a ten year cycle

ten years ago i could not wait to leave phoenix, arizona..i was finishing up my nursing school and was counting the days until i could leave that hot dry hell hole. ten years later, after living in hawaii for four years, i am ready to go back and spend some time getting rock solid experience in nursing again. funny how life cycles us back to the same rock we came from

i don't know when i'll be back on the island. am looking forward to daily winter sunshine and tall dry mesas again. am looking forward to driving fast on open highways and watching dust storms approach from the estrellas. am looking forward to my tenants leaving should i be there in april, as a gorgeous four bedroom house awaits that's mine all mine.


sometimes life on the island wraps you up and you forget what your other dreams are. you spend your time collecting shells and fishing to get by to remain on the island and then there comes an opportunity to sit on a solid rock again and build a foundation. and maybe find a new island for summer break.

there's been a recent breakdown of everything lately. what appears to be an earthquake is just shifting the bad bricks out ..and determining if the land is worth building on again. arizona is that land right now, it's forever, it's eternal. it's home. i'll miss hawaii but it's nearing winter in hawaii right now and the summer blazing energy is gone. the tourists have gone home and i'm sad to see them go. it's time to park it near a cactus with a notebook and reorganize. laptop on hand..

falling stars

day two, the patient census was the same, luckily there were no new admits or labs or xrays but the patients i did have were a handful. i plunged right in to the med pass and prayed nothing else would happen until i could get a good portion of it done. it seems it would make more sense to me, if there is a 7am med pass, to start report at 530 so we could be on the floor with the keys by 0600. but not much makes sense about facility organization.

those who are arguing over health care reform..press the reset button and please first start with the organization of facilities. the whole thing needs to be flushed and re-done. it's a mess. i don't even know where to start.

the bully nurse was there, once again schooling the night nurse on everything she didn't do, instead of thanking her for what she did do. i've developed a quick relationship with the night nurse and told her that she was doing a great job, that no single nurse can handle all those tasks alone. i must have had a very set expression on my face yesterday as the bully nurse left me alone. she must have realized that i am a damn good nurse and even after a long absence i busted ass and took names. she told me that she would handle the front desk and doc orders and i would run the floor..which i agreed to quickly. then i found her outside playing guitar. AND she left before shift report. i'm stunned. the agency nurse..that's me..was the one who stayed longest.

yesterday one of our patients was starting to ..fall.. we refer to hospice patients as falling stars. as you know i've done hospice work before and felt very fulfilled by it.

this lady , we'll call her Eve, was starting to have the shallow rapid breathing, body rigidity, slight fever, and was not responding to verbal anymore. i saw the hospice nurse assigned to Eve make a quick visit but she was outta there before i had a chance to ask anything. the family started arriving, all of them, so i ended up spending a lot of time with them and assuming the hospice nurse role. they needed answers to questions about the death process. they wanted comfort knowing Eve was not in pain. of course they asked me when she would pass and we can't answer that. one of the grand daughters asked me if Eve could hear her if she knelt by the bed and talked to her..i said yes, she can, so she spent some time talking to Grandma. There was a strong family dynamic, it was obvious one of the sons was the leader of the family and his distance and face rigidity made the other family members tense.

This facility does not necessarily do daily charting on a patient. I pulled the chart to see nothing had been written since the 27th. Her bp had been high and she had been agitated following a fall (no injury). I reviewed her history so I could better answer their questions and get a better picture of what was happening. The nurse who had visited that day had not left any charting or note but maybe it's faxed over later? I don't know. All I could see was nurse assistant reports with vital signs and the general 'no change' status.

I could feel with this nursing intuition I've been blessed with that this family just needed a nurse to be there with them to answer questions.

At one point I was standing next to Eve, the one son who was the family leader, unbreakable, showing no emotion, was standing on the other side of the bed. I touched Eve's hand with my own, then reached out and took his hand. He jerked away. I looked up at him and took his hand firmly but gently, then used my hand to place his hand on Eve. His shoulders dropped and he started crying. I could see relief ..there was a gasp in the room. I was later told that no one in the family had ever seen this man cry. He looked up at me and gave me a single nod.

