Hurray! I have survived another whole month of work, as the month comes to an end, I sit here in bed half dead. I should be sleeping, and for that I will be in trouble from my husband since he hasn't seen me in 4 days. I hadn't seen my kids in 48, thats probably because I worked 42 of that 48... I guess the remaining 6 hrs I could've, but I chose sleep over kids. I'm a bad mother.



I turned down the job that was offered to me, after I interviewed a couple weeks ago. I tol dno one that I had interviewed, or was looking, afraid that it somehow would be used against me. I wonder if I did the right thing. I asked her to please make it an open offer... (funny. But only funny to us transplant ppl) I wonder if I should ask for full wavers also....hmm.



My donor this weekend was a glorified horse and pony show, better yet a complete cluster. I don't want to relive the nightmare 30hrs of which I was awake, otherwise I might have to start drinking and I can't tell you a place in the world that it is 5 oclock yet so I know its too early. Next time I choose to brag about how wonderful a case is going, slap me.

People ask why I like my job, and I tell them that I only like it 75% of the time. And here's why; every case has something new, a new challenge. It may be donor related, transport related, family related, who knows. And every case I honestly think that I have seen it all, tackled it all. I had to laugh because this case was going so well, and then wham... a problem I have never had before. "We are sorry, but the OR is shut down this weekend." WTF???! What hospital doesn't have an OR? I guess this explains why they aren't a trauma center, though they could be due to their size. That will teach me to brag.

By the end of the night I had sent an ambulance code 3 with my donor to another hospital and I had a list a mile long of people I wanted to kill with my bare hands and people I wanted to kiss, but I practice self control on both parts. My second donor wasn't much better, it seems everything I touched this weekend went to the worms.

The whole weekend might had been more bearable had I had co-workers that actually talked to me. I have decided that I dont care, I am actually more happy not being aorund people that are so misserable with their own lives that they have to constantly try to bring others down with them by being mean and spitefull.

Lost in thought

Wow, I just realized its been a month since I posted last. Not intentional, I think I have just been busy, and not really with donors either. Sure I have had 2 within the last week and I am just today recovering completely sleep wise. But I think I have been more pulled into the drama at work, and with my own thoughts about this job. I have been thinking a lot lately about many things...
First though, my donors this last week. One was at county... oh the joys of doing a case at county. These include: double and triple lining the toilet before you sit, opening all doors with your hand covered with your sweater sleeve, being forced to sit in a corner out of the way so that people dont trip on me, eating pizza that is 6 hrs old and so on. The OR RN was a nightmare, and I just dont understand what compels someone to be so damn ass cranky towards me when I have done nothing wrong. I had a table pulled out from under me, told I couldn't sit and had to apologize to the teams that came in for the staff. Even when she asked me questions it was done with a rude manner and plenty of scowling. Hell, its not like I am there trying to intentionally make her life miserable, do you think I enjoy doing a donor OR at 0400? I am just on my 22nd hour of doing this shift, trying my damndest to be so nice so I dont get complained about, and doing all this for a giving family and recipients waiting. And yet, someone is shitty to me... makes me wonder WTF?! So after I left wonderful county, I had a case at the local children's hospital a few days later. Much better staffwise, I was allowed to sit in a productive place, the nursing staff in the OR couldn't have been sweater and more wonderful to me, that I almost cried. And on my 18th hour when I finally finished the OR, I had to clean, dress, bandage and cover with warm blankets, a 2 year old who had just donated 3 organs to save other children. I took him back up to the ICU where his family waited to see him and heard again, as I do on every case from nurses: "how do you do this job?" And that got me thinking...
How do I do this job? If it was just the donors and the families and the recipients and the staff(make that nice and supportive staff that I could work with every day), I dont htink I would EVER stop doing this job. But its not.
Thing at the office have been down right shitty lately, well in the last year. There is no sense of teamwork, and those that are the most guilty are the most vocal about how there is no teamwork. I say you all fix yourselves and your attitudes and the teamwork will fix itself after that. The staff meetings have been awfull, lots of yelling and crying etc. The back stabbing and just rudeness is off the charts. I have been a recipient of all of the above, and that is the reason I just keep to myself. My boss keeps saying we need a team building activity, I say wtf would I want to spend time with those people?? And since I have been given a charge position, things are worse. You want to make yourlife fun? Just start doing what I am doing. Suddenly everyone is critical of me, of what I do, how I manage a donor, where I go, what I say, how I say it and who I say it to. They accuse me of things I dont do, of checking up on them, of not doing this or that, you know its a wonder my boss hasn't shot him/herself doing this soley for the last few years. I am getting to the point where I dont think it matters what I do, it will be interpreted the way they want to interpret it.
A couple weeks ago a close co-worker friend of mine was fired, or rather asked to leave her position. Normally, I try to stay out of things like this, but I did call my boss and I did ask why. WHY? Well apparently there was a lot I didn't know, point taken. I can handle that, but dammit she is a damn good ORC, granted she has no filter, but she can get things done and lately has busted her ass even more than me in fullfilling her requirements as a coordinator. I told my boss that makes me sad and sickened when there are plenty of people still employed who dont care, dont do there job and cut corners every day. Its so frustrating because now I feel very alone, which is sad. I used to think I had friends at work, now I dont. I dont feel like I have anyone to catch me if I fell, which sucks.
So now I think... why do I keep doing this? I used to say to co-workers that the positives outweight the negatives. I had many reasons for doing this for 5 yrs, most of them good, very little bad. Now the balance is shifting. I keep doing and trying and its not good enough. I dont feel like I have many friends, I have to dress dead children, put up with shitty nurses etc. BUT is the grass really greener elsewhere? I have thought about other jobs, positions in cath lab, in PICU maybe, maybe as a post transplant coordinator. But have rejected them all. I dont know, right now I am just pissed off, mad that I am feeling this way, that others are making me feel this way about a job I love. I have always told myself and had friends tell me: Dont let other people ruin something you love. Its just getting harder and harder though.

