the next step in the journey

(3:20. I have been asleep for 5.5hr, and am now wide awake. this is not a good thing.)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I didn’t want to make the phone call. I wanted to sit down face to face and have a conversation.  But… sometimes the reality of night shift is that I don’t know when my boss works, and I sure can’t wait at the hospital for her.

I am scared. nervous. sad.  anxious.  excited.  conflicted.

I told her I had been trying to find her to talk to her, she asked if I wanted to come in. I say no… I have got to go to bed soon.

The words come out of my mouth.  she doesn’t like them.  really?  Oh… that makes me so sad.  Family reasons, I tell her.  I love my job, I love the people.

You won’t get to help us move to the new building. I know.  I was looking forward to it. 

This happened really fast.  They called the day after I put in my app. I am assuming you don’t need a reference since you got the job without it.

(I got hired without them calling a single reference of mine)

I think you should be a charge nurse. I will definitely give you a reference for that.  Thanks… but seeing as how it is an ICU I think it will take me a bit to get there.  Oh, true.

If you ever want to come back, just let me know.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I just quit a job I like to start a new job 3 days later… a job that I wasn’t entirely sold and that I am not going to be as good at as I am now (at least for a while.) A job where I know and like all the people for a job where I know no one. A town where all my friends live for a town where my family is.

It is the right choice. I don’t doubt that (at least not for more than a minute at a time.)

But a scary choice.

My brain has been spinning about what decision to make for so long that now that it has been made… one job accepted, one job quit… I don’t know how to handle the stillness.

Someday I am going to learn not to second-guess my every decision.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Here is to the next step in the journey of life. 

It will be interesting to see what happens.

 

(3:40.  going back to bed now.)

Low.

Getting low is not something I usually do, probably because I am somewhat tall.  But here are my attempts…

Sitting on the side of the pond.

You can’t really tell but that is a turtle in the middle.  It was swimming furiously in place… I am somewhat convinced it was stuck but then I just decided it was having fun because honestly? there wasn’t anything I could do to help a stuck turtle in the middle of a pond. 

Note to self: laying on the ground in shorts and a tank top to take a picture is a good way to get lots of bug bites.  Especially near water with as wet as it has been.

Note to self, Part 2: sitting cross-legged on the trail to take pictures of what is probably a weed is a good way to almost get hit by 2 bikes and a dude on roller-blades.  Especially if you are at the bottom of a hill and around a corner.

Part of You Capture.

Age.

She is young.  Young enough that every one of our hospitalist refused to have anything to do with her, and we ended up having to call a pediatrician.  Who has never been at our hospital and has no clue how to turn on a computer.  The specialist didn't refuse to see her, but freely admitted that there were doctors with more experience of patients her age. The nurses didn't like it... if we wanted to be a peds nurse we wouldn't be working at our hospital.  She sits in bed and watches all the romance movies we have, with a parent on one side and a friend on the other.  Her parents advocate for her, and she deals with the pain.  Who knows what is wrong with her.  Hopefully she will be fine, go home and live a good life. 

She is young.

She is alive.

She is strong.

She is young.  65, blonde-dyed hair, better at computers than I am.  She offered advice at a problem I was having with my computer.  It worked.  Always cheerful, knew all the respiratory therapist by name, she was living in a world of denial.  Every doctor who saw her told her the odds.  The realities of end-stage copd compounded by nasty gunk growing in lungs.  She insisted she would get better.  Over the weeks she spent with us, getting q2h breathing treatments, q4h antibiotics, and q6h steroids she went from insisting she was going home, to agreeing to home health, to talking about rehab, to giving in to a skilled nursing facility.   I walked into her room one morning and found the sun shining right on her.  The look on her face... that sunshine was pure bliss.  I laughed and told her I was going to offer to close the curtains.  She said no way.  All doctors wrote notes about discussing code status with her, discussing the end.  She left us a full code, with lungs so bad I could barely hear the air moving. 

She is young. 

She is fighting.

She is dying.

 
She is old.  95 if she is a day. Last time I saw her it was with a rapid response to find a patient seizing... heart rate high then low, a mess.  Now she sits next to the window and reads her harlequin romance.  I ask her questions, she answers so completely wrong it is sad, but she answers with such a look that I almost feel silly asking the question.  I laugh at her reading choice, wonder how much she remembers.  A dnr, she is going home with her sister the next day. Family refuses all thought of SNF.  I have to wonder how old the sister is. 

She is old. 

Living

and yet dying.

Age is relative.  The 60 year olds who can't rehab after a heart cath.  The 90 year olds who bounce back from a CABG stronger than before.  Where is the rhyme and reason, I wonder?  Where is the sense in the failing lungs of the 65yo with a brilliant mind and the failing mind of the 95yo with the perfect lungs?  The kid getting ready to start her life with what could possibly be a chronic condition is going to be strong enough to handle it.  The middle-age man who wants  us to fix the problem that he pretty much self-inflicted, all the while knowing when he walks out he will cause it again.

Sometimes I don't understand life. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I love my sister, but when we are 89 and 95, she is so not living with me.  

Sorry, Ricki.