There was a quietness in the room and there was also a glow as if tiny candles were set around the room. I'm not sure how to describe it..death has an anticipation somewhat similar to the arrival or birth of a baby, of course the energy is different but there is an anticipation in the room. Eveyone was very peaceful.

My prayers to Eve and her family.

day one

was as expected..the night nurse was so far behind we didn't get report for thirty minutes which left me already behind a stiff heavy med pass on my first day. i felt bad for her since she was getting her ass chewed up one side and down the error by one of the old school nurses who felt it was her only concern to nitpick. i guess that old school nurse has forgotten what it's like to be a floor nurse and prefers to hide behind a desk with paperwork. she's forgotten the troubles of being on the front line. that's fine i'd much rather be on the front line. but hey lady if your ass is going to be sitting behind a desk all day don't give me the cell phone to answer while i'm holding morphine sulfate in my hand.

i'm pleased to know that at 38 years old i've really grown into myself, i do not really know any more about nursing that i did when i was 28, but the life experience has provided a confidence that simply won't take shit from others. if the old school nurse could ask a question without adding "you haven't bothered to do this yet have you" the day would run smoother. nurses need to work as a team, we are already up against nearly insurmountable conditions.

but i did it and i did not go home feeling deflated or emotionally abused. i feel ready to meet her head on again today.

they stuck me on the crappy hallway, i knew they would. census 19 of some pretty involved cases. three labs, one xray, doc order changes, a new admit. wound care, jevity feeding x 2, an incident report and i caught a pretty hairy med error that was incorrectly transcribed and has been going on for two weeks. hey old school nurse with your ass sitting how did you not catch that since you are so by the book?

back again today. glad i work two days a week. met with two hospice nurses who practically guaranteed me jobs on the spot. i'm torn between trying to get in to labor and delivery and going to hospice. hospice thrives on team work and you leave the day feeling like you really made a difference.

general nurse blog disclaimer

Yesterday was a five hour orientation back into a life I left behind 9 years ago for too many reasons to count. I do not know what lies ahead and can't pre-judge my reactions but it's sort of like being previously married and then entering into a new marriage with more info and experience about what to expect..knowing that nursing is not a fairy tale where you put bandaids on people and heal them and they smile and everyone is saved. I have 9 years more life experience , am more confident in myself as a person, am more assertive dealing with crappy attitude people, and found that I truly do love working with the elderly.

My disclaimer is that I will be sharing a lot of stories about working as and being a nurse. It is my priestesshood, something I took an oath for (and had to take time off from). I will use names but not the real name of the person involved. Blogs are for information and entertainment purposes. We see so many fragile and uplifting human conditions..what better way to learn about the human race than to understand them inside out.

I do not assume that I am on expert on anything. crap, I've been out for nine years and a lot has changed , but bedside care and an intent to heal people and to try to get a smile from them when they are in a not so good condition, is still my purpose. I do not treat conditions I treat people.

Nine years later it does not surprise me how many times I see other medical professionals treating patients as the job, and forgetting to say hi to them with a smile or asking about their family. Nursing homes are tough places to work, we see the same faces and sometimes get a new admit. But in that way, you end up developing relationships with people. You are going to know that Edith won't take her meds first time around but soon she'll forget about it and 20 minutes later take them without an issue. You will know Yumi will yammer at you until she gets coffee. You will know that 70 pound Irene will set off her alert constantly by trying to get out of her wheelchair but if you park her near your cart and talk to her quietly, she'll stay put and then by breakfast time you will find her asleep on her eggs and toast.

yesterday my confidence skyrocketed. I guess the crowded mind tries to figure out what was left behind and how much is really remembered. I have never worked as an RN in a hospital setting, I worked as an LPN in school in long term care, skilled nursing, assisted living and hospice. After graduation I charmed the recruiter at a hospice into training me as a hospice nurse. LOVED the job. May end up back there. But I did a lot of agency work and loved the freedom.

