Tuesday, March 31, 2009

The LOL's will get you every time.

I went into work yesterday, expecting to find my favorite patient in her usual, non-verbal, only-able-to-communicate-by-grimacing state.

I was really surprised when I walked into her room to say hello and she said, as clear as a bell "I really have to pee".

I was even more surprised when she refused a bedpan and wanted to sit on the toilet, and I was shocked to find that, despite my protestations that she wouldn't be able to, she was able to sit upright with minimal support from me and my compadre. She really did have to pee, too, and used the toilet successfully the rest of my shift. I told her that I'm going to have to stop telling her all my secrets now she can talk....

It was like a scene from 'Awakenings'; she talked up a storm all evening, right up until I left for the night. I'm hoping that when I go in today, she'll still be able to talk, that yesterday won't have been a one-off. However, if she can't and it really was just a random thing, I'm going to be able to take great comfort in the fact that I got to talk to her for an evening.

It's moments like that that make the assaults, the slaps and the bites and the pinches and the downright nastiness I get from some patients all worthwhile. She got to me a long time ago, this LOL who everyone thought was basically unresponsive and who's facial grimaces were random. I talked to her nonetheless and came to realize in very short order that she really was in that shell of her body and that she DID have some purpose to her grins and frowns.

BTW, I got bitten AND pinched by the same patient last night (a different patient than the lady who started talking). After each time she did it I'd step back and say "now that's not nice! I know your mama taught you better than that!" and she'd just smile sweetly at me like she was proud of what she'd done. Because of the nature of her disease process, she doesn't know any better, bless her....but that doesn't make the bruises and teeth marks smart any less this morning.

EpiJunky is right. It's the LOL's that get you every time.

Sunday, March 29, 2009


I was shocked to learn the other day that a few of the most profoundly disabled and demented patients I care for are all full codes.

That makes me sad. The thought of having to do CPR on them makes me cringe and whilst I would do it, I don't know how I'd feel about it afterwards, especially if they survived their arrest. I think that I would have some guilt issues - because I personally believe that quality of life is what matters, not quantity.

I can totally understand a person not wanting their loved one to die. Us humans have difficulty accepting the concept of impermanence, especially when it comes to matters of the heart. We want those we love to be around us forever; we don't want them to change and we certainly don't want to lose them to disease and then death.

But, the plain fact of the matter - and of life - is that people DO change. Time takes it's toll on a body; things wear out and break and just don't work as well as they used to. Diseases develop and rob us of ourselves, of our dignity and even of our time. Yes, modern medicine has 'cures' for many diseases and treatments for even more, but at some point I think that we have to stop and take a step back and ask ourselves just what kind of life we are saving. What quality will there be for our patient or our loved one if we insist that "everything" be done to 'save' them? And, are we really 'saving' someone if we are returning them to a life full of pain and misery? How about if they don't know who they are and have no concept of time or place? What kind of a life is that?

As most of you know, I do some work for hospice and I am a huge fan of palliative care. I think that it absolutely has a place in modern medicine and is largely underrated. I believe that sometimes the kindest thing a family can do for their loved one is to sign a DNR and let them, when the time comes, slip away without having to suffer the indignity of CPR and other 'life saving' measures. Caring for a hospice patient and making what's left of their life comfortable is, to me, the biggest and greatest gift I can give someone.

I wish that more people would really look at the person they love when they're deciding whether to enact a DNR order. I think that a lot of people focus on who that person USED to be, not who they are currently. They remember their father/mother/brother/sister/husband/wife at their most vibrant, in the prime of their life...I don't think that they see the frail elderly person they are now; the person who cannot walk unaided and has to be fed a pureed diet with thickened liquids, the person who is incontinent of both bladder and bowel, the person who cannot verbalize what they want or even recognize their loved ones anymore. I wish that I could somehow make them see exactly what they're 'saving'; I wish that I could have them spend a couple of days with their relative and see exactly what quality of life they have. But, I can't...and so I watch them spend a couple of hours a week with them and then walk out of the door to go back to their own lives. I'm not saying that they don't care, because I'm sure they do...I'm just saying that they are perhaps not aware of the full reality and gravity of the situation.

