One would think that being dx with cancer, and a particularly deadly form just a few years ago would make a kid sit up and take notice. Apparently, if that kid is my 19 year old nephew, one would be wrong. He virtually stopped taking his medication back in January. He's not doing well in school and last semester, we all said "Well, who can blame you?" His local MD wrote out a "Get out of flunking out of school letter" but warned him he'd never do it again. He started an antidepressant, started seeing a therapist, and hell I needed those things without a dx of cancer.
He seemed to rally, is doing marginally better in school, and likes his job. He's taken interest in a girl who seems to reciprocate the feelings. But stopped taking the medication, taking the chance that his cancer could become resistant to the gleevac. His cancer MD opened a can of whoop ass on him, asking him what he'd like to do die or go for a bone marrow transplant. Smart ass teenager replied "I don't know, I'd have to think about it."
This statement says that for now, smart ass teenager is alive and well, but he thinks the cancer is not in control. Part of me is glad he's still acting like a "normal" teenager. It's no surprise that his stopping the meds coincides with him achieving cellular remission. He may not hit molecular remission now though, which means that he risks a full cure. What he fails to understand, like most of us, is that we ourselves are not in control either. We fool ourselves into thinking that we control our own destinies, and God just sits back and smiles. Occasionally, He will let us continue with that delusion for quite some time.
I sincerely hope his wake up call does not come in the form of a bone marrow transplant. He'll wish he was dead before it's over and has a 50/50 shot of that happening anyway. He'll have wished he took the damn nausea inducing, joint pain causing gleevac instead. And his family will sit by his side, in a mask and gown, and hold his hand wishing the same thing. Dumb stupid teenagers.
Saturday, April 25, 2009
Friday, April 24, 2009
When Nurses Have Meltdowns
When a nurse is having a bad day, here are a few handy tips for coworkers:
1. Jump in and help. Don't wait for the nurse having the bad day to ask. This is a good time to put the phrase "Just do it" into action. Thankfully, I have such a co-worker, actually, surprisingly two. And one of those is a manager. Color me surprised!
2. Don't bitch about what a rough day YOU'RE having and ask for my help. This will rapidly piss me off even more--and make your day harder for sure.
3. Don't walk by me and announce "Oh you're going to love me for sure! Guess what? You're getting an admit in about an hour. This makes me want to give you an enema--after taking a running start, without the lube.
4. For God's sake, do NOT give me the slowest TMA on the planet--nice woman, good heart, good CNA, HORRIBLE TMA. Oh yeah, don't do that AND short me on an aid.
5. Jump in and help with the needy, cranky, demanding family members.
I have a pt. dying, with family calling for updates. I happen to have a distant connection to this family as well, making them expect more from me. Under normal circumstances, I want to go that extra mile. I want all of my pts. to have the highest quality of care. I have high expectations of myself in this regard.
Next, had a discharge. Fairly simple, straight forward, anxious to leave. Fine, until he calls me because he can't get the meds he told me he didn't need me to order. Why is this my problem? Could have solved it at 7:30am before my day went to hell.
Next pt. is sure that the meds are WRONG, and don't you dare bring me those meds after my food is here. Fine, eat your food cold...want one to one care? I'm a lot more expensive...so a call's made to try and straighten out the meds and spouse harrasses me for not getting a reply fast enough. PLEASE NOTE: I'M NOT THE SECRETARY FOR THE MD WHO WORKS OUT OF AN OFFICE DOWN THE STREET. This one doesn't want to eat either, refuses her supplements, can't figure out why she's so tired. Surely there's a reason...could it be the terminal dx, the high dose pain meds? The lack of food? Nah, probably the inhaler you insist I didn't order correctly for you, even though I didn't enter your orders.
This one still has a port a cath access needle in (and I need to figure out what to do with it, um, how to get it out) wants a suppository--but not now--maybe later. Asks me why the maintenence man would know the therapy schedule. Maybe because he's a really nice guy, trying to be helpful, and was here to set up your requested equipment that therapy provided. Maybe you could treat him a little crappier, eh? After all, he's JUST the maintenence man.
Next pt. has c-diff...lots of fun. Doesn't want to eat, despite this, a shocking amount still coming out the other end.
Opps, another one started hospice and is rapidly declining. Someone else can convince him to deep breath and cough every hour. Doesn't want to eat.
Super Gay Hospice Nurse had to add a little dig at the end and piss me off..."Just a friendly reminder to do oral cares frequently." WTF? I personally did oral cares x2, there were swabs bedside, and vaseline bedside. Did it look like efforts were not being made? Asshole.
