Fantastic!

This weekend has been fantanstic!

An old High School friend came into town, Flagstaff, in order to meet "her sister halfway..." that is, my friend lives in Oregon and flew into Phoenix, her sister lives in Kingman. Halfway was 2 hour travel time for both of them, which meant Flagstaff was the spot!

I got to play host, tour guide, and gentleman... they won't admit it, but I let them win playing pool/billiards this evening... not that I am the shark... but I can hold my own... if they only knew! Hmm... hehehe...

While I was playing host, I got to see one of my work friends, which was cool! She wished me a happy Sunday! Which was a bit odd as it was Saturday... when I pointed this little fact out to her... she declared, "Bonus! Another day off!"

I hear you BDN! You are a great person and I enjoy working with you!

So my friend is off and about this evening visiting other friends in the Flagstaff area. I let her into my home to take a shower and get ready... Yes... I was the gentleman and made myself scarce to check my mail and start laundry while she was potentially indecent...

Earlier in the day I got to meet her sister. We walked around the downtown area, window shopped, visited a few stores, and then went walking... a total of 2.5+ miles in and around downtown and in Buffalo Park... not much really, but for those who live at a lower altitude... ;)

So, what does this have to do about me?

I lot! Friends, thier family, fun, outdoors, excercise, etc., etc!

This was a fantastic weekend!

Memories...

Tonight, I got to chat with an old friend that used to live down the street from me when I was growing up! Gotta love FB for providing the opportunity! Found out a few tid-bits about the old neighborhood, as she recently moved back into it! Like, my former next door neighbors... they still live there! Talk about a "Wow! Really?"

I had the opportunity to drive through my old neighborhood a few weeks ago... was sorta a sentimental trip...

A lot had changed, so much so that I hardly recognized it! Saw the house I grew up in... that was a trip! But the neighborhood, although familiar, was vastly different! For one thing, the houses were a lot closer together than I remember... but I was a bit younger... and a whole lot smaller way back when... Last weekend, my parents gave me two pictures. These two pictures were of me when I was very young and was living in the house that I previously mentioned.

A few years ago, this same house was up "For Sale," and vacant... I was able to walk around the property and into the backyard... posing as a prospective buyer...

Back then, it brought back a lot of memories as well. Tonight, it sorta came full circle.

It is somewhat strange that we have memories and pictures of previous parts of our lives, that we can recollect, see, and reminisce...

Tidbits, parts, and snapshots... a simpler time... an age of innocence... we were, of course, younger then...

But the purpose of my ramblings, is that although many things change, there are some things that never change! I guess that is the beauty of it all, that no matter what happens in one's life, there will always be something or someone that will always remain a constant! One may not know it, one may not even be aware of it, but it will always be there...

Waiting for a rediscovery or remembrance...

Anticipation

Today was a medium long day. In that, I mean that I went into work and circulated one, quick surgery. It started a little after 7:30am, we were done a little after 8:00am. I didn't leave work till after 12 noon!

I hung around to help get things ready for Monday... which will be another medium long day. Then I helped a friend run an errand... of course when we we were finished I learned that lunch was being provided (typical Friday event!) so I hung around doing little things that needed to be done until lunch arrived. Afterwards, since I was still hanging around, I got recruited to provide a lunch relief.




I have been house/dog sitting for two friends this past week. The friend whose house I was camping out at came home today. So after work, I went there to pack up, move out, clean, and take away two dogs before they got home! I then moved into the other friends house! I'll have to repeat this maneuver on Sunday, when my second friend returns, with the exception that I will only take away one dog, my Sadie girl.





Tomorrow, I am going down to Phoenix to spend the day with my daughters! It has been almost a month since I have seen them. We have an event filled day planned, although one of them gave me the run-down on what to wear/do/say/act so I don't embarrass them... teenagers!


I look forward to seeing my daughters. As a divorced father, with visitation issues, every moment is precious to me. Hopefully, soon I will be able to modify the visitation 'limitations' and get to see them more often, go more places, do more things with them!

