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Will I ever get my drivers license?

When I shadowed for my current job, I knew I would be responsible for picking the patients up from preop holding and bringing them back to the procedure room and then bringing them back to their room when finished. What I didn’t realize was how hard pushing a stretcher could be.
Last week was my first time trying it. The gal I was with had to help in the other room. Well I had no idea there are three settings, park, steer, and wheels locked in forward position. So I take off with the patient in steer and we are all over the hallway and crashing into stuff. She had the ride of her life. After that I flat out refused to go get anyone until I had a driving lesson. Taking the patient back is easy because anesthesia goes with you.
The next day was somewhat better as I didn’t crash into the walls. Tiffani was a huge help with when to have it in steer vs the free for all. This week she pointed the mirrors up in the ceiling at all the corners so you can see if people are coming. This is very important because today I avoided about three crashes. These hallways not only serve my department but OR, Cath lab, MRI, and PACU so there are a lot of stretchers coming and going. I warn the patients when I pick them up I’m still a permit driver. A couple said today that they had never had a ride quite like mine. And just when I was finally thinking I got it, I almost crashed into the anesthesia cart!

This job is nothing like I have ever done before but I’m enjoying it. And if you are reading this thinking colonoscopies are the same thing over and over, you are dead wrong. First of all no two are the same, second the schedule is constantly changing with people not coming and adding people on. It’s just my speed of craziness.

Mole moral ~ According to my husband and kids I can barely drive a car so it’s wishful thinking I can drive a stretcher. Bahahaha

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Week Three is Almost Finished.

Tomorrow will be my tenth day in my new unit. The first week was all class and computer stuff. I’m not going to lie, I seriously considered quitting after the first week. I cried in the middle of the day Thursday and the entire way home. I left floor nursing and am working in the endoscopy unit. So I left beaver town for the butt hut. I have never been so completely overwhelmed in my life. I had so much information given to me, I am surprised my head did not spin off my shoulders. On Thursday they had me scrub nurse and I was assisting the doctors who are both awesome. Anyway you hand them whichever wire they need and they insert into the scope. When they are done you pull it out into these nice loops. Until I tried it. I had the wires in figure 8’s, knots but no circles. I almost hit the doc once. Friday I started washing scopes. How hard could that be? It’s a million steps and takes my full concentration. (I realized on the way home I could do beaver town on auto pilot). So by the end of the day I kind of have it down but I do notice my left wrist looks a little red but it goes away.

