The American Gazette

Commonsense political and social commentary from "Flyover Country"

Location: Rural Michigan, United States

Monday, October 11, 2004

A Note on Blogging and Time

Any one who has read this blog previously will note that I am a nurse, for the last year and a half I have consistantly worked overtime and or homecare and in some cases both.

Last July I started doing sub contracting for wound care through agencies. The first case I picked up was with a patient that had a non healing wound that had been present for nearly three years with multiple hospital admissions and several surgeries. At that time I worked M-F as a wound care specialist at a long term acute care hospital or LTAC for short. It is a speciality hospital in which long term vent weaning, long term wound care and very difficult infections are dealt with. I always explained to people the type of hospital it is was doing what hospitals used to do before the advent of DRG's, only we did it better and more effectively by being able to focus the exact needed resources for those difficult to heal patients. I was scheduled to work 8 hour shifts but like so many nurses the end of the shift is rarely when it was supposed to be.

When I picked up the first home care case it meant that I would drive from the hospital 35 miles one way to the patients home after I had worked a full day, do the necessary wound care and documentation and then drive another 35 miles home. I did this every single day. I was there for every holiday, bringing my patient a plate of goodies and a good meal, something he did not always have. I tell this not because I am some wonderful nurse angel, I really am not. I have a keen interest in being able to heal wounds that have been unresponsive, because too often those wounds are unresponsive because the doc has absolutely no clue what to do with various types of wounds. That is a sad commentary but ever so true. I drove through driving rain during thunder storms and I drove through driving snow storms, just put the ole Jeep Wrangler in 4 wheel drive and off I went. I had made a commitment and would see it through. In December I picked up another patient, I tell about him in a post from Sunday.

At first I did not see the second patient Claude, every day. By this time I was picking up Saturday's to work on the floor at the hospital, in other words I was not doing my regular job I was working as a floor nurse. Of course no matter what I still ended up doing much of my regular job as well. The Saturday time was 12 hour shifts, most floor nurse today work that. From December to Febuary I juggled this all, and did it fairly successfully. Part of it was because I was earning extra money to ensure I could pay college tutuiton for my oldest child and part of it was an attempt to build a consulting business for wound care.

At the end of Feb. I had a terrific argument with the new nursing director for my facility. I had been pulled to do floor work on a day that I was to do wound care and then it happened the next day, but not only was I expected to take a patient load I was also being expected to do the wound care patients that needed to be seen as well. That effectively gave me 14 patients and I flat refused to do it. My license is far to precious to me to do dangerous work for one, and I refuse to do poor patient care. What the director did not know was that I had already gotten another job and intended on giving notice the following Monday, though I had intended to give a 45 day notice as there was no one in my facility trained to do wound care and it was my intent to train someone in at least the basics, though effective wound care takes at least a year to learn appropriately. I loved what I did, watching a wound heal that has been non healing is extremely gratifying for both me and the patient. But I knew it was time to leave as I was clashing often with the new director over what I felt constituted appropriate care.

So I left after this argument. I would not under any circumstances do care that I felt was either unsafe or poor. So I had a week off and started my new job. I now work 12 hour shifts at night, I took the night job because it worked out better with my agency wound care obligations. When I first started I was not working nights, I did many classes in cardiology because it was an area I was not familiar with and would stop by the one patients home in the morning and the other patient's home in the evening. By the end of April the first patient was essentially healed, at least to the point that a wound nurse was no longer warranted, and a regular nurse could handle it. I fully expected the wound to close within a couple weeks, checking in by phone with the patient confirmed that in three weeks he was completely healed.

I had started doing more visits with my other patient as his wound was not doing well and more aggressive treatment was required. I was also working 4 twelve hour shifts a week at the hospital so I had one day of overtime each week. Claude ended up in the hospital, two admissions together for about a 10 week period, it was the least amount that I worked for a year. I was still working 48 hours a week but it was ok. I would put my days close together so I could then have several days off together. The hospital I work at now allows self scheduling and as long as all needs are covered the days you choose to work are not changed. It was a nice way of being able to do things over the summer and then I could spend several days in a row off while my kids were out of school.

When Claude came home from the hospital it was the end of July and I started seeing him twice a day every day, as well as my 4 twelve hour night shifts at the hospital. It worked out well because I would see him on my way home and then on my way to work. I won't lie it was tiring but I was doing what I wanted and it worked well for my family life. I had gotten quite close to Claude and healing him became a huge priority for me. 7 or 8 weeks ago I started picking up weekend 11-7 shifts with him at his home and dropped my hospital overtime. Initially I did it to help cover for someones vacation and we had just gone to 8 hour shifts there instead of the 12 that the agency was doing. Claude liked having me there so much he wanted that to continue and it meant that the regular 11-7 gal could have every weekend off. This was available to me because my unit at the hospital is an outpatient unit and we had started to close on the weekend instead of staying open for only 2-3 patients who could be taken care of on another floor saving the hospital some $30,000 per weekend.

Life was busy for me but it was a good busy. With the 11-7 shifts I could sleep but still get up and have time to spend with my kids and the other days I was sleeping while they were in school. My hubby tolerated it because he supports me in my endeavors and knowing that we had one child in college and he is also taking classes and the next child off to college next year, as well as finishing the remodeling of an old farmhouse it was good to have the money coming in. I loved what I was doing in both jobs and the agency had plans to expand as far as wound care so there was much to look forward to.

Every day I saw Claude and we would joke and laugh and enjoy the relationship that we had. Each morning I would come in and his wife would have a cup of coffee ready for me, and after I did my wound care we would chat along with the other nurse that was there. I became good friends with the other nurses, we shared books and movies and things that we thought the other may be interested in.

On Sunday morning Claude died, and I lost a good friend, not just a patient. For a year and a half I have spent every nearly every single day except when my first patient healed and Claude ended up in the hospital driving out to someone's home. And even then I was working overtime anyway. Yesterday I had no where to go. Today I had no where to go. No patient that needed to be taken care of, no overtime to go to. It is an incredibly odd sensation. So many times yesterday and today I had that anxious feeling of having forgotten something to simply realize that I just didn't have anywhere that I needed to go. My heart hurts and every time I have that feeling of I was supposed to be somewhere I remember why I don't need to be, which only makes me feel worse.

So I have blogged to fill my time. The kids were at school today, hubby doing his thing and I simply had nothing to do. Such an odd sensation. I'm reading a book on Ghengis Khan that is really very good but could not get into it, after I read the same paragraph for half a dozen times I just gave up.

There have been few days in the last year and a half that I did not feel very blessed in my life. And part of that blessing was the unexpected chance to know Claude. It was a job I did not go looking for, it was a job that found me.

I think maybe I have posted too much today, but it helps me keep other things off my mind, so excuse my excess today. My life was touched by a wonderful guy and I shall miss him very much.



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