imposter

i wonder if they noticed how nervous i was, my hands shaking as i drew up the medications. it felt like my heart was going to pound out of my chest, i swear they could hear it. if only they knew how i felt on the inside because it surely didn't match my confident exterior.
he was in dialysis when he stopped breathing, they realized he didn't have a pulse and started chest compressions. within minutes he was hooked to a machine that read his pulse and knew he needed to be defibrillated, so they shocked him. they worked fast, they must have because as a result, his blood gases were normal (meaning he wasn't without oxygen for too long and his body didn't have to work to make up for it).
he came in CPR in progress and i'd only arrived to work an hour before. i was still covering lunches so they decided to give him to me, he would be my patient. and the ER was slammed so i was alone in the room. me and my almost dead patient.
but i worked furiously to keep him alive, giving him medicines to help regulate his heart, electrolytes to replenish him but he was fading fast and i was so nervous. the doctors were at the nurses station and i wanted to yell for help, his pulse went from 80 to 35 and i knew that he could get worse.
we pulled through it. i, ever so calmly (although i don't know how) explained to his children everything, the tube in his lungs, the IV in his neck, the medications and what they were for. i knew they'd been through this before so they were familiar but i know it's scary and i could see they were terrified of losing him, they didn't know how much i was too.
in the end, he lived. i don't think, however, he will make it much longer. and his family thanked me for all my hard work. i guess they couldn't see the fear in me.

the halloween party

if it weren't for my job at st. joe's i would have almost no friends in orange county. don't get me wrong, i enjoy SOME Of the people at irvine regional. the total of them, though, probably equal a whopping two or three.
i was invited to a surprise birthday/Halloween costume party. the girl, Julia, just turned 32 and looks amazing! we went to dinner last Wednesday as well and so far she's the only person i've met that i wouldn't hesitate to call "friend".
here are a couple of pictures from the party, just so you guys don't think i have imaginary friends. ;)
this is julia aka the birthday girl and i. i was a black cat, she was "the mile high captain".

this is lance and i. he's an ER tech and was really digging my costume.

this is kevin, the french guy, his costume was very elaborate and even brought a plate of really nice cheeses and spoke french mostly the whole time, me, J-BOB (the redneck gynecologist- he had a tool belt around his waist with speculums and a sign that said "home school gynecologist") and julia.



i am already counting down the days for my move back to texas. i still haven't found an assignment but i'm not terribly concerned. there are plenty of cities in the great state and if one falls through there are other possibilities.
i'm working the next two days and then my uncle, aunt and 5 year old niece are coming to visit. with all the excitement of them coming, my vacation home for thanksgiving and my big move, i've broken out on my forehead. since moving to california i've started having more and more problems with my skin, one more reason to be excited about moving back. maybe my skin's homesick. ;)

gray

it's not the sight of something burning i wish i could capture for you, it's the smell. the smell that you cannot escape no matter where you are, that is thick and choking and unimaginably real. the sad thing is, someone started the fire in irvine. yes, arson...that's what they're calling it. the ER where i work in irvine smells so strongly of burnt wood that it hurts your eyes and tickles your chest. at first it was cool, it smelled like campfire, like a hot sauna...that comforting smell of burning wood that reminds you of tents and roasted marshmallows or spas filled with beautiful people. no, that's not it though, California is on fire.
Texas is my home, that is well known, but i cannot help but feel immense sadness for my current residence and it's fellow inhabitants. these people are losing homes, homes that were probably way overpriced to begin with that now are worth nothing. this isn't the first time, though, that this state has had fires but i've heard that this is the worst southern california has seen.
my pictures aren't impressive compared to the one's i've seen on yahoo and msn or cnn.com. i know that people in other areas are experiencing way worse. but on my way to work the other day i took a few photos hoping to show you where i'm at in relation to the fires.
my heart goes out to those who've lost their homes, possibly family members and their spirits broken from watching what they had burn to the ground.

wait....what?

