After quite some time in a hospital that more often than not feels like a war zone I applied and was interviewed at a nice shiny new hospital. It's part of a larger system of hospitals that has been established in this region for a number of years and this is their new baby. I was offered a job in the Intensive Care Unit, which I love, both for the acuity of the patients (so much to learn!) and the fact that the nurse/patient ratio is quite low. This is a very good thing.
I've been orienting at this shiny new hospital all week long. Every day I go in and learn more about service excellence, performance standards, protocols --the "this is how we do things here" speeches. I keep getting teary eyed as I listen because the culture they have created is so vastly different from where I've been. They actually staff enough people that you can help people one at a time. A few days ago I told my husband, "I feel like I have just entered the Disney of hospitals." Ironically, they quoted a book today called, "What if Disney Ran Your Hospital?" What if a hospital visit became a good experience? What if the staff exceeded your expectations? What if they used their profits to reinvest in more staff, better equipment, more help for the community? Imagine that.
So I sit and listen and get teary because even if they live up to half of what they profess my days will be so different from how they have been that I will actually walk out at the end of the day with my head held high knowing I did a good job and was able to live up to my goal in helping people. And that is an exceedingly good thing.
07 April 2010
04 April 2010
When I don't measure up...
"When I don't measure up to much in this life, Oh, I'm a treasure in the arms of Christ."
Why Do I Do That?
Last week I ran into a mom after school who decided I needed to hear her vent for 15 minutes about the housecleaner that didn't show up at her house the day before. "Did you hearwhat happened?", she asked, and then went on about the wayward housecleaner, who needed the money and said she'd come, then backed out....and the ensuing calls and texts that went back and forth between this mom and the girl. And then the final tragedy....She had to clean her very big house all by herself.
And all I could do was plaster on a fake smile and "oh" and "wow, that's too bad" the whole way through.
When what I wanted to say was, "Consider who you are talking to - I work at a hospital - let me share some real tragedy with you -- how about the young father who dove into a shallow river on christmas day and now will never hug his daughters again; how about the guy who has cancer spread so far throughout his body that he's lost his mind and his poor family waits for his suffering to end; or the guy who got the H1N1 virus and died in the prime of his life; the woman who had simple surgery and every possible complication that could happen, did happen and is now hooked up to a ventilator just to breathe? How about that?"
Beyond that my thoughts are purely selfish. I was without a home for a year so cleaning one now is a small price to pay for the joy of having a home. I work full time and manage to keep things picked up (or my husband and kids do and I'm grateful).
But I didn't say anything. I smiled and bit my tongue almost clean off.
Why? Why couldn't I have gently redirected her thoughts to those real tragedies? Not in a mean way, but just saying anything, something, to change the conversation and help her see how ridiculous it seemed. Maybe because if I had let my real thoughts out I would've come at her with both barrels blazing. Or maybe I was afraid of causing a conflict. Maybe I knew it wouldn't matter what I had to say. I don't know, but I'd like to figure it out.
And all I could do was plaster on a fake smile and "oh" and "wow, that's too bad" the whole way through.
When what I wanted to say was, "Consider who you are talking to - I work at a hospital - let me share some real tragedy with you -- how about the young father who dove into a shallow river on christmas day and now will never hug his daughters again; how about the guy who has cancer spread so far throughout his body that he's lost his mind and his poor family waits for his suffering to end; or the guy who got the H1N1 virus and died in the prime of his life; the woman who had simple surgery and every possible complication that could happen, did happen and is now hooked up to a ventilator just to breathe? How about that?"
Beyond that my thoughts are purely selfish. I was without a home for a year so cleaning one now is a small price to pay for the joy of having a home. I work full time and manage to keep things picked up (or my husband and kids do and I'm grateful).
But I didn't say anything. I smiled and bit my tongue almost clean off.
Why? Why couldn't I have gently redirected her thoughts to those real tragedies? Not in a mean way, but just saying anything, something, to change the conversation and help her see how ridiculous it seemed. Maybe because if I had let my real thoughts out I would've come at her with both barrels blazing. Or maybe I was afraid of causing a conflict. Maybe I knew it wouldn't matter what I had to say. I don't know, but I'd like to figure it out.
I'm a talker, She's a talker...and neither of us can talk!
I now live near the cousin I was closest to growing up. We always lived hundreds of miles apart (seemingly in my ten year old mind) and only saw each other at family reunions and other visits. But we loved each other dearly from a young age and we would talk and play every time we got together.
I'm a talker, she's a talker. When we were about thirteen we had a family reunion on a lake and some of the families rented boathouses. We slept on top of the boat at night. Or maybe I shouldn't say slept - we watched the stars and talked all night and then slept a couple hours. Talk, talk, talk.
Now we live within thirty minutes of each other. But there's a lot we can't talk about these days. My job is governed by privacy laws (HIPAA) that restrict me from giving patient information; her job is much more exciting - she arranges travel for certain parts of the military. Top secret stuff. When I ask her about it she vaguely says things like, "well, you know what I do" or "you can figure it out well enough" but will not confirm anything. It kind of astounds me that this former talker has the discipline to keep her mouth shut, but I suppose that she understands what hangs in the balance if she were to violate her oath. I admire that.
