By: Angie

I was at work on the surgical trauma floor. It was 1730, almost time for shift change, one of the busiest times of the day. That’s when he started singing….that’s the time he chose. It was a blues-ish type song with long, melancholy notes, with kind of a country-western feel to it. He sung loudly and with passion – “just letting it all out”, he shared with me afterward. It reminded me of those old movies where some poor soul would start singing away all his pains and sorrows. The patient in the next room said laughing, “there he goes again”. People passing by in the hall would stop and stare with a curious look – “what’s with the singing?” What none of these people knew was the fact that this man was about to die.

Anyone standing there as an observer would have simply seen me busily running around as usual trying to get things done – passing medicine, answering the phone, hunting down a doctor, etc – seemingly ignoring the “noise” coming from the fourth room on the right. But I both heard and felt every note. Quite moving, indeed.

The poor guy had a glioblastoma, the most aggressive and most fatal type of organic brain tumor there is and the same type of tumor Senator Ted Kennedy has. Getting diagnosed with a glioblastoma is like getting a death sentence, you generally have months to a year or so to live depending on how much of the tumor they can kill or remove, or in other words, how much your insurance is willing to pay for such expensive measures. Either way, you’re gonna die, whether sooner or later. Basically, you’re a ticking time-bomb. Get your affairs in order and tell everyone goodbye.

He was a very nice man, but generally cynical and careless about his future. They can be like that sometimes, especially depending on what stage of grief they are experiencing. This is the third patient I’ve had with this ailment. The last one, coincidently, was in the very same room as my singing patient. Imagine you’re simply out of town visiting relatives. You start to have some visual problems, go the ER to get it looked at and then told you have 3-12 months to live because you have a brain tumor. That was her story, except she just chuckled, seemingly uncontrollably, every time she talked about her future. I suppose she just had no talent for singing.

I can say that I passed into the physical world at 5:04 p.m. on June 3, 1977 at St Johns Hospital in Queens, NY. Conversely, I will pass away from this world and into the realm from whence I came at a completely unknown time and place. I don’t know when and where. At one level, this is comforting, yet at the same time a bit daunting. How does one get over the emotion one gets from exploring this dichotomy? One just doesn’t think about it much, that’s how. I understand that death is a morbid topic and a prognosis of this type is not common, but just think how you would react if you heard this news about yourself….or a loved one. I have given it much thought, so much in fact, that I may concentrate my future career on palliative care and/or pain management. That’s one of the revelations I’ve gotten from my “horrible” experience as floor nurse so far. And yes, I do know now what I would do if I was in their situation – do you?

]]> http://www.pottsroadtrip.com/2009/07/25/how-morbid/feed/ 0 http://www.pottsroadtrip.com/2009/07/12/two-years-of-sanity/ http://www.pottsroadtrip.com/2009/07/12/two-years-of-sanity/#comments Sun, 12 Jul 2009 23:18:15 +0000 admin http://www.pottsroadtrip.com/?p=1307

Celebrating two years of sanity.

I was walking at the park today, something I do multiple times a week for the past three years. It is a city park where all types of people come to do all types of activities….jog, skate, picnic, fly kites… I go to get exercise, but secondary to that I love to people watch, think, and listen to music. I have a strict policy on the music: no Ipod, no walk – been wiping the dust off the MJ CDs lately.

On this particular day, I noticed a few orange and white barricades and a sign announcing that part of the park will be closed on July 3^rd and 4^th. A brief, feeling of anxiety suddenly hit me, then went away. Ahh yes, I know why they were closing the park…they have an enormous fireworks display every 4^th of July…that’s right.

Two years ago in July was my one year homecoming anniversary from Baghdad. Believe it or not I had fun there…I made a lot of friends and have some very unique memories. But it is Baghdad *sigh*, and there were way too many days when we had to hear gunfire and explosions in the not so far off distance. Often, mortar rounds would land randomly in our compound as they lobbed them aimlessly over to us from the other side of the Tigris…needless to say if some unfortunate person just happened to be standing in the wrong place at the wrong time…it would probably hurt really, really bad for him. You just never know when it’s your time.

So anyway, two years ago on this day I was walking the park, seeing the same barricades and signs. I only live right across the highway from the park and was looking forward to watching the fireworks display. However, when it came, instead of ooing and awing, I had an anxiety attack. Uncontrollably, I started pacing around, heart pounding, hands shaking…I couldn’t keep still. It had been a year since I’d been back and I had been just fine, my usual calm, cool self…so why the sudden craziness? I tried to talk myself down, knowing full-well I was safe at home. No luck. I called my mom and she talked to me until the fireworks stopped. Then I was ok again. Too weird.

