TagDeep Thoughts

Personal blogging evolution

For the first four years of my blog, I used it more as a journal of sorts. It was a place to go when I needed to write. Only my close friends knew about it and I maintained a sense of semi-anonymity.

This summer brought about quite a lot of change in my personal life. It was almost as though I was able to push up through the dirt, unfurl my leaves and bloom. Part of that metamorphosis was the decision to no longer blog half hidden.

With that being decided, I told my chief flight nurse about my blog and the plans I have for it. I slowly began telling my colleagues who have offered great support (yes Maria you ARE my favorite communicator!).

I actually had one of my Docs call and ask for my blog address so he could show a friend (hey Steve!). This excites me to no end. As so many people who have been ‘outted’ or even fired for their blogs, I couldn’t be more grateful. They have gone so far as to give me ideas and even video (thanks Ron!). Just as important to me is that they are reading it. They are helping me make sure I am not overstepping boundaries (thanks Tony!) and keeping it as I intend: a positive but realistic look at flight medicine and medical aviation.

With this, I decided to post my CV online in its entirety. Okay, minus my phone and address. I am also adding a page that has more information about me and why I do what I do.

Hopefully by seeing a real person, being a real nurse, my life will touch, inspire, give hope and convince at least one nurse or potential nurse that this profession is not one of being a handmaiden. It isn’t all about bedpans, following orders, or the realm of the woman. To be a successful nurse you must be open minded, intelligent, have a passion for people, a thirst for knowledge, and above all want to help and protect those who need it the most: our patients.

That is why I blog.

That is why my life is online and my heart is always on my sleeve.

Img 2614
Me blogging via pen and paper

Emotional Mess

The past few months have dragged me and my heart through the muck. Difficult patient flights and other drama has worn me out.

Writing has been the last thing on my mind.

It is difficult to realize that sometimes it is necessary to let time do what it can do and let go of the rest. Yesterday I did that.

I forced myself away from it all and did something therapeutic. I quite literally tore apart my office.

Destruction is therapeutic.

Halas. What will happen will happen.

Destructo Crzegrl
The wave of destruction

Ambition and Dreams

I spend a lot of time asking myself, “What if.” Not in the sense of, “what if I had said this?” or, “Why didn’t I do that?” More in the realm of, “What if I go back to law school?” or, “I wonder what kind of a book I should write?”

It is all my mom’s fault I ask for the moon.

As a child, I was never once told that an idea I had was ridiculous. I did all manner of crazy things that girls didn’t normally do. Never did she say, “Emily, girls aren’t supposed to do that!” Instead, I was given the head way to compete, encouraged to take math and science classes, take on as much as I could handle, and push the limits of what a girl in small town mid-America should consider.

In sixth grade I carried around the brochures for West Point (although I didn’t apply). In high school I scored an interview with Malcolm X’s youngest sister for my school paper right around the time of Spike Lee’s movie release. At 21 I got fed up with not finding a job and joined the Army when it wasn’t politically sound for me to do so.

Never once did she tell me anything other than, “I know you will be good at it!”

Being who I am now, I look back at the patterns in my life, my accomplishments and my failures. I am grateful for those who have helped pull me up by my boot straps and set me back down that path of accomplishment and happiness. Because, unfortunately, there were times when my mother’s encouragement wasn’t enough. It took Patrick years to undo the damage a man I once loved, did to my soul. This man laughed at me when I said I wanted to author a book someday. Cuttingly told me that I never finish anything. Patrick believes just the opposite.

My mother is still my biggest supporter. When I tell her that there is something incredibly huge that I am supposed to do with my life, she simply smiles and says, “Yes, Emily. I know that.”

I now have the self confidence to cast aside those who question, and those who doubt, when necessary. I now know what it is to be the one doing the pulling on the boot straps of those I love, respect and admire. I know what it is like to tell them that I believe in them (k&b).

“Big dreams are a powerful, motivating force. One of the traits of a leader is the ability to dream about what could be.” Jim Ziemer, president/CEO, Harley-Davidson

Although I may not follow through with all of my crazy ideas, or dreams, I will still have them. I will still talk about them. Because, in the end, if I accomplish just a few, I will have accomplished a lot.

