In which Jo gets a disturbing differential.

My arm is fucked up. Seriously, majorly fucked up.

I woke up yesterday morning with the kind of muscle cramp in my left shoulder and back that made me actually wander around the house yelling and whimpering until the hot water bottle water boiled. It was miserable. I spent most of the day changing position every five minutes, trying to get comfy.

It was better today, so I trotted off to work. A buddy of mine rubbed the hell out of that shoulder and shoulder blade when I arrived, and it felt still better.

Then, at about 0930, my left arm stopped working. I still have grip and fine motor, but I couldn't raise it, quite suddenly, more than chest-high. And the pain came back.

So, handing off my soon-to-be-discharged patient to another nurse, I trotted off to the local doc-in-a-box, where they keep an outstanding nurse practitioner. He poked and prodded and rotated my arm, and kept asking if things hurt. "Dude," I replied, "everything hurts. I'm just one big ball of hurt."

The differential is this: either I have the mother of all muscle spasms, bad enough to affect the nerves running across my shoulder blade and down my arm, or I have a cervical spine nerve injury.

I'm full of steroids, both fast-acting and long-acting injectable, and muscle relaxants and antiinflammatories. I refused narcotics, on the grounds that they make me stupid and itchy, and I already feel like a retarded orangutan. I have orders not to bend, stretch, twist, lift, squat, or turn my head sharply for a minimum of five days. If I'm not better in three days, it's off to the spine surgeon I go (hi ho, hi ho) for an evaluation of my C5 disc.

There are a number of points arguing for muscle injury and against nerve injury, thank God, and only one cardinal for the nerve alone: the fact that I can't raise my arm without shrugging my shoulder up near my ear. *How* I would've injured a nerve in my neck so acutely is also in question, as the symptoms of C-spine nerve damage don't usually come on overnight.

Still, it's scary. And frustrating. I can't take out my own trash, or lift my own groceries, or do any sort of scrubbing or vacuuming or compost-pile turning or lawn-mowing.

Anybody who wants to come scoop the cat boxes is welcome. You can run the recycling out to the curb while you're at it. And peel me a grape, willya? I have a feeling this is going to be a long three days.

It's not all about the barbecue.

From We Band of Angels, Elizabeth M. Norman, Pocket Books, 1999:

"The Malinta Tunnel complex, organized into a series of narrow corridors, or catacombs, called "laterals," was like a small cramped city with sections for administration, supply, mess, ordinance, and a thousand-bed hospital staffed at first by the few dozen nurses originally stationed at Corregidor's post hospital above ground and, later, by the nurses evacuated from Bataan and some civilian volunteers. . .A main corridor 750 feet long, 25 feet wide, and 15 feet high served as a spine for the laterals. . .

The incessant [Japanese] bombing was concussive and some of the women developed severe earaches and headaches. Walls and ceilings trembled and shook, medicine bottles toppled out of cabinets, bunk beds bounced across the floor. The concussions increased the air pressure in the narrow laterals and caused the nurses' skirts to wrap tightly around their legs. . .

. . .The concussion was so colossal it slammed shut the tunnel's slatted iron entrance gate, and the laterals echoed with screams from the outside. Corpsmen and nurses in the nearby laterals sprinted toward the entrance to aid their comrades. When they arrived they had to pry open the iron gate, a grisly task, for jutting between the slats were body parts and pieces of torn and mangled flesh. . .

. . .almost every one of the seventy-seven Angels had dental and gum problems from three years of prison-camp food, diets dangerously low in calcium and vitamin D. . ."

From And if I Perish, Evelyn M. Monahan and Rosemary Neidel-Greenlee, Anchor Books, 2004

"...the sounds of bombs exploding in Anzio harbor had been rumbling through the hospital site for at least thirty minutes as Miernicke entered the postoperative tent and began her rounds. She had changed the dressing on one patient and was about to examine the bandage of the patient to her right when the roar of airplane engines vibrated through the tent. A moment later, the sound of machine-gun fire grew louder: a German and an American plane were engaged in a dogfight. As the two planes swept low across the hospital, Miernicke heard a whistling sound as a .50-caliber machine-gun bullets ripped through the canvas wall. Almost immediately, she heard a short, soft cry on her left. When Miernicke turned, she faced the soldier whose dressing she had changed only moments earlier. The young man was staring motionless up at her. . .he had been killed instantly."

