Wednesday, January 21, 2009

Keep your eye on the prize

On a boat, in the ocean, I will likely get seasick. I prefer the mountains and the forest. Some friends of mine just returned from four months of sailing their boat to the Caribbean. One of them recently shared the following words of wisdom with me, in response to my litany of complaints about my very expensive nursing school.

When sailing, one chooses a destination, and then charts a course. If the winds or currents change, the navigator must chart a new course. You don't have to change your destination, but if you don't adapt to the changing winds and currents, you will not get there. And you just might sink.

I've been staying away from the keyboard because the only thing I had to write about was how frustrated and disappointed I've been this past month. Just about everything that could have gone wrong with my pediatric rotation indeed did, and I've been committed to being angry and unhappy about this situation. It's interfered with my friendships, dating, my sleep, and most unfortunately, my experience of pediatrics. So while a small part of me would still like to rant and rave about how this has not lived up to my expectations, I am DONE complaining about this school. Really!

Another one of my sea-loving friends said to me, "It's so obvious that you're passionate about becoming a pediatric nurse, and I know you will be one. Don't let these problems, or anything, distract you from your passion. Adapt, but stay focused on why you're in school." Wiser words could not have been spoken. So here is me sharing about my passion, about why I know I will soon be a pediatric nurse.

On the first day of the first weekend of our pediatric rotation, I was standing in the hall, waiting for some real action. I heard a noise from behind me. Turning around, I saw a young girl approaching me. She was the seven-year-old sister of a patient, and we had not yet met. As she walked by, I said, "Excuse me, are you a doctor?" Frowning, she replied, "No." I said, "OK, listen. The next time someone asks you if you're a doctor, you say, 'Yes, how can I help you?'" She said, "OK." We high-fived and said goodbye. An hour later I saw her again and said, "Excuse me, are you a doctor?" She furrowed her brow, closed her eyes for a minute, and said, "Yes. How can I help you?" I asked her what I can do to not get sick. She said, "Eat healthy foods." I said, "Thanks, doc." She said, "No problem." We high-fived and said goodbye. I went to see my patient and she went off to save a life or maybe get a sticker.

My patients have been amazing. They are suffering; their young lives have been forever impacted by the chronic diseases that inflict their growing bodies. My six-year-old patient has a kidney disease, and may need a transplant. My two teenage patients, young women with amazing resilience, have chronic diseases, one of the intestine, the other of the blood. These massive health challenges have been piled atop their adventures of adolescence. I could tell they were sad, maybe depressed. And still they laughed with me.

A five-year-old girl, my favorite patient, is three days recovered from spinal surgery when I meet her. I tell her that today she will take her first steps since the surgery. It takes one hour to get her to put both feet on the floor. Another hour and she’s walking across the room to her mother. I felt so proud of her, a child I had known for a mere two hours, I could have cried, shouted, and danced. I wish I had.

While only in my life for a day or two, these children have forever transformed me, and unknowingly cheered me as I traverse the path of becoming a pediatric nurse. I wish I had written about these miracles as I experienced them, but I was too wrapped up in my own anger, self-pity, and victimization.

This past weekend was our last of the rotation, and I was determined to learn as much as I could. I told my nurse I would like to take three patients instead of two. She was incredibly supportive, telling me she was going to show me how to do everything my instructor had neglected to teach me. I left the nurses' station filled with confidence and enthusiasm.

I stopped by each room to introduce myself to my patients and their families. The kids were just waking up, so I mostly spoke with their parents. I then returned to my first patient, a four-year-old girl, to take her vital signs and do an assessment. She was incredibly shy and withdrawn, but after a few minutes of talking and playing, she started to open up to me. Just as I was putting the blood pressure cuff on her arm, another student walked in and said, "We have to leave the hospital. Our instructor is still not here."

I was in shock. I said goodbye to the family and walked to the nurses' station. The other nursing students were waiting for the elevator, and the nurses were just staring at us. For the entire rotation, our instructor had been lazy and negligent to us, and annoying to most of the nurses. Her not showing up this morning was the last straw, and our entire group now had to leave the hospital. We were told we could return for the rest of our weekend, but only with another instructor. My school did absolutely nothing to remedy the situation, so we lost yet another weekend of clinical time. Our first weekend (out of five) had been canceled because this same instructor called in sick. Needless to say, she is history, and so is my pediatric rotation.