Transitions

So much of my life has historically been spent in transition. Every two years, almost like clockwork, it was a different state, a different school, a different job.

When I bought my house, a friend accused me of nesting—of ‘giving in.’ Just the thought horrified me.

My NP job lasted for just short of two years. My one year anniversary as a flight nurse is rapidly approaching. In retrospect, nesting is the last thing I did. I was simply positioning myself for the opportunity to do what I knew I was destined to do.

So, as I sit, blogging long hand on a long flight to pick up a trauma patient, I am thinking about my friends what are all at the start of experiencing some major life transition.

Flightblogging

Kev, Craig and Ben are all beginning CRNA school. A most daunting task.
Gideon recently became an eligible bachelor again and is moving into a new home as I type this.
Patrick is graduating from the training for his new career in the next two weeks. (I am so proud of you!)
CS is deploying to Iraq, embarking on, what is guaranteed to be, a life changing year.

I am thrilled to see their success and concurrent fear as it takes great personal risk to achieve lofty goals. What amazing people I am surrounded by, and am able to call my friends.

Birdies and Band-Aids

There are times in a person’s life when you are able to sit in the company of those who understand you and simply exist. All is in balance and at that very moment you know you could die happy, fulfilled and loved.

Img 2294 2
It began as a Friday Golf Scramble with Army comrades. Beer, BBQ and letting our hair down was the order for the day. It then blossomed into a Wednesday trip to collect Ben, Thursday night with Kev, Friday golf, Saturday Ethiopian food and more BBQ with J9, Sunday promotions and a quiet evening at home which extended into Monday Morning.

Img 2301

Although this is a blog where I try to keep up with Nursing issues, and submit my version of the Flight Nursing world, this is part of my life as well. It is days like this that make me feel the most alive.

Img 2300

See Kev’s link about the weekend here at ventl8.com—and my Treo is the one which is plugged in!

flickr set here.

the commitment

After jumping all over the “post for 90 days” challenge, I found myself in a strange place mentally. I needed something, somewhere else. I gravitated away from my online life and threw myself into the world of the living.

The past month was filled with major events, quiet moments that will be in my heart forever, and patients–both sick and well.

Recently, I thought balance had finally settled over me. This past few weeks brought the realization that my crazy life needs chaos to truly be balanced. The chaos which introduces instantaneous adventure, spontaneous drives in the rain, and moments of deep conversation.

I return to my online life feeling more alive than I have in quite some time. There is so much more to write about when I am experiencing offline life.

So, what a better day to meld them into one than on my 32nd birthday. I would never want to be any younger than I am today.

Pa12ick, Kev, Ben, J9, Gideon, DK—thanks for making my life more than I could ever make it on my own.

Nightmare

He shot me in the head.

I saw a flash of light but did not die.

You cannot die in a dream.

Last night was the first time in my life I had a gory dream. No, it wasn’t my first subconscious foray into nightmares, or even the first in which I should have died but woke up in the nick of time. It was the first in which I was to die a violent death. The first that I woke up remembering what I looked like with the side of my head pulverized.

In the daylight my dream, in some ways, seems comical. In other ways it frightens me even more. As the second person lined their weapon up to my head I remember trying to go to a happy place so I wouldn’t know what they were doing. I didn’t want to feel them move, or hear the mechanism of the gun chambering a round.

In my mind I focused on hearing a friend’s voice calling a nickname given to me by my mother.

Emilina Carolina.

The gun did not go off.

There is more to the dream, like my begging for another angle to preserve my eyesight if I lived through another bullet to my brain. “I wouldn’t be able to handle not seeing,” I calmly explained.

The ending to this post is as in my dream. Abrupt.

Paying my Respects

When I think about Washington DC, I don’t automatically associate it with the White House, the Washington Monument, or the Smithsonian. Instead, I think about the Vietnam Memorial, the Women’s Memorial and Arlington National Cemetery.

