Putting it all back in perspective

Sometimes life has a way of making up your mind for you. Like when you're on the fence, trying to decide if a long distance move would be a good idea. On the one hand, it would be great to get away from everything and everyone you've known for so long, just start all over. But then on the other hand, would it be a good idea, in case your family needed you all of a sudden? And what about your child's relationship with her grandparents and aunts and uncle, not to mention the friends who have become more like family than your own family sometimes? What to do, what to do....

And then the decision is made. Not by your own rationale, or the careful weighing of the options, but by the voice on the other end of the phone who, in casual conversation, tells you that the biopsy results were positive. Tentative and meek, like she was waiting for me to cry, or explode, or something. But I did what any good daughter would do, allowing the prolonged silence and heavy sigh to convey what my absent hug would otherwise provide. I'll be there, Mom. You just tell me when, what day, what time. We'll get through this.

And the wheels start spinning. What type, what stage? Any mets? What about a PET scan? The poor expert surgeon, whom we have yet to meet, doesn't know what he's getting himself into by taking on this case. See, I'm not just a daughter of a cancer patient now, who are already the worst when it comes to overbearing and nitpicky. I'm a nurse. So I know those words that most family members don't, and when you try to broadbrush us with highly technical terms, I'm going to be ready with some of my own.

I know what this thing can do. For the past five years, I've been on the other side of the devastation, watching lives morph into a melancholy existence spotted with hope and fear. I have a different take on life, bouncing between the ferverent struggle to save it in the ER and striving to make others comfortable at the end of the journey. Where does my mother fit in? Why are my opinions and comfortable understandings of the medical field suddenly tossed into chaos when it becomes personal?

And now, because this is the way I am, I will bottle it up and hide it away, because I have to be strong. For her. Because she has been there for me through everything. Because I have regrets, things I've never said, things I should never have said. Because I will never have done enough to deserve her love and strength and support. Because she is my mother.

Mortality

I know there are those who would say that pre-planning your own funeral, or that of your spouse, is an unnecessary and morbid practice. However, in the line of work I'm in, I think I've become a little desensitized to the inevitability of death, especially my own mortality. I don't have an issue discussing my preferences for a funeral service, or the plans for scattering my ashes. I have my flowers picked out, and the music I want played, and the Bible verses that I want read before the invitation by the Baptist preacher.

We've filled out all the requisite paperwork for my husband's military funeral honors, and I have the flag display box picked out. I wonder why I would be thinking of these things on the eve of my second wedding anniversary. I must be a little off to organize our funeral services when we've only been married two years. Maybe that is an extension of my "glass half empty" view on life. Just makes me wonder sometimes, why I plan for things like this, other than my fear of not being in control of everything.

But I guess that I can rest easy, knowing that at least that aspect of life is taken care of. Just a little food for thought, in case any of you need to make your own arrangements...this way I know that what I want will be done, and nobody has to guess what that is. Happy days.

Nitnoy stuff, since it's been a while

Wow, so its been over a month since I last posted. I guess with all the writing I do on a daily basis now, my brain hasn't wanted to conjure up anymore creative explanations for daily life. I do enough of that with the in-depth descriptors of patients' bowel programs or vague pain complaints, attempting in vain to justify their melancholy existences to governmental bodies whose job it is to regulate a person's qualifications to die in comfort. Now I will never think that it is only an ER nurse who is overworked, underappreciated and pushed beyond the physical limits on a daily basis. Just a quick shout out to all my fellow nurses, both ER and hospice, who strive every day to make some sort of an impact on a generally ungrateful society. Once in a while, someone does notice, and even when you feel like nobody cares, just remember that I think of you often and silently commiserate with you.

Now onto better and brighter things: I would like to form the anti-uterus task force, whose mission it will be to eradicate all unused and unwanted uteri (is that a word?) from the female population for all those willing to participate. I have had my child, my husband and I (thanks to previous surgery) will not be having any other children, and I have some of the worst monthly experiences a woman could have. Why in the world would I want to keep this useless, painful, leaking organ? I think I will hold my hand out for the female stimulus package, whereby the federal government will pay for my hysterectomy and time off from work for recovery. Sounds plausible, right? I think that I fall into the "minority" category with this "disability" too. Maybe all put together that would get me what I'm looking for. I'll keep you up to date on that...

