Tuesday, March 27, 2007

Just Another Day at the Office...oops...Hospital

I worked Fri, Sat, Sun and Monday nights. I tried to sign up for tonight, but they were overstaffed already - so I'm off. At first I was disappointed, but then I got this critical patient at 5:30 this morning & I'm glad I don't have to go back to that stress. She was a transfer from med-surg whose heart rate was in the 170's. Well, they discovered her heart rate was that night when they did the 4 am vitals, but who knows how long it had been elevated like that since they only do vitals every 8 hours. Anyways, they give her to me without any real orders except to transfer to PCU. The only person on the case was the surgeon that did a laminectomy 6 days ago. I like to think I have the magic touch, but no way was I going to get her heart rate to decrease. I got an order for a cardiologist...it just had to be the one I really don't care for because he's so rude on the phone. I woke him up at about 5:45 and all he ordered was Cardizem 15 mg/hr. No bolus, no digoxin. Her heart rate was still elevated when I left at 7:15. Hopefully they'll get it under control. I don't like transfers like that...where I don't know anything about the patient or their history & they are critical. Not to mention the family members asking me why her heart is doing that. I wish I had the answer, but I don't....and I don't like "not" having the answer. My other 3 patients were luckily ok. Actually better than ok....they were stable & didn't need any meds or anything so I was able to focus on this new transfer & able to get the charting done so I didn't have to stay late.

Two of my patients I have had since Friday night. One has been there a month! She came in with chest pain & shortness of breath. She was supposed to be discharged & as she was waiting for her family members to come pick her up, she had a seizure. Well, they think it was a seizure, but they also think she was faking it. I don't know what has kept her here for a month & I don't really know what their plan is for her. She was a sweet lady...kinda needy - it was more like taking care of a baby than a woman. I probably shouldn't have catered to her as much as I did because she should be doing things more independently for herself, but sometimes I can't help it. Some patients bring out the maternal instinct in me. This one even had a teddy bear that had to be tucked in with her each night. It was cute.

My other patient came in Friday night needing a pacemaker inserted. She had been at the hospital the week before & left...only to be advised that she needed a pacemaker. She was in denial, but finally brought herself back to the hospital to get the operation. The cardiologist spoke to her & she was asking him how many of these operations has he done. He told her "Plenty." She asked "What do you mean by plenty?" He came back with a snappy remark like "What number do I have to tell you in order for you to be alright with me doing the surgery?" She didn't like that answer & refused to let him treat her. I say good for her. It was nice to see a patient not put up with the b.s. that some doctors throw at them. So the cardiologist consulted with our top surgeon & the patient really liked him. He was at her bedside, holding her hand & talking to her about the surgery. She felt much better. I had a good rapport with her. We talked about life & family, about her daughter having to put her dog to sleep recently - I shared with her what I just went through. Last night I noticed her doing one of those Sudoku puzzles. I asked her if it was enjoyable & she said it was. I told her I looked at them a couple of times, but just didn't grasp what was so much fun about it. I told her maybe I'd learn on the plane when I go on my trip since it's such a long flight to Hawaii. It turns out she went on the same cruise I'm going on. What a small world...lol. I wish all my patients were like her. I went in to say good-bye to her this morning & she started crying...telling me how sweet I am and thanked me for taking care of her. Awww! That is what makes all this hard work worth it.

The other night, another nurse had a patient that had a massive stroke. It's scary...one minute he was fine & the next he was unresponsive. The CT scan said he had a blood clot in the brain AND hemorrhaging in 3 to 4 ventricles. We were told there isn't anything we can do for that. The family came in and gave their consent for "do not resuscitate" orders. How sad...I felt bad for them. To leave the hospital earlier saying good-bye to their husband/dad and to get a call a few hours later & find that he's no longer responsive...so sad.