I share this because the sadness I felt at having to leave the hospital was profound. And while I first responded to this incident (and how my school ignored it) with anger, I now see the ironic gift in it all. Being ripped away from those children hurt so deeply because I was so goddamn happy being their (student) nurse. I've been angry at my instructors and my school because it's seemed like their incompetence and negligence were endangering my chances of becoming a pediatric nurse. That was just my fear talking, and I'm done listening. I am going to be a pediatric nurse, and no bungling school or instructor is going to get in my way. And I'm done being resentful, and am instead focusing on being of service, which is where this all began.

I'm keeping my eye on the prize and letting passion fill my sails.




That's just how the Macho Nurse rolls.





.

Saturday, December 6, 2008

presence

Sunday was the final day of our maternity rotation, of which I spent the last few hours in a rocking chair, holding a tiny baby boy, as he drifted in and out of sleep. Baby Stan (not his real name) was all boy, five pounds of boy to be precise. And that's a week after he was born and brought to the NICU, or Neonatal Intensive Care Unit. The NICU is where I've spent the past two weekends of my time in the maternity ward. It's been an incredible experience. But first, a brief reflection on my recent time in Labor & Delivery.

After having witnessed my first birth the previous week, I was seriously considering switching my preceptorship (internship) from pediatrics to L&D. The intensity and passion of the delivery experience had been intoxicating, and it was the first time I had seen nurses connect with their patients in a manner that resonated with me. In the following week I spoke with my clinical and classroom instructors about my new interest in L&D, and received strong support. I also met with my adviser, who happened to be the only male nursing instructor in the program. I knew he had spent his nursing career in public health working with families, but had forgotten that he had actually been an L&D nurse for a few years. So it was with great enthusiasm that I entered my next weekend in the L&D ward.

When I arrived on the unit, I was assigned a patient who was almost fully dilated; her first baby was only hours away. My nurse and I introduced ourselves, and mom and dad said they were fine with me taking part in the delivery and care. As I was examining her cervix, I was surprised to feel the fuzzzy little head of her baby. Woah. I can still feel the thrill as I write these words. She had taken great care of herself during pregnancy, but had not been to any prenatal classes. The nurse taught her how to push for about fifteen minutes, which she did like a mother of four. She did so well that the nurse turned to me and said, "Call the doctor. This baby is ready!" Picking up the phone and speaking those words to the doctor once again sunk in the reality that nursing is becoming my world.

The first delivery I had experienced was intense, like a volcano of love. The mother had been screaming and writhing on the bed as the family rallied around her, and when, after six hours of intensity, that baby came out and rested on mom's breast, nothing else existed in the world. Well, this pregnancy was different.

It was a beautiful birth. All ten minutes of it. This mom, who had not been pregnant before, pushed just three times and birthed a perfect 10 pound baby boy. Not only was this child beautiful, but he looked like had just had a bath! He cried for about ten seconds, spent a few minutes on mom's chest, immediately latched to her breast, and "passed" our assessment with flying colors. Within an hour plans were being made to transfer the family to the postpartum unit to heal and bond. A perfect hospital birth.

Since things went so smoothly with mom, I helped assess the new baby. He was as cooperative as he was beautiful, and by the end of the assessment, I realized that I was much more drawn to caring for him than for his mom. I soon became aware that all this time during my maternity rotation I had, in a way, begun working in pediatrics, which is why I became the Macho Nurse in the first place. I've loved just about every minute of both my classroom and clinical experience in maternity, and now I get that it's really because I'm finally working with children, my true calling and passion. That night I sent my clinical supervisor an email requesting that I work in the NICU the rest of the weekend. No one else was scheduled there, so she gave me the green light.

Saturday morning I walked into the serenity of the NICU, excited to finally be working with children again. I was assigned to work with a cheerful and helpful nurse. She was explaining the histories of the two babies we were caring for when a team of nurses burst through the door pushing an infant resuscitation bed. They rushed past us and my nurse told me to go watch what they were doing. As I was standing there observing, a nurse called out for some tape, which no one had, except me. I handed her a strip of tape and was promptly given another task. I spent the next four hours working with this team to get the baby ready for surgery. It was an incredible experience working with them, and ended with my gowning up for the surgery, which was amazing. The child was born with gastroschisis, which means the intestines had herniated outside of the abdominal wall and actually developed outside of the child. The surgery entailed putting the intestines, and in this case the stomach as well, back inside of the child's abdominal cavity. The surgeon explained the entire procedure to me. After the surgery, the nurse and I wheeled the baby back to the NICU. I spent the next day taking care of this child. It was an incredible weekend!