As an aside, there are moments when I miss the emergency room. Not often, but specifically when I REALLY want to tell a patient's family member where to get off. That, unfortunately, is a luxury I gave up when I left the ER, as hospice nurses are typically relegated to the "angel" category: sweet, gentle, slow to anger, patient and non-judgmental. I play that role with the best of them, even on days when I don't feel like any of those things, and most days it isn't even an act. But there are days, like today, when I really wish I could educate certain families on the "hospice philosophy"--your loved one is dying, and frankly, their TSH and lidocaine levels (lidocaine is local anesthetic, not systemic, FYI) are not going to impact their quality or quantity of life. Butt out, or graduate from medical school. One or the other, I don't care which.

Ok, so I feel a little better now. I'm off to bed, in the hopes of getting fewer admissions tomorrow than I got today. Say, in the ballpark of...zero. 17 patients is plenty for me to juggle, and if I'm lucky, I'll make it back here before May.

From Tepid to Boiling

Frog #1 & #2 are sitting in a pot.

Frog #1: Is it getting hot in here?

Frog #2: What are you talking about?

Frog #1: The water...does it feel warmer to you?

Frog #2: I haven't noticed anything. Why do you ask?

Frog #1: Because I think that I see little bubbles...is this water starting to boil?

Frog #2: You really don't make any sense. Now be quiet, you paranoid idiot, and put the lid back on.

So, with that being said, I'll take a chance at alienating my *large* fan base and state what I really believe. SOCIALISM, A ONE WORLD GOVERNMENT, THE RAPTURE AND SEVEN YEARS OF TRIBULATION ARE COMING VERY VERY SOON.

There. Now you will never be able to say that I didn't warn you. I am looking forward to Heaven, anytime the Lord wants to take me, and I don't even care if you all think I'm crazy. I guess we'll just see who was right on the other side, won't we?

Life Preserver

This is going to be a very short posting about how I have felt this past week. The best way for me to sum it up is that I have felt like a life preserver (and if I was a little rounder, I might look like one too :)). I think it is ironic that I could feel more like a life preserver now than I ever did in the ER, where it was our job to save everyone, and especially more so in hospice where we aren't saving ANYONE. There are truly no words to describe how it feels to walk into a home, or speak with someone thousands of miles away on the phone, and know that the reason they are able to continue caring for their loved one is because of the support you provide them. I have never experienced such gratitude and appreciation for my efforts as a nurse, and I have to say that I have also never loved a job the way that I love this one. If you are a nurse who is tired of the over-worked, under-appreciated, adrenaline-addict healthcare venue you are in, and want to pour yourself into the care of your patients, then I would seriously consider hospice work. I know it's not for everyone, but I believe that the Lord put me in this position because it lets the real me blossom and grow, and there are plenty of compassionate and kind-hearted nurses who may never get to exercise their full potential because they will stay in their comfort zones. Just my two cents.

Looking back

I occasionally look back on my life from time to time, and I see a mix of moments that make my heart swell with pride at my accomplishments, and moments that make me wish I had done things completely different. I believe that anyone who says they can reflect on their life and not have ANY regrets is a liar, for there is not one of us who is perfect and has not done or said something (or has failed to do or say something) that they wish could have been different.

That being said, I think that responsibility is a lost art. As I sit in my modest rental home, I become all the more nauseated as I read and watch stories about all of the people in this nation standing around with outstretched hands to our newly elected government, asking for "bailout money" from an "economic stimulus package" invented to save this nation from sure economic collapse. Why is this even being considered?

When did the hard-working Americans who ran this country for centuries breed lazy, irresponsible, needy, immature pseudo-adults who make poor choices and then expect everyone else to save them? In my limited 27 years on this planet, I have seen the moral decline of society and wonder how our grandparents and great-grandparents must feel to know that their values have fallen by the wayside, overthrown by a self-serving attitude that is outshined only by the voice of entitlement shouted across the nation.

