So things are the same

Just finished a long week of work.  I've done enough suicide assessments that I no longer need to read the questions off of the form...and there are a lot of questions.  

Anyhow, the procedure/biopsy is next week so it's all about waiting.  My mother says that my dad is taking all of this very calmly...almost too calmly.  It is the calmness that is unnerving my mother more than anything.  She told me that she's been staying late at work to avoid going home.

Consideing that I found myself booking shifts 6 days in a row to take my own mind off of things, I couldn't throw stones.   My mind wanders down dark roads if I have too much time to think.

The doctor is optimistic given how fast the growth appeared:  he thinks there's a chance it may be a foreign object or cartilage.   Meanwhile, I've done some reading up on bronchial cancer and found that the five-year survival rate is very good.   Of course, as it stands right now, surgery to remove it completely isn't going to be an option, so whatever they can't remove during the procedure will have to be treated with radiation or chemo. 

Maybe one good thing will come of this:  perhaps it will finally scare my parents into finally quitting the cigarette habit.

I did go back and unschedule myself on my birthday.  

In which Meriwhen is socked in the stomach

Not literally, though given the specialty of nursing that I work in, I'm sure a few of you were thinking that...

My mother called to tell me that they had to cancel their trip out here for the holidays.  The sock in the stomach is the reason why it was cancelled:  they found a growth in my dad's lungs during a CT scan.  Mind you, this was a follow-up CT scan for something else, and that growth wasn't there before...so it grew in the space of a couple of months.  So how rapidly this growth appeared is what alarmed everyone, plus where it's located.

The doctor himself scheduled an appointment with the specialist for next week.  They're going to go in, take a look-see, grab a sample for testing.  The doctor told my parents it could be anything and that they would not know until they were able to take a look at it.  The doctor also put the kibosh on dad flying:  dad wanted to wait until after the trip, but the doctor said that given how fast this thing sprouted up, who knows what will happen in a few weeks.  They also can't take the risk of the lung collapsing due to the plane ride.

Where it's positioned apparently makes it inoperable:  right lung, in the bronchus, at a fork.  I hope they can debulk it because it's almost closed off the bronchus.  If it were an inch up or down, they apparently could have removed it and put a tube in.

Lung cancer is a very real possibility:  both of my parents are (my dad did cut back drastically in the last several years but never fully stopped) die-hard smokers, so if they weren't smoking the cigarette itself, they were taking in some of that secondhand smoke.   And the Big C is no stranger to our bloodline, unfortunately.  It's appeared throughout the family in many different types.

I realize that my father is no spring chicken.  He's on the downward slope of the 70s and in addition to this, has had cardiac problems all of his life.  To be honest, I'm sometimes surprised he got as far as he did.  On the other hand, we all say that since he sees the doctors so frequently, he'll probably live until 100.  Still...

*sigh*

I'm trying to figure out if I (and little one #2) should fly out to New York and be there for the procedure, or go the following week, or go maybe later in the month.  I couldn't leave any earlier than Sunday.  I could go for a week and come back...I'd have to cancel three days of work, but I think this qualifies as a damn good reason to cancel.  If I waited a week, I wouldn't have to worry about work, but I'd be cutting it close to Christmas.  Or maybe we'll all go at the end of the month once the better half is off.

Better half is in a spot of denial...he's holding out hope that my father will be able to board a plane and fly across the country mere days after this procedure.   I told him several times that the chances of that happening are on par with snowballs in hell.   He continues to be in denial.

In a sad--as in Greek tragedy way--I'm not surprised that they discovered this now.  When I was growing up, his health would always go south around this time of year.  He was usually hospitalized for some part of December because of his heart, though he was always sprung before Christmas.  One year he cut it close though, discharging on the 24th.   For a few years his health perked up and he managed not to have the December hospitalizations.

*sigh*

I can't believe it's already December.  Two birthdays this month:  little one #1 and mine.  Then Christmas.  I've scheduled all my work shifts for the first half of the month so after December 15, I am off to enjoy the holidays.