Back to Baby Stan. Rocking this little guy was the perfect way to wrap up my two weekends in the NICU. We worked well as a team, Stan and I. His tiny head fit perfectly in the small of my arm, the rest of his bundled body tucked up against my chest. His nostrils gave the slightest hint of his breathing, the flicker of his eyelids evidence of his dance with sleep. He breathed; I breathed. While rocking my new friend, I became aware of how long it had been since I had meditated, since I had really slowed down and been still. It had been a long time. Nursing school can do that to a guy. Stan breathed. I breathed. My little five pound yogi.

During my two weekends in the NICU, I was fortunate to experience the vast range of this unique and powerful world. Be it rushing a newborn to surgery or holding a baby until mom arrives, it's all about being in the moment, being present to the needs of the child. Being with these new human beings has reminded me again of the precious gift of life, its sacredness, its strength, and its frailty. Being present to all of this can be both daunting and exhilarating, but as one of my mentors once said,

What else do you have to do?











.

Monday, November 24, 2008

on being born


Yesterday I explained birth to a pregnant woman.


Well, at least part of the process. Me, a guy with no kids and no chance of becoming pregnant. How, I ask myself, could I possibly be qualified to teach a pregnant woman
anything about having a baby? In the past three weeks I've seen one vaginal birth and one Cesarean, and have done assessments on a few newborns and new moms. I doubt if I could even get a small part on Gray's Anatomy with that resume.

As I've mentioned here before, nursing school has thus far, for various reasons, ranged from being disappointing to discouraging to despairing. I've been disappointed in the quality of the school and of the clinical experience. I've been discouraged about not being inspired by my experiences in the hospital (although I've really enjoyed the occasions when I was able to get to know my patients). And I've felt despair at the prospect of my experience never changing, that I would never become passionate about nursing.

And then I saw my first birth.


For those who have witnessed this miracle, you know that words cannot do it justice. I've tried to describe it to friends, but it's been like trying to describe God or Goddess or maybe even chocolate. One is appropriately humbled by the attempt to get one's mind around birth, the human manifestation of creation. Sure, we can come up with all sorts of polysyllabic words to help us think we understand what's going on here, but I think we're only fooling ourselves.

It is not the understanding which inspires such awe in us, it is the feeling that comes with witnessing the phenomena of birth of which I am speaking. It is this feeling that allows us to know that something amazing and incredible and beautiful has just happened. Beyond words. Beyond art. Perhaps it is our connection to the experience of birth, our most shared experience, that has kept us from really messing things up. Perhaps, conscious or unconscious, this connection is the real source of our hope.

The power of birth isn't just about the new life of a child coming into the world. It's about
the unbelievable strength and courage of the mother, bearing such pain as she has never known, and knowing the deepest of love. It's about a man learning what really matters. And it's about the love of friends and family, coming together to support this mother and welcome this baby. All of this is part of what has made my one weekend working in labor and delivery the only time I have been truly excited about becoming a nurse.

The very first patient I was with in L&D needed a cesarean section. They were clearly disappointed at this dramatic change in their birth plans, but also grateful for the technology that would be safely bringing them their baby. I worked with the Advanced Life Support (ALS) nurse, a women passionate about her job and eager to teach me. The baby was immediately brought over to us, quickly cleaned and evaluated. The father of a child born via c-section gets to see the baby before the mother, and this dad was right there with us, speaking to his child. I was amazed that dad's voice immediately caused the child to stop crying and turn in
the direction of his father. Newborns cannot see, yet this child seemed to be looking right at his father, his familiar deep voice a beacon of comfort amidst the noise and lights of the OR.

Prior to starting this rotation, I had wondered if women would be comfortable having a male nursing student take part in their delivery. I remember thinking that at least I would be able to connect with the fathers. I couldn't have been more wrong. During both of the vaginal births I attended, the mothers and her family were completely welcoming and appreciative of my presence. When I left, they gave me lots of appreciation and compliments, telling me I was going to be a great nurse. But not the dads. They barely spoke to me, but I don't think it had much to do with me. They seemed to be in shock. But once that baby was in their arms, they lit up and even smiled at me.

