Saturday, March 29, 2008

You're going to feel a little poke...

This is something I say an average of 50 times a night while at work. I say it no matter how big the needle is, where it is going, and regardless of whether the patient is conscious enough to hear me, let alone feel anything. Yes, I have said the words 'You're going to feel a little poke' while holding a 14 gauge (slightly smaller than a ballpoint pen) needle over the arm of a not-officially-dead-yet-but-we-all-know-what-is-coming unconscious patient whom we are both breathing for and pumping their heart. It gets to be habit. One of those things that automatically falls out of your mouth. It's as much a part of the procedure as putting on the tourniquet. Very routine and mundane ...until...

So, there is a Friends moment for every situation you will come across in life. I have been saying this since I was 11 when the show first began, and it was true last night at work as well. There was an episode (I'm thinking around season 5 or 6) where Rachel decides she's going to complete the crossword puzzle in the NY Times all by herself --something she's never done that before. When she finishes, she is by herself in Central Perk, jumps up enthusiastically and says, "I did it! I did it ...and there's no one here to hug!" This was me at work last night (that would be early this morning for those of you who sleep when it is dark outside :) ) Only no crosswords were involved. No where in the US will you find an ER where the staff has time to do crossword puzzles on a Friday night --especially after last call.

In other places I've worked, Respiratory Therapy has been in charge of drawing arterial blood gasses. For those of you who don't know, an ABG is a small sample of blood taken directly from an artery (usually the radial artery --on the inside of your wrist where you would normally count your pulse) It's a little more difficult than your routine blood draw and IV start --artery walls are much thicker and deeper --and closer to bone and nerves. People don't like you when you hit their bones and nerves with sharp needles. Until today, this has never been a problem for me -whenever I've needed one drawn, I've just paged RT. Well, last night my very sick diabetic patient who was not doing well needed a blood gas drawn. At this hospital, the ER nurses draw their own. RT gets the ones on the floor, and are available for backup (like in a code situation.) Generally in the medical profession, we operate on a 'see one, do one, teach one' basis. However, in a busy urban ER on a Friday night, my fellow nurses were all busy trying to save their own patients lives --I would have to bypass the first step. I actually called RT for reinforcements (this took a giant gulp of swallowing my ego and stooping to the level of a floor nurse -gasp!) but they were busy in the NICU. I got a brief set of instructions over the phone, and decided that I could handle it. I really had no other option --my patient was sick. How hard can it be right?

So I get all the stuff together and head into my patients room and under the very watchful eye of her family explained what I was doing as I felt for the artery, said 'you're going to feel a little poke,' stuck the needle in and got it on the first try! It took some work to not appear too pleased with myself. My patient could not appreciate the magnitude of the procedure I just performed, neither could her family --they were all under the impression I had done this before. Trick of the trade -- NEVER tell the patient things like, 'yes, this is my first one' or admit that your nervous, and you never let your hand shake. Even if all the above are true. If you don't feel comfortable to be doing the procedure confidently, then you shouldn't be doing it.

Back to my original point. When I was done, I refrained from jumping up and down, but in my head I was screaming 'I did it! I did it!' Then when I walked out of the room, there was no one to hug! Sad! My coworkers who would have appreciated the magnitude of the story were all otherwise occupied, and the tech I was working with was not the hugging type. So I settled for coming home and writing about it.

The commute home gave me time to think ...I was still immensely proud of myself, and in the car by myself I could grin all I wanted at my accomplishment. The thing is though, the things I've learned while being a nurse apply to much more than just getting a blood gas. Life is really about how you sell it. There is a lot to be said for taking the bull by the horns. I wasn't going into this blind, I had all the preparation I needed, and if I wouldn't have felt comfortable doing the procedure, or if it would have been outside the scope of my practice, I certainly wouldn't have done it. But sometimes in life, you have to push along with a confident smile on your face --no matter how nervous you are on the inside --bite the bullet and do what needs to be done. No whining, or procrastinating. I felt good leaving work today knowing that I helped my patient, and that she got better quicker because I was able to do so. And I felt good leaving that patients room and having them think that for me this had been just another routine part of my day. Just like starting the two large bore IVs that I had done earlier -something I have literally done tens of thousands of. I do wish though that someone had been there to hug!

Tuesday, March 25, 2008


So this is what comes of me being too bored. I'm sitting here in my apartment in Seattle, and it's raining ...which is great. I love the rain. Really. The thing is, I've had the last three days off work, and most of my work friends have not. So, I've read two entire books (that I've already read twice) ran 24 miles on the treadmill, watched so much SportsCenter I could quote it, scrapbooked until all remaining creativity dissappeared, checked all my email accounts, read every update available on the Yankees, and spent hours on facebook. Oh, and during the few hours of sunshine yesterday I walked all over downtown Seattle and Pioneer Square. Essentially, I've ran out of things to do inside, and it's to wet to do anything outside. So I've been inspired by all my great blogging friends, (and a little by all the boredom :) ) to start my own blog. I actually had a recent conversation with one of them about how I didn't feel the world was ready for another websited dedicated entirely to me :) I'll try to keep it updatedfairly often.

For those of you who I havent' talked to in a while, I suppose I'll give you the rundown. I'm currently in Seattle working as an RN in an Emergency Room. I'm a travel nurse, which essentially means I get paid to live on vacation. I tell the company I work for where I want to go, and they find me a job and an apartment, and then bankroll the whole project :) I contract with each hospital for 13 weeks, and have the option to extend my contract if I choose. I absolutely love it! So far I've been to Long Island NY, Orange County CA, and now Seattle WA. Don't ask me to pick a favorite, I've loved them all!

So, the title. I pondered for an unbelieveable amount of time over what to title my blog! I wanted something that reflected me. I love things that sparkle, shine, smell nice, and feel good ...and I love trauma! The more blood and guts and spouting chest wounds the better! Intereting dichotomy, I know :) For all the sparkly shiny stuff, I'm really not a pink frilly person, I like to keep it real. I love all things Yankees, Ocean, and Sunshine, and now I have to go! Dinner plans on the pier ...did I mention I love Seattle?!