Hidden Treasures in Plain Sight

As I stand here patiently waiting by her bedside, I watch for ‘the sign’. It will come. Maybe not today or tomorrow, but it always does by the time my job is done. At first I didn’t know what it was or what it meant; but now I am a bit older and the fragility of life, health and merely being human is now nipping at my heels.

I remember the first time it happened. Her name was Mrs. Mary McConnaughey. She had been a prominent citizen in that small town in her younger days. By the time I met her, however, she was reduced to living in nightgowns, puddings for breakfast, lunch and dinner and enema regimens. For a while she pretended not to know anything or anyone – especially the myriad of friends and family – mainly family - that came to call on Sundays.

After a few weeks of constant time spent together, however, I began to catch on and she began to trust me. I enjoyed those long talks in the middle of the night when she would describe her former life and make fun of the wealthy people she had known and the skeletons in their closets behind the facades she had been privy to. She was as brilliant as any scholar I’d ever encountered and her sense of humor, though dry, was exquisite. Why, I wondered, did old age have to be so harsh?! The light behind those eyes, behind the wrinkled face and wispy hair was so beautiful to me. I couldn’t understand for the longest time why she would want to hide so; but eventually I realized it was because she was simply tired and bored with her life and everyone in it.

Later, when the time came for me to return to college, I knew I would never see her again, but that my perception had been transformed in such a way that I would never be the same. I have had similar experiences over the years, but none have been so dear to my heart. There is always the sign of life in an old, withered shell if I look for it. It’s like finding a hidden treasure on the beach.

I have come to understand Mrs. McConnaughey a little better. Maybe some of her reticence came from the knowledge that our society has a hard time looking beyond the outward appearances; is too fast-paced to sit down for a leisurely stroll down memory lane, or to soak up some of the wisdom of those who have gone before. Almost every magazine, television commercial, sitcom and movie portrays the young, perfect specimens of health. Everything is about fast-food, fast-living and instant gratification. We have gone from extended families to nuclear units and the idea of someone taking care of their parents has given way to nursing homes and/or extended care facilities where caring is just another line on an itemized bill.

The saddest aspect of all of this to me, is the wealth of information that we are and our children are missing. The wisdom, the history and the experiences that will be forever lost. That’s why it’s so important to me to look beyond the drool on the chin, the untamed hair and the seeming incomprehensibility. There has always been a treasure inside, just waiting to be opened. One that’s priceless, ageless and timeless.

Life as a Newbie Nurse and My First 'Sundowner'

As a new nurse, almost everyone has to pay their dues working nightshift for a while until the older nurses retire or transfer to the less strenuous positions in the hospital in order to save what’s left of their backs and feet. I was hired immediately during my first interview partly because of my alma mater (a private womens' college known for its excellent nurses) and realistically more likely because the hospitals were beginning to feel the first pinches of the coming nursing shortage.

3-North was an ICU Step-down floor and known as one of the most difficult (if not THE most difficult) units in Winston Central, as I would soon find out. It was definitely a trial by fire. All nurses must go through what is termed an orientation phase where they are teamed up with another nurse called a prefect or trainer until they can integrate what they've learned in the books into a real practice, are familiar enough with the procedures of the unit, and have the (blind) confidence necessary to take care of patients on their own and my first couple of weeks there were rough since I was training with the dayshift nurses - all of whom were "too damned busy to bother with a newbie".

Most nurses will agree that there is a world of difference between dayshift nurses and nightshift nurses. The dayshift nurses were usually more competitive and...less helpful, okay - RUDE - unless you were lucky enough to fit in to one of their 'clicks' right away, (which was not my fate). This was partly understandable because they were the ones who had to deal with the walking giant egos, otherwise known as doctors and their harried assistants. Not only that, they had too many patients at a time who were too sick, or what we called high acuity, to be on 'the floor' instead of the ICU in addition to the constant comings and goings of the physical and occupational therapists, case workers, fresh post-op patients, and various and sundry procedures they had to oversee with each patient - not to mention the families and their constant questions, fears, demands and inter-family politics to juggle on top of all the rest.

Being moved to nightshift earlier than normal was a blessing. I was shocked at the difference in not only the pace of the unit, but the personalities of my new co-workers. Night nurses and most other hospital personnel were what you could term 'laid back' and their sense of humor was worlds beyond in improvement over the hectic day shift people. I was assigned to a male LPN as a prefect, in spite of the break in protocol this represented. Registered nurses were supposed to train registered nurses and licensed practical nurses were supposed to train other licensed practical nurses. The difference was an extra year of school and a much deeper knowledge of pharmacology, among other things. LPNs weren't allowed to administer or hang IV drugs without the signature of an RN. This was often a 'bone of contention' for the experienced LPNs because they felt they were doing the same job as the RNs, but getting paid less. I can't argue with that for the most part and may discuss that in another post.