Recovery Process

I am recovering today... this morning I went for a 5 mile run and left my damn phone at home, on the counter, off. I had my music blaring and it was beautiful and every mile that went under my feet erased some part of the previous week, at least the least fun parts. The run plus an hour in the sun by the pool has healed me somewhat, oh yeah that and a glass of wine.

I got chills when I heard from the ORC who is with the family of yesterday. The donor is a young woman, and she was to be a DCD (donation after Cardiac death) but all things considered and then some, she wasn't going to arrest in the time needed, but today she was worse and so we attempted again, thinking this time it would work, and it did. She arrested in 26 minutes. The chilling part is her family chose direct donation. A nurse who works in the ICU, her husband needs a kidney and will receive it today. She actually took care of the donor, but stayed in the ICU during the recovery part of it all (conflict of interest, which I understand). But again, someone will live. It feels good to know that our effort plus their generosity did this, their determination and our willingness to give it a shot, it's something that will keep me going this week as I am off... This should carry me through my big test this week.

I just found out a coordinator who I have known for 4 years is having a birthday, and other coordinators are going out tonight for it, and I wasn't invited, in fact my friend said she was goign to dinner with her bf and I find out thats not the case from someone else. Hmmm, now I know how my boss feels. She says no one ever invites her to lunch etc, so I have been trying to do that when I am around. At first I was afraid that others would think I was sucking up, which I do not do, but then I stopped caring. Think what you want to think. Maybe its because they think I will talk to management now that I am in charge, hell. Whatever.

I headed off to the shower, then going to watch a movie with my feet up and some wine.

wow

Wow, is all I can think or say right now... wow. I have a new appreciation for my bosses. I have been on orientation for 2 weeks, 2 weeks of being in charge of the madness. Everyday I learn something new which is cool. And most everyday we have a donor so Its challenging to say the least. So far I haven't screwed up anything so that is a plus. I'm getting somewhat more confident in what I am doing, when suggesting donor management.
I'm too tired to even write right now... I am so behind on sleep I dont remember what dy it is or how behind I am. My nights and days are all screwed up, and right now I am drinking which isn't good, well it feels good at least, but not sure about the drinking alone thing... that might be bad.
So, this week I take some time for me... I am laying by the damn pool tomorrow. JUST LAYING. Not moving. I do need to exercise, too many cheetos in the ICU last night, but after that, I am verticle by the water. Then maybe some more to drink...uh oh.
The donor last night has a cat that needs a home. I want to take it but I think my husband would kill me. I could name it UNOS, or NoGo....

