The patients I carry

When I was a nursing student and a CNA on a skilled nursing unit in a hospital there was a patient who bonded with me. That is the only way I can think to say it. She would wait for me to come to work in the evenings and she would hug me and chatter at me when I entered her room.

She had esophageal cancer and had a radical neck dissection with a permanent trach.

She had very few visitors, her estranged brother lived in the area and would not come to visit.

She was lonely.

She and I struck up a friendship.

She was in her fifties but was on the skilled nursing floor to get strong enough to go home.

There was to be no cure for her.

She was essentially waiting to die.

She and I talked about all manner of things. Politics, which I’ve since learned to steer clear from, fashion, the deficit of cute doctors in our retirement community of a town.

She got stronger and was scheduled to go home.

I cheered her every step of the way.

The day she was to be discharged, I helped her shower and dress, brushed her thin hair.

She said that I was her friend and although she was glad to be going home, she would be sad to not see me every day.

I encouraged her to come visit.

She smiled and said she would. With one last hug and a good luck with nursing school she was gone from the unit. On her way home

Going onto the next stage is to be celebrated. Whether it is to home or to a place where there is no more pain. Celebrate it all.

Ding Dong She’s Gone

My least favorite anesthetist left for … I don’t really care what.

The one who was never satisfied with my decisions, always wanting to move the schedule around to satisfy her need to get off the floor.

The one who would never take no for an answer, preferring instead to badger and cajole and talk shit about me behind my back to anyone who would listen.

The one if I said black, she said white.

My boss wouldn’t let me throw a thank God she’s gone party for the day after she left.

Me, publicly, subdued yay.

Me, in my head, YAY!!!

I might have had a party of one. I got lunch out from a grab and go place near work. I had my favorite cold caffeine. I deleted her number from my phone, I deleted her as a friend on Facebook (she friended me first before she knew I would not bend to her will).

My husband says don’t worry, someone will hate you soon.

I shrug.

Let them.

What a dispatch is

I’ve been doing this blog, on this platform for 18 months.

I have struggled with finding the time to write, with cementing the days I publish blog posts.

I have exposed new coworkers to the idea of a blog about the evening shift OR.

I have gone back to graduate school and struggled there as well.

I got my first C ever. EVER.

A dispatch is a communication to the front lines.

I have decided to make a dispatch from the front lines instead.

I am not Kate DeVine.

I write under a pseudonym.

I work in a suburban hospital but don’t identify my location or state.

I work evening shift.

I am the evening shift charge nurse.

I may write about patients but I do not write about specific details.

I may change the ages of patients, the diagnoses of patients, even the sex of patients.

I write about my coworkers, again no names although some have been recognized by people in the department.

I do not watch my tone, or my words, and am frequently very sweary.

I just wanted to reiterate that nothing in my posts can be identifiable regarding patients or the hospital. This is not just to protect them but to protect myself.

Back on the horse

After licking my metaphorical wounds for four months I reached out to the graduate school.

I learned I was dropped after getting a C. Which I expected.

I learned I would have to reapply to the school. Which I did.

I learned that I would have to resubmit a bunch of paperwork, such as a new CPR card, another copy of my nursing license, my flu vaccination record. Which I did.

What I didn’t learn was if my scholarship that I had just received was terminated. If it had been, I will be reapplying.

What I didn’t learn, yet, is if I’ve been re-accepted into the program.

I hope it is as easy as I was led to believe.

Because I am not done yet.

I am not alone

I was explaining to my best, most supportive friend at work about the recent series I’ve been doing on Dispatches From the Evening shift. She began nodding when I said it was basically about those patients who don’t leave us, who we carry. She placed her hand over mine and said, “I understand.”

And in her saying that I knew that she understood about my patients. I also knew that she had patients of her own that she carried. My friend, the most compassionate nurse I know, the nurse who when one of our techs got devastating news about a newborn in her family was the one that I asked to speak to the tech. The nurse who had been caring for her in-laws for years, through health and sickness, even in death while making sure the family, who are not medical, understood what was happening with them. She’s the one who I look to to make sure what is coming out of my mouth isn’t too harsh.

Because I can be harsh, and crude, and expect people to be better than they are.

She and I have different ways of handling things and people.

But she makes me understand that I am not alone in what I feel about past patients.

I am not alone.

She is not alone.

We are not alone.

No, really, back off!

Me: frantically trying to figure out the mismatch between a patient and a case booking last weekend. Same patient name, just reversed, same birthday.

You: standing very very close to my left shoulder pointing out the obvious ‘This is not our patient’

Me: on phone with ED, trying to solve the problem ‘I’m working on it’

You:  who knows NOTHING about how to schedule cases or where to find patients in the computer ‘Why is this wrong?’