I will be the first to admit that many of my choices in life were, in hindsight, not the best ones to have made. But I can say that for the majority of those choices, there was a lesson permanently learned, and that I have never made those mistakes again. I also thank my father for teaching me to learn from others' mistakes, so as to not make them myself. Hence why I do not own a home, nor have ever had a mortgage, or paid for a loan on more than one vehicle, or gambled in the stock market, or dabbled in drugs, or thrown my money around like I hadn't a care in the world.

So why is it, then, that I stand to benefit none from this proposed "bailout package"? Why do those Americans who made poor choices in investing, or in buying a home when they couldn't afford it, get on the list to receive a benefit from a bad decision? When do those of us, few as we are, who have not taken from the public or leeched off of our neighbors get a reward for good behavior? Never, it appears. I could have applied for Medicaid, or welfare, or an ARM at any point in my young adult life. But I didn't, because it is just not my nature to take from the system if there is some other way, ANY other way, for me to survive.

Don't get me wrong, I would love to own my own home. A 2500 square foot log home way up in the mountains, away from everyone, to be exact. But I know that realistically, without extending my family beyond their means, that is not going to happen, at least not at this point in life. I guess that instant gratification-type mentality has permeated this society to a point of no return. And just for the record, I hope this bailout package passes, and the economy still eats the big one. I get excited when I see the stock market dropping, because a large part of me wishes this nation would finally be smacked upside their entitled heads and realize that this is a mistake that cannot be covered up by throwing more worthless money at it.

So I'll just continue to plod along, working my rote little job, driving my economical little car, living in my modest rented home while the world crumbles around me. I know the time will come, sooner than you think, when all of those Hummer-driving, mortgage-owing, stock market-watching nail biters will come to us responsible citizens and ask how it is we are able to live on one income and haven't lost our homes. The sad part is, they'll be standing there with their hand out while they do it.

Oh! Ouch! You're stepping on my FEELINGS!

It is sickening that we have come to a point in our society where one can no longer voice an opinion that could potentially be perceived as intolerant by anyone on Earth. I simply do not understand this train of thought. I hear plenty of things, daily, that irk me to the bone, but I keep my mouth shut because it is everyone's (watch out, I'm gonna say it) GOD given right to speak their mind and exercise free will. Now what really torques me is that when those of us who respect others' right to free speech decide to take said liberty ourselves, we are verbally spanked for "ignorance" or "intolerance". I would like to take this opportunity to illustrate my point, at the expense of my dear blog buddy and friend, on her latest post and resulting comments.

So, for the sake of all that is free and legal, I have chosen to make today my own personal Day of Intolerance. Any of you who wish to adopt this day as your own, feel free to do so. I do not hold any patents or copyrights to this label, and I think this damned country needs a serious dose of reality such as this. The world is not a warm and fuzzy, hand-holding, kumbayah-singing, dope-smoking, love your domestic-partner, convenient "embryo disposal", don't-say-that-it-hurts-my-feelings kind of place. You want to shove your immoral, whiny, entitled, intolerant demands for acceptance and approval in my face, then get ready: right back 'atcha.

I don't care if you like me, or my viewpoints, or if you care about my beliefs in God or Jesus Christ. I don't walk around demanding that you accept my statements, or that you tailor your comments to preserve my feelings. But turnabout is fair play. If you get the ability to voice your opinions and affect change for your beliefs, then so do I. And believe me, there's plenty about this God-forsaken nation that I'd love to change.

For instance, government handouts without reasonable qualifications are gone. No more welfare, Medicaid, WIC, EMTALA, and any other taxpayer-made donation to a lazy way of life. People with a true disability who qualify for Social Security or Medicare are okeydokey. All the rest of you moochers, hit the road. Maybe another country that wants to socialize and carry you, hmm?

Doctors (poor people) are forced to come up with "new" diseases to explain the otherwise unexplainable complaints their pain-in-the-rear patients continue to request pain medicine for. And I don't care what American/National/Association of Whoever's say it's a real disease. Maybe if there wasn't such a prevalence of junkie, drug-seeking jerks permeating our emergency rooms looking for their next fix, we wouldn't be so opinionated about pseudo-diseases like fibromyalgia/chronic pelvic pain that have been classified as potential drug seeking diagnoses often employed by malingerers. I know, big words. Invest in a dictionary and a brain.