So yesterday was ease, the brain sparked alive by seeing charts and things i thought i may have forgotten. I'm still a bit rusty and won't be rushing off to start any iv's on a dehydrated or agitated patient. But I was able to competently discuss conditions with family members (teaching is my fave part of nursing next to getting a smile from the grouchy ones) , the cart was familiar in its stacked chaos of meds , I knew a treatment cart charting, I knew where to place doc orders. I could probably even shuffle slowly thru a new admit. Many nurses hate admits due to the paperwork..I love them. I love gathering information and although I am a nurse, my brain works to figure out diagnoses too. I think like a doctor and care like a nurse.

Nine years ago I went on hiatus from nursing, I was BURNT OUT after six months of being an RN. I had already worked for a few years as a CNA and LPN. I was disillusioned by the perfect world of healing and tasking that I thought nursing would be and was horrified by what goes on behind closed doors. I vowed to always be a patient advocate, screw the facility. My loyalty is and always will be with my patients.

In that time away I started a business, helped raise one son, and had another one. The baby is two and I knew it would be good timing to go back. My surgery was a week ago, to the astonished look of others I am back at work 8 days later (what's the biggie, guys?) I have been remarried, bought a house in Arizona, and found my place of heaven on earth at south shore in Waikiki. Yesterday the mini planets aligned and there was an audible click as I entered the nursing home, nine years late, and felt right at home.

Met with the usual disapproving look of nurses who work at the facility full time. Ohhh agency nurse. But I did not cower and act 'nice' ..I latched on to another agency nurse and she showed me the ropes. I felt ready to be on my own in two hours.

I love akai silks and will keep things running and balance it with my boys, with surf, and with the nurse job. but it's a wonderful feeling to walk in, clock in, clock out and know I just earned a nice chunk of change. Something that required school that was long, grueling, full of social sacrifice. I did not keep my license active but by the grace of Hawaii it was easy to get it back. I took a refresher course on my own (could have used the time better to just study from textbook) .

It is a wonderful, secure feeling to know the time I put in to the job today will result in steady pay. I can, by myself, go out and rent a penthouse unit overlooking the beach. Akai is good money, at full speed that sweetheart was a cash calf, and I put blood and sweat into it, and won't let it drift away, but the needs of the business have turned into wants and that allows a greater experimentation..and taking time off from it to renew. Akai is not always steady pay, you save for rainy days. Nursing is steady enough I would consider signing a mortgage in Hawaii if i found the right place.

With my first nurse check I'm treating my boys to new clothes and shoes and maybe some itunes for the teen.

I gotta go make a poo poo. Then answer akai emails. Then go surf :) Life is good.

veils again what else

just an excerpt from a passing thought posted elsewhere, it keeps the world in balance for me. there's nursing and financial means and there's akai

My work and dance with veils was heavily influenced by Loie Fuller, Eva Cernik, and Adnan Sarhan. I believe in the veil as a meditative dance partner and an extension of the human energy (an aura field) ..not just an accessory. Veil dance has been hugely influential on life, I love to make silk veils for dancers of all types but also make some for practioners of healing work and therapy. I donated veils to a nursing home once, and they used the veils with a group of people who were still ambulatory and you should have seen them light up. I have always believed that Adnan Sarhan, one of my mentors, has instructed me not only to dye and color the veils but to move into instruction and teaching with them. Production has taken up 75% of work time over the past 8 years and if I can afford to cut back now , to travel and teach using some of the bellydance teaching and also Adnan's teaching, I would love to do so.

