R(etired)N

I have my wrist sorted out now - MD appointment was yesterday - loooong drive there and back - and was given a cortisone shot in my wrist/ligament that is supposed to cover the discomfort. AND...I have covered my past experiences as a patient as much as I care to - so............

Back to my Career as an RN – the early years.

After completing 2 or so years of Surgical Nursing and 2 or so Years of Psych Nursing, I decided to go into the float pool in the same local hospital. Each hospital in our Province has their own Nursing "Casual pool". Agency or Travel Nurses are unheard of and never used in our Province – and I am thinking – most of the country. Some nurses were casual because they couldn't get a full time position, some because they liked the varied nursing experiences they could have floating and some because they wanted control over their own time off. The latter was me.

I liked to have my freedom. If I wanted to go away for a week or have fun with friends, I wanted to be able to take those days without the struggle of having to negotiating time off. When you were in a permanent rotation your options were limited. It wasn't easy to trade with others. The other thing I liked about it was the free time to take up another job.

With the Canadian system, you usually don't find more than one hospital per town so one’s choices are limited as to what hospital you will be working in – at least in the interior of my province. With the Vancouver city area, there are more options. So, when I heard about a local well known department store needing an RN, I applied. Something different. This Province wide department store at a local mall had an opening for an RN. They needed a Part time nurse to help relieve the Full Time RN.

I LOVED this new job. It required me to take an Industrial First Aid Ticket, probably the most difficult part of the job. But, at the store, a few of the responsibilities of the RN were new employee applicant medical interviews, WCB claims, caring for sick staff, Health education promotions and Customer/Staff First Aid Calls - mostly kids falling out of shopping carts and fainting pregnant moms or allergic reactions. ( By the way, if you ever had the misfortune of reading "Cherry Ames Department Store Nurse"......the job wasn't ANYTHING like that!!! Take a peek at that excerpt on my link to the book......hahahaha. It's worth a laugh or two....especially take note how Cherry rules out an MI by taking a pulse and checking the breathing - and treats her condition by "chafing" her patient’s wrists....hahahaha....)

As a Department Store Nurse - as an occupation – the RN was a very respected position, I found, which was quite different than the hospital, in general. People really listened to you, asked for advice and cared for your opinion on health issues. Hospitals were always too busy and the average patient's stay too short to develop the kind of rapport this job did. The pay was a little less per hour than hospital RN wages - but the same as the Department managers'. The benefits were great (shopping discounts). And I got to wear real clothes. I worked independently in our own office and had our own timetable with lots of time to do the work required. LOTS of time. And, as it seemed - lots of available time required the Management to review the usefulness of the RN.

So, eventually, not only were we in charge of anything medical, but we were to fill our *extra* hours working in the Human Resources department. A lot of the nurses in other stores complained and fought against the extra non-nursing duties. They didn't like the "secretarial stuff" that they felt was below them. I LOVED it. Anything new and interesting - I just loved to learn. Plus, the HR was the hub of social activity.

I ended up amending payroll, taking applicants resumes, reorganizing the whole office system, composing and typing out letters for the HR Manager and filing and answering questions related to Human Resources, including investment, paychecks,deductions options, transfers etc. This is where I was first introduced to computers. Computer data entry was a lot more complicated back then – DOS system – Windows not even heard of – nor the World Wide Web. It wasn’t the simple operation/programs we now use – but lucky for me that I learned this back then, because eventually Nursing was to catch up to the computerized world and I would be way ahead of the game when it did. It was a fun and interesting job....and SO totally different than what I did in the hospital. This was the mid to late 1980s. I would have never guessed back then how much working with computers would eventually give me the advantage in hospital work.

I thoroughly enjoyed the different role of Department Store Nurse - and though it was short lived.....only 2 years part time....but the Computer knowledge I learned and the typing skills I honed benefited my present nursing career tremendously. It also made a nice mix at the time - doing both hospital float work and Department Store Nursing. Plus there were always the cute guys that worked in the store. One step up from the MDs and the Orderlies. One of the cutest guys that worked at the store later was to also go for his RN. I like to think I may have influenced that decision!

I still enjoyed working in the hospital, in fact, enjoyed it more - now that I only had to be there part time and also that the Department store work was less physically demanding. Plus, there was the benefit of being floated to all areas – now that I was only “casual” – I floated to wherever I was needed – Telemetry (did a course), ICU, ER, Med, Surgery, Nursery, Gyne, Psychiatry, Rehab.......wherever I was needed. Definitely kept it interesting.
Moral of the story: don't hesitate to step into nursing areas that are unconventional - because you never know where it may lead you.
There was one other type of nursing that I did during those 2 years prior to moving to California. BUT............

I had better give my wrist a rest and continue this tomorrow....
Posted by A NURSE at 11:08 AM

Lucky for me, once again, I was able to save the "comments"!

4 comments:

newnurseinthehood said...
Wow, this sounds pretty awesome. Discounts and not cleaning bodily fluids sounds like a plan.
May 1, 2010 12:56 AM

A NURSE said...
Ya, to tell the truth, I almost felt bad taking my paycheck because it was more fun than any job I had ever done...hahaha...and it was a great store to shop in...PLUS - like u said - NO BODILY FLUIDS.... ;)

May 1, 2010 9:19 AM
nurseXY said...
One of the biggest reasons I decided on nursing was the wide variety of things that can be done with "only" an RN license.
Thanks for the comments on my blog, they are appreciated.