"If anybody had a complete strap on their helmet, they had not been over there very long. The strap would fall off and get burned on the hot stove (while heating water for bathing). . ."

". . .I can still see him at times--whenever bad memories come to mind."

"If ever I come close to believing, it is when I hear 'Taps'." --Robert Heinlein

Atomic Batteries to power; Turbines to Speed!

Max has a Youthful Ward this week.

Her name is Molly, aka Good Golly, Miss Molly! Molly-Loo, Mollycoddles, and Mollywubbles.

Molly is eight months old and part border collie. The rest of her is either Corgi (judging by her ears) or speed freak (judging by her behavior). She has no clue how to be a dog, having lived her life to this point in the company of humans, specifically Nurse Ames and Her Lovely And Charming Husband.

Nurse Ames and LaCH are on one of those schwanky sailboat cruises through the Bahamas at the moment. Molly got here last night, right before they left.

This is Max being awesome. His youthful ward is just visible behind the big tree stump.

Molly, in full flight.

Max, wondering what the hell I've done here.

This is how awesome Max is: I gave both him and Molly pig's ears (thanks, Mom!) to chew on.
Molly had no clue what to do with the pig's ear. She sniffed it and was uninterested, so I gave Max his and dropped hers on the deck. She immediately went to see what Max was doing, and saw that he was chewing his pig's ear.

She ran back to hers, looked at it curiously, and ran back to Max. He didn't even lift a lip at her, and he's normally very posessive about food. Back to her pig's ear she went, then back to him. The lightbulb finally went on, and I left them on either side of the doghouse, both peacefully chewing their pig's ears.

She's already filthy muddy and covered with tree debris and she hasn't even been here twenty-four hours. Nurse Ames won't recognize her.

Sometimes, evil plans can come true.

I punched in for my first shift in the NCCU (two nurses, four beds, no waiting!) and the guy working with me, who handles most of the staffing for that unit, slung his arm around my shoulder.

"So, Jo," he said, "what sort of plans do you have for your unit?"

Er. Um. Aaahhhh.....gah.

The next day, one of the house managers grabbed me by both hands and started raving about how happy Manglement was that I'd taken on the job, that the unit really needed organization and efficiency, and how I was just the person to get all that done.

It would've been easier, and I would've preferred it, had nobody had any expectations. If I'd been able to do this under-the-radar, so to speak, there wouldn't be as much pressure.

I hate pressure. I am extremely pressure-averse, in the sense that planning and organizing something as big as this unit is going to be (and as fast as it's going to get big) are not my strong suits. Give me a couple of patients, both of whom are crumping in different ways, and I'm good: that sort of pressure is cool. *This* sort of pressure....well.

It's a challenge, right? It'll force me out of my comfort zone, right?

Right.

Other than getting bonked on the head by that Expectation Bat, things went remarkably smoothly. It's not dead-ass quiet, and it's not killingly busy--yet--so there's time to actually do nursing. There are problems, not the least of which is that we're working with borrowed equipment in a borrowed space, but the problems can mostly be fixed.

The two biggest problems-I-mean-challenges I see right now are these: The person who directs (well, supposedly directs; I'm not sure what he actually does other than wander in and complain about signage) the unit is someone with whom I have never gotten along and probably never will. How the hell we're supposed to get things done when his primary interpersonal-relations style is condescension with a side of bullying and a sprinkle of humiliation is beyond me. Seriously, this guy is such bad news that HR has been called in a number of times to set him straight about how not to manage people.

Oh, and nobody's really sure where we're supposed to be getting our supplies, like gauze and needles, but *shrug*. And there is no central monitoring capability in the unit. Yet. And we lack enough trash cans. Little things like that, you know?

It's going to be a bumpy six months. After that, it'll be an insanely busy year until we move into a new, dedicated space. And, since everybody seems to think that I really *can* do this, when what I'd planned was on-the-DL influence, I guess I'll start asking for stuff. Like trashcans and gauze.

Y'know what? I'm enjoying the hell out of this.

Ooo I had forgotten about this yes I had ooo.

Yeah, I don't feel so good.

