I have a strange job.

Happy 2009, everyone! First off, I would like to apologize to my thousands of loyal followers for my lack of posting in the last several weeks. I am very sorry to let you down. With the holidays and finishing up my critical care nursing residency program, I have been very busy. But now I am DONE! With the residency, that is. Beginning tomorrow evening, I will have my first shift without having someone hovering over me, watching my every move. I am excited, but very nervous at the same time. Now if I make a mistake, there is no one to catch it. It's all on me. Needless to say, I will only be taking care of the most stable of patients in the ICU, if I can help it!

My last shift in residency was on Sunday, and it seemed only fitting that I had my first patient death. That may sound kind of grim to some people, but it was like a natural transgression. I started off taking care of very stable patients and gradually transitioned onto sicker and sicker patients, to finally one that was so sick that there was nothing left that could be done.

He already looked like a dead man from the moment I started that shift. His skin was mottled, extremities were cold. You couldn't feel any of his pulses. Pulse oximetry monitoring wouldn't work on him since his peripheral blood circulation was non-existent.He was on three different vasoactive drips to keep his blood pressure up. He was maxed out on two of the medications, and so our only option was to gradually go up on the third until that one was maxed out. And from there, we just waited for him to go.

It was a bit tense, standing in the room with the family members, all staring at the monitor, watching his heart go into arrythmias. Brief runs of ventricular tachycardia. Blood pressure kept dropping. I had to just turn off all the alarms on the monitor because the constant blaring was just a reminder of how quickly this man was going down.

Onces the blood pressure dropped into the 30s and 40s, my preceptor and I attempted to find either a carotid or femoral pulse. Nothing. Decided to page the on-call doc to examine the patient, because at this point, he probably really was dead. On-call doc was just an intern. Idiot intern. He didn't show up for nearly 20 minutes. He couldn't feel any pulses either and decided to call it. "So, is there like a form or something I need to sign?" he asked me. "I don't know. You're the doctor," I replied.

The respiratory therapist came in and disconnected him from the ventilator, while me and my preceptor turned off the numerous IV pumps, turned off the monitor. I'm not sure why I expected the man to move or breathe or anything like that, but of course he didn't. Everything was still, quiet. He was dead.

After all the necessary paperwork was completed, I went to get the keys to the morgue and a gurney on which to put the body. By the time we zipped him into the body bag, it had been almost three hours since he was officially declared dead. I was surprised that his body was stiff. Weird.

But it got even weirder. After unlocking the door to the morgue, there was yet another door to unlock, which was the door to the cooler. Yes, it was about the size of a walk-in refrigerator at a restaurant. Not nearly as big as you would expect for a hospital as large as the one at which I work. Four or five other gurneys with adult-sized bodies were in there. To the right, there were shelves with plastic storage containers that had tiny, baby-sized body bags. And there was a big red barrel that said "Placentas Only."

The third key was to open up the box where my dead patient's chart would go. And then I had to sign him into the morgue; much like you would sign someone into a doctor's office or a meeting.

So there you have it. My job, my work as a nurse. Well, only a small part of it. A small, strange part of it.

The Best Part of Holiday Shopping . . .

. . . is that you will hear "Last Christmas" by Wham! at least three times during each trip to the mall. Word.

Observations from the E.R.

As part of my orientation, I got paid to spend the day (a.k.a. sort of work and observe) in my hospital’s E.R. I had a really good time when I rotated through there during nursing school, and this time was no exception. There were several things that I noticed during that day:

1. As much as I enjoy working with the unconscious or intubated patients who cannot talk to me up in the ICU, I also really enjoy working with the “crazies.” At the county hospital, there is definitely no shortage of those. Take, for example, the old prostitute (so insist the ER nurses) with a walker who demanded to speak with the head of the hospital because we would not prescribe her narcotics. Or, the older African American gentleman who suffered a minor burn to his face after lighting a cigarette while on his oxygen tank. He was there so we could “get this black stuff off of his face.”

He couldn’t even tell us why he needed to be on oxygen in the first place. I must be a bit of a risk taker, because as agitated as he was getting, I still dared to put a catheter in him since he wasn’t able to “go” and we needed to get a urine sample to do a drug screen. He had initially flat out refused to get a catheter put in, but I was able to sweet-talk him into it. For that, I earned the nickname of “Angelina Jolie.”

