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.

Return trip

I was on call last night, just third call but there was a donor in progress so that put me to run referals so that the next day's 1st call could go and do OR fresh in the morning. Just as my head hit the pillow, my boss called me. She needed me to go see on old man across the city in a hospital about 50 min away. I pulled my body out of bed, I was so tired, and threw on a sweatshirt and scrub bottoms and jumped in my car and prepared myself with my ipod for the long drive. Once I arrived, I did my business. The pt wasn't brain dead, we would just follow. I left and thought, looong drive home and when I am almost home, my boss calls me again. Same hospital is calling in another referal. I scream WHAT?! into the phone and exit the next exit. I'm told to turn around and go see him, the nurse says he is brain dead and absent reflexes... oh wow, another 40 min back. I drive back feeling dejavu in my return trip, get out of my car and paste a smile on my face as I walk back in the ICU. I was just here, they could have called me then but they didn't. I walk back in smiling and the charge RN notices and apologizes and says she is sorry, and thank you for still smiling. I shrug, its my job... I can't be mad. Its what I do and I know they are busy... I can forgive it once. So I sit down to look at the chart and talk to the nurse. So they pt is brain dead I say, she says yes. I go through all the reflexes with her. Cough? No. Gag? no Corneals? no. Is he breathing on his own? No. Flexing? No. I chart all this but something tells me to go see first hand. Usually I dont do this, as there are 10 family members in the room, two in wheel chairs and its just cruel to ask them to leave sometimes. But I needed to know for sure and something in her affect tells me to double check. Once family is gone, I head in with the nurse in tow. I start with corneals. Yes they are there. I sigh... ok next. He has a STRONG gag and cough and continues to cough after I suction. Ok. He postures when I suction. Big sigh... ok. He isn't brain dead and I educate the RN on the nuero assessment which I feel should be something she is capable of doing correctly in an ICU? Correct me if I am wrong here. I talk over the plan, leave a note and head back home, praying I will make it back to my bed. 3 hrs later after I am originally called, I am back asleep. Little do I know the same ICU calls in another referal! My boss tells them, forget it. We have had someone there twice already tongiht, someone will come by in the morning first thing. Thank god because I would've had to go postal on them, and no smile this time.

I saw this in the hospital restroom, hanging on the wall...

The Invitation
It doesn’t interest me what you do for a living.
I want to know what you ache for
and if you dare to dream of meeting your heart’s longing.
It doesn’t interest me how old you are.
I want to know if you will risk looking like a fool
for lovefor your dreamfor the adventure of being alive.
It doesn’t interest me what planets are squaring your moon...
I want to know if you have touched the centre of your own sorrow
if you have been opened by life’s betrayals
or have become shrivelled and closed
from fear of further pain.
I want to know if you can sit with pain
mine or your ownwithout moving to hide itor fade it
or fix it.I want to know if you can be with joy
mine or your own
if you can dance with wildness
and let the ecstasy fill you to the tips of your fingers and toes
without cautioning us
to be careful
to be realistic
to remember the limitations of being human.
It doesn’t interest me if the story you are telling me is true.
I want to know if you can disappoint another to be true to yourself.
If you can bear the accusation of betrayaland not betray your own soul.
If you can be faithlessand therefore trustworthy.I
want to know if you can see Beauty
even when it is not prettyevery day.
And if you can source your own life from its presence.
I want to know if you can live with failure
yours and mine
and still stand at the edge of the lake
and shout to the silver of the full moon,“Yes.”
It doesn’t interest me
to know where you live or how much money you have
.I want to know if you can get up
after the night of grief and despairweary and bruised to the bone
and do what needs to be done
to feed the children.
It doesn’t interest me who you know
or how you came to be here.
I want to know if you will standin the centre of the fire
with meand not shrink back.
It doesn’t interest me where or what or with whom
you have studied.
I want to know what sustains youfrom the inside
when all else falls away.
I want to know if you can be alone with yourself
and if you truly like the company you keepin the empty moments.

Quotes...

Some quotes that are my favorites and that I use on a daily basis while doing this job:

"Perseverance is the hard work you do after you get tired of doing the hard work you already did. " Newt

"Perseverance is a great element of success. If you only knock long enough and loud enough at the gate, you are sure to wake up somebody." Henry Wadsworth Longfellow

"Of all that is good, sublimity is supreme. Succeeding is the coming together of all that is beautiful. Furtherance is the agreement of all that is just. Perseverance is the foundation of all actions. " Lao Tzu

"When you come to the end of your rope, tie a knot and hang on". ~Franklin D. Roosevelt

"When people show anger and malice , listen for truth in the message, ignoring the way it was said"

Hospital from Hell

Well, I started this blog and then quit. But I think I will continue it for myself, and I really dont care much who reads it, but its a good way for me to log what has happened and something for me to look back on, not to mention the therpeutic part to it.