May 1, 2010 8:07 PM
A NURSE said...
Thanks NXY....certainly can do lots with that RN license....I just never thought I would be doing it this LONG.
But, all's well. Life is an adventure.

Thanks for dropping by!
May 2, 2010 10:18 PM

Some say it is an advantage to "know the system". Yes, well, I must admit if you have inside information, it can give you a "leg up"- so to speak. But, sometimes, believe it or not, it does have its drawbacks.

Stupid me, but I worry about blood exposure when I go to my dentist. I scream and back off when I see blood in public. Doorknobs and public bathrooms gross me out.

And, yes, knowledge can be an advantage...in other words, I know that every fever doesn't require a MD visit and I know at what point I should have a wound or abdominal pain looked at.

Knowing stuff like that is useful when I can't get a family MD in my own community...and it saves me a trip to the hospital.... But sometimes it isn't. I cringe when I think of the time I was a patient in the hospital I was born in, and later worked in....

If you ever get to look after a Nurse, don't assume she/he knows everything. We don't and can't.

But, as Nurses, we try to save face and perhaps pretend to know what is going on.

Ok - we might know a lot of what is going on, but as a patient, it is easy to lose perspective of what is going on with one's own body. That goes for MDs too. They might know some things but they aren't nurses, and patient care on a unit is not something they are versed in.

Also, the way your hospital does something, isn't necessarily the way another hospital does something. I have worked in 5 different American Hospitals and 7 different Canadian Hospitals over the years, and believe me, there is more than one way to skin a cat. *apology here to my 3 cats*

Having had a fairly long nursing career, I can safely say that through the years - things change!

Ongoing research through the years - and months! - changes what we know and how we treat illnesses and recover patients. If you have read some of my previous blogs, you have already noted the differences between now and "back then".

Gone are the days of post op baths (yay) - you are lucky to get a "lick and a promise" and that is only if you had something done in "that" area, or soiled yourself- and only if you can't do it yourself. Gone are the days when you were on bed rest for weeks on end.... and so on.

You get my drift.

Things change, and sometimes quickly - so never assume anyone knows anything.

Ok. Having said that...there are always nurses like me that feel they shouldn't burden the nurses on the unit at all, and try to do everything myself, no matter how impossible.

The anesthesiologist visited the night before - to explain everything (no daycare admit- you actually were admitted to the ward you would be in post op!). Of course I had to tell him that I really don't react very well to anesthesia (who does?) and I told him I hoped he was good at what he does.

"Are you asking me this because I am younger - you don't trust me?" he asked. "Heck, no" I replied "I don't care WHO you are - I just don't want to wake up dead...if I am not in control...it scares me..."

Premonition of things to come.


Post op, I was wheeled back to my semi private room, absolutely no recollection whatsoever of the trip or the transfer.

Not five minutes later, I come to completely, and feel I am good enough to wander down to the desk and ask for something for pain.

Didn't want to be that patient that bothers the nurses by using the call bell for something I felt I could do myself.

I scoot myself to the foot of the bed and lean over the end so I could roll up the head of my bed (ya - that long ago - not electric! It was also a very old hospital.) then proceed to crawl over the end of the bed (so much for the raised side rails) which was no small feat ( they left the bed in the highest position)... got dressed in my own jammies ( even threaded my IV bag through the arm) made my bed (!) and dragged my IV pole and myself down to the nursing station.

I can already hear what you are thinking, and I am ok with that.... I even hate patients like me.

Of course the nurses were shocked - " you weren't even conscious 5 minutes ago when they brought you from PAR!" (I am sure that I was at least extubated before my ride back to my room) I reassured them that I was "just fine".

Their phone rang and it was my nurse girlfriend wanting to talk to me - to see if I had survived surgery. The RNs handed me the phone at the desk - THEN - mid sentence .....that horrible wave of overwhelming nausea. Without thought to the IV or lines, I dropped the phone and ran for the garbage can in the utility room...

Well, lets just say the nurses were none too happy - the post op abx flipped out of its port (not the needleless system) and squirted its contents all over like a loose garden hose...IV pole swung dangerously at a 45 degree angle before settling upright.

Total Embarrassment. If they didn't scold me, I certainly deserved it.

I didn't only have a T&A, I also had a "repair of deviated septum" (cast on my nose) and so not only did I have a sore throat, but a headache from the swelling in the sinus area. This pain caused a lot of nausea,but it would only happen at certain times... and I learned that if I got the gravol in time (Dramamine for you American nurses !) - no nausea.

Now, I have already admitted to my needle phobia. I have no fear if the needle is heading away from me into someone else.

BUT.

I will do anything to avoid a puncture of my own. Even to the point of appearing obnoxious.

So, the next day - I asked the nurse on duty - "hey, do you mind getting me a p.o. (by mouth) gravol instead of a shot?"

I tried to explain to her that if we could just do preventative medicine - I could nip it in the bud...and avoid nausea and a needle. (Besides, the nurse the pm before had given me a tab instead of shot when I asked, so why shouldn't she?)

Keep in mind this is not the era of Pyxis drug dispensing, and in my world of nursing at the time- not a complicated request for a patient to make.

"Nope" - she said - "the doc only ordered it IM. Can't give you a pill form" WTFlip? That's news to me. Where ever I have EVER worked, gravol was ordered IM/PO/IV - whatever - pick your poison.