I inevitably reflect on those who have sacrificed their lives for my country and the pride I feel walking in such noble, hallowed places. I told Patrick I feel as though it is necessary to pay my respects in some way each time I visit DC. Making the trip to walk along the names of the Wall and step through the grave stones of Arlington, especially of those long passed, is almost a pilgrimage for me. It makes me feel intensely, then gifts me with a sense of peace.

While at Arlington on this trip, I stood beside the Eternal Flame amongst an uncharacteristically subdued mob of spring break teenagers. As I took a few steps back turning to admire the view of the Mall I heard a girl of 7 or 8 years ask her father, “why is everybody whispering?”

He quietly said, “I will explain it in a little while.”

I smiled, hoping to be able to hear the same question from my nieces and nephews. It is up to us to make sure the next generation never forgets.
I truly hope he did indeed take the time to explain it.

Img 2136
The Eternal Flame & resting place of President Kennedy

Tattoos, Preconceived Notions and Cultural Diversity

About a year ago, I had a poly-trauma patient (MVC) who happened to be a tattoo artist by trade. As the stereotype goes, this guy was a walking advertisement for his craft. He happened to be in his mid twenties and co-owner of a very successful studio.

My Artwork

As fate would have it, this patient had a mother who did not leave his side and after a few days the uncomfortable patient and his hovering mother began to wear on the nursing staff. The nurse who had been assigned to him for the past three days or so was in her mid 50s and bombarded me with the examples of why this patient was being so difficult. (picture a very annoyed, frazzled nurse who had a heavy patient assignment)

Her biggest bitch? They were putting * gasp * Tattoo Goo on his abrasions!

“Emily, I need you to go in and explain to them why they aren’t allowed to use that stuff!”

I stood there, shook my head a bit, and told the nurse I would talk to the patient. In grateful relief she strode away to check on her little old ladies with hip fractures as I went in to “deal” with this annoyingly needy trauma patient.

As I entered the semi-private room, located at the very end of the hall, I was immediately struck by, not the patient, but his demented elderly room mate who was loud. The patient’s mother was at his side hovering as mother’s do, when they know their child is hurting but there is little they are able to do to help.

After saying hello to both of them, and introducing myself, I addressed the mother first. My initial question? Who did your tattoo? This woman had obviously been through a lot over the past week or so, but took pride in her appearance. She accentuated her ample bosom with her choice of clothing which in turn displayed a gorgeous tattoo on the top of her left breast. After hearing my question, she smiled from ear to ear and began talking about how her son was the artist. The pride in her voice was unmistakable.

Small talk ensued about his tattoos, his shop, my tattoos, and eventually his car accident.

It took all of about 15 minutes for me to figure out that he wasn’t sleeping, his pain was not quite under control, he had no appetite so he wasn’t eating or drinking in adequate amounts, he didn’t remember when he last had a bowel movement and he was somewhat concerned with all the abrasions over his tattoos.

Last I checked, these were all NURSING DIAGNOSES. Why did this take a phone call to the Nurse Practitioner to figure out?

Although his nurse was one of our more experienced on staff, she walked into the room with a whole boat load of preconceived notions about the patient and his mother. Both were very tattooed, spoke freely about “partying” together and even being at a coke party a few days before the accident. The nurse couldn’t get past the way the mother was dressed or her seemingly overly interested body language/doting towards her son.

This guy was broken from head to toe. His injuries would have warranted a lot of narcotics in any other patient, but the perception of “drug abuse” led the nurse to under-medicate him. This was her first mistake based on judgmental notions.

Her second mistake? Not taking the time to figure out what could be done with the noisy room mate. She didn’t explain to the family that he was being transferred out of the hospital that morning. After letting the two of them know this small piece of information, the relief was almost palpable.

Mistake number three: not telling the family to bring him anything he wanted to eat. They simply hadn’t been told that this was an option. This not only made him more interested in food, but gave his mother something productive to do so she felt like she was helping.