Of course, my work-around is to have an anonymous blog. You don't know me or where I'm at so I can drop bits of work information that won't lead you to anyone who may or may not be in the hospital. And I realize that is stretching this thing as far as possible, but it's how I've decided to deal with it. Cause I'm a talker.
I'm a talker, she's a talker. When we were about thirteen we had a family reunion on a lake and some of the families rented boathouses. We slept on top of the boat at night. Or maybe I shouldn't say slept - we watched the stars and talked all night and then slept a couple hours. Talk, talk, talk.
Now we live within thirty minutes of each other. But there's a lot we can't talk about these days. My job is governed by privacy laws (HIPAA) that restrict me from giving patient information; her job is much more exciting - she arranges travel for certain parts of the military. Top secret stuff. When I ask her about it she vaguely says things like, "well, you know what I do" or "you can figure it out well enough" but will not confirm anything. It kind of astounds me that this former talker has the discipline to keep her mouth shut, but I suppose that she understands what hangs in the balance if she were to violate her oath. I admire that.
Of course, my work-around is to have an anonymous blog. You don't know me or where I'm at so I can drop bits of work information that won't lead you to anyone who may or may not be in the hospital. And I realize that is stretching this thing as far as possible, but it's how I've decided to deal with it. Cause I'm a talker.
Code Blue
To see the blue light flashing above a hospital doorway is an eery thing. There isn't time to think much other than "go." Last week it happened as I was finishing up in one room and taking off my blue plastic gown (the ones that both protect me from hospital bugs and cause me to lose a half gallon of sweat every time I put one on.) I heard the alarm, poked my head out the door and saw the light. I called to my co-worker, a Respiratory Therapist (RT), who was talking to the patient in the room we were in. "Jake, Code Blue, let's go!" and we ran the 20 yards or so to the room.
By then the family were standing outside the room, a nurse was trying to find a pulse, the RT ran in to get the equipment ready to bag him, and I did the functions that are my role in this situation. I am not a nurse so there are about six things I can do - record the events (code blue 10:14 am, CPR began 10:16, 1 dose of Atripene 10:20 etc), do chest compressions, bag, open the cart drawers and hand meds to the nurses, get calls out to doctors to get them on the line with the charge nurse, stand with the family for support, pick up trash (you wouldn't believe how much trash a Code can generate. People are opening meds and IV fluids and discarding the trash on the floor behind them.) Behind me came in about five more people to do their roles.
In this case once the crash cart was in place and I had the recording chart set up and handed off to a nurse I went to be with the family outside the door. This particular turn happened unexpectedly so the wife and daughter were pretty freaked out. Get a chair, put an arm around, give encouragement, watch.
Wait.
In this case the waiting was very short lived. Whatever the cause of this man's sudden unresponsiveness and lack of heartbeat he came out of it quickly before any drugs were given or any CPR needed. One minute it was full steam ahead and then it was like, "Hey, he's ok. Look, he's waving at you." And with that, everyone pulled off their blue gowns and gloves, packed up the crash cart and filed out back to their normal work stations.
The only problem was that the family was still freaked out (understandably!). Sensing a need for the tension to break I said, "Well, now you know how many and how fast everyone runs when there is a problem!" and they laughed and took a deep breath and you could see the fright drain and the adrenaline start to leave their bodies. I hugged them and led them back in - and I knew I'd done my job well in that moment.
****************************************
By then the family were standing outside the room, a nurse was trying to find a pulse, the RT ran in to get the equipment ready to bag him, and I did the functions that are my role in this situation. I am not a nurse so there are about six things I can do - record the events (code blue 10:14 am, CPR began 10:16, 1 dose of Atripene 10:20 etc), do chest compressions, bag, open the cart drawers and hand meds to the nurses, get calls out to doctors to get them on the line with the charge nurse, stand with the family for support, pick up trash (you wouldn't believe how much trash a Code can generate. People are opening meds and IV fluids and discarding the trash on the floor behind them.) Behind me came in about five more people to do their roles.
In this case once the crash cart was in place and I had the recording chart set up and handed off to a nurse I went to be with the family outside the door. This particular turn happened unexpectedly so the wife and daughter were pretty freaked out. Get a chair, put an arm around, give encouragement, watch.
Wait.
In this case the waiting was very short lived. Whatever the cause of this man's sudden unresponsiveness and lack of heartbeat he came out of it quickly before any drugs were given or any CPR needed. One minute it was full steam ahead and then it was like, "Hey, he's ok. Look, he's waving at you." And with that, everyone pulled off their blue gowns and gloves, packed up the crash cart and filed out back to their normal work stations.
The only problem was that the family was still freaked out (understandably!). Sensing a need for the tension to break I said, "Well, now you know how many and how fast everyone runs when there is a problem!" and they laughed and took a deep breath and you could see the fright drain and the adrenaline start to leave their bodies. I hugged them and led them back in - and I knew I'd done my job well in that moment.
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A side-note about CPR. It ain't pretty or neat. If you're doing it right you usually break their ribs and sometimes their sternum. And it is exhausting. We usually have three people who rotate in and out doing compressions because it is so tiring. The last code I participated in (before this one) was 1 hour and 20 minutes long. That is a LONG time. Compressions, drugs, IV fluids, analyze heart activity, repeat. He lived, but coded again that night and was revived again. The next morning, and before he coded a third time, his family decided to sign a DNR (Do Not Resuscitate). His journey ended shortly afterwards.
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