One year later...

Last night I worked an extra 4 hours to get in a little overtime and help out the unit. I walked into a bit of a mess. I had 4 patients: two admissions (one scheduled chemotherapy, which requires some time to ensure the dotting of i's and crossing of t's), one comfort cares (actively dying patient) and one patient with fevers and tachycardia.  Of course, within the first 30 minutes of the shift, the comfort cares patient died, the patient with fevers and tachycardia worsened, and my two admissions needed attention.  Talk about overwhelming.  But the really cool part is that I did it.  I assessed my resources and asked for help, delegating tasks to ensure that things got done in a timely manner and everyone received attention.  It wasn't smooth or unchaotic, but for the most part, everything got done and within the blink of an eye those 4 hours were over!  Time to start my evening shift. 

As my shift wrapped up, the night crew arrived ready for their shift. Three of the 4 nurses were new grad nurses.  Talking with them took me back to my first days, weeks and months as a new nurse and how difficult they were.  I realized that I've been a nurse for almost 1 year now (just two weeks away).  It's exciting to think about how far I've come in just one year. Even just reading through my previous blogs, I see growth and change! My assessment skills have greatly improved (but still have a long way to go), I have a better understanding of cancer disease processes and treatments, and feel more confident in my education skills.  It's amazing how much I didn't understand (especially about cancer) when I first started as a new nurse.  Now I feel more confidence and enjoyment in my job on a daily basis, which is important to long term happiness in a career.  Balance in the rest of my life is also getting easier, as my dreams about work have lessened and processing my shifts takes less time and energy. Thus I think about work less while I'm at home and focus on enjoying my time off.

I've realized that while my job is still difficult emotionally, it's much easier to handle now that I have a better understanding of the factors that affect a patient's prognosis.  I can better anticipate patient outcomes and am not caught off guard when their condition declines. I can also provide helpful feedback to families and patients about their condition and their options.  I find myself engaging in heavy conversations about what's important to a patient and/or their family and trying to provide them the tools and resources to make difficult decisions. Our unit uses primary nursing model, and as my skill and confidence levels have increased over the past year, I have continued to "sign up" for patients as part of their primary nursing team.  This option provides me to opportunity to get to know patients and their families, while also providing more individualized and consistent care.  I absolutely love it. 

So as I look back one year later, I'm very pleased with my journey and growth thus far.  The choice to pursue nursing is one of the best choices I've made and I couldn't be more thankful. 

Winding down

Despite the fact that it's still 84 degrees outside, the summer is winding down.  This weekend marks the official end of summer for our family, as we've been scheduled to do something fun (usually out of town) every other weekend since May.  When you work every other weekend, the free weekends fill up FAST.  But it's truly been a wonderful summer! I can't complain about it at all, although I have to admit I'm looking forward to fall and to things slowing down a bit for us.  Our summer ended on a wonderful note, as we spend a week with my husband's family (all 27 of them) at the Arcadia Resort (otherwise known as the annual family cabin week). This year was our first year as a married couple, which was a pretty exciting change for the family.  The weather was amazing, the water was refreshing, the food was delicious and the company was fun.  I brought along my camera and tried out my new telezoom lens, which turned out to be awesome! I'm really happy with the fun moments I was able to capture.  It was the perfect end to a great summer!

My hubby and I had so much fun horsing around with the nieces and nephews, and this year all 15 of them were old enough for some fun.  The week was filled with adventures--tubing, scavenger hunts, sand castle contests, volleyball, water trampolines, and fishing.  Watching the kids get lost in play is one of my favorite activities, so I ended up with roughly 200+ pictures, most of them of the kids while they played (and some of the adults joining in).  Love it! Here's a recap of our final hurrah of summer, with a special thanks to Grandpa and Grandma H for making it all possible.  :)

The dog with 9 lives

My update today is a very happy and relieved one.  After three days of IV fluids and many diagnostic tests, Samson's labs have come back very positive.  His kidney function has improved significantly and is about 98% back to normal! He is no longer in immediate danger, but we still have a ways to go.  He's not eating yet and is trying to eat grass to throw up.  We're giving him meds to help with the heartburn and trying all his favorite foods to get him to eat.  I'm optimistic that we'll get there, as this no eating stuff is not new for him.  For now we're breathing a huge sigh of relief and hoping that he continues on the road to recovery.  As my co-worker said last night, Samson is the dog with 9 lives! He's pretty amazing. 

Thanks for all the kind words and positive thoughts. It's been a rough weekend and every kind word helped us get through it.  Thank you to my sister, Chris, for helping us with Samson care on our weekend to work! You helped make it easier for him get all those hours of fluids without us losing a day of work, so thank you thank you thank you!! We'll keep everyone posted  :)

ARF...not the noise my sweet Samson makes

It's with a heavy heart that I update my blog today.  My very sweet 10 year old dog, Samson, is very sick this week.  We returned from our Boundary Waters trip to find that he'd started vomiting again on Tuesday.  He stopped eating and looked just generally unwell. The vomiting and loss of appetite has been a chronic problem for my buddy and we've been doing symptom managment really well over the past 6 months. In the middle of the night on Tuesday, he got up and peed in the bathroom on the rug.  I was so astonished! He's NEVER peed in the house since he was just a puppy, so I knew something was up. He also started drinking huge amounts of water and peeing a TON. So we went to the vet yesterday and they kept him to run some tests.  After checking his urine and blood work, it was determined that he is in Acute Renal Failure (ARF).  This means several things.  1. Something is causing damage to his kidneys and they are shutting down.  So we continue to run tests to determine the cause of his ARF. 2. His lab values indicate that his kidney function is somewhere in between 1/3-2/3's of the normal function.  The bottom line is that we won't know how much damage is done and if it is reversible for a few more days. 

So he is at the animal hospital getting fluids for 14 hours per day (the hours that the vet is open) over the next few days until we have results of the diagnostics and some answers.  Today they are checking for leptospirosis (a bacteria transmitted via water) and doing an ultrasound of his kidneys to look for physical damage or indication of the source of infarction.

It's so hard to have your four-legged best friend get older and have health problems. I have had Samson since he was 10 weeks old...my little dumpster dog! He was digging for trash outside of my apartment in Nashville, TN when I found him.  He was a hot mess...mange, round worms, whip worms. You name it. But he grew into such a sweet and loving dog.  We've been through so much together.  So keep him in your thoughts and keep your fingers crossed that we'll be able to reverse this kidney failure and get my boy back.