I believe homosexual marriage is wrong. Just as gay/lesbian/transgender/dog/cat/cousin/pedophile relationships are wrong. I don't like/approve/tolerate/support/condone that behavior nor do I knowingly fraternize with anyone who participates in it. Keep away from me and my family. AAAAHHHHHH, the intolerance!!!!!

I believe men that minister/pastor in the ways of Rick Warren, Joel Osteen, Ted Haggard, Mark Driscoll and the like are securing their followers eternal damnation, and deserve a special place in hell themselves. And women, by authority of the Bible, you are not allowed to preach. Sorry. Look....I have an opinion. Sue me.

I believe that if you strike a healthcare provider, you should automatically be arrested and sentenced to 30 days in jail. No trial. No bail. No appeals. No I-was-drunk/high/psychotic/confused excuses without a previously diagnosed incurable mental illness that would incapacitate your ability to control your own behavior. And if that is the case, then you should probably have a court appointed guardian, since you are unable to make safe and reasonable decisions on your own.

I believe that life begins at the moment of conception (for those of you who don't know what that means, it is the moment when the sperm and the ovum join together) and extends through the moment of natural death. Anyone who "terminates" the life of a human being between these two points is a murderer, regardless of whatever politically correct reason you want to give for it. If you don't like that stigma or label, don't do it. Easy enough. Think that's bad? Check this out (and I agree with his idea as well).

Shocked and appalled? Disgusted? In disbelief that someone could be so intolerant in her feelings and opinions? Well, there's a lot more where that comes from. If you don't like it, you can leave a comment that tells me how much you don't like it. And if I don't like your comment, I'll delete it. Ahh, the power of comment moderation. Gotta love that freedom of speech and intolerance!

So this is normal....

Things are different. The new job is nice; low-key and a totally new mindset, too. It's difficult to look at these patients and keep myself from thinking of ways to fix them. I love being able to single-handedly direct the majority of patients' care, though, and only consult the doctor once a week (unless I run into something strange). And being able to take the time to educate patients and families, or get things they really need just by making a phone call, feels great. I don't feel as rushed, and not nearly as jaded, but I have realized that my organizational skills could use some major improvement.

I'm drowning in paperwork! I never thought I would say this (ever), but I really think computerized charting could help here. My biggest fears, after these two weeks of orientation, revolve around this silly paperwork. I'm sure I'm going to forget to fill out some form, or run out of forms in the field and be an hour away from the office and not be able to fill out something important. Hence the multitude of binders and page protectors and folders and dividers that have been procured and planned for special spots in the trunk of my car. I'm sure one day I will long for an office job where I can put up handmade pictures from my child in my cubicle, and maybe even own a file cabinet or two. Until then, I'll just stick to my office on wheels.

All that aside, I really do enjoy the pace and scope of my newest venture. My husband and daughter seem to be glad to have me home for supper every evening, and I like going to bed at night and getting up in the morning. Strange, I know. I never thought I would have a "9 to 5" type job before I turned 40. It sure is nice that the good Lord watches out for me. And I have to laugh....I've only been gone two weeks, and already three people from the ER have called to say hi. Funny how you never know how integral a part of the team you are until you leave.

I keep praying for patience and guidance and wisdom, especially in this new position. It is so nice to have the time for introspection, not to mention compassion for other people who truly deserve it, and I don't want to waste this wonderful opportunity to grow. And to digress for a moment, I have to say thank you to my loving husband for taking time today to help me pick out fabric for my next sewing adventure. I'll have to let you all know how the skirt comes out, but if nothing else, the fabric is beautiful! And I was shocked on Wednesday to find out that one of the ladies at church would like me to make a birthday cake for her daughter's birthday next month, similar to the one I made back in November for Missions Conference. Who knew anybody else cared about my cakes?! What a nice surprise.