My Version Of Water

Driving to my parents house the other day I took the back dirt roads.  Half-way home I randomly stopped and started taking pictures.  Here is the river up the road from my house:

All the rivers around our place are crazy full.  After all the reading I have done about the flash floods in Arkansas I have spent time thanking God for full rivers that are at least mostly in their banks…  and praying for all the families that are dealing with horrible losses this week.

This picture doesn’t have any water in it, but as soon as I saw it all I could think of was the song that goes “rain makes corn, corn makes whiskey…”  I don’t actually drink whiskey, but the song makes me laugh and I love fields full of corn:

Of course, all of the rain is actually hurting the crops at this point, but still, the world is amazingly green right now.

Driving back along the turnpike to work on Wednesday was interesting.  It was a day full of gorgeous clouds…

… that as soon as I was under I had to stop taking pictures because at the rate the water was falling from the sky I could barely stay on the road.  I made it out from the other side of the clouds and got home safely, only to have the clouds land right over my apartment as I left for work.  Nothing like starting work in wet clothes…

And for one last picture, pretty sure the ducks are liking all the water right now…

__________________________________________________

You Capture on I should be folding laundry.

Fun!!!

With fun being this week’s You Capture challenge, I was wondering what I would take pictures of… driving back and forth, working 4 in a row… not a lot of time for fun.  But then Tuesday night it ended up storming, and my dad made me hang out in the car in a parking lot for a couple of hours so I wasn’t on the turnpike during all the flooding.  As unhappy I was not being able to go straight home, it ended up being a good thing.  and whereas it doesn’t take a great picture…


… those 108minutes I spent on the phone with a very good friend who lives way to far away and whom I don’t get to talk to near enough?  without a doubt the best and most fun 108 minutes of my week.

I am puppy sitting for my brother and sister in law this week, and Hurley has been moping because they aren’t here.  Today we decided to go to the park, thinking I could take some cute pictures.  Apparently the park is all it took to make Hurley happy again, because he had a blast and all my pictures ended up looking like this:

or this:

So in the end Hurley had fun and I failed at getting any good pictures,but that’s okay. 

 

In other news, after filling out application after application, I have an interview for tomorrow!  In a cardiac intensive care unit… and I am so excited.  and nervous.  I really believe that moving closer to family is what I am supposed to do, and that is only possible if I get a job here.  So… prayers that I can speak clearly and make a good impression would be greatly appreciated!

The E-Mail I didn’t mail.

I was informed recently that I send really depressing emails from work to my parents.  I was in a funk for a while… I am gradually coming out of it, but it took too long.  Night before last I started to write an e-mail, and I stopped.  It went as follows…

this is not a depressing email from work.
I think I have a concussion I have been banging my head against a brick wall for so long.
it is frustrating to call doctor after doctor and have no one acknowledge that something is wrong.
I will leave knowing I did everything i could for my patient.
and that his doctors let him down.
not a good feeling.

Pt had a bp of 212/102 for somewhere around 30hrs WHILE in the hospital.  By the time I’d got him he had some pretty significant expressive aphasia… meaning he was still talking, but having a super hard time finding his words.  This gradually went to him talking but making not the slightest sense.  I called the primary… who ordered 1 pointless drug and a neuro consult. I called neuro, who yelled at me for calling him at 1030 on a Saturday night.  Never had any problem with this neurologist, and he yelled at me for calling about dangerous BP, mental status changes and a pounding headache… I was not a happy person.  Neuro called cardiology… who ordered a pill.  a pill that is really a prostate pill that lowers blood pressure as a  side effect.  It did AMAZING things… lowered the blood pressure to 198/96.  I made doctor calls like 6 times.  I had my charge nurse call, cause they were obviously not listening to me.  They pretty much ignored her too.

Fast forward to 8am.  Day nurse comes in… the same as the day before.  She walks into the room to assess the patient, says “oh my word his bp is high and his mental status has changed from yesterday!”.  she called a rapid response, 3 doctors showed up (I talked to them all the night before, remember…) and all of a sudden they order what they should have done 2 days before and all is well.

I was so frustrated.  I DID MY JOB.  I advocated for my patient.  I got yelled at multiple times by multiple doctors.  and yet… I feel I failed my patient because I couldn’t do what needed to be done… but there was nothing else I could do.   Day shift walks in and everything falls into place.  There are times I hate working nights.  There are times I wish day shift could work a night so they will stop talking about how easy we have it… 

And then there are times when I just need to acknowledge that the system has flaws, that some doctors are jerks, and that I walked into my patients room last night, 24hrs after he flat out couldn’t talk, and he saw me and said “hi Corrie!”.  He knew me, he is okay, and now it is time to put it to rest and sleep…

Choosing just one…

Today the challenge on You Capture was to post just 1 picture.  I am more of a take a million pictures type of person, but I actually didn’t take that many this week thanks to the whole moving thing.  So… my favorite capture?

My brother is big into cars, magnums to be specific.  This is his beauty, which is actually a “chargum”. Somehow he took the front half of  a charger and put it on a magnum… yeah, I don’t get it, but it makes him happy.  Anyway, he enters into all sorts of competitions and one of them was for black and white pictures. I was going to take some good ones and then convert them in Photoshop, but apparently that would get him banned, so here is a straight from the camera black and white.  I didn’t even know my rebel did black and white, and it seems a little flat to me, but I still like it… and it makes it a new challenge to take good pictures without the help of Photoshop afterward.