So perhaps I'll share how my Saturday went. Or not.

I hope everyone has a great weekend!

What a great day!

I almost had the day off today... until 9pm last night when I was asked to cover someone who couldn't go in today due to an injury. I didn't mind, I'd rather go to work and earn PTO than not work and take PTO! Besides, it was a way for me to help a fellow employee and friend!

While at work I had the opportunity to impact the lives of two patients! They were in our overnight stay, or Recovery Care, unit. One of the patients had a sub-talar fusion (big screw put through the calcaneous). He was in a lot of pain when I got there this morning. It took about 30 minutes for me to figure out the problem, and once I did, his pain level dropped from a "5" to a "1!" Needless to say he and his wife were very grateful! The other patient had a total hip arthroplasty (hip replacement). He was a bit depressed and feeling a bit claustrophobic, being inside for the past 3 days... I got him to step outside and walk a bit in the fresh air and added him to the "lunch list!" He got a catered lunch take-out from La Fonda, a local mexican restaurant! It made his day and he let all of his friends and family know what a great facility we were for taking such good care of him, especially ordering him mexican food for lunch! (Next time you're in the hospital... ask your nurse to order you some food from an outside restaurant, AND, ask them to pay for it! See what kind of response you get....)

But what really made this day a great day, was I worked with an awesome person! Brooke is an old friend, from my ED days! She is now a EMT/Tech at the facility where I work. She is a down to earth, no nonsense, kind of person! We work well together, especially when we are both racing each other to get something done, knowing that the other will probably get it done first, if we both don't jump on it!

Back to the lunch-list...

I also bought lunch for everyone today at work. In full disclosure, it was a skeleton crew... so I spent a lot less than our doc's do when they normally splurge for lunch on a Friday. However, it was an honor and a joy to do something for my fellow employees.

Adding one of my patient's to the lunch-list, and buying his lunch too, only added to it! You see, as a nurse, my job first and foremost, is to provide for the safety and security of my patients. That is a very broad statement, as the safety I provide is not only physical, but emotional, mental, spiritual, etc.

I made my patient's day, by providing a special lunch treat! What made it even better and more satisfying... he had absolutely no idea that it was me that bought him his lunch! I added to his mental and emotional well being. It was well worth the $7.00 I spent on his lunch...

So...

Here I am, winding down from a great day at work. The dogs are fed, I am fed, watching TV, reflecting on my day...

It was a great day!

Karma and the Monte V...

Tonight I went out to dinner with some work friends. We had sushi at a place called Karma. It was nice, great service, not very crowded.

Afterwards, we went to a historic hotel here in Flagstaff, the Monte Vista (or Monte V to those in the know...) to listen to a local band. One of the band members is a "significant" person in the life of one of my co-workers...

While I sat there listening to the music, I had the opportunity to watch people.

Going to a bar, not drinking, and watching people can be a lot of fun!

I saw a large number of people that I knew. Most of which I worked with at one time or another. But it was sort of funny watching them interact with one another. You see, I was sort of tucked back into a dark corner... I think one person might of recognized me, but didn't initiate contact. I was blocked in by the seating arrangement, so I didn't get into the mix...

I ended up leaving early for two reasons. First, I need to go to work tomorrow and therefore need to get some sleep. Second, I ran into a friend that needed a ride home (enough said).

Not very exciting, nothing profound!

Happy St. Patty's Day!

Friends

It has been a few days, for you that are following, I apologize!

Last night I had the opportunity to reconnect and spend time with a friend. At the time, it was where I needed to be, who I needed to be with.

Today, as a result of last night, I let down a great number of family, friends, and co-workers...

To those that were relying on me, to those that thought that they needed me, to those that were wondering where I was... I can only apologize. I am truly sorry!

However, things still happened. Things still progessed. Everything that needed to happen, happened. So, how important was I in the grand scheme of things?

I do not want to minimize the impact of my abscence... I know and fully appreciate the undue burden that I created. Yet each and every one of you, stepped up, covered, and got things done! Something I am proud of! You see... we are a team. We are there to provide a service and every now and then one of us falls... yet without even a moment of hesitation, others step up and in to cover, to get the job done!

