Lotus in the City

Blah, blah, blah

2011-11-20T00:37:00.000-08:00

I think the reason I don't write as often as I'd like is the fact that, all too often, I feel like my job just defies words. Specifically, my words. I lack the eloquence, and especially at this point in my career, the insight to put my experiences into perspective. If I sat down and basically barfed up my thoughts about my night onto this blog, I'd have a series of short, lurid vignettes that are as fun to read as driving by an accident on the highway. What was my night like tonight? People at their absolute worst. One, at her best. Sudden death. Giving up. Strength and coping. Lives consumed by illness that make you rethink your own choices and beliefs. It's deep, it's profound, it's Life... and I can't tell you shit about what it all means. I can't put it all together in a tight, thoughtful, ultimately (somewhat) educational experience. I give you voyeuristic blather that barely scratches the surface. 'Grey's' instead of 'House'. Star instead of Vanity Fair. Twilight over Lord of the Rings. '$40 a day' instead of 'No Reservations'.

Ah, Tony. It'd be great if I could do "the Bourdain." I would love to be able to create fun, bite-sized, easily digestible pieces of an otherwise foreign culture. Take you on a tour of a world you don't know, conducted by a guide with intelligence and humor, wit and wherewithal. Ultimately, produce the finished product -- a respectful and entertaining piece of media that educates you, opens your eyes, and (as he puts it), leaves you 'hungry for more'.

Maybe someday I'll pull it together and get my head in order. I'll stop being an idiot when shit goes down. I'll be decisive. Confident. A resource for others. I'll stop taking everything so seriously. Maybe then I'll be ready to write an RN-focused, HIPAA sanitized, health care version of 'Kitchen Confidential.' That would be awesome.

...and sinking

2011-10-22T21:04:00.000-07:00

Soo I went out for a run outdoors today; it was my first run *not* on a treadmill. I just hadn't gotten around to it; given my OCD tendencies on getting to work on time, I'd much rather run a virtual rather than a physical distance when there is somewhere I have to be in a matter of hours. Anyway, today was my first day off after three days of hell at work, so I thought it would be ideal to go for my first outdoor run.

Oh my god it's HARD.

My legs felt like lead. My lungs objected from the minute I began warming up. The only time I started to feel the familiar, spaced out "zone" I'd grown to love at the gym was after a mix of running and walking, on a quiet stretch of pathway along the Chicago River, and that went away pretty quickly. There just are so many more distractions when you're outside... people and landscapes to maneuver, and the sense that I was traveling an actual *distance*. I was periodically forcing myself to think about work for the past week, which as I said earlier, was hell. Crazy people. A full house. Multiple admissions and discharges in one night. Multiple "situations" to deal with. The crowning event was an encounter with a family I had become close with on a previous admission. Their loved one was admitted onto our sister medicine unit; I ran into one of the family members in the hallway and learned that he wasn't doing well and was entering hospice. I finally was able to see him and his family last night when my shift was done and it was really, really, really sad.

I thought about ALL these things that have kept me running for over an hour straight at the gym on the treadmill but for some reason out on the pavement my body was like "lol fuck you um no way." On a brighter note, the iphone app I was using to track my run was quite encouraging; it told me I was (with walking, mind you) averaging an 11:30 minute mile which is a whole lot fucking faster than I was running on the treadmill.

Moral of the story is, with regards to my running, I'm confused but I'm going to go with it. I'm off all day Sunday, the weather's supposed to be good, and I'm pumping myself up for outdoor run #2. One perk of living downtown is that there's little to zero traffic in the middle of the Loop on the weekends. The run is two weeks away today, so this shit is going to happen for sure. With regards to everything else, well, here's hoping I can find that 'zone' again cuz I miss it and I could really use it.

Floating

2011-10-18T13:21:00.000-07:00

A couple weeks ago I made the totally rash decision to run a race. I've pooh-poohed running for years, crying "It's bad on your joints!" and "Are you crazy? Why would you do that to yourself??"

Why indeed? I decided to go for it because I was tired of my same old workouts. Yoga and pilates just weren't cutting it anymore. I needed a goal to work towards, other than weight loss and flab-elimination. I also needed a constructive outlet for stress that doesn't involve drinking. Mark's sister Kate is a runner; she ran the Chicago Marathon last year, and she's all about it. I thought, what the hell. I signed up for the Hot Chocolate 5K run. I figured, it's only 5K (3 miles), and there's chocolate at the end. Seems like a good start.

