What a Shock, I Chose New York

In case you didn’t know, I’ve decided to stay in New York.  Probably not a big surprise to those of you who know me well.  (New York has been my dream destination for I don’t know, the last 9 years-ish). 

The fact is that I love this city.  I felt right at home here from the beginning.  (At least more so than my previous travel assignments).  Don’t get me wrong, I was pleasantly surprised by Texas, and Los Angeles has beautiful weather, but let’s face it, no city can compare.  I desire the subway and bus over driving, and I’ve always wanted to live within walking distance to I don’t know…everything.  I’ve spent the last 4+ months walking 12 blocks to work each morning and the same 12 blocks home each evening.  There is a type of peace and calmness that exists within me here.  Perhaps it is being surrounded by so many people.  For some this would make a person feel more lonely, but for me I feel as though it does the exact opposite.  I interact with few of the people I see, but instead of isolating myself within the confines of my car I cram myself onto the train or hurry past other rushed city dwellers on the street.  There is always the possibility for interaction, although sadly I believe that few view this as a plus or use this to their advantage.  None the less, living here has been fantastic and at this point in my life, the exact experience I have been craving.

It’s difficult for me to accurately describe what my life has been like the last…wow!…third of a year, but here is my random assortment of happenings that will hopefully paint a halfway decent picture.

Let’s start with the BIG one.  I signed a lease and will be moving into a studio apartment on the Upper East Side tomorrow!  (Building entry between a McDonald’s and Indian Restaurant).

Second runner up…I discovered, through the help of a very important fellow travel nurse, what is hands down the world’s BEST brownie.  I’ve included it at all three meals and find that it stands up /pairs well with toast, cottage cheese, sandwiches, and chicken.  (In case you had your doubts).

I’ve been working in gastroenterology “office practice” wearing business casual to work each day, learning the “secrets” to Outlook, and having most of my patient interaction occur via telephone.  The job has included advising patients to 1) take a laxative, 2) include fiber in the diet,  3) try a different laxative, or 4) purchase and ingest either Metamucil, Citrucel, or Fibercon.  Joking aside I teach patients about the procedures they will be having, triage their symptoms (do they need to try one of the four or all four of the above interventions, come to urgent care clinic, or just relax and let “things” happen).  I also call to inform them that their biopsies are negative and they don’t have cancer, of which had already been alluded to, but not officially confirmed.

I’ve learned that living in the city involves actually designating a time for laundry rather than just throwing in a load after work and then leaving the clothes in the dryer for 2 days.

I silently judge those who own large dogs and live in tiny apartments.  I have polite conversations with them in the elevator, all the while thinking that if their oversize pet drools, sheds, or nudges me I will have no choice but to let loose with my meanest dirty look.

I decided to give the Lactaid pill another shot and happily rediscovered all things dairy.

Again I seriously contemplated pursing my writing career over nursing.

Again I continue to find myself in the nursing profession.

I’ve been cut in line several times and not really cared because I know the person at the register will “have my back” and yell at the customer for me.

Yesterday a patient said, “Good-bye Lucy Lu.”  My response was to simply say “I don’t look like her” and walk away.  (Apparently on the east coast a person of Asian descent can and will be referred to as “Chinese” regardless of their actual ethnicity.  At least I’m not being characterized as “the Oriental girl” as was once the case in Texas).

I’ve expanded my knowledge of the Jewish faith.

I’ve attended more weekday Masses and found that it helped me feel less anxious while I was in the process of finding another job, a place to live, and contemplating whether staying was ultimately the right choice.

I drove a car in New Jersey, contemplated selling my car, then bought insurance for the car I will no longer be driving.

I got a tad restless in the city which resulted in visiting a close friend in Chicago, where by the way I felt like I was back in the suburbs.

I’ve worn every outfit I brought in my ONE suitcase.  I’m now sick of my clothes and glad to be taking a short trip back to Seattle to gather my winter wear as well as other small items that are to soon find themselves in a new home.

I’ve learned that it is 100% okay to want what I want, but to sometimes be a bit more patient and allow the pieces to come together on their own accord…in New York of course.