Me: ‘I’m working on it’

You: leaning closer, pointing your finger at the top of the screen. ‘look the sex is even wrong’

Me: leaning away from you, still frantically typing, aware of the patient, their mom, their dad, the anesthesiologist, the trainee nurse all staring at the confrontation ‘I’m working on it’

Me: what I didn’t say, at this company we do not point out what seems to be obvious differences in sex listing in the computer, didn’t you pay attention to the lgbtq presentations that have been going on for the last six months. Maybe they are in transition and don’t need to have it pointed out to a room of strangers. Oh, that’s right, you’re a bigot.

You: edging closer yet. ‘Is it fixed yet?’

Me: turning my head and whispering, sotto voce, ‘Please back away. I would like room to work.’

Me: looking at anesthesiologist, ‘Dr, I’m afraid I’ve had to repost the case and you have to re do your pre-op note.’

You: tsking ‘You’re always so disrespectful. You always have been.’ Loudly, so the family and the patient and the rest of the whole room can hear.

Me: hunching my shoulders, finally getting the case reposted and beginning the pre-op checklist.

You: FINALLY backing away so I can work. Sorting out the lines so you can whisk the patient away to the operating room. Without waiting for me to tell you that I have completed the check list and they are ready to go back.

You: Finally acknowledging the patient and doing the time out without me.

Me: what I do not say, ‘My God, really! In front of the patients and the rest of the staff.’

You: taking the patient through to the OR.

Me: smiling at the mom and telling her to come with me.

I walk her to the waiting room, explain the phones on the desk, explain that she will need to answer the phone when it rings, explain that we will take excellent care of her child and to expect a call soon. I explain to her, briefly, that the problem with the computer was that the case had been booked under another patient, who had a very similar name but that our focus was on her child and fixing the problem so the child could go home.

Me: not speaking to the CRNA for the rest of the night.

Me: rejoicing that the CRNA’s last day in my OR will be ten days from now. I can do anything for ten days.

Me: mentally planning the Ding Dong, Thank God She’s Gone party I will be throwing after her last day.

Haunted? Not really. Patients I carry.

I’ve been thinking and haunted isn’t the correct word. Haunted denotes that the memories are unpleasant and something to get rid of

A better phrase is the patients I carry. This is a less negative connotation.

The next patient I carry is a patient whose name I no longer remember. Which is an odd thing to think of.

She was mentally disabled, blind and deaf and lived in a local state hospital. She was near my age in numbers only, her mental age had been gauged to that of an infant. While we were caring for her she couldn’t interact with us. I imagine to her we were just hands out of the darkness. Although we tried to be gentle, how much did she understand?

She was so, so ill. No one knew exactly what was wrong? Just that she kept bleeding. There was no interaction, no this makes me feel bad, why is it happening? She was utterly passive.

She had no family that visited. Ever. But she was a full code.

I remember that all she was able of doing was laying in bed, her eyes closed.

I know that I was in nursing school at this time, so it was in the 90s. I was working as a telemetry tech/CNA in an rural community hospital. I was new to the hospital, new to patients who were less than 60 years old.

One night she arrested. There was a lot of blood. To me there was a lot of confusion. The code was called and the code team responded. I was hovering, waiting to be of assistance. The ED doc snapped at me to begin compressions. Why me, I have no idea. Apparently I took too long to step forward, an ICU nurse, who he may have been barking at, gave me a dirty look and began compressions.

I felt horrible. But I still stayed to be the fetch and carry portion of the code. But she still died.

It was my first code.

It was not a happy code. Are they ever?

After it was all done I was left with the body. I was to clean her and prepare her for the funeral home. I’m not sure if she was a coroner case. Even then I knew that an autopsy had to be done in the person had been in the hospital less than a day. But she’d been there a week.

The local priest came to bless the body. Last rites were of no use to her, as they are done with an alive person who can confess their sins, and receive communion and absolution.

He and I had a much needed conversation about her and about faith’s role in the hospital. He had not known this particular patient but he knew me from church. He asked me to say the rosary for her with him. I told him my rosary was at home, he offered me his own, a wooden well used one, and pulled out a plastic one for himself.

We said the rosary over my patient and he blessed the body. He told me that my presence was one of comfort for the patient, even though she had died. It was good that I cared enough to participate in the rosary for her soul with him.

And then he had to go back to the parish house and I had to go to my other ten patients.

He wouldn’t take his rosary back. I still have it, over twenty years later. The priest has himself died. I hope that the nurse who attended him at the end of his life was a comfort to him.

The lesson is there is room for faith at the hospital, but not as a leading force, but as a comforting one. Regardless of faith, my own or that of a different religion. All people deserve comfort.