This am I was back on call after having 8 days off over Christmas. Last night I read a man's blog, about receiving a set of lungs from a 17 year old girl. I had been sitting there griping to myself about going back to work and it set me strait really fast. I thought "hey you, most people dont have jobs like you do, most people sit at desks all day, do the computer, sell insurance, but look what you get to do the next 7 days on call, you get to make a real difference for someone, for many people, and that is so priceless in many ways." I thought, ok priorities strait, I'm ready to go back to work tomorrow. I woke up cheary and ready to go, and got a page around 8 from a local trauma center who had an older lady who met brain death criteria and was told the doctor will be in shortly to do an apnea exam to declare her. Her daughter wants her to be a donor.

I drove to the hospital, thinking what an amazing family. Here they are right after Christmas, and they are thinking of others at this horrible time. I was honored to be going to help them. I arrived, was told that the doctor wasn't there yet. Dealt with some unruly RTs who were upset about having to work, a nurse who moved about .00005 mph... and doctors who wouldn't come into delcare the patient brain dead so that we could procede. I spent the next 4 hours, trying to get someone, anyone into to do THEIR JOB, but no one would. No one would support the patient either and her blood pressure fell because of the DI. So in the end, I had to tell this family "I'm sorry but your mother can't be a donor because the doctors wont come in". I felt sick, there was nothing I could do and it pissed me off that this hospital let it happen. The charge RN, the Hosp admin RN, no one would do anything. The doc took 3 hours just to call back, making this family wait this whole time. It so sad that this was denied them. I hope to never be a patient there ever, but no I will eventually have to go back as a coordinator...

So I am sitting at the office, upset that someone today wont have the opportunity to receive what this family had to give because of tis hospital staff. I want to say that I hope one day they are in that position and someone does that to them, but I would never wish that on anyone, would never wish that anyone was denied that life saving gift that that family so unselfishly had to offer. My discust with this hospital is pretty deep right now. I need to get back in the ring and take it out on my instructor when I get back to class soon. :)

Imagine this...

Imagine, your standing next to your spouse of about 8-10 years in a foreign place, a Pediatric ICU. All around you are rooms filled with sick children, they're parents waiting for a miracle of healing so they can leave like the people they see walking through the electronic double doors. Your standing there looking down at your daughter, she is 6 months old, innocent and helpless. She moves not a muscle, around her head the sheets are stained red, tubes extend from every orfice it seems, winding their way towards machines that are keeping her heart beating, her lungs inflated. Her swollen eyes are closed and you lean forward speaking to her, knowing she cant her you. She's already gone, her brain is dead from the massive injuries from the car accident. You are in a hospital gown and bare feet, so is your spouse who sits in a wheel chair in the doorway, head in hands sobbing. Your daughter will die soon, as you have made the decision to let her go, you say to the nurse "She's suffered enough". You look up, your older daughter is headin goff to surgery to repair her injuries. She will live but it makes it no less easier. You tell her at the door to the PICU that you will be waiting for her when she gets back. She hears you, though sedated with a tube in her throat, she is still among the living. Turning back, you see your spouse holding your younger child. She looks at you and nods that its time.

This was my day yesterday. Somedays I just shake my head that I can keep doing this. I came home, walked in my door and grabbed both of my boys and hugged them until they yelled "mom!! let me go!" at which time I did, reluctantly. Everyday is precious to me now, every moment, every football game and every school play. It was before this day in the PICU, but this day just gave me a little reminder of what I was most thankful for: two healthy children and a healthy husband. I hate to send my kids off to school, some days I wonder "what if I dont make it home?" Again yesterday I was asked twice, How do you do this? I just do. You 'de think I would have a better answer than that after being asked so often, but everytime they ask, I stop and wonder how also.

So back to the PICU. This is what i walked into. The nurses were in their protective mode, flocking aorund this family like guardian angels, trying to protect them from any further harm which included me. If I would have had on a grim reaper costume I dont think I would have been treated any differently. What pains me was that they were making the decision on what was best for that family, by protecting them. Its hard for PICU nurses to switch mindsets mid stream with a case like this, I sympothize. How do you go from taking care of a little baby, to giving up, to thinking about other kids that might benifit from this tragedy through organ donation? No, I think on some level that means they have failed. Failed to keep this girl alive, despite there being nothing they could have done. Me being there was a reminder that that had happened. In the end, the process was done wrong, the family let her go, she did not help others and it was so very sad because deep inside many PICUs across the country are desperate parents waiting for miracles that yesterday did not come.

Someday, god willing never, that might be me as a waiting parent or as a parent of a dying child. Signing on that line would be the hardest thing ever I had to do, but I would do it. How can I ask of parents to do something I wouldn't even do myself? Everynight I pray that this will never happen.

Back to normal today, Kids at school, husband at work... I am relaxing with the cat on my bed. Life seems so normal for me, but tomorrow I will do it again. Because its in my blood to go to work for 100,000 people a day, and I love it. :)

The definition of difficult

To say this job is difficult would be like saying the sky is blue. While it is blue most of the times, there are stormy days, rainy days, windy days, cloudy days and clouds that change shape Sunsets that appear and dissappear, sunrises that happen and colors varying from place to place. You are knocked back by the beauty of it all and running for cover when the rain comes down. So difficult is one word yes, but never have I had a job that I can say that inside the space of a 24 hour period I have been spitting nails mad, frusterated beyond belief, saddened without hope, excited with promise, etremely energized, and just plain exhasted to no end. This job is like no other job I have ever worked, and like nothing I ever would have expected, but I can't imagine my life without doing it. Daily it gives me hope in a greater good, and it has changed me as a person for the better. I now see outside the circle that most people are so stuck in, I see what can be, I see hope in the face of tragedy. I see unselfishness and giving in the time of extreme sadness and loss. I have also met some incredible families and people doing this job and my life has been forever changed by them.

