chris brings a humility to her patients that is rarely seen in things medical.  I believe that she is truly honored to serve…

…I say with humbleness and quiet “thank you” to a woman who made a maddening experience bearable.  (She) made me comfortable at all times, absorbed my fears, my questions.  I carry a debt of thanks I cannot repay, yet I thank (her) profusely and repeatedly.  Knowing Chris has allowed me a small sip from the fountain of youth, even if by proxy.  I will never forget her.”

 

My thanks to my patient, “CS”,  for writing ths beautiful letter.  

Hugs to you today,

feefee-butterfly-annette

P.S. I plan to post some of my favorite heartfelt personal nursing stories on this blog.  I have a love/hate relationship with nursing.  I hate what healthcare has become.  I hate the politics, the budget cuts, working understaffed, the long hours and what it does to my back.  It is draining.  But I love meeting people I would have otherwise not had the chance to meet.  As a nurse you get close to people really fast.  You are in their personal space and get to see the real person they are very quickly.  Though I have never stayed in touch with any of my patients, some of them stay close to my heart.  They really do. 

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