I hope that everyone is doing as well as we are. I do miss some of the camaraderie in the ER, and being able to turf patients that are a tad on the difficult side. I think one of the most poignant things I've learned in the past two weeks is that familes that were dysfunctional before terminal illness are going to continue to be dysfunctional after diagnosis, and there is nothing that we can do to fix it. So, we'll just form a care plan around it, and do the best we can to keep the patient comfortable. Pretty laissez-faire compared to the ER, but I bet I'll get used to it. :)

Don't infringe on my Second Amendment rights, and no one gets hurt

See this gun? Ok. Besides being a semi-automatic .45 caliber handgun, is there anything that differentiates it from other handguns, especially in the arena of stopping power (or deadliness, as I'm sure the left-wing anti-gun fanatics would call it)? Yes. In fact, this particular handgun is less deadly than, say, the .357 Magnum 5-shot revolvers that preceded it. Granted, if I were shot with the above firearm, I would definitely be reconsidering the action I was attempting, but I would be more likely to survive than if I were shot with a standard .357 revolver. This is based purely on the velocity at which the bullets travel (facts and physics, I know, are confusing to those who are afraid of the big "G" word--GUNS!!!):

.357 Magnum---> velocity= 1,410 ft/second energy= 574 ft-lb of force
.45 ACP---> velocity= 1.080 ft/second energy= 518 ft-lb of force

Ok, so if I haven't lost you yet....let's move on with the above premise in mind. One of our great liberal nation's legislators has proposed the Assault Weapons Ban and Law Enforcement Protection Act of 2007, H.R. 1022, that would take out of my hands the less deadly of these two weapons, simply because it is "a semiautomatic pistol with a fixed magazine that has the capacity to accept more than 10 rounds" (see subsection G). Apparently Carolyn McCarthy (D-NY) has not taken the abbreviated version of handgun physics as provided above, and therefore is also afraid of the big "G" word. Shocking.

Now, for those of you who do not own such an "assault weapon," you may not be as outraged about this as I am. However, I would encourage you to check out the link to this bill, as there are a slew of new and updated restrictions to all classes of firearms that would be considered illegal should this bill pass. And anything not listed yet would be up to the discretion of the Attorney General as to its legality. Hmm, here in about 10 days, that's scheduled to be Eric Holder. That name sounds familiar...oh yes, he was the deputy Attorney General during the Clinton administration. Questionable pardons, unethical practices, and now dishonesty regarding dealings with our friend Mr. Blagojevich. Yep, I think I'll trust him with my Second Amendment rights....when hell freezes over.

In closing, I would like to offer a reminder of the Second Amendment guarantee to American citizens, just in case anyone forgot: "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." So, I will be purchasing for myself in the near future a handgun that will not (at least initially) be outlawed, should such an asinine bill as this be passed in the coming years. Take a good look, because if you come to take my guns away, it may be the last thing you see.

Pronto al Viaggio

I have an itch. And it seems to be getting worse, as I will be unable to scratch it until this coming Thursday. I am ready to leave this God-forsaken hole and move on, even if it ends up being just as mentally exhausting and terribly nauseating as the ER. At least I will be able to say that I gave it my best effort. And not staying on PRN makes it even more permanent, as I will not have a safety net to fall into in case there is something about hospice that I don't happen to like. So, in light of my pending exodus, I feel that a list of some reasons why I am leaving the ER is in order. Note: this list is by no means exhaustive, nor is it ranked. :)

1. Condescending, know-it-all doctors who do NOT know it all.
2. Rude, angry, physically and verbally abusive patients.
3. Impatient patients (oxymoron?), family members, and friends.
4. Parents of small children who double as imbeciles.
5. Untrained, underqualified security guards (I don't use that term loosely).
6. Unsafe working conditions and asinine policies/regulations.
7. Surplus of non-emergency conditions clogging up beds needed for real emergencies.
8. Alcoholism, drug abuse, and mental health disorders.
9. Lazy, unmotivated, slacker co-workers.
10. Administration without a clue, but with enough hot air to float the Hindenburg.

I don't see an end in sight for any of these issues, and unfortunately with the inauguration of Mr. Obama this month, I believe it will only get worse. So I will watch from a different venue, and listen to my friends' lamentations when they experience first-hand these sickening frustrations over and over again. And I will refer to this list if I ever suffer from a bout of nostalgia for the ER, for as my loving husband said, if I even entertain the thought of returning to the ER for at least a few years, we will have the biggest argument we've ever had. I don't think I want to go there. So, I'll get ready to leave (again), and see what the Lord has in store for us when I take this leap of faith.