Imbalance

Psychiatry is probably one of  the areas I am weak at as far as dealing with patients.

 I always thought of myself as a very empathetic person, but i feel like im one of those nurses who would rather deal with physical exhaustion than emotional/mental one. That is why (i even said this before), I can never be a Psych Nurse.

 The problem is because i connect with other people easily and i can  put myself in their shoes, and it hurts me.

Growing up in the Philippines, I have always thought that other countries make a big deal of mental health illnesses. I was raised to believe that just because someone feels depressed- doesn't mean they have depression, which is probably true in some cases. And i really hated it when people call someone "bipolar" just because that person is moody. I thought it was very offensive.

But i learned and i knew all along that our mood, emotions are all linked to our body's chemistry. Certain neurotransmitters/hormones (dopamine, serotonin etc) regulate and coordinate  the way feel. And if there's an imbalance, (just how it is for a other illnesses like Hypertension, diabetes), you're not going to feel/be normal. (what is normal, anyways? lol)

I still do feel though that there are instances in our life where we are allowed to be "imbalanced" in some way. We're humans after all. The feelings that we feel and how we react to situations makes us what we are- humans. I feel like most people falter into the deep hole of mental illness because of the combination of bad coping strategies, poor support system and a series of mishaps in life.

Don't get me wrong, i don't judge people who are diagnosed with mental health illness. Mental Health illness, just like with any other illnesses have to be going on for awhile (talking about months, years....) in order to have a proper diagnosis.

I just wish that everyone can buy that time to feel better and put get their balance back when something bad happens in their life. 

Whole point of this post i guess is:
1. Everyone comes from all walks of life and go through different types of hell, so don't judge.
2. Mental health is as important as physical health
3. It's always important to have good coping strategies and support system in life
-- and if  you have them, don't forget to seek for them when you're feeling low/sad. (This blog is my outlet. ;])

Hah, this post is random but psychiatry lectures for grad school got me to look back at my post 6 years ago about my Psych rotations when i was still in nursing school.

There's beauty in chaos

Had the craziest shift today in Cardiac ICU taking care of a really sick patient who was on ECMO. No matter how many times i say that I hated going to work, i really love the beauty in chaos that happens in the ICU. Code blue, christmas tree of IV pumps, alarms going off every second, labeled tubings, ventilators, nonstop blood transfusions, saving lives.. I have always dreamed of myself as a critical care nurse & even though im on my venture to a new career, i know i will always be one

50 shades of crazy.

Last night, I had the craziest verbally abusive patient I have ever had in my four years of being a nurse, and although it does not affect me personally as I am used to confused/agitated patients, I can honestly say that this patient has drained the crap out of me last night.

Saying you're a nurse and being a nurse are two different things. I can't even name any other career job that deals with people who are sick, unwell and who takes "being called a bitch at work" lightly as a nurse would. I felt like an emotional punching bag.

What an exhausting night. Mentally.

How do you rest when you get this kind of tired?

A clean patient is a healthy patient.

Not all the time.
But i think that patients who get bed baths once in awhile recover better.
Or maybe I am just partially OCD. Haha.

I am not going to say that i give my patients full baths every single shift because that's not true. And believe me, there are days when I honestly feel lazy to bathe my patients. However, when my patients obviously smell like they haven't hit the shower for MONTHS, i think it's time to get the basin and washcloths.

I know that my main priority as a nurse is to keep my patients alive at the end of shift, but it really bothers me to see a patient so dirty when his/her nurse is out in the nurse station browsing on his/her phone.

I know and I believe that patients feel better when they are clean and taken care of physically.
I guess I just hate to follow nurses who leave their patients sitting on their wet linens or poop for hours, and I find out they sat on their butts all day.

Back to Reality.

Woke up today looking for mosquito bites and checking to see if breakfast is ready..then woke up again and realized I have to cook my own food and I have to go to work already. 3 weeks went by so fast!

Back in Murica. I don't like the feeling of going back to work after a long stretch of days off. I feel like i need to be reoriented in the unit. haha. I almost forgot how to work. ;) Anyone else feel the same?

On Working.

When i was younger, I couldn't wait to grow up and have a job. The thought of being able to financially support myself sounded so enticing when I was 14 years old. I remembered I used to pretend that I was just a renting a space at my parent's house and that my bedroom was own little abode. At that age, I just couldn't wait to do "adult activities" like driving a car, having an income, buying material things that I wanted without having to ask mom or dad for money, and having the freedom to do whatever i want.

Little did i know that being an adult is not as easy as what they make it seem like in movies or tv shows. With freedom, comes responsibility. Actually lots of it. This is the time when I actually have to start thinking about the future and what consequences I have to face with every decision I have to make.

Three years ago, I started to enter the adult world when I graduated college and got my first full time job. Last year, i fully experienced that world when I moved out of my parent's house and lived on my own.

In this world, i think it's really important that we choose a career that we enjoy. Working for a living is something that we have to do for almost the rest of our lives anyways.

Making money is one thing, but doing something that we love another.
Medical field has always been a passion of mine. It started at a young age when I used to go to my dad's (who was a physician) clinic after school. It was when i had the sight of black stethoscopes around the neck of doctors and nurses walking around the hospital and when the idea of saving lives was something i want to do for the rest of my life. I have always been fascinated with words I can't pronounce and the complications of the ever changing health system in our society.

I now work as a nurse, and although i enjoy every thing about this job, it's not always a cloudless day.. not always easy and not always fun either. There are days when I feel exhausted from constant running around the unit after 12 hours, when i have to clean up poop, vomit, sputum,and all other body fluids you can think of. When i have to take care of someone's family when a family member of mine is sick.. when i have been kicked at, spit at and called names I've never been even heard of before. There are days when I want to just call-in sick not because I am sick, but because I just don't feel like working. Some days when I have to drag myself to go to work.