Damn, trays are late and I gave insulin to another pt...crap...should I re-check his insulin? Where the hell is my TMA? I already have my medicare vitals done, how can she not have that cart done yet?
Why isn't anyone in my dining room? Thankfully Super Nurse Co-worker is on top of it and now a bunch of my pts are in the dining room. No clue where my CNA is....
Great, the discharge from yesterday wants us to round up the O2 cylinders he brought from home. Dude, call your O2 company, not me. You have been DISCHARGED.
Okay, guess I'll have to pass meds for the second cart. Crap, there are three people who have crushed meds. Oh, there's my CNA, someone is refusing to get dressed until I change his saturated dressing. YUCK. Gross...it's smelly too...What does he mean I slapped the bandage on wrong? How many ways are there to put a giant band-aid on? Seriously? You won't get up until I get a new one? Oh my, that IS tempting. Of course the other nurse does it right...she works with you every single day and I'm just a big old loser replacement nurse in charge of double the amount of pts that she is because we're working short handed again!
Oh, pain meds, pain meds, and more pain meds. Pain follow up, ice packs, and rubbing sore joints. Answering hospice questions, social worker questions, and doing treatments down the other hall that has the best TMA ever. Damn, why couldn't I have had her instead? Doctor's call...I hope it's on one of my regular pts. Thank God, it is and I knew what he wanted to know/hear.
This is why I had the meltdown when I found out my admit was early. I seem to keep finding more and more problems, have no time to fix them, and can't get my assessments done.
Thankfully, my Super Nurse Co-worker validated my crappy day. I was actully feeling bad about crying, but she made me feel better, told me I was right, and that a lot was being asked of me (yeah, I know it's pathetic that I still felt bad) Just call me the doormat.
Thank God it's my weekend off!
1. Jump in and help. Don't wait for the nurse having the bad day to ask. This is a good time to put the phrase "Just do it" into action. Thankfully, I have such a co-worker, actually, surprisingly two. And one of those is a manager. Color me surprised!
2. Don't bitch about what a rough day YOU'RE having and ask for my help. This will rapidly piss me off even more--and make your day harder for sure.
3. Don't walk by me and announce "Oh you're going to love me for sure! Guess what? You're getting an admit in about an hour. This makes me want to give you an enema--after taking a running start, without the lube.
4. For God's sake, do NOT give me the slowest TMA on the planet--nice woman, good heart, good CNA, HORRIBLE TMA. Oh yeah, don't do that AND short me on an aid.
5. Jump in and help with the needy, cranky, demanding family members.
I have a pt. dying, with family calling for updates. I happen to have a distant connection to this family as well, making them expect more from me. Under normal circumstances, I want to go that extra mile. I want all of my pts. to have the highest quality of care. I have high expectations of myself in this regard.
Next, had a discharge. Fairly simple, straight forward, anxious to leave. Fine, until he calls me because he can't get the meds he told me he didn't need me to order. Why is this my problem? Could have solved it at 7:30am before my day went to hell.
Next pt. is sure that the meds are WRONG, and don't you dare bring me those meds after my food is here. Fine, eat your food cold...want one to one care? I'm a lot more expensive...so a call's made to try and straighten out the meds and spouse harrasses me for not getting a reply fast enough. PLEASE NOTE: I'M NOT THE SECRETARY FOR THE MD WHO WORKS OUT OF AN OFFICE DOWN THE STREET. This one doesn't want to eat either, refuses her supplements, can't figure out why she's so tired. Surely there's a reason...could it be the terminal dx, the high dose pain meds? The lack of food? Nah, probably the inhaler you insist I didn't order correctly for you, even though I didn't enter your orders.
This one still has a port a cath access needle in (and I need to figure out what to do with it, um, how to get it out) wants a suppository--but not now--maybe later. Asks me why the maintenence man would know the therapy schedule. Maybe because he's a really nice guy, trying to be helpful, and was here to set up your requested equipment that therapy provided. Maybe you could treat him a little crappier, eh? After all, he's JUST the maintenence man.
Next pt. has c-diff...lots of fun. Doesn't want to eat, despite this, a shocking amount still coming out the other end.
Opps, another one started hospice and is rapidly declining. Someone else can convince him to deep breath and cough every hour. Doesn't want to eat.
Super Gay Hospice Nurse had to add a little dig at the end and piss me off..."Just a friendly reminder to do oral cares frequently." WTF? I personally did oral cares x2, there were swabs bedside, and vaseline bedside. Did it look like efforts were not being made? Asshole.