Monday comes and it’s back to washing. The gal with me sees that I can pretty much do it so no longer stares at me but hangs in back for questions. It seems like I’ve had less water leaking into my super long gloves but my wrist looks red like I’m reacting to something. Tuesday I’m on my own and listening to music. I’m getting a little faster and not forgetting a step as much. I’m much more relaxed and not feeling like a bull in a china cabinet. Then Wednesday arrives.
Still cleaning scopes feeling invincible when we had a double. That’s an upper and lower on the same person. The upper goes in a red bucket and comes to me for pre-clean  which is usually done in the procedure room but no time to do it when doing a double. I pre clean,do what I’m suppose to and clean the hard plastic container. I decided I’ve progressed far enough I can put it away myself. I pick up the other four that are stacked together, put fifth one in and then proceed to drop them on my foot. It makes a huge crashing noise so when I come out they ask if I’m ok. I tell them what I did and doc asks if there was a scope in it. I say no and he says then all is good and smiles and his eyes sparkle. I look at my foot at lunch and it looks ok. At the end of the day the girls had me take my shoe and sock off to evaluate. It was purple underneath so they made me report to team leader (manager). She called workman’s comp and I was sent to urgent care. I went to the X-ray room and then the computer locked up and the guy had to call tech support. He ended up having to reboot the entire system. He finally gets them done. I go back to my room. The doc wasn’t there five seconds before he comes barging in with big eyes and asks if she’s seen the images. She comes back and tells me it looks like a fracture in one view but she’s not positive so she will let radiology call it and let me know tomorrow. I’m sent home in a shoe and can only stand 10% of the time. No cleaning scopes for me and my wrist is now burning and hurting. I diagnose myself with chemical burn. I put neosporin on it and wrap it like I was taught in the burn unit. I’m convinced when I wake up it will be healed.
This morning I get up and it looks worse. I show my preceptor who says I have to show my team leader. She takes one look at it and sends me to employee health. The employee health nurse takes one look at it and calls the workman’s comp gal again. Yesterday I had attempted to put in an incident report for injury but I’m not in system so I cannot report it. So workman’s comp tells me I have to report it in the system first so I call tech support. Tech support has to skype into my computer and sure enough he sees I’m not in there. He cannot add me and has to escalate it up. So I call comp gal back and tell her this. My team leader then attempts to enter it for me and she is unable to as well. So once again I’m over at urgent care without an official report. In the middle of all of this chaos the doc from urgent care calls to tell me the radiologist is unsure if it’s a new fracture or an old one. I have never dropped anything on this toe so congratulations I have a broken toe. I then remember Saturday is ice skating with the kids from camp Kesem so it looks like I’ll just be watching.
I am officially diagnosed with a chemical burn and given Silvadene cream to put on it. Now I’m banned from washing scopes which I told her I couldn’t do anyway because I’m banned from standing. Do you know how hard it is for me to sit. Every single person I worked with reminded me at least once to sit down. I will do whatever they tell me because I want healed ASAP and back to my orientation.
I really love the job but I need God to protect me from anything else happening. I don’t want them to cut me loose because I’m a big bull in a china cabinet liability.

Mole moral~ Change is good even when it involves a break and a burn!!

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I survived week one!

Some random thoughts from my first week.
1. Schleprock is alive and well
A. I stepped on the water pedal not once but twice (same day) and squirted water all over the floor.
B. I didn’t connect the water tightly and therefore water squirted all over the doctor. He said hey I’m getting wet and was very nice.
C. I dropped a 45K piece of equipment on the floor on day three.
D. Almost hit same doctor in the head with a wire.
2. I realized I was on autopilot with my old job and didn’t even think about what I was doing. So being 100 percent focused for forty hours is exhausting.
3. The drive does not involve 270 which is fantastic.
4. Working full time is for the birds.
5. I’m way too hard on myself.
6. I love all the people I work with. They are happy and fun.
7. Everyone over the age of fifty who does not have a screening colonoscopy is playing with fire.
8. Learning something completely new is intimidating (see number 5) but also rewarding.
9. You can teach this old dog new tricks.
10. Looking forward to week two  What disaster can Schleprock avert?

 

Mole Moral ~ Change is scary but better than misery!

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New Job, Finally!

It’s been quite a while since the last time I wrote a blog. It’s because I was so distracted with attempting to find a job. My summer sabbatical ended after I finished Camp Kesem Maine. I stupidly thought I would be back at work by the beginning of September. I had no idea how applying for a job had changed since the last time I applied.

It had been twenty-nine years since I walked into St. John’s Mercy Medical Center Human Resources and asked for an application. I filled it out and then handed it back to them. I don’t believe I even had a resume and if i had it would have been typed out on a typewriter. I went home and received a call on my land line to set up an interview with the head nurse, assistant head nurse and a staff nurse. I’m pretty sure they offered my the job either right there on the spot or the next day and I started two weeks later after I gave notice to my other job. Now let’s jump into what it was like this time.