The Update

It’s official.  I am going to LA in approximately one week.  Yes, it will have been over two months since my job in Fort Worth ended, and yes, I think I am finally ready for this “vacation” to come to a close.  The time off has undoubtedly been nice.  Due to my job title of “travel nurse” I made it a goal to only work 9 months out of the year, and it appears I am on track for making that quickly become a reality.  (Perhaps a little too on track).  Maybe I should just become a teacher.  That way I’d be guaranteed the time off without really having to think or plan it.  Hmmm….

I prefer to not endorse the option of viewing myself as lazy.  I have tried to work several times at my per diem agency, but it appears that I am just not needed.  In a way this is disappointing  and in a way it really is not.  When I do schedule myself to work I must get up at 4:45 am to call and see if I’ve been canceled.  This means going to bed early, preferably before 10 pm, and having all of my “nurse things” ready the night before so that I can jet out the door quickly.  It also means that I may not be working at the hospital that I originally said I’d go to.  Example:  Overlake says they don’t need me so my agency calls Valley to see if I’m needed there.  So extra time in the morning is good because there is always the possibility of getting lost, not knowing where to park, getting disoriented coming out of an elevator and heading in the wrong direction, etc.  In Fort Worth it took me weeks to understand the hospital’s layout.  I can’t believe I use to brag that I had a good sense of direction.  Being so reliant on GPS totally screwed with my inherent ability to problem solve.  Now I just turn and walk and pray that I arrive at my destination. 

I have to admit, when I make that 4:45 am phone call I secretly hope that my services are not needed.  I feel that if I ask to be scheduled and put in the effort of getting ready for work I should not feel guilty for another day of daytime TV, leisurely coffee drinking, online chatting, happy hour, and evening (or afternoon) wine drinking.  I only wish some sort of monetary value could accompany my efforts.  Too bad for that….

Los Angeles will be good though.  I want to go with no expectations (except for sunny weather of course).   I already have somewhat of a preconceived notion because I have visited throughout my life.  If my memory of reiterated moments by parents serves me right, I first went to Disneyland when I was less than one year old.  There have also been road trips with the family, a high school orchestra excursion, and visits to friends.  Texas was fun for me because I truly did not know what to expect.  I had never heard of Fort Worth, didn’t really understand the whole southern hospitality thing, and just recently realized how far Texas is from Seattle.  I’d go back, but am done with the long drives for now.  Basically I heart Texas and hope to heart LA and Cali as well.

We shall see….

Leaving Fort Worth

It’s hard to believe that in about a week and a half I’ll be making my way out of Texas.  The time has felt been both short and long.  I’ve been counting down the number of shifts I have left at work, and I am excited to say that there are only four more!  The job hasn’t really been all that bad.  I know that it could have been a lot worse; however last night was in many ways the icing on the cake (or whatever the negative equivalent is), since they gave me seven patients while everyone else took five.  (Long story behind it, but basically they just do things “differently” on Harris 6).  I stood up for myself and ended up getting some relief from the charge nurse, but the whole night was just confirmation that I am ready to move on.  I do feel as though I’ve made progress and grown professionally, or at least gotten back to where I was a few years ago, seeing that it had been awhile since I had worked continuous med/surg.  In the beginning I felt I was struggling a bit.  Both due to sleep deprivation and the overall task of getting my groove back.  I also (and I’m going to be really blunt about this), had trouble truly caring about my patients.  That sounds like such a horrible statement, but I think it had a lot to do with my feeling overwhelmed at work.  Still, and I think most nurses would agree, we all go through phases where it seems that one more drug seeker or confused/demented individual could quite possibly push us over the edge.

When I first got here I strictly enforced my rule of NOT talking about work when I was not physically AT work.  I still believe that overall this is a good policy, at least for my mental sanity, but I have chosen to loosen the reins a bit.  I know that this is a huge relief for my friend Jonah.  In the beginning I practically cut him off mid-sentence if he so much as mentioned Harris 6.  Now I am able to entertain some work conversation, i.e. gossip, without becoming too bitchy, although sometimes I do still sense my blood pressure rising and need to change the subject. 