Heck, we were known to give a little bit of "preventative nausea therapy" at bedtime for those post op insomniac patients denied sleeping meds. Couldn't she just give me a pill anyway??? It isn't like I was asking for a narcotic for gosh sakes - just an OTC.

"Nope - not without a MD order". Adamant.

"Well, can't you call the MD and ask?" After all, it is daytime - not the middle of the night...and anyway, smart MDs leave orders and let the RNs use discretion...so he deserves and should appreciate a daytime call.

And I did say Please.

"Nope" Ya, just my luck, I get the OCD nurse.

I decide that next time I am bringing my own stash of gravol pills. And hiding them.

Next problem came up on the second day.

Did I mention that every once in a blue moon I have these apneic spells where I can't breathe?

First time this happened, I lived alone and was sitting up in bed - and suddenly, I couldn't take a breath in...no matter how much I tried. I started making this horrible stridor sound.....I grabbed the phone next to me and started dialling 911 - then stopped.

My thoughts ran like this: "Ok, I can't breathe, so I call 911 and oh, say, 20 minutes have passed and I live in an apartment with a door buzzer that I can't answer and a door with a really strong bolt...never mind I would be unconscious or dead when and IF anyone arrives. At the very least, I would be brain dead."

I put the phone down.

Whats the point? Eventually, after about 5 minutes, i could gasp a few breaths....i was fully recovered within 10 minutes, but - what a frightening feeling!
I can safely say, "not being able to breathe" is the worst possible thing one could ever experience.

So, to get back the story:


OK, so the second day, middle of the night, I have one of these apneic spells.

Wakes me from a dead sleep. Scares the heck out of me.

But, at least now I know eventually I might be able to get breathing again...on my own. But, just in case, I grab the call bell - thumb poised and ready.....

and I start to go into the stridor stage.

I hear nurses running down the hall into the next room to me. I guess they were following that stridor sound to where they thought - logically - it might be coming from.

Did I tell you there was a guy with a trach in the next room?

Ya, you guessed it. The nurses ran to the obvious and woke up some poor startled schmuck having a nice little snooze. You would not believe the harsh dressing down I got!

Hey - it's not like I did it on purpose, you know............

On my last day...I finally was drinking well....and wanting to escape before any more embarrassing incidents occurred...I thought....ok, let's lose this IV already.....so I asked the nurse on duty...."Hey, do you mind taking this out? I really don't need this anymore...honest, I am not nauseated and I am drinking!" Proud of myself.

"Nope (same OCD nurse)...we will wait until the whole bag goes through"...apparently when my eyes were shut, she had hung a brand new IV bag and now she didn't want to waste it. WTFlip?

Needless to say, I clandestinely shut off my own IV, d/c'd it when I could dig up a bandage and signed my discharge papers at the desk.

I had to get out of there.

I am getting chest pains just thinking about that whole incident....... ;)

Aug 8/2010  -  OOPS. Forgot the original blog posting from APRIL 27TH that got me blogging about my own experiences as a hospital patient. I injured my wrist at work in April and it took me 5 hours to create the following post, so I don't want to delete it. One-handed-Finger-pecking is work! By the way, I am fully recovered, thank you very much:

A blog entry usually takes me only a few minutes...after all, all of my nursing "paperwork" involves the computer keyboard - and I am now fairly proficient at 65 wpm. This entry, I swear, I am typing maybe .125 wpm ...finger pecking with my left hand is NOT very efficient....you have no idea.....

Yesterday @ work, when finishing up a client's file, a sudden "snapping" type pain zapped my wrist.

 "CRAP!" I yelled.

Normally, I work from home, but today was an office day, so the Supervisor who heard my scream from across the building, came to investigate who died.

After icing my wrist, anti-inflammatorizing myself and filling out the ensuing paperwork, I was sent home...to see an MD.

Three walk-in clinics later (the first 2 were too busy and weren't accepting any more patients for that day) I finally drove the hour home to the clinic near my house where I was surprised to find that I was only ONE of TWO patients!!

WOOO-HOO!!!! That NEVER happens! That alone deserves a post!

Let me interject here that we moved to this community 4 years ago, and because of the MD shortage (well, generally there is a shortage here in Canada of ALL medical personnel) I can't get an MD in my own community...so I keep my Family MD who's office is 1.25 hr's drive away and just use my own triage skills and utilize the local walk-in clinic if only absolutely necessary.

The lineups are usually horrific - but - Miracle! I was seen within 10 minutes!!!

Wow.

That must be some kind of record...duly noted.

The kind doc examined my swollen wrist and diagnosed "tendonitis" (Incorrect dx btw...but he was an ancient prison doc..what can I say?). Thought it was something to do with my wrist, but the Compensation Kingpins demands that someone with an "MD" after their name says so on their paperwork.

SO - I am supposed to TOTALLY rest my wrist. This means not only NO WORK for a week, but NO COMPUTER keyboarding - TOTAL REST OF MY RIGHT WRIST..........WTFlip???

No can do.

I am a computer junkie. I got my first computer in 1995 and haven't looked back!

I even met my husband online (thank-you yahoo!) ....how am I supposed to survive??!?


I now have my R wrist wrapped with a tensor bandage (that's Ace wrap to you American nurses!) with my thumb immobilized per MD advice....and I am painstakingly finger picking with my left hand. Tedious to say the least.


