i feel no sense of community here. maybe i have a skewed definition of community. maybe i have different values than my friends. maybe i have no friends? maybe that is because i have different values or define "community" differently.
i'm looking forward to a change. to a fresh start. i was ambivalent at first. moving across the country is a huge decision. frightening, even. but exciting as well. the gears are in motion. 2010 will be a bit of a different year. it's about time.
2009. it's been a doozy. i graduated university with a degree in nursing. got a job on a neuro & trauma unit. explored turkey for a couple of weeks. got engaged in a hot air balloon over fairy mountains in goreme, cappadocia (central turkey) wrote my RN exam...and passed. played my first show as one half of nascent state. added a link to the chain with a bike ride to niagara falls. got a few camping trips in this summer and up to algonquin for thanksgiving to cook a bird over the fire. witnessed the birth of my nephew, jackson philip. that same day, tested for my 2nd degree black belt in karate...and was successful! shortly after, experienced the death of my dear nonna.
this is, by far, one of my most favourite patients ever. a horribly sad story, she was almost killed by her brother and his girlfriend...they attempted murder and left her with a closed head injury, subdural hematoma, a gash in her neck so big that i'm surprised she's still alive, and ultimately a traumatic brain injury... she has improved dramatically in the few months she's been here, but has gone between our trauma unit and the trauma/neuro ICU multiple times, near death, battling multiple infections, and the deepest pressure sores i have ever seen... she is now eating and talking and moving, but is moody, sometimes agitated, sometimes tearful, confused as to place and time and generally everything, but i am sure that she has brief moments of lucidity...and she's just funny as all hell sometimes... ~
on initial assessment, trying to locate the pt's feet under a gazillion blankets:
me: where are your feet? pt: i usually like to find them at the bottom of my ankles.
on the afterlife...
me: do you still talk to your mom? pt: well she's dead, so it's a little difficult...of course, i still do sometimes
on italian heritage... (which, by the way, she is not...but i am...and she seemed to be using random memories as her own experiences to share with me...too funny)
pt: i mean, how many pictures of an italian horse do i really need?
leaving the room:
pt: be careful! me: why? pt: it's crazy out there.
as i was sleeping off my night shift last night i began dreaming of intermittent catheters and giving myself an IMC...only to wake up and realize i had to pee like crazy.
did you smile when you saw the light? did you finally give in...or had you been waiting? the bittersweet irony of choking on chicoria. oh irony, how i love you so. you make life worth living (dying for?)
my sweet sweet nonna. i cried. but i'm not sure if it was because society tells us to cry at death. because really, with any faith, should we not be celebrating life?
on days off, my ritual consists of sittin my ass on the couch with a coffee, reading email (well, if any of my 4 friends send me anything), catching up on my favourite blogs and sites, all the while on msn with mum, whose office life is anything but exciting...not that i'm any more exciting than her work environment, but we all need a little distraction in our lives...
so telling her about the lost ring and my thought of getting my wedding band tattooed on my finger (this isn't the first ring i've lost), she writes:
maybe you should hang them on a chain around your neck, you never lost your house key when you were a kid and it hung around your neck, lol
when the weather starts to turn, i start to wuss out of riding my bike for transportation. the only thing i like about riding the ttc is listening to my ipod, reading a book, and occasionally looking up to people watch and make up stories about my fellow passengers...
== his eyes tell the truth. he loves you. and even if you see it, you'll treat him like shit for years. and yet his love--it's relentless. he won't care when you hate yourself for putting on a few extra pounds. he'll love you even more. he will always see you. on the inside. and no matter how much that scares you, it's real.
in a patient's bed linens? down the laundry chute? in a latex glove, in the trash? down the garbage chute? i may never know. the ring that was given to me by the love of my life after 11 years of togetherness. the ring that was so unexpected and wonderfully surprising and in such a beautiful place. i haven't felt this terrible in a long long time. "it's just a ring" he says. what remains is a non-tanned strip of white skin on my ring finger and this photo:
i think i'm more upset with myself for 3 things. 1. for not getting the ring re-sized sooner, so it wouldn't fall off my finger. 2. for wearing it to work anyways. 3. for not noticing when and where it fell off.