So here I am, two weeks in, and I'm shocked at how much I'm loving running. It's true, there is such a thing as runner's high. About a mile in, I start to feel the fatigue, and then it inexplicably evaporates. I'm still running, and I'm still feeling my body working, but my mind just spaces out. I feel the rhythm of my feet hitting the treadmill, I hear the beat of the music in my ears, and I start floating. It's amazing, and the more I do it, the further I start to go.

At the moment, I'm running a 12 to 14 minute mile and slowly working up the duration of time I run. I started at 15 minutes, and with a combination of speeding up and slowing down I'm steadily working on running longer and longer times. Today was the longest yet; with a speed up, cool down, and start up again at a slightly slower pace, I ran for 50 minutes. FIFTY. What the fuck am I DOING out there?

The adrenalin rush is addicting. I step off the treadmill, and I feel light. I think I must look retarded bouncing along the gym floor like a balloon. I feel accomplished, I feel beautiful, I feel ready to kick some ass. I want to go back for more.

The next step is gearing up to run outdoors. It's getting chilly and I'm a big wimp when it comes to being cold. Running clothes are fucking expensive too, so it's going to take me some comparison shopping time to find the best deals. I'm looking forward to it though; I want to see how my endurance changes, and how my running groove feels when I'm actually *going* somewhere. We'll see... !

Yay! I wasn't useless!

2011-10-16T12:27:00.000-07:00

Last night was the first code I participated in where I didn't totally suck and stand around with my mouth open. I was about to go into a different patient's room when I heard the staff assist light go off. It's a "step up" from the patient assist light, and we're all trained to head down to that light when the staff light rings. I poked my head out, and the sound changed to the code light, and nurses started running for the crash cart. A PCT and I grabbed the supply cart from the storage room; it's a supplement to the crash cart with extra IV pumps, a sharps container, sterile gloves, central line kits, suction containers, yanks, IV kits and needles, etc. Basically, it's a cart with all the extra stuff you need in a code that doesn't fit into the crash cart.

We ran to the room, and I checked the name in front of the door: I admitted this patient three days earlier. She still had strong pulses, but had gone into respiratory arrest. Her O2sats were in the low teens (I still don't know if this was accurate or not) and she was being bagged. They were having a really hard time intubating and starting a central line. Someone was already recording (I'm not about to step up and do that yet anyway), and three senior/experienced nurses were at the bedside with the docs. I ended up "running", getting necessary supplies from the cart and so forth. Doesn't sound like much, but after a year and a half of nursing I was pretty happy I wasn't frozen in place for once and could actually be useful. Codes are hard to describe. They're a flurry of frightening activity. Blood and bodily fluids are everywhere, and if you aren't able to be helpful, you need to get out of the fucking way for someone who can. It was a long code due to the difficulty with intubation; finally after an hour and a half they secured an airway and she was stable enough to be transferred to the ICU.

It's a creepy fact in medicine and nursing, especially at teaching hospitals -- you do everything you can to prevent patients from "going south" and "coding", but at the same time it's times like that that are the most vital to your education as a nurse or doctor. Last night I literally got my foot in the door and saw more in less than 2 hours than i have in weeks. Hopefully it's one step closer to me knowing what to do if and when (god forbid) it's my own patient on the line.

Liberal Lotus?

2011-10-14T11:30:00.000-07:00

I am, and have always been, an avowed liberal. I fully support gun control, Planned Parenthood, abortion, the Morning After Pill, gay marriage, gays in the military. I'd Occupy Wall Street if I still lived in New York. However, working in health care has changed me, and I'm starting to feel a little conflicted.

This conflict has been going on for a while, but it has really come to blog-able thought status in the past week. A girl I knew in college wrote this article on the Huff Po about the rights of "poor people." Apparently, "poor people" are being targeted for drug testing when applying for public assistance, but "bankers, traders, and anyone else who received money from the bailout" are not. As she puts it, "Mandatory drug testing, whether as a condition of employment or as a requirement for the receipt of public assistance, is an unnecessary intrusion into personal privacy." Hmm.

Then, I see this other article posted on the FB; it's a response from a writer at the Daily Kos to "the other 53% guy" who is a Marine, avowedly proud of working 60-70 hour weeks, and not having health insurance. Of note, the author of the response states:

I’m a liberal, so I probably dream bigger than you. For instance, I want everybody to have healthcare. ... I want drug addicts to have healthcare. I want bums who refuse to work even when given the opportunity to have healthcare. I’m willing to pay for that with my taxes, because I want to live in a society where it doesn’t matter how much of a loser you are, if you need medical care you can get it. And not just by crowding up an emergency room that should be dedicated exclusively to helping people in emergencies.

Okay.