Thank you, Dina, and others, for reminding me why I do this. It's not about the next color pattern or how many wholesale accounts or being the fastest distributor. This 'business' has been so much a heart and soul project since the very first veil.

the kiss of sleep

i don't think i'm gonna get lucky enough to be blessed with a waking kiss from some hot dude. but i'll take the sleep.

the other day after surgery..i normally come home and sleep for three to four hours, for some reason i made myself wake up and pulled thru, and stayed awake till rather late. dumb but i didnt want to sleep my boys' entire birthday away. so i've been playing catch up the last couple of nights and unfortunately 6 hours a night is not enough.

yesterday was really emotional..withdrawals from pain medications and four hours of sleep the night before. finding out the cancer had all been removed and the lymph node was clear. i think it was the first time i've exhaled in three weeks. and even after that i still went to bed late.

this morning the coffee was fine but by 10 i was ready for a nap, crashed for an hour, solid. woke up still feeling exhausted. relief is exhausting. took z to the park this afternoon and hid in the shadows so i wouldn't scare the birds, he went to bed after seven and i fell in around nine.

each time i wake up i notice an ache lower and lower in the body. it's as if the body is slowly removing the toxins and treatments in regions. my head is still hurting from the facial edema and the worst part is being restricted from activities i love. a small but impatient price to pay for peace of mind. today the ache is in the neck area so tomorrow it will be in the shoulders. it will take maybe a week to move out. i hate having a numb brain that can't think, can't remember, can't study, and can't be creative. i'm like this when i have a flu too, am pissed if i'm not out of bed skydiving by day three.

next week, i hope starts a new cycle. i see the surgeon on tuesday for a check up. he may tell me that i can go back in the water, but i'm still scared of turning my neck too quickly and having my head fall off. the incision is pretty long.

wednesday i am supposed to do my first nurse orientation in 8 years or so..i hope this agency keeps their word and sends me out. i have been so busy juggling akai orders and working around almost daily doctor appointments. i'd love to say that i am cutting back on akai to work as a nurse but i think it will take time to transition. i dont know if i will be happy with agency work and may end up putting effort into finding something more permanent.

there are a couple of boys breathing down my neck anxious to see how the new schedule of me working will be. i told them this first year is like being a student again and i am going to be very committed to learning my new job, and/or holding out for the one i want, and my kids and job will come first with surfing as a close second. anything after that filters into married life. i know that's not nice but i've given a lot of everything to a marriage for three years and raised a baby and not feel like it's time to focus on nursing.

well..woke up but am feeling the slide towards sleep again. i hope the ache moves further south and we get thru this quickly..there's so much life to continue on with

survival of the fittest

yesterday was my fourth surgery of the year. i'm getting really good at this.

a few weeks ago i was diagnosed with melanoma (or skin cancer). a couple of years ago i had noticed a light brown freckle that was a bit bigger and irregular shaped over my right eyebrow area. it looked like just a freckle so i didn't have it checked out. didn't have insurance at the time.

finally went in and they did a biopsy and confirmed melanoma. have spent the last couple weeks going thru a series of tests, a PET, CT, lymphocytograph, chest xray, blood draw.

it was determined by my surgeon to remove any remaining cancerous cells and also remove the sentinel lymph node in my neck.

i'm still sedated and feeling drowsy but my appetite is excellent and i'm looking forward to getting thru a restful day and enjoying sleep again tonight. the surgery was a breeze..i remember vaguely falling asleep then waking up and the first thing i asked the nurse is if my shoulder still worked (there is risk of nerve injury which would have made it difficult to surf). James drove me home , we had a good dinner , walked around waikiki a bit and then retired to my living room to rest.

There is a long row of stitches under my right jawline. he did a great job sewing me up though, nice and straight. The incision on my forehead is a little less fortunate..forehead is swollen and i have a black eye on the top. Because the stitches pulled skin around, my eyebrow is noticeably lifted..doc says it will come back down as the stitches are removed and the skin relaxes. he also promised to fix it if it doesnt settle back in properly. i dont want to run around looking surprised all the time. i may end up getting a free brow lift to the other side . gotta love when plastic surgery is deemed medically necessary. he can take a few eye wrinkles out while he's there.

anyways, i'm going to keep bugging people to check their skin and stay on top of things. melanoma is fast growing and deadly. early detection saves lives, nevi, or moles, are very common but it's a good idea to be checked out by a dermatologist so any potential problem can be caught.

am going back to sleep