Wednesday, November 21, 2007

Yes Virginia, The Saga Continues

Dear Editor—
I am 8 years old. Some of my little friends say there is no Santa Claus. Papa says, "If you see it in The Sun, it’s so." Please tell me the truth, is there a Santa Claus?
Virginia O’Hanlon

So starts the famous editorial written by Francis P. Church 110 years ago this month. He goes on to say that little Virginia's friends are wrong. "They have been affected by the skepticism of a skeptical age." It gives one pause to think what Mr. Church's reaction to the 21st century might be, were he here to see it. Is Santa Claus still real? Well, Newsweek hasn't yet proclaimed, "Santa is Dead", so I guess there's hope.

In my house, the controversy continues. My husband, a man of much romance but not an ounce of sentimentality, has decided to tell our daughter the truth about the Santa "myth",as he puts it. "There are plenty of other, more meaningful myths I want to raise her with," he proclaimed, although so far substitutions are not forthcoming. It should be noted that when Mr. Higgins learned the truth about Santa it was a traumatic event (insert your own instant analysis here). My own fact-finding about Santa was not only NOT traumatic, but is actually remembered fondly-a product of a childhood that is not known for many fond memories. In a nutshell, I read the truth about Santa in a fictional story in one of my mom's magazines. A young boy finds out about Santa, is disappointed but then learns about the true meaning of Christmas and responds by playing Santa himself. It wasn't award winning fiction and I can't really convey what it was that had such an impact on me. Perhaps it was the realization that my parents would go through such hard work to make me so happy and not take any credit for it. Especially since my siblings were so much older and I'm sure were threatened with their lives not to tell me. Whatever it was, the magic of Christmas never left me. Perhaps it's my fertile imagination. In 3rd grade, I wholeheartedly believed in Santa, gnomes and my parent's omniscience.What didn't I believe in? The Easter Bunny, Original Sin and my parent's veracity.

Somewhere in the Santa story is the essence of Christmas for me. Yeah, I know, it's a Christian holiday. It should be about the baby Jesus and all that. But if you read Church's entire response about Santa(and you should, it's a classic for a reason), it goes beyond Christmas and religion to the heart of what makes us human. "I still believe in the good of man" said Anne Frank. Sometimes, that seems as fanciful as Santa and his elves. Yet at work today, I saw a bunch of kids, who have access to the internet, Bratz dolls, Dr. Phil, and Youtube, in a word-kids who should know better-light up when they saw Santa. Santa the Biker came to our hospital this week and the kids went gaga. "It's a miracle!" one girl said, "Santa came in November!"

I think it's more than just the free toys. Most kids I know like the giving of Christmas, as well as the getting. When my eldest daughter was young, her school would have a day where the kids could go and buy cheap presents for their families. I'd give her $20 and you would have thought she was the luckiest girl in the world, able to buy presents all on her own without any parental input. And homemade presents? "I made it!" they shout proudly. If you've never been the recipient of small lump of clay decorated with garish stones and feathers and presented to you as a "paperweight", you are poor indeed.

I don't know where this leaves us with Santa at our house. My husband is still convinced that most people are disillusioned when they learn the truth about Santa. I'd love to hear your stories. I'd also like to win an argument in my house for once. So, if you want to tell your own Santa story, please leave it in the comments section. As for my little one, if she's anything like her parents, I have a feeling she's going to believe in whatever she wants to believe in.

Tuesday, November 20, 2007

I know what I know

I really haven't been on the internets in over a week, except for quick scans of my email. I did, however, pass PALS (pediatric advanced life support). I think it's the 3rd time I've taken it and it seems to get easier and easier, which is not a good thing. In fact, I think there was too much of the fancy videos and not enough content. I didn't have a problem, but I felt sorry for the people who were taking it for the 1st time, including one respiratory therapist I know who I thought was going to have a breakdown when they gave her the "baby in asystole" megacode. There's no real end to that code, except to call it, but who wants to have a dead baby. It's broken tougher participants than her, to be sure.

So in addition to realizing that I know more about PALS than I thought I did, I also learned in the past week:

I know what to do when someone faints, or almost faints, or is just having a culturally diverse grieving response. Help them to the ground(extra points for avoiding back strain) or a chair. She was up and about before I could bring back water and a cool washcloth. Code purple avoided. (Code Purple is medical jargon for, "help, someone received bad news and fell out!")

I learned how to use the peritoneal dialysis cycler. Than I became the point person for the rest of the floor, because, really, when do we ever use that? On someone who weighs 6 kilos, no less? 4 more kilos and he'll be ready for transplant! Go, little baby, go!

I went to conference on nursing research and learned that if I ever want to get a PhD, I can kiss my family goodbye for 4-6 years. Sigh.