My prefect turned out to be a blessing as as trainer, however. He had numerous years of experience and was a better nurse than most of the staff rolled into one because of his knowledge of medicine, overall intelligence and cool head in a crisis. I felt lucky the more I got to know him and became quite fond of him over time. He watched over me and showed me many of the 'tricks' (he could get an IV in a patient when no one else in the hospital could do so) that make an excellent nurse as opposed to a good nurse.

As the weeks went by, I quickly developed a bond with my fellow nightshift workers and everyone worked as a team. We usually had more patients than the day nurses, but things were more calm - for the most part. Once in a while we would have a bizzare night full of adventure. They always seemed to come in threes. This particular night we had already had to call the house supervisor over a drunk, unruly family member who belligerently insisted that her son was not receving the care she thought he deserved and a mentally ill young gentleman who had decided to tear out his IV and run down the hall naked trailing a stream of blood from the open IV site. He managed to get down the stairs and outside. The security officers along with my prefect finally managed to find him by following the trail of blood and to calm him down and lead him out of the middle of a five-lane road and back into the building.

After the aforementioned crises we were finally able to sit down at about 4 am and catch up on the tremendous amount of charting, arrangement of medication sheets and other paperwork for the next day. No sooner had we taken a few deep breaths and starting chatting about our husbands, kids, house renovations and the like; there was a sudden bloodcurdling scream from the room directly across from the nurses' station.

That particular room was a double occupancy room. In the bed closest to the door was a lady whom we were evaluating for a possible heart-attack, who was quite nervous and needed a peaceful environment. She happened to be my patient. In the bed across the room beside the window was a tiny elderly woman who couldn't have weighed more than 90 pounds fully dressed and soaking wet with boots on. She was admitted for dehydration and the general malaise that so often occurs with the elderly when they live alone.

During the day this same little lady had captured the hearts of the entire staff with her charming personality and sense of humor. She had been as mild- mannered and sweet as humanly possible and several of us felt the urge to simply take her home and make her part of the family. Upon entering the room and switching on the lights, however, we discovered this same little angel had been transformed into a wild-eyed 'wrangler' standing on the bed over her terrified roommate intent on wrapping the lengthy phone cord around the ankles of the poor woman! She had done an excellent job of doing so before anyone could stop her.

This scene would have been extremely hilarious had we been rehearsing an episode for Bonanza or Wild Kingdom but given the reality of the cirumstances and the condition of her human prey, we quickly talked her down off the bed and my co-workers gingerly led her back to her own 'corral' while I gently untied my trembling, shell-shocked heart patient. Needless to say, I quickly arranged for a private room for my patient for the remainder of the night.

The sweet little woman was only my first experience with what is referred to as a 'sundowner' in the slang terms of a hospital staff. There is no predicting who will suddenly develop the super-human strength and creative ways of acting out common to a sundowner. That's why I developed the habit early on of making rounds on my patients at least every 30-60 minutes no matter how quiet the night may appear.

(Actual names of persons and places have been changed to protect the not-so-innocent & to stave off any undue lawsuits.)

In the beginning...

I’ve wanted to blog for longer than I care to admit, however, due to my current 'attention deficit' state of mind, I've been reluctantly entertaining one of my least favorite character defects - procrastination. Procrastination is one of those $10-dollar words that define the main cause of chaos (a shorter but even more detested word) in my life. Therefore, although I don't feel ready in any way to write a decent (meaning interesting and halfway intelligent) blog; I am going to dive in nonetheless and 'get this party started'. My goal in writing this particular blog is to purge my system of the negativity of the past few years once again experience peace of mind and its byproduct - joie de vivre (‘a keen enjoyment of living'; wordnet.princeton.edu/perl/webwn ).

That brings me to the next step. At what point in the history of the myriad of life adventures do I begin the exposition? I could start at the beginning; such usually explains the make-up of a person - their particular emotional/mental quirks, the events that shaped the patterns of their perspective, patterns of thinking and reacting to life's challenges and blessings; or to be politically correct, their issues (a thoroughly bastardized word). On the other hand, I could start with the recent events of 2001 that have led to my present state of dis-ease and interject occasional historic episodes that have been influential in the choices and behaviors exhibited by myself and others. I may do a little of both.


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