Because if they were, I don't see how they could possibly refuse to sign a DNR.

Thursday, March 26, 2009

Heck of a week.

It's been a heck of a week. First, I got assaulted by a patient - sexually assaulted. They knew exactly what they were doing and now nobody is allowed to deal with them one-on-one; we have to deal with this patient in pairs.

Next, I got slapped and scratched by a bedridden patient who didn't want their wet pads changed. Because of their condition, decubitus ulcers are a real danger so leaving them in a wet bed isn't an option. So, I had to fight them a little to change their bedding and in the process they slappedmy face and clawed my hands and arms. They apologized later -they aren't able to verbalize, but I did get a smile and a hug after it was all over.

I have bruises up my legs from being run into by wheelchairs. Some of my patients aren't the greatest drivers in the world...

I had to break up a fight between two LOL's. They're both pretty confused and one thought the other was in her apartment. Words were exhanged, then shouts, and by the time I got there to intervene they were circling each other and looking like they were ready to strike. I had to have one tag along with me whilst I went about my duties so I could make sure they didn't come to blows.

I saw the absolute biggest bowel movement I have ever seen. It was so big I had to weigh it: 8lbs 2oz and that's taking off the weight of the commode pan it was in. It was HUGE.

I lost count of all the hugs and smiles I got. It's those hugs and smiles that make me look forward to going to work every day, that make all the gropings and slaps and fights and complaining I hear well worth it. Knowing that I mave made a difference in someone's day, whilst it may sound trite when I write it here, is it's own reward.

They are my patients, and I am growing to love them.

Thursday, March 19, 2009

Personal ad insanity

Some of these have left me stunned. I've been wondering if natural selection isn't the reason some of these people are single..

First up, we have a young man in his mid 20's who describes himself as 'Singel and ready':
I am a singel guy looking for someone real not in to games. I work and have a great job have a car and home. Cause I no all you women arent looking for a broke ass. I am real it gonna be warm today. I have alot to offer to the right person. I have pic if you are intersted.

Not knowing when it's appropriate to use 'know' instead of 'no' at his age alarms me greatly, and what's with the 'it gonna be warm today' comment? It has no relevance to anything else in the ad.

Next, we have 'Mick! love hugs and kisses!'
mick lover of life kind soul with good heart with loving arms around my lover i look for a true heart a friend for life one girl who needs one lonely boy to walk beside him every where and she has a lot of love she wants to share hugs in the night time even holding her with kisses on her mine a friend even if she just needs strong arms around her INTO THE NIGHTand just needs a loverTO LAY by her side,don't need a sex kitty but if she feels free that's ever more of two hearts just to be free LIKE BUTTERFLYS she don't have to be anyTHING BUT A WOMEN but just a friend in the NIGHT a friend a lover AS WE KISS SO SOFTLYand never meet again a girl with long hair a woman to hold on to i am good hearted GUY very romantic to,i need a nonsmoker,a young GIRL IF SHE FEELS FREE TO one even that she just wants a LOVER A FRIEND A GUY TO HOLD HER IN THE NIGHT IS OK TILL THE MORNING SUN SHINES ON HER SWEET FACE I CAN BE WHO EVER YOU WANT ME TO ME IN THE NIGHT THE KING IF YOU SAY THATS ANY TIME OF THE NIGHT IS OK IF YOU NEED A HUG OF A FRIEND ALL

Umm...I don't really have anything to say about this; I am stunned into silence. Is this a stream of consciousness ad, perhaps? I sure as fuck hope so, because it makes no sense to me whatsoever.

'IT WOULD BE NICE TO MEET YOU' is the next contestant. He says:

Hi girls, Just looking to meet someone to have fun with do stuff on the weekends, flirt with during the week. I'm 5'9" 160lb good build level headed and fun to hang, goodlooking aswell, really just want to be friends and laugh with. To be honest i hate bar thing, its eazy to pick up chicks there but really no thanks, no angle been down that road and it sucks. Looking for someone from mid tweenties to mid fourtys, you can be in a relationship or out of one. Not trying to just get laid just really prefur haning out with chicks, you gals are way more fun and alot more thoughtfull, and you smell better too, lol So if you intrested in being friends and enjoy having fun drop me aline your pic gets mine. ps I more of the county boy type, but not a redneck.

