Failure of Caregivers

Can you imagine being locked within your own body?  I was recently told a story about how a middle-aged man of Asian descent was left overnight in an emergency room.  Reading that sentence you may think, "hey, that happens to everyone at some point in their lives"  because of the ridiculous waiting times in the ER.

This scenario is different.

Hemiplegic.  Aphasic.  Discharged. Alone.

Every word has a meaning.

Hemiplegic. Aphasic.  

The man had recently arrived from overseas and was a transfer from another hospital that was discharged.  He had suffered a stroke in the past and as a result he was aphasic and hemiplegic on the left side with right sided weakness from a new stroke.  To be exact, he had expressive aphasia.  He was able to comprehend anything anyone said to him if spoken in a slow manner.  He would become frustrated when trying to communicate his needs because it was so difficult.  Can you imagine having every sentence and thought formed inside your head but not being able to express it to someone else? It would rip you apart inside.

Discharged.  Alone.  

This man was discharged from the hospital and his discharge plan was left completely in his hands. This is the reason why he sat in a chair helpless overnight and crying when people realized he was there.  He did not have family or friends around to help him go home. What happened to the nurse involved in his care?  

As a nurse, I was trained to advocate for my patients.  I am my patient's voice when they're weak and unable to speak.  I am their healthy body during their time of illness.  I do for them what they cannot for themselves.  I am their spokesperson and cheerleader until they can stand on their own two feet and go home and care for themselves.  I don't understand what happened in this situation.

I remember my grandfather when he was dying... I wanted to be his lungs, I wanted to be his body, I wanted to take that pain away and endure it for him.  Hearing this story, I wanted to be that person for this man,  I wanted to suffer the worst so he would be happy and unscarred from what had happened to him.  I wish this never happened to him.  The emotional toll that this experience took is unfair.  It was unjustly inflicted by those who SHOULD recognize when someone needs assistance... this is the worst part.

A tray was left for this man, however none of the staff members witnessed him eating, nor realized that he needed assistance eating.  This breaks my heart.  Can you imagine someone leaving food in front of you and you are unable to move any extremity nor say you need help. He was probably so hungry that the food was just taunting him by being there. Can't the other person who is completely capable and is there to CARE, simply take 15 minutes to just feed you?  People waste 15 minutes all the time surfing Facebook, twitter, playing candy crush...Can't even a good Samaritan just feed this man in those 15 minutes?  This kind of careless, heartless behavior upsets me to no end.  

Can you imagine it being you?  Your brother, your father, your mother, your sister, your grandparent?  Your child?  Put yourself into the situation.  

Put this man on the street, and the scenario changes once again.  It would be understood if people completely ignored him; people do it every day in New York City.  We ignore the homeless for fear they may be falsely displaying their disposition or believing they should just get a job and stop begging.  Or regular people on the street just don't want to be bothered to deal with him.  People are selfish, as a baseline.  It is so rare to find caring people.  In the hospital, this should be expected.  People are there to care for others, so what happened here?  This is a failure of health care and I hope it doesn't happen again.  If only people were a little less selfish, this would not have happened.  Maybe the care giver in his case wanted to go home early, maybe they didn't want to be bothered to make a phone call to social work, maybe they were afraid of more work they would put on their own plate.  I don't know what the reason is but this should not have happened  in the first place.  God bless his soul and I wish this would never happen to those who are in need.  

CLL

" chronic lymphocytic leukemia.  " (cacophony at its best)

initial reaction: chronic ___ leukemia? what is that again? leukemia. leukemia. leukemia.

all you hear is leukemia and you think "ohmygod" but isn't lymphoma worse? grandpa had lymphoma and died a few years after......

it's chronic.  chronic being over a span of time. chronic is not acute; not now. but chronic can change in a heartbeat. at least that's how I see patients in the intensive care unit. Chronic transformed into acute.

then you become an e-health consumer and proceed to (aren't we all guilty of doing this at some point in our lives) "google" CLL.  Ads, Wikipedia, Mayo-Clinic, and the National Institute of Health result.

okay, i read and skim the e-literature... but "what did the doctor say again?" and what does it mean?

Hearing, but not Listening.  a million thoughts flash in my head. former patients, working in a hospital, my late grandfather and his lymphoma, chemotherapy, are you living life?, she always lives her life!, live your life even more and the way you want it, but people without cancer die any other day from freak accidents so it doesn't even matter, do i treat this like a chronic disease like diabetes?, it could be worse, why am I so calm and not phased completely? more of a reason to go for genetics? they say CLL is caused by a genetic mutation. 2 causes in my life encouraging me to become a genetic research scientist.

still trying to digest this.  my heart is slightly heavy, or is it the paper for my masters that's due in 2 days?

never take a day for granted and live everyday as it is your last.  but working in the ICU has already taught me this.

it will all be okay.  Thy Will be done. the rest will follow...

