Moments

The other night after a long rehearsal I stopped to sit on the Rose Kennedy Greenway.

I picked a spot right on the grass where I could rest against a cool slab of stone bordering one of the walkways. I decided to face east, so I could watch the moon move across the sky behind the Custom House Tower.

Streetlights lit the way for tourists bustling around the North End, stepping over Haymarket debris. Across the lawn a couple cuddled. Behind me I registered the clip clopping of high heels across pavement.

I realized that I had been hiding a lot of disappointment from myself about not moving to Chicago with Liz and Steph.

But I realized it because in that moment, listening to the sounds from the bars and the streets and smelling the Atlantic ocean on the wind, I started to let go of all that regret; and I got honestly excited about staying in Boston.

I'm not an ER nurse...but I'm not an idiot.

After thinking it over I have decided that the poor relationship between RNs at sub acute care centers and EMTs is largely due to a lack of understanding about each other's jobs.

I am not an ER nurse. And this is not an ER. It's not even a hospital. We don't have suction at bedside, we don't have wall oxygen and we don't even have the equipment to start IVs never mind a med room full of fluids and STAT meds.

My job as a respite nurse in acute situations is a nursing assessment. My assessment is backed by four years of training, three of experience, knowledge of individual patient medical history and of this patient population in general and my own gut. Then I weigh in my assessment against my knowledge of our facility's capabilities and protocols. It's a simple algorithm and I have illustrated it here:


As you can see, unfortunately for EMTs sometimes we have to call on them for non emergency transport. If the situation is urgent but not a time sensitive emergency, there isn't really another choice.

EMTs are more useful in an actual emergency than I am. If I had an emergency I'd want EMTs there over most nonemergency medical personnel. Seriously.

But just because you are good at your job doesn't mean I'm not good at my job.

Calling emergency personnel in to help does not mean that I am stupid, panicky, lazy, or haven't done my job to the fullest detail. It means that I have come to the conclusion that this is the best plan of care for this individual patient during this unique situation. If I could just wheel patients to the ER myself and hook them up I would. This patient isn't coding. He's conscious and alert. He just needs an ECG/ IV fluids/ a bladder scan/ whatever. But those things are not part of my job. Just like knowing how to safely detox a diabetic heroin addict with a non healing foot ulcer over the course of five days is not part of an EMT's job. But one way or another, it all has to get done.

When everyone does their jobs to the best of their ability without thinking that they have the monopoly on the most important one, patient care is at its best.

That's my last entry on this for a while. I promise.

Secret Garden

If you couldn't already tell by my sudden interest in writing again, and about writing things that aren't just about how sad I am to leave JP or how frustrating it is to look for an apartment...

... I found a place to live.

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I am very excited. I am sorry that living with Laura in Somerville fell through but I am psyched to be in Central Square which is very much where I want to be if I can't be living in a multi level tree house bungalow in a forest near a rocky beach.*

I think the coolest thing about the place is this:

"Have you tried visualizing your perfect place yet?" Scott asked me.
We were in his car, driving around on Monday looking at places.**

"Well, sure," I answered, "I even wrote it down, 'laundry, close to the T, cheap...'"

He shook his head and looked at me as we pulled up to a stoplight.
"No," he demanded, "really see it."

After a while he started asking questions that made me laugh like "what are the walls made of?" and "what does the bathroom look like?" As if I would ever turn down a place based on the walls being wooden paneled versus exposed brick.

"Scott, what's the point. I'll never find a place with all of this. It's a fantasy."
"Yeah," he answered, "but now you know."


Later that night, as Scott headed back to his own dream apartment in Western Mass, I was standing on a porch with my new roommate Luke. Crickets were chirping and we were looking over the garden that Juan, the landlord tends to.

"You will think I'm nuts," I said, "but having a porch that overlooks someone else's beautiful garden was on my list."

Luke just laughed.

**********************************************************************
So yeah. It doesn't have laundry. It's a little over my price cap. And I've turned down other places for the same two reasons. But something about it just felt really right. So I'm going with it.
Come over soon. I'll be on the porch.

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* Which would obviously be my ideal situation.
** Scott is one of my absolute closest friends and when he offered (out of the blue) to spend a day apartment hunting with me I was reminded of why.

EMTs v. RNs

My morning started off hectic one day a few weeks ago.

The number on the page said "43," and I did a double take hoping it was a "7" and I was misreading the aide's handwriting. A heart rate of 43 is not compatible with life for very long.