We had another patient that was drinking & driving...saw a snake in the road - so he stopped his car. He got out to pick up the snake so it wouldn't get run over. Turns out it was a cottonmouth (otherwise known as a water moccasin) & it bit him. He went into anaphylactic shock. Amazingly they got him to our ER, administered many doses of anti-venom & he's going to be ok. Bet he'll never pick up another snake again!!!

Wednesday, March 21, 2007

Feeling a Little Better

I'm feeling a little better than I did two weeks ago.  All day today I kept thinking "it's been 2 weeks since I had to say goodbye to Jagger forever."  Sometimes it feels like 2 years, other times it feels like only 2 days ago.  I'll always miss my buddy, my puppy dog. 

I took my niece & nephew to the Nickelodeon Hotel in Orlando for a few days.  It was ok.  The hotel is great...everything a kid could want.  My niece loved it.  My nephew...well, all he seemed to want to do it watch tv & play Playstation 2.  I was disappointed.  I thought they'd spend a lot of the day playing in the pools...the awesome slides & kids activities, but nope, they really didn't want anything to do with it.  That frustrated me.  So no more Nick Hotel for me ever again.  If I decide to do another mini-vacation, it will be at a normal hotel that doesn't have hundreds & hundreds of kids roaming around. I am so looking forward to my Hawaii trip.  It's only about 2 months away. The countdown is on.

I start back to work on Friday night.  I'm not looking forward to that, but I do need to start making some money.  I hope I can still pick up extra shifts. 

I hope everyone is having a good week!


Tuesday, March 13, 2007

At Peace with it All

Hey everyone!  Amazingly I'm doing ok over here.  I went to work Saturday night and they had me as a unit secretary for a few hours & patient care tech if I wanted.  It was nice to come back to simple work like that.  It was also nice back to be in some kind of routine.  I wasn't distracted from my thoughts....I was able to share with some of my co-workers what happened & they were very supportive.  I didn't cry at all or even feel like it.  In fact, I went home Sunday morning feeling at peace with all that has happened this past week.  I didn't cry at all...I just wanted to lay in my bed & get some sleep.

Sunday night I was at work again & I had patients this time.  Luckily they were all pretty simple to care for & I was able to have actual conversations with all of them as opposed to being short on time & not getting to know them very well. 

My first patient was a woman in her 80's that came in with a suspected GI bleed.  Her H&H on admit were something like 3.8 & 10.  That is extremelyyyyyyyyyyyyyy critical & she was in ICU receiving blood.  By the time she got to PCU, she was much better although now tests revealed she had a blood clot in her right thigh from a femoral line.  The doctors had the day nurse pull the line, which we both thought was odd.  She was afraid it was going to send the clot right up to the heart or lungs.  And on top of that...we had orders from the cardiologist to ambulate the patient...with the blood clot.  That made no sense to me, so I didn't ambulate her.  She was on a Heparin drip, but still...this was a new found clot. 

My second patient was a gentleman in his 50's in with chest pain.  He had a high alcohol level & tested positive for amphetamines & marijuana on admission.  24 hours later the alcohol was still high, but lower than earlier.  He was a very nervous man.  Wanted to know exactly what had caused that chest pain.  My guess would be anxiety.  His family seemed very high-strung also.  I was beginning to feel anxious just talking to them.  The doctors advised him to quit drinking, smoking & taking illegal drugs.  What are the chances that he'll actually listen?

My third patient was in with possible GI bleed and a very high INR result.  Normal is 2 to 3, hers was 6.4 when admitted.  She also had 2 prior falls within the last few weeks, but it didn't seem like the doctors were focused on that. 

My last patient was in with pulmonary embolisms...blood clots in her lungs.  She had hip replacement surgery 2 weeks earlier & it seems like when someone is in a hospital bed for more than a day or two straight...the clots start forming.  She was a sweetheart.  We talked for quite awhile about life.  She was so appreciative of me that she gave me a kiss.  I like patients like that.  I was reading the progress notes from what the pulmonologist had written...the patient said "I kicked ASS ambulating up & down the hall."  It was cute.  She is afraid that if they think she can't take care of herself, she'll end up in a nursing home & she doesn't want that.  She wants to be independent & remain in the skilled nursing facility she's in.  Hopefully she will be able to return there soon. 