First of all job applications are filled out on line and you attach your resume. I do believe when I applied for the Lutheran School Nurse job I did do a resume on a type writer as I did not have a computer. Microsoft Word and I do not get along so my friend Liz was kind enough to let me just input the major information and she straightened it out for me. After it is submitted then I waited for an email to see if they were interested in setting up a phone interview with a nurse recruiter. That consisted of a schedule in which I picked a time that best worked for me, when she was also available. The phone interview lasted approximately thirty minutes and then she would decide if I was worthy of having an interview with the nurse manager. Then I had to drive in and interview in person. At one of my interviews I was asked why I became a nurse. I wasn’t expecting this, nor had I thought about it in many, many years so out of my mouth came “I wanted to be a doctor, but my father refused to pay for medical school and my mom caught my sister and I playing with matches under the covers when I was eight and threatened to take me to St. Johns burn unit.” Later I remembered the real reason why I became a nurse. When I was fifteen I had an emergency appendectomy and ended up in the hospital for a week. I had two incredible nurses, Joe and Caroline and I wanted to be just like Joe. So I was all prepared to say this at future interviews and I was never asked it again. The interview went well and then I had to set up a time to shadow. This means following a nurse around on the unit I had applied for to see if I liked it. I loved it and then had to wait for over a week to see if I would be offered the position. It was by far the longest week of my entire life!

So now I have a job and I am like great I will get to start working. It would be another week and a half before I would begin nurse orientation. Before I could start the classes I had to agree to a back ground check and go to the lab for a drug test and blood work. I am still immune to hepatitis B, measles, mumps, rubella and chickenpox. I was negative for TB. I just had the whooping cough vaccination four years ago so the only thing I needed was a flu shot which allowed me to whine about my arm hurting for three days.

After I passed all that it was on to five days of classes, computer stuff, videos etc. For me it was a very nice review but while sitting through it I thought I cannot imagine being a brand new nurse and be hit with all of this. I probably would have said forget this insanity. I’ll just be a hooker. These classes were called nurse integration and the managers are not called managers but team leaders. The charge nurses are called clinical support nurse. It gives the entire process a more family team feel to it. I suppose this is the type of stuff non medical jobs come up with.

So tomorrow I start in the unit and I cannot wait. However, it’s only for four hours and then I am off to another computer class for four hours. It’s how to chart specific for my unit and something I have never done so I’m pretty excited to learn something new. After that I will be working full time for six or seven weeks and then fear not I will be back to part time girl.

 

Mole Moral ~ Good things come to those who wait!

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The Second Patient I Keep in Touch With

Here is the story of the second time I broke the no keeping in touch with patients. It is a little lengthy but amazing.

It was December 31, 1999, and Y2K was coming up fast. I was at a wedding reception with most of my family. My friends Denise and Dennis decided to get married and risk the fall of the world which did not happen. At the same time T was admitted to another hospital with flu-like symptoms that would quickly be diagnosed as meningococcal meningitis. It is the bad kind, the really bad kind with a not very high survival rate.
Sometime in February T was transferred to Mercy burn unit for would care. He had survived the meningitis but the vasopressor medicines he needed to keep him with a blood pressure to stay alive had destroyed the circulation to his hands and feet. They were pretty much black when the burn unit met him. I believe he may have still been on life support as well as dialysis for kidney failure. He was twenty-nine years old and had a picture of himself crossing the finish line of the Chicago Marathon in under four hours. I can still see the picture as if it was yesterday. I was not a runner, never planned to be but was so impressed by this.
He wasn’t with us long before it was apparent the only thing to do was amputations and we started with his legs. I will never forget I was his nurse the night his mother had to sign the consents. She asked to talk to the doctor and others were like she already talked to him once. Looking back and being a mother myself I totally understand. I had a really hard time witnessing the consent because he just ran the Chicago marathon and this would most likely prevent him from ever running again. By the time the surgeries were completed and down to viable tissue T was left with one leg above the knee, one below the knee, one hand gone and the other arm mid forearm. However he was alive and it wasn’t too long before he peed on my best burn unit buddy. She was never so happy to be peed on! He was out of kidney failure and soon off of dialysis.
He then was transferred to rehab which at the time was still in the hospital on the third floor. I worked three to eleven back then so would often stop by and see him. I will never forget one day when we were talking and I told him I would rather be dead. (Leave it to me and my brutal honesty. I can still see the look of utter shock on his face) He said “not me I still have plenty of things I want to do.”
He was discharged on May 5 and started outpatient therapy. I would stop in and see his progress from time to time. He was learning how to walk and use both prosthetic arms. I visited one day when he was trying to button a shirt. I was so frustrated just watching him but he never gave up. During this time I would mail him crazy stories of my life. (Foreshadowing for this blog I suppose.)
My nephew was born in August and T sent me a hand written sympathy card. He was only three months home from the hospital. I have it in my scrapbook on Andrews page. It blew me away and his prosthetic hand writing was better than mine with real hands.
The 2002 Winter Olympics were to be held in Salt Lake City Utah and T set a goal to walk and carry the Olympic torch when it came through St. Louis. He met that goal 1/6/02 and I took Emily and Kayla out of school. I even had my scheduled changed and my manager was thrilled I went and asked to see the pictures.