Dreamland

Humbled. Relaxed. Appreciative. Serene. Life-changed.

I woke up to another typical hazy humid June morning and instead of blasting my AC higher, I took it all in. It's my last day in Manila; the Philippines; dreamland. This is the longest stay I've had in this country since I was 9-years-old.

In the 12 days I've been here, the experiences I've had have brought me down to earth. June 11 I found myself 5-hours north-west of Manila in Alaminos City, Pangasinan. It was a different stay for me because I have been to my dad's province so many times, that I feel like it's another home. Tita Elena, who I am extremely grateful for, was awaiting our arrival and was able to show us the accomplishments of the Alexander Begonia Foundation in the town. Due to the medical mission, it was unfortunate that we could not be present for the openings of the playgrounds in the schools there. I was able to see my uncle's new hotel and my old friends, who I was able to help out a bit. It's hard to see people close to your age not able to go to college because of the need to work to support the family. I told my friend Ruby to come to my house after work and so she visited with her sister. I didn't know she had to bring her entire family - cousins, mother, etc- all because they were afraid of being in the house alone in the evening. Also, the tricycle that brought them over had to wait around because it would be difficult for them to find another mode of transportation at that time. Before they left, I gave them enough money to cover the tricycle fare, wait time, and gave them the rest of our merienda pizza we had bought for her family, as well as other trinkets and clothing. It's the least I can do for a friend.

The country-side of Pangasinan is so immaculately beautiful. The blending of the rice terraces, mountainside, and glow of the sky with sunrise and sunset was breathtaking. Though the people do not have much monetarily, they have nature's priceless beauty.

Being a New Yorker and wired to be independent, fast-paced, and stressed, I was quite a bit culture-shocked during the beginning of the medical mission. Like most provinces in the Philippines, Sariaya, Quezon rarely had running water in facilities where we held the mission. I knew about manually flushing toilet bowls with tabos*, washing hands without soap, and low-pressure showers without heat...but, knowing about is certainly different than living it day-to-day. I remember taking tabo-baths and not having any of what I've listed, but that was when I was 9-years-old. I remember the first times having to do any of this, I was extremely irked and grossed-out. Fortunately, I did bring my own supply of paper towels, toilet paper, antibacterial wipes, purell, and liquid soap; it made each day a little bit better while living in those conditions.

So many things I saw really made me feel lucky for what I have. There was a baby with severe hydrocephalus - the baby's extremities were extremely small and his head was so large from the fluid build-up. The mother did not know what to do or how to care for her baby. The surgery for a V-P shunt* is way beyond what the mother could afford. These people cannot afford prescription medications, so what more with surgery. Apparently, the same child also had a congenital heart defect. There was another child with Down syndrome who was barely able to speak. That really touched my heart. Being closely related to someone with Down's syndrome, I felt so helpless. This child had no resources. The government doesn't sponsor any special needs programs, any medical programs, or anything to support it's people. I felt that they relied on medical missions and outside support too much.

Knowing that certain people in the government are corrupt, I still ask why. Why can't funds that are being pocketed by officials trickle down to local governments to sponsor local programs to benefit the people. The gap between rich and poor is so blatant. Filipinos are typically a close-knit community of people, so why is there barely any support? There are so many factors that come into play here, but the mere idea is so infuriating. I wonder why this country is so behind sometimes, and it's because of corruption. Such corruption in a religious country; I guess the religion is what holds it's poor people together. There are so many anomalies.

I know I went completely into a different topic, but it's part of the thought process that I've been having here. When I'm home in New York and stressed to the max, I barely have time to think outside the box. Life in New York becomes routine; eat, sleep, work, eat, sleep, work, and be too tired for anything. . .



To be continued....








Next time, I would like to spend a month or more. . .

loves the serene aftermath of thunderstorms....

chaos. chaos. chaos. my life has felt like this the past few days with work, family activities, and more work. twelve hours pass by quickly but can be very tiring, especially catering to people who are used to getting things on a silver (ahem, platinum) platter day in and day out. by the time you're out of work and have time to spend with loved ones, you feel drained and a bit short on personality; like there's nothing more to give. your body just craves some empty calories and a soft mattress to rest on, preferably your own. forget the mega-millions! empty, errand free days are a winning lotto ticket, though a pina colada on a white sandy beach on the equator would do wonders.

my reprive came this morning in the form of my backyard. interesting how relaxation can come in different forms. lightning storms are beautiful, but i really abhor thunder, especially on days spent alone. the aftermath, however, is to me, unmatched. i walked outside to my backyard and saw how peaceful it was. i took it in in deep breaths and probably appeared as if i was in a complete mindless daze. the moisture of the air soothing my skin, the smell of fresh air cleaning my lungs, the healthy green grass and plants soothing my eyes....it just felt amazing. overcast, warm, moist, quiet...soothing to my soul. no patients freaking out, no codes, no running around, no alarms, no driving to and from stores, no allergies, just nature and me. love it...