The last time I checked, 'good looking' and 'as well' were two separate words, not run-ons. Spelling 'easy' with a 'z' went out years ago, and I have no idea what kind of age 'tweenties' or 'fourtys' are. 'Prefur'? That sounds like something PETA would be interested (or 'intrested') in. This person either doesn't know how to use the space bar on his keyboard or he likes to create his own words.

'hey how you doing Are YOU LOOKING AT ME' clearly cannot find the period key on his computer keyboard:

He also doesn't know that the singular of 'women' is 'woMAN', that it's 'girl' not 'gril', 'knows' not 'know', that you take the 'e' off of the end of 'care' and 'love' when you place an 'ing' behind them and that it's 'golf', not 'glof'.

This 'SWEET GUY' is 'giving up':
hey im tired of the friend zone i find that i spoil girls and treat them good and it seems to back fire everytime lol hmm im a sweet funny cocky goofy kinda guy laid back relaxed stray away from the drama at all times in school for massag therapy and have a great job i want a girl i can cuddle up with watch a movie or go out o dinner ill pay and idk i would like to find a girl to spoil and go SKY DIVING haha if ur not to scared that is im adventures and love out doors if ur the jealous type move on i have a best friend who is a lesbian and my other best friend every guy wants lol so i would never give my friendship up for a girl i barly know well hope to hear back from u i sent a few pics for u as well have a good night

im looking for a girl who is attractive if there isnt attraction there cant be feelings sry i want a athletic girl seeing how i workout alot and i stay fit race dosent matter im mixed white and blaxk i want a sweet girl or a funn girl hmm please be around 5'7 or shorter.

What the hell is with people not using periods? That is one of the longest sentences I've ever read, and I'm not even going to get started with the text-speak....if I were this guy, I think I'd maybe concentrate on learning basic writing skills (you know, the kind you learn in 2nd grade?) before I went looking for love again.

Next time, women looking for men.....

Sometimes I despair for the future of humanity.

I really *do* despair for our future sometimes....usually when I'm reading the classified ads of the local newspapers, but especially when I'm perusing Craigslist.org.

Today, I managed to find these gems:

The man in the photo above is looking for love, apparently. He describes himself thus-ly:

looking for women - 45

i am single mail 45 yrs old looking for a friend/lover/solmat . am a social drinker open minded like to mike popple laugh and horney ass hell !!! can you take care of it grils ??? xoxo

*sigh* Where to begin...? First of all, if he is 45, I'm a monkey's uncle. Secondly...yeah, you know what? I'm not even going to go there. I think that his self description says it all, don't you?

Next, I found someone who is selling a "CARIO CABBINET WITH SOME DOLLS IN IT" (caps are their own work, not mine).
What is a cario cabbinet, exactly, and why does it have dolls in it? Why are the dolls included? Are they nailed or permanently attached to the piece of furniture?

A "Ma-hoggeny dinning table with leef" caught my eye next. I'm not familiar with the wood or the 'leef', but there seem to be an awful lot of 'dinning' tables up for sale in my locality. Are people sitting around these tables and shouting or playing loud music, perhaps?

I'm still trying to figure out what the next items are:
"Caprice - name brand" When I clicked on the ad, there was a photo of pants. I'm thinking that maybe the author wanted to sell their capri pants..?

There seems to be a lot of pieces of furniture called "Chester drawers" that people are trying to sell, some of which are "french Providential" style. I am not familiar with either of those things.

I had to post this next one in it's entirety because I don't think my describing it to you could have done it justice. It's heading is "free to upholster student" (which I don't quite get, either):

this is a chair from the 20's it is a rocker,has wheels,and alot of fancy wood work very nice chair but needs a uphostery job has original material i used this chair for many many years till grandson wiggled arm enough it came off its not broke its like i lost the screws its wierd and the wood work is perfect i can send pics if needed but this would be great for some one learning big pieces and straight cuts this is a family chair it was great great grandmas small chair she was 4 ft tall sits low to floor


Woah. That's a whole lotta single sentence right there. I wonder if the author came up for air when writing it?