Kayla is hiding behind Emily in the picture. This was before the day of my digital camera so the pictures are not the best but they still make me smile when I look at them.

 

T was a Pharmacist with a doctorate degree and decided to go back to law school in the fall of 2002. He decided he wanted to fight for disability rights. So he applied, attended, graduated summa cum laude and passed the boards. He then taught pharmacy law at St. Louis College of Pharmacy for a few years. He then moved out-of-state to practice law and then eventually moved back to the midwest and again taught law at a pharmacy school. It seems he may be the dean of the school but I’m not positive.
I have received a Christmas card every year from his as well. He always has a small hand written note for me. This year his mother said to tell me hi! That so touched my heart. I have not seen her since he carried the torch.
I find myself thinking of T when I’m running and it gets really, really hard. For a full marathon that is somewhere around the twenty-mile mark. When I ran the fifty mile it was the last ten miles. I often tell myself I am running for him. He had hoped one day to do the Chicago marathon again but that never happened. I think it takes a lot of energy to walk on prosthetic legs.
Currently there is such an anti vaccine movement in this country that I am going to take this opportunity to say that when T came down with meningitis there was not a vaccine for it. There is now and although it is rare I would bet my house he would tell everyone to get it. The only reason he survived was because he was in top shape from marathon training. (I remember the doctors telling him back in the day.) I am pretty sure he’d rather risk autism, big pharma getting rich, government poison and mind control over waking up two months later after thinking he had the flu to discover he had meningitis and now would have to learn how to use four prosthetics and relearn how to take care of himself.
Mole Moral ~ I’ve taken care of some amazing people over the years but T is by far the most incredible person I have ever met, that taught me a lot, and I’m so glad I reached out to him with my first note when he was in rehab.
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Two incredible amazing people.

 

It was May of 1991 and I had been a burn nurse for nineteen months when Gary was found in a car that was on fire after the fire had been put out. The fire department did not think anyone was inside. His burns were extensive and he had breathed in a ton of smoke so Dr. Ayvazian told his fiancé Linda that he would not survive. Gary and Linda had both worked on the movie White Palace which was filmed in St. Louis about a year prior to his burn. I have never seen the movie but always remembered this fun fact.

Anyhow Gary was with us for a few months  and then he was discharged home. The thing I remember most about him was the day they were making the mold of his face for his pressure mask. They inserted straws into his nose for him to breath through and then pretty much covered his head. I was his nurse that day and had to think hard about other things as I was having a claustrophobic panic attack for him. I am pretty sure I gave him extra Valium, Versed or something to make it more tolerable for me. Hee hee

