Life Goes On

I am back..not writing as much as I would like to this year...but trying to do my best...Have been thinking a lot about the next phase of my life...retirement...what would I do...when can I retire...I am 52...I am already thinking of this. A lot of this is due to jealousy of my spouse who is 10 years older than I and has already retired...he was fortunate to do this at 59....some of it had to do with health issues and just plan old being the oldest dog in the rat race where he worked....he is probably the most happiest I have ever seen him in the 24 years we have been together....he still works 2 half days a week at a hardware store....and has a very small business..( this is really just a hobby with tax right off benefits)...but he gets up everyday and just does what he wants to do...mostly his day starts as going to visit a group of men his age who hang out at a pool supply store...he stays there til lunch...eats lunch there (usually chinese order out) then comes home...takes a nap then gets into stuff around the house.
So I think what would I do if I retire....well first off I have to get there...I am thinking another 6-10 years...if I wait til 62...I am going to hang up my stethoscope collect my pension and ssi and just relax...if retire earlier ...will have to work part time...
But then I think...I really love what I do...I know there are days I am totally drained and just had enough...but I come home...have a relaxing night..go to sleep and back to work the next day ready for more...I have come to realize that what I am doing now is what I was made to do...I have come such a long way in my personnel and professional life that in hindsight...this is it...I really struggled in the past to become an NP ...but once I made the decision to go back to school I was really dedicated to get through....this was another story I will tell next time..the hardship I faced personally when I was going to school...even when I first started practicing I faced some challenges...first I could not find a full time job...so I had to work 2 part time jobs to make a full time job..then I was so unsure of myself in what I was doing...it took me at least 2 years to fell comfortable in a family practice...then I decide to really switch things up and work in a VA with elderly complex medical patients....I have been through many challenges and learning curves...I fell very good of where I am now in my life and profession...granted I still need to read and educate myself ...but I really feel good...retirement is a goal ....they say you will know when you are ready...I am not ready yet... but dreaming doesn't hurt....

Friends through thick and thin

I am currently saddend by a friend who is strickened with transverse myelitis....first of all I have known her for 18 years...we have been through a lot...first met at a job that was new to both of us...we were both clinical nurse specialist. I was a Med surg clin spec and she oncology clin spec...I looked up to her beacuse she was in the role a lot longer than I was...she taught me a lot...we faced many challenges together at the hospital we worked for ...however we and the other clin specs raised the bar of nursing practices as well...this was done with many challenging forces both staff nurse and administration...in the long run...the challenges got us all ..and more or less chased us out of the institution...we all went back to school to become Nurse Practitioners..I was the last. My friend was one of the first...again she helped me with this new role being my preceptor and a great supporter in my new role...our lives have changed million times and we both had face personnel challenges throughout the years, along with this and our professional challenges, we always managed to stay in touch..instead we grew closer and closer together...this new challenge for my friend has given us another challenge to face....not with our friendship..but how to help her make her better and get back into the mainstream of her life and career...currently she is paralyzed from the waist down..she has faced many relapses and has tried to stay positive ..but this isn't always easy...she is now on the other side and is the patient...facing the many challenges of knowing what is right and not right when it comes to providing the better of health care...I think this is the most frustrating thing for her....she has seen good and bad care and becomes very discouraged..but yet has enough will in her to know what she wants and verbalizes that as well....she has been in rehab for over a month...faced with a relapse during this time and has said enough is enough....she is going home and doing it her way...she has been stricken with over 3 UTI's during her rehab stay (needing to be straight cathed) and know that at home she won't be exposed to the multiple care providers and potential for bacteria with cathing...she is going home and paying out of pocket for her own rehab therapist....I am going to do my best to help with her wishes and see she gets better and back to walking again...if you are reading this and have any faith in God...please pray for her...thank you.

