Hug Your Local Home Care Nurse

Here is how a home health nurse spends her day during a snowstorm of 12+ inches, a la Snowcopalyse.

I started my day yesterday by finding out that the boss had taken me up on my offer to be on call if the agency closed.  I found this out an hour and a half AFTER I started on call, because somehow they forgot to TELL me that they'd taken me up on it.  Oh well, that's fine.  They had other priorities, and no calls had come in.  No harm, no foul.  I did offer, after all.  The day wasn't too bad.  There were a few cranky people who didn't understand why we were closed, despite the governor's pleas for everyone to just stay home.  But that's ok too.  I'm used to cranky people -- I did phone triage for 15 years or so, after all.

So today, I got to start my day by doing labs on a patient at 6am.  Let's just use that time loosely, because although I was up at 5am, I didn't get out the door till 5:40 -- for a trip that, by Mapquest, should've taken 38 minutes.  It took an hour and 25 minutes. Once I got to her street, I realized that I couldn't see the house numbers.  NOTE:  please make sure for your own safety that your house number can clearly be seen from the street, both coming and going, in daylight AND at night.  It not only makes your nurse cranky if she can't find you, but it also is a safety issue if an ambulance or police can't figure out where you are.  I could not, for the life of me, find this lady's house.  I finally called and got the old "oh, we're the first house on the cul de sac.  There's a red truck in the driveway" routine.  Except not only could I not see a truck, I could see a cul de sac at all.  AT ALL.  Finally, the fourth or fifth time through this very small addition, she flashed her porch light at me.  AHA!  I could see her house, but still couldn't see the cul de sac, because snow had been plowed about four feet tall at least, and I didn't see an entry in the dark.  I finally found it -- a very narrow path -- and made it up to her house.  What a sweet lady she was.  I even got out of her driveway backing down that very narrow path with my 4 wheel drive.  My reverse skills have been keenly honed since my first year of home ownership, when I ran over two bikes and a boombox in the first summer.  It was a long, difficult driveway, with a big blind spot.  Today, I managed to get out of that tight spot with no problem, and headed to the next patient, who was supposedly ten minutes down the road.  More like twenty, really.

 I was concerned whether I could get down the patient's street, but he'd pleaded with the city and they had plowed.  Plowed, as in, plowed him in.  As in, the only way to get to his door was to plunge in feet first, where I promptly sunk almost up to the hip, whilst balancing my bag -- a sturdy duffle type gym bag.  I did have the good sense to leave my computer in the car -- a big no-no, but he's the only house on the street, and I didn't want to go plunging facefirst into the snow and lose the damn thing.

I knocked on his door, and it took several minutes for him to answer.  Mind you, it was a true -15 degrees outside, not including wind chill.  He finally came to the door, and asked me, very confused, why I was standing out in the cold instead of coming into the porch.  I just pointed at the bungee cord that was holding the door shut.  He laughed, let me in, the stopped and stared before he grabbed a broom and started sweeping me off.

Sweeping. Me. Off.

Not sweeping me off my feet, mind you.  Sweeping off my jeans -- yes, I wore jeans, because by golly, if I'm plunging out in that weather in the dark, and climbing through snowbanks, I'm wearing something sturdy and warm.  He finished sweeping, I did my thing, and I was out of his house in something like 16 minutes.  When I promptly plunged right back into the snowbank again to get back into my car.  At least this time I could climb into my own foot tracks.  I climbed into my car covered in snow up to my knees.

All this, before 8:30am.  By noon, I had climbed into another snowbank, after parking around the corner from the house, walking on an ice covered street to get where I needed to be, selected my spot, and plunged in -- this time with computer in hand.  So. Much. Fun.

That being sad, I do love winter.  LOVE it.  The added reward was how absolutely beautiful it is right now.  So beautiful that I came home and dug out the trash can from the snow, shovelled a path to the mailbox, and even partially cleaned off the other two cars in the driveway.  Of course, now my lungs are saying "oh no, you shouldn't have done that and I'll have a hit of the inhaler, please" but oh well.  It's all in a day's work for a homecare nurse.

Hit Me With My Best Shot

What a week.