This MD visit/injury thing takes me back to all the times in the past that I have been a patient myself.

I had my tonsils out at age 31. If you have ever looked after a post op tonsillectomy ...you might think ....no big deal. Let me tell you, if you are going to have a T&A performed (and by the way, why is it when I am looking for photo illustrations-they are ALL of little kids?) - I can't stress enough - HAVE IT DONE WHEN YOU ARE YOUNG.

I don't think I am a big baby. OK....well, I am a little needle phobic. I've already admitted that.

Several times.

And YES, I know that nurses make the worst patients, but IT HURTS. Months later. And whatever you do, drink WARM beverages - NOT cold.

Cold creates unbelievable painful spasms in the throat. Ice cream and Popsicles post op are for kids.

Take my word for it.

If your adult T&A patient is carrying on a little excessively - take it from me - they aren't kidding....and they aren't drug seeking when they ask you for something to kill the pain.

Funny thinking back on that hospital stay. Hmmmm. Here's a thought.

I should reminisce a little on my own experiences on the receiving end of my hospital stay (and thus the #2 blog below) ....but - tomorrow. This teensy little blog entry has taken me a whole flippin' 5 hours...........and I am exhausted and frustrated.

Besides, it's ice and ibuprofen time......maybe I'll have a little Baileys with that ice......and continue tomorrow...... *cough cough*

...a little bit of medicine won't hurt.....will it? ;)

My next Job as an LPN was on a Medical floor. There were 3 arms to the unit....each arm had at least 20 patients. Each arm had ONE RN and ONE LPN. It was the RN's job to give out the meds (poor things-because on a Med floor that means MILLIONS of them- and basically, that's all they did all day!) monitor IVs (all glass bottles -no bags!) and do the treatments. It was our job as an LPN to do everything else - bathe all the patients that needed bathing (which meant most), toilet everyone, answer call bells, change sheets every other day, make beds and turn any patient that required it, take vital signs, mobilize and generally do all the direct patient care as needed.

LPNs started at 7 am and we didn't get any verbal report....just a list of patients and quickly scan the Kardex for activity, I&O's and vital signs that needed doing - and off we went - 10 minutes max - or else! The RNs came on at 8 am (I was envious of that extra hour of sleep!) and then sat through report which at that time meant ALL 3 WINGS worth. Of course by the time they got out of report an hour or two later, it was almost 10 am and most of the physical work was done by the LPNs.

It was a tough go, mostly because of sheer numbers, but generally, the patients were *fairly* stable, and even though you had 20 some odd patients to look after, the acuity level was a lot lower than a medical unit nowadays. Patients stayed in hospital a lot longer so were less sick than your average medical patient today. Charting was only one page of nurses' notes and a graph sheet and a couple lab pages - no signatory, no multiple signatures or daily MARs- just one page for meds and MD notes.

Definitely fewer machines and computers- but then the rooms were too small anyway – and I don’t recall doing even one O2 sat on the ward. I can remember only one patient for whom they brought over a Pulse Oxymeter from ICU ...and it was a HUGE box. There was only the very rare IV pump. Heparin was by volutrol drip only and TPN drips were freeflow-no pump.

Thermometers were the glass-and-mercury ones for under the tongue (it took f.o.r.e.v.e.r to do temps!) - and they sat in an antiseptic solution at each bedside. We had time on days and evenings to give out ice water (which LPNs did all together along with the vital sign taking!) and there was time to give everyone a back rub (mobile or not!) at bedtime, or get them tea or whatever they needed. It was busy, but not a harried-nothing-is-ever-getting-done-oh-crap-someone-is-going-to-die type of busy like today.

We had orderlies to help with the heavy patients and care for the male catheters if we didn't have time. They were a fun bunch of guys. We had a great time, joking around, laughing, helping each other out, and I even ended up dating one or two for a while. :P

The only time I was ever involved in a full blown CPR as an LPN was on the 3rd wing of the Medical Unit. I had finished my rounds, and came back to the first room where an elderly gentleman was waiting for discharge. He was the first on my rounds. I had taken his vital signs, chatted with him about going home and then asked when his wife was coming to pick him up. I had told him to get himself ready and I would come back after I peeked in on everyone else and help him out with getting his things together. When I walked back into the room not 20 minutes later, there he was keeled over on the bed. I called the code and then set in motion the things we were supposed to do to begin CPR.

This next part is going to gross out any new RNs. Back then (now I am starting to sound like a dinosaur if I haven't already!) there were no airways or masks in the patient's rooms to use for mouth breathing. You just did the mouth to mouth directly on the patient....no gloves, no protection, no nothing. Gloves were only the sterile kind and were never used for patient care no matter what you were doing.

No electric beds - I had to hand roll with the crank at the foot of the bed so it was flat and elevated for CPR. There was only one ambu bag and it was on the crash cart in some cubby hole down the hall. Eventually someone would haul it to the scene. My RN was first to arrive. She made the BIG mistake of asking me which end I wanted to take (head or chest) and of course I picked chest compressions......for obvious reasons. I knew exactly what was coming. Three rounds of compressions into the CPR, the patient vomits - right into the RN's mouth. Whoa. So glad I made the right choice.

