Friday, June 18, 2010

Revelation

I had an epiphany at work: I really, really need to make time to eat lunch. A lifetime of body image issues have left me with a high tolerance for hunger. I'm like a camel in the desert where food is concerned. It had been my habit to eat a light breakfast, bike to work, perhaps snatch a five-minute sit-down to snack on a clementine during the middle of a twelve-hour shift, but otherwise take in no nourishment other than sips of water and strong coffee, bike home and then, without stopping to eat, go for a run. I assumed, because I never actually collapsed, that my body has some sort of superior blood sugar regulation system. What I didn't consider was what the lack of food was doing to my mental status. I thought that quietly weeping in the bathroom toward the ends of my shifts, full-on sobbing after getting home, generally feeling like life would never, ever be joyful again were related to the stress of being a nurse when actually, they were related to the fact that my brain was starving.

On Sunday, I was working my fourth twelve hour shift in a row--with the extra half-hour tacked on for lunch (which I never take) that's fifty hours in four days. I had had the same patients and they were getting on my nerves. Two of them (there were five, total) were the sorts whose family members come looking for you when they need something, instead of using the call bell, which meant I was constantly getting interrupted for stupid stuff ("Can you do something about the guy in the next bed who is snoring?" "Can you bring us a cup of ice/ a towel/ an ice cream? "Can you make my roommate's visitors talk more quietly?""Could you provide longer IV tubing so Dad can move his arm more easily?" "Can you give Dad these particular pills at this time, but wait half an hour for this other pill because that's more convenient for us? And then can you bring him pain medicine a half an hour after that?" "Can you fly to the moon and bring back a piece of it for us?"). It's not like I'm checking my facebook when I'm at the nurse's station. I'm charting, I'm sending pages, I'm checking in with the social worker or physical therapists, planning my care, in other words, WORKING. And I'd had big plans for a different patient who had been with us for months. I'd wanted to put him in a wheelchair and try to get him outside for some fresh air--his first trip outside in over two months, but I was just too busy with all the other patients. I was frustrated because this patient was quiet and undemanding and I resented that my other patients were getting in the way of my plans for him. When I finally sat down for a minute to grab a quick bite, I got paged to one of my rooms--the patient's visitors in the other bed were concerned about the roommate, who was moaning in pain. The moaning patient, for whom I had done a lot to get improved pain control is someone who doesn't suffer silently. It's just her way. I helped her (and her chest tube) transfer from the chair to the bed--her lusty screams could be heard all the way down the hall-- encouraged her to press her PCA pump button, told her when she could have more Percocet. She was comfortable, but it had taken fifteen minutes to accomplish all that.

Then her roommate's daughter wanted to talk to me at great length about how disappointed she was that her mother wasn't being discharged to their top choice nursing facility. It was all my fault you see, because I'd verified that they'd communicated their choice to their doctor's administrator, and I'd told them our social worker would arrange it--provided there was a bed available. And the social worker should have arranged it, but for some reason placed the patient in a different facility, possibly because the family's choice facility doesn't show up in the computer when you search for it, ("Oh," the family said, "That's because it's new.") Well how the fuck are we supposed to find it and, more importantly, WHY ARE YOU BLAMING ME ABOUT SOMETHING THAT IS THE SOCIAL WORKER'S RESPONSIBILITY? Anyway, this woman talked and she talked and she talked and suddenly the room started spinning. I steadied myself with the bed, told the woman I had to leave, and walked out. Some nurses aids in the hall asked me what was wrong and I started crying and said I thought I was going to pass out. They couldn't have been kinder: they made me sit in a private office, brought me washcloths for my face, brought me food, told the charge nurse who took my pager away, and then left me alone to eat and cry and recover.

The thing is, the food didn't just give me physical strength, it improved my mood. It improved my mood a LOT. The angry family wasn't so terrifying any more, the demanding family, well I'd be going home in a few hours and they'd be chasing a different nurse down the hall with their demands. The quiet patient I wanted to take outside? We did at least manage a short walk in the hallway. Unfortunately, a few days later, he suddenly got very sick and is unlikely to ever see the light of day again.

Update: The patient I wanted to take outside for some fresh air coded and died a few weeks later.  He never got an opportunity to do outside and breath fresh air.

4 comments:

  1. I shudder to think that most of my personal and professional decisions in the last ten years were made in a similarly food (and sleep) deprived state. I'm not sure why we beat ourselves up so much.

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  2. Wow. I'm a being whose life revolves around food, never mind body issues, and I acutely feel its lack.

    In fact every time I'm grumpy James asks me whether I'm tired or hungry. And it's usually one of the two.

    I guess that's a lesson to learn - your body needs you to take care of it just as much as any patient. And there are tons of quick items to eat - energy bars, Vega smoothies, etc. etc. Please take the time to fuel yourself, you've seen firsthand the results of not.

    PS my capcha word is hookers??

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  3. Hi! Visiting your blog for the first time because I was reading one of my favorites just now, a blog called "Whoopee," and you had written a comment there about living in a city that you referred to as "smug central" and I thought "she's got to be talking about C'ville." So I followed the links to your blog and was very amused to find I was right! I live in Free Union and have only to been to the City Market a couple of times, but I loved your description of it.

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