i need an apple dessert recipe that can double as a birthday type dessert and something easy to transport on a camping trip for thanksgiving dinner...something i can warm on the fire. this will involve a little leg work. i need something i can make ahead of time and possibly freeze, before leaving to go up north. something that can make it until sunday in a cooler, and will go well with a bird cooked over hot coals. something i could potentially stick a candle in. something gillian gellybeans would enjoy for her birthday cake. and something that really tastes like the apple-y goodness of fall. i have a ton of tasty apples. ones that are perfect for a dessert. but i want to taste fall. i want the dessert to taste like tasty, delicious october apples...and possibly be gluten free...and vegan? hmmmm.
...at my new fangled healthcare job that is...not in life...gawd no...in life, i've come across many, but as a freshie RN, recently released on my own sans preceptor/mentor, this was tough.
my first night of 3 in a row and i had 6 patients...4 of which were in a "high observation" room, meaning that a clinical assistant (CA) is always in the room as these 4 patients are prone to being agitated, pulling tubes out, at an extra high risk for falls, or some other reason that they need 24/7 watch. as i walked in the room, one of these women is already quite agitated and insisting she leave at once. but you see, this woman has a brain injury, and her communication was a word salad at best. funny thing is, i could totally understand what she was trying to say most times, just by her tone and intonation, and the odd word that came out correct (she hated me, that part was clear)...but for the most part, i can only imagine how frustrating it must be for her to not have the right articulation. the CA was having trouble keeping watch over 4 patients and trying to keep this woman in the room, so two CAs got her in to bed and applied the wrist restraints.
wrist restraints already come with a whole not-so-nice-human rights-ish vibe to me, let alone the ethical issues...i have a fantastic team and there are a couple of charge nurses that i felt really comfortable talking to, despite my being new. because not only did i have to restrain her for most of the weekend with physical restraints, but after coming back for saturday night and finding out that other staff was pissed that i didn't give her the haldol on saturday morning, which apparently then caused her to be "restless and agitated and exi-seeking all day" (like she wasn't already) on sunday morning 4 of us had to hold her down, give her the IM shot of haldol while putting on the wrist restraints... so not just physical restraints, but medical restraint...straight out of a 1950s "insane asylum" movie. it just doesn't feel right to me, but my charge's counter was that she was not safe in the outside world because of her lack of communication, and obvious brain injury. point-counterpoint. oh, and did i mention she was mrsa+? uh, yeah. that news came in on saturday, in the middle of the night. so not only do we have to keep her on the unit, we have to keep her in her room, and not let her touch anything... rrriiiigghht.
monday morning i decided not to give her the haldol. she was redirectable to an extent. she was exit-seeking, but willing to stay sitting on her bed. she was under the CA's watch. she was o.k. so i mentioned it to the charge, then i mentioned it to the RN covering during report and shift change. all was fine. all was good. 3 nights of craziness and i went home to sleep like a log. fast forward to dinner time, where my man had come home from work wanting to take me out to eat. i was on the phone with fido, so bob turns on the 6 o'clock news while he's waiting.
bob (poking me and pointing to the tv): uh, uh, hey babe? me (finger over lips, mouthing): shhh. i'm on the phone bob: but, um, hey...look me (giving the angry eyes, mouthing shut up)... bob: you might want to see this at which point i turned to the tv to see a fuzzy security camera pic of my crazy lady (!!) exiting the hospital entrance in her gown, sunglasses, lei around her neck, purse slung on her shoulder... me: holy crap! hang on (i yell to the poor fido rep) bob: i kinda had a feeling that's who you were talking about (note: even though i tell him random stuff, i still keep a certain standard of confidentiality...yes, yes, i do) me: that's her! that's my girl! oh my god! what did they say? did they say when she escaped? what's the story? bob: i don't know. i couldn't hear because someone was on the phone. (smart-ass -ed.)
i freaked out a little, thinking because i didn't give her the haldol that morning, she had escaped during the changeover when there is way less staff on the floor...but no, she left in the late morning, when the CA had let her walk out and not called security. so she got free. (they found her later in the afternoon, at a friend's house in the east end. how the taxi driver knew where to take her is beyond me. what does that say about our city's taxi drivers? wow) i must say, i am so impressed by her determinism. scary, but she is just so damn resilient. it's amazing, really.