Once the crash cart arrived - along with the orderly, the ICU/CCU Code team and the Charge nurse and Supervisor - I stepped back to let the crowd do their thing. No one needed this body in there and besides, I had 19 other patients to sort out still. Suffice it to say, that poor gentleman went Home - just not to the "home" he thought he would be going to. The docs said it was a blown AAA.

Speaking of which. I remember doing the "rounds" one night, doing the turns, changing the beds, answering call lights - generally making sure everyone was breathing. Routinely, we would start in the 1st wing, at the four bed rooms and work our way around to the end of the hall and back. Approximately half way through the round a bell call light came on from the first room. I walked back to find out what was the problem. Everyone had been fine 30 minutes ago. Three of the four had been asleep, and the third, a (DNR) stroke patient, we turned and propped with pillows.

The call bell was from the 3rd patient kitty corner to the stroke patient. "Yes, can I help you?" I asked. "That patient over there" he pointed to the stroke patient, "is dead." "What?" I was perplexed. It wasn’t like he could have gotten up out of bed on his own and checked.
" Yes, he is gone" the gentleman continued. " I saw an angel come and stand at the foot of his bed and he took that guy by the hand and left..." No way, I thought. I went to the stroke patient's bed. Sure enough. He was gone.

That was a story I have told over and over again. Angels - right on our unit.



Working on a Medical unit, we had lots of Cardiac patients. They were my "pet" patients.....being a young thing and all, and not realizing what men REALLY thought back then, I catered to them to no end. I would make sure they were all given fresh linens, fresh water, bedtime back rubs......I just loved taking care of them....they seemed to really appreciate (no wonder!) the attention and showed gratitude for everything done for them....compared to the elderly females who would basically complain about everything! The "elderly" men I looked after back then were approximately my age now. I can't believe I thought they were "old"!! But, back then, what did I know?



Most MDs were a real pain. I felt sorry for the RNs because the Internists would come on their rounds at any old time and leave pages and pages of orders (mostly STAT) and then walk off without telling anyone. One or two were civilized but it always seems there is at least ONE that is so totally Dr. Obnoxious.

I can remember looking after one of his patients (one of 20-some!) with an RN that didn't take any guff from anyone. His “special” patient was in one of the three private rooms. In the middle of the night we had to transfer his patient out of that room and into a ward because we needed that room for a dying (DNR) patient and her family. By morning, the dear soul had passed and after the family had said their goodbyes, we were left dealing with the body.

The custom of the unit was, if it was close to morning, rather than call the family MD from home, we were to get the first doc to show up on the unit to pronounce the patient. Unfortunately for him, but mostly for us, it was Dr. Obnoxious that first arrived on the scene that am . My RN informed this doc of the expired patient that he was to pronounce. "I will NOT" he stated emphatically "Get someone else". He grabbed his chart and headed down the wing on his way to the private room where he last saw his patient, my RN on his heels, saying nothing about moving his patient. He walked into the room and pulled back the covers of the poor departed soul.

"WHAT!"he exclaimed, shocked. "But - she's - DEAD!". The spunky RN passed him the chart for the deceased patient. "Thank you, that's all we wanted to know - now please sign these". She was definitely my hero.

Generally the medical unit back then was a good place to work. Very busy despite the lack of computerization. Sometimes chaotic. But the camaraderie and friendships more than made up for any difficulties encountered. The one thing that I really liked was the independence that work brought me. I was making $8 per hour, which I thought a lot back then. At least it was better than minimum wage which was approximately $1.75 per hour. I bought my first 2 bedroom apartment at age 21 for nothing down, $200 per month for $20K, then sold it, making $10K and with that bought a 3 bedroom townhouse right near the lake for $46K.
I always rented to friends from work and we always had a great time – at work and otherwise. Not once did I ever think that one day I would be a nurse in my mid-50s, looking back on the past, shaking my head and wondering at the life of a young nurse - taking life for granted.......


Like I said.....I look back and shake my head.........

My first job as an LPN was working in extended care. I was, what...22?

It was the only job I could get at the hospital I did my training in. The old folks there mostly didn't do much anymore - save the bingo games or the “art” classes, some OT - but there were sure a lot there that had lived a full life. I could tell by the photos and the stories....and opinions.

I still can picture in my mind's eye- that little old lady with the thick brogue accent who told me the amazing story of how she immigrated to Canada with her Canadian Soldier husband after falling in love (apparently after turning down the proposal of Prince of Wales -later King Edward that abdicated for Wallis Simpson) and moved to the Great White North.

She told me (during her morning bath) that she had, at that point, no idea where babies came from and when she started getting morning sickness...she had NO IDEA she was pregnant – all she knew was that she was terribly sick and in the middle of nowhere.

She walked miles to get the help of her neighbour who recognized her symptoms immediately and had to break the news to her – “you’re going to have a baby!” I admired her fortitude - coming to a foreign land – not knowing anyone and then enduring all the hardships of living in Northern B.C.! Such a positive lady and - so happy. The stroke that confined her to her wheelchair didn't seem to dampen her interest in life and those around her.

In contrast, there was the sad old woman that reported different nurses for "not cleaning the bedpan out good enough" and verbally chastised me for singing while working - "Don't you know there are sick people here??" - nothing good to say, everything was awful and nothing anyone could do could please her. She couldn’t help with the wheelchair transfer in the least (many nurses hurt their backs on her – yet she was seen, on a pass to her old home, wandering about on her own) and made life miserable for everyone about her.

