Big paws to fill

Our family dog passed away last week. His name was Dylan and he was 12 1/2. He was a combination black lab and Rottweiler. He was a good boy. It's difficult. I tried not to get too attached because he's not our first dog and I know how it hurts when they go. But, I failed. He was my walking companion, my motivation to get out the door. He was guardian of our house and yard, protecting against all forms of cats and dogs. He loved people, I think he believed himself one. He was best friends to my grandchildren, especially Elijah, who is seven. He came to our house as a puppy, a refugee when our son couldn't take him to a new apartment, and he moved into our hearts. He had 12 good, healthy years before he started having problems. He went for his walk, very slowly, on his last day. He died in his home, peacefully, in his sleep. Logic tells me that he was a dog and that dogs don't live forever but unfortunately logic doesn't play a  role in emotions. Love is love and healing will take time. As nurses we see people every day who are experiencing loss, of health or life. In his last gift to me Dylan reminds me to treat them all with the greatest compassion. My sister-in-law Marianne said it well, "Dylan has left big paws to fill."

To everything there is a season

One day this week I went outside at 9 pm and it was so light out that I could see across the yard. I know, I know ... I've experienced that every June of my life, but it still amazes me! To think, the reason we have the seasons and a climate that sustains human life is because the earth revolves on an axis that is off kilter with the sun. So often I search for order to my life, feeling that if only order existed, my life would be peaceful. But if perfect order existed, then the earth wouldn't be tilted, and life wouldn't exist at all. Often in nursing, we wish for order. If the pharmacy would get the meds to us on time, if the doctors would agree with each other and especially with me, if the patients would be compliant; life would be good. But order in nursing is a rare and fleeting thing. Situations and patients change from moment to moment, requiring constant reassessment and adjustment of plans. But that is what makes it interesting, that is what hooks us to nursing, what gives us the love/hate relationship we have to our profession. We must also understand that sometimes we need a boring day, sometimes we need some downtime, because we cannot survive excitement and change all the time, any more than the earth could survive an endless summer. So I guess the moral is to seek balance but to realize that balance and perfect order are not the same thing. To everything thing there is a season.

A tribute to Rosie

All the day long, Whether rain or shine She’s part of the assembly line. She’s making history, Working for victory Rosie the Riveter During our union organizing campaign we used the classic poster of Rosie the Riveter, dressed as a nurse, to celebrate Nurses Week. I heard both directly and indirectly that some in management disapproved of that image. I even heard some of them felt she stands for the "uneducated and dirty"! First of all, we do not need nor do we seek management's approval! Second, Rosie is an American icon, representing all of the women who entered the workforce during WWII!! They, along with the men who could not serve overseas for one reason or another, rebuilt our army, navy, and air force and were critical in the war effort! They opened the door to the workplace for women, they improved racial harmony by working side by side with people of all colors, they furthered the women's movement by working with men as equals, and they often did so without equal pay. Were they uneducated? NO! Only the uneducated would say so. Did they get dirty? You bet they did, and sweaty too! But my God, it was honest sweat! There is nothing more honorable than working and contributing to society with one's own hands and muscle and brain! Rosie the Riveter represents that. There is nothing more dishonorable than getting rich off someone else's sweat and effort and heartache. Unions, and the middle class, are under attack in this country, blamed for all kinds of economic evils. But Wall street, not Main street, is at the heart of the problem. Greed is the vice. Becoming rich off another's hard work is the method. No society without a healthy middle class survives. We needed Rosie in the 1940s, without her we would have lost the war. We need her now also.