People ask me, often in fact... almost once or twice I am in a hospital: How is it that you can do this job? I am sure every coordinator has heard this question, Im not alone. My usual answer is: How could I not? This job and what I do are part of who I am. Its extremely difficult yes, and there are some days I want to quit because I can't do it another day, but I can't think of anything else I would rather do, so I continue only to be rewarded with yet another day.

This job puts my life in perspective. I am thankfull for things I once took for granted. The ability to spend time with my family. The health of my children and spouse, my parents. People live in such a bubble that they dont realize how lucky they are sometimes. Everything I have I am so much more thankful for, and this job has made me realize that every day I live is a precious gift.

Holding it all in

Last week I found myself forwarding my mail to the local trauma center PICU. I had arrived early that morning to a busy unit, nurses running everywhere, kids crashing... A kid being put on on oscillator, your general business. Somehow, a little boy who had yet to see his second birthday, had ended up there too just like me. I walk into his room, no one is there and I look down at this kid mentally throwing up the daily wall. Hey little guy, its you an dme for the next 24 hours... what do you say? Ok, first things first... Apnea exam... This gets done with lightening speed as all things do in the picu. I meet with the childs mother who stares at me with tears in her eyes and asks what he can donate. I explain in a shaky voice, even though I have done this a thousand times that he is so young that he could give other children the gift of life through his heart, lungs, liver, intestine, and kidneys. She starts crying, the childs father is to her left with his arms around her attempting to be supportive. I wonder if I ever would have the strength to make this decision about my own children. I notice that her hair is unwashed, her clothes are wrinkled, she has dark circles under her eyes and I wonder again how long she has been by his bedside hoping for a miracle. The consent process seems to take forever, the room is dark, my gaze drifts out the window to the city, and I remember looking west while mom thinks over her decision. Slowly she initials the blanks next to what she will give. I dont know if my hand would work if I were in her spot. No matter how many times I have done this, it NEVER gets easier.

A few hours later, mom decides she would like to see her son after surgery... My reaction? oh no, not again. I have done the dressing of the dead child after surgery before... very low on my most fun list. I try to talk her out of it. Do you know what he will look like? The color, the lifelessness, the lack of warmth... I explain all these things. She seems to think about it, nodding like she understands what I am saying and that it is logical as she is laying next to her son in bed. I walk out wondering if I would want to see my child afterwards. A nurse is standing outside the room with a couple others, they have heard the conversation inside. She says "No one could stop me from seeing my child if it were me"... weird. I would never want to, but then again how do I know, my kids are home, alive and healthy. So I really dont know how I would feel unless it happened.

Much later we prepare for the OR. Mom is still laying in bed and she has decided to see him later after we are done. My stomach twists at the thought. I can do this, I say to myself... and luckily the childs nurse is coming to OR with me, she would like to see the process, but we have bonded and we can do this together we agree. Every now and then I meet some very cool nurses, she was definately a keeper. The process of leaving the room is how you would expect and more. I try to hold back the tears, but they come anyways as I tie up loose cords and unplug the bed. By the time we roll out of the room, I am already mentally exhasted but know I have a few more hours to hold it together until I can sit in my dark car and have a good cry on my way home.

After the usual shenanigans in the OR by a transplant center of another state, its finally done. Or nurses are cleaning up the room and the childs nurse and I give him a warm bath, whiping off all the old blood and trying to cover up any sutures and incisions. I place a cap made of cast stocking net on his head and smaller sections over the IVs on his arms. He is an MEs case so it all has to stay in. I even put one over his ETT tube trying to cover that also. We wrap him in warm blankets as his temp is quickly dropping, dress him in a gown and I place him back on the bed he came in. We wheel him back into the PICU... utter silence as we come in the doors. I feel like the grim wreaper walking down the hall. We turn into the room and mom is waiting. She crawls into bed and holds her little boy in her arms. I think it might have been completion she needed, something to show her he was truely gone, to see with her own eyes he is gone. I finally left the room and leaned against the wall in the hallway wishing I was in my car so I could let it go. Its getting really hard to hold it in.

I gather up my stuff, its been a long shift. Its 6am, an hour left to go in my 24 hours of call. I just want to go home and hug my children, feel their warmth and life. I thank the staff and trudge to my car and call my husband to talk me home because I am afraid I will fall asleep and run my car into a tree.

At home, its still early. My kids are still asleep... I creep into their rooms just to look at them, assure myself they are there and to watch them breath. They are so warm under the blankets, their nostrils flare with proof of life, there is no wires, no tubes, no incisions. I take a deep breath, kiss them good morning and head to the shower to let it wash away some memories. I know there is so much good that came out of this, and I try to focus on that as I drift asleep.