What a difference in attitude! By the way, I can talk about these 2 old ladies because
A. They are long dead and gone.
B. I have no clue what their names are.
C. I would guess their relatives don't remember their names either - 35 years after the fact. They were already really old back then.

How sad...to have lived and no one remembers you existed. The only thing worse is no one remembering you existed while you are alive.

Looking back on those days: all those 8 hour night shifts just making the rounds, turning every “resident” every 2 hours, changing and turning, wiping and draining catheters - then the day shift - one person transfers, taking down to dinner, making sure everyone was fed......what really stands out in my mind is all the fun we had.

I can remember phoning the local radio station to have the DJ make an announcement over the night time radio for the nurses on Night Duty to "wake up and do your rounds". The camaraderie was unique and fun. Fun, not just with the other nurses and staff.....but with all those "old people".... they really made an impression on me and I did care about each one.

Every single one of them had once been someone’s precious little girl or boy, growing up with brothers and sisters - experiencing the first day of school and growing up with their families, going to college or getting that first job, meeting the love of their lives (or not!) and having babies of their own - watching them grow up and leave the nest.....and gradually getting older.....and older.

It was so interesting hearing all the stories...all these "broken bodies" that once had a vibrant life, were young once and had – and still have - feelings.....and probably still felt no older than 18 inside their earthly body. They were once somebody's baby, somebody's lover, somebody's mommy and now somebody's Grammy.



I would always pause at the bulletin board by the head of their bed and look at all their yellowed and dog-eared photos their family posted ...a young man smiling - arm around a beautiful woman looking vaguely like the person in the bed.....a fragile sepia square with cracks criss-crossing the photo of a little family.... and you realise that these precious Old Ones went through life....just as we all are....experiencing life, love, laughter, sadness, tears ....dreams now part of that past - and now confined to an ECU....some with visitors, some not so many and some - none at all.

As a younger person I had no concept or thought that at that at some point I, too, would travel down that same road......and I felt a tug in my heart for those beautiful vibrant young people from years ago frozen in time on those old photos that were now, by life's circumstances, transformed into the withered figure in the bed..... and wonder at the change in fortunes that life dealt them....

Nursing in the ECU was the start of a real human experience for me. It brought into perspective not only the art of caring for people....not just physically but also as human beings - living souls.
I really did love every minute of it. But, after ten months – I wanted a change.

I wanted to know and learn more.

I transferred to Medical.

In my diary, my actual entry reads "Got the posting on Medical!! YIPEEEE!!!!"



Kitty at the laptop, my photo

 I was going to blog a little more about my LPN experience....but today I am a little sad....One of my precious cats, Kit #2, has developed Mammary Cancer. As an RN I knew from the looks of the lump near her right fore nipple - it was cancer. I knew it before I took her to the Vet for an actual diagnosis. I knew there was nothing that could be done but I still wanted to know. I told the vet that I knew it was Cancer.... to which he replied...."Oh no....those lumps are usually benign".

But, once he examined her....he confirmed my worst fears.

I knew that for cats...if they develop cancer, the treatment you would normally do for humans would be next to inhumane for a cat, especially since without treatment the aggressive forms will kill them within a year - or sooner - and with treatment - they are lucky to last 3 years maximum - but at what cost (and I don't mean money here)?

I found Kit#2 at an SPCA four years after I got Kit#1. Kit#2 was abandoned by her original owners at the SPCA (they lied and said the "owner had died" - but I know they didn't because I talked with them 4 yrs later when I was making inquiries with the same phone number I had saved in Kit #1's file) with what would be her last batch of kittens. Years later - when comparing a photo of Kit#1 with her mother that the previous owner gave me at the time - I would discover that Kit#2 was the mother of Kit#1! So, based on calculations, Kit#2 had had her first batch of kittens at age 10 months. ( This really upsets me for several reasons....ONE...no kitten should be having kittens....TWO..who dumps a cat because the owners are too irresponsible to prevent another batch of kittens??? It was obvious that is why she was dumped, because I could see that the kittens were not "all Siamese" like my Kit#1...but mixed.)

ANYWAY. Any adult female cat can develop mammary cancer, but the average age is usually 10-14 years of age.
Strike one for Kit#2.
Siamese cats appear to have a genetic predisposition for developing mammary cancer and are twice as likely to develop it as other breeds.
Strike two for Kit#2.
Unspayed females are at a much greater risk of developing mammary cancer. Female cats that were spayed after having one to several heat cycles, with or without having kittens, are also at a greater risk than a cat that was spayed before her first heat cycle.
Strike three for Kit#2.
I guess Kit#2 just didn't have a chance.

So now the tumor has burst open and my poor Kit#2 has a huge draining hole. I cleaned it up this am. It is getting *slightly* stinky but there doesn't seem to be much necrotic tissue at this point but I am sure it will be getting that way soon. That's just what cancer does. It doesn't appear to be infected at this point - the drainage is serous type and clear. She has no pain or fever. I have towels laid out in every area she lays down to catch the serous drainage, and launder these frequently. At this point most people would question - WHY NOT PUT HER DOWN??? (certainly my husband thinks this.)

My answer to that is: Quality of Life. The moment I don't see her prancing out of the "bathroom" after her daily dump, the day I see that she is having pain, the meal I don't see her eat ravenously, the moment I think that her quality of life is compromised - that is when she will be euthanized.