Friends

I am currently saddend by a friend who is strickened with transverse myelitis....first of all I have known her for 18 years...we have been through a lot...first met at a job that was new to both of us...we were both clinical nurse specialist. I was a Med surg clin spec and she oncology clin spec...I looked up to her beacuse she was in the role a lot longer than I was...she taught me a lot...we faced many challenges together at the hospital we worked for ...however we and the other clin specs raised the bar of nursing practices as well...this was done with many challenging forces both staff nurse and administration...in the long run...the challenges got us all ..and more or less chased us out of the institution...we all went back to be Nurse Practitioners..I was the last. My friend was one of the first...again she helped me with this new role as acting as a preceptor and a great supporter in my new role...our lives have changed an million times and our personnel challenges, along with our professional challenges never broke us apart..instead we grew closer and closer together...this new challenge for my friend has give us another challenge to face....not with our friendship..but how to help her make her better and get back into the mainstream of her life and career...currently she is paralyzed from the waist down..she has faced many of relapses and has tried to stay positive ..but this isn't always easy...she is now on the other size and is the patient...facing the many challenges of knowing what it is right and not right when it comes to providing the better of health care...I think this is the most frustrating thing for her....she has seen good and bad care and becomes very discouraged..but yet has enough will in her to know what she wants and verbalizes that as well....she has been in rehab for over a month...faced with a relapse during this time and has said enough is enough....she is going home and doing it her way...she has been stricken with over 3 UTI's during her rehab stay (needing to be straight cathed) and know that at home she won't be exposed to the multiple care providers and potential for bacteria with cathing...she is going home and paying out of pocket for her own rehab therapist....I am going to do my best to help with her wishes and see she gets better and back to walking again...if you are reading this and have any faith in God...please pray for her...thank you.

It always happens in 3's

How is it in the medical profession everything happens in threes....someone dies...it is in 3s...someone codes...it is in 3's..someone falls ...it is in 3's....well this week we had 3 codes in a matter of 48 hours on our floor.....is it the change of season..the lunar force...time change...don't know if anyone out there has an answer let me know....another thing is Full moons..if you are working in a hospital, you don't want to work during a full moon...crazy things happen...for us ...people fall, leave ama or do crazy things...like being admitted for alcohol detox and leave the unit to go to the downtown bar...again..lunar forces????
The codes on our floor were from a man being unresponsive, a staff nurse suffering a panic attack (aka chest pain) and a patient who decided to not breathe very well because of his moprhine for pain medication.....of course they all happened when I was there..and 2 out of the 3 happened right before I was ready to leave work....so much for getting out of work on time..and the last one happened on a Friday afternoon..not very good timing...but codes never are...but I do have to commend the nursing staff, respiratory, ems, and my attending for always doing a great job and acting smartly and quickly in providing great emergency care....until next time...watch out for the full moons...and remember it always happens in 3's

DNR

The worst part of my job is discussing DNR status with a patient or their family. I find people are not well educated as to what really happens when a patient is found without a pulse or breathing...people only know what they see on TV which really doesn't protray the reality and success rate of CPR....the drama of doctors and nurses beating on someone's chest and putting pattles on someone and then showing the EKG monitor going from aystole to NSR is not what really happens. I had the opportunity to really explain the success rate of CPR to a family member the other day...I have to say this is probably the 100th time a provider has explain this him during his brothers longterm stay and he always says "I want to do to my brother the same thing I want for me"....well the reality is that the healthiest person will only have a 20% survival if CPR is preformed on them....if the person, like this patient, has any other health problems(emphysema, ascvd and heart disease) that 20% significantly drops...then I get the question...what would you do if it is one of your family members...I don't even want to go there...why does hearing what I would do help you decide what you are going to do...just know the fact plus look at the quality of life...this particular patient has already has a poor quality of life...has dementia,fed by tube feed is dependent in his care, is immobile, needs a lift to get him in and out of bed...I just don't understand how his family sees that doing CPR will make this man's life any better.....I am all for doing the best for our patients and do no harm but really what is truly the best for this patient...I just hope after my lengthy conversation with this patient's brother, that he really makes a sound and educated decision....I know thats what I would want for my family members...