I am honored.

I am embarresed.

I have been humbled.

The only thing I can say is, I am sorry.

Nothing I can do or say will make up for it, so...

I am sorry... please, I beg for your forgiveness...

Another Monday!

I had the day off today! That makes two in a row!

Tomorrow I have to go to work, but it will be a half day!

This morning, I took advantage of a well deserved day off and slept in! I awoke to my dog, Sadie, nudging me to remind me that she needed to go outside to take care of business! I was a little bewildered as it was overcast, just on the verge of needing sunglasses, yet it was freezing rain/light snow flurries! Nothing acumulated, no great photo ops...

I did go geocaching today. Only got one, but dropped off two TB (Travel Bugs). I also placed two new geocaches, and scoped out a few different areas for a series of geocaches that I am in the process of placing.

Late this evening I went over to a work friend's house. She and her husband are going to Costa Rica for 10 days! I will be stuck here in Flagstaff, so I agreed to house/dog sit for them. They have two little Chihuaha's... my Sadie will have a great time... I'm sure that the two of them will have a new attitude afterwards! Sadie, is an old girl... she is about 500% bigger than them... she doesn't take to much abuse... she will be in control!

My foot is a bit sore... not actual pain, just an ache! Probably due to a bit too much walking/hiking/scrambling/climbing... over these past two days! It makes me realize that I need to do this more often! Luckily I have a hobby that encourages getting out and about!

To all of my friends, take care, I'm thinking about you!

Peace...

A great day!

I went out to Williams, AZ this afternoon. Got to have lunch with and incredible person! I'm pretty sure that they probably don't want to read or hear anything more, so I'll stop right here!

Afterwards, I went Geocaching! In and around Williams, then here and there as I travelled back to Flagstaff!

It takes a little over 30 minutes to get from Flag to Williams & vice versa...

My return trip took almost 4 hours! Of course it was because I kept stopping every now and then, taking short hikes, hunting for that cache...

And every now and then, I would see things that no one else would or could! That's one of the best things about Geocaching! It gets you out and into areas that the vast majority of people don't get to see!

I travelled down a road that ended up turning into the original, actual, old Route 66! The asphalt ended and suddenly I was on concrete! I was now travelling on a part of the American History! I parked and hiked into areas that hadn't seen another human being for at least 6 months! I saw wildlife, plants, birds, elk and deer! I even got up close and personal with a freight train!

Today was a rekindling... the first real day that I got myself out and about in a very long time! It was invigorating, fresh, real and great!

My answer! (A long and drawn out one...)

I asked a number of my peers about the "Moral Dilemma." I even asked a few non-medical people how they would respond to the question...

No one, said "no," "never," "absolutely not."

A few put conditions on there answer.

The majority said probably or absolutely!

Absolutely = 50%
Probably = 41%
Conditionally = 9%

By the way, I got a 94% response rate, N=30.

So probably not a significant population sample... but it begs further research!

The conditional responses were regarding friends/family involved...

The probably responses all revolved around quality of life afterward issues...

The absolutely responses, were just that! Absolutely!

Many years ago, when I was first posed with this question, I was definately in the minority! I responded with conditions! As I matured in my profession, my viewpoint changed and I became a probably.

I have been involved in Pre-hospital/Emergency medicine for 23 years! (EMT, IEMT, Paramedic, Flight Paramedic, Emergency Nurse, Flight Nurse) My last 2 years, have been in outpatient surgical nursing.

I can't tell you when, that is, exactly the time or year when, my answer changed to probably... But it was after I was a Paramedic! I was trained in Tucson, AZ. At Tucson Medical Center, under the direction of Drs. Kent Carey, MD, and Richard Carmona, MD. That might raise a few eyebrows! Hopefully, at least one person might recognize at least one, if not both names named!

It was shortly there after, that I changed my answer again to absolutely!

