December 30, 2010

So my PCP thinks I'm suicidal

I went for some follow-up blood work last week and asked my PCP to throw in a thyroid panel since I had been so cold intolerant. Didn't think anything was seriously wrong with me...I was just feeling the cold worse than I usually do. I also was tired, yes, but I had no sleep the night before. And I was a mite hungry since it was a fasting blood test. Maybe I wasn't the most chipper patient, but I certainly wasn't manifesting any signs of SI.

So I get a call on Christmas Day and it's my PCP following up on "my feeling down." I reassure her that I wasn't feeling down; I was cold, tired and hungry that day. I told her that I work as a psych nurse and I do understand her concern, especially since depression and suicide rates go up at this time of year. I also asked how my blood work was, and it was fantastic. The Zocor is working wonders.

Today I get a letter in the mail: please follow up with the PCP re my condition. Now I'm nervous...did the nurse not have my right lab results? So I call and ask what is going on. Turns out that apparently the PCP had wanted me to return in one week to follow-up on my "malaise." Either he didn't tell me, or did tell me but I was too cold, tired and hungry to remember. When I didn't show on that day, the phone call was made (and that nurse who called didn't mention anything about needing a follow-up) and the letter generated.

Meanwhile, this nurse is interrogating me: am I feeling OK? Feeling depressed? Thoughts of hurting myself or anyone else? Can I please return in the next couple of days just to follow up and make sure everything is good.

My first reaction was, "Oh, this is how it sounds when I ask my patients those same questions." It was weird being on the other end of that conversation.

I reassure this nurse that yes, I'm fine, no SI, no HI, will come by in the next two days, cross my heart and hope I didn't say the last part. But I will be spending my New Year's Eve at my PCP's reassuring them that I'm not about to off myself. I'm worried though...they're so serious about it, I'll bet I find myself being handed a script for Zoloft with a "let's just try it out and see what happens."

December 29, 2010

At least it was a nice thought

I'm always tickled when I go to the doctor's office (any doctor, really) and they plunk me on the scale: without fail, they start out by moving the bottom bar to 100.

"Thanks for the compliment, but start at 150."

At least I haven't hit the point where they have to start with the bottom bar at 200, though I've come close. Today at the gynecologist's office (I know, why are they weighing me there?), I came in at 198. In my defense, this was after breakfast and coffee and while fully dressed, shoes included. And things aren't that bad if I can still fit into Lane Bryant size 14. Seriously, I love that store: it's the only place in the world where I can fit into their smallest size of clothing.

Anyhow, I have no intention of stepping on my own scale until the last of my family leaves on the 4th. Until then, I'm just doing my best to eat sane...which has not been easy. I also started exercising again. I got on the treadmill today and put in 30 minutes of brisk walking. I felt pretty good afterwards...until the chub rub started burning. So much so that I had been planning to walk again tomorrow but now I'm rethinking it.

Oh well. I didn't get like this overnight, and I'm not going to undo it overnight.

The nursing part of the entry: I'm off for a few days, which is nice. My last day in I had to take care of the kiddies: the kids' unit day nurse called off so enter Meriwhen, the hospital's professional floater. It was a nice day. We didn't have a lot of snotty kids, but several newbies for a change...and one frequent flyer who is truly psychotic. The last time we met (during a prior admission) I was administering a shot to him. This time around he was more cooperative...but psychotic enough that working with him was a challenge. Time to bring out the psych textbook and refresh myself on a few topics.

December 22, 2010

Giving up for now

Decided that I'm just going to be fat and happy until after all the family leaves in early January, instead of trying to starve myself, overexert myself or beat myself up.  Doesn't mean I'm going to give myself license to overindulge...but I'm not going to stress over it. 

Having said that to myself...I feel better about myself.  I'm still overweight but I'm temporarily at peace with it.  Being at peace is a nice feeling, one that I haven't felt in a while.

Got my blood work back.  My cholesterol is back down to normal range:  184.  My thyroid is fine.  Waiting to hear from my doc to see if he still wants me on the simvastatin.

December 13, 2010


Got my student ID.  A very unflattering picture of me...but usually IDs are not meant to flattering.   And another visual reminder that I have to lose weight.  I'm trying to be good about what I'm eating...starvation isn't going to work, either physically or mentally.  I'm aiming for just being sensible.

The school's lab also lost my UDS.  Fortunately for me, I have ths slip from the lab verifying that I did take the UDS and that they have accepted my sample as legitimate.  Not sure what will happen next...unless they find the sample between now and orientation, I'll probably have to retest.  I'm not worried about any test as I know my sample will be clean, except possibly for some alcohol depending on whether I had a glass of wine the night before...and last I checked, I'm well over 21 and alcohol isn't illegal.  But I still feel like a criminal whenever I do a UDS.  Plus the fact I feel like the school thinks I'm sketchy, especially when they're told that I never showed for my drug screen when I actually did.   Oh well, that will get straightened out at orientation.