Work Doldrums

Well, I am trying to keep my promise to write more this year and here I am again...I am sure many of you feel when does the work day end and when can I go home and soak my self in calgon to get me away from it all... typicallly I don't feel this way. I have learned to handle the stress of my job creatively and productively...I come home kiss my husband and sit down and relax to a good home cook meal..maybe accompanied by a glass of wine,...then prop my feet up and do some mindless reading or knitting in the winter or gardening in the summer...for the most part I look forward to work..but this week was not so...first of all I am really hating winter...Southeast PA has had its share of weekly snow or ice storms; secondly (as I mentioned before) running solo at work without help on these snow days hasn't helped my morale...then I was sick last weekend into the beginning of the week...I hate being sick... no kidding...my job is taking care of sick people all day...why do I want to feel the way they do...not...so I was really feeling low and under...to the point I told my husband ...not sure how much longer I can do this....so, I thought, what are my options...Well I can retire in 3 more years...but I still have to work...and if I still have to work what would I do...I know nothing but health care. If I retire and have to work...I want nothing to do with health care...and if I work I want to work part time like 2-3 days a week from 10am to 2pm....I did toss around going for my certification in laser hair removal...but do I really want to go back to school again and learn something else...not...do I sound like I am winning because I am....What other options do I have....well when I came to this point ..the weather finally turned around and we had a 60 degree day and a 70 degree day...all of a sudden I wasn't thinking of options anymore but back to lovin my work...there is one thing I have learned when I do get down and out at work not to take it out on my patients or their families...this does take a lot of patience and indurance...I want the best for my patients and I don't want them into my mind where they feel they are making me this way....after 12 + years of being an NP this has taking sometime and self training to do...so come on warm weather...I nee a healthty dose of Vit d to help my happy thoughts to keep me in the work mode for a longtime...at least another 6 years!!!

Winter Coldness andLoses

Well, we are certainly in the midst of weather in southwest Pennsylvania. Thankfully, Phil predicted an early spring. My winter has been very busy at work. Not because the weather has been bad or the flu season is here. I have been working solo on the worst snow days... My co worker has decided not to come in on snow day because of the distance to work which leaves me holding the fort....Actually it has been ok....thankfully I enjoy my work...despite the busy unit I work on I have found solitude and enjoyment in my patient load. I do have one patient I would like to share of my experience during these months. He was a very challenging patient when he first came to me in September. He literally damaged his mind and body from cocaine. He drained all of his finances and laid in his bed agitated confused and angered. He required 1:1 nursing 24 hours for almost 2 months. Psychiatry saw his patient everyday..The nurses did not fear this man but worked hard to bring him to the point that he would recognize us and cooperate with us. He learned to communicate effectively. Sometimes with choice words and foul language ...but by the time Christmas came around he would wheel himself in his wheelchair and sing Christmas songs with the visiting musicians. He was more social and would even have an attention span long enough to play tic tac toe with one of our nurses....We grew very fond of him but his time was growing short with us and was medically stable to move to a longterm care unit.... that day came he we said our good byes...I knew deep down inside he would soon return....for one thing that I have learned in my years as a nurse and nurse practitioner ...this type of patient can easily become sick and not get better....one month after we transferred him he returned...sick and more demented...I knew as much as I tried to help him he would never be the way I remembered him singing the Christmas songs...I worked closely with his family and many discussion occurred and the family decided to make him hospice...he died within a week of going to hospice unit...Although I was sad to hear this, I knew he lived his last months in a sheltered environment, comforted, in no pain, and around people and family that loved him and cared for him...His family and children are beautiful people and have grown up to love him very much...I did tell him that before he went to hospice..he looked at me and I knew he appreciated me telling him this. The day he died his family came to thank me for all I did.....I was only doing my job and I knew if this was my loved one, I would want the same thing for them that I gave to this patient.