But enough about work because that is truly the boring part of life, my life anyway.  I’ve enjoyed my time here in Texas.  Unless something hideously drastic happens in the next 9 days I will look back on this experience very positively.  Honestly it wasn’t really that hard for me to venture here without my solid social network.  Sure I had some anxiety around the whole issue, but I guess it just “felt right” and therefore the daily/nightly routine has come pretty natural.  It also helped (a lot!) that I made a friend right away and luckily it is someone that I know I will stay in contact with for a very long time.  Jonah is a wonderfully smart, caring, and hilarious individual.  I don’t think I have ever laughed so much in one 3 month stretch of time.  We’ve attempted to skydive together (twice), taken turns accompanying each other to both gay and straight bars (although the ratio is about 1:10 in my favor), and felt comfortable enough to share our slightly odd food habits.  I’ll miss our gluten free pizza and chick flick nights, as well as 3 am dashes to Wal-Mart for 99 cent fries and browsing their 5 dollar DVD sales.  Very good times.

Probably the number one thing that I enjoy and learned feels so good is getting in my car and driving wherever I want, knowing that wherever I choose to venture will feel fresh and new and freeing.  It can be a 50 minute drive to Dallas or a 4 hour drive to San Antonio.  The distance doesn’t matter.  I get a small rush when I take off and explore a new place.  I believe it is more that I am utilizing my opportunities and stepping a little out of my comfort zone which makes the journey to these places that much more satisfying. 

One thing that I wanted to do and said I would is go to the rodeo.  I just haven’t been able to fit it into my schedule (or maybe I didn’t really try hard enough).  Oh well, I feel that I have gotten a pretty good taste of Texas and will be able to leave without feeling too remorseful. 

Right now I am looking forward to the next phase of my itinerary.  Back to Seattle for a few weeks to spend time some QT with good friends, then off to Korea to visit my family and spend Christmas in a body jarring cold climate.  I’ll start my next assignment in San Jose, California on January 9^th.  Yes, that’s right; I am taking 30 plus days off!  As for now I continue to put off all forms of packing/organizing.  Leaving in 9 days still seems like an event of the distant future.  Perhaps reality will hit when I finish at the hospital and go for a margarita at 7 am.  You can’t buy wine at the grocery store before noon on Sunday, but you can find a restaurant that mixes a drink at the time when most people are just rolling out of bed. 

Nights

I’ve never considered myself to be a night owl.  I’m more of a morning person, however I just completed my first round of night shift and I have to say, I am pleasantly surprised/proud of myself.  I don’t like hospital politics (actually I’m not a very political person to begin with), so I find it refreshing to not be drawn into all the co-worker gossip/unit tension.  The floor I’m working on is big-38 beds and there are a ton of nurses.  I can literally go a full 12 hours without seeing some of the people who are working the same shift. 

I have to admit the first few nights took some adjustement and not soley due to sleep deprivation.  It’s not that I forgot how to be a nurse, but given that I went nearly a month doing no patient care (which I loved!), going back hit me hard.  I had to remind myself that when there are confused and unsteady people trying to get out of bed it does not paint a pretty scene.  Having my patient fall on the floor during my first shift would be all around BAD (and not just for the patient, but for me as well).  Ick…documentation, MDs…embarassment.  Luckily this did not happen.  Everyone stayed safe, and I got to hold onto my pride.

Last night I sought the aid of an organic “energy” drink which lacked true caffiene.  Hmm…didn’t really do the trick, but at least it was tasty.  I’ve found that nightime tired is different than daytime tired.  Basically I can walk around on night shift having what appears to be a glazed over look on my face and no one questions me about it since everyone pretty much looks the same.  (Either that or people are just too tired to care).  I think being successful at working nights is all about taking care of yourself and knowing when you are feeling run down and starting to loose focus.  I would hate to make a mistake and really hurt someone.  Gosh, what a horrible thought, but I know it happens and no one is immune.