Damn, trays are late and I gave insulin to another pt...crap...should I re-check his insulin? Where the hell is my TMA? I already have my medicare vitals done, how can she not have that cart done yet?
Why isn't anyone in my dining room? Thankfully Super Nurse Co-worker is on top of it and now a bunch of my pts are in the dining room. No clue where my CNA is....
Great, the discharge from yesterday wants us to round up the O2 cylinders he brought from home. Dude, call your O2 company, not me. You have been DISCHARGED.
Okay, guess I'll have to pass meds for the second cart. Crap, there are three people who have crushed meds. Oh, there's my CNA, someone is refusing to get dressed until I change his saturated dressing. YUCK. Gross...it's smelly too...What does he mean I slapped the bandage on wrong? How many ways are there to put a giant band-aid on? Seriously? You won't get up until I get a new one? Oh my, that IS tempting. Of course the other nurse does it right...she works with you every single day and I'm just a big old loser replacement nurse in charge of double the amount of pts that she is because we're working short handed again!
Oh, pain meds, pain meds, and more pain meds. Pain follow up, ice packs, and rubbing sore joints. Answering hospice questions, social worker questions, and doing treatments down the other hall that has the best TMA ever. Damn, why couldn't I have had her instead? Doctor's call...I hope it's on one of my regular pts. Thank God, it is and I knew what he wanted to know/hear.
This is why I had the meltdown when I found out my admit was early. I seem to keep finding more and more problems, have no time to fix them, and can't get my assessments done.
Thankfully, my Super Nurse Co-worker validated my crappy day. I was actully feeling bad about crying, but she made me feel better, told me I was right, and that a lot was being asked of me (yeah, I know it's pathetic that I still felt bad) Just call me the doormat.
Thank God it's my weekend off!
Monday, April 13, 2009
Baby thoughts and dreams
I'm surrounded by pregnant people, yet again. This is the way the world works. Population statistics say this should not surprise me. Yet, occasionally I'm caught off guard. Because it takes doctors, medications, surgery, and tons of prayer and tears to even get close to a pregancy for me, other people's "surprise" pregnancies and happy accidents still have the power to catch me off guard.
Progress has been made, though, as these events no longer send me into a week of tears with the covers over my head. There is, and I know always will be, a twinge of jealousy. However, progress has been made, or perhaps that damn cliche is true that time really does help heal. There is a work friend who is now pregnant, a happy surprise in her case. I've watched her go from "OMG, seriously?" to "I can't wait to have a belly". It's beautiful to watch, and still, despite the progress that's been made, manages to re-open a small area of my heart that never quite heals.
And I think about the babies that should be running around now, with beloved's blue eyes and curly hair. I see in my mind him playing with pretty little girls, rocking both of them in his recliner. I hear them calling him "daddy" and him lovingly scolding them when they are naughty.
It's terribly confusing, when you can be happy with your life as it is, yet long and wish it was another way. When you can come to acceptance, and then something happens to make you wish the dreams would have come true another way. I suppose its regret, but how can you have regrets about something you couldn't have in the first place?
Sadly, one of the ladies lost her baby this last week. Even more sad, I felt a little bit of satisfaction, now she'll know what it's like to be a member of my club too. I'm one sick puppy.
Progress has been made, though, as these events no longer send me into a week of tears with the covers over my head. There is, and I know always will be, a twinge of jealousy. However, progress has been made, or perhaps that damn cliche is true that time really does help heal. There is a work friend who is now pregnant, a happy surprise in her case. I've watched her go from "OMG, seriously?" to "I can't wait to have a belly". It's beautiful to watch, and still, despite the progress that's been made, manages to re-open a small area of my heart that never quite heals.
And I think about the babies that should be running around now, with beloved's blue eyes and curly hair. I see in my mind him playing with pretty little girls, rocking both of them in his recliner. I hear them calling him "daddy" and him lovingly scolding them when they are naughty.
It's terribly confusing, when you can be happy with your life as it is, yet long and wish it was another way. When you can come to acceptance, and then something happens to make you wish the dreams would have come true another way. I suppose its regret, but how can you have regrets about something you couldn't have in the first place?
Sadly, one of the ladies lost her baby this last week. Even more sad, I felt a little bit of satisfaction, now she'll know what it's like to be a member of my club too. I'm one sick puppy.