Our common welfare should come first; personal progress for the greatest number depends upon unity. (Tradition 1)

Last night I went to a Michael Buble concert with my wife. She loved it. Don't get me wrong, he's a great singer and he put on a terrific show but let's be honest, the majority of the men in the audience were there because some lady wanted to go. Earlier this year I brought my 7 year old grandson to the Justin Biber movie. We do these things for those we love. I've covered shifts for coworkers so they could attend events that were important to them, I've stayed late to help someone catch up or because the next shift would be short, I've gone in early for the same reason. We all have. We do things for those we care about, we set aside our own needs because we care. The bargaining committee has started to meet. We are looking at the surveys and discussing each issue. There are over 400 nurses who will be covered by our contract. We know from time to time we will disagree about the relative importance of each issue or the best way to resolve things. There will be arguments. This is what I believe -it is our diversity of opinion and our ability to discuss and even argue, that makes us strong. You do not have to agree to have a voice. We all grew up in families or knew of families where siblings fought like cats and dogs. Invariably the families who fought the most were the ones who would defend each other the most vigorously if a threat came from outside their family. So, our members will discuss and at times disagree and even argue amongst ourselves, but it will make us stronger. That is how it will be in our family. But there is no doubt in my mind, After we discuss, we will set aside our differences, we will come to consensus, and we will stand together, united and strong!

Answer the call

What is a "calling?" We often hear this term for a call to religious life but there are different callings and I think we all have them. When an ambulance occasionally rolls past my house my dog will howl. He starts low and quiet, deep in his throat, mouth closed, as he hears it in the distance. By the time it passes by he has to let go, head back, mouth open, full voice. It's almost like he tries not to but he can't help himself. I imagine it comes from deep inside him, from a time gone by when his ancestors ran in packs, he tries to resist but in the end he must answer the call of the wild. People are like that also. We hear our callings. We may resist, but when we do we feel the conflict inside. Sometimes, like today, a thought will enter my head. It starts small and I try to put it aside and fall back to sleep. Sometimes that works, but most of the time it just gets stronger and I know that unless I get up and write it down I will not sleep. So I start to write and the words just flow. Not that it will be a great piece of literature, any more than my dog's howl will be an opera. That's not the purpose, and I think that's the point, a calling, through it often does serve a purpose, doesn't need to. Have you ever been in an activity and had time slow down? Had hours pass by in the blink of an eye? Have you ever had the feeling that you don't need to think of the next step, that your mind is a few steps ahead of you and everything flows, effortlessly? Watch a great athlete when they're "in the zone", no one can stop them. At that moment they are doing exactly what they were meant to be doing, at least at that moment in time, they are answering their calling. It may or may not serve some greater purpose, that is not the reason behind it. It is simply that person answering their call. We all have calls, many of them. Answering it gives us fulfillment, what Maslow called self actualization. Writers feel it, artists feel it, athletes feel it, we all do. At times it can border on compulsion. Have you ever been working on a hobby and lost track of time? Have you been so involved at work your mind and hands work in synchronization without effort? Have you tried to get away from a sport, maybe to rest an injury, and felt uneasy and just need to return? I know nurses who left the bedside, because they were burnt out, only to return, because "I had to." I know activists and organizers who worked untold hours for their cause, because "they had to." When we answer our call logic is not important. It's a feeling thing, not a thinking thing. My friend Jim is answering a different kind of call. He is going to Afghanistan. Until about a year ago, he worked in our ER. He joined the navy and will go in August to a war zone. He is not a soldier, he is a nurse. He goes to save lives but to do so he will need to put his own life at risk. I do not fully understand his motivation, I don't think I'm supposed to. I do know what that urge feels like, that pull, and I respect him for having the courage to answer his personal call and the call of our nation. There are so many like Jim, men and women who are serving or have served, God bless you all, and please, stay safe.

