Tuesday, August 26, 2008

Too Much Work

I am working too much. I have had to go in on many of my days off for training classes and meetings such that I'm in at least 4 days a week. This week it's 5 days, in a row.

I know what you're thinking. "Most people work 5 days, so quit your bitchin'."

You are right, dear reader. Nevertheless, I am tired and feeling a bit overworked. Work is not so much fun - and on Monday, I walked on the unit (barely on time) to find out I was surprise precepting (orienting) the new hire. Surprise! I thought I could get away without having to precept him again, because I didn't especially enjoy doing it last time. The last minute change to my plan for the day is stressful to me. Additionally, the new hire guy has this "Robin Williams" kind of schtick he does in an attempt to be funny or likable or to deal with his stress or something. It gets on my nerves after a while.

I am looking forward to the weekend. I have 5 days off in a row; a rare gift. Oh. Wait. Make that 4.5 days off in a row. I have to go in to work on my first day off, Friday, for a meeting. Middle of the afternoon. Yippee.

I just want to sew and quilt and enjoy my beautiful backyard right now. Just a little humble fun.

Monday, August 18, 2008

Fall comes early

It seems like fall has arrived early. The weather has been very pleasant in the midwest with cool mornings and warm days. Sunny and clear. I barely got enough heat from the 3 weeks of hot summer to thaw me out from the winter. Yet, here we go again, back to the darkness and cold.

My garden has been delightful. I have had a great crop of cucumbers and plenty of basil and parsley. The tomatoes are few but delicious. Four fat eggplant berries drip voluptuously from their stems. It is almost too late; now is the time to get working on fall crops. I hope to get a few more rows of carrots in, some arugula, and another cabbage. One cabbage is in and it's hanging on after a vicious attack from little green caterpillars. Its partner did not make it - my dog Winnie decided she needed that baby cabbage plant, picked it up (peat pot and all), and carried it across the yard. She tasted it for good measure. It never recovered.

Quilting work has been slow and pensive. I have been interested to work on my "Mom's Quilt" project, a large pieced wall hanging started in September 2001. I remember the exact date because I bought the fabrics over the weekend after the 9/11 attacks. We had gone up to visit Mom and Dad and see a Penn State / University of Virginia football game. Like many public events right after the attacks, the game was cancelled. Instead, we went to Dayton VA and visited a quilt museum and shopped in a quaint Mennonite village. There we found the beautiful fabrics for this wall hanging.

I am terribly remiss in this project. It is 7 years old, after all. I am hand quilting it, and that is why it is taking so long. I got frustrated with marking the quilt for the quilting. The quilting goes along fine. I am so close to done, I really have no excuse not to finish it. Thank goodness I have the motivation to pick it back up. Progress was stalled recently because my dog, Winnie, decided she needed to floss her teeth, and my spool of quilting thread was just the thing.

Detect a theme here? Dogs...

I'm always doing more projects, though. I have more fabric for my "Aunt Millie's Garden" quilt, but I haven't started sewing on it just yet. Much of the prep work is done. Yesterday I bought some yarn for a bulky knitted sweater, thanks to a nice sale at Michael's (an arts and crafts store). It's a nice rust color, in Lion Brand's Thick and Quick wool blend yarn. I haven't made any more blocks for the log cabin bed quilt - I think I have completed around 60 out of the 80 needed. Gettin' there....

My latest whim is learning crochet. It's a little pastime, nothing serious. The look of crochet does not excite me except in certain applications (like edging lace). It's quite easy, so another fun thing to do.

Life goes on. I am neither happy nor sad. I am busy, but I want to be lazy. I want to be home doing my own things. I have indulged this feeling for the summer - if I didn't mention it in a previous post, I decided to quit the singing group after all. It just wasn't fun. More of my time is my time and I am satisfied.

As usual, I dread the coming winter. I need a plan to fight the oncoming depression. More on that later.

Tuesday, August 12, 2008

Fatigue

How can I be tired? I get plenty of rest. I eat well, and I get exercise. Yet today, I am tired. It is my 5th day off in a row so I should be well rested by now.

Last night, I was awakened by a blistering headache. It was about 2:30 AM and I was awake for about 1 hour. At first I tried repositioning. I got up finally and took some Ibuprofen. My muscles felt achy so I tried massaging and stretching my shoulders and hips. Next, I got up and did some gentle yoga stretches on the floor next to my bed. I could not believe how sore and tight I felt. Slowly, the ibuprofen kicked in and I was able to relax and go to sleep again.

I slept in late! Until 8:15! What could have made me so tired?

Yesterday, I got a lot done, including walking the dog, cleaning out the back yard after the new fence had been put in, and mowing the lawn. I called it quits before running the weed-whacker and using the blower to clean off debris from the driveway and sidewalks. In the afternoon I completed a number of errands and shopping. Complete the day by cooking dinner and doing a few chores after dinner.