I went to work on Black Friday because you can't pay me to shop on Black Friday.  Seriously, any day of shopping where people are killed in the name of bargain-hunting is not a day for me.  Plus I detest crowds.  So I'm willing to forgo rock-bottom sale prices to both live and not have to deal with parking my truck in a crowded mall parking lot.

Anyone, I went to see a coworker.  It was part work, part break.  I had to update him on a mutual patient (no HIPAAs were violated in the making of this conversation), and then after that, we fell into chatting about random topics.

I told him that as horrible as it sounds, after a patient discharges, I really don't care about them anymore.  I know that it's not the most compassionate, "it's expected of a nurse" response, but the reality is that I can't.  At least, not if I don't want to burn out.

I take the best care of my patients that I can whether they're my patients for five weeks or five minutes.  But when I leave for the day, I put them mentally away.  It's very rare that I let my mind dwell on a patient after I've clocked out...usually it's a very sick one that I hope will be OK in the AM, or one of my frequent flyers who is in the facility so often that when admitting calls to admit them, I can give them the report.

When a patient discharges, I wish them the best (and sincerely mean it), but once they're out that door, they're also out of my mind.  Again, the rare exception may be the frequent flyer that I might hear updates about from coworkers or other patients who've seen said patient in the community.  But once the patient discharges, I have to move on and focus on the patients who remain...as well as those who will soon arrive.

Part of it is to avoid my burning out mentally and emotionally by always subjecting myself to the service of others that I forget my own self-care.  I think they call it "compassion fatigue."  I learned from my pediatrics rotation how bad burning out could be...hence why I'll never work peds.  I could never mentally leave those kids at work.

I also think that part of it is because of the patients themselves. After years of dealing with patients who need help and don't want to be there, who go AMA, or who keep coming back because the minute they leave the facility they choose to drink/drug again, or choose not to take their meds anymore, or decide going to follow-up care isn't worth it...well, it's hard not to get a bit jaded.

Not so jaded as to provide the best care that I can, though.  And I do have tremendous compassion for my patients...while they're my patients.  But I have to set limits on that compassion for my own mental and emotional health.

The next challenge

The 30-Day Shred is the most agonizing 22 minutes of my life.  I struggle through it grunting and panting.  For whatever reason, I have difficulty with a different exercise each time:  either certain muscles are sore, or I just can't get the form right, or I get fatigued really quickly.  I'm cursing anyone and everyone--especially Jillian Michaels--in two languages.  When I get to the final stretching period, I stay face down on the rug and pray for a swift and painless death.  Then two days later, I go and do it all over again.

The scale isn't budging, but the pants are fitting better and better.  And I've been told by someone that I've really lost weight, so I guess it's working...or they're being too kind.  Who knows?

Soreness notwithstanding--I have a torrid love affair going on with my bottle of ibuprofen 800mg--I do feel better overall  Not that I'm ready to run a marathon...but I feel more "fit" than I did at the beginning of the month.

Anyhow... 

I requested that my transcript be sent to myself as soon as my degree was conferred, so when it gets here, then I can officially sign things with "BSN."  I guess I technically could use BSN in my signature since I did complete all requirements, but I feel weird doing it without having my degree in hand.  Or at least having a transcript in hand stating that I have earned that degree.  

Since I no longer have classes to take and clearly still need another outlet for my energies (besides exercising, I've read several books, already knit a shawl and two hats, and have cast on another pair of socks), I decided that it was time to embark on the next challenge:

It arrived in the mail earlier this week.  I'm joining the elite...or going to attempt to, anyway.  From what I hear, this examination is truly hell on wheels.  So I decided that if I'm going to make the Spring 2014 test, I need to start revising now.  I have this guide, I have a bunch of addictions manuals, books and journals to go through, and I've made arrangements to pick up more hours working shifts in the addictions programs over the next couple of months.  I also need to sort through my CEUs and see how many addiction ones I have finished, because I will need to have 30 CEUs completed before I can test.