I jetted to his room, my own heart pounding, I did my assessment. He was alert, oriented. Breathing normally. Pulse was thin, thready. I counted 52 radially. The patient denied feeling a shock from his ICD, but he was sweaty and pale and complaining of nausea and vomiting.

The patient's chart had an order from Doctor Chemo to send him out for certain parameters. He was meeting them three for three. I conferred with a nurse practitioner who agreed with me that the patient needed to go to the ER at Dr. Chemo's hospital. We also both agreed that this was not an emergency, but was urgent and had the potential to become an emergency, so we called a private ambulance company instead of 911 or a taxi cab.

I did exactly what I should have done through and through. And like a well oiled machine the other nurses chipped in to save time, one copying medical records another writing out the ED consult.

So why, when the EMTs arrived did they treat us with such derision? The Front Man was loud and boisterous. His voice echoed through the hallway, and if he saw that he was disturbing patients who were trying to sleep he gave no notice. He was condescending to all of the nurses, including me. I felt like no matter what I said it was the wrong answer.

To make matters worse he was smiling and laughing the whole time but we all got the impression that it was mostly a big joke to him and his partner. Did they expect us to join in their jokes? They laughed and made small talk right over my patient's head. My patient sat on the stretcher, silent tears in his eyes and the EMT only addressed him once. Politely, but still with an inappropriate grin and side glances at his partner.

It was as if just because it wasn't a life or death situation the EMT thought he didn't have to be present at the scene. But even when my patients' needs aren't as exciting or action packed as an MVA, they are still real needs. They are still real people who deserve to be looked at in the eye and spoken to with compassion. Not left to sit on a cot crying while you and your friend laugh about something that happened on the ride over.

I comforted my patient as best I could before they left. It's hard to be belittled in front of the patients, but I feel like the EMTs almost always manage to to just that. I wish we could be a louder voice for our patients. But how can we be, when I feel like someone needs to be a voice for the nurses too? We're just as disrespected in those situations. Whenever I complain about it I get the same answer. "You know how those EMTs are."

But the thing is, no I don't. I have plenty of friends who are EMTs who don't act like that. And saying things like that just perpetuates a system of negativity. So I'm not sure what else to do.

Meeting Strangers

One of the best parts of my search for a new apartment and new roommates has been the process of meeting people.

A month ago as Laura and I walked from meeting with five house mates in a gorgeous house in Jamaica Plain I wished aloud that we could just do this for fun without the pressure of having to make a decision.

No one's guards are up when you're interviewing for housemates it seems. Because you both know what the other one wants. And lying won't be productive in the end.

I meet up with these people and then they show me their lives. They invite me into common spaces, tell me about why they chose the artwork they did, how they feel about network television. I get to see the proud gleam in their eyes as they show me their vinyl collections or their deep fryers or their gardens.

I sit on a couch, or a chair or a stool and I sip tea or eat popcorn and rework the creases in my skirt while we laugh and swap stories. Stories about friends, family members, and jobs.
I heard a story about someone having to show his phallus piercing to an air port security officer, I met someone who found her dream job at the Museum of Science. One man riffed for several minutes about why he really insists on seat belts in the car, a throwback to driver's ed school in the 1970s the midwest where he was subjected to watching actual footage of gruesome wrecks. Something his 16 year old self never let 39 year old him forget.

And then I tell stories. I've explained what I do for work and why so many times now that I feel like I'm discovering things about myself all over again. I've developed a new sound byte for myself.

I had been feeling like everything I built up over the past two years was getting lost in the chaos of having to move, but as it turns out it was only misplaced.

I still wish there were a way to go to stranger's houses and listen to their lives just for fun. Without becoming a Jehovah's Witness, that is.

Boxes of my belongings, tripping over progress

My apartment hunt occupies almost all of my free time and most of my thoughts.
I think about it on the train, I dream about looking at spaces in the night.
My phone is full of the numbers of strangers, combinations of their names and the places they offered up on craigslist:
Ali Prospect St, Dan in Camb.

I talk to these people more than I talk to my friends.


But my hunt isn't interesting enough to blog about. A part of me hates myself anytime I even burden someone with talking about it in person so how can I expect to write about it every day.

No new changes, we're a week until move-out day and I have no idea where I'm going to be living, no way to picture what my life will be like in a week.

It's thrilling and terrible.
I secretly wonder if this how some of my patients became homeless.

