Saturday, January 28, 2012

First Time

The other night was the first time I actually felt something emotionally for a patient. That might sound let me tell you more. 99.999999% of the time I can do my job without forming any emotional attachment whatsoever. Within a week, I have usually forgotten who I've even taken care of. That's not to say I don't connect with my patients. I do....I am very easy to talk to & get along with & I know my patients appreciate that. The blonde hair & blue eyes doesn't hurt either. I don't think I've ever had a patient ever complain about me to anyone. If they have, I never heard about it. Maybe it's because I know customer service & that is exactly what healthcare is turning into. We may not be able to save your life, but as long as the patient feels like we kissed their ass....that seems to be all that matters. Don't even get me started on patient satisfaction.

I got this patient as a new onset of 2nd degree heart block type 1....wenckebach. I don't see it very often, so I was somewhat worried & wondering how long before she slipped into 3rd degree heart block. She was an older lady, in her late 80's...lived at home alone. A jokester...she was asking for rum & coke as soon as she got to the room. She had a line for everything & while at times that can be annoying, she was cute. Her blood pressure was stable, her heart rate was ranging from 48 to 58. So far she was non-symptomatic, although she did have some dizziness earlier. I spoke with the on call cardio nurse practitioner & faxed her the EKG. She called back & told me to keep a close eye on this patient. Uhhhh, ok. Quit scaring me.

Off to sleep she goes & it isn't long for her heart rate to drop into the 30's. Eeekkk....I don't like it. So I do what I normally wouldn't do...I woke her up. She talked & talked & talked. I listen & listened & listened. I felt for her. She belongs in an assisted living facility, but she owns a home that will not sell. Therefore, she can't afford an assisted living facility. She also has no family around. So she relies on taxies & acquaintances to help her get to the doctors appts, the grocery store, to clean her house. It broke my heart. It made me think about how many of our elderly population is in the same boat. How many are living alone......feeling lonely & having to trust that these mere acquaintances aren't taking advantage of them? How many are being taken advantage of & possibly abused alone with it. She went on to tell me she had 13 brothers & sisters & the celebrations they had when they were younger. Just sad that their final days are spent so alone. I don't know if she had children, she never spoke of them & I figured it wasn't my place to ask. If she does though...I have to wonder how they can just abandon their mother like that. I could never do that. I finally exhausted the poor lady from all her talking & told her to get some sleep. I walked over to the monitor to check her heart rate & rhythm....wouldn't you know it...she converted back to a normal sinus rhythm!!!!!! Heart rate was in the 70's. That doesn't mean she couldn't slip back into the heart block....but it did mean I could breathe a little easier the rest of the shift.

I had a patient two days earlier....nearly 100 yrs old. She was easy to care for. Her son, however, was not. When I say that I would have preferred to jump off a bridge as opposed to listen to him talk....I am not kidding. This guy talked & talked & talked & talked. I was ready to bang my head against the wall as he never shut up...ever. If he wasn't talking to me, he was talking to his mother or the secretary or the patient in the next room or anyone that walked by the room. He never shut up. And he was one of those that thought he knew it all too. Around 9:30 pm he finally said he was gonna go home & get some sleep. Great! Bye!!!!!!!!!! Two hours later he was back & fully recharged to talk more. Ahhhhhhhhhhhhhhhhhhhhhh!!!!!!!!!!!!!!!!!!! Even as my shift was over & I was in the elevator to leave, he was holding open the elevator door to talk to me some more. I nicknamed him chatty Cathy. I also refused to take his mother back as a patient ever again. I just could not take anymore non-stop chatter.

On a bright note, I have stopped stressing about work. I figure all hospital administrations suck, so I may as well get used to it & make the best of it. I did a little research of my own on this HCAPHS/patient satisfaction stuff. And while my hospital tries to tell us they won't get any reimbursement from the govt if we aren't super high scoring on the turns out we are talking 1%. They will take a 1% cut if they are a low scoring hospital. I'm sure that is millions, but it's not what I was picturing....that the hospital would be getting no compensation. I think their goals are too hospital wants to score 85% or higher. Ummmm....who usually fills out surveys? Happy people? NO. Mad people? YES. Cause they want someone to know why they were unhappy. Drug addicts? YES. Because we will never be able to meet their pain requirements. Disgruntled family members? YES. Because they seem to think the hospital is a hotel & nothing we do is good enough. Oh well............I'm letting that stress go. Not gonna worry about it anymore.

Things with my guy......a mess. I think I've broken up with him like 5 times in the last 2 months. Funny thing is, he never believes me. He doesn't leave. He also doesn't get mad, which I guess is good for me. I, however, seem annoyed a lot. I'm not so sure it is all his fault. I am giving him credit for being patient & loving me even when it is the last thing I want or deserve.

And when I say I'm not so sure it is his fault...I am convinced I have started perimenopause. Yes, at 42.....I feel like I have hot flashes & moodiness. My period which use to last a max of 3 days is now dragged out over a week. I can cry for absolutely no reason. Like just last night I was watching something on tv & tears came to my eyes. It wasn't even anything sad or touching. In fact, I don't even remember what it was! And the cruel thing about all this......I know when it is happening. Like I know when I am acting irrational, that I truly am irrational. It isn't like I display this behavior & days later I realize I was wrong. I know in the moment that my behavior is not normal. I'm usually so calm & easy going....not much gets to me. The last few months....forget that! And no, it isn't mental illness either. I'm not doing anything inappropriate or detrimental. It's just the moodiness. And the hot flashes. Don't even get me started on the night sweats. I thought this stuff didn't start until at least 50. Sigh.

Ok, enough of this depressing stuff. This week I only work Sunday & Monday. On Wednesday I'm having lunch with my mom, aunt & sister-in-law. After that I'm planning to spend a few days in Orlando relaxing poolside. I hope the weather cooperates. I was going to bring my niece, but now I think I will just take a few days to myself...where I don't have to care for anyone but me. I hope that gets me out of this funk.

One thing that definitely lifted my mood was LUKE BRYAN. He was in concert this past Sunday with Jason Aldean. He is amazing! I felt so much better after the concert.

Have a good week!


Carlene Noggle said...

Hi Jen,
I have been goe for a long time when my computer died, but am backnow and am enjoying catching up on your journal!

Amanda said...

:) Glad to see you back. I am so with you on the senior patients thing. It is really sad that some of them worked their whole life (or had spouses who did) and now can barely afford to turn on their heat.