Monthly Archives: June 2010

They like me! They really like me!

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So I got hired at .6 FTE at one of the places I work oncall.

I have to tell you, friends and neighbors, the relief I feel is almost palpable.  Sweet, slightly sticky, and smelling faintly of vanilla and cinnamon.  Yes, relief is basically the emotional equivalent of a Cinnabon.  No longer will I have to scrounge up three shifts a week, or worry about getting sick and missing a whole week of work (which happened recently and cost us hundreds of dollars).

It is a night shift, which isn’t ideal, but on the bright side the shifts are on good days for me schedule wise and there is that tasty five-bucks-an-hour differential to wallow in.

I’m just going to blow my own horn for a minute too.  Today I finished up my training in admissions.  Admitting a patient to detox is really not that terribly complicated, in my opinion.  You fill out some paperwork, sit with the client and ask a shitload of questions, and then decide whether to medicate them for any of their detox symptoms.  You send them back to the special waiting room (where they watch movies on a nice big flat-screen tv and are given snacks or lunch while they wait) and finish their paperwork, call report to subacute, and hand their finished documents to the clerks who put it into a chart for you.

People, this is not hard.  The most challenging part is remembering to put their vital signs in about four different places.  Oh, and placing TB test injections.  It ain’t rocket surgery.

Generally, I was told, a newbie such as myself would be given one intake to do and depending on how badly they screwed that up, they might — might — be given a second.

Naturally, because I am Slightly Above Average ™, I did three.  And still got out of there half an hour early.  Even with the construction-snarled traffic that made me twenty minutes late getting back from lunch.

But, it’s not like I’m a real nurse.  🙂

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A Productive Day, with slug photo

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It’s been a kind of fits-and-starts couple of months around here, with a certain amount of yard work and house work being done some weeks and others… well, not so much.

Today I scrubbed the shower out, put a new shower curtain liner up, did a couple of loads of laundry, and refilled all my little bottles of shampoo and conditioner and all that for my gym bag.  A few other things got done along the way, and now I am going to pack up and head to the pool before work.  For me, this is a seriously productive day.

Oh, and the Collective Spawn ™ are all enrolled in swimming lessons twice weekly starting in August.  Take that, freakishly responsible parents who routinely get this kind of thing done without fuss!  IN YOUR FACES!

To be fair, what brought that on was a one-two punch combo of a) taking Elder Spawn to the pool the other day and watching her go almost literally insane with joy, and b) being reminded by my ex that I had agreed to be the one who enrolled her.

In case all this self-congratulatory stuff isn’t doing it for you, here’s a photo of a truly magnificent slug  that we saw at camp.  Seriously, this thing was huge.

Ve Haff Vays

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Attended a training session with the new Helga last week before leaving for camp.  The core exercises that she forced me to perform made climbing in and out of the bunk so much more satisfying than it would have been had my abdominal muscles been actually functional and not cramped into a board-like mass of pain and misery.  Thanks, Helga!

Camp Nurse

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Well, that was fun.  The most complicated nursing task I performed was to provide a nail clipper to a family in need.  One of their offspring had bent a fingernail backwards, not to the point of bleeding or anything, but it smarted.  Despite my lengthy training and expertise, I allowed one of the parents to trim the offending nail so as to prevent further bendage.  Go, me!

It was fun though, the kids had as much fun as currently feasible, and there were silly camp songs by the campfire and s’mores and crawdad fishing (using leftover breakfast sausage; who knew crawdads found it so irresistible?) and marginally comfortable bunks and low water pressure and dirt.  Oh, plenty of dirt.  There were also very nice people, and trees, and gigantic slugs, and a trip into town for a latte when we had reached nearly our breaking points of caffeine deprivation.  Coffee was plentiful but of the drip variety that is hurtful to my tender stomach, oh and also it tasted like crap.

It was such fun, in fact, that I signed on to go back later in July to do it again, for a week.  The board of directors came to join us for a meal and one of them is running the week in question (and attends my church and is very nice) and when she spied us she cried, “You’re the camp nurses?  Why aren’t you the nurses for MY camp?!” And thus I was drafted.  Rhonda is working but will visit when she can, and Elder Spawn will be with me for either all or part of that week, communing with The Nature (i.e. pawing at slugs and throwing rocks into the creek) whilst I attend to the first-aid and medication-administration needs of a pack of wily young teens.  We made friends with a couple of the counselors and learned that wi-fi is available in the admin building, wherein we will be housed, such that I should not be deprived of my connectivity.  Furtive french-press-sharing arrangements were also made.