I was scared I would end up with PTSD or something. But fortunately, it seemed to be an isolated incident. Since then I have seen a few firework displays and even heard an explosion (a supposed meteor, they say), and I’m still mentally intact. Not complaining or anything but, I can’t help but wonder why I never got another “attack”. At any rate, I continue to celebrate my sanity, for now I know just how easy it is to lose it.

The following is a guest submission from Angie

We all create our own reality, not through what we do but by the way we think.

After I was off orientation and was on my own for about a week, a co-worker asked “So how do you like it here so far?”

Now before I go on, I have to tell you that I am a brand new nurse at my first nursing job on a surgical trauma unit. We get gunshot wounds, stabbings, burns, car/bicycle/motorcycle/pedestrian accidents, jumpings, neurologically compromised patients – my favorite-, and post back/neck surgery patients. IT IS A HECTIC FLOOR. Because it’s trauma….it comes with a lot of drama! It’s one thing to be hospitalized with complications due to cancer, diabetes, heart problems or some other chronic condition that a person has to live with everyday. Once they’re diagnosed they pretty much know they have a hard road ahead and can expect being hospitalized every now and then. But it’s another thing to wake up healthy, strong, and gorgeous thinking it’s going to be just another day then BAM!…. you get shot in the face….point blank. Needless to say you would have issues unique to your average patient. First, you’re mad as *beep* and want to get the lousy *beep* that did this to you (or live in fear that he may try to finish the job). Second, your body is literally broken and you’re in the worst pain of you’re life. There is no such thing as comfort and every millimeter you move can be excruciating. Third, in having to deal with the two previous issues, you start to get frustrated and can get quite the attitude. Life as you know it has abruptly stopped….you can barely brush your own teeth now when just yesterday you felt good enough to do cartwheels all over your backyard. Of course, just how much of a “tude” you get depends on how well your coping skills and support systems were before the accident. Nevertheless, even a fairly light trauma can bring out the worst in you, even if for a fleeting moment.

So how did I like it there so far? My co-worker had a very sincere look on her face as if she really wanted an honest answer instead of my usual, “oh it’s just fine”, drenched in sarcasm. So I spoke my mind. I got patients: 1). who either have nasty attitudes and/or very little coping skills and are drama queens/kings, 2). who are needy and stay on the call bell all day cuz they’re so sick, unintentionally or intentionally monopolizing my time, keeping me from my other 5 patients who now hate me cuz they think I’m ignoring them, 3). I’m so busy it’s hard to find time to chart, eat, or even PEE, 4). doctors, particularly the residents, often confuse me with their orders and I spend valuable time trying to figure out their intentions, 5). my God!… I could go on and on. But I got no sympathy…”Well, that’s pretty much how my day’s going too, welcome to nursing! You’ll get used to it eventually” she said, then just walked away. Her and others like her have been nurses for a while and make those 13 hour days look like a cakewalk.

I’m normally a fairly calm, Zen-like individual and have faced some fairly stressful job-related scenarios, being in combat zones and all, but I have never worked this hard in my entire life. And of course, I am painfully introverted so being in people’s faces all day just adds to the problem. These past few months as a new nurse have led me to question my aspirations of being in healthcare period – something I’ve wanted to do since I was 12. So I have been forced to do some soul searching and fortunately, have come up with some conclusions:

First – that which does not break me will make me. I can either quit like a punk, or buck up and learn to cope. My co-worker was right, I am starting to get the hang of it by prioritizing my tasks, delegating to others, and learning how to talk to patients, for there is a certain way you can finesse a conversation to make it lead wherever you want it to go no matter how attitudinal or mentally challenged a patient is….yes, it is an art!

Second – I can always do something else. I actually wanted to be a nurse so that I can be a practitioner or go into research…ie get an MD, NP, become a nurse anesthetist or a PhD, not do “floor nursing” as we call it. But those advanced nursing jobs require “floor time” before I can get into them. Knowing that I am gaining valuable experience so that I can move on is helping me to appreciate my current situation and everything I learn from it.

Third – empathy is important to have….understanding what another is going through. These patients go through a lot – how would I act if I were going through the same situation? It’s hard to say – I’d surely like to think I’d do better, but I thank God that I’m not where they are. Putting myself in their shoes helps me to think that I am actually doing something worthwhile for people and their families since I would want a nurse to do the same for me….*cue the violins*

In conclusion, if you’re unhappy then you have two options: change you’re situation or change your outlook on the situation. Sometimes all we can do is change our outlook…and that’s what I’ve done. Surprisingly, it actually works….once you get past your ego, of course….there’s NO room for ego with personal growth. I still struggle with job satisfaction, but being a realist, I know my personal happiness is completely up to me….not circumstance.