i have had her as a patient since then. just yesterday, in fact. still as exit-seeking as ever. on 1:1 constant observation. even in 4 point leather lockable wrist restraints. they discontinued the haldol, because really, what's the point? it didn't even work for her.
when i came in yesterday she only had one restraint on, her left wrist. and she managed to contort out of it by mid-morning. if you can believe it. it didn't really surprise me. security was called twice. first time, we gave her ativan. didn't work (surprise!) second time, we held her down to put her in restraints. and she cried. and i almost did too.
bob and i often find ourselves walking around a book store after a dinner out. yes, our dates end with book shopping...we are serious nerds. bob saw me take an interest in this book, that he promptly bought for me as Book City was closing its lights for the night.
i told T this and added "do you think he thinks i have an eating disorder?" "do you?" was her reply
it made me think. i've never been anorexic (love food way too much) i've never had the guts (so to speak) to purge, so bulimia is not a label for me. but i do binge eat. probably emotional. usually anger.most often because i get so frustrated that i care so much about what i eat. because i get so frustrated that the whole idea of "healthy" eating and body image consumes my thoughts. and then i eat to say "fuck it!" does that even make sense?
i have an unhealthy relationship with food, and yet, on a whole, i eat really, really "healthy". but i don't always want to. and when i don't i feel guilt. horrible, horrible guilt. and i don't want to do that either. and that gets me so angry. it's a vicious cycle.
unfortunately, binge eating disorder isn't really classified as a disorder in the DSM-IV without the purge to go along with it. so does this count? the author of the book so far is arguing that yes, these unhealthy relationships with eating and self-image are forms of eating disorders that largely go unnoticed--and they affect much older women than the public thinks "classic" eating disorders usually affect, like teen girls. but these days, doesn't that mean that every woman would have some sort of eating disorder? our society is so caught up in dieting and thinness that i feel no woman can escape this. and it's makes me angry because i never used to be like this.
i used to be 30 lbs heavier...and happier (once i left the house and didn't have to listen to my dad's unhealthy "teasing" anymore) it took some menstruation and hormone issues and one trip to an endocrinologist to finally see that i wasn't at a "healthy" weight...so i began to eat better, bought a bike, started training in karate... but then i ran a marathon, got really thin and the issues started. to put weight back on seems like the biggest issue in the world and i hate that. i never cared about body image, i never cared for falling in with societal norms...i only always wanted to be happy and healthy...but by what definition? it seems so muddled now. so it is SO goddamn annoying for this to be in my thoughts and contributing to me being unhappy with myself. it seems so complicated. and i just want to be able to celebrate the fact that with a 15lb weight gain i also quit smoking, finished 4 years of university, and have more time to hang out and have a beer and nachos with my man. the obsession has to stop.
i only see my best friend once every few months. we make all these grandiose plans and they never pan out. instead, we end up meeting at a second cup halfway between my place and hers to chat over my soy latte and her skinny chocolate chiller.
you see, my best friend has been battling addiction, depression and anxiety issues for more than 4 years now....although it could be argued for the better part of her life. being clean for the last year has put her in a position to examine her life and find the things that make her happiest, but has also kept her from holding down a steady job (or have one that she has been on leave from for 4 months), leave the house regularly, or engage in social activities. she wants to live her life and enjoy her life, not be bogged down with mental health issues. so our conversations are usually pretty heavy (albeit peppered with bits of comic relief due to T's obsession over celebrity lives...which would normally turn me off, but in T's case i know it is such a sense of enjoyment for her to be a part of the cult of celebrity just to laugh her ass off at the idiocy of it all) but our meetings and chats are generally mirrored and whether T knows this or not, they are just as therapeutic for me as they are for her. hence this new, somewhat sporadic, feature: conversations with T
patient: how old are you? me: 32 patient: why do you look 17? me: genes, i guess patient: what are your friends going to say when you tell them you bathe old men?
~ on dating
(me, wearing glasses) patient: men don't make passes at girls with glasses
~ on hospital food
me: aren't you hungry? patient: let me put it this way, the food here is less than desirable.