I guess once I go to orientation this week, I will officially be a nursing student...again.  The pre-reqs are over:  now it's time to get down and dirty.  Well, OK, most of the pre-reqs are over:  I still need to take History and Public Speaking.  But now the nursing program starts in earnest.

I have to admit I'm slightly apprehensive starting in a BSN program that is still undergoing CCNE review.  I'm reassured by a few things:  first, their diploma program is/was certified and received glowing reviews (too bad I could not afford to attend it the first time around).  Second, I already have a degree from a NLNAC certified school so there will never be a question of me being able to obtain licensure and/or work (as far as certified schools go anyway).  Third, once the school is approved it's retroactive, and that would cover me.  Fourth, the MSN/CNS program I'm looking at has a RN-MSN option, so even if things entirely go south with this school's accreditation, I can use that to apply instead of the BSN-MSN option.  And last, being a graduate of the school will give me some priority when applying for jobs within the organization's hospitals. 

So at orientation I will meet the other RN-BSNs.  I heard it's a small group:  only 12 or so.  That'll be nice.

December 11, 2010

Yeah, I know

A patient asked me if I was pregnant.  I told her No, I was just fat.  She apologized and said that based on how my ID was tilted, she thought I was expecting.  It didn't bother me...but it did remind me that I need to get serious about losing a little weight.  I've fallen into the overweight nurses trap.  Actually, I weigh what I did when I graduated a year ago.  I guess more of it has shifted to the belly area.

But it's hard to do that in December:  the month starts off with my birthday, then leads right in holiday parties, holiday gift baskets from doctors, patients and other facilities, Christmas and home cooking, and New Year's and eating out.  Plus the parents, who cook VERY well...and the in-laws, who love their food and drink.  It's hard to lose weight under those culinary conditions. 

In all fairness, I don't have to just diet.  I can exercise...which I haven't been doing as I've been recovering from an injury.  But now that the injury is healed...but the problem there is the little one:  I spend all day away from my child while at work, that the last thing I want to do is plunk him in childcare while I go exercise.  And when he's gone to bed...well, then it's really too late to get any exercise in, not if I want to go to sleep at a decent hour so I can wake up pre-dawn for work.


I do need to be better about both though.  I heard Weight Watchers revamped their plan and since I'm still a member, I thought I'd go over and check it out.  And I can make an effort to move more...I'm doing that already at work.  But at home, I can get on the treadmill for 30 minutes while the little one watches some television or plays a computer game.

December 10, 2010


Today is my birthday.  Celebrate with me by hugging a ball of wool.

This was the week from hell, and yet I thank God for it because it renewed my faith in psychiatric nursing.  Because my unit's census was low, I was floated to stepdown at the beginning of the week.  There, I got to work with some truly psychotic patients:  paranoia, active hallucinations, bizarre thoughts, ideas of reference...stuff that I hardly see on the detox or depressive units unless the patient is admitted while under the influence.  It took a little bit to switch from "high-functioning patient" mode to "psychotic patient" mode, but it all came back to me.  Those days were tough as hell, but I thoroughly enjoyed it. 

I worked one of those days with the director of the stepdown unit.  I had told her that I was enjoying my time there because lately I felt the urge to get a med-surg job but being here made me feel better about psych again.  She asked me why I wanted a med-surg job and I told her "just because it's expected you do it when you first get out."  She said that I didn't need it, especially if I didn't want it.  She also told me that she went straight from nursing school to psych 14 years ago, had no problems ever finding work, and never regretted it.  So that was a big boost.

Then I got sent to the ICU.  Things were really hopping there:  it was as though they found the most actively psychotic patients in town and wheeled them in.   I actually went there in a tech capacity since I was the extra nurse, so except for a couple of assessments, all I had to do was tech I was really in the trenches.  I had to set a lot of boundaries, including telling one to keep his hands off of me, but it was a good challenge. 

I finished the week off in the kids' unit.  Calmer patient population, except  for one very histrionic, paranoid, delusional teenage boy.  I have to give it to the techs on the kids' unit:  they know their stuff.  The kid was violent and screaming (and strong!), yet no code was needed as I gave the shot.  It was a little frustrating as for all my therapeutic communicating skills I could not persuade him to take the medication PO...but that's the nature of the psych nursing beast:  sometimes you can talk them down, sometimes you have to shoot them down. 

Now I have a LONG weekend ahead of me to relax.  I treated myself to twelve hours of sleep for my birthday, and it was the  best gift I could get after this week.   Third best was the week itself.   Second best will be whatever I decide to buy myself today.