once again, I'm a nurse!

I have recently been reminded that I am a capable nurse...it took about five 12 hour shifts back on the bone marrow transplant unit and now I feel like I'm back. Since I haven't worked on a hospital unit for about 8 months, when I did come back last week, I felt like it had been a lot longer. I found myself thinking, "wait, how did I get this job?!"

It's not that I didn't think I was capable. It's just sometimes the responsibility just hits me and it is really humbling. I don't think about it too much though, because then it is scary.

It really is a job filled with craziness. oddities, and lessons.

In the past three night shifts, I have given blood and platelet transfusions, had patients getting continuous chemotherapy with all sorts of frequent monitoring, had some critical labs values called in to me at 2:30am, donned a hepa filtered air mask (conveniently over my entire head!) complete with a gown and gloves, to protect myself from a respiratory virus as well as the room filled with the mist of a continuous medication tent in which "the long term effects have not been established"... but do warn of potential birth defects.

"You aren't pregnant, are you?" a co-worker asked. No.
These, I learned,  are the important things to note when you breathe in chemo fumes as well as have contact with all sorts of other toxic things working in oncology. Working with the substances that not only kill cancer cells, but other things too; sometimes I wonder if it's just as harmful to the staff as it might be to a fetus.

But I like it enough to come back. Sometimes I think I can learn something from my patients' amazing attitudes and perspectives. One, having just been given a stage 4 metastatic cancer diagnosis while he is still in college, I overheard talking to a friend on the phone... "I'm not dying..." he stated very matter-of-factly, as the chemo dripped into a port in his chest. It made me stop and wonder what kind of words would I speak, and what would nurses think of me if I were in that place? I can't say for sure, but I wonder if I would be so positive.

I had a seemingly perfectly healthy patient who was back in for this third transplant, having relapsed after both of the others. He was in getting the first round of chemo; again. Yet his quality of life is good, so for him, it makes sense. He is strong in a way I don't know if I would be.

I found a razor and shaving cream in one of my male patients rooms. "Did you shave today?" I asked him. "No, I am going to in the morning." he stated. "I'm sorry, we can't allow you to use that razor while you're here... how's that for a rule?" I teased him. I went on to explain that a small cut could cause bleeding that might not stop, due to his lab values. He just nodded in agreement. "I'm sorry..." I told him.

How awful. We don't let many of our patients shave, brush their teeth, or use normal mouthwash. We sometimes assist them to shave off their hair. We make them get up and walk in the halls or on the treadmill a few times a day, even if they don't want to. We wake them up at 4am to take their vital signs and watch them even in the bathroom. We ask them all sorts of questions about their bowel habits. We shine a flashlight in their eyes and mouth. To me, these things are normal and make sense. But what an odd experience for those we care for.
  
Last night I watched one of my patients like a hawk because I just had that feeling something wasn't right....he kept mumbling in his sleep and shaking a little, along with some worrisome lab values and other potential problems. But every half hour or less when I donned all the appropriate gear and entered his room and woke him up to make him answer another one of my questions, he woke and told me the correct answer to everything I asked. He stuck out his tongue and squeezed my hands hard enough. Complete with stable vitals signs and other appropriate findings, I couldn't find anything exactly wrong... so I just kept staring in through his window.

I wonder now how he is now, and what the doctors found out about him today. Yes, I will back in a few nights, but obviously a lot can change by then. Although one of the things I like about my job is that I don't take it home with me in a traditional sense, yet almost every shift, I take something home. A prayer for someones particular situation, hope that my patients will be well cared for after I leave them in someone elses care, disappointment in the way some situations end up, sorrow at family members lack of understanding, sometimes anger at the doctors and the way some situations are handled.

Despite the fact it can be stressful, busy, chaotic, difficult, and sad...I am happy to be back in the hospital. I am grateful I found something which challenges me; and each time I go to work I have a new experience and get a natural "in" in someones life. Even if I sometimes wonder how I got this job, I am glad that I got it, and am happy to be back. Let the chaos and craziness continue. And may I remember that it's not normal to be woken up at 4am...