Sounds like a busy day to me. You'd think 8 hours of sleep would be enough. Guess not.

Last weekend, a friend from the east coast came to visit for a few days. We had a grand time - busy with sight-seeing and visiting. No chores done so I have to catch up on them on the days following.

When I feel so tired, I get concerned. I wonder if it's something monumental in my health. A nighttime throbbing headache makes me fear that it's a burst aneurysm, and now I await the loss of consciousness. Should I wake my husband, so I have some hope of being saved from my brain bleed?

Eh, it's probably just a headache.

The fatigue makes me wonder if something silent is lurking within - ovarian cancer? Pancreatic cancer? Brain tumor? Worse yet, old age?

Logic usually saves me from my fear. Where logic fails, faith kicks in - well if it's my time, so be it. I'd rather go than be prolonged in a semi conscious state.

Sunday, August 3, 2008

Discipline of Blogging

I want to become a better writer. One of my motivations for creating this blog was to practice writing. Part of the discipline of writing is to write when you may not otherwise feel like writing. So it is today.

I used to write more in my previous jobs - they were technical documents, such as system specifications and design documents. I wrote more email. In nursing school I wrote copiously - papers, care plans, study guides, and other assignments. I never thought I'd miss writing because I used to dislike how much writing I did. Now, I find a do miss it a little.

As a hospital staff nurse, I don't write much at all. I write notes on patients' charts, yes, but that writing is extremely functional, curt, and efficient. There are some creative aspects of the writing - using the fewest words that stuff the most information in. Creativity cannot outweigh functionality and I see the only real purpose of creativity is to demonstrate that I actually thought about what I was writing. This would be creativity in stating the same thing using different words and adding little personal bits that show I was talking about this specific patient. I must not include opinion or speculation and to the best of my ability, I must defend all my actions legally with these words. The words must prove that I followed the hospital's standard of practice in the unlikely event that I will have to defend myself (and the hospital) in court.

I hope I never end up at a deposition. It will be scary, embarrassing, and it could end my nursing career.

The only place I (consciously) indulge in opinion in my notes is when I write discharge notes. I want to write all my notes in the computerized charting system, yet one part of our nursing documentation remains on paper. It is called the "Interdisciplinary Plan of Care," or IPOC. Supposedly, all disciplines within the hospital are supposed to consult this thing and document on it. In reality it's a piece of paper there for the regulatory boards benefit and for the pleasure of the executives of the hospital. Nurses fill out this paper on admission, and it is here that we are to document every time we teach something to a patient. Thus, when we go over the patient's discharge instructions, we are "teaching," and we document it on that sheet.

As a result, I have to write two notes on discharge: one on the electronic record, one on the paper IPOC. I resent having to write on the paper. In the electronic record note I usually write something like this:
Patient discharge teaching completed. See IPOC for details on individualized teaching topics.
This is my way of saying "I did the teaching, but nyah, nyah, you have to go look at the paper chart to find out what that teaching was. If I can't document it here conveniently with the rest of my discharge documentation, then I'm not going to make it convenient for you, the reader, to get to it either."

It's a moot point, because who the hell reads my charts and my notes after discharge? No one.

But maybe one day, if I am unlucky, someone will read it. On that day it will give me personal satisfaction and hopefully not impact the deposition.

On a related topic, I was recently reading Oprah's magazine, and in it there was an article about Ben Affleck's recommended books. He recommends Strunk and White's "The Elements of Style." I haven't looked at that book in ages. I think I should look it over again. I feel rusty and out of practice. I certainly don't think Ben Affleck has the answers to life's questions...his article merely reminded me what a good resource it is. Who couldn't use a little reminding not to write too much?

Thursday, July 24, 2008

Age hits me

This weekend I got a call from a friend from college. We had a really nice conversation, but I left it feeling old. Her daughter just finished her first year of college. When did I get old enough to have a friend with a kid in college?

Yeh. Over the last 19 years, mush-for-brains.

As we talked, the conversation centered on her kids, her health, and her job. We talked a little about me - I did more listening this time. It was alright with me to do so. I was secretly pleased to hear of her health issues - that's one thing I did better than her! My health is good, hers is not so much. I know, I know...this is terrible of me to admit, and I certainly don't wish ill health on her and she hasn't had an easy life, by any stretch of the imagination. She is closer to the norm of a 40 something female in America at this time - divorced, overweight, single-Mom, lonely and looking for answers, working in an underpaid female dominated industry, and two of her kids are learning disabled. Scraping by in the economy, but rich in relationships. She embodies American society.

In this human form, in our western culture, it is very hard not to compare and compete. I am not the norm. I envy her conformity, in some ways.

It is hard to transition psychologically from being the hope for the future, to being the establishment. From being young to being old. From wishing and dreaming to remembering and sometimes regretting. From having endless possibilities, to living with the consequences of your choices (good and bad).

