I think I lost the time to write. After a while it all starts to type out the same way. My eyes still hurt. I wondered how long this has been going on, and then I re-visited my old blog posting and found out it has been a year of eye troubles.

Eye drops are the worse! I don’t like administering them to patients, but even worse is dripping them into my own eyes. The eye doctor says my eyes are dry, and recommended some over the counter drops. I have tried them all. My eyes are still red, itchy and irritated. They are worse at the hospital, by shift change it looks as if I had been smoking some funny bones on breaks.

I am not sure how my eyes can be so dry, I certainly do not lack any tears over the last few years. I will be crying more and more as I suffer through one paper after another—at school.

 

 

Control

 

Turned on, turned off. That is my love light switch and my head is a big red ball. When it comes to love I am like the annoying family member that demands the trivial of the nurse, while the nurse is critically thinking about the large scheme of things.

If only I could apply those thinking skills to my life, I would be a shooting star that never burns out.

I need  perspective and I am back to revise my own care plan. I am wasted in vulnerability, forcing small bites of nutrition into a mouth that does not desire food.

Life is demanding me to get organized and I am headed….To the beach!

I am up-to-date on my NIH, BLS, ACLS, and CEs. I will pack up the house and start moving tomorrow. I am going home.

 

See-Saw

Who is standing in the middle of these organs trying to balance the see-saw? That is the imaginary Mr Rational on the pivot, and he is a buzz kill.

My heart has taken over my prefrontal cortex. My frontal lobe has selective attention and there is only one thing on my mind. I am out of control and I like it.

And if I break my own heart while I wreck my brain: I work with stellar neurologists and cardiologists. I will take a full strength Aspirin, wrap myself in sterile gauze, listen to my heart tones and check my pupils.

ahahahahahaahaha #loveme #loveme

Consciousness

Where does consciousness live? In the Reticular Activating System!

The RAS runs from the lower brain stem to the mesencephalon and thalamus– to the cerebral cortex, it is a path between our lower brain and our upper brain.

It brings together a response to the outside world. It filters out stimulus that we do not need, and we focus on what we do need to pay attention to.

If someone tells me something I do not want to know about, I will say—I am sorry my RAS filtered that information out as unnecessary to my knowledge bank, please try again later.

I slept now I am awake! I am aroused and paying attention, thanks to my RAS.

I am PERLA too

I found something about neurology that I really like: pupillary response. I know I can’t be the only one out there checking out pupils. I do it to myself in the mirror all the time.

Balance

Let’s balance this blog out like the ironworker walk- stories high. When I think about how hard it can be to nurse, I will just remember: I can climb a clinical ladder, but I couldn’t climb up a beam and work.

Maintains is the name of the game here and I am cleaning up the shop. I am sweeping the floor and catching up with the shine. I am happy to see that some of my favorite writers are still writing, and I am super happy that Nurse K is off the private duty blogger jobber. I checked out Kim’s Change of Shift, and I might even go and read Grand Rounds too (is that still around?)!

 

It has been a crazy year! I missed nurses week, the respiratory therapists and the EMS weeks! We all have rough years, seems I am not the resilient cockroach I once was as a child: the bounce back is hard but I am ready to hop on the happy ball and get it together. I might even go back to school!

 

I skipped on over to a new job in neurology. I love the low ratio. At first I was thinking: this is a cakewalk, the patients seem hemodynamically stable, there isn’t even any ectopy on the tele monitors!

 

It is not easy at all, I soon found out why the ratio is low: The impact of the neurologically impaired is devastating.  The emotional toll is high. I have never bagged so many bodies in my life as I have in neurology. I figured out that the comparison between ischemic stroke occurs more than the hemorrhagic but the big brain bleeders die more.

 

I know I won’t stay in neurology forever. I think it is a good experience and I will take the information and run away with it. It will give me some balance because I always said: it can’t be Afib, CHF, AMI forever. I will get back to the heart, eventually.

 

Speaking of matters of the heart: If you are an ironworker and stumble upon this blog which is probably not likely since I am guessing stumbling is not in your nature (thirty stories high)  message me.

 

 

Eye Pain

My eyes have been hurting and it is not from looking at dirty pictures. Somewhere the will to write got lost and I ended up with a neglected nurse blog. Todays poem was something about green fairies and Absinthe, my own green eyes and a purses made out of cigar boxes, but I trashed it as raw and never started over again. I will blame it on the new job and the pursuit of domestic bunny-ship. It might just be the cold weather. Hot chocolate loses its magical comfort a few months in- and I know spring is coming.

I might need reading glasses. I am finding it hard to get into the brain. The truth is, I have not really tried. I am looking for my get-a-way car but it does not exist.

Ripped Panty Hose

She does not have holes in her hose because she is wearing a dress. I have holes in my hose: a small secret.

I wear control type panty hose under my scrub pants and run to the bathroom and secretly rip little holes in them while sitting on the toilet that I don’t have to pee into.

Nurses are so controlling.  It is a constant swing of taking command and giving it up at the same time.  It really is bizarre.

Writing little numbers perfectly in small boxes on the chart: intake vs. output every two hours. Floating around the room putting everything in a certain place, untangling wires and tubing because the twist drives me crazy.

Complete control over another human being in a vulnerable state, while attempting to remember to give that person some control over themselves to restore their own sanity: ‘No, I can not remove the intravenous catheter that is infusing hemodynamic cardiovascular chemicals into your blood stream, or remove this blood pressure cuff but would you like your telephone here or there?’

When I go home, I try to put the spoons in the right spot to get the same feeling, but it never really feels quite the same.

There is no night nurse at home to give report to, no accountability at all. I can make it all up in my own imagination: submit, and dominate myself but it is exhausting work.

And again: I wear control type panty hose under my scrub pants and run to the bathroom and secretly rip little holes in them while sitting on the toilet that I don’t have to pee into.

It’s An Automatic.

Drawing from http://xkcd.com/175/

In a world of ventric(k)s and burr holes and really big words, I got pulled to Neurosurgical ICU with my preceptor.

I said: The patient had cardiac ablation therapy in July and in December for Atrial Fibrillation and is now in a regular rhythm on: Rythmol, Lopressor, and Lisinopril and was on Coumadin at home. On admission his INR was supra therapeutic, and the patient was hypertensive.

It is brain bleeding.

Rythmol? Yes, Rythmol. In my brain I was thinking Na+ Channel Blocker. I was drifting off into a space of action potential and excitability. I was thinking about resting and diastole. I was dreaming of heart automaticity that is not dependant on the brain. There were little letters dancing around: Na+, Ca++, Cl-, K+ and gates, and the Na+ wants in real fast. I realized I might be escape pacing and I returned back to earth.

Back to earth to figure out how the brain and the heart communicate, and why does my patients tongue deviate to the right when sticking his tongue out at me on my command. <shocking>

now give me a smile and stick out your tongue.

thank you.

Communicate

Sometimes we travel down some dark roads- sometimes we put ourselves on the inky road and just when we think the road will never end- we find a surprise exit that was not on the map of our life.

So, I got a new job with a focus on neurology. I was always hung up on the heart- but maybe I will figure out how these two amazing organs communicate- and just maybe something will make sense, after all.

Follow my heart or follow my brain- one of the two has got to take over and control the rest of my life.

 

*click the link to credit the deviantArtist!