Nights are calmer, lacking the hustle and bustle of day shift, which makes for a less stressful environment.  I like that.  There are still moments (many of them actually) when I think “why am I doing this?” but taking care of truly sick people continues to be rewarding.  And it’s nice to feel appreciated…like when your 80 year old patient says “God bless” every time you leave the room or when the 90 year old grandma, great-grandma (whatever), offers you a bite of her ice cream at 2:30 in the morning while fully dressed and sitting on her potty chair.  Those are the precious moments.

Week One Completed

My first week in Fort Worth, for lack of a better word, was splendid.  (Actually splendid is a pretty nice descriptor).  I started hospital orientation for Harris Methodist Memorial on Monday.  Six forty five am!  That’s early to have to sit in a classroom.  General hospital orientation is usually pretty boring, but they cut it short and only gave the travelers the info we really needed to know (or are legally obligated to listen to).  This included probably the best HIPPA video I’ve ever seen.  It was on VHS, which totally malfunctioned, forcing our speaker to call engineering to get the tape removed and started again.  Basically this video reminded me of daytime TV…only much more overacted.  The possibility is hard to believe, but trust me, it can be done.  Example:  Neighbor walks by doctor having conversation with patient’s wife.  Neighbor raises eyebrows and eavesdrops on conversation.  Neighbor goes to nurses’ station and asks nurse about patient’s status.  “I heard (insert name here) is dying, is that true?”  Nurse states “yes.”  Patient lives another year, but because of rumors looses his job and is seen sitting on his porch in a wheelchair very depressed.  If they give out awards for HIPPA media, this one should take the cake!

In addition to a lot of listening (or pretending to listen) we had to take a few “tests” in order to prove our competence and safety.  Some were easier than others.  Mostly they involved prioritizing patient situations and giving our rationale for our interventions, i.e. Why are we calling the MD and what information will we give him/her?  What do we do if a patient has a blood transfusion reaction?  Etc.  If we don’t pass the “training” (they prefered it not to be called a test) then we can’t work there, which makes sense because no one wants a nurse who is going to stand around in an emergency without a clue as to what should be done.

We also had to complete about 10 plus hours of computer training.  I am with a really large group of travelers, (apparently the largest group Harris has had) because starting in October they are switching from paper to electronic charting.  The computer modules were overall pointless.  I clicked through as many of the lessons that I could to get to the post-tests, but for a good majority I had to actually wait and watch the mouse move ever so slowly towards the button that would complete the task.  Towards the end my brain was fried so I just let the computer do its thing while I went to the bathroom, took a walk, checked my email, etc. and then came back and took the test.  If you failed you could take them again.  A couple tests allowed you to take them 101 times.  Weird.  You shouldn’t need 101 tries to pass a test on logging into the system (especially when they give you the correct answers), but whatever. 

I anticipate problems with their new charting due to the fact that it is super colorful and complex.  I consider myself very proficient when it comes to electronic charting, but this thing is ridiculous.  Charting should be simple and quick.  With this program there are about 10 tabs on the top of the screen, 10 on the side, and 10-20 more scattered throughout.  The multiple colors and buttons made me feel like I had taken a drug, and unfortunately not a very good one.  Next week I get to sit through 18 more hours of instructor led training on this system.  I like to think positive, so should be fun….

I carpooled with Jonah, one of the nurses who lives here in the complex and whom I will be working with.  Basically our humor is much the same.  Some of the modules were so utterly pointless that we just looked at each other and started to laugh.  It was the kind of laugh you have when you are exhausted and think everything is funny.  I was afraid I was turning into that girl who can’t shut up and distracts everyone else.  However the people sitting behind us were watching old videos of Micheal Jackson dubbed into Indian on YouTube, so I don’t think my laughter was really that out of line, but still I had that fear.  Jonah was also my navigator since every time we walked out of a building it took me a while to get my bearings.  It got so bad that I asked if my lack of direction was annoying.  Of course it wasn’t, he just couldn’t believe that I could get turned around so easily.  Usually my sense of direction is not so poor, but all the buildings are brick and from the outside, at least to me, they look the same.  Plus we were taking elevators and walking underground so my confusion was well warranted, per my opinion.

