What I see during the day

What I see everyday is different from anyone else....working in health care is different from any other career....things I see would not be seen in other peoples' work areas..it may not be accepted or appreciated...My day starts by greeting my first patient sitting outside in his wheelchair catching the rising sun, drinking coffee and smoking a cigarette...they aren't in regular clothes because they may not have any other than the VA pj's we issue everyone when they come in....walking to the elevator I see recovering(substance abuse) vets who are now attempting to be reintroduced into society by working as an escort on my floor...they accompany me on the elevator up to the 2nd floor to start their day of work as well...please note the pay for this job is below minimal wage...but they are thankful they are provided room and board by the VA during this transitional period....I walk to my office an are greeted by the nightshift nurse...always smiling to see me ...accompanied with reports of what happened through the night and a swift good bye so they can leave and attend to their normal lives...once in my office I may occassionally get a knock on my door from an early rising patient who has questions or greets me for the day....once I complete my morning computer run...I walk to morning report to the next building...always greeted by other vets waiting for the DAV van to take them to appointments either to Philly VA or Wilmington VA....once report is completed...I head to my unit again and already have made a mental note of my priorities for the day...walking down the hall I catch a glimpse of many vets lying in bed sombering away....in one room is a wife sitting by her dying husband looking out the window...what is she thinking...does she know that today may be the day her beloved lifelong partner may leave her and this world...further down the hall I see the vet who helps recreational therapy preparing the morning coffee and snacks for the vets on our floor in the day room....I see vets who are bedbound and others who are rehabbing their injuries or recent surgeries...many vets who are on oxygen but don't want to give up cigarettes and turn the oxygen off as they go out and smoke...I see vets who are homeless,disabled and have no money and depend on us to find them a place to go....see vets who have drank themselves from a lively person to decompensated person with no one love ones to help them during their end of life...many come to us with no family support or social support and depend on us to help find them a home or give them a place to die peacefully...I have seen multiple individuals who have been riddened with psychiatric problems with no one to care for them but us...some with multiple medical problems that have no other insurance or finances but the VA to care for their complicated medical course....I have seen loved ones bring their family members to us to find answers for their medical and psychiatric problems...the list goes on...I have found that my day is bombarded with many emotional facets to the gammet of problems and issues that come from all of my patients....my beeper goes off continuously as well as my phone rings without a break..multiple interruptions from families, patients and nurses and other disciplines....but my day ends knowing I have done my best to help these vets...I always walk away knowing I have accomplished a list of tasks, answered questions and held a hand an mostly smiled and consoled my vets and their families...I never walk away dissatisfied with my job...I may be tired and frustrated but I know I have done my best....my day is fulling and I am so grateful I have chose this profession...I look back to my career path..and it only seems right that I have chosen to be an NP...I only wish I decided to do this sooner...but life has a funny way of working its way to what is best for you...this was a perfect match for me ....I cherish my days that I have helped someone being an NP

Full Moon

So I am sure if you work in health care you have heard the term... full moon means a crazy day at work...well that was today..no sooner I walked on the unit...the wolves were howling...Code Blue to start the day on patient that was about to go home...went in to fulminating respiratory distress...ok..get a grip...the day should only get better....although my thoughts were...why me...and how did this happen he was doing so well...wrong to think the day was going to get better....next thing was morning report with nurses when another nurse came in to say another patient was decompensating...uggghhh....thankfully he pulled out of it quickly with quick thinking on the medical teams approach and was stable within minutes...ok..now I can really get to my work...so things went well until mid morning ...attending calls...there maybe an admission with TB...great....but wait until the CT confirms this...so I keep my nose to the grind stone...met with family members on patient #2 that decompensated but now stable...then went on to my daily rounds...wow...things seem to be going better ...hopefully I can eat lunch and take my 30min daily walk...wrong ...phone call from Urgent Care....patient needs blood transfusion...defer to attending to make a decision....wait...does this patient have GI bleed. please check hemeoccult in Urgent Care... in the meantime I eat lunch at desk while working, checking labs and email...call from attending...the patient in urgent care doesn't have a GI bleed can you admit...sure why not...what else am I going to do today....the history and physical wasn't bad but I had to go through multiple records to figure out why this patient has had multiple blood transfusions in her life...nothing really noted in her PCP's notes...(what is a PCP for)....so after multiple phone calls, pages, knocks on my door and 3 hours later I finished the history and physical on this patient.....in the meantime I get a call from radiologist to tell me another patient definitely has osteomyelitis in 4th toe (5th toe was already amputated for this)...had to call podiatry to discuss plan of care then call his wife to give her options on plan of care....then I get a call from a pain doctor who decides to tell me 100 options of pain management on a patient with pancreatic cancer...then another call from a x wife of a patient who decides to run down a list of a 100 questions she wants to answer at 415 pm ...uggghhhh....so the day ended pretty much on time...came home to my hubby who was as tired as me and suggested dinner out...thank God!!!