I feel a bit better doing this.  I've been working so hard at school for so long than I feel like I'm wasting my time if I don't work towards the next thing. 

It's been a busy several days.  Between both jobs, I've been everywhere:  ER, outpatient, partial, step-down, back to the ER.  Thanksgiving tomorrow....no four day weekend for me...I'm off tomorrow, but on for Friday and Saturday.  I'll do my Black Friday shopping online.

I've done the 30-Day Shred for five times now.  Considering I started on Halloween, I'm averaging about one workout every two and a half days.   I haven't lost any weight, but some of my pants fit a little better.

I've also gained some endurance.  When I first started, I was only able to do five consecutive push ups before stopping for rest.  Now I can do eight consecutively.  I went from doing 15 in a minute (be aware that the minute is broken up into two 30-second sections) to doing 30 in a minute.  That is serious progress for me.

I'm also getting through the DVD with fewer breaks.  It's not pretty, and I prefer that no one be watching me as I workout as I'm sure I look as much of the uncoordinated wreck as I feel like I am.

I had to modify one exercise.  For reasons unknown, I can't mock jump-rope without having severe pain in my right tricep.  Even just the jumping without the mock hand actions hurt.  I can do the jumping jacks with no problem or pain.  I just can't mock jump-rope.  So I march in place for that segment...it's probably nowhere as effective, but it enables me to keep going.

I'm on a new assignment this week.  I'm vaguely familiar with the program that I'm going to cover, but it will be trial by fire.  Should be interesting.  It's at my main facility, so that means guaranteed shifts:  no worries about cancellation.  Three full days, one half day.

I also have no three-day weekend...oh well.  That's nursing for you.

Ow

As the first days of the rest of my life play out, I started doing an exercise workout:  Jillian Michaels' 30-Day Shred.  Tagline is that I can lose up to 20 pounds in 30 days.  Now, the nurse in me knows that losing 20 pounds in 30 days is a.  not necessarily safe, and b.  not likely to last for the long haul.  I'll settle for losing 5 pounds in 30 days.

This is a short yet intense 20 minute workout.  I need nothing but the DVD, a workout mat, hand weights (which I didn't have until today, but I didn't let that stop me), sneakers, and 25 minutes to allow for a little warm up and cool-down.  Little one #2 providing commentary optional.

I opted for the easiest workout level and followed the modifications for beginners ("If you feel like you're going to die, follow Anita").  It was TOUGH.  Seriously.  I would have wimped out and burned the DVD if it was going to be any longer than 20 minutes.  I was so sore that I needed three days and plenty of ibuprofen to recover...and mental note to myself:  do not attempt a new workout before working inpatient.

I wasn't entirely ow-free when I did the workout the second time, but I also knew that if I didn't get back in the saddle as soon as I could, it'd just get harder and harder.  So on day three, I did the workout again.  The second time went a little easier, and I wasn't quite as sore.  I didn't need as much Motrin.

Since I was feeling a little better after this workout, I waited two days and did it again.  The workout is getting easier.  Yes, I still feel sore.

Anyhow, the rate I'm going, it's going to take me about 90 days.  Thank God I didn't opt for Power 90X.  That might have taken me half the year.

*sigh*

Rough shift recently:  everything that could go wrong at work did, and it was out of my control.  I can't go into too much detail without violating HIPAA or anonymity...but it seemed like very little went my way, and there was nothing I could do about it.  It was one of those days that I'm half worried that the agency will tell me the facility doesn't want me back anymore because of how bad the day was.  I'd be the perfect one to throw under the bus for everything because I was one of the few agency nurses on hand.  Didn't do anything wrong AFAIK nor was told as such...yet my thought is, Meriwhen, meet Bus Wheel.

Yes, I know I'm being a little paranoid.  But it was THAT bad of a day.

Oh well.  I did do my best and got through it.  And in the long-shot that I'm no longer desired by the facility, I'm sure my agency will let me know before my next scheduled agency shift.

Next week, I've got a week of guaranteed shifts at my main employer...and after today, I'm already looking forward to it.