This past Sunday a few of us sat in on a class for expecting couples. All five of the couples were having their first child, full of excitement and questions. The nurse educator led the class in exercises to try out some of the possible positions for labor and we, the nursing students, were encouraged to work with the couples during the activity. I worked with two couples, and much to my surprise and delight, was able to answer all of their questions. I felt completely comfortable and confident talking with them about the birth experience, and left knowing that I had done my little part in supporting them.

What makes all of these positive experiences even more meaningful is the fact that in one weekend I had more excitement, enthusiasm. and inspiration than in the entirety of the program up until then. I am no longer discouraged about having chosen to pursue a career in nursing, and am really looking forward to my upcoming weekends working in labor & delivery.

I used to think that the only significant way to really "make a difference" was to save a rainforest or stop a war or reverse global warming.


Who coulda known?



.

Saturday, November 15, 2008

holding the flashlight

Today I was splashed by a baby.

She didn't mean to splash me. It just happened. This beautiful little girl was too busy being pushed out of her mommy to even notice me. But I noticed her.

I first met her when the doctor asked me to reposition the overhead light. It was only the very top of her curly-haired head, wet with fluids and mineral oil the nurse had poured to help the delivery, but it was her. Mom cries, "Pleeeease just pull her out of me! Please!" We tell her she's doing great, that the baby's almost here. The next contraction comes. Mom grabs my shirt and almost pulls me onto the table. I give mom my hand, plant my feet and help her hold her leg up.

Push! The little girl's head pops out, this time for a few seconds before retreating back into mom. Grandma and sister and aunt are cheering. Dad, looking a bit faint, is fanning mom with a bandage. "Push again! We're almost there!" the doctor yells. Mom screams, "Mama!", puts Grandma in a headlock (no kidding), and becomes a mom with one final push. And then, the little girl splashed me.

With one final mighty push from her mother, this little marvel of life enters the world in a storm of fluid and blood and squeals and you can just feel the love and oh my god she's here and I'm here and wow and the baby looks good and give her to mom and dad needs to sit down and the baby's crying and we like that and where's that nipple and Grandma says "That's (grandchild) number 13!" and sister's taking pictures and I'm standing there watching the placenta come out of the mommy and up to the baby and give dad the scissors and he's not really sure what to do and snip!

that's one
cute baby girl.

.

Saturday, November 8, 2008

back in the game

I have officially turned the corner, in more ways than one, with nursing school. This auspicious occasion is due mostly to the children I met this past weekend, some big ones, some little ones, and some really, really tiny ones. I'll call this my "Florence Nightingale" moment, which lasted the entire weekend.

Our first day of the weekend rotation, Friday, was spent meeting our clinical instructor for supervision.
While my first two supervisors were extremely nice and supportive, I can't tell you how happy I am to finally have an instructor who is truly an educator. Her lab coat even says, "Nursing Educator." We took a tour of the hospital, met some of the maternity nurses, and I left feeling excited about returning the next day. This is no small event for me; during my three rotations in adult med-surg, I often woke up not wanting to go to the hospital.

I was not disappointed on my first day. I was assigned to the NICU, the Neonatal Intensive Care Unit, mostly filled with children born prematurely. My nurse was a cheerful and helpful mentor the entire day. She loved her job and it showed! Each nurse in the NICU has two patients, and both of ours were in good shape when I met them. One was recovering well from surgery; her mother had not left her side in many days. They were hopeful about leaving in a few days, and mom had been preparing well for the transition home. The nurse had been teaching her how to take care of her baby, and she passed on her motherly wisdom to me.

Our other patient slept the entire day, which at first wasn't the greatest learning experience for me. Around 10am the mother showed up with "big sister," who was very excited to see her very little sister. They didn't speak much English, so I got to practice my Spanish most of the morning. Spending time with this five year old filled me with a joy that reminded me why I'm becoming a pediatric nurse. That was much needed medicine for this guy.

On Sunday I worked in the postpartum department, where moms and dads bring their fresh, new babies. I was assigned to another fabuloso nurse. Before we entered our first patient's room, she told me that she wasn't going to explain anything to me in front of the parents, and that I should act like I knew what I was doing. This was the exact opposite of my entire time in med-surgery; most days it felt like I was standing on the edge of the pool afraid to jump in. It really helped to have someone push me in! So five minutes later I've got my hands on this woman's stomach assessing the size of her fundus (uterus). Wow!