Nobody teaches you this in a real sense. This life down here is really hard.

Tuesday, July 15, 2008

Whew!

I had a pretty good day at work yesterday and I would like to write about a few things.

My IV skills are staying about the same. I have been having some bad luck in the last several weeks but yesterday I placed 4 out of 7 attempts successfully. Not bad and I only had to get help once! I still get a thrill on placing an IV successfully - I hope that feeling lasts. And, don't worry, those 7 attempts were on 3 different people and two of them needed 2 IVs. I didn't poke 1 person 7 times!!!

I got all my paperwork done at a reasonable pace. I wasn't pushed too much. My patients were generally pleasant people. It was sunny outside and I got my lunch break on time. I got a couple of breaks. I got to chit chat with some of my favorite colleagues on the job (even one of the doctors). I am a happy woman.

One of my patients was nearly my age - about 6 months older than me. His cardiac cath revealed that he has severe coronary artery disease and he will go for bypass surgery this week. It gives me pause when my contemporaries come in, and have bad disease. You hope they are all false alarms!! He should do very well with the surgery, however, I am not sure he understands how his life will change in the future. I don't know if anyone talks to him about his risks in the future, such as possible heart rhythm changes necessitating a pacemaker, possible restentosis of the bypass grafts requiring a second bypass. If the disease continues, he will be out of options - they can only do bypass twice.

Of course, technology may be very different in 20 years and there may be more options available then.

I don't know what the "right" answer is - in this person's case, without surgery it is very likely he will die young from a massive heart attack. The kind where the person just keels over one day and hopefully doesn't survive...because if he did survive he'd likely have a lousy life remaining. There may be no value in giving him all the information about what is to come after bypass - and it may even be a detriment because it could cause him to delay or cancel the surgery with dire results.

But I digress. I've digressed along these lines before; I think the decision process for surgery is fascinating and complicated.

My point in writing about this patient is that he had two 11 year old children - twin girls - that came to see him. I found those kids insufferable. Yakkity yakkity yak. No seriousness. You'd think they'd have some sense of the situation, that Daddy's in the hospital and he's going to have major surgery. He could die. He could even die before the surgery. Nope.

On the one hand they are ignorant and I suppose their parents did not impress upon them the seriousness of the situation.

On the other hand, they are 11 years old and should have some idea about what a hospital is and why people go there, and such. Maybe no one ever taught them about it.

Maybe Mom and Dad don't appreciate the situation, either.

Broken family. Naturally, Mom and Dad are divorced. Dad's "main family contact" is his ex-wife. I just don't get that. If you need to remove someone as intimate as a spouse from your life, why do you continue to hang around with them? When you have broken the family, why do you continue to act as a family when it's convenient?

My subject for this post refers to how relieved I was that I was turned off by the kids. Yes, I am not parent material after all, and despite my doubts, not being a parent is really the right thing.

Saturday, July 12, 2008

The Poker Group

I belong to a poker group. Nothing formal, we get together about every 2 weeks at someone's house and play Texas Hold 'Em, no limit tournament style. A little bit of money is involved. I have learned how to play reasonably well, which makes it that much more fun. Some days the cards go in my favor, some times they don't. Often I get mediocre cards, and the trick is all in how I play them. Much like life.

I think about poker and the differences in how women and men play. As you might guess, as a female, I am in the minority - I'm usually not alone, but last night was pretty typical - 4 men, 2 women. It was an average night of play for me; I was out early in the first game, but took second place in the second game. Taking home some money satisfies me. As long as I play fairly well and get a few good hands, I am happy. Of course I prefer to win, but it's not like the men. They really like to win.

Men like to bluff in a poker game. They like to get the better of someone by bullshitting them, achieving this seems to be a badge of honor. As I thought a bit, I saw similarities in the poker bluff and to men go about pursuing women when dating - they try to bluff their way into seeming just a little bit richer, more clever, luckier, more glib, more socially connected, etc. than they really are. That's all in the game. If the poker bluff fails, they still get admiration from their peers - that was a ballsy move.

I generally don't bluff. Every once in a while I try it and occasionally it works. Sometimes my bluff starts out legitimate, and it falls apart when the flop, turn, and river are revealed. Usually I stop my losses when I see my chances slip away, I'm such a wimp!

Experience has helped. I know what a good hand is and I pretty much know how to bet it. I could learn more about pot odds, reading other players' actions better, modifying my behavior to play the cards I have better. Practice and a little research would help; in fact, I read most of Phil Hellmuth's book on Texas Hold 'Em and it improved my game significantly. It gave me a different way of thinking about the game and the players.

I doubt I'd ever make any real money playing poker. It's fun. It's social. And most importantly, it's something my spouse and I do together. Very valuable.