Patients Say the Darndest Things

The other day I had a very active patient who had just had major elective surgery. He was determined to get out under par, but one of the stipulations is all patients must have a BM before we let them leave as one of the side effects of pain meds and anesthesia is constipation. When I told him this he was in agreement but said it shouldn't be a problem because he's always "regular." When I took care of him the next day he was getting frustrated that he hadn't gone yet. The following is a sample of our conversation:

Patient: I can't understand why I haven't been able to go!
RN: Don't worry, that's normal. Patients normally don't go until their third day anyways. You should be able to go by tomorrow
Pt: But I go everyday without fail
RN: Yes, but your body just went through alot! You must be patient with it.
Pt: Is there anything I can take to make me go?
RN: You are already taking a stool softener. You can try prune juice or we can get an order for a suppository for you.
Pt: I hate prune juice. Does the suppository work?
RN: yes, but it's not pleasant.
Pt: I don't mind, just give it to me. I need to go so I can get out of here early!
RN: You do realize what a suppository is, right?
Pt: It's a pill.
RN: Well, it's kind of like a pill, but it will be put up your rectum.
Pt: (eyes get HUGE!) WHAT??? Nevermind, I'll wait until tomorrow.
RN: OK

The Reason Why...

...I'm a nurse. The reason why I am who I am.

The other day I was taking care of an older gentleman who was recovering from major surgery and his dear wife was sitting on the couch in his room. Since I believe the care we give should not only be directed at the patient, but to the family as well, I always try to engage the family and friends in what I do. After assessing the husband, I walked over to talk with the wife and noticed she was cross-stitching some sort of floral thing. On closer inspection, I saw that it read, "Christ Is Risen!" I immediately responded with, "He is risen indeed!" The wife looked up at me with shock on her face and her eyes started to water. "I haven't heard a young person say that in years. Thank you!"

Throughout the rest of my shift we talked about our faith, our priorities, our lives. The connection was immediate, all because of a simple response. When I left at the end of the day, she gave me a big hug and said, "I will probably forget your name, but I will never forget you. Thank you so much for all you've done and for who you are." I'm no extraordinary nurse, I'm just me... but this is why I love what I do. I'm new yet, and there will be hard days...but remembering stories like this one will help keep me going.

In other news, my first night shift is tomorrow night. I'm a little nervous, but I'm looking forward to guiltlessly sleeping in tomorrow! (After church tonight, of course!)

What I've been trying to say

For those of you who read this and haven't heard yet, this last trip to the Philippines was incredible and life-changing. I say life-changing because it really opened my eyes to the possibility of returning someday to work as a full-time missionary.

I've really had to work through some issues as I used to view missionary kids who return to the mission field in their adult years as weak or incapable of staying away. Those of us MKs who had a wonderful experience on the field often want to go back, and I thought those who did were doing so just because it was comfortable and familiar. Now that I am seriously considering a return, I'm having to rethink that and deal with some things within myself that aren't always pretty.

When I tell people that I want to go back most of them think, "Of course!" I know the people, understand the language and culture, and have a sincere love for them. It just makes sense. And yet, I don't want to take this too lightly. I know the challenges that returning MKs face are different than those faced by new missionaries with limited cross-cultural experience. For example, they often have to deal with over-sensitization while many of us MKs are desensitized.

During a meeting tonight, I was given a letter written by a missionary and what he wrote is exactly what I've been trying to say but haven't been able to clearly find the words for. Exodus 3 tells us of Moses and the burning bush. During this sacred encounter with God, he was given a commission to return to Egypt and rescue his people from oppression. "The fact that Moses was Jewish, a Levite, and a prince in Egypt counted nothing towards qualifying him as deliverer of a nation. However impressive the things he had were, he needed to be emptied of them in order to be qualified. It is a remarkable paradox, that in order to be sent of God, we have to be emptied first of our qualifications."

Just because I seem to have all the right qualifications, doesn't mean that my venture will be easy or even obvious. God must first strip me of them and work with an empty slate in order to commission me for any service He might have for me.

Patients Say the Darndest Things

I've decided to start a new "feature" to my blog... Whenever I hear something I find funny said by a patient, I will add a short blurb so you can share my humor. Hehe.

During my last shift, I helped take care of a white female who had just had major surgery. She was still groggy from the pain meds and anesthesia, but she still had enough cognitive functioning to crack a joke. While we were performing the skin assessment we have to do on any patient, she said,

"I wish I could have warned all my nurses to bring sunglassess to protect their eyes when they have to look at my white butt."

White Coat Syndrome

Today I worked another 12 hour shift and learned the definition of "white coat syndrome." I'd heard of this phenomenon that goes hand in hand with "black and white fever," but never witnessed it first hand.

I had a young male patient today who was scheduled for surgery ...let's call him Mike. He was a very sweet, cooperative guy who didn't want to cause any trouble or inconveniences for us, even if it meant his personal discomfort. I noticed that his blood pressure ran a bit high, not something you want to see in someone about to head down to surgery. The doc came in and assessed him, prescribed him a drug to lower his BP and instructed us to send him down to surgery. When we got him back he was on continuous pulse and oxygen saturation monitoring. His blood pressure was still above normal, but not as bad as it had been...chalk it up to pain. But his pulse was sky high! Why??? We didn't notice any bleeding and the EKG showed a normal, but fast heart rhythm. I later came back to check on him, multiple times, and always knocked on the door to announce myself. When I came in with an IV medication in a syringe, his pulse went even higher.

I decided to do a little experiment. His pulse/oxygen machine shows his continuous heart rate, so I started to peak into the room without announcing myself, and before he noticed me, his pulse was fully 40 beats per minute lower! This guy had a horrid case of White Coat Syndrome. I'd never seen it this bad...he was terrified of us!

I'm not sure if there's anything that can be done for it...most people don't even realize they have it. But at least it's nice to know there wasn't anything seriously wrong with Mike...he just didn't like white coats, just like some of us don't like seeing police cars. :)

Aching Feet

I had heard that nurses walk alot, and got to do some of this during nursing school without many problems, but I did not realize how much my feet would hurt after two straight days on the floor. I don't think the shoes I got are the best for the job...hmmm, might have to rethink that one. Anyone up for giving a good foot massage? :)

I've really enjoyed working with the staff as I get to know the routine and am given more and more responsibility. It is weird to have access to all the potent narcotics and give the patients meds with no supervision. I love not having someone constantly glancing over my shoulder. Many new nurses have a hard time not having this safety cushion of knowing that someone is watching to make sure they don't "mess-up," kind of like a security blanket. Not me! I love the freedom, the autonomy to make my own assessments and decisions. This doesn't mean that I don't ask for help or advice, but I love knowing that I don't have to check every little action with an instructor or the RN I'm shadowing.

Yesterday I was introduced to the world of nursing potlucks. Wow! So much food, so much JUNK food! Pizza, KFC, lasagna, chips, soda, cookies, cakes, brownies. It was one of the CNA's birthday and boy, do they know how to party. I have also heard that the night shift is notorious for potlucks and bringing food to party with. Yikes! I have to watch it. I haven't stressed too much about what I eat for years, but unless I want to buy a whole new wardrobe, I'd best be careful. hehe.

So I'm on day shifts for two more weeks, but I've survived my first week of working 12 hour shifts. I've already learned that I'd much rather have a busy day than a slow day, as the busy days go by so much faster. I also need to wear good shoes and bring lots of gum. Other than that...I'm loving this profession of nursing!