I came home, got some sleep & have just been taking it easy since then.  I didn't cry at all in the last 2 days...except for a little while ago.  The vet's office sent me a condolence card & inside was the story about The Rainbow Bridge.  I found a pet loss grief message board on Friday & posted there with all I was feeling on Friday...a lot of sadness.  It was nice to be among people that knew exactly how I was feeling.  I thought it would be helpful, but in the last couple of days, when I go back there...I find it sad & depressing.  There are people with whom their pets have died long ago & they still cry every day.  I don't think that's healthy for the mind or the body.  I also read posts in which they replaced the pet right away & were disappointed with the new pet.  Every time I go back to read any messages, it makes me sad to see how much grief & sadness there is.  I don't want to be like that. 

I want to remember the good stuff.  I want to cherish what he meant to me & I know he would not be happy seeing me cry day after day.  He never wanted to disappoint me.  I feel like the lucky one...I was the person who got to take care of him for so long.  And I was allowed far more years than usual with a dog of his size.  So as much as I wish I had more time with him, I feel greedy.....in people years he was practically 95 yrs old.  That's a long time for a dog.  I'm at peace, I feel no guilt about putting him to sleep.  He gave me the look that I knew in my heart it was time...he was letting me know it was time & I wasn't going to let him continue to suffer.  He's in a better place & I'll see him again one day.

It's funny - when I first started planning this long trip I'll be taking in May, I had worried that it meant Jagger & I didn't have much more time together.  As it turns out, this trip is going to be helpful in getting over the loss of my sweet dog.  Before his health went bad, I had been looking for books about soul-searching to take on my trip.  Now it seems like it's all falling into place (as life usually does) & this trip won't just be for enjoyment, but also for reflection & for having time to figure out where I go from here.

Travel nursing is looking more & more promising.  It's a huge step out of my comfort zone, but I figure life as I know it right now....my comfort zone has been damaged.  So I'm going to have to do some adjusting regardless of whether I do venture out & try something new or if I stay at the same hospital I'm at.  Right now I'm all for trying something new.  The hard part will be deciding where to go.  I have plenty of time to think it over & gather some information.  There is a job fair at the end of April where I can make some contacts with job recruiters. 

2007 is definitely going to be a year of change for me & as challenging as it may be, I know I'm going to be ok. 


Friday, March 9, 2007

Pictures of my baby

Y'all are probably tired of me talking about Jagger by now, but I had to add some more pictures of my baby to the journal.  These pictures make me smile.  A couple are when he was a little puppy, then in his prime & a few of him not too long ago.

Karla...I'm so sorry for your loss.  I hope you are doing ok.  Thank you for your kind words & thoughts.  I like the way you think!  :)



The Lone Wolf

I don't know if I mentioned earlier or not, but I did get my official acceptance letter for my Bachelor's Degree in Nursing program.  Now I have to fill out all the admission paperwork...yuck! 

I went into work this morning for that stroke class.  Our hospital is becoming certified as a primary stroke center.  It was very informative.  Although I was distracted quite a bit while sitting there thinking about Jagger, I do feel as though I learned more than I ever knew about strokes. 

I didn't sleep well last night.  I had to take 2 Tylenol PM's just to fall asleep.  I woke up a few hours later.  It's just so empty without Jagger nearby.  It felt so strange to get ready for work & not have to do anything but take care of me.  I got out of class a couple hours early & usually I'd be happy about that so I could come home & see my dog.  This time I sat in the parking lot thinking "Why even go home?  Nothing is there."  I came home anyways & was quickly reminded of reality.  I've been crying on & off the rest of the afternoon.  I've been reading articles about the loss of a pet.  It's comforting seeing that other people understand exactly how I'm feeling.  It's also comforting to have all of you that have been writing me & leaving comments...it makes me feel  better.  I know it's going to take a lot of time to heal & I'm trying to endure it.  I'm not holding anything in, I know it's ok to grieve & hurt. 