Our next mom and dad ended up both being school teachers, so I was able to really connect with them, which helped the macho nurse fit right in during the breastfeeding teaching. I later heard that other students (of the female variety) had actually done hands-on teaching of the art of breastfeeding. Not sure if that's in this male nurse's future, but we'll see. I was incredibly aware of being a man as I stood there next to the father, watching his wife breastfeed his new baby. We smiled at each other as his wife and son bonded in a way that he and I will never know.

This coming weekend I'll be working in labor & delivery. I'm hoping to see a vaginal birth, and hopefully catch the baby ;-)

But I'll be happy if I get to hold the flashlight.

.

Monday, October 6, 2008

that's life


I'm an uncle.

My brother and his wife had a baby boy last week. I flew back to NY at the last minute and missed the delivery by four hours. I was able spend four days with my first nephew, Joseph, all the while studying for our upcoming maternity class.
My very own field trip! I've held many babies and a few newborns, but this was the first child that was family. Looking into his eyes was an incredible experience that truly seemed to transcend time and my own sense of self. Holding his little body in my hands made me deeply aware of myself as a man, and the power to create that we each have within us. I can only imagine what it would be like to hold my own child.



Cute, eh? So now I'm back here in California, reading about pregnant mothers and their newborns. Maternity class is a much needed change for me, after having spent last month in Intensive Care. My ICU rotation was not what I had expected it to be. My first weekend there was with a patient who was extremely ill, and I left feeling really inspired, thinking I wanted to work in ICU right out of school. By the end of the rotation, I was clear that it was not for me, which wasn't really a surprise, since I entered nursing school to become a pediatric nurse.

We're about halfway through nursing school at this point. For the most part, I have not enjoyed being in adult hospital care. I have however, really enjoyed spending time with my patients; I really felt like I was making a difference in their Lives. It's not that the other parts of nursing aren't important; they just don't fulfill me. This is a big part of why I've been unhappy for much of my time in nursing school. I'm not feeling passionate about nursing, and I need to feel passionate about whatever work I do. I wasted too many years sitting in a cubicle designing some silly router that was obsolete in six months. Never again for the Macho Nurse! This lack of passion has made it difficult to rise to the challenge of our insanely fast-paced classes. I just haven't cared about it that much. But with maternity, I feel this shifting in a big way.

I'm reading the maternity textbook with more than just an intellectual interest, which is all I've had in my classes so far. Now I read about mothers and birth and neonates and I really want to know more so I can be a part of it all. Spending time holding Joseph last week was not only an incredible experience, it truly transformed me as a man, and as a nursing student.

The birth of a child is something I've yet to personally experience, yet the concept of birth is as awe-inspiring to me as a the vastness of our universe. I think that's a big part of why I like working with children so much; they inspire me with their vitality, which is perhaps a reflection of their proximity to birth, creation, and who knows, maybe god.

Check back next week after my first clinical rotation in the maternity ward. I'm committed to writing this blog every week from now on, so keep coming back!

Uncle Macho

.



Saturday, September 27, 2008

intensively caring


Today, after throwing up bile, a man asked me to hold his hand.

It was my first day in the intensive care unit. Unlike my first day on med-surg, I was assigned an awesome nurse who really wanted to teach me. She went over everything, the patient's pathology, the meds, and the incredible technology. It was a great learning experience, and it's only beginning. We did a procedure to measure the pressure within his abdomen, infused platelets and red blood cells, and suctioned another patient's endotracheal tube. A very exciting day, and I was only there for three hours.

This afternoon I ran into a friend in my neighborhood, who asked me what was most exciting part of my day. I told her about holding my patient's hand. Here's what happened.

He threw up. I cleaned the tub. He threw up. I cleaned the tub. He threw up. I cleaned the tub.

My patient is a 45 year old man, diagnosed with some bad stuff. As I was standing there rinsing out the tub for the third time, I heard him banging on the bed rail and turned to see him. He was motioning with his hand for me to come over. Shaking, he grabbed my hand and whispered, "Stay here with me." So I planted my feet firmly and held his hand. It was a real manly handshake, ya know, the kind you do before a chest bump. We never got to the chest bump. Always the nursing student, I asked him to squeeze my hand, part of a neurological test. He gave me a good squeeze, and kept on squeezing, like a slow, steady heart beat. I asked him if he was scared. He said he was. I told him it would be alright.
We held hands like that for a good, long five minutes.

Later, when I was leaving my shift, he told me I was a good man, and that I would make a good nurse.


So that's intensive care. I'll be working there for four more weeks, so stay tuned!