Luckily, there are distractions and moments of solace. Work, for example, because focusing on the problems and hardships of other people is generally a very effective way to forget my own issues for 8 hours at a time. Performing at IA, because I become a different person for those two hours at a time, existing in a world where only production matters. And, of course, prayer. Because in the end, I have to trust that God won't let me fall by the wayside now, not after everything else I've come out on top of.

this year in the places we go go go

The thunder just started in Jamaica Plain.
But last night heat lightning was mostly without accompaniment except for me and Pim exclaiming over it in the car on the way from Goody's to Costello's.
"Did you see that?"
And then occasionally, on his end, "I can't believe I don't live here any more," because Florida is his real home now.

And now the rain begins, skewing my chances of sleeping out on the porch like I had hoped.
Although, the last time I slept on the porch I had 14 welts up and down my left arm. Something small and hungry, but not a mosquito, found me resting on my right side.

The rain has also changed my plans to go find dinner. Instead, I seek distraction on the internet, choosing to catch up on viral videos rather than make a real decision about where I'm moving to in a few weeks.

Change is always exciting. But because I didn't initiate this move, my landlord did, I've been dragging my feet. I want to move to Costa Rica, or Chicago, or the moon. But not until next year.

I liked the idea of one more year with Boston as my baseline, providing a safe easy place to return to after international trips, crazy weekends on the road with shows, and a new set of goals to accomplish for the year* (aerial silk classes, taking a trip with Patch Adams...).

With a move like this comes doubt because I'm changing the baseline but trying to maintain my my lifestyle. Unlike moving to a new city entirely where I'd make new friends and have a new job I have to worry about how the move changes the status quo. If I move to Somerville will my commute be too long? Will I be late to work often in the snow? If I move to Central Square will I be able to save enough money for traveling to CR as often as I like? Will I like my new roommates? Will they think it's weird if I sleep on the porch?

None of these things are questions I want to ask without the thrill of an adventure. "Where (in Scotland) can I find chinese food?" is a quest, not a chore. "How do I get to a church (from my new place in Chicago) and then rehearsal (in Chicago)" is a project I can dedicate myself with pleasure to because the payoff is bigger.

I guess the key to all of this is obviously to start thinking of the move as an adventure. And praying more. And... getting off the computer.

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* ...having met most of my goals from last year including Spanish classes, getting onto a mainstage cast in Boston, riding a horse on a volcano, joining a gym, and traveling outside of the country.

I am a Respite Nurse

"She works at a homeless hospital..."
"You work in a nursing home, right?"
"How did you get involved at the shelter?"

A lot of people are a bit unsure of what I do. And I don't blame them. I had never heard of "respite" nursing before I applied for my current job. And I went to four years of nursing school.
Even the EMTs who respond to our 911 calls (wait - don't you work in a hospital, why are you calling 911?) are unsure of where they are. ("What kind of shelter is this?").

This video is new, I have never posted it before. But it explains what respite nursing is, and more specifically shows you exactly where I work (and who I work with!) every day.

Although I had never heard of respite care before, after two years, I am a very strong supporter of it. I would like to see more programs like this one form all over the country. I think that educating the public on what we do is an important first step in gaining future support for respite programs.

http://www.nhchc.org/Respite/

bike gang

"I wasn't going to go over there today, you know, I didn't want it done."

I looked at the patient in front of me. He's a "frequent flyer," a tough old italian man with a gravelly Tom Waits voice and a mean temper but a quick sense of humor as well. His mood changes as quickly as weather does here. He's talking to me about a procedure he had to have done at The Hospital.

"And you know what? I went over but it took like five nurses to make me go. They surrounded me and made me go and I said to the nurse 'I can't believe you all forced me to go!'

"And she said, 'at least it was us and not five bikers.'

"And I said, 'five bikers I could handle, but nurses - forget about it!"

He laughed.

"Can you believe that? But it's true. I'd face bikers over nurses any day."

in the sleepy west of the dirty east,,,

I had a few days off of work thanks to the miracle of scheduling so I decided I'd drive west.
After the first hour of driving I could smell the air change.

After an hour and a half I was just grinning while I drove.

Last night I took a long walk in a peaceful cemetery, ate an amazing home cooked chicken dinner, then enjoyed debates about everything from comic books to religion with friends over wine.

Today after a remarkably on point sermon by father McDougall at a 10:30am Newman Center service I made my way to the Black Sheep. Long gone are the days where Nick would make me a coffee when I would come in after an overnight shift, but Mark made me a sandwich and I sat and took in a folk quartet.

Back at the bungalow-style house she lives in, Amy and I had "zombie practice." We practiced throwing a knife and a hatchet into a pile of tree stumps for a good half hour.

It finally feels like summer.