One morning I was coming on shift as a Paramedic/Firefighter. I was going through the normal routine of the morning truck check, oxygen, supply and equipment check. I had just finished checking my drug box for outdates/expired drugs, and I had charged up my LP-5 monitor/defibrillator (yes, I know I am dating myself somewhat...) to check my defib settings. After I got a satisfactory discharge... I paused...

You see, I was still a fairly new Paramedic. It suddenly dawned on me that I was given the responsibility and accountability for other people's lives! I couldn't even legally drink alcohol, yet I was pushing narcotics and had electrical interventions available to me! Talk about a reality check!

Complete strangers were calling 911, I was responding, and they completely and utterly trusted me with their lives! And I couldn't even buy them a beer! Talk about a paradox!

I was trained and educated as a Paramedic in Tucson in the mid 80's. Paramedicine, that is pre-hospital medicine was still going through a lot of changes. Our program went "full-bore!" We learned everything that was allowed at the time! One of my Medical Directors mentioned something about we (as Paramedics) are the front line, first line... life and death decisions are made by us! No time to call for medical direction, you need to know what to do, how to do it, when to do it... and this is what stuck with me the most... and most importantly, when not to do it!

My viewpoint, philosophy, and answer changed!

One day, I was dispatched to a Chest Pain. Our response to a remote location South East of Tucson took over 30 minutes. Upon arrival at the scene, my EMT (and Paramedic student) partner and I found a mid-30 year old gentleman, experienceing chest pain. The symptoms were classic for an MI... substernal, crushing chest pain, diaphoresis, nausea... we hooked up our LP-5, he was talking to us appropriately... my partner started to take vitals...

I was turned away from him asking his wife about his history, medications and allergies... when my partner started yelling, "Relax! Put your arm down!"

I turned to face them, saw this gentleman with arms extended out, palms down, purple...

I glanced at the monitor and saw a lethal rhythm, V-Tach! At the time (again, I am dating myself...) I delivered a pre-cordial thump!

My partner looked at me and asked why I just "punched" the patient!

I replied, "Look at the monitor! V-Tach!"

To make a very long story short....

We initiated BLS and ACLS on this individual. Within 10 minutes, we were in the ambulance, on our way back into Tucson to the nearest hospital... which was 30 minutes away! I emptied my drug box into this person. I gave drugs not in the ACLS Algorhithm (in the 1980's...) just becuase! Perhaps he was a diabetic? D50! Perhaps it was an Addison's Crisis? Hydrocortisone! (Methylprednisolone [Solumedrol] was still a few year away...) Lidocaine! Bretylium (now I'm really dating myself!)! He remained in refractory V-fib/V-tach!

Today, it would probably more precisely described as Torsades de Pointes! We have at least two new drugs for that!

However, I poured myself out for this gentleman! I did everything and anything I could to attempt to save his life. Here I was a fairly new paramedic... the most opportune time to have a paramedic present was when you went into cardiac arrest! Arrest to ACLS time = ZERO (0) MINUTES! I gave drugs outside of the ACLS Guidelines... luckily, at the time, they were just that... guidelines....

I did everything and anything I could to save this life!

I wasn't worried about liabilities, I wasn't worried about certifications or licensures... I was worried that I wouldn't do what needed to be done, when it needed to be done! I was worried that my inaction, would lead to a persons demise... his death...

It was at that moment I became an "absolutely!"

It has been many years. In that time, I have been faced with many situation that have caused me to ask myself the same question!

I am proud to say that I have done what needed to be done, at the exact time that it needed to happen! Some say I am lucky that there was no dis-advantageous outcomes...

My answer is simply this...

That patient is alive today, because of what I/we (in the case of my peers/partners) did!

I have no regrets!

...

Absolutely, no regrets!

So my answer to my own question:

My purpose is to save lives. If I need to do something to save a life, I am the only one available to do it, and if I do it, I will lose my license... I don't care!

I saved a life! I sacrificed my own well being, my own security...

Someone lived! That is more than ample payment!

A Moral Dilemma...

A few days ago, I posed a question that was a moral dilemma...