Making enemies

So today I am in charge, Advisor, the one to hate. The one to despise... the one to cuss out when no one is looking, to talk bad about over drinks tomorrow. The one that gets accused of this and that and wasting this time and saying to do this stupid thing... boy am I going to hit up the boss for a raise next month. Someone just said to me, "I got to give you credit for doing that", my thought all day has been "how the hell do they do this all the time?" The phone incessively ringing every 10 minutes... I think I have used up only a 1000 text messages today so thats good at least... Its non stop. I have to give them credit... its a whole new world. A lessen in communication, diplomacy and critical thinking. Its challenged me and thats what I wanted right? to be challenged right? Things were getting somewhat stagnent, I was becoming too complacent in the job, just going through the motions, so this has been a good thing. Its just that I am making enemies pretty fast and finding out that I do things, everyone does things A LOT differently. This is only my 2nd day doing this so I have to go easy on myself and not be so overly critical of myself as my boss says I am, am I that way?? Yes , we all know I am. I have learned a lot today, a WHOLE lot, and its been good. I feel as coordinators we know so much more than the average nurse, hell than most docs even, so why am I so hard on myself? I hear what they dislike about the boss, so its hard not to try and not do things they do... arg. So time will tell if I can hang with this and if I alienate everyone...

A rough 2 days

I have been on a rough call stretch and I am getting my proverbial ass beaten. I have had 7 hrs sleep in the last 2 days and got to see my kids for the first time in a few days also. In the last two days I have been asked if I like my job at least 10 times, asked to explain my job thoroughly at least 5 times and given out my business card 3 times to nurses interested in a job. All the while repeating the "I love my job" chant to myself quietly as I try to keep my head from crashing to the desk in the TICU at 3am. I had nurses look incredulously at me both nights after they found out I would be there til 8am. I overheard nurses say to one another "Not worth the money, no life, no way" as I called transplant centers and tried to think about manging the donor as my brain was trying to think about a nice warm bed. Both nights I contemplated taking a 12 hour job in PICU and quickly rejected the idea and kept plugging away at what I do best, knowing I would regret it if I did.

Problem is I am so hard on myself, I am a perfectionist. Nurses are in amazement at what we do, what we know and how we do this and sometimes all I can think about is how the hell I forgot to do something I have done a 1000 times. I can't stand to make mistakes, or errors or be wrong, or miss a crucial peice of information. I hate being criticized by people who think they are perfect and dont make mistakes. This job makes me go through all that on a daily basis. Other co-workers are constantly in competition with each, our group lacks any cohesiveness, any teamwork and it seems that no matter what you do or efforts you make, opinions never change so why bother. Good thing is I get to work by myself most of the time and that helps.

I finished off my shift this am helping the wife of my donor crawl in bed with him to spend some time alone laying in bed next to him. Now I just need something alcoholic to drink since I am too tired to go run.

Just another day in paradise

Just as I exited the freeway this morning downtown, Guns and Roses came on the radio blasting "Welcome to the Jungle" and I giggled to myself, thinking that the song was highly appropriate for the hospital I was going to. After I pulled up and parked in the County hospital lot, I was awarded with the lovely sight of a middle age man, obviously homeless, standing in his skivys outside on the lawn in front of the hospital. I'm not sure what he was selling but I shuddered at the thought. The police were there already telling him to put his pants on, so he did, wrong side in, dirty white pockets hanging over his now covered nonexistent ass, dirty bare feet showing. Someone could've transported me there, and just shown me that scene and asked me where I was and I could've told them.
I headed up to the ICU, making sure that I pushed the elevator buttons with my keys, used my hips on the doors, and used every hand sanitizer dispenser I walked passed. Again I was awarded with all sorts of interesting sights. One thing I cannot understand is how a mother can allow her child to play barefoot, on the floor of any hospital, much less this one... Ugh! I walked into the ICU, which is the size of a box ,did my duty and left since there wasn't any family due in til later to approach. Leaving the hospital I saw underwear guy still being harrassed by the cops. I stopped by the childrens hospital for a quick peek at the little munchkin there that had an unfortunate delivery and then went to grab some lunch. I spent the rest of the day waiting and waiting for the family to arrive and finally went home. Hint: the best way to make a family in denial come back into the hospital is by heading home. As soon as I was 10 min from my house, Children's paged me again and the family had arrived at county. Its already near drowning season again, and after the denial family declined and I saw the new kid, I went for a hard run until most of the visual had cleared my head. I came home sweating and then found I couldn't go to sleep. These are the nights I need to drink and I can't because I am on call. So I layed in bed awake and finally fell asleep only to awake and reach for my phone in a panic this morning because I hadn't received any pages... Nope it was still on loud. Whew, I've done that before. I have 2 days off and I am going to enjoy them before Friday.