More mistakes? Yup. Number four: the nurse didn’t take the time to explain that his irritability was not only related to his pain, and lack of sleep, but also because he hadn’t “taken a shit” (my words exactly) in days. Oh, yeah, and the narcotics are going to stop you up as is immobility! By gaining his trust in the first few minutes of conversation, he eventually admitted that getting on a bedpan and needing someone else to wipe his ass was humiliating. Duh! He is a mid-twentys, otherwise healthy guy. It is humiliating for anyone, but especially men his age.

I talked him into a suppository.

The Tattoo Goo? For those of you unfamiliar with the stuff, I wish I could prescribe it to all my trauma patients sporting superficial abrasions. For those of you who have never gotten one, or have never seen one being done, tattoos are nothing but abrasions with color injected into them. Tattoo Goo is a vitamin rich salve that speeds tattoo healing and in the process helps to minimize scarring.

Tattoo Goo Tin .75 Oz-1

Tattoo Goo ‘The Original’ INGREDIENTS:

Olive Oil, Beeswax, Cocoa Butter, Wheat Germ oil, Tocopheryl Acetate, Lavender Oil, Sunflower Oil, Rosemary Extract,, D&C Green 6

By judging this patient by his age and appearance, the nurse not only gave SHITTY nursing care, but missed an opportunity to learn about the craft of an amazing artist and business owner.

Such a shame.

Epilogue:



After writing very specific pain medication orders (meds around the clock), diet orders and abrasion care orders (ok to use Tattoo Goo) I took a moment to reeducate the nurse in a very tactful manner. The next morning, upon entering the patient’s quiet room (I had requested that he be left without a room mate if bed assignments allowed) I was greeted with smiles from a well rested mom and patient, and was told how right I was about taking a shit! He felt much better and even ate all his hospital food breakfast.

I am happy to report that the patient was discharged 36 hours later which was days earlier than predicted.

Moral of the Story:

Over the years I have heard horrible “tooth to tattoo ratio” comments during rounds and have witnessed the unnecessary defacement of tattoos in the surgical arena. ie: Belly tattoos which were STAPLED closed off centered ON PURPOSE. The reason? “That’s a stupid place for a tattoo anyways,” per the offending surgeon.

We need to realize that tattoos are artwork and a very personal form of self expression. They are an investment just as any other piece of art that hangs on a wall or sits on a shelf. They are usually one of a kind and have deep religious, spiritual and personal meaning. Just because someone has “fuck you” tattooed to their knee caps doesn’t make them a horrible person who deserves shitty care or attitude.

Cultural diversity doesn’t just refer to different shades of skin color, religious beliefs or languages spoken. It also refers to differences in life style choices which may not be something we necessarily agree with.

Tattoo4

If I am your patient someday, take care of my tattoos, don’t pray over my bed and don’t be offended if I come out of anesthesia cussing like a sailor. I may be an Ivy League educated white girl from the mid-west, but I am also a tattooed atheist who believes in freedom of choice in any manner of contexts.

He came to me in a dream

The past few weeks have been ones in which I have questioned my skills and ability to do my job. The more I am exposed to what I need to do, the more I realize I don’t know. My cardiology experience is pathetic. My exposure to pediatrics isn’t much better.

For the first time in my life I am truly questioning my ability to walk into a horrible scene and have the knowledge, skills, and balls to give my patient exactly what they need to save their life.

This self doubt has bounced around both my conscious and my subconscious over the past few weeks. I ponder it while driving back and forth to work. I look at my nieces and nephews wondering if I could save them. It has driven me to read/learn/memorize even more.

“The moment you are no longer scared when the mission bell rings, is the moment you need to quit flying.” This advice, given a long time ago, batters around in my head. There is no chance of that. Every time the phone rang during my last shift, I got jarred from a pitiful sleep with an adrenalin rush.

I fell asleep last night reading the paramedic text which will be my bible for the next two weeks.

I woke feeling a sense of peace. I dreamt of Danny who reminded me that he taught me what I needed to know, and in his own way that he loved me.

Although it is strange to feel peace from a dream of a long dead young man whom I knew best when we were both children, he is right.

He did teach me what I need to know.

Dream