Well, friends. We’ve reached the end.

I’ve decided, after lots and lots of thinking, that it’s time shut down this blog. There reasons are many.

First of all, I have to be extra, extra, extra careful of HIPAA precautions these days. A few months ago, a coworker came across my blog randomly. She knew right away who it belonged to, which means I haven’t done the best job of keeping myself as anonymous as I’d like

Second, now that I’ve moved out of the country, my location and thus, my hospital, could be much more easily identified based on my posts. I’m not willing to take that chance anymore.

Third, I am not a nursing student anymore. I’m an experienced nurse on my second job. I’m going to be expected to precept and take charge roles and be a role model, and crap like that. If I’m going to continue to write, I’m going to have to find a new way of writing; a new vision. I know it won’t be hard to find, but right now I’ve got to concentrate on some different things first.

It’s been a pleasure. You can always find me at caroline at gmail dot com.

Thanks for reading.

Readers,

Big news: I am currently in the process of moving abroad for a new ICU job! Needless to say, things are just a bit hectic, and I’m having trouble finding time to blog. I’m going to hold off posting until July, until something really pivotal happens. (In nursing, you never know…) I hope you’ll keep me in your feeds, as I promise to be back with a lot of new and interesting adventures, and I may even pop in before that. I’ll be reading…and I’ll be back.

Sincerely,

Caroline

Sorry for the slow, behind-schedule posting of this shout-out, but I wanted to let you all know that Change of shift is up at NurseMe! Check it out here. As usual, a great source of info for nurses everywhere.

Well past my first year as a nurse, and yet I’m still having firsts! That is what I love about nursing.

Today,  my first patient left AMA. And I was thrilled to see him go, not because I wanted him gone or because he was particularly nasty to me, but because I was elated to see someone advocating for themself. Secretly, I saw it as a giant middle finger to all the providers (nurses AND doctors) who had jacked things up for him. I couldn’t wait to be the one to cut off his ID badge. One of the statements I heard at the final family conference pretty much summed it up:

“The ball is my court now, bitches.”

The man had been jerked around for at least 2 days, and prior to this, probably months. It was a prime example of how the health care system can fail someone. And as providers, we ought to have been ashamed. There was an incredible lack of flexibility, and absolutely no communication. The right hand and the left hand were definitely not talking. Hell, they were probably not even attached to the same body. I was really appauled at how this patient got pushed to the bottom of the priority list. Of course, his medical issues were being well-addressed. But the patient was forgotten.

Some of the highlights of this case were the long conversations with the man and his wife, the times when I felt like I was the one that was hearing their problems. I felt honored that the man allowed himself to get angry in front of me. I took it as a sign of his trust.  I stood up for the guy, even when the doctors were all mad at me for taking 5 minutes out of their day. It’s funny how the most frustrating situations for the patients can turn into the moments that I really treasure. Those are the times when I feel most human, and most like a “nurse,” and that’s when I find my voice. It sure as hell isn’t all about titrating drips.

Frankly, I totally suck about posting links to other blogs. Sorry, nurses! I’ll try to do better. In the meantime, Change of Shift is up at the Millionaire Nurse Blog!

I basically sacrificed my scrubs to Haiti. I mean, they were disgusting. The place was hot and humid. We sweated all day and most of the night. Not to mention the parasites and other diseases that our scrubs took the brunt of while we were there.

Scrubsgallery.com is offering 15% off Cherokee Workwear Scrubs to those of you in the same position as me, or even those of you who just need new scrubs. If you decided you don’t want Cherokee, there’s about a million other things to choose from, including shoes, magazines, and gadgets.

Scrubsgallery.com has been a longtime, faithful, and very patient sponsor of this blog, so even if you don’t buy now, I hope you’ll consider supporting them next time you’re in the market for medical supplies.

There are no words to describe the place, but I’ll try anyway. It’s amazing how 10 days can change you.

My notes are a total mess. I’m working the next 5 out of 6 days. Give me some time to get it together, then I’ll share everything. I’m going to backdate the posts so they reflect the actual timeline, so you may have to look backwards to find the new stuff!

Weird day. Major guilt. Seeing weird stuff at night. There is a lot of hero-shit going on here, and in a way, I can’t subscribe to it. I’m no hero; far from it, especially because I take so much from just being here. Being a hero implies altruism, right?

Can’t believe my time here is almost over. I must say that today was full of sadness, guilt, and frustration. A large part of me feels like I accomplished very little. In truth, I know it is all relative to the size of the problem. Wnat to stay but can’t keep up this pace. Tonight I oriented new nurses to ICU/post-op. Realized how far I’ve come. I recognized the terror on their faces but no longer felt it in myself. Knew I had to let them fly, and couldn’t stay there all night. My chest tube patient is going home tomorrow. (Home? Ha.) She still has no lung sounds on the right. She would call out to me to come over and visit her ever single time I entered the room. I think all she wanted was a little love. I let her listen to her own lung sounds, then mine, and then gave her my pen which she was really excited about. These people make you feel like a celebrity all the time…

The people I will miss the most…The Haitians.