Kitty on her Cat-porch, my photo

At this moment, she is happy. There is nothing more that she enjoys but to lie in front of the fireplace and bask in it's warmth. She cuddles with us, she bosses Tia around, she begs for more soft food rather than the kibble. She jumps up to the windowsill and watches from her perch the world beyond the window. She visits the outdoors via their "catporch" and is interested in what is going on around her. She just doesn't seem bothered at all with that draining plum sized tumor on her chest. She keeps her fur meticulously, she makes sure the drainage is kept to a minimum......

Quality of Life. I know more PEOPLE with less "quality of life" that aren't sick.

So I will continue to monitor my baby (yes, when you have no children - they ARE our babies! FACT: 70% of animal owners- cat and dog- have no children!) and the moment she is uncomfortable, or won't eat, or has declined to the point where she just isn't Kit#2 anymore........I will think about euthanization.

AND - I won't be taking her to a VET to do it. She HATES the Vet office. I will have it done at home where she isn't traumatized in her last hours................ It's the least I can do for an animal that has given me so much joy and unconditional love.

I revamped one of my postings of my First job as an RN & some of the Changes in Nursing in the last 30 years since I started nursing.

I know nurses that have worked in the same job for 30 years and are afraid to make any moves elsewhere - even within their own specialty.

It is definitely more difficult nowadays to switch areas. I know that specialization restricts lateral moves between units and you have to question the safety factor - floating an RN to a unit where they are basically a fish out of water - yet it is still done all the time.


My first job as an RN was on a Surgical Unit that had approximately 45 - 50 patients. There were 4 RNs to look after 12 or 14 patients each (much improved over the 20 patients on Medical 5 years previous). Nowadays that sounds like a lot of patients (that was during the day.....at night perhaps you had 16 to 20 patients) but that was the norm back then, "back then" being 30 years ago. Nowadays the nurse to patient ratio has improved but the actual "acuity" level has gone up so I am not sure that it is any better.

I think the fact that we kept patients a lot longer back then made the load a little easier....you had more patients that actually could care for themselves, mobilize independently, and had less machinery attached to them. Lack of pumps/machinery = more space and less monitoring although what you were watching definitely needed to be followed carefully.

For Heparin drips we used volutrols and TPN would sail in "sans pump" – free flow – try calibrating by eyeball lipids at weird calculations - 35 mls/hr and the regular solution at 68 mls per hour. By this time IV bags as rather than bottles were being used (the lipids came seperate in a glass bottle).

Not one post op patient had an O2 Sat done or even were initially on oxygen when first brought out to the floor. I have suspicions that there were many patients that probably could have used O2 – if we had only known what their sat level was. Now oxymeters are pretty well routine as part of the post op assessments.

Funny, the things that were deemed "important" back then. They all DID get their complete post op bed bath and nightly back rub by the shift's end - and in this way I am glad things have changed.

There were no needle disposal systems for each room (only one huge container at the nursing station - no lid). After using a syringe you would recap and pocket it, and at some later time during the shift when you had time, dispose of it in the big open bucket at the nurses' station....unless of course, the cap fell off the needle while in your pocket.

Most new nurses listen in horror when I tell them I have no idea how many needle sticks I got in my hip from used syringes that serendipitously uncapped themselves while I was working. None of these stab wounds were ever followed up or treated. It was just: “oh well...another poke!”.

There were no gloves at our disposal...only the "sterile" ones that would be used only by MDs for procedures and NEVER by nurses or anyone else doing direct patient care no matter how messy a job you were taking care of and what bodily fluid you were dealing with. I can remember sneaking a pair of sterile gloves for a particularily messy cleanup.

It was never thought that you really had to protect yourself from anything...and heaven forbid you should make a colostomy patient "feel dirty" (yes, we were told that by our instructor!) by using gloves while changing their appliance!

Whispers of HIV were just emerging – but no one really knew anything about it. No such thing as “universal precautions”. There are now boxes (plural) of gloves of several different colors and composition in every room....and you certainly wouldn’t care for a patient without a pair of gloves. And yes, we did wash our hands religiously.

Thank goodness for running water and soap!

There was a little recipe box with cards for each surgeon – their “preferences” – whether or not you could just give a sleeping pill without calling him during the night or what they did or didn’t like for their patient.

No “standing orders” ever written down. I know that some RNs didn’t even chart some of these prns given– they were just doled out as needed and requested.  Occasionally an RN would get a "cover" order the next day, but if not - oh well.

Nurses and MDs smoked at the Nurses' station while charting. Patients could smoke in their rooms but weren't allowed to smoke when oxygen was in use in their rooms.  Every once in a while at night on "rounds" you could once identify a hardcore smoker, in bed, by the soft blue glow from their nasal cannulas....the oxygen on fire when they took a puff. No smoking is the rule in all hospitals nowadays, so you really notice a whiff of cigarette smoke wafting off anyone who is a smoker.

The MDs might bring in Bailey's Irish Cream at Christmas for the nurses and we would sip on our "medicated" morning coffee with delight! Often, "the girls" would go out dancing the night before and come straight to work.....smell of smoke and alcohol permeating- still half intoxicated or at least a pretty bad hangover......and no thought given that they shouldn't be doing this....


Things certainly have changed.

Working in hospitals nowadays....I won't have even a glass of wine 24 hours before a shift.