.


Friday, September 5, 2008

break time

Not much to report this week. We finished up our ten-week rotation, and are heading into a much deserved two-week break. Just one more final exam to go and then we're done with our first of three semesters!

I'm going camping next weekend with my men's group, and then it's back to New York for my brother's wedding. The night before I leave NY I'll be getting together with a few friends from high school. We haven't seen each other in over 10 years! Well, I guess it's really more like 25 years. That would make me how old?

What I've learned so far working in the hospital:
  • Sick people aren't so scary after all.
  • Older adults are really, really special people.
  • It's easy to make a mistake administering meds if you're not careful.
  • It's easy to be careful administering meds.
  • Some nurses are nice; some nurses are not so nice.
  • Some people are nice; some people are not so nice. (Wait, I already knew that)
  • Poop ain't so bad.
  • People don't like having a plastic tube shoved down their nose.
  • Hospitals may generate more pollution than the automobile industry.
  • It doesn't matter (to me) if I don't get A's, as long as I'm learning and having more fun than misery.
  • As a nurse, it's good to wake somebody up and see how they're doing. They may not seem happy about it, but it's what they need in the long run.
  • In two months as a nursing student, I handled more drugs than I did in four years as a high school student. Well, not exactly, but we sure do dish out a lot of drugs!
  • Sick people need nurses.
  • Nurses need sick people.
  • I guess that breaks down to, "We all need each other."
  • Cool.
So what did YOU learn last week?

Macho Nurse out.

.

Friday, August 29, 2008

Calvin Coolidge


Calvin Coolidge was the 30th president of the United States. Ask me how I know.

I had a great time in the hospital last week. On Thursday I shadowed a nurse in the Emergency Department. A man came in having a heart attack, but they caught it early and he was doing fine when I left. Another man, a very old man, needed a nasogastric (NG)tube, and I got to do it! It was my first one, and it was not easy. An NG tube goes in through the nose, down the esophagus, and into the stomach. As you can imagine, it's extremely invasive.

The nurse I was shadowing told me that I was in luck; the man who needed it was very calm and cooperative. He sure was, until I stuck that tube in his nose. He promptly transformed into Octopus Man, writhing and moaning as the nurse held him and I worked the 15 inches of plastic into his nostril. It was intense, and hard to think of myself as "being of service." Later I was reminded of the first time I held a child in the ED at Children's Hospital, a three-month old girl who needed a urinary catheter. It was my second night on the job, and there I was holding her legs open while she looked me right in the eyes and screamed her lungs out. As with the old man and the NG tube, I told myself it was in her best interest. I don't like this part of nursing.

Tuesday and Wednesday, I was back in the telemetry unit, this time with two patients instead of the usual one. Tuesday was tough; I barely got everything done and was really stressed out by the end of the day. Wednesday was great; I was completely in the groove and had really connected with my two patients. I like this part of nursing.

Both of my patients were men. GH is 94 years old and CT is 90. GH just had his third heart attack. While giving him his physical assessment, he almost passed out while squeezing my fingers.
Imagine for a moment that your heart is so weak that giving a good handshake tires you out. Consider what it takes to get out of bed in the morning, do your business in the bathroom, walk down the stairs, make breakfast. Whew! Time for a nap. And your day is just getting started.

I was able to spend time chatting with both men quite a bit. There's a unique elder presence to which I'm becoming more and more attuned. It's hard to describe. In certain mythologies it is called the "king" energy, or in Jungian psychology,
the king archetype. For women it is the queen archetype. When I spend time with elder patients in the hospital, I experience it as the embodiment of a lifetime of experience and wisdom. And it is only with time that I am able to truly access its power and beauty.

On Wednesday I was on my way to the supply room. Walking toward me, one arm holding his cane, the other grasping the hand of another nursing student, was a man I had spent some time with the previous week. He is 88 years old, and looks like a skinny Don King. The resemblance ended there, as this man was one of the most gentle and elegant souls I had ever met. I say hello to him and approach. He extends his hand and gives me a firm shake. He does not let go as he looks in my eyes. I ask him how he's doing, and he says, "The Lord takes good care of this old man." I tell him I hope I look that good in five years. He laughs. The he says,

"I remember when Calvin Coolidge..."

"Excuse me," a nurse interrupts. "Can you give me a hand?"