he was 97 years old and in good spirits for being seen in the ER for abdominal pain. when i asked what his allergies were he said "women" which both gave us a chuckle. but something wasn't right, his breathing was labored and his color was gray. i kept asking if he felt short of breath but he didn't really notice, then i went to catheterize him and he didn't even flinch.
he wasn't my patient, i was covering someone's lunch when he came in. when the nurse came back from eating, i gave report and went to cover the next person. eventually i got my own patients and then at shift change i was put in triage. i tried to keep up with him but things got busy and the last thing i remember was seeing his lab results. curious to find out what the results said, i took a peek. a potassium of 6.1?! so his labs are out of whack, a high potassium can cause lethal heart problems. but triage beckoned so once again i left.
i came back in search of a room for a patient who was probably stable enough to wait. i saw one room was closed off and asked our charge nurse why. she said the man that was supposed to go to the floor coded at some point and they were holding his body in that room. then i saw the name written on the board, the name i labeled the blood with, since i started the iv. the name i labeled his stool samples with since he was complaining of diarrhea. the name i pulled the foley catheter out on and tried to catheterize him with no luck thanks to his large prostate.
wait....what? MY patient? the man i joked with when he arrived? yes, sadly so. no one was freaked out except for me.
here's how i'm guessing it went down. i took care of him and then his nurse came back from lunch, the patient went to CT or Xray. when he returned he wasn't placed back on the monitor, i saw him right when he arrived back from CT/Xray and he was already not as responsive, why didn't i tell the doctor? at change of shift (6:30PM)the oncoming nurse took report, looked at the vitals last taken at 6:15pm and figured he was stable. the patient was to be admitted and had a room assignment so she called report. a question came up she didn't know so she walked in the room and he'd already died. at what point? i have no idea. were those really the last vitals?
the truth is, he was a DNR (do not resuscitate) and the doctor knew. i don't know how much he did for him, why he didn't stress that the patient be on a monitor? how come no one noticed? all i kept thinking was, what would i have done differently? and really, what more could have been done? he wouldn't have wanted heroic measures, no chest compressions or intubation kits. he would have coded and we wouldn't have done anything and that would have been more difficult.
the family came to pick up his belongings. they got his gold watch that i removed so carefully when i started his IV and then ever so carefully placed back on his wrist. they took his gold chain that i put in a biohazard bag before he went to xray. but they left his glasses behind. i was tempted to bring them home since i was more upset that the family left them there for no one, his body was already gone.
we get so used to saving patient's lives that defeat isn't taken easily. it was his time to go, that i understand, i just wish i could have done more.

gray

it's a dismal day in southern california. the usual sunny sky is filled with gloom and the weather is cold, a great day for sleeping in . this won't be the day i have though. the day i have ahead of me is going to be filled the task of moving from point a to point b. it's funny though, because the day i moved here was exactly the same, except it wasn't cold.
although it should be easier to walk away, it isn't. for me this apartment symbolized adulthood, the first place i've lived completely on my own. the marble countertops, the stainless steel fridge and stove, it was all something new to me. i know, people have walked in on me...probably more times than i like to remember but i have been here for 6 months.
well, today it ends. i am moving out and moving on. i wish i could say i am going somewhere new and exciting, but no i am not. the apartment, i am excited to report, is across from the mall, which is both good and bad. i will live next to a starbucks, a pat oscar's, a pier one and the oh-so-lovely barnes and noble. i will be across the road from my second job at st. joe's.
the part that i'm not looking forward to is packing today. because the truth is, i just got off work, it was the last shift in a string of 5 twelve hour shifts, i am tired, cranky and my back and feet hurt. i'd love to sleep in but i can't. this apartment that catapulted me into adulthood, as i saw it, has brought tremendous stress and i am ready to end the let's-walk-in-on-the-young-girl-in-apartment-140-and-see-if-we-can-give-her-a-panic-attack stage of my life.
to the hotel for four days, and then on to the nicer and hopefully safer apartment.