Learning

"I don't know how you're always calm and collected, always in control..." -frazzled family member of a 1-month-LOS patient.

I learned a few things about myself today at work- I learned that I work better/efficiently when calm and relaxed. My patients see the difference and use the call-bell less. Two families and patients realized this and complimented me on it today; not to mention these families are difficult to deal with, as one of them is thinking of suing the hospital. Usually, the call bell is going off all the time for these families, but I tried to anticipate their needs and quell it asap.

I notice if you make an effort to know your patients, the days get better and they tend to work with you more. Being social helps. Laughing, making jokes helps, too. Depends on the patient, but the effort should be made.

I also brought in a book for a patient from my bookshelf at home...her case really touched my heart and she really grew to like me as her nurse and would request to see me sometimes if I wasn't her nurse. I gave her the book i read enroute to the Philippines February 2009- "Eat, Pray, Love." She was really grateful and the look on her face was priceless.. she showed me the picture of her 4 month old son Michael and I told her to hang on and to read.. then left for the night.

I can't imagine sitting in a room- all white walls, day in and day out, makes you go crazy..

I also transferred a patient to CCU because he went into rapid Afib. HR 220s. Adenosine x2, amio, adenosine x2 given and he converted back to afib low 100s. I made sure to xfer him out right away and give report, unlike last time when I should have given report a long time ago and my patient went back into vtach.
Acting calm and collected in this "code-like" situation helped too. Just thinking about what u need and communication are key.

BSN RN :D

So, it has been quite a while since I've posted and I definitely have good reasons for this.

Feb 8- my grandma, who was in the Philippines at the time, passed away suddenly

Feb 12- I took the NCLEX in 2 hours with 75 questions. I left the test feeling good about it. Later that day, I immediately booked my flight to the Philippines...

Feb 13- Hopped on a plane solo to the Philippines to meet the rest of my family (they all flew there a couple of days before me--I had to stay because of the board) and say my final goodbyes to my grandma. It was a long 18 hour flight (well 2 flights--16 hours to Hong Kong and 2 to Manila, Philippines)

Feb 14- 10PM Philippine time/10 AM EST (US) I landed in Manila and as soon as I got on a computer, I found out I passed and was an official Registered Nurse!

I spent a week in the Philippines for my grandma's funeral, humanitarian work (my family has a foundation to support local children/schools with feeding programs and scholarships), and also enjoyed the gorgeous islands/beaches.

Feb 21 I came back to the US and was definitely in for a temperature shock! I went from being in 90 degree, humid as anything weather, to 25-30 degree temps. Definitely not a pleasant surprise.

I got over jetlag after a couple of days and saw some friends and did some errands. Lately I've been cleaning my room out because I haven't really had enough time or patience to just sort things out/throw old and unnecessary things away. Also, I think it will be easier later on (prob May/June) when I move out to an apartment in the city.

On that note, I am happy to say I had some job offers before the board and I chose where I did my summer internship. I will be on a telemetry/vascular unit and I start Monday, March 9!

I just had a TDAP vaccine (apparently the most recent tetanus shot avail) and handed in all my paperwork today. My final interview with a unit manager (it had to be post-board--they wouldn't hire without a license) was this past Friday and so I was in HR and Employee Health all day getting processed.

It feels so great to finally have achieved the RN license and just be able to relax from all the pressures of actually attaining the degree and license. Of course, the journey isn't over. It just seems that the basic academic part* has ended and a new chapter of my life is beginning...

* not to say that working on the floor won't be as much as "academic" as college and the nursing program

Stressed out

This studying business is getting super old. I can't wait to take it already! I caught myself in a depressed state earlier because
a.) it's freezing cold outside
b.) i'm always home or indoors somewhere studying
c.) no change in routine
d.) studying all the time (I feel guilty if I don't)

Tomorrow night, one of my nursing friends agreed to go out to a bar to just chill out. The exam is next week and I'm feelin pretty good about it. I finished all the Kaplan questions on the online QBank and just doin the incorrect ones and answering other questions from different books/ERI website. For the most part, I just gotta review the drugs a bit more....

I've also decided to BAN myself from facebook as it is inundated with negativism and other new grads freaking out about the exam. I can't deal with the negativity anymore; I'm being as trying to be as positive as possible... Falling apart and stressing out just isn't doin it for me anymore.



Enough babbling...back to drinkin some wine and relaxin.