I hastily said goodbye to my friend, and walked away from someone who actually had a story to tell about Calvin Coolidge. So how do I know about Calvin Coolidge? I looked it up! I never got the chance to go back and hear about our 35th president from someone who remembered him.

A few years ago I attended a seminar by Michael Meade, an anthropologist who does amazing work with teenagers. He was talking of stories, of how one of the distinguishing features of humans is that we tell stories. Or at least we used to. And the elders were the keepers of the stories, and it was their duty and honor to pass along their stories to the next generation. But now, Meade said, we don't listen to our elders. We don't ask them to tell us their stories. So their stories are being forgotten. And if there are no stories for our elders to tell, well, maybe there's nothing to remember at all. Maybe we're not just losing those stories; we're also losing our elders. And with it, a piece of ourselves.

Then someone raised their hand and asked Meade if this forgetting might have something to do with Alzheimers Disease. The room fell silent. Someone said, "Wow."

I'm going to be seeking out these stories as I continue down the path of nursing. And listening, really listening. What a great way to connect to another person.

And so much better than texting.

.

Friday, August 22, 2008

cooties

One day in kindergarten, a bunch of us crazy kids were playing hide and seek in the playground. I was "it" and was sitting against a rock wall, eyes squeezed shut, counting to 10 or 20 as loud as I could. All of a sudden, I feel something wet against my cheek. I open my eyes, and this girl Jill is inches away from my face, smiling and giggling. Just behind her are three other giggling girls. One of them yells out, "She did it! She kissed him!" Then they took off running. I could have died.

Really. I could have died. I'm not being dramatic here. I had not had my cootie shots that day, and they probably knew it. I was pissed. I got up and ran after the little *&^%#. Obviously, since I'm sitting her typing this, I caught her and did whatever I was supposed to do to reverse the cooties. If you don't get the seriousness of what I'm talking about here, google it.

I was reminded of this near-death experience last week in the OR (that's "operating room" for those of you who don't watch ER or Gray's Anatomy). We each spent one day observing a surgery or two. I got to see a thyroidectomy on one patient and laproscopic surgery of the colon on another. The thyroidectomy, as a learning experience, was pretty boring, and I couldn't see much. I did enjoy spending time with the surgical team and watching how they worked together. They listened to eighties rock and pop and made jokes. They were trying out a disposable scalpel, which generated a nice little conversation about the ridiculous amount of landfill generated in hospitals. It really is insane. I wrote a paper on it last term, which I recycled.

The laproscopy was pretty cool, both from a medical and technological perspective. The patient had an obstructed bowel, so they went in through the stomach to explore. They made three holes, one for the camera and two for surgical instruments. The doctor and surgical tech looked around for a while, and then started cutting away the adhesions, fatty tissue that was "sticking" the colon to the peritoneum (the cavity in which many digestive organs call home). The technician operated the camera and the doctor operated the pinchers and clippers. It was amazing how they worked so smoothly together, a dance of sorts.

The OR nurses were very welcoming, and it was great to see them in action. One reason why we were given this opportunity was to think about being an OR nurse in the future. Action for an OR nurse seems to be making sure that everything runs smoothly, which is much trickier than it looks on TV because of this thing called the sterile field. Sterile means no contaminents like bacteria, nasal hair, or cookie crumbs. The center of the sterile field is the patient, specifically where the operation is taking place on their body. The field then extends out across their entire body, then to the surgeon and the surgical technician. The surgeon and technician go through elaborate cleanup before the surgery to become sterile, and part of the OR nurses job is to help them stay sterile by being the interface to the non-sterile world. The surgeon and technician keep their hands above their waist to maintain this sterile field. They cannot touch anything outside of this field, so you see them inching past each other's backs (which are not sterile) as well as equipment and furniture, looking like an alarm might go off if they touch anything. It's extremely important that they don't, as there is the very real possibility of the patient's wound becoming infected, which in worse cases, can cause death.

Kind of like cooties. And the OR nurse is the cootie police. I don't think it's for me.

Last year I started watching the show ER on Netflix. It was the perfect break while studying for my prereqs such as anatomy and physiology. When nursing school started, I took a break from the show. Last week I started watching the show again and it was a completely different experience. I understood pretty much everything they talked about! It was a surprising barometer for how much we've learned in school and at the hospital. And it's only been three months!

I'm thinking that by the end of the program I'll be able to audition for the show. Or maybe House, MD. Or maybe even that new reality show, America's Hottest Nurses.

Who's going with me?

.