Monday, February 17, 2014

A Day in the Life: Nursing Edition

I love nursing. I’ve wanted to be a nurse since age six. In school I toyed around with the idea of being a labor & delivery nurse, but have never regretted landing in the ER.

Here, for your consideration, is a random compilation of story bits throughout my ER days thrown together to make a day in the life…



9:30am – alarm rings. Snooze for 15. Wake up.  

11:53am – clock in. Because many have mentioned, yes, nurses make a decent salary, but probably not as much as you think! ER nurses don’t make more because our job has “the stress level of a soldier/policeman.” We’re there because we want to help, not get rich. If we wanted to make $$$, we’d go into research or become a nurse anesthetist.

12pm – hug my co-workers hello then take one’s assignment so he/she can go eat lunch. Check and makes sure one patient’s circulation is still good (since he’s in restraints for trying to hurt himself, others, and having, to put it delicately, “intercourse with the mattress”).

1pm – give discharge instructions to a guy who came for heart palpations after taking cocaine. He says now that he knows that cocaine can lead to heart attacks, he’ll never do it again.

2pm – two mothers rush in with infants in their arms, “My baby, my baby!” they scream. One child is awake, the other is limp in her mom’s arms. That one goes straight back to a room. Still breathing, praise the LORD, so probably in a post-febrile seizure state. Come back for the other baby. Call language line for translation help. Mom is concerned that happy, healthy baby has an infection “because that belly button thing fell off after a couple weeks.” Resist urge to ask if she still has hers.

3pm – triaging a man with tiny paper cut. Me: “On a scale of 0-10, with 0 being no pain and 10 being the worst pain you can imagine, where would you rate your pain right now?”  Patient: “I’d say about 50/50.” Me: “Have you been out of the country in the last 14 days?” Patient: “I’m not sure.”

 
4pm – car screeches up, man comes in, grabs our wheelchair, and heads outside. I follow and discover him dragging a not-quite-breathing person (turning blue) out of the car. “What happened?” I ask. “What did he take?” The companion refuses to answer and, as soon as I begin to wheel the patient inside, gets back in his car and takes off.

5pm – a woman presents to the ER stating she took an allergy pill and now the side of her face is caving in and her thighs are purple. Ruddy skinned and full faced, she admits that she is hearing voices speak to her from the toilet bowl and radiator, so we prepare a psych safe room for her.

6pm – a man storms to my ER triage window and yells, “Take me to see my brother NOW!” I pull up a list of patients on my screen and ask his brother’s name in order to find him. “No! Don’t ask me questions, I need to see him now!” I explain that we have many patients so I need to know his brother’s name so that I can take him to the right room. “Stop looking at that computer and get me to my brother!” is the response. I finally get a first name from him, locate his brother, and as I am personally escorting him back to his brother’s room he continues yelling that I need to take him to see his brother.

7pm – I see cocaine man from earlier being wheeled back to one of our trauma rooms. He told me mere hours ago that he would never do it again, so I put on my disappointed-in-you face and start walking towards him when I realize that he’s been shot in the abdomen and groin. He looked at me and said, “I didn’t do it! I didn’t do cocaine again!” He learned two lessons about cocaine that day: #1 it can give you heart problems. #2 that you need to pay for it.

8pm – pray with a woman who is grieving the miscarriage she is having then go to the next room where a woman is upset that she’s pregnant again and wants information on how to terminate it. “There’s just no way I can be pregnant. I pee every time after I’m intimate!”

9pm – an inebriated man comes in via ambulance stating he’s not drunk because he’s only had a couple pints of vodka. He informs me that when I start drinking I need to start with at least 5-6 liters because that’s how much it will take before I feel a buzz. You learn something new every day ;)

10pm – teenage boy comes in with right sided abdominal pain…appendicitis work up started! A healthy adult male visitor comes up to my triage window and asks me to open a bottle of Diet Sprite for him. I do so, silently taking his man card. He asks if we can fall in love today. I tell him I am too busy triaging.

11pm –a woman and child walk in. Mother states she thinks the child might have an ear infection. Man walks in clutching his chest. I tell ear infection mom we’ll get her back shortly while I put potential heart attack man in wheelchair. Mother appears shocked and says, “but we were here first!” EKG done. Man is having heart attack. Draw blood, put in IV, and transfer patient to the cath lab where they will place stents in his heart so blood flow can return.


12am – “I think I might have an STD, but I haven’t had sex since The Blindside with Sandra Bullock came out.” I wonder in how many jobs googling a movie’s release date can actually be considered helpful. Sign in a patient who has no complaints but wants all her regular prescriptions refilled because “y’all here are a lot faster than going to my regular doctor.”

12:05am – my charge nurse comes to me,“I know it’s time for you to go home, but we have four discharges coming up, a patient transferring in from another hospital, a psych patient about to be transferred out, and EMS just called to let us know a code is coming in…can you stay for a few more minutes?”