I have no idea what this next person is looking for:
Im Lookings for Gondolas

I need a bout 20 secation gandola 2 sided . i need it for grocery store im willing to pay around $40 per secation.you can email me at (removed by NM)

Is a 'Gondola' the same as a 'gandola', and what exactly is a 'secation'?

Finally, we have a post that alarms me:
Hi im looking for a few new people to Tattoo. im very professional. all (((((new needles))))) an everythings pressure cooked in front of u. Im very professional an respectful to the client. for exsample those stars for 70 that butterfly is 40 the cultic heart is 50 an the heart with the banner with color an name 60 WILL TRADE FOR A NICE DIGITAL CAMERA!

First of all, a cheap tattoo isn't always a good thing. I don't understand why there are multiple parenthesies around the words 'new needles', and I sure as fuck wouldn't get inked by a guy who can't spell OR punctuate appropriately. I wonder how many people come out of his shop with thing's like 'Your Next' and ' mohter' etched into their skin. I'm not even going to touch the fact that he's willing to trade tattoos for a digital camera.

Watch this space for more classified and craigslist madness, coming soon!

Wednesday, March 18, 2009


I've lost weight. Again.

Saturday I was wearing jeans that I haven't been able to fit into since 2006. I wore size medium scrubs to work yesterday and spent most of the day pulling them up because they were sagging - they're slightly too big.

I am now wearing a size 'S' scrubs. I haven't been a size 'S' ANYthing since 2006.

My duty pants are too big, my jeans are too big and most of the T-shirts I have are so loose it looks like I'm wearing someone else's clothes.

My butt is smaller (and firmer), I'm starting to get definition in my abs, and I can actually see my biceps when I flex them now. My calves are very well defined and I can actually see my quads without flexing them. I feel smaller.

Once upon a time, not too long ago, a size 3 was too big for me. I was shopping in the kid's clothing department, and I didn't see anything wrong with that. I could wear my daughter's clothes and I thought it was cool.

I don't want to be that small again. I like my curves and shape, I just want them to be a little firmer overall. I'm not worried about my weight; I have muscle mass that makes me weigh heavy - I'm more focused on overall health, shape and size.

Firm, toned and healthy. That's my goal.

Monday, March 16, 2009

No stories.

I'm not quitting totally... not just yet.

I just got done signing more confidentiality agreements and clauses than I have ever signed in my entire life for any job, ever. The short version of the deal is that I get fired if I talk about work. Period. I know I have people who read my blog in my locality and I'm not willing to risk getting 'Dooce'd' (Heather B. Armstrong, aka 'Dooce', got fired from a job for blogging about her coworkers, hence the phrase Dooce'd).

So, whilst I'll still be blogging, there won't be any tales from the rehab facility. EMS, yes - and I still have tales waiting to be told on that front - but there won't be any LTCF stories, no matter who much I want to tell them.

Sunday, March 15, 2009

Nothing to say

I apologize for the lack of posts recently. It's not that things haven't been happening, because they have...I just haven't really had a whole lot to say.

I created a Zazzle store. I'll post the link to it sometime next week.

I had to get new scrubs because all of my old ones are too big. I lost more weight than I thought I had, apparently. Yesterday I wore a pair of jeans that I haven't been able to wear since 2006, and all of the shirts that I was wearing last fall are baggy on me now. I don't want to be uber thin; I'd be happy being a size 6 - a muscular size 6.

I ran the mile in just over 1o mins on Friday, but my iPod died on me right at the end so I have no record of it.

Turned my ankle running yesterday. The roads were too busy to run on, so I was on the sidewalk. A couple with a stroller were coming in the opposite direction, and they decided that they didn't want to walk single file for a second, so I had to run in the grass. I stepped off into a divot and heard a nice crunching sound as my ankle bent in a way it's not normally supposed to bend. I had to call Urbaner to pick me up because I couldn't walk home on it. When I got back immediately iced, wrapped and elevated it, and this morning it's stiff but not too swollen. It sucks that I can't take NSAIDs, but I'll survive.