**I warned you that my notes are a mess! Now the dates are starting to blend in…**

I love my job description. I could do this forever. The pace is different and so is the job. I’m managing people and communication and not doing as much patient care as I expected. Hanging out with the surgeons and doctors more than anyone. We have a good time. We share tuna and macaroni and cheese and a random can of spaghetti o’s. They are open to teaching me things. I am a sponge here. A hot, sweaty, sponge.

I was told I could extend my contract and stay. There is nothing I want more than to do just that. If I didn’t have a life at home, I would never come back to the States. However, I have to trust that, however unfortunate, there will be other disasters in my future…although truthfully, this experience would be lost without the people that have made it so wonderful and rich. I will be forever grateful to each and every one of them; I’ve learned lessons from them all, even the annoying ones who don’t show up to work (yes, they do exist! Even down here!) I’m reminded of that dorky poem about “Footprints” that seems to be hanging on the door of every nursing home resident in the United States…

I don’t always feel like I am doing any outward good. Sometimes, I make them laugh or smile, or forget about the horror for 5 seconds. They love to watch me dance, perhaps because I am a skinny, no-assed, white girl with obscenely short hair and a nose piercing. Medically, I don’t feel altruistic at all. But is it wrong for me to get more out of this experience than them? Sometimes I feel that happening. I’ll go home to my cushy, 2 car garage and health insurance with lots of interesting stories. They’ll leave the hospital and have to struggle to find food for tomorrow. Sometimes, all I see is hopelessness, no matter what we do. So many of our processes and efforts feel futile…then again, how is that any different than the States? Yeah, right. I kid myself.

Today I was so sweaty that I found a thermometer stuck to my arm…at dinner. Wonder how long it had been there. Losing weight, and had my head basically shaved out back behind a shed with medical scissors that I wiped down with an alcohol swab. It’s just too hot for hair, here. No diarrhea yet! Amazing. Tomorrow is another day.

Scrubbed for a crash c-section! OMG, when could I ever do that in the States? Charge nurse (or something kind of like it…) in peds. I’m not perfect at managing kids AND Haitian nurses AND translators, but hey, I’ve only ever done 2 days of peds in my life and a full zero days of charge/management stuff. I’m giving myself some freaking credit.

I also saw a vaginal delivery. It was full of screaming and sweating and pain. I would scream, too. It was about 110 degrees in the room she delivered. And in the end, it wasn’t the happy, tearful occasion that so many American moms are blessed with. Instead, it as “business as usual” and “another mouth to feed.” At least that’s what it felt like to me. No tears of joy, that’s for sure. And no dads. Hell, Mom was just a kid, herself. Of course, no “accessories” like birthing pools, or even an epidural. Really, an IV with a shot of morphine would have been considered quite the luxury. The woman is probably just thankful she’s not standing outside behind a sandwiched building, ankle deep in sewage, sharing her delivery with God knows how many dead bodies that will never be found among the rubble. The irony of life and death in Haiti. Part of me actually mourned the birth of this baby. Her name was Fifi, and she’ll likely never know even the slightest privilege that American kids consider routine. Fifi will be lucky to see her first birthday at the rate this country is going. Then again, the Haitians love their babies, and just this observation makes me boil with anger at the “missionaries” who tried to take a bunch of kids out of the country after the quake. What a bunch of dumb asses. The Haitians treat their kids better than we do, without all the organic food, big screen TVs, and designer shoes. Yesterday, I saw a Haitian kid go flying across the room after his mom backhanded him for something. But even with the  harsh discipline, I won’t interfere with their culture, and I have seen many other moments that prove to me that these people love their children, and sometimes, love is enough.

OB nursing is not my thing. If I never seen another vaginal delivery, I will still die feeling very pleased with all that I have seen and accomplished. Sorry, but watching a woman stretch like that is just not…right.

My last thought of the day…part of me wishes I had become a surgeon. For years I thought very seriously about orthopedics. Here in Haiti, I’m jealous of their ability to see problems and fix them, day in and day out. A broken bone gets and external fixator. Problem solved. As a nurse, or at least as an observer outside of the OR, I see problems…immense problems, that cannot be fixed. It hurts me. I long for a small, tangible problem that can be solved. I’m not saying the surgeons have easy jobs. In fact, it’s not about them at all. It’s about feeling helpless, and wishing to find a missing puzzle piece that fits perfectly into its spot.. Unfortunately, here there are just too many puzzles to solve, and the pieces are scattered across the floor, and I’m a blind woman in a dark room.