Tuesday, April 29, 2008

regardless

I ran by this sign the other day on the sidewalk outside a church in my neighborhood. It made me think. I appreciate and value the message conveyed, and it doesn't surprise me that this sign would be outside a Portland church. But why do we need the sign in the first place?! I wish these things were a given.

Tuesday, April 22, 2008

5:25 am

Prize for anyone who knows the meanings of these silly acronyms which fill my brain and documentation while I work...
TBI
PPH
SBAR
GVHD
VRE
CSA
MUD
MONA
CDB
OU
FK506
CMP

Monday, April 21, 2008

additional workout



These are "the stairs" which Katie introduced me to soon after I got to Portland. They are found at one of the entrances to Mount Tabor Park, a great hilly park near my apartment. The picture doesn't do the experience justice; there are 250 stairs total, and I still can't run them all....however 6 trips up and down them quickly proves to be quite a workout! One day I will make it to the top running....

Thursday, April 17, 2008

Monday, April 14, 2008

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...

Monday, April 7, 2008

Hillsboro family helps rescue Cambodian sex slaves

I met James during the last few weeks I spent in Phnom Penh. This was on the news here in Oregon just a few weeks ago, and I am so thankful that injustices like this and the people who do something about them could be on the news here; and therefore raising awareness and educating more and more Americans. Please read this article!

11:09 AM PDT on Monday, March 17, 2008
By WAYNE HAVRELLY, for kgw.com

As the Pond family sits around the dining room table playing trivial pursuit, they appear to be the typical American family.
They’re not. Anything that was typical changed forever after watching a Dateline NBC investigation four years ago. The story about Cambodian children being sold to sex peddlers touched the family so deeply, James Pond, a father three, quit his six figure sales job and traveled to Cambodia to see what could be done to help.
“We were seeing pedophiles walking up and down the riverfront purchasing kids," James Pond said. Pond knew he could make a difference, but only if his family wanted the same thing. “We were trying to teach our kids you can do more in life and we should all be helping others, but we really didn’t have an outlet for that before this,” his wife, Athena, said.
It was a unanimous vote, so the Ponds sold nearly everything they owned and moved to Cambodia to open a transitional housing center for girls rescued from brothels. Fourteen-year-old Srey Neth was sold by her mother for $300.
“Her virginity was sold a week later for the same $300 she was sold for. After that, she was forced into a brothel where she saw 10 to 20 men a day," said James Pond. Neth was rescued. After two years with the Pond family, she's now working for their Oregon-based charity called Transitions Cambodia. “She's not just our voice, she's the voice of every girl that’s ever been through something like this,” said Pond. Transitions Cambodia now provides shelter, support and vocational training to about 20 rescued girls each year. The Ponds run the charity from their Hillsboro home. They have a staff of ten running the program in Cambodia. They recently moved back to the US to raise awareness about the child sex issue. They hope that will lead to more financial support, which will enable them to open even more shelters in Cambodia and other countries around the world. They said what started out as an idea after watching Dateline NBC has turned into a lifetime commitment. They hope to create awareness on a large scale starting in Portland and spreading all across America.

For more information go to the charities website at:
Transitionscambodia.org

Tuesday, April 1, 2008

xoxoxo!

Can anyone give me their opinion?! Hugs and kisses...XOXOXO... No, the question is not, "which is better?" (am I allowed to say both?!) But when you write XOXO before your name on a card or letter, which is which?! I have heard a number of arguments for each... still not sure which is correct... but who says, anyway?! Any thoughts?! Comments please! (and yes, I AM a physical touch person... no one else would write an entry about something so silly!)