     It wasn’t too long before we started seeing him again. There was a Burns Recovered Support Group that was run by a guy who was before my time. It wasn’t long until he passed away and Gary and Linda stepped up to take over the group. I believe they met once a month and Gary would come visit patients once or twice a week during the day time.
     After seeing an article in People magazine about a burn camp in Texas, Linda felt called that  Missouri needed a children’s burn camp. After doing research she discovered we had none so she and Gary decided to start their own. The first year (1997) they had 17 campers and no child has ever paid for camp. The camp is located at the Lake of the Ozarks. Brian’s parents have a house at the lake so one summer Emily, Kayla and I made a visit to burn camp. Either Linda gave me bad directions or my lack of GPS skills were showing because I somehow managed to miss the turn and ended up driving to Jefferson City. I turned around and went back to the lake. Brian got his map out and gave me new directions. We found it the second time around. Although we didn’t stay long, I immediately knew it was a wonderful place for the kids. A week where they can be just kids and not burn survivors.
     I have had so many burn unit memories over the past couple of weeks. Linda shared my blog and I heard from a nurse friend I have always remembered and wondered what happened to her. Back in the day people would ask how I could work there. And my answer was pretty much everyone got better and went home. I never really knew how most of them did after they left. There were certainly days when I left wondering if all the torture I and the team inflicted on these patients was worth it.
     So on Friday I went and spent the evening with Gary and Linda. I had such a wonderful time that I ended up staying past eleven and the next day went to Universal Studios on four hours of sleep. I would have done it on no sleep! They are both two amazing selfless giving people. They took the support group to an amazing place and they started the camp from the ground up. I am sure at the time of the accident if you would have asked if this would have been their path in life they would have said no way. I can’t help but think God had this planned all along. I use to see Gary in the cafeteria on Tuesdays from time to time. It was always an exciting day for me. I cannot remember (even though we just talked about this) if they retired and moved four or six years ago. I do know it took me close to two years to stop looking for Gary in the cafeteria.

 

     I’ve never felt that were truly recognized nor appreciated for all they have done, especially by the hospital. However it’s as if God purposefully put these words of Jesus in my head (yes I had to look up exactly where they are located. Bible bees locations are much like patients names. I know their story but not their names)
 Matthew “Be careful not to practice your righteousness in front of others to be seen by them. If you do, you will have no reward from your Father in heaven. 

“So when you give to the needy, do not announce it with trumpets, as the hypocrites do in the synagogues and on the streets, to be honored by others. Truly I tell you, they have received their reward in full.But when you give to the needy, do not let your left hand know what your right hand is doing, so that your giving may be in secret. Then your Father, who sees what is done in secret, will reward you 

These two live this every day. I’m so thankful that I decided to share my Dr. Ayvazian blog with Linda. She responded with an invitation if you are ever in the area please come see us. She was probably blown away when I said I will actually be there in three days, free on Friday. Originally Emily and I were both coming on Saturday and starting trip on Sunday. Since I’m a theme park nazi I decided we should start on Saturday and fly in Friday. She took a red-eye so she could work on Friday and the rest is history.

Mole Moral ~ Gary and Linda are my providential people. (Another church term). Meeting them changed the direction of my life and so many, many more and for the better!

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The Greatest Doctor I ever worked with

This week I went to “don’t call us St. Anthony’s, we’re Mercy South now” to visit a childhood friend’s father who is in intensive care. While in the lobby looking for directions I saw this on the wall.

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Since I was curious about what sort of propaganda was on display, I walked over to take a closer look. When I saw this picture on Mercy’s timeline I stopped rolling my eyes and was flooded with so many memories.

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It’s not easy to read so under the picture reads Dr. Vatche Ayvazian leads the expansion of the burn unit designed to treat patients of all ages.

New research is conducted in the burn unit at St. John’s Hospital, which cares for hundreds of patients each year. Highly specialized treatment protocols draw patients from throughout Missouri and Illinois for treatment of severe burns, and the center becomes the largest of its kind for the state.

I have thought about Dr. Ayvazian over the years. He retired from the burn unit not too long before I left in 2000. His leaving was one of the reasons I left, because although his replacement is a good doctor he was not even comparable to Dr. Ayvazian.