Things I hate about being a RADish parent
1. Lying: RADishes lie. Constantly. If their lips are moving they are lying. It's true too. I'm tired of it.
2. Stealing: RADishes steal if it's easier. I'm sick and tired of finding evidence of such in DS's room. I stopped going into his room, for the post part, because of this. I'm tired of locks everywhere, of having to hide my soda, my meds, having a separate fridge with a lock, a lock on my closet, locks on the basement, locks on the heat/AC controls, locking the vehicles, locking up all the keys, my purse, not being to ever have cash around
3. Eggshells everywhere: I walk on eggshells around him, because you just don't know when he's going to blow. So instead we have a lot of silence. Yesterday at Easter, everyone was asking how he was doing--since he was in the room, I had to lie. Yup, now I'm a liar too.
4. Hopelessness: When we first met DS, we felt like we were helping a child. Who doesn't want to help and protect a child. And we saw evidence of the fruit of our labor. He was happier, responded to therapy, and there was signs and symptoms of child-parent relationship. Then he discovered drugs and alcohol, and we landed right back at the beginning.
5. Isolation. When you're the parent to an addict, who also happens to be a RADish, you end up feeling isolated. There are two choices, lying, which sucks and makes you feel isolated, or telling the truth, which results in akward silences, lots of "I'm sorrys" tons of assvice, and everyone taken a big old step back. There also seems to be a callusness to me, an edge to my voice, and this I do not like about me.
6. Along with hopelessness...helplessness: Do we try treatment? Therapy? More therapy? A new therapist? Family therapy? Can we afford any of this? Can we afford *NOT* too...and then the callusness again on my part when we do the leg work, get services lined up, and he refuses to go more than once. Bitterness and anger with six months of bills...
7. Frustration: Sadness gave way a long time ago to frustration when I see this child who had a future throw it all away. When I saw more than he did, when he would look to me to make sure he was worth it, and watching him say "fuck it" and run away from himself.
It's hard to walk around tired all the time. It's hard to admit I'm happier when my child is not home, while knowning I'd rather not know what he's doing when he's gone. It's hard to look at him when he's home, seeing the pot-bleary eyes and knowning what he did. When we first started doing this, I was passionate, reading and studying everything I could get my hands on that was practical about living/raising/helping RADishes. When one technique didn't work, I happily and, with determination, tried another. Some things worked, and we'd celebrate our success--which meant DS's success. The books and therapists are out of ideas, and so am I.
2. Stealing: RADishes steal if it's easier. I'm sick and tired of finding evidence of such in DS's room. I stopped going into his room, for the post part, because of this. I'm tired of locks everywhere, of having to hide my soda, my meds, having a separate fridge with a lock, a lock on my closet, locks on the basement, locks on the heat/AC controls, locking the vehicles, locking up all the keys, my purse, not being to ever have cash around
3. Eggshells everywhere: I walk on eggshells around him, because you just don't know when he's going to blow. So instead we have a lot of silence. Yesterday at Easter, everyone was asking how he was doing--since he was in the room, I had to lie. Yup, now I'm a liar too.
4. Hopelessness: When we first met DS, we felt like we were helping a child. Who doesn't want to help and protect a child. And we saw evidence of the fruit of our labor. He was happier, responded to therapy, and there was signs and symptoms of child-parent relationship. Then he discovered drugs and alcohol, and we landed right back at the beginning.
5. Isolation. When you're the parent to an addict, who also happens to be a RADish, you end up feeling isolated. There are two choices, lying, which sucks and makes you feel isolated, or telling the truth, which results in akward silences, lots of "I'm sorrys" tons of assvice, and everyone taken a big old step back. There also seems to be a callusness to me, an edge to my voice, and this I do not like about me.
6. Along with hopelessness...helplessness: Do we try treatment? Therapy? More therapy? A new therapist? Family therapy? Can we afford any of this? Can we afford *NOT* too...and then the callusness again on my part when we do the leg work, get services lined up, and he refuses to go more than once. Bitterness and anger with six months of bills...
7. Frustration: Sadness gave way a long time ago to frustration when I see this child who had a future throw it all away. When I saw more than he did, when he would look to me to make sure he was worth it, and watching him say "fuck it" and run away from himself.
It's hard to walk around tired all the time. It's hard to admit I'm happier when my child is not home, while knowning I'd rather not know what he's doing when he's gone. It's hard to look at him when he's home, seeing the pot-bleary eyes and knowning what he did. When we first started doing this, I was passionate, reading and studying everything I could get my hands on that was practical about living/raising/helping RADishes. When one technique didn't work, I happily and, with determination, tried another. Some things worked, and we'd celebrate our success--which meant DS's success. The books and therapists are out of ideas, and so am I.
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