I came across this story a little while ago.  It is somewhat connected to The Rainbow Bridge, just a different perspective.  It stopped me from crying for a few minutes...thinking what if Jagger is up there looking down, watching me cry, blaming himself.  Some may say that's silly & maybe it is...but life is silly, so who cares!!!

The Lone Wolf

The Bridgekeeper was doing his usual rounds. Every couple of hours the Bridgekeeper would walk the lands at Rainbow Bridge, making sure that there was plenty of fresh water, toys, and treats for each one of the residents.

Every time the Bridgekeeper passed by the Edge of Forever, he noticed the same silhouette sitting there --- tail flat, head on paws, gazing out into the distance. Many would approach the silhouette and try to get him to join the rest, but each time, the silhouette would gently place his nose under the chin of the well-meaning friend, give a soft whimper, and return his gaze to the horizon.

It had always been this way since the Silhouette had come to the Bridge of Rainbows. Many had come and joined the Silhouette for a time --- understanding why he was there and going through a similar thing, but eventually each who had come would retreat as silently as they had come. It was only the Silhouette that remained each and everyday.

Whenever he had finished his rounds, the Bridgekeeper would join the Silhouette. He would gently put a hand on his head and the Silhouette would put his head in the Bridgekeeper’s lap, all the while making sure not to block his vigilant watching of the distance.

There was no need for words anymore between the Bridgekeeper and the Silhouette. The story had been told long ago and now there was only the waiting. As the Bridgekeeper and the Silhouette sat in silence, the Bridgekeeper recalled the only time that the animal had spoken to him, so long ago…..

The Bridgekeeper noticed that the Silhouette had been there for longer than any other had been. Usually the ones that stood on the Edge of Forever would gaze back only for a short time until they knew their Human was ok. Some stays were short, some were longer, but eventually the animals would retreat from the Edge, knowing that their Human would be ok.

And still the Silhouette remained…

One particular night, the Bridgekeeper joined the Silhouette for the first time. He sat down beside him and put a gentle hand upon his back and stroked his fur. They sat this way for sometime without words, until the Silhouette finally spoke.

“I’ll not leave here, so there is no point in trying to make me go.” said the Silhouette.

“You may stay here for as long as you wish.” Replied the Bridgekeeper, all the while stroking the back of the Silhouette.

The Bridgekeeper could feel the heavy muscles on the back of the Silhouette begin to relax as he continued petting him.

The Silhouette took a quick glance at the Bridgekeeper, making sure thatit was not a trick to get him to leave his post. After a time, the Silhouette realized that the Bridgekeeper was true to his word and he spoke…..

“I did not do enough for him while I was there. I should have treated him better, I should have behaved more – I let him down. I chewed many things I was not supposed to, I did not always potty in the right place, and I did not listen to him when I should have. I did so many things that I now regret, but the worse thing I did was I made him make a choice. I will never forgive myself for doing that to him. I see the sorrow in his eyes, sorrow that I placed in those eyes. And I never had a chance to show him how much I really love him.”

The Bridgekeeper said nothing as he continued to pet the weary Silhouette and hoped he would continue talking.

“I watch now as he goes through everyday now, feeling so guilty for his imagined faults. If only I could have one more moment to tell him how much I love him, and how much I wish he would not blame himself for what I made him do. All he ever did was love me. My dish was never empty, my needs were never neglected, and in the time I needed him the most --- when my mind was no longer my own and when I needed to come here, I was defiant. I did not come willingly, and so I made him send me. Oh how much love this man had for me to forget his own pain to do what had to be done! Oh how bad I was for making him make that choice!! And now I watch and I wait for him to forgive me.”