United we are strong

This morning I was stopped by my good friend Tom. He complimented me on my blog post about my grandfather. He has given me several compliments on my posts and I respect him greatly both as a person and as a journalist. He also pointed out a mistake. In one post I had referenced George Jefferson when I ment Fred Sanford. I have corrected that and thank you Tom, for pointing that out but also for being the kind of man I wish to be, a true gentleman. I have an woderful editor of this blog in case you were wondering. Ole is not just my editor, he is my friend. Like Tom, a true gentleman. Many have told me that they have enjoyed reading, that a particular entry made them laugh or cry. I am extremely grateful both for the compliments and that I have been able to touch and hopefully, move people. I would be remiss if I didn't thank God for this opportunity. In going back to correct my error, I was rereading some of my posts. I was amazed at the level of confidence in my words in the early posts. Looking back I realize now that my speaking about our eventual success was far from certain when I wrote it. Where did that confidence come from? I am not that person! I believe that it came from you. Each of us added to the other's strength and made us all stronger. Truly our strength is greater than the sum of our individual strengths, it is multiplied! I am honored to be a part of this, honored and a better person to know you all and to call you my brothers and sisters. Together we can accomplish great things. It's been a heck of a journey so far, I look forward to the next steps.

Maybe tomorrow will be different

(written last Thursday)

Today was another busy one in the ED. I won't go into details but one of my patients had to be flown to Hartford and another had to go to the OR for emergency surgery. We have a 33 bed main ED and what I like to call "pseudo beds". The pseudo beds have names like 6a, 8a, hall 3, hall 10, etc. They are every nook and crannie of the ED that a stretcher will fit into. They were all in use today. That means that at no time did I have less than 5 patients. Every other nurse was in the same predicament, so expecting help was unreasonable. Now, 5 patients might not seem overwhelming but you have to remember that they arrive with symptoms, not a diagnosis. They need IV lines, blood draws, EKGs, X Rays, etc. On days like this the doctors are backed up with work so we need to use our clinical judgment to initiate protocols and order tests and meds we deem appropriate. That autonomy is one of the things that makes the practice of ED nursing so rewarding, but it also makes it tiring. At the end of a day like this one I'm both exhausted and satisfied, in that I know I made a difference. A day like today is also not highly unusual, which is also both tiring and satisfying. All the same, I hope tomorrow is easier. (ps Friday was not better)

They're eating snakes!

Triage has to be one of the funniest places in the world. I know, how can a place where people come to when they or a family member is sick or injured be funny, but it is. Maybe it's just that twisted ER sense of humor.
First of all, look at the word "triage". It's French for "to sort". In a profession dominated by Latin root words, it's French! It's mispronounced often enough that we call the triage nurse the "tree hag" nurse. Working in triage is also called being sent to the box, short for penalty box, because after a shift of listening to 50 people explain to you why they're the sickest person alive, you realize that you must have offended the charge nurse in some way.
In our triage, people fill out a green slip of paper with their name, the time, and what is the reason for their visit. These are precious. One of my favorites is "sick". (Thanks for narrowing that down for us). Others include, "my tutu hurts", "I want a pregnancy test", "my doctor said to come", "blank stuck in my blank", and "my doctor won't give me pain meds", just to name a few.
I was not born with the ability to spell. (Spellcheck has been good to me) I had a nursing instructor who put it this way. "John, you're going to be a great nurse but if you don't learn how to spell no one will know it. " We had a doctor, Anna, who had great laughs at my expense. She used to say she enjoyed reading my charts because she could read my hand writing and if she sounded out what I wrote she could figure out what I meant, and it entertained her. She's moved to Florida but I think she stayed around a little longer just to enjoy the laughs. I remember telling one coworker that I spelled phonetically and she said "no you don't", to which I replied, "yes I do, it's just that I also mispronounce my words". She thought for a moment and replied, "your right."
What God did not give me in spelling ability He made up with in the ability to laugh at myself.
Anyway, one day I had triaged a woman with abdominal pain. We were busy so I sent her to the waiting room. Shortly after I observed her eating. Wanting to update the triage note but not being sure how to spell Doritos, I wrote "patient eating snacks in waiting room", however, true to form, I misspelled and it came out,
"Patient eating SNAKES in waiting room".
As luck would have it, Dr Anna ended up with the chart. She came in chuckling, and said, "I think we know why you're having abdominal pain".