Let me say up front: people should not be targeted for drug testing simply because they are applying for public aid. No one should have to work 60-70 hour work weeks to make ends meet, and no one should work without health insurance. I fully support needle exchange programs, methadone clinics, and free access to health care that is not an emergency room.

However, I think it shouldn't matter if you are rich or poor. EVERYONE, from businessmen to bums, should undergo mandatory drug testing when applying for public aid. I was tested for drugs before taking my RN licensing exam, and before I was hired at my hospital. You trust your nurse and your doctor with your life, don't you WANT them to be tested for drugs? Don't you want to know that your waiter/lawyer/bus driver are drug free? And, sorry but I am NOT willing to pay for a loser's health care. I think that if you are seeking health care and you are unemployed or addicted to drugs, you should have to show some proof that you are actively participating in rehabilitation and/or looking for a job in order to receive it.

I don't see anything wrong with requiring someone to pay for their drug test if they come up positive. Drugs are illegal for a reason -- you aren't supposed to use them. If you choose to use them, you choose the risk of punishment by law. And if you choose to break the law, the very rules that govern the society you live in, that society has every right to deny you the public aid it offers. If you want society to help you out, it makes perfect sense to me that that society should ensure you are following its rules.

And, as things stand, I have seen plenty of "drug addicts and bums who refuse to work even when given the opportunity" receive medical care and plenty of it -- in some cases, more so than people who have jobs and are productive members of society. Where do I start? There's the paraplegic man with bedsores, a feeding tube, and a tracheostomy who is dealing drugs from his hospital bed and has gone into respiratory arrest ("coded") due to drug use while in the hospital. There is the avowed heroin user who has used for 20+ years and has openly stated he will continue to do so; he is checked in because he has been shooting heroin into his hip replacement wound and has a raging septic infection. Two people come in with hepatic encephalopathy and end stage liver disease; they are jaundiced and out of their minds because both of them haven't been taking their meds. The difference is that one hasn't been taking his meds because his insurance doesn't cover rifaximin, the other because he doesn't give a shit and prefers to drink his fifth of vodka a day. Guess which one is on his second liver.

It shames me to think this way. I was an Albert Schweitzer fellow while in nursing school. I worked in a free clinic that strictly saw people without health insurance, and I saw first hand the damage that limited to no health care access has on peoples' health and well being. At the same time, I feel there has to be some sort of promise, a willingness on the side of people receiving care to work with us in becoming well. The morbidly obese woman with severe diabetes and blood pressure through the roof who checks into the hospital cannot insist on eating junk food and refusing any medical care that involves needle sticks. The drug addict seeking food stamps and a housing subsidy has to prove that he is actively in a rehab program. I believe there has to be accountability on the side of people receiving any sort of public aid or medical care, however I feel like believing so revokes my "card carrying liberal" status.

I have seen such a wide spectrum of humanity in the past year and a half, and I just don't know how to reconcile it anymore. In my fair and happy fantasy land, there is health care for all. Free clinics on every corner and Planned Parenthood in every community. Everyone that asks for public aid willingly submits to drug testing. Addiction happens, and the people that come for medical help all realize that they have to be in the process of rehabilitation in order to receive the help they need. No one expects for society to care for them without giving gainful employment in return. Then again, in this fantasy land, you also need a license to have kids, but that's another story. If I've learned anything in the past year and a half working as a nurse, it's that the system isn't fair. Life isn't fair, and I don't know what the answers are.

New life, new blog

2011-10-12T11:32:00.000-07:00

I've dabbled in blogs in years past. I grew up writing in journals. I experienced the drama-rama of Livejournal, and I've even started up a couple themed blogs here that just didn't pan out for one reason or another. I think in the past I just tried too hard to be "literary," "meaningful," and a "blogger." By trying to emulate bloggers I followed and admired, I spent too long on my posts, and the final results always felt artificial, scripted, and lame. At the same time, the urge to chatter and blather about what I'm thinking and doing remains. I could get an "analog" journal, but at this point I type faster than I can write and, well, if need be I can delete an online blog a lot faster than I can burn a written journal. I guess I still have some of the old LJ defensiveness.

Anyway, here I am again, in the third incarnation of my pleasantly "anonymous" blog*. I'll blabber and chatter about my job (I am a med-surg nurse in downtown Chicago), my hobbies (I LOVE to cook), and my life (I am getting married in a year's time, and I live in a small zoo with two cats and a dog.) I'm happy if you read it, and won't give a shit if you don't. And, if you couldn't tell already, there will be moderate to profuse usage of profanity. Come on in.

*though I am going to guess that you are reading this because you found my link on facebook and therefore it isn't anonymous at all. Oh well. I'm not planning on any crazy shit in here.