2. I am getting better at putting in IVs. I was batting 1000 that day. Three for three, baby! I’ll be honest though; every person I stuck had veins fat enough that you’d have to be blind not to get one in. But whatever.

3. The ER nurses are a lot nicer than the SICU nurses. Don’t get me wrong, I do like (most) of the people I work with. However, as talented as they are, there is some serious attitude that gets thrown around, and it’s something I didn’t quite fully realize until I went to the ER. As much as I love my coworkers’ sick sense of humor and can relate to them on many levels, I just hope I don’t get fully sucked into their cult of superiority. I’m telling you, the nurses in my unit have a reputation around the hospital, and now I can see why!

4. Docs are around constantly. I thought we saw them a lot in the ICU, but they are literally there all the time in the ER. That is where they live. And all the hot ones are married.

5. If you are a trauma patient (car accident, fall, shooting, stabbing, etc.), expect a doctor to put his finger in your rear. The trauma hall was very busy that day, and on every admit that I saw, the same doctor was always sticking his finger up the patient’s butt. Yes, yes, there is a totally valid reason for it (to check for bleeding and rectal tone; no tone can mean a spinal cord injury), but the juvenile side of me smiled. I secretly wondered exactly how many butts had this doctor stuck his finger inside of during his tenure in the world of medicine? I was also amused by the male patient who screamed expletives while getting his special exam, as if the doctor was taking his manhood away from him . . .

6. There is nothing like getting to meet a patient up on the helipad. Okay, so I’m sure by the hundredth or even tenth time you get to do it, it would get old, but I was absolutely giddy inside when I learned that I would get to watch the CareFlite helicopter land and help wheel the patient on a gurney all the way back to the trauma hall. The warm wind, the setting sun, and the Dallas skyline in the background made for a perfectly surreal experience. You couldn’t pay me enough to be a flight nurse, but I’d love to take over once the copter lands! In a word: awesome.

Random musings about J. Crew

I'm just going to quick hit a few deals I got and make a few comments about a few items:

Salina Iridescent Patent Leather Flats in Guava:

I think I got these on sale, plus 30% off, so they were around $60. They are very pretty and the guava color is neutral enough to go with almost anything.

Large Odile Bag in Driftwood:

Once again, a great neutral to go with everything. It's also the type of neutral that will work year-round. The leather is very soft. It is lined with cotton twill. I was a little disappointed that it didn't come with a dust bag, but I can live with that. It was only around $150 including shipping after 30% off the sale price. I actually ended up with two of these bags after I got an e-mail stating that my original order had been cancelled. Well, I reordered the bag since it was showing as still in-stock, and what do you know, both my original and the new one arrived at my doorstep. While returning the extra bag, a woman in the next line over loved it so much that she decided to purchase it after my return was complete.

Italian Calfskin Jamie Bag in Dark Cloud:
The leather on this bag is soooo soft and pretty, but it will scratch quite easily. It is quite roomy and lined with a silk grosgrain type material. Unfortunately, on my second day of using it, the tassel on one of the zipper-pulls came detached. It's hard to describe, but basically I am going to have to try to take it to a shoe repair and see if they can do anything about it. J. Crew was already sold out of the Jamie bags in this color, but they did credit 10% of the purchase price back to my card to cover the expense of getting it repaired. I got this bag on sale for around $210, which is almost half of what it originally cost.

Morgan Cozy Cardigan:

I posted about this earlier on my list of things that I wanted. I bought it, but now I am having second thoughts. It is super soft and cozy. However, it is not made entirely of alpaca wool. It also contains acrylic, which is not acceptable for a sweater that costs nearly $200. I was in my local J. Crew today, and they had the sweater on sale for $130 (plus an additional 30% off), so I might see if there is a store that has my size left and repurchase it at the lower price.

Cashmere Sweaters:


They are all only $99 in stores, plus an additional 30% off. I got an off-white cardigan and a black turtleneck. Boring, yes, but they are just some staples I needed for my wardrobe.

My local store was pretty close to clearing out all of their winter merchandise and predominantly featuring their spring/resort collection. Some of the items are very pretty, but I have barely even started to get wear out of my fall and winter stuff! I just need to hold out for as long as possible, knowing that it will eventually go on sale. While I love the J. Crew Aficionada blog, reading it all the time makes me become a bit irrational. I decide I *have* to get a certain item right as soon as it comes out, because it won't be available for long. Well, that bit me in the ass more than a few times, because practically everything I ever bought at full price ended up sticking around and getting marked down big time! This is good for J. Crew, but bad for my checking account...