the 60 hour work week

someone please remind me next time i want to do this...that it is a bad idea.
don't get me wrong, the past two nights at st. joe's have been heaven sent. the people there are like old friends, the kind that are happy to see you and really work as a team so the shifts don't suck. also it's big, like 50 something beds. so when you are frustrated with someone you can walk away. in an eleven bed er, you're always within ears range. so the people that are talking about you 8ft away who don't think you can't hear, don't realize this. EVERYONE CAN HEAR YOU, it's a small ER.
back to my story (see working this much makes me cranky). (and hyper) (bad combination)
i'm exhausted. it's only been three shifts, but the first was 3pm-3:30am and the next day i worked noon to 12:30am, so i didn't get much rest. then today i worked 2pm-2:30am and i worked out prior to work....so really, i'm very sleepy.
i pulled another "no more caffeine" comment. but it's really not that, it's that i'm so tired i'm amusing myself to stay awake. the problem is, other people aren't really amused by me, or me being silly. basically i am my biggest fan, which is true.
so i was trying to tell the people at st. joe's about anchorman tonight. one out of 10 people saw the movie and so i was having a hard time soliciting laughs. i tried the "pants party" comment, and the crying-in-the-phone-booth-practically-sobbing-so-nothing-is-understood scene....and nada. that's when one person said i needed to lay off the caffeine. seriously, what's up with everyone suggesting this? they just don't know that the silly, giggly, nut-case of a nurse, is actually just being herself. and she's tired.
so, i have two more shifts left. then i will have one day off and go back for three more. i will buy my ticket home with the money i made today and yesterday.
i am already dreaming of turkey, stuffing, family, friends, alcohol (shiraz), and corpus boys. wait, did i say that? ;)
maybe i should add boy-crazy to my above list.
ok, off to bed....
i don't even know if this blog make any sense.

sometimes

sometimes i sign up to work extra time without even thinking about it. if there are things i want that i don't have money for i call and book myself a shift. and sometimes i want to hit myself for doing it.
today....is one of those days. i will continue to remind myself that it's only from noon to midnight that i'm working. i will think about the fact that this shift will allow me to buy my ticket home. i will think about the cute guy that works at st. joe's as an anesthesiologist that i met yesterday at irvine. hehe. (oh you knew there was a cute boy, there always is)
but i am sooooo tired. i slept a whopping 4.5 hrs last night, no bueno. i know, i know...
i will make it. i'm a trooper.
but seriously? i'm really tired.
cute boys, going home, only 'til midnight....
there's no place like home, there's no place like home.

finally

last night, for the first time since my arrival to california, i went to "girls night" with some pretty awesome ladies from st. joe's hospital. we met at the melting pot, a fondue style restaurant, and had wine and gossiped about all the people i don't know from st. joe's. and i felt at home, relaxed and most importantly, like i belonged.
it's hard, in orange county, to make friends even for the most outgoing person. i've heard this many times, from different people. i have tried at work to nourish almost-friendships in hopes that a girls night would eventually come out of it, but so far, before last night, i'd only been out less than a handful of times with people from work.
it's hard to take, people not "getting" you at work. i think people are shady of the fact that i'm a little loud, a little bouncy and silly and ready to befriend everyone. it's not their style. but it's mine, and i'm not changing. so instead of waiting for them to come around i've looked elsewhere for friends, specifically at st. joe's (my second job). and in turn, i have found funny, intelligent, outgoing ladies with a love for food, gossip and spirits. and what more can a girl really ask for?

i'm thankful for....

at work, it's me and another girl who will be sharing the 3pm-3am schedule from october 17th to january 5th. we sat down last night and made our schedules from now until the day i leave which will be january 2nd.
anyhow,with thanksgiving coming up and her being canadian she doesn't mind working so i can go home. so i'll be going home for a week, i'm pretty sure. wednesday to wednesday. and i'm so thankful that i will be able to spend thanksgiving with the loves of my life. it just gives me the chills.
and then i'm going work christmas eve, christmas day, new years eve and new years day! some of you may feel bad, but if you could see me you'd know i'm not upset about it. in fact, instead of seeing tears in my eyes you'd see dollar signs. that's right because i will get double time for twelve hours X 2 (for both holidays)!
ok, i really need to get ready for work.