I can remember recently the comments made to me after eating several Christmas chocolate brandy beans that some patient left for the nurses at the desk...whereas - back in the 80s - it  wouldn't be questioned.

I can remember in California it was routine to advise Laboring moms over the phone to drink “a glass of wine or a shooter of any alcohol of your choice” when in the prodromal stage of labor - and that was only 20 years ago.

It wasn’t too many years previous  that MDs would order IV alcohol infusions for preterm labor patients to stop labor. Now - Nurses will note ETOH on a patient’s chart when even a small whiff of alcohol is smelled anywhere on a patient.

Another thing I noticed has changed throughout the years is the camaraderie. It just isn't the same anymore.

Maybe it is just that I am older and it is the younger ones that take the time to do things in the evening together. Maybe I just don't have the energy. Maybe because I am not single anymore. Maybe because I am fairly new in the communities where I worked (I have moved so many times!) ....and we aren't "newbies" just starting out together like my first job. Maybe it is the style of management nowadays, or maybe it is that we are so busy we don't have the time for fun anymore.

I just can't put my finger on it....but things have changed in the camaraderie department.

That's ok though - as I ponder upon nursing past.

Things have to change. Change is good. I love change. I even embrace it.

And I think I like the detachment at work...... having it not so personal. It has been "too personal" all my life and this calm existence away from the personal and political drama at work is feeling good.

Besides, I have my husband now, after the single life for the first 50 years........and less drama is good.

*SIGH*

I certainly was determined to get there!

Nothing Nursing.

Nursing was going to be a temporary job that would allow me the flexibility and the funds to train for a career that allowed me to be creative – which did not include Nursing.

Already I had played in a band, wrote music, designed clothing from scratch, decorated houses - nothing that even closely resembled nursing.

Nursing: not the occupation one would REALLY want to get into. Not if you knew anything of what it was all about in advance.... the things one would have to do in the line of duty....and how *little* one would get paid for so much aggravation.

When you first go into nursing you think more about the Respect and Glamour of the job - you know - the *Super Hero* part of nursing.

Who thinks about the reality of it? - cleaning up people that crap themselves - head to toe poop, under the fingernails, EVERYWHERE - between the sheets and smeared all over the wall?

Who ever thinks about geezers handing over their dentures with a string of gooey mucus and metamucil that stretches from mouth to dentures - into the palm of your hand?

Who would ever think that you would have to deal with 300 pound bedridden human beings that you are expected to roll over - single handedly - and change every two hours?

Or dealing with vomiting blood or exsanguinating human beings. Or worse yet - think of all the diseases you could possibly contract. Who deals with this stuff in real life?

And who really wants a job that takes you away from family and friends right when the fun is starting or miss all the special events like Birthdays, Christmases, Family Reunions, Thanksgiving, New Years, Relatives visits from Other Countries - and -  instead of having fun - you have a work load that is impossible, patients and visitors that are complaining and doctors that are downright mean and rude to you????

I had been a patient twice before I did my training.

Why did I EVER get into this occupation?

That thought has crossed my mind MORE than once over my nursing career that has spanned the last 5 decades. 

One would have thought that I would have clued in immediately the day I stepped inside the hospital for my first clinical. I was petrified to roll the head of the patient's bed up or down for fear I would kill them. Our instructor had scared us to death about *what not to do*.

Or, perhaps on my first practical nursing exam when I answered the question "what things can you do as a nurse to ensure your patient's safety?" and I couldn’t think of anything but "melt the sharp edges off the ice cubes" (hahaha that makes me laugh every time! Clueless).

AND - I should have had a premonition when the nasty old nurse Instructor wouldn't let me off early to be in my own brother's wedding party because apparently - "you won't be able to get the time off once you are working as a nurse!!" - and was threatened by the crotchety old Instructor that my $100 per month much-needed-measly-stipend would be withheld if I DID take even an hour off.

Nothing like running last minute to get dressed in the church parking lot - makeup and hair askew........ Flip I hate those wedding pictures - to this day I curse that nursing instructor.

Yes.

Nursing.

Why would I or anyone want to get into it? Even better question, HOW did I get into it??? I was so naive.

Once I actually started nursing I could see a lot of the positives. There was the companionship of my colleagues – they felt like family back then.

Great camaraderie.

Great for going out when I was younger AND – best of all - there was a *paycheck* ! I could now afford my own apartment. I even bought my first house on my own at age 20. I could come and go as I pleased and didn’t have to work under the thumb and microscope of my folks.

Freedom.

I could work 8 hrs per day rather than the 24 hours per day that I was doing at my parent’s Resort......and the pay was a little better than the waitressing I had been doing at that family restaurant on Main Street. (although shortly thereafter I realized my best friend was making MORE than me working 4 hours waitressing to my 12 hours of nursing )


I started out as an LPN.......and when I wanted to go back to school to take my RN.....my boyfriend at the time said that I couldn't handle it and that I was too stupid.

THAT really made me determined to go back and get my RN....if only to prove him wrong.

But - I still wasn't sure that it was something I really wanted to do.

I wasn't sure I even LIKED nursing.

But - I thirsted for knowledge. To me - Knowledge was everything. There is something amazing about coming to work every day and being challenged with something new.

I wanted to know the whys and the hows and the ins and outs of medicine.

I punted the boyfriend and chose Nursing instead.

No looking back.

punting boyfriend

BUT....it would only be for a while......at least I THOUGHT......