Real Ladies Wear Underwear

Okay, so I was sitting in class/work the other week and could not help but stare at this girl who was in the row in front of me, because her pants were dipping down so low in the back that you could see her crack. Yes, her crack. I don't know how she didn't know that thing was hanging out; you would think it would get a little drafty back there, no?

It got me thinking about why exactly some women choose not to wear underwear. I just do not understand. I find it disgusting, and with all of the new undergarment technology out there, there is really no good excuse not to. Are you wearing low-rise pants? They do make low-rise underwear, you know. My personal favorite is Hanky Panky's low-rise lace thong. It is made of super-stretchy, super comfortable lace, and one size fits almost all.

You say you don't want VPL (other wise known as "visible panty line")? Try Commando brand underwear. These things are totally thin and seamless. If they show underneath your clothing, do you think, perhaps, it's not a good idea that you wear something that tight??


What I really don't understand is when some women don't wear underwear when they are wearing short skirts. Really? You want to rub your vag all over dirty public surfaces and flash it to strangers? Worse yet for the rest of us, we have to sit on the juices that have rubbed off from your bare cooch. Yes, I know that sounded gross, but I'm trying to make a point! And the point is, in case you haven't gotten by now, please, for the love of sweet Jesus (and the rest of your fellow human beings), wear underwear! Me and your grandmother will thank you.

The Holidays are Here!

I just spent the afternoon buying a few festive things to get my apartment in the mood for the holiday season.

First off was this pretty wreath from Pottery Barn:


Right now their holiday decor is up to 50% off, so I got this for only $49.99, down from $99. There's no way in hell this thing is worth anywhere near the original price, so I was glad I could get it for less, since it is the only wreath that really caught my eye. They also have some cute woodland creature and acorn ornaments that I might buy on after-Christmas clearance sale if they are still around (and I'm sure they will be).





To really get myself in the spirit, I stopped at Starbucks to pick up a Peppermint Twist Mocha. I have no idea if this is supposed different than the regular Peppermint Mocha, they probably just changed the name to entice suckers like me to buy it. They also have a new Espresso Truffle latte, which I tried yesterday. Tomorrow I plan on trying the Gingersnap Latte. Once again, this is probably just the Gingerbread Latte with a snazzier name. Btw, my local Starbucks is now carries some hot, savory breakfast items. They are tasty, but it brings the bill close to nine bucks. Oh, I think I would be very disgusted with myself if I added how much I spent on breakfast and triple grande holiday-themed lattes at Starbucks this week.

Next, I went to Target to pick up a wreath hanger and a few other random holiday things like some winter white place mats with metallic branches and leaves embroidered on them, and some glittery pears to replace the fake apples in this green glass bowl that sits on the counter top. Target really does have some cute Christmas decor, grouped into cute themed collections, like Birchwood Chalet, Snowfall Splendor, and Arctic Solstice.



I also picked up a few bird ornaments. Although I sadly do not have room for anything other than a miniature tree in my apartment, I am collecting bird ornaments, because one day I hope to have a full-sized tree that has nothing but birds on it. I love birds. Except for grackles and pigeons. I think when I am older and own a house, I will put all kinds of bird feeders in my backyard and become an amateur bird watcher or something. Anyway, it seems like I am in luck, because bird ornaments are just everywhere this season. Anthropologie has some especially adorable ones.

Once I put out the decor and put the pine-tree scented refills in my Wallflowers (which I wisely bought well over a month ago, because the holiday scents always seem to be sold out before Thanksgiving!), my humble abode will be ready for holidays! All I will need to do to make it complete is play my Rat Pack Christmas CD and pour a glass or two of champagne. It's about time I made a dent in my seven (yes, seven) bottle stash...

Word of the Day

squirrelly (skwûr'ə-lē, skwŭr'-) adj. Slang
1. Eccentric.
2. Cunningly unforthcoming or reticent. 
(Source: 2006 American Heritage Dictionary)

It wasn't the first time I'd heard this word, but I was recently reminded of how awesome it is by a patient I was helping to admit a few weeks ago. He said that he had a drug allergy to morphine. When asked what, exactly, happens when he takes morphine, he replied, "It makes me get real squirrely." This made me smile. And vow to use the word "squirrelly" more often in my everyday conversations.