Yesterday, I had surgery on my wrist, to correct Dequervain's Tenosynovitis.  Say that three times fast.  It was a little surgery, but I had to go to the surgery center for it.  Seth volunteered to take me, but Jim, ever the gentleman, insisted on taking his woman forth to the slaughter.  Everyone was quite nice as they prepped me.  They told me I didn't have to put a gown on, instead having me put on a "bunny suit", which is code word for waterproof zip front jumpsuit, complete with matching hat and shoe covers.  Jim promptly announced that I looked like a Smurf, which I'm sure I did.  Thank God his phone was dead, or those pictures would've been out there for everyone to see.  I brought it home for Seth, figuring hey, he's in college.  He can do things with a zip front waterproof jumpsuit.  It likely will include his horse head.  What happens at Butler...........

So tonight, I had to give myself my first Methotrexate injection, for that damnable rheumatoid arthritis.  I haven't been doing as well as the doctor wants on the oral stuff, so she changed it to injections and added a malaria drug too.  Reading the package insert on that one is great:  it'll treat malaria, but rabies shots might not work on me.  Chew on that for a while.  That's not the kind of side effects you read about every day.  Add to it that Methotrexate is used for chemo and tubal pregnancies, and it makes my life just that more odd.  It's a darned good thing I have a sense of humor.

I psyched myself up for this injection thing.  I actually told Seth that I was gonna teach him how to do them, because if he wants to go to med school, it's something he should learn.  He thought it was kind of random for me to suggest it and in the end, I decided to just do it.  You'd think it wouldn't be a big deal, because I've been a nurse for 30 years.  Seriously.  I've given shots to probably hundreds of people, and started IVs on almost as many.  I've stuck needles in babies' heads and feet, and everywhere from stem to stern on grownups too.  So what's the big deal?  I have no idea.

I took it all out and headed to Seth's room, because Jim was not gonna be any help, given the level of snoring he was doing.  Told Seth I just needed a little hand holding, and we talked about why I was having to do injections, with a little talk about RA.  Teachable moments, yes.  Delay of game, YES.  He was playing some weird engineering game that I don't understand on his computer, so I laid down on the bed by him and prepared my attack.

Only I couldn't bring myself to attack.  Started to a few times but just couldn't close the deal.  I finally decided that I just couldn't SEE lying down, so I sat on the side of the bed and went for it, straight into the "shakes when I laugh like a bowl full of jelly" area.  You know what I found out?  I give a damn good shot!  I literally didn't feel a thing.  WOOHOO!

So now I guess there's nothing to be afraid of unless my hair falls out in clumps or I get bitten by a raccoon.  Let's keep our fingers crossed.

Friends, Romans, and Granddaughters

A couple of weeks ago, I spent the day in the home of one of my very favorite patients ever.  She was dying, but didn't want to go to hospice, because she didn't want to lose her nurse (me).  She was stubborn like that.  She had planned her funeral, right up to a seating chart, and had paid for it all, in cash, some weeks before.  She knew what was coming and had, in fact, told me the night before that she was ready to go, because she was just flat out tired.  I spent the day getting her comfortable, with a pain pump and nausea meds.  It was a long day, but I knew I'd done what I could.  In fact, I had put a catheter in her, which was no small feat, because though her eyes had been shut for hours, she started moving every time I made the attempt.  I finally got it in, but not before she said to me, eyes still closed "that's just about enough."  Those were her last words.  She had waited for her dear friend to arrive from out of state, but was comatose when the friend arrived.

I took her in and explained the situation, then let her have time alone time with her best friend.  I was going to leave soon, because I had gotten my patient as comfortable as I could, but I wanted to be sure that everyone had their questions answered.  A group of us sat down in the kitchen to have a heart to heart.  The friend came in and joined us, then looked me in the eye earnestly and said "Miss Lisa, can you please explain to me what Roman cancer is?"  I was confused, and asked her to repeat herself.  "Roman cancer.  What is it?"  I couldn't for the life of me think of what she was talking about, and it must've shown on my face, because the next thing you know, she said "I'm so sorry, I don't have my bottom teeth in, so I'm not sayin' it right.  I said ROMAN cancer."  I replied, "I'm so sorry, but I'm still not sure what you mean."  We just kind of looked at each other, each trying to figure out what it was.

It was about then that her granddaughter said, without ever looking up from her plate, "Oh Miss Evie, it roamin' cancer.  She called it that cause it was roamin' all over her body."

And that, dear people, is yet another reason why I'm a nurse.

How I know God exists

There are some who doubt the existence of God. I don't, and I will tell you a recent example of why.