But the good thing with having a job that you love is that, at the end of the day you are still content and happy. When even if you feel like you didn't touch someone's life, atleast someone touched yours. It's a forever rewarding job to take care of people who are not well and who are at the lowest moments of their lives.

According to Steve Jobs:

"Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do."

Loving what you do, and doing what you love is really just the secret to living a gratifying life. :)

PS. I am writing this because I am working overtime tonight and needed the motivation. Clearly, money alone is not enough reason to get motivated to work. Haha.

Heart.

"Every heart has two parts. One that pumps and the part that loves. If you're gonna spend your life fixing broken hearts, then learn both. You can't fix one without concern for the other." 

Always my first love. The HEART. 

One of those days.

Sometimes, I question why I do the things that I do or why I decided to do the things I did. 
I tend to be very impulsive sometimes, and I hate it.

A lot of people asked me WHY i moved out of my parent's house, out of a familiar place with a bunch of familiar faces.

Well, I feel like i need to venture somewhere where i can grow as a nurse and as a person.  I need to stretch out of my comfort zone. Life was becoming too routine for me there, and i needed a change.

In the end, i truly agree that we only regret the chances we didn't take. We lose on 100% of the opportunities we didn't go for.

Before my 12 hour shift.

Oh sunsets, I love you. 

Antidote of Death

What can one do? Go home, love your children, try not to bicker, eat well, walk in the rain, feel the sun on your face, and laugh loud and often, as much as possible, and especially at yourself. Because the antidote to death is not poetry, or miracle treatments, or a roomful of people with technical expertise and good intentions - the antidote to death is life.

Theresa Brown RN, Critical Care: A New Nurse Faces Death, Life and Everything in Between  

Alcohol pads, everywhere.

You know you’re a nurse if you have a lot of this in your car, in your bed, in your laundry, and everywhere in your room.

Sometimes you cry.

Last night was my first night on my own. I was put in the ICU w/ two patients. One of my patients was a respiratory failure old man and the other a 20 yo female w/ encephalitis secondary to teratoma. 

My old man has two peripheral IV lines. One on the right hand and the other on the left. No central line. Around 11pm last night, as I was about to draw blood from him, i noticed that his Left hand was starting to get swollen/puffy. I immediately stopped the infusion and switched his Ativan Drip and IVF tubings to the peripheral IV on the Right hand which was patent at that time. I called the doctor, told her about the situation and that WE NEED A LINE. With all these harsh medications to the vein, a central line is a MUST.

 She told me “It’s okay, just put it on the other peripheral IV”. I said, okay..so i did. she even told me to increase the infusion (which i should’ve questioned).

Around 2, i checked on my patient and he was still doing okay. I decided to do my bath early for my other patient At 3ish in the morning, as the respiratory therapists were doing their ABG blood draws, we noticed that that my old man’s right hand was swollen, purple and firm. It looked really bad. I immediately stopped the infusion, put a warm compress on it and told my charge RN.

 I called the doctor again and told her “WE NEED A LINE”, the hand was infiltrated and i did this, and that.

She said, keep trying to find one and if we can’t find one, we’ll put a line on him in the morning.

So i told our charge RN again, then one of the other older nurses said “Lemme try to find a good vein”. As she was trying to start a line, she flipped the right arm and to our shock found a pool of blisters. it was gross. and it looks like it hurts! It looked so awful. I checked the pulses and it was there. I went to the phone again and told the doctor about the worsening condition of the right arm. She came and evaluated the patient.

LONG STORY short, it was IV infiltration gone REALLY BAD. my pt developed non traumatic compartment syndrome. AND I FELT RESPONSIBLE. :( 

The thing is, he was doing good for me, we were going to extubate him that morning. His fever has gone down. His vital signs were stable. BUT Now, he’s going to the OR to get a fasciotomy.. they have to open his arms to take the fluid out. To make me feel better, the doctor said “Thanks for catching it early”. Other RNs in our unit told me “You did the right thing”. “You are a good nurse”.

All those things can be true.  but whether true or not.. It didn’t change the way i felt after seeing his poor infiltrated arm.  I felt really horrible. All i can think of is that I could’ve caught it earlier. i keep beating myself up about it. 

As nurses, we always think that we can save people. It reminded me of this quote:

"We all do our jobs with the belief that we are invincible. That is not true, of course, but being shown our inability to save every life hits hard. Eventually the belief in invincibility comes back, because how on earth could you do this job without it?”

I went home, crying. It might seem like it’s not a big deal for someone.. He didn’t die, but the possibility of losing his right arm is there. And it hurts me. That night when i was taking the report from day shift RN, his pleasant wife and daughter was there saying hi to me and telling me how much they want to bring her husband, her dad back to LA (because they live out of town). Now, i don’t even know if i can face them when i go back to the unit tonight.  

No matter how horrible i feel, i know i can’t really do anything with situations like this. It happens. What matters is how i reacted to it.. and how this experience can make me a better nurse

. I feel like I will be an IV NAZI from now on…

Judgement Day

This has got to be my favorite formal outfit. I was wearing this during my clinical rotation in the Public Health Department 6 months ago and got so many compliments. Today, i wore it again to the interview i have been waiting for the past 5 months since i graduated. (me and my superstitious self thinking this might give me lots of luck today)

I must say the interview went really well. It really pays to be prepared for something you have been anticipating for a long time. I really believe that success is hard work, preparation, and learning from mistakes. Now, i just have to wait until Monday to see if i got the job or not. I told my dad "waiting game again".. then my dad said "at least you're waiting for something".. which is true. It's feels good to know that there's something i am actually looking forward to this time. :)