Blown away

All I could think about yesterday morning was how tired I was, how it wasn't fair that I had to go to sleep at 10pm while everyone stayed up partying in my backyard. How I had to cut the margaritas short and stick to beer, and how I had to get up at 5am and go do a donor. So all the way into the city on my drive I grumbled and complained to myself. I had visions of being an OB nurse, wouldn't it be nice to see new life instead of death? Maybe easier to do a 12 hour shift and come home with no meetings or calls or complaints. I thought about how the people I work with right now are sorely lacking in a lot of things (thats a whole nother post) and I wouldn't miss some of them. Hmmm maybe a starbucks girl, a bartender? Anyway I looked at it, I was in for a busy 24 hours and I was miserable about it... until.

Until I got to the hospital. I was introduced to this family and I did a complete 360, I was so moved, so awed by their courageousness, their generosity and their spirit in the light of such tragedy. Here I was feeling sorry for myself and this family had every reason to be angry at everyone, at god, at whomever for having their loved one taken from them so early and suddenly. She was so young, had a teenage daughter and wonderful husband, 6 brothers and sisters, a huge family. And not ONE of them was angry, everyone was smiling and excited that they were helping other people live on. At that point I knew that maybe this might be God's way of saying " your not quitting yet, your going to keep doing this job". Because after I met them, I think I could have worked 48 hrs non stop. In my 4 years at this job, I have yet to meet a family like this one, and they have left a lasting mark on me. I think they might have just given me the gas to go another 4 years doing this job.

Later as I stood in the room with all 25+ of them and told them where their loved one's organs would be going, I cried as I looked around at their faces, the smiles and the excitement was so obvious. I think I have cried off and on with most donors but never like this. I cried because their love and spirit filled that room and I was so overwhelmed by that love and hope that they had. I told them I had never been so honored to work my tail off for 18 hrs for anyone. In the end her lungs, kidneys, liver and pancreas saved 5 people and her family can't wait to meet them.

This famiy stayed with me long after I left last night, even when my pager went off at midnight and I drove again into the city trying hard not to fall asleep, and again at 5am. Not once did I grumble or complain, knowing that this was all part of the process, that I had forever made a difference in a families life by doing what I did. As hard as it seems sometimes, as much as I disagree with political issues in the workplace, the policies, the co-workers, the gossip, etc, I will always have what I love and do best.

Amnesia in a bottle

I was on call this weekend. It's left me exhasted to say simply. I spent all day today almost on the phone with conference calls and I am tired of thinking about death. Yes people are living because of that death, but I never see them, its a one way mirror for me and thats hard. A co-worker just called me, she's frustrated with management and physically and mentally exhasted. I listened the best I could, being sympathetic but trying to stay objective. Sometimes I see her side, sometimes I see their side. Right now, I dont want to see either side... I dont want to think about work, the politics, the donors or the recipients. At least not right now, maybe tomorrow. I've already taken my allotted dose of advil today, thrown in a couple mutivitamins, some macrobid with some tums on top of that...

