Nurse Practitioner Web Log: BFF's

Nurse Practitioner Web Log: BFF's

BFF's

well my best friend has ended her battle with a progressive neurologic disease that had left her paralyzed and dependent on bipap. She has left a great void in my life, but at the same time she allowed me to take part in her last few hours. After 17 years of friendship, I watched my friend go from a healthy and active 52 year old Nurse Practitioner, mother, wife,vegan and avid runner to a person who is dependent on everyone to live minute to minute. Her disease started almost a years ago with a limp. Got better. And then with each remission came back with vengence. This last remission left he a flaccid quadraplegic and dependent on bipap for breathing. She could never to continue like this. Despite 2nd and 3rd opinions and best the teaching hospital, she took things into her own matters and demanded to come home and be placed on hospice. She was very percise on how and when she wanted to have her life ended peacefully. She knew what she wanted to wear, what pictures she wanted to have around her and even the music playing in the background...even her water bottle by her side...The last 18 hours I spent by her side and we smiled, talked, joked and laughed...then was the time she had asked me to dress her in her running gear and then say good bye...She was the best friend I ever had...We had similar likes and dislikes. We also saw some things eye to eye and some not..but respected each other for who we were...we shared good times and bad times ..we cried and laughed together throughout the years...you are going to be greatly missed. but I thank you for letting me see you through the end...You were a co worker, preceptor and confidant ...you are my hero

In Memory of Deb Rodzwick Carlis CRNP

Hard Times

I have had some really emotional times in the past couple of weeks..both at work and on the personal front...At work, my co worker has changed 3 times since October...my first co worker, who I wasn't sad to see move on, is now back again..can I tell you I really didn't miss her over the past few month...when she left I worked with 2 other PA's both men...let me tell you ...they did their work and let me a lone and left when the work was completed...they didn't want to talk much ...which was fine by me...this gal is opinionated;critical; talks too much and is driving me nuts... I am really finding it hard to get re acclamated to her again...I have to learn all over again how to ignore her...any tips...all are welcomed
On the personal front...I know I have mentioned my friend with transverse myelitis...well she had been in and out and back in the hospital again...all the mobility and sensation she has gained is gone 100 fold....she was first admitted with hypothermia, hyponatremia, hypotension and bradycardia...she ended up with SIADH...now as a pacer...was discharged and not even home a week and back in with hypernatremia...and now she is completely paralyzed (quad) with dysphagia, inability to speak and respiratory decompensation...what the hell is going on .....why can't anyone help her...she is now going to need a feeding tube because she can't swallow...anyone out there have any thoughts...from what I know her neurologist is going to try some type of chemo(cytoxin?) agent to boost her immune system however one of the side effects is leukopenia which she already has...I feel so helpless...know all that I know and I can't even help her...I think of her day and night...I wake up and she is my first thought...if anyone has experience with any patient that has had similar symptoms...please email me....would love to hear how it all worked out for them...in the meantime...prayers...

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