The Bridgekeeper waited a few moments for the Silhouette to relax again, and then he gently said, “ Look closer mighty one and look into his heart. He clings to the sorrow because he thinks he let you down. He cared not that you chewed the wrong things, or that you dug holes on the yard. See how he now cherished the very shoe you chewed, and see how the hole you dug is now surrounded by flowers? The things you did that you blame yourself for are now the very things he clings to --- so deep is his love for you.”

The Silhouette gave a side-glance to the Bridgekeeper and snorted slightly before replying, “My life has brought him such sorrow, such grief, and pain. And all he ever did was love me ---- even his last gesture was the most loving thing he could have done. I was no longer myself, and I gave him no choice but to make that final choice for me. And now he blames himself for something he had no other choice but to do. And so I now watch over him, waiting for him to forgive himself, for how can he ever forgive me until he forgives himself?”

The Bridgekeeper softly responded, “He does not see it that way. He feels he let you down, that he could have and should have done more. ”

The Silhouette sighed and continued, “With every breath in his body, he loved me with it. And I love him more with each breath he takes. I will stay here at my post, watching and waiting until his heart heals ---- until he realizes that the only thing that ever mattered is the LOVE. Only when his heart is free will I be able to walk the path next to him, where I truly belong.”

And with that, the Silhouette spoke no more. With his eyes looking out towards the distance, the Silhouette lifted his head and placed it in the lap of the Bridgekeeper, who held him close and continued to stroke him.


Author unknown

Thursday, March 8, 2007

Rainbow Bridge

I ended up going to my parent's house earlier today.  My mom & I did a little shopping for my vacation of a lifetime.  Then we had dinner.  I also talked to one of my brothers & he made me feel a little better.  That I should be celebrating that I had almost 14 yrs with Jagger, that not many dogs live that long & that he died peacefully in my arms as opposed to being hit by a car or running away. I know all that stuff, but it still hurts to have him gone.

My brother also reminded me that if I miss having a dog around, I always have the option of getting another one.  The thought has crossed my mind, but it wouldn't be anything I'd do until after my trip.  I really have to think it over as my crazy work schedule with long shifts makes me think it would be unfair to any puppy or dog.

I've never been without a dog ever in my life. I usually had two or more dogs at a time.  Whenever one would pass away, I'd at least have the comfort/companionship of the remaining dog at home.  Then I'd feel bad that the remaining dog was sad & I'd get another dog to keep him/her company.  As I said in an earlier post, I put my last dog to sleep 13 yrs ago, Jagger was only about 5 months old at that time.  It's just been him & I for the last 13 yrs together...no other pets.  So this is all new to me...not having anyone to take care of or greet me when I get home or having a quiet house.  I'm adjusting. 

I'm feeling a little better.  The good memories are resurfacing & making me smile.  I know he's in a better place.  A friend of mine sent me something really touching & I do believe in it.  I like to think that Jagger is up in heaven with my other dogs...running around & playing.  Here's what my friend sent me...

Rainbow Bridge
Author Unknown

Rainbow Bridge
Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge.
There are meadows and hills for all of our special friends so they can run and play together.
There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by.

The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Rough 24 hours

It's been a rough 24 hours...as expected.  My birthday dinner was nice.  I went to Carrabba's with family & friends.  I had 3 margaritas but it wasn't enough to dull the pain.  When I got home, I started crying again.  I talked to a few of my friends, explained what happened...the more I talk about it, the better I think I feel, but then the sadness starts all over again. 

I called my mom around 10 pm because I missed Jagger & couldn't stop crying.  It's so weird going in my room & not having him laying on the bed waiting for me to get home.  He was always there, always waiting, always happy when I got home.  I didn't sleep well, which I figured I wouldn't.  I'm so used to petting him when I watch tv or playing with him.  Waking up to him waking up.  It's so empty right now. 

