Tuesday, May 27, 2008

Contest for Recipients

Astellas Pharma-who need no free advertisement from me, but I thought you might be interested-have a yearly contest to help promote themselves and their website Transplant Experiences. They're looking for essays from transplant recipients and the winner gets to ride on their float in the 2009 Tournament of Roses parade.

If you go to the above site, there's a link called "The Ride of a Lifetime" that will give you all the info and includes winning essays from previous years to inspire you. The essay must be submitted by June 13, 2008 11:59 pm EDT, so if you're interested, get crackin' and good luck.

Saturday, May 24, 2008

Starting Over

I'm a newcomer, again. On a new job, with new people, not sure of what I'm doing or even where I'm supposed to be half the time. While my sense of adventure is still intact, it is a little bit tedious to be a newcomer at my age. I keep thinking that I should really be more settled by now. I tell myself that the many job changes (7 in 11 years? Eeks!) has enriched me with invaluable experience. As for enriching my retirement account, not so much. (Right now my retirement plan is to be nice to my children, so they'll take care of me when I'm old. That, and staying in shape, because I'll probably have to work 'til I'm 80).

Also strange is the transition to a desk job. I mean, occassionally as a procurement TC I'd be a desk jockey, but most of the work was in the field. When we all would get together in the office, it was usually riotous and no one could get any work done anyway. My new coworkers are "office people" though. There's a total of 5 of us, plus my boss. Three would (and do) gladly work for 8 hours straight at that desk making phone calls and sending faxes with the occassional potty break. They eat at their desk. The guy who's training me told me that he doesn't eat lunch. Yeah, ok. I can understand that there are days on the unit, when you have an unstable, vented patient who might not live to see the next shift and so you skip lunch. But in an office? Seriously, the phone calls can wait half an hour. Besides, sitting in that little office all day, you start rebreathing your own CO2 and the next thing you know, you're a little loopy-which I think has already happened to one of them.

The first 2 weeks I mostly watched people work, which I can't stand. I'm a doer, not a watcher. This week I managed to cut my chops on some actual work which involves calling people and telling them what to do, where to go and what meds to take. Twice a week, in the mornings, we have clinic. The newly transplanted come twice a week for several weeks, then they come twice a week alternating lab and clinic visits. Then they come every other week, with just a lab visit on the off weeks-all for the first three months when the risk of rejection is highest. Then we see them every three months for the first year, as long as everything's going ok. Then every six months and then once a year. After the first three months, their primary care gets turned back over to their nephrologist.

The patient's clinic day goes like this: they take all their meds in the morning except for their anti-rejection meds. We do a trough level every visit. They come into clinic, sign in and then go to the lab on another floor for bloodwork. Then they come back to clinic, take the anti-rejection pill and wait to be seen. When they first come in, the TC(me) goes over their meds to make sure they're taking the right things. Note to God, please don't ever let me become chronically ill, because I can't even remember to take my daily vitamin. How anybody manages to stuff so many pills down their gullet is a wonder to me. Basically, everybody is on the following: Prograf, cellcept, prednisone, multi-vitamin, iron, potassium and magnesium supplements, blood pressure pills and, of course, something to protect the ol' stomach from taking so many pills, like nexium or prevacid. This doesn't include the drugs for whatever other problems they have-insulin, water pills, more blood pressure pills, pills for gout, whatever. I'm trying to get used to all these "old people" drugs (no offense, but kids are usually on meds for breathing and reflux, period).

Clinic ends at noon and then we write down all the lab results in columns by patient for the docs to review, write them again in everyone's individual chart and together with the surgeon go over the labs for everyone who's been in the clinic and a few who have their labs faxed to us from outside labs. Then we write down the changes they want to make and THEN we spend the afternoon (and the following day) calling folks and telling them to increase their prograf or decrease their magnesium, etc. Anyone who looks like they're going into rejection gets scheduled for a biopsy and possibly comes to the hospital for 3 days for high dose steroids. It's not rocket science, but it's a lot to stay on top of. One good thing is that the docs are all super and my boss is pretty laid back as long as the work gets done.

You want me to take WHAT with a sip of water?

In other news, our recent bout with the plague of the week is dissapating. Everyone in the house is on antibiotics, except for the teenager, who's never home long enough to catch our germs. Possibly, if she did come in contact with one of our germs, she'd kill it with a withering glance.

Also, my friend and former coworker is working on a Mercy ship in Africa for a year and has a blog. Besides, being a better writer than me, she's also an amazing photographer and altogether more awesome human being than I could ever hope to be, plus she's muy modest, so she'll probably be pissed that I'm even mentioning it, but you should read her blog. It'll blow you away.

That's it for now. I'm off to enjoy me weekend, now that I have weekends to enjoy.

Wednesday, May 14, 2008

Well, I started checking some of my links and found that Moreena's wasn't working, because I never updated it. Whenever I haven't been to her blog in a while and then I go there, she usually has something up that makes me cry. Then I wonder how come she hasn't written a freakin' book yet, because her writing talent makes me gnash my teeth in jealousy.

Then I watched the video and cried some more. A whole lot more. It's worth reading, but don't say I didn't warn you.

So long and thanks for all the fish

Three weeks ago this Friday was my last day in PICU. Possibly my last day as a bedside nurse, ever. Mmmm, well, maybe. There's something to be said for taking care of the immediate needs of another human being. A long time ago, my friend John dated these two women (not at the same time). They could have been twins: they were both tall, blonde and bitchy. Well, there's something to be said for his taste in women but he was a fun guy to hang out with. Anyway, fast forward to 1997 and I run into girlfriend #1. She asks what I'm doing and I tell her I've become a nurse. She sneers and makes a remark about how co-dependant that is. (Remember co-dependancy? Or as I like to call, As Crazy as You Want Me to Be). I was brandy-new to nursing, at the time, so I just mumbled something about her not understanding and made my get-away, before I caught whatever it was she had. Another year goes by and I run into girlfriend #2. She also asks what I'm doing and again I say I'm a nurse. She ALSO says that that's soooo co-dependant. Now, I could have said that nursing is about caring, not co-dependancy. That it's about advocating for the sick, helping people when they're vulnerable, and healing folks who are wounded in their hearts, minds and bodies. It's about education and research and community outreach and technology and putting it all together in a multi-disciplinary, holistic package. But I didn't say any of those things.

Instead, I smiled and said, "How interesting, that's just what C-- said to me."

She just turned on her heel and walked away.


Without a doubt, some people think nurses are co-dependant. I know one or two doctors who think we're overpaid babysitters. (Oh, is the nurse talking? How cute).


For the past few weeks I've been doing another kind of nursing. So far I've mostly been making phone calls, or watching people make phone calls. I've done med reviews and taken histories and started to learn about the process of getting people on the waiting list for a kidney and then what to do with them after they get one. I will eventually wind up on the post-transplant side with another coordinator. People are constantly saying, "Oh, you're going to be working with him? Good luck." Love Monkey thinks this is a bad sign but I'm taking it as a challenge. I'll let you know how that all works out. For now, I'm not sure how much I'm going to be talking about my actual coworkers or patients because I've come to find out how non-anonymous the internet is and I've already been bitten in the butt making that mistake. I will say that the worst part of my week was telling someone that they're not a candidate for a transplant due to other health problems. Not fun. Think of taking away someone's puppy on Christmas and then telling them Santa's not real. It was worse.

And do I have to say that I'm sick again? Toddler germs. Just when I thought I'd caught every germ in the Mid-Atlantic states, I find a new one. Oh, well.