Monday, June 17, 2013

Hotter Than Hades...

It’s cooler this weekend that it was last week, and I’m glad for that.  I can’t really complain: we have insulated windows and air conditioning.  It’s just the pits to go outside when the sun is out….that’s all.

As I tried to go to sleep last Saturday night, it was too warm to be comfortable.  Sleep did not come easily.  

 I found myself remembering a long-ago encounter with a patient and reliving it in my head.  Not just remembering it: analyzing it to figure out how I could have done it better…

Have I mentioned that I think too much?  I do….

So, it was about ten years ago, on a very hot, muggy evening.  I was the nurse on call for my home health agency and there was a little boy who needed to be seen and given antibiotics at six in the evening.

He was so little.  About four years’ old, if I remember correctly.  His skin was very light colored, and his huge, brown eyes were dull, not shiny.  He had been home from the hospital for about an hour when I arrived.

I must have looked like the circus came to town, hauling in a box of IV supplies and dragging an IV pole behind me.  Usually, the infusion company would deliver the IV supplies but I didn’t want to have to wait for them, so I picked them up myself.

His mother spoke only Spanish, so my interpreter was his six-year-old sister.  As I assessed the little boy and asked the required questions, I began to realize just how hot it was in their apartment.  I began preparing the IV infusion, and prayed that I would be able to start his IV on the first stick.  (Some well-meaning RN in the Peds Unit at the hospital was “afraid” to send him home with an IV needle, so she took it out….)

I excused myself to go to the kitchen to wash my hands before doing the IV, and there, on the counter, was a slab of brown-gray meat covered with flies. Apparently, mom was defrosting it for supper. Knowing that the little boy was hospitalized with sepsis, I wondered if the family food preparation practices had anything to do with his condition.

Should I say something to Mom?  Could a child-interpreter really do justice to what I had to say?  Was it really something I needed to address, or was I out of line? As the visit unfolded, I realized just how much this young mother was overwhelmed with her son's illness.  And life, in general...

I returned to the patient’s bedside and started his IV.  I needed to stay until the infusion was complete and discontinue it.  Another RN would come to the home the next day and do the infusion again.  Since it was only for three days, and since there was a significant language barrier, it was decided that we would not teach the mother to do the infusion.

I could feel my uniform sticking to me, wet with perspiration in the stifling heat of that little apartment.  My patient was sleeping now and it was quiet in the room.  Mother sat staring at nothing and stroking her son’s hair, soothing both of them.

Suddenly, there was a loud BANG as the front door slammed shut.  Mom stood up with a look of panic on her face:  her husband was home and she had forgotten to turn on the air conditioning so he would be comfortable.  She ran and turned it on as he walked towards the bedroom.

I turned around and looked up to see him glaring at me.  He turned to his wife and asked her, in Spanish, “Who is this woman and what is she doing to my son?”  I was genuinely concerned by his demeanor.  Mom explained to him that I was a nurse and that I was giving him his IV medications.  He said, in English, “no more! Finish what you are doing and NO MORE!”

What to do?  I decided to be as blunt as he was.  I explained that the ONLY reason his son was able to come home from the hospital was because a home health RN would come administer the remaining antibiotic doses.  If he would not let us do it, his son would need to go back to the hospital.  Or risk becoming very ill again...

After a heated discussion with his wife, in the hallway, he came back in and said: "OK.” 
I walked out into the warm evening relieved.  The visit was over and, although I had a couple of hours of documentation to do on the computer, the worst of my evening had just passed.  I chastised myself for not being…..whatever it was that I thought I should be.  I didn’t feel comfortable about that home situation but I didn’t know what to do…

All these years later, I can still see that little boy and his mother and sister.  I can’t remember dad’s face that well, but I will never forget his voice.  Was I too intimidated to do the right thing?  That was the question that went through my head over and over last week…

And I still don’t have an answer…


Saturday, June 15, 2013

Blog Redux: "Run, Forrest, Run!"

{Here's a repeat from last year.  It still resonates with me.  I hope you enjoy it!}

“Life is like a box of chocolates….”

Last week, on Wednesday, we had lunch at Bubba Gump’s on Cannery Row, in Monterey, CA.  For an hour or so, we were immersed in all things Forrest Gump.  The waitress even quizzed us on our knowledge of facts from the movie.  We got 4 out of 5 right!

I love the premise of that movie: life is what we make it, and our image of ourselves is more important that what other people think they see.  That sense of self-esteem is what made Forrest so successful in his endeavors.

On our table was a sign: “Run Forest Run” in blue.  Underneath it was another sign, in red: “Stop Forrest Stop”…  The waiter explained that we should turn the sign to the red one if we needed anything, or leave it on the blue if everything was fine.

In my life, I think I leave the blue sign up most of the time.  I might not be running, per se, but I am moving and doing and being.  Only in times of great sorrow, as the death of my parents, have I had to turn up the red sign.  Even then, I’m back to the blue sign as soon as possible.

Life is going to happen, whether we want it to or not.  We can go with the flow or buck the tide.  The choice is always ours, as are the consequences. 

Sometimes in my life, I feel that I have faced a brick wall, six feet high and ten feet wide.  I have tried and tried to climb over the wall without success.  And then, at some point, figured out that I can just walk around it most of the time…

So, maybe that’s a good motto for this time in my life:  “Run Forrest Run……” 

And I think I will keep moving, keep being, and keep living until the sun goes down for the last time.

Pass the chocolates, please!


Wednesday, June 12, 2013

Thoughts About Adornments...

Bracelet from Kohl'

I spent some time today cleaning some of my jewelry.  I used those cleaning cloths to get the yuck off some bracelets, mostly.  

 I have purchased some new pieces of “costume jewelry” (read: not expensive) recently and today I rearranged everything after it was cleaned.

In the past couple of months, I have purchased several new purses, too.  And scarves.  And shoes.


That’s the question I have been trying to answer today…. Is it because I suddenly care how I look when I leave the house?  Is it because I have the time, now that I’m retired, to choose my ensemble more carefully?  Is it because I have lost so much weight and so many more of my clothes fit again?  Or is it because I am no longer spending my days in scrubs, “adorned” only with a watch on my left wrist and a stethoscope around my neck?

All the above, I think….

Whether you prefer wild prints and sky-high heels, or jeans and a tee shirt, I think it’s about feeling comfortable in your own skin.  Whether you must follow the latest fashion trends, or you are comfortable with your own, personal sense of style, it all comes back to your sense of self.

For now, I’m having fun choosing adornments to go with my clothing: jewelry, purse, shoes…. Six months from now, I may just wear sweats and a tee shirt and flip flops and be comfortable.  Or I might ramp up my fashion look to suit my changing style.  Probably NOT the crazy shoes women are wearing these days.  I spent too many years taking care of patients in sensible shoes….for twelve hours at a time.

I wrote a blog a couple of years ago about granny shoes.  My point was: I won’t be pigeon-holed by my age and wear “appropriate clothing” as they say (in that case, it was pink high heels that I liked). I am thrilled to be my age and not dead!  I don’t care about my “lumps” and scars and imperfections anymore.  I guess I am finally comfortable in my own skin….

In any case, I will wear what I like, add a big smile to the fashion statement I’m making, and enjoy my day.