We at the Low-Pressure Church that I attend are very laid-back about the whole religion thing — as the minister once described it, we’re not particularly of the “my pal Jesus” school of thought — and it was interesting to attend a camp that was arranged by those who are.  There are as many types of UCC churches as there are individual ministers running each one of them, it seems, and our cheerfully self-described introvert-forced-to-be-an-extrovert minister’s style appears to suit me quite well.  To us, Jesus is srs bzns (srs but kindly), and we’re not inclined to attend services all day and then break out the guitar and sing devotional songs far into the night.  Sure, a couple of them, but then bring on “The Cat Came Back”!

It’s Tuesday

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Which means The Game is down for maintenance.  Rhonda is home, having been called off, and Elder Spawn is here a day early, so we three sit jacked in to our laptops in full TimeWasting mode.

We have errands to run today, and there is always yard work to do, cleaning, tending to the tedious upkeep of the home, etc.

When it gets to be a drag I remind myself how much more rewarding it is to keep up this home, with its yard and its three bedrooms and its laundry facilities, than it was to swill out the cramped, crappy apartment we squeezed ourselves into for that last year of nursing school.  Let us be grateful for that which we have, for so often it is better than what we used to have, not to mention we are lucky to have anything at all.  (Don’t make me tell stories about that cardboard box we lived in, in the middle of the intersection, and how it was up hill both ways in the snow and all that)

Tomorrow afternoon we depart for camp, wherein we shall be Camp Nurses, that our offspring might play in the healthful and fascinating out-of-doors.  We’re trying to remember why we thought this would be fun, in that we must all sleep (ha!) in the same room and there is (gasp!) NO INTERNET, but since we’ve committed to it I guess we should see it through.  I understand we might sit around the table manipulating small pieces of pasteboard emblazoned with arcane symbols, which strikes me as an odd pastime for a church camp, but we’ll just see how this “cribbage” thing works anyway.

And now to pack the several hundred items required for Adequate Parenting, including but not limited to SPF 9billion sunscreen, first aid kits (we are nurses after all), flashlights, jellybeans, flyswatters, crayons, graham crackers, bowling balls, dry socks, turnip twaddlers, yogurt squirters, etc.  Wish us luck!

Yard Work

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So today I was finally feeling well enough to go out and tackle the back yard.  I mowed the front on Saturday during a brief moment of sunshine, but then the rain and the cold symptoms returned in force.  At last, today is cloudy but warm and dry, and although I am still feeling pretty snotty and coughing a bit, I decided to get my mow on.

It’s been some time since we last mowed the back, and the grass is over a foot tall in places.  Many, many places.  Our mower is valiant but has its limits and so it took me nearly two hours to get the main part of the grass under control.  Then I got this wild hair and decreed that the sandbox could no longer stay where it was, and using an ingenious method (mostly consisting of swearing and scooping buckets of sand into a rickety wheelbarrow and grunting a lot) I accomplished that.  Then I got all distracted with the huge laurel hedge or whatever (okay, so I’m not a botanist) that fell down a couple of months ago.

Out come the loppers and the yard debris can and the gloves, and now half of the bush is in the can and the other half waits for me to return from picking up the Elder Spawn from her school bus.

I’m not sure where this burst of yard-work-frenzy is coming from but I’m riding it, my friends.

In case you wondered

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What a detox nurse does…  I work for two different types of detox programs, one is hospital-run and one is a subacute rapid detox serving basically anyone that comes in the door.  It’s run by an agency that serves the homeless and disenfranchised of Metropolis.  This agency provides housing and all kinds of other assistance; detox is just one of the many services they have.

I haven’t really gotten a good feel for who comes to the hospital-run program and why, or how, or who pays for it.  Nor am I really sure who pays for the subacute rapid detox either, except that they request insurance information from anyone who has it.  One must also be a resident of Metropolis or at least of its state, or else pony up nearly a grand up front.

Let’s just imagine a day in rapid detox, shall we?