The man was not only a genius but the most compassionate doctor I have ever worked with. He had a choice of becoming a doctor or a concert pianist. Lucky for Mercy he chose surgery. I never heard him play but I’m sure he was incredible. He was also fluent in seven languages. One time we had a patient that only spoke French. He went in and had a conversation like he spoke French as his primary language. It was so mind-blowing to me, I can still see the patients face and which room he was in. Dr. Ayvazian treated everyone the same and he never cared if the patient had insurance or could pay. It was completely irrelevant. He was upfront and told everyone exactly how the patient really was and what the odds were for survival. He never sugar-coated or gave false hope but it was done in such a caring and compassionate way. And when he lost a patient (this happened a lot) he took it personally and although he didn’t say much, I could tell it really bothered him.

He treated not only adults but children as well. I have never met another physician that could treat both as the difference is like vanilla and chocolate ice cream. Nurses usually either take care of adults or kids but not both. Although in the burn unit we did take care of both.  However, almost every single nurse that left went on to a job that was adults and not kids. There was nothing that outraged Dr. Ayvazian more than child abuse and it was the only times I witnessed him lose his temper. He let a couple of parents really have it.

There is no way to describe the stress and adrenaline surge that would run through the burn unit when we got the call a big burn was coming in. The teamwork was phenomenal among everyone to pull this off. This left me with a life long friend and fond memories of so many others that also went elsewhere in Mercy with their careers. Dr. Ayvazian always came in to evaluate and if they had circumferential third degree burns escharatomies or fasciotomies would have to be performed. This was done with the Bovie machine and would effectively cut through the skin and cauterize at the same time. If you have ever singed your hair, this is what it smells like times ten. Often there would almost be a visible cloud of smoke hanging in the burn unit. Dr. Ayvazian would yell “follow me with the light” when doing this and if you got behind he would really start yelling. However, after everything was done and settled he always apologized. Maybe he was a little like me, the more excited or nervous I get the louder I yell.

The first two to three days after skin grafts we would give Ketamine during the dressing changes because the donor sites were so painful. One of the first times I was the nurse in charge of donor site changes I did something wrong. Dr. Ayvazian yelled at me but then afterwards pulled me aside and told me that I would be a great nurse and he didn’t mean to yell. I still can remember this patient, how he was burned and what room he was in.

Its been almost twenty-six years since we had a patient with ninety-three percent burns. We actually had a layer of his non burned area removed and sent to a lab. They grew his skin in the size of saltine crackers and we used it on his arms. This probably saved his life but they were such a pain because we couldn’t move his arms much for I swear six weeks or they wouldn’t take. It seems like the cost was forty-seven thousand an arm or something outrageous. We did attempt to use it on another patient but aborted it for reasons I cannot remember.

I googled Dr. Ayvazian and found all his research papers. I had no idea he did research because the internet was just coming to light when I left and I had zero desire to go to a library. We would soak the skin grafts in CeN04 for the first twenty-four hours. I cannot remember if it’s spelled Cerrous Nitrate (this is crazy because it was never approved by FDA so we always had to get a consent signed for it) but I did find the articles he and the other burn unit director published on the research. The burn techs that had been there for twenty years would tell us about how they had to mix it in the burn unit back in the day and if they spilled it on themselves it would stain. When I worked there the pharmacy mixed it and it came in big brown jugs. When Dr. Ayvazian retired so did it. I am sure there was a party in the pharmacy.

According to google Dr. Ayvazian is eighty-three years old at the time of this blog. This does not seem possible. However, it also doesn’t seem possible it’s been over eighteen years since I worked there. It was the hardest job of my life but the teamwork and comrodary is unexplainable and made it the best job of my life. I am so thankful for Dr. Ayvazian and all the people he helped. God made a true one of a kind gem with him.

 

Mole moral ~ Till the day I die my favorite line will be “when I worked in the burn unit……”