From Jackie to John...Godspeed...& ThankYou

Everything in life happens for a reason, cliche maybe,  but I believe it, really believe it ... I think it might be one of the few principles I truly believe in.  As this group of musings grows the examples of how this has become a driving force in my life will be examined but let me start with today.  I arrived to a single patient assignment with the potential for an admission.  How I was chosen for this designation is convoluded including a broken hip...or two...a missed promotion...or two...and assorted scheduling phenomenon that only another critical care nurse, mother of 2, wife of a cop, could understand.  my goal it seemed was to keep my patient stable for transfer to the mothership...It seemed simple enough...until I looked at him.  On first glance that inner screech went off ..the screech that signals "that ain't right" and sounds in my head like one of those cartoon character sudden stops.  15 years of critical care told me that was not going to happen.  Suddenly though it all seemed eerily familiar.  I was about to embark on a life changing day and I knew it...
Jackie had been my first admit, screech, crash, burn and die all in an eight hour shift patient.  She was the kind of patient that HH & I were still trying to send to "the unit"  except ...damn...we were "the unit".  In the months, and yes decade and a half that followed I never forgot her or the lingering self doubt that made me wonder, if I had been a more experienced ICU nurse would her outcome or course been any different? While 15 years taught me that you can't ...and shouldn't save them all, the thought of her young daughter stayed with me.   Today as I watched the events unfold my frustration grew. As I stood in the utility room looking for another piece of equipment that in all reality was going to be as useful as rearranging the deck chairs on the Titanic the frustration came flowing out as a reponse to the simple "can I get you something" offer from the charge nurse..."this man is dying right in front of me and there isn't a damn thing I can do"...And so he did. We gave him everything until his wife came to realize what I had known since early that morning, and then we simply gave him peace...what every patient whose quality or quantity of life is about to take a dive deserves.  What that grieving family will never know is that with his passing John gave me a sense of peace...one that was 15 years coming.  And for that I will forever remember and be grateful to him...      

Some days are just better than others...

Every now and then I am forced to accept that all days do not have meatloaf on the menu...that sometimes my "enduring sense of tragedy" must take a back seat to a temporary moment of joy...and life is indeed good.  Tonite the widowmaker failed to live up to its name and someone dear will see another day because of what we do ...well not so much me...I don't do cardiac...but I do know the widowmaker.  This could have been a very different nite...another 3am post on loss...but instead I am left feeling good about what I do...unlike how I felt just hours before as I drove home smelling of pee and curry...Thanks Karma...I needed that.  But thank you...for also reminding me that my very small world is the most ironic and convoluded place on earth and for yet another event to prove my theory that everything in life happens for a reason....

Standards and Expectations

I am an ICU nurse, therefore my standards for and expectations of people are low. For those of you who function outside of my world where everything is "stat" and triage (prioritizing) is a means of survival (for me and those entrusted to my care) not just a mere necessity, I will explain the first sentence. In the simplest of terms...if you are not dead or I am not pounding on your chest to keep you from being dead ...you are golden. Unless of course, you are one of the many unfortunate persons whose family thinks that continuing to live long past the expiration date of ones vital organs (and yes the mind is a vital organ) is an entitlement. For these unfortunate souls, the opposite applies. If you are dead and I am no longer being forced to keep you alive to satisfy some member of your family who has obviously lost one of their vital organs, you are golden. On the other hand, my standards for and expectations of myself are very high. They have to be. If they are not, people, (not the ones in the second category listed above) die.
I am not oblivious to the fact that not every job is quite like mine and that my sense of reality (not to mention my sense of humor, smell and sensibility in general) is somewhat skewed by what I do. However, I am at a loss for understanding why so many people are willing and apparently very much able to let their standards and expectations of their profession of choice go consistently unmet.
I realize that no one will die if I can't get a couch or if I have to make two trips to the tire place to get the holes fixed ( ok... so the tire thing, yeah someone could have died, but they didn't and that's not really my point). But is it really outside normal expectations to think that the people entrusted to get me a couch and fix my tire do so in a timely and effecient manner. By this I mean, less than eighteen months for the couch and fix both holes the first time and not send me off with my two kids on a leaking tire. I won't even mention the personal standards of the guy cutting his nails in the waiting room of Mavis Tire.
I often wonder why the powers that be seem to have such a twisted sense of humor when it comes to my life. The best I have come up with is that it is a big Karma b****slap for my own twisted sensibility.   Yes, this entire rant was all the result of a single 24 hours in the life that is mine.  I am however grateful for the evening that ended it all and apologize to the children who's plans were altered as a result of the chaos that is me...