Got my hair cut off and colored. Think of 'P!nk', and you'll have a good idea of my new 'do, and it's now red with a blonde chunk at the front. Yeah, photos will be forthcoming and I'll be changing my ID photo soon.

Sir Napoleon Dynamite Mousey McMousington is ill. I think he has viral CMP, which is mousey pneumonia....there's not really much I can do for him except keep him comfortable and hope he gets over it.

That's it, in a nutshell. Not much else is going on - not things that I'm going to talk about here, at least. Some things just aren't meant for the blogsphere to hear, you dig?

Tuesday, March 10, 2009


I found out from some very reliable sources that my boys have been playing a game called 'Possum'.

They've been going out at dusk (their curfew is 8pm on a school night and 9pm on a weekend) and laying themselves in a carefully arranged prone/supine position on or near the street and waiting for a car to come along. When said car gets close enough, they jump up, shriek and run away.

The aim of the game is to either a) startle the driver of the car or b) have the driver of the car think that they're ill or injured and THEN jump up and startle them.


I have tried to explain to them that startled drivers tend to do some very unusual and unpredictable things, but they're not getting it. My eldest boy asked how what they're doing is different to their dad or I running in the dark, feeling tired, bending down to rest, then standing up as a car came by, thereby startling the driver.

Clearly he has not grasped the concept of intent and deliberate actions yet. I have spent an hour this evening trying to explain it to him, but I fear this has been a fruitless enterprise.

In any event, they are both on punishment for their folly.

Folly that I am going to go snicker about when I get done writing this, because I played the same game when I was their age. I was just smart enough to NOT get caught....

It's not EMS, but...

...I got a job.

It's in a long term care facility that has both a skilled nursing hallway and an independent living wing. It scored high on the Medicaid scale and had a reputation in the area for being one of the best around. I interviewed there this morning and I was offered a job.

I've seen these places from both sides of the spectrum: the facility staff side and the EMS side. I've been frustrated because I didn't feel I was being given enough time or equipment to adequately care for my patients and I've also been frustrated as an EMT - being handed a patient's file and been told "they're not acting right, last door on the right" is NOT adequate information about a patient.

I explained my frustrations to the director this morning. I said that I have ethics and personal standard regarding residents/patients and their care and that I know from experience that the fallout is NOT pleasant if I deviate from those standards. I said I wanted to go home at night knowing that I provided the best care I could for people and, should EMS be called, I wasn't going to just grunt and point, I was going to give as detailed a report as I would if were the EMT delivering the patient to the ER.
I said that I wasn't going to follow the herd but that I was going to try and be an example of how proper and adequate care should be provided. Nobody *has* to follow my lead...but I hope that they do.

And I meant it. I MEAN it. I'm going to do that, no matter how slow it makes me and no matter how everyone else is going it. I'm not going to let my standards drop, regardless.

It's not EMS, but it IS in my chosen career field. It's also more money than I'd be making as an EMT. Can't argue with that.

I'm actually excited and happy about going back to work!

Monday, March 9, 2009

No suffering, just passion.

Someone I know made a comment that death appears to have been following me around recently. Patients have died, people I knew have been involved in tragedies...they worry that I'm suffering alone.

I'm not suffering.

I learned a long, long time ago that I had to find a way to compact any mourning I might do for patients into a shorter window of time. When I first started palliative care I carried the first couple of patient deaths with me for weeks, and as a result I was fucked up emotionally, mentally and physically. It was a difficult time and a hard lesson to learn.

As a result, I don't mourn in the traditional sense. That's not to say that I don't still connect and bond with my patients because I do....I just have learned to separate a part of myself and keep it hidden, away from hospice and EMS. To date, only one person has seen that part of me and he has promised to keep it as secret as I have.

I am no less compassionate than I was, and I give no less of myself to my patients. I still form bonds with them and I still take on pain (mine, theirs and other people's) when they die. I just don't let it into my core and I deal with it in a souped-up method. I mourn like a Ferrari rather than a Neon.

When I cry after a patient's death, it is more as a release of emotion than it is as a display of sorrow and pain. I prefer to remember moments in time that person and I shared; happy moments, brief glimpses of sunshine....snippets of smiles and laughter. I want to remember them fondly, not sadly. I want to remember their life and their love and their happiness, not their illness or the event that led to the cessation of their life.