You were asked to do something to save a life, if you did it, you would never be able to help another person ever again. If you didn't do it, the person would die. Here's the actual question/situation from my blog:

"A long time ago, I was part of a group that was asked a "what if" question,
regarding something that needed to be done, that we were not authorized to do.
If we didn't do what needed to be done, the patient would die. If we did what
needed to be done, the patient would live, but we would lose our license and
ability to practice.

Before I tell you my answer, how would you answer this question or respond
to the dilemma? Would you do something to save one individual life, never to be
able to help another person; or would you not act, knowing that you would be
able to influence and affect, potentially saving many more lives in the
future?

Yes, a moral dilemma!"

I emailed/messaged several people this question. Obviously, the
responses are biased as the majority of the people I sent this question to are
in the healthcare field... but then again, they are the one's most likely to
encounter this situation! Here's the question posed to them:

"A hypothetical question...

You have been asked to do something in order to save a life. If you don't do it your patient will surely die! You know how to do it, you are capable of doing it, and you can accomplish it safely.

However, it is not within your Scope of Practice and if you do it, you will lose your license. You will never be able to help another patient again. What do you do?

I appreciate a reply, even if it's "I won't answer!"

So... I'm reviewing the responses and will give a summary of them in a day or two. Then I will tell you my answer!

The Case/Surgery went well!

Today was a good day!

Everything went well, my friend's husband was well cared for, the outcome was good!

However, my foot/toe was screaming at me by the end of the day! I was in pain, and several of my co-workers noticed that I was "limping" by the end of the day....

A small sacrifice! Yes, I probably pushed myself a little too far, but it was not about me! It was about a friend's husband, my patient, and another person, a husband as well, also my patient!

Two cases today, about 7 hours on my feet. Moving, grooving, working, circulating!

I love it!

To my co-workers... Thank you! I am truly honored that all of you notice, are aware, and more importantly, are concerned about my well being! Thank you!

To my patient's... Thank you! You are at your most vulnerable state, and you have allowed me to be your nurse, your advocate, your protector, and your champion!

Be well.. Heal well...

Know that I am thinking about all of you!

It's Monday!

The first day of the work week and I am already exhausted! Went to work today, a full eight hours I might add! And yes, my foot/toe is reminding me of that!

There was only one OR today, with a really great surgeon! But like most, he is a bit eccentric!?!? That is probably a good word to describe him! Don't get me wrong, I would let him operate on me for anything orthopedic in nature, as he is an truly great Surgeon. I have full faith and confidence in his abilities.

Yet as only a fellow nurse could comprehend... he has his quarks!

Tomorrow, I have been honored to Circulate a specific case! A fellow employee has asked me to be the Circulating Nurse for their husband, who will be having a complex surgery involving a total joint replacement! For those that may not understand, any surgery has risks and benefits. A lot of the risks are dependent on the Circulating OR Nurse... from the set-up, the pre-op, the skin prep, to the ongoing vigilance during the case... the Circulating Nurse has a lot of responsibilities, but also has a great accountability to insure that the case progresses safely! The Circulating Nurse has the ability and authority to stop a Surgeon, question a decision, make the final call on a breech of asepsis, and much, much more!

For an individual to request me as a specific person that they want to care for and be an advocate for their loved one, is an honor and a privilege to say the least! I will treat their loved one as I treat each and everyone of my patients! With the utmost respect, care, concern, and vigilance that I can muster!

This may be their husband, whom they love, honor and cherish... but, this is my patient! Who will be helpless and totally reliant on me for their safety and survival!

Which brings up another memory...

A long time ago, I was part of a group that was asked a "what if" question, regarding something that needed to be done, that we were not authorized to do. If we didn't do what needed to be done, the patient would die. If we did what needed to be done, the patient would live, but we would lose our license and ability to practice.

Before I tell you my answer, how would you answer this question or respond to the dilemma? Would you do something to save one individual life, never to be able to help another person; or would you not act, knowing that you would be able to influence and affect, potentially saving many more lives in the future?

Yes, a moral dilemma!

Think about it... I'll tell you how I responded later!