With work out of the way I accompanied Jonah to a gay bar on Friday.  It was fun.  They had a drag show, and I love a good drag show!  There were 4 girls.  They lip sang to Mariah, Shania, Celine, and Madonna.  Three were good.  The last one was creepy.  I didn’t like looking at her, but she kept trying to make eye contact with me.  Made me uncomfortable.  We left during her last song, but not before I requested Madonna’s Express Yourself.  (Jonah said he would dance with me, but only if that particular song came on).

Yesterday I drove 25 minutes for Wi-fi.  I forgot that although Fort Worth is similar to Seattle in population, the city limits are much larger.  The coffee shop I found myself at may not have even been in Fort Worth, I can’t remember.  All I know is that it was a little too far to drive for an Internet connection.  Once I plugged the address into my GPS and had driven 15 minutes I figured I should just complete the journey and keep going.  So I experienced the effects of Ike in my car amongst the rain and wind.

That’s the update for now.  More adventures and stories to come!

Beware of Scooters

Recently I learned a new hazard of my profession…electric scooters (aka Rascals).  What is considered a “helpful” advantage for the elderly, disabled, or just plain lazy can actually be a threat to those of us who are still fully ambulatory. 

These contraptions have always made me slightly nervous.  I’m not exactly sure why.  Perhaps it has something to do with their awkward size or ability to go a little too fast, but most likely it is due to their drivers.  I’ll admit (because I’ve had the experience), steering one of these things can actually be quite tricky.  Like any motorized vehicle one must practice turns, speeds (yes a picture of a rabbit and a turtle is actually provided), and be familiar with its dimensions. 

This being said, I’ll cut to the chase and give a brief description of my encounter:

Upon giving a patient his pre-op instructions I was accidentally hit by his scooter when he was attempting to leave my cubicle.  Instead of going backward he went forward–right into my chair.  (Luckily he wasn’t going full-throttle on rabbit speed).  Basically I was lightly bumped and uninjured (the chair absorbed most of the impact), but surprised to say the least. 

Given the fact that he was in his eighties and a nice gentleman I was not offended.  Accidents happen.  However after his mistake he did not apologize.  Actually he barely acknowledged it, which leads me to believe this was not the first time for this to occur. 

Of course, as luck would have it, I was his nurse when he came for surgery.  I made a mental note to stay away from his scooter so long as he was on it.  (Anesthesia, being in your eighties, and having a history of bad driving simply do not paint a pretty picture).

Due to my planning I was able to avoid further injury, although on this day I was the one to do something “bad.”   When the patient was ready to get out of bed I went to fetch his ride which was parked out in the hallway.  Upon seeing the scooter I realized I didn’t even know how to turn the thing on.  I pushed a few buttons (actually all of the ones that I could see), but the power remained off.  I had to go back to the room and ask the patient for directions.  Once I got it “running” I attempted to back it up only to have it lurch forward.  Ooops.  To make matters worse it was set on rabbit speed and parked right next to a water fountain.  It was one of those moments where you hope no one is looking, and I’m pretty sure no one was.  I did however manage to put a small dent in the black metal basket hooked on the front (which of course I bent back so that there was no evidence of a collision).  Basically it was an “awkward Aimee moment.”  I was able to remain composed, but had anyone else witnessed it I probably would have cracked up.  Instead I just had a nice internal laugh and returned to the room with a smile, which the patient probably found a bit confusing.

Ever Heard of a Murse?

I’ve learned a lot working at the VA, but perhaps the most important lesson I’ve received is my schooling on a murse, otherwise known as a man’s purse.  First off I’d like to state that this piece is in no way meant to offend or slam men’s accessories.  I of all people am aware that without proper accessorizing true fashion cannot really exist.  Before coming to the VA my knowledge of this important wardrobe stable was mostly limited to its occasional mention in the media.  (Remember the Friend’s episode that paid tribute to Joey’s “man bag?”)  Fortunately, thanks to a very special patient of mine I am now much more familiar with the murse.