We are all dying. Every single one of us. Some of us will die young. Some of us will die at someone else's hands. More of us will become victims of circumstance and of fate, and some of us will live long and productive lives and die having lived more than our allotted threescore and ten. We never know when it will be our time.....I don't know when it will be my time, and I'm down with that. I don't want to know.

Instead I prefer to live in ignorance and love with a passion that would make even Freja's fire seem but an ember.

Friday, March 6, 2009

A cessation of suffering

One of my former patients died this week. I just read his obit in the local paper and spent some time crying and reminiscing about him.

Doodle was one of the funniest, sweetest people I have ever had the pleasure of knowing. He would walk the hallways and when I had a quiet moment I'd offer him my arm and we'd walk together, chatting about nothing much but conversing nonetheless.

Me: "It's a beautiful day today, Doodle"

D: "Oh, that's for sure, it's a beautiful day, that's for sure. *singing* And the roses growing in the garden, and the lilacs and the roses, the roses growing..."

That song was constantly on his lips. I can still hear his baritone voice murmuring that song as he walked. When he was stressed about anything, that song would get faster and faster. I knew Doodle was not happy when the wordsallrantogetherlikethis....

Once, after he'd had an accident, I was cleaning him up and getting him into new underpants. I was wiping him and accidentally grazed a very sensitive part of the male anatomy and he jumped and said "Hey! Watch the junk! Gotta watch the junk, that's for sure...."

I smiled and cried at the same time as I read that he had died this morning. I am sad because I truly believe that the world is a little less bright without his presence, no matter how limited it may have been....but at the same time I am glad that there has been a cessation of suffering for him.

There is a memorial service this weekend for him, and I think that I may attend. I don't normally attend funerals, but this isn't a funeral...because Doodle, in typical Doodle-style, has donated his body to science.

It's almost spring, and I think that I may plant a rose in memory of my friend Doodle. I think he would have liked that.

Tuesday, March 3, 2009

Wash thy arse. Really.

I don't know what it is about me that attracts older, malodorous men to my general vicinity, but I sure as fuck wish I could lose it.

The other day it was an old man so slick with body oils and secretions that his skin shone and his hair was plastered to his scalp. His jeans were so dirty that they were shiny and his shirt had remnants of...well, I don't even want to think about what the stains were remnants of. Ick.

He got so close to me that I could feel (and smell) his breath disturbing my hair. I was buying drawers, and he made a comment about how they were "purdy" and he'd "sure like to see them on".

Eww. Just eww.

I couldn't think of what to say, for once. 'Fuck you" and 'get the fuck away from me you perv' would both have been very appropriate phrases, but the only thing I could think of was to play the boyfriend card. I told him my very tall virile boyfriend (I shoulda added "with a jealousy problem and a hair trigger temper" but I didn't) had said the same thing and that he was around the store somewhere if he wanted to talk to him about it.

He declined and shuffled away. I can't imagine why.

I know that a few people read my blog, and I don't know if any of them happen to be malodorous, but just in case they are:

You may not be able to smell yourself, but trust me, the rest of us can. We can smell you coming from quite a distance, actually, and it makes some of us physically ill. There's this stuff called 'soap' and when it's used in conjunction with this other stuff called 'water' it does quite an effective job of removing your secretions and accompanying stench. You could even go so far as to apply this stuff called 'deodorant' - you'll find it on the same aisle as the 'soap'. I think you'll find that you wont be shunned and avoided nearly as much if you WASH YOUR ARSE regularly. It could be the start of a whole new life for you! You might start getting invitations to lunches and dinners and, if you're a single person (and I have a feeling that you might be because no self-respecting spouse would tolerate that kind of nastiness - unless they are themselves a STANK ASS) you may even get a date. You can thank me later and invite me to the wedding if that happens.

Next time we'll talk about washing your clothes. No, they don't fall to pieces if you get them wet. Fabrics are actually quite sturdy these days and are actually designed to be cleaned with that strange stuff called 'water' and another thing called 'detergent' - which, in case you were wondering, is soap for your clothes.