Monday night after going for a hard run to try to get the picture of my donor's young wife crying at his bedside, her 2 year old child, out of my head, I drank too much, so much for the calories burned (but well worth it). Sometimes I need to just wash it away with alcohol, or attempt to anyways. No... I am not an alcoholic, I find outlets in plenty other healthy places as stated above. But, as I was explaining to the nurse in the ICU as we were both crying with the wife, "this is a 2 drink case", and I meant it. Sometimes I just have to indulge for the sake of amnesia.

Alcohol is the anesthesia by which we endure the operation of life.
George Bernard Shaw (1856 - 1950)

I am sitting here with my feet propped up, a warm fuzzy blanket spread on top of my legs and my laptop sitting on top of that. I have the fire place going strong and its getting increasingly harder to stay awake for an afternoon conference call that I am required to be on. I was awake until midnight last night, not in bed until 1ish due to the necessity of food which I had been without the prior 12 hours. My husband, bless him, made me a turkey burger, which I enhaled the minute I sat down after getting home last night. I sat eating and watching the "pursuit of happiness", never hating and loving a movie so much. But it became emotionally too much to watch after the day I had had, so after kissing my boys and standing at their bedside for a few minutes staring at them, I finally I collapsed into my warm bed, my feet and heart aching.

Yesterday afternoon, I watched a mother say goodbye to her son. I watched a sister say goodbye to her brother. I watched a father say goodbye to his closest friend. And a girlfriend say her goodbyes also. Sadly, I have watched a thousand goodbyes over the past years, but for some reason, the wall was hard to throw up yesterday. Maybe it was because I was tired, or hadn't done a case in awhile. Maybe it was because I have boys and it hit me closer than most cases. Or maybe it's God's way of saying "Hey, your still human after all!". I cried in the room with the family, and for their loss. I cried because the thought of possibly being that mother someday, was more that I could handle. Surviving your kids must be horrible and something I never want to experience. I dont think she or he intended it to be that way, so why did God? It's a question I often wonder about.

That morning, I was up at 5, stopped at Starbucks on the corner and tried not the bite the head off the counter girl when they didnt have the coffee I wanted. (Pre-coffee mood sux). I drove to a local trauma center and started my day, contemplating the calories burned by standing on your feet for 24 hours... :) My donor was 27, and a good looking guy. Can't really spill the details, but he wasn't supposed to be there, and it was a sudden, possibly unexpected loss for this family. I was told he was an athelete, and his lungs and heart proved that. They were both very strong and some of the highest PO2s on ABGs I have seen in a long time. They saved the life of another young man in his 20s and imagining that families excitement and relief, was what kept me going strong and even prompted me to tell the OR circulating nurse: "I have the best job in the world" as I pulled my warm blanket around me in the freezing OR, my stomach rumbling, my feet and knees cramping, my face breaking out because I haven't washed it in 20 hrs. Yep the best job, wouldn't trade it for the world. I love the docs I work with, my co workers and the families I help. I love the proudness that echos in my kids voices when they tell people what their mom does. I honestly dont think I could do anything else, I try to think about it and fail. I am destined to do this for the rest of my life, but you know what? That suits me just fine.

This morning the alarm came much too early. I drug myself out of bed to see to two hungry children pacing the floors. I quickly sprouted another pair of arms and at the same time I: made coffee, made a bowl of cereal, heated up a breakfast burrito, threw some laundry in the dryer, signed two agendas, chewed out my son for not listening in class, and listened to the morning conference call with my phone of mute and speaker from the counter in the kitchen. My kids are used to hearing words like "brain dead", "trauma", "IPD, SDH" and "withdrawing care". Its almost as common to them as Sponge Bob saying "I want a crabby pattie!". Are they traumatized from it? No. Unless you call yelling at the other kids in the neighborhood to wear their helmets or they will be ''organ donors''. I am thinking I dont mind being on call today, I have had some time off. Went camping with the family, have had to time to regroup myself, drank far too much etoh and ate too much bad food, but it felt good. My younger son and I went mountain bike riding about 5 miles, he hung tough the whole way and found it incredibly fun on the downhill path back until a bump came up and threw him face first into the dirt, making him bleed on his lip and elbow. But he was ok, he says to me "good thing I had my helmet on mom!" I am thinking, uh yeah... This job makes you paranoid, as I have said before...

I am about ready to head home from the city if things stay the way they are, knock, knock.