 

My lesson began when I called this particular gentleman from the waiting room.  At first nothing about this encounter struck me as odd, but as my patient rose from his seat he reached for and picked up a woman’s handbag.  My initial thought was that the purse belonged to his wife and that maybe she was using the restroom and didn’t want to lug the bag with her, as so many of us women prefer not to do.   For a split second I contemplated asking the patient if he would like to wait until his wife returned, but he had grabbed the bag with such confidence that I chose to refrain.  I was sure that the purse would get back to his wife eventually.

 

Because this individual was scheduled for cataract surgery I needed to confirm his ride home.  When I asked him this question it turned out to not be his wife/girlfriend (you’d be surprised at how many in the over 70 crowd do have girlfriends)/daughter or significant other.  Hmmm…whose purse was he carrying around?  Had he accidentally grabbed the wrong bag? 

 

After he had changed into his hospital gown and settled himself onto the stretcher our conversation went something like this:

 

“So, have you had cataract surgery before?”

“No, but I need to get it done so I can go back to school.”

“Oh that’s great!  What will you study?”

“I’m going to get my pilot’s license, but I have to get the other eye fixed too.”

“Oh….” 

 

(I glance at his birth date; he’s in his 70’s.  I glance at his medical history; no mention of dementia, stroke, etc).  He goes off to surgery.

 

Upon his return this patient was not in my care, but thankfully my co-worker unselfishly shared her experience of his post-operative care with me and so, I was able to learn my valuable lesson.

 

Apparently as this patient was getting ready to go he asked the nurse if she knew the difference between a man and woman’s purse.  Her answer was no.  (We’ve all learned you can’t say yes to these types of questions.  The answer is coming regardless of our desire for free education). 

 

            “Well,” he states, “A man’s purse is organized and a woman’s purse is not, therefore

            this is called  a murse.”  (He opens up his bag and proudly lets her peek inside). 

            “I got this murse at a garage sale.  It was one dollar.” 

 

 

Old People

Yesterday I took care of a 98 year old man. He doesn’t drive, walks to the local market, and is the primary caregiver for his wife with Alzheimer’s. He’s been married for 72 years and 2 weeks. When I asked him how he was, he responded, “terrible,” but had a huge smile on his face. He said that people should not make him angry because he’ll live even longer:

“If I get really angry I might live to be 110 or 115 just to make them mad.”

When he left he asked me if I wanted “boy candy” and handed me 2 tootsie rolls.

I like old people.

Written January 24, 2008

Only at the VA….

Only at the VA does maintenance decide to work on the pipes in the middle of the afternoon resulting in no water pressure.  Fine.  We’re nurses, we adapt, we’re flexible.  We’ll use hand sanitizer instead of lathering up and hope that the water is fixed…soon!

However what do we do with all the “stuff” that starts to accumulate in the toilets?  Hmmm….

Well, since there was no water pressure, or very little to be more precise, I decided that there would be no harm in flushing the toilet (after emptying my patient’s urinal) and waiting to see what happened.  The only problem was I waited too long. 

Basically I had an unfortunate lapse in judgment (either that or I was still feeling comatose from lunch).  After flushing the toilet the water started to get abnormally swirly and loud noises started to come from a very distant and eerie place.  Instead of backing away from the thrown (as most alert people would have done), I stayed and marveled at the show.  Big mistake!  What was I expecting to see?

As the noise got louder and the water more violent (by now it was starting to overflow) I decided that I needed to bolt and FAST.  Unfortunately I couldn’t get out of there quick enough.  The toilet made one last grunt and water shot out.  I was nearly out of spraying distance, but with my body half turned the VA’s mysterious water managed to splatter my left leg and one small, but very disturbing drop landed on yes, my face. 

Needless to say I was extremely disgusted.  The water appeared “clean.”  It was clear with no indication of sediments, but come on, how clean can toilet water really be?  I felt the cool moisture penetrating my scrubs and manifesting itself on my skin.  I was angry.  I told my co-workers what had happened and warned them not to flush the toilets unless they too wanted a very unclean and unexpected shower.  Basically my experience became a source of entertainment for the mid-afternoon lull.

Thirteen more weeks and counting!  If this had happened at any other institution I would probably have been more likely to laugh it off (while still feeling very appalled), but let’s face it, things of this nature are just more likely to happen only at the VA.