Firstly, if you want to avail yourself of the detox you must begin by appearing in its lobby at an appointed early hour each morning, consecutively.  It is considered a measure of your motivation that you continue to appear, day after day, until you get in.  This may take a few days, or may occur very quickly if you meet certain magical parameters: you are more than a little sick from detox (dopesick, they call it, for the opiate users, or going into DT’s if you are an alcoholic), you have nowhere safe to go, you are prone to seizures or DT’s.  I have attended this call and seen a few very twitchy people in the lobby, as well as the huddled masses that mostly just look tired and like they don’t feel that great. I have seen others taken away in ambulances to be stabilized before they can come back to their bed at the detox.

Say you make the magic cut, and finally you are in.  You are taken back to an assessment room and if you are quite ill, once you sign the consent form you may be medicated immediately.  Otherwise you are assessed, a history is taken, vital signs, urine drug screen.  You are asked what exactly you are detoxing from and how often/how much you have been using, as well as when  you had your last fix/drink/whatever.  You are given several opportunities to get rid of any substances of abuse that you might have on you; should you fail to do so and it is found among your things back in the unit, you will be escorted out immediately and may not be permitted back in the future.  Once you are finished with the assessment process, you are taken to a shower and given clean scrubs to wear.  Your clothing is laundered while you are in the program so you can leave wearing clean clothes.  For some of the clients this is a nice luxury.

On the unit you are expected to participate in groups, although you may be excused from them if you are too sick to attend, as many people are in the first couple of days.  This program utilizes acupuncture and it is mandatory for all clients, which I find very interesting.  Otherwise the day goes like so:  your vitals are taken at 8am or so, and based on an assessment of your symptoms you may be medicated according to a protocol.  Alcohol detox is done via Librium dosing, while opiates are detoxed using Suboxone.  Depending on your dosage, you may be re-assessed in as little as one hour.  All day the assessments take place and the medication is handed out accordingly.  Meals are provided as are all toiletries and basic needs.  The beds are in large dorms, all the men in one room and all the women in the other, no real privacy.  It’s not luxurious but it’s quiet and it’s clean.

Lest you consider that this is cushy for the addict, let me tell you: this just rounds the corners off the detox.  It’s still miserable.  They sweat, they shake, they are nauseous and vomit and have diarrhea.  They get monster headaches and high anxiety.  It would be easier for them to go out and use, that would take all of this away, but they are here trying to kick it.

I have met people who have been drinking a fifth of hard alcohol a day for years, who have been shooting up heroin for months, who slept last night in a dumpster and apologize for stinking; who have lost their homes and their children and their spouses and their jobs and their health.   Some of them try to pursue every medication we can offer and argue with us, others just look tired.  Most of them have  a little spark of hope.  Some will go on to inpatient programs or outpatient programs.  Some are trying to get their kids back from the state.  Some of them are just young kids who made some bad decisions and are not too far into it yet, others are older and more beaten down — but they still have hope.  It’s amazing, they still have hope.  They have guilt, and shame, and fear, and sorrow, and depression, and hope.

My job is to be kind, with an eye for fairness, to assess and to medicate and to monitor and to keep them safe.  I don’t have to judge them for being addicts, although a healthy dose of reality is not considered to be out of bounds.  I heard a young, hipster heroin addict tell another nurse she should not eat meat, “It’s, like, so not healthy for your body.”  “Oh,” she responded, “but injecting heroin into your body is okay?  Yeah, I thought so.”

Many of the staff, from nurses to techs to janitors to clerks, are in recovery themselves, from alcohol, from drugs, from gambling, from some combination of these things.  They speak of it frankly and without shame.  I feel almost at a disadvantage sometimes, because I grew up pretty sheltered and pretty disinterested in drugs and alcohol aside from some (occasionally rather spectacular, it must be admitted) social drinking.  Hell, I don’t even smoke.

Once you’ve made it through the protocol for your particular substance you are considered stable and will have met with a counselor to consider your options from here.  Those counselors do their best to line the clients up with services of some kind after they leave the detox.  Most clients don’t make it all the way through the program on their first shot; most will leave once they feel better, but many of them will return several times, each time staying longer, each time staying clean longer after leaving.  Some will never stay clean and will return occasionally when their misery exceeds their ability to medicate it away on their own.   The clients are almost without exception very polite and grateful to be there in detox.

Am I  a real nurse?  Well, I’m helping people who need help.  You be the judge.