See how I feel?

My kids both went to a NYE all night party and had a blast. NY day morning as they stumbled in the front door, dark rings under their eyes, their feet barely leaving the ground... I laughed to myself... Time for some education! After I listened to the "Mom I'm so tired, mom let me go!" cries, I made them pause and evaluate for jsut a moment how they felt. I said "Now tell me how you feel right now." I got a variety of answers, and whining with it. I said to them "Now, right now how you feel, is how mom feels when she works all night and comes home from work." They both just looked at me and trudged off to the bedroom. It was a sort of mini revenge for me... :)
I never made it home last night. After I visited the hospital that paged me, I got another call from the county hosital. The patient I had see earlier in the evening was very unstable. The resident tells me that if we want to give the family any option for donation, I needed to hurry on over. So I finished up and drove a fast 10 min to the hosital. Funny thing was, he was more stable than earlier in the evening, but the family had made him a DNR. It was a tragic situation for the whole family, a member of them being responsible for the injury. So sad that now so many people will be affected.
I pulled mom and 3 siblings into a small conference room. I wanted to much to take this mothers pain away from her and hoped what I had to say would lessen it even just 1%. I would feel successful if it was even 1%. I told her he could save up to 8 lives. I watched her face light up, her eyes opened wider and she sat up straiter. I had given her some hope, I could see that, so I continued. They all agreed he would want that, but they wanted to wait for his dad to arrive.
Today he is going to save people, I slept and am now awake and another coordinator is there continuing the case. As tired as I am, I love doing this. Makes me have faith in the world, amazement that people still possess generosity for those they have never met at the worse possible time of their lives. I believe that a mom who gives her son to help others when she is greiving so is such a hero, more so than anyone who may be labeled that. He gift is so unselfish, so selfless, so not for personal glory. Even after 4 years it never fails to move me like this.

“To laugh often and much; to win the respect of intelligent people and the affection of children...to leave the world a better place...to know even one life has breathed easier because you have lived. This is to have succeeded.”

New Years Day

All is quiet on New Year's Day.
A world in white gets underway.
I want to be with you, be with you night and day.
Nothing changes on New Year's Day.On New Year's Day.

Except there is no world in white, just brown today with some red here and there. And all is not totally quiet, though its just been referals today. One thing is, things do change new years day, neuro assessments for one.
I traveled around the city this morning, my first stop a hospital 10 min away. This isn't a place we have done many donors at, actually 1 to be specific. But they keep trying to their credit. Now if they would just understand that if someone breathes on their own, their brain works. Its black and white. Dead, or not dead. You either breath or you dont. Simple right? No. Not even for educated individuals, nurses and doctors included to understand. Sometimes I wonder how these people get their medical degrees and pass their state boards. So the patient I see is a young girl. I listen outside the room as the neurologist talks to the mother. She is overbreathing the vent and flexes, I know she isn't brain dead. He comes out and the charge RN and pts nurse ask if he is going to do brain death testing... oh jeez. We both explain that if the pt is breathing, no testing, no point. Blank stares... ohhh jeez. I also spend 30 minutes in the break room educating another nurse to that fact because she was frustrated over another pt that couldn't donate because they weren't brain dead. I told her there are things we dont compromise on, and thats one of them. We dont declare pts brain dead when they are still breathing. Simple right? No... apparently not. Sigh sigh double sigh.
I leave and journey NW to the big hospitals who's nurses understand somewhat more, but sometimes not. Things are crazy all over, I see a wife crying over her husband who collapsed taking xmas decorations down, I see a mom by her son's bedside praying. He was beat up last night at a party...
I come home and look at my kids, my oldest is told about the young kid, drinking, at a party, a normal child, but somehow I hope by telling him these things he will be somewhat unnormal...I dont know. I hope and pray everyday I am not that mom, or wife for that matter. Collateral damage from this job happens every day to me.
I just ate at my parents, about ready to head home and I get a page. The lady has cancer and I feel bad because I am happy I dont have to go. I'm so horrible sometimes, lord bless the starving pigmys in new guinney. oh no, the same hospital just paged me back, I was lucky once, but usually not twice.