I am a homecare nurse. I have a patient who lives alone and is confined to her bed. We will call her Pat (not her real name). I visit her nearly every day. She's a treasure -- a woman with serious health issues who has steadfast faith in God. She's amazing, and I just love her. We tease and harass each other all the time, but I really love her.

Last week, I went to see Pat. I walked in and the lights were off, her covers thrown off the bed, and the phone on the floor. Remember, she is bedbound, so she had no way to communicate with the outside world if that phone isn't within reach of her one good arm. It wasn't. I took one look at her and knew something was not right. "What's wrong," I asked her. Her reply was a weak "I'm sick." She looked like hell, quite frankly. We ended up sending her to the hospital, and within an hour, she was unresponsive. It's been a touch and go few days, but she's improving slowly, and it looks like she will make it. Thank God.

But you ask, why does this prove the existence of God? Let me tell you. Pat had called the agency that day to cancel my visit, as well as her aide's visit. She thought that she had caught a GI bug from her grandkids, and didn't want to expose us. I told her to never cancel your nurse when you're sick -- that's what we're here for. In either event, she tried to cancel me, but I never got the message. I even checked my voicemail later -- nothing.

I am watching over another patient -- we'll call her Amber -- while her nurse has a couple of weeks off. Amber gets a nurse visit one time every month, so I had her on my schedule for the next week, a month from her last visit. On the day this all happened, I was on my way to the other patient's house, when Amber's mom called, wondering where I was. Turned out that the regular nurse sets up the monthly appointment in advance but she didn't tell me, so mom was waiting for me, and I didn't know it. I asked the mom if she wanted me to go ahead and come -- hoping she'd say no, because I was almost to Pat's house, which is close to home for me. Going back would've meant a half hour drive one way, then the visit, the return trip to my patient's house, and me being late getting home. No, the mom decided to wait till the next day for the visit, so I went ahead to Pat's home. I ended up calling 911 for her.

What are the odds that I would not get the first message? Add to it that I didn't get the second message about Amber's prescheduled appointment, then add that the mom declined me coming late, and that's three strikes. If I had made that visit, I would've been at least an hour late to see Pat -- rememberm an hour after I got to her house on time, she was unresponsive in the ER. If I hadn't come in when I did, she would've been alone all evening, and who knows how it would've ended.

God works in mysterious ways, they say. I firmly believe that God put me Pat's house to save her life. Don't get me wrong -- this is not about anything I did. Not at all. It's about God using me for that patient, on that day. I am just a vessel. That's why I love being a nurse. And that's why I believe in God.

The Power of Queen

24 years of nursing gives one an interesting viewpoint on life. I started out as a 20 year old new grad, sweet and fairly innocent, and grew to realize I had powers I never knew about.

I was talking to a Ang, from Dorothea's Closet Vintage, tonight. Her dad is really sick, so we've been keeping in touch, trying to decipher what the doctor's do, and don't, say. She was talking about the nurses, and something reminded me of this patient I took care of in the hospital, when I worked in Florida, at Manatee Memorial, in ICU.

Guy comes in, in his early 70s. I admitted him, and tried to get him settled in, but the guy's calcium was something totally whacked, and we didn't know why. The end result was that the guy was climbing the walls. Trying to go over the rails of the bed, pulling at all of his lines, going totally nuts. We'd given him enough drugs to stop a Mack truck, to no avail. I had called his doc to get some more, so he could get some rest. Guy tells me, very seriously, "if you don't let me outta this bed, I'm gonna die." "Well, you can't get outta bed, so you're gonna have to lie back down."

Secretary pages me to the desk. Doctor is calling. Gives me orders for a sleeping pill for Prince Charming. I go to the cabinet to sign it out. Suddenly, I hear an alarm go off, turn around and damn, he's outta bed. ::sigh:: Head in the room with his sleeping pill and nope, he's in bed. Flatline.

No joke, the guy just dropped dead cause I didn't let him outta bed. I had no idea that I had so much power. We run the code, nothing works, and after he's pronounced, I tell the doc what happened, and he looks at me, very seriously, and says, "next time, let the guy outta bed."

So, since we all know that I'm the Queen, and now you know that if I tell you to stay still, you'd better run like hell, cause the Grim Reaper might be wandering over to get you. And for the power of Queen, here's a vintage Smiths T shirt, proclaiming The Queen Is Dead, from rock2you.