12:15am – assist with patient intubation (breathing tube down her throat since she’s not breathing on her own), she loses her pulse again. Start chest compressions while my fellow nurse gives epinephrine. The patient’s heart starts beating again and we get ready to send her up to the ICU.  Getting a heart beat back is definitely worth staying over for :-)

 

1am – go home, eat a couple pieces of pepperoni pizza while watching Community, then fall asleep :)

Every day I see things that…

break my heart – families losing loved ones, abuse, neglect, people not knowing how to break out of generational cycles of addiction, ignorance, hopelessness.

annoy me – people taking advantage of the system, selfishly putting their own comfort and convenience literally in front of people in need.

delight my heart – lives saved and changed, people learning, co-workers (they’re awesome), people both and hurting and rejoicing with one another.

The ER can take you on an emotional roller coaster. The only thing that you can count on is that you have no clue what is going to come in next.  How can a person cope – even thrive – in such an environment? 

BY THE GRACE OF GOD.  

By trusting in Christ’s consistency and faithfulness, not flawed humans. We are able to return hateful behavior with love because Christ did that for us first (Rom. 5:8, I Jn 4:10). By acknowledging the pain in this world and agreeing with David that “I would have lost heart unless I believed that I will see the goodness of the LORD in the land of the living (Ps 27:13).” By never giving up hope that those who walk in darkness will see a great light (Is. 9:2, 2 Cor. 4:6). With minds fixed on our LORD, ER nurses can walk in perfect peace (Is. 26:3).

We’re nowhere near perfect. We fail to do the aforementioned over and over again. But by God’s grace ER nurses can say, “What? There’s a place where sick and hurting people gather together and I would get paid to come and help? Sign me up!” This is how we can walk into the craziness with a smile…

 

*Obligatory disclaimer* This and all posts about patients may be fictional, may be my experiences, may have pertinent information changed, or may be a combination of patient experiences.

Sunday, February 2, 2014

The Ghost and the Darkness

I was 18. It was my first time in Africa. A girl invited me over for a “great movie about lions…if you can take the suspense.”  I told her I could. Pshht, I knew the popular western mindset of lions roaming the streets in Africa was ridiculous. I was too learned to fear. 


The movie was “based off a real story,” but Hollywood exaggerates. Sure, in the movie over a hundred people were devoured by the Tsavo lions and on film they seemed eerily smart and devious - even for a dangerous, predatory animal.  I figured a handful of people were killed during the railroad building and the producers took it from there.  The movie was suspenseful (yes, I screamed), but it didn’t make me afraid of a real life attack at all. It was fun. The movie ended with: If you want to see the lions today, you must go to America. They are at the Field Museum in Chicago, Illinois. Even now, if you dare lock eyes with them, you will be afraid.” Bah. Stuffed animals intimidating? Pretty much forgot the whole thing and had a great time NOT getting eaten by lions or kidnapped by Basotho in Lesotho who speak Sesotho (but that’s another story for another time :).

Fast forward a decade. My friend took me to the Field Museum in Chicago a few months ago and we saw the infamous Tsavo lions. Their eyes are strangely bright and I didn’t look into them for long, but I did definitely appreciate their size and strength!  If I had met a full-grown one in Africa, forget the idea of a bare-handed struggle, I would have been the one who died, let me tell you.  One thing embedded into my memory at the museum that day was that all those years ago in Africa I was wrong.  The story wasn’t really blown that much out of proportion. Those lions killed over a hundred people for real!  And they were cunning!  These were not the cuddly babies I met in Johannesburg:


I watched The Ghost and the Darkness last night and it made me even more curious about reality.  In his memoirs, Patterson (the man who killed the man-eaters) wrote: "(The lions') methods became so uncanny, and their man-stalking so well-timed and so certain of success, that the workmen firmly believed they were not real animals at all, but devils in lions' shape."  Oh man. Of course that made me think of I Peter 5:8 where Christians are told to be sober, be vigilant, “because your adversary the devil walks about like a roaring lion, seeking whom he may devour.”  After the movie, what a mental picture that brings! Those who rise up against people trusting in the LORD and false prophets are also like lions lurking in secret places, eager to tear into their prey (Psalm 17:12, Ezekiel 22:25).


But before incorrectly typifying all lions as “evil,” our LORD Himself is called the Lion of Judah (Rev. 5:5, Hosea 11:10-11)! Lions are often seen as pinnacles of strength in Scripture.  How amazing is that that the God is on our side?  Even more amazing than a terrifying, yet good lion walking around defending you all the time!



Amazingly to me, Christians are also said to be bold as a lion (Proverbs 28:1)! Scripture also talks about the power of two together being stronger than lions (2 Samuel 1:23, Ecclesiastes 4:9-12). I admit I don’t always feel that bold, but when I don’t should look to my LORD who by grace has declared me righteous. May all we who trust in Him be encouraged toady!  Yes, we will be strongly attacked, but He who is in us is greater than he who is in the world (1 John 4:4). Our Saviour is Most Powerful and He has already won the victory, praise be to His name! :)