I start back to work tomorrow.  I have a stroke class from 8 to 5.  I think it will do me good to be focused on something else.  I am scheduled for Saturday & Sunday night and am planning on working the rest of the week...partly because I've taken it easy the last weeks & need to earn some money & partly just to be out of the house & distracted from my loss.  That is one thing I am grateful about though...I've barely worked in the last 3 weeks & got to spend a lot of time with Jagger in his final days.  I didn't know these would be his final weeks, but I am glad I was home a lot with him. 

I'm debating about whether to take my niece & nephew to Nickelodeon Hotel.  It's something they've wanted to do for awhile, but I always put it off because I didn't want to leave Jagger in anyone else's care.  The kids are on spring break in about a week, so maybe I will go ahead & make the reservation.  As much as being around hundreds of screaming kids, it would probably do me good & I've already agreed to watch my niece & nephew for a few days of their spring break anyways. Nick Hotel is really cool...so geared towards kids & the pools are amazing.  The rates are expensive...anywhere from $300 a night up to about $800 a night.  I found a pretty good deal where I can get it for less than $200 a night...so I think all signs are pointing to go there sooner rather than later.

I guess I never realized just how dependent I was on my puppy dog.  I guess that's like most things in life...don't realize how much they mean until they are gone.  I know I gave him a good life & he was always there for me..day in, day out.  I know I'll always miss him.

Thanks everyone for all your kind words, thoughts & prayers.  It helps so much. 

Wednesday, March 7, 2007

He's Gone :(

My baby is gone. It was as peaceful as you could ask for, but it's still hard. I know the pain will ease with time, but right now it hurts a lot. I miss him so much. I feel like I let him down even though there was nothing else I could do. I know it was the right choice. I just miss my puppy dog.

The last time I had to put one of my dogs to sleep was about 13 yrs ago. Her name was Missy & it was sudden. I came home to find her very bloated - her entire body. It immediately made me think that she went into heart failure. I had no time to react. I got her to the vet immediately & they said she had to be put to sleep. I freaked out, paid & left her alone with them. I always regretted that I left her in her final moments with strangers. As hard as it was being with Jagger, I am glad I was able to be there for him to the end...to comfort him & for the last thing he was able to see was me. I hope that eased his suffering somewhat.

A friend of mine (Linda) said that this happening on my birthday probably has some kind of meaning. I know it does also. I have put off traveling for the last few years because I didn't want anyone to take care of Jagger other than me. When I've been approached about travel nursing, I always said "Not until my dog is gone", because I couldn't see dragging him all over the country at my expense. His home was here, in the house that he knew, in the bedroom that he knew & I'm glad I kept him here. And it was an excuse to not take a risk, to try something different, something outside of my comfort zone.

I turned 38 today. While my heart grieves for my puppy dog...my companion for the last 13 1/2 years, I also look towards the future. It's an open road. Of course right now I don't feel like going anywhere, but in the near future, I may try out travel nursing. I'll think about that later.

I'm going to an early dinner tonight with my family & friends. As much as I'd rather sit home & cry, I know it is best for me to get out. Jagger wouldn't want me to sit home & cry anyways.

I have so many good memories of Jagger...those are what I'll treasure & most definitely hang onto.

Thanks to everyone for your support. The kind words help a lot.

Tuesday, March 6, 2007

Tears are falling

I should be happy - tomorrow is my birthday, but I'm very sad. I am putting my dog Jagger to sleep tomorrow. It's time. I thought I had been doing a good job of mentally preparing myself for the last 3 years, but I haven't. I can't stop crying though...thinking about saying good-bye to my baby that I've raised since he was 6 weeks old & now he's nearly 14 yrs old.

I was hoping to prolong it, but the past couple of days he has been acting differently...crying out, not wanting to eat much, sleeping most of the time. I can't allow him to suffer. This is probably the hardest decision I've ever had to make. My heart is breaking. :(