I learned that I have completely fallen in love with a little imp who is probably going to die within the next year. I can't help it...she wormed her way into my heart and that's where she'll stay.

I know (from years in the ER) that when you smell diesel coming through the vent system it's because someone hasn't turned off their truck(or ambulance), which is highly annoying for staff and possibly dangerous for your respiratory patients.

I know that sometimes when people appear unresponsive it's because they don't speak English, are hard of hearing, are just plain scared or all three. Maybe you should check on that before you write them off.

And finally, that like being a Catholic or riding a bike, nursing is something that you never forget, no matter how much time you've been away from the bedside.

Thursday, November 08, 2007

I am so not bitter

Can someone please explain to me why amalah is up for a weblog award? Excuse me, but I bitch about my loved ones, I show cute photos of my kids, I have snarky DOWN PAT, for goodness sakes. And I also talk about a little thing called ORGAN DONATION! But do I get nominated? I've been complaining about it all week to the fambly to no avail-they haven't given me an ounce of sympathy.

And the comments!! I'd rather have 2 little 'ol commenters than 167 versions of "OMG! Me too! You're so awesome!"

All right, it's not all about me. But what about the other great mom blogs out there? Like my friend Moreena-top notch writing if I ever read some. (Unlike my perpetually unfortunate grammar-I speak English good, don't I?)

Anyway, I'm voting for Notes from the Trenches out of spite. Not that I'm bitter or anything.

This goddess is NOT bitter

And the word of the day is:

hu·bris /ˈhyubrɪs, ˈhu-/ Pronunciation Key - Show Spelled Pronunciation[hyoo-bris, hoo-] Pronunciation Key - Show IPA Pronunciation
excessive pride or self-confidence; arrogance.

You may recall a few posts ago where I said I was reasonable sure that the baby didn't have pneumonia. Silly mommy. Last Friday, after spiking a temp of 103.6, her parents(both nurses, thank you very much), decided that maybe medical intervention was called for. Of course, my FP was not on call, so I called the guy covering for him. After telling him the medical history in a nutshell-basically, 5 weeks of being sick, one ear infection, countless sniffles, bronchitis, a lacey rash and now more fevers-he tells us to get our butts to the ER as a CXR is probably in order.

So there you have it, bad parenting example #567. At least it's not as bad as the time MY mom thought I was faking sick to get away from the dinner table and then realized during my bath that I had chicken pox. And she's a nurse, too. So, anyway, Daddy nursed(not literally) the baby over the weekend while I took care of other people's sick kids. Sunday, she was a little better, but then Monday she spiked a temp again and looked really listless, so we were back to the doctor's. She was mildly dehydrated, and the augmentin wasn't working, so he changed her over to zithromax and said to give her more fluids. Hurray for the power of breast milk, since it's the only thing she wanted, except for sips of water. Tuesday, she felt well enough to be cranky and we managed to feed her some bread soaked up with potato-leek soup. Today she was definitely on the mend, enough so that I will only feel a little guilty about leaving her cranky-clingyness to go to PALS manana.
Other than that, we've been forced to watch Signing Times DVDs for hours on end. Pooter calls it "babies". I will say this, it's better than Thomas the Train, "choo choo", which is like kiddie valium. We also watch the "woo-woof", which is a Little Einstein DVD that features, you guessed it, dogs. Thank God the signing ones are good, although I now know every song by heart, including The Silly Pizza Song which I can sing AND do in sign.
All that signing, though, and the Pooter still says something that sounds like "budday" when she wants water. She can sign dog and cat and eat and sun and cookie and a myriad other things, but for life nourishing fluids, she cries and says, "mauw budday?" We're starting to get the hang of it, but it's hard to remember on little sleep.

Speaking of PALS, Good Lord, I haven't been to PALS in almost 3 years. Now, there's homework I have to do beforehand. And they changed all that CPR stuff, too. 30 compressions in 23 minutes, etc. What do I know, everybody I code is intubated and we just pump and bag, pump and bag. Uh-oh, hubris again. Now I've gone and jinxed myself-I'll probably witness somebody collapse on my way to class tomorrow.

Work is, well, scarier in some respects, because being away from the bedside for 3 years has dulled my nursing 6th sense. But I did have a good laugh because they floated a NICU nurse down to us last week and gave her a 17 year old boy. Who needed to be straight cathed every 6 hours. Poor girl wasn't used to wee-wees that big. I helped her through it and hopefully she'll say nice things about me to the NICU nurses so they'll return the favor when I'm floated upstairs to take of some little mouse that doesn't even weigh a pound.

I have managed to make nice with one of the pediatric nephrologists after telling her I used to be a TC. Now she's nice to me, but apparently a little cold to some of my coworkers. My specialty, winning over the difficult people. Just one of my many super powers-sorry, they can only be used for good and not evil. Oh, wait, I think that's hubris again. Sigh.