Nightmares. As my brain switches from sleeping during one half of the day to sleeping during another. People getting locked out of the CCU, me not showing up on time to work, funeral corteges going past, people I know going missing.

MONDAY NIGHTMARE REMEDY!! That's what we need.

This is worth clicking, as embedding is disabled, and Robyn is the shizznit.

All you have to watch of this one is the first twenty seconds. In that time, you'll see staggering baby elephant running-times, and hear a tiny trumpet from a baby elephant schnozzle.

Later, I will make this pasta salad to take to work. Artichokes yum.

And that is all. Time to go lift heavy things.

Sunday Night Poetry: ee cummings

It may not always be so; and I say
That if your lips, which I have loved, should touch
Another's, and your dear strong fingers clutch
His heart, as mine in time not far away;
If on another's face your sweet hair lay
In such a silence as I know, or such
Great writhing words as, uttering overmuch,
Stand helplessly before the spirit at bay;

If this should be, I say if this should be --
You of my heart, send me a little word;
That I may go to him, and take his hands,
Saying, Accept all happiness from me.
Then I shall turn my face, and hear one bird
Sing terribly afar in the lost lands.

I hate nursing. Now what?

You're a nurse. You're paying off student loans with interest rates so high they make you dizzy. You're a new grad, probably working a crap shift in a crap unit, because that was the only job you could find. You're dealing with sick people every day, bullying coworkers, crazy family members, and inscrutable doctors.

And you hate it. You fucking hate it. Your life is a misery; you dread punching in. You lose sleep over having to return to work this weekend (because you've got the crap shifts). You obsess over how miserable you are, but you don't feel like you can quit.

Because of money. Because you've invested all this time. Because the loan guarantors are coming after you for payments, and it hasn't even been a year yet. Because you'll disappoint your family and your friends. And, most of all, because leaving a field that is widely seen as a Fulfilling, Sacred Calling That Only A Few People Are Suited For carries a huge stigma.

Y'know what?

It's okay to hate nursing.

Really.

It's okay to do something else with your life.

Sometimes *I* hate nursing, and I do it and think about it and blog about it and get quoted in books about it and sometimes lecture about it for pay and for free. The key, though, is that I only hate it sometimes. Most of the time, I'm as happy as a baby elephant in a kiddie pool. As messy as this job might be, it keeps me coming back, because it does something for me that nothing else does.

If you hate it all the time, it's time for a change.

I got a BA with a double major in music and sociology. I had no idea what I would do with it; write protest songs, maybe? I hated studying music. Hated it. I have a fair-to-middling voice with no real ability to act or interpret what I'm singing, and I barely scraped through on piano class because I hated screwing up so badly, I could barely practice. It cost my parents tens of thousands of dollars and untold worry to finance my degree, and I ended up doing everything from working in a bookstore to doing voiceovers and voice-mail mazes until that fateful day that I walked into a Planned Parenthood, asked for a job, and discovered what I'm really good at.

And you know what?

My folks, and my husband-at-the time, were baffled by my decision to go to nursing school. Not a one of them could figure it out. Not a one of them understood what it was that got me so het up over nursing, though they could appreciate that I was het up. My father finally said to me one day, "Johanne, I've figured out why you like nursing. You're the only one who was ever good at math."

The point of all this is, she says, taking another swig of Hardcore IPA (quite nice, by the by, if you like a fresh-hopped, dry, strong beer) is that you don't owe it to anybody to stay in a field you hate. Presumably you've done enough of it by now to understand what it is about it that makes you unhappy, and what it is about nursing that's a bad fit.

Eventually, the people who love you will realize that you're happier being a bank teller or a firefighter or an airline attendant, and everything will be fine.

I'll miss you. I'll throw you a huge party when you leave to go to firefighter school, and we'll keep in touch--and I'll be really proud that you decided to do what makes you happy.

Because, at the end of the day, you cannot compromise your own happiness for a paycheck (or to save face). You have to do what it is that you know in your gut will send you to work every day without feelings of dread and horror.

It's okay to hate nursing. Nurse Jo hereby gives you absolution, a blessing, and the help-wanted section of the local paper.

Holy Cats I Have Just Found The Best Blog Ever.

It's Always Something.

How did I not know about this before?

I have a new hero. Go read. NOW.