Thursday, November 01, 2007

You want fries with that?

Hospitals continue experimenting with ways to improve customer service, usually at the expense of employee morale. I've had my own experience with that. When I worked in a busy ER, the three biggest complaints were 1)wait time to be seen 2)wait time to be treated and 3)wait time to get upstairs to a room. Almost always, the Press-Gaineys had nice things to say about the employees. Then some big, upstairs Wahoo comes down and tries to teach the nurses how to say "Please" and "Thank You" and THAT leads to cranky nurses. Boy, you do not want your nurses cranky. In fact, right now, go to your nearest nurse and give her some chocolate. THANK YOU.

Working with donor families has given me a whole new perspective on meeting people's needs. When you've spent 8 hours trying to find out if it's possible to recover sperm from a brain dead husband, suddenly getting a cup of tea and a box of tissues doesn't seem so hard. (Please don't ask how they get the sperm-you really don't want to know). Granted, that's an extreme example, but I was taught that you do whatever you can for the donor family, if at all possible. They're giving a tremendous gift. In return, if they need information, a parking voucher, a cup of coffee or a shoulder to cry on, you give it.

I returned to the unit carrying this credo in my back pocket, I guess, without really thinking about it. So I was surprised to hear people grumbling about, of all things, guest trays for patients' parents. "They just came in and now they want to eat? Why didn't they eat at home?" My first thought is, "Why do you care?" It's not extra work, because dietary brings up the tray. It's not impinging on my Christmas bonus, because the patient is billed. I think there's just a certain type of person who is suspicious that someone, somewhere, is getting away with something. They're not bad people. My dad is one. Just don't kick the ball into their yard.

I have to say, also, that I like being nice. I don't enjoy being in a bad mood(no comments from family members, please). Sometimes, I am so cranky I can't stand myself. Last week I had a woman tell me about her four year old daughter, " I don't know where her attitude problem comes from. Life has made me bitter, what's her excuse?" I'm pretty sure that mom can't stand herself, either. And I think I know where her daughter's attitude problem comes from, too. Believe me when I tell you I am not a perky person. The last time I checked, sunshine and rainbows didn't come out of any of my orifices. I like being a pessimest because I would rather be pleasantly surprised than always disappointed. Still, I have found, more often than not, that when you are kind to people they respond with kindness.

So what's the solution? Can you train "niceness" into people? I recently attended a customer service seminar. Well, it was really only an hour, so I guess that makes it a lecture. A message that says, "We want customer service to be a priority, but not so much that we'll spend $50,000 for the famous motivational speaker. Instead, view his motivational video and then motivate yourselves." (Friendly hint, don't motivate yourselves too much or you'll go blind). Anyway, the lecture instructed us to introduce ourselves, explain to the patient what was going to happen and about how long it would take and then thank the patient. Wha? I think this falls under the category of either you already do it or you can't be taught it. I mean, do they really think there are people sitting there going, "Tell the patient who I am? I had no idea! Up 'til know I've just been going into the room, reaching under their gown and asking them to cough."

I think a lot of crankiness stems from burnout, personally. I was floated to the nursery a few weeks ago and they had that one nurse who just seems to infect the rest of the unit with her bad attitude. You know just what I'm talking about if you've ever worked with this person. She bitchd about everything and everyone, including the babies, who she considered "bad." How can a newborn be bad? Makes me glad that my husband went to the nursery with the baby instead of staying with me. Anyway, I was charting and I looked out the window and all you could see was the roof. Vents and smokestacks and gravel and pigeons. I said, to no one in particular, "Wow, your view sucks." Nurse Cranky asked me to repeat myself. "Your view, out the window. It sure is awful." "Oh," she said, "I thought you were talking about my personal point of view."

Now, if you recognize yourself in that example, it is time for a massage. And a job change. Because, really, working in the nursery is NOT hard. (I'm probably going to get lots of comments from nursery RN's telling me how challenging it is to feed, diaper and rotate the little hamsters. Bring it, is all I got to say).

Somewhere in all this is a point. I suppose if we all had jobs we loved and got paid what we were worth and were able to leave our personal issues at home, we'd all be much nicer to the patients. Then we can tackle peace in the Middle East and world hunger. So here's my 2 cents: Be good to yourself and be good to the people around you. If you start to view the world through crap-colored glasses, take a break, get some perspective and lighten up. And if your friends at work start getting obnoxious, say something to them. Then, we can go to as many customer service seminars as they want, knowing we're still providing the same great care we always gave. And if the hospital wants to take credit for our "pleases" and "thank yous", let 'em.


Oh, yeah. Change of Shift is up at Nurse Ratched's Place. See ya there.