if you can dodge a wrench...

not a lot to say really except i'll be leaving for halifax in 17 days and i'll be in hamilton in 23. so stoked.

finally took a look at some of the pics i took at our playoff dodgeball game... which we got annihilated at. but whatever... i had fun the whole entire season.













so i know matthew gets a kick out of this...
it's hailed here once a day (today twice!! and for half an hour!!) for the last 3 days... what the shit?!?!
i get all super stoked seeing the flowering trees.... magnolias almost in bloom... and then it does this.
this is the fruit tree in the backyard... blossums covered in hail. ice is still on the ground.
fucker.




oh... in the last couple of weeks 3 different people have asked me for prints of my photos...
neat.

oh oh. and i can't get this song out of my head.

thank you note

dear dave c,
i woke up this morning with red lipstick all over my mouth.
i may have been kissing your girlfriend last night.
thank you for not kicking my ass.
jess

neat

twice in one day?!

i forgot to mention that my uncle peter (he's the science writer for the toronto star) is once again back up on a giant ship wedged in the ice somewhere in the arctic... he's pretty funny and always rubs in my face his awesome cameras and camera associated toys. he's also an avid nikon user. it was his lenses that i was playing with way back when. he uses a D200 and most recently a D300. he's been using nikons forever i think... especially back before everything went digital.... back when they used to use...*gasp* FILM.

anyway... back to my original point...

he's being a blogasaurus while he's up there... (apparently the arctic has wireless internet)
you can read it HERE.

I have something to tell you...

hahaha this is the funniest thing i've seen in a while...
you've probably seen it but whatever... i laugh my ass off every time i watch it. especially kimmel's response. the josh groban part kills me.








oh ya... this also has some pretty funny shit on it too.

quick.

i miss the summer.
everything seems so much easier then.




i just found this pic lurking my friend bryan's stalkbook. we went out for beers one evening when he was back in ottawa to defend his thesis. he actually just got accepted to the London (UK not shithole Ontario) School of Economics for his PhD. congrats buddy!!!

the last few days i feel like i'm waiting for something that will never come. it's hugely unsettling. and after my last set i kind of dread going into work and i've never felt that way before. i hope its just a phase because honestly i've been thinking about doing something totally unrelated to nursing. i need out of this space. now. i want to feel settled and comfortable and have my own things. have my own space to put these things that are just cluttering up my life right now.

i need to get off the fucking internet and eat... and maybe bake something.
i hope that makes me feel better.

sweetpea

drunkas nuts right now... a few drinks wiht an old friend turned into getting wasted ands breaking shit. or... playing on our upsetears neighbours trampoline... bombed ad trying not to break our necks.

this kid is intown.




haven't seen him in more than a year. so glad he's here.

and i have to fuckin get up in 5 hours .

fack.


i need to be kissed.

2 in a row.

this is going to be another post about nursing... in my experience most people don't want to hear about what i do for a living but you know what... don't read this then. nursing is part of who i am and it's what i do.... so deal with it.

the last 2 nights have been a huge headfuck for me. i admitted a 49 year old lady, previously healthy, last time she was in hospital was to deliver her now 24 year old son. she was admitted for respiratory failure related to a football sized solid tumour in her left breast. on further examination it was shown that she has diffuse metastases throughout her lungs and possibly her brain. she never went to see a doctor because of her abnormally large growth... she and her family thought it was a rash related to her allergies. no joke. because she left it so long she's at the point where a doctor who specializes in breast cancer surgery said there is NOTHING more we can do for her. it's so sad and so tragic that it makes me sick to my stomach thinking about it. i spent half of last night listening to her shocked and devastated son sob at her bedside.

you know... in my line of work, i deal with the sickest of the sick; cancer, sepsis, MVA's, spinal cord injuries, trauma, multiorgan failure, transplants etc. most of the time you go to work, detach yourself enough so that you can do your job and go home without being completely overwhelmed with all the sickness, the death and the dying. but every now and again you'll get a case that hits home and sends your head spinning. days/nights like these send me home numb, emotionally and physically exhausted, nauseous and unable to sleep. the last time i felt this bad was when i was working in ottawa a couple of years ago and we had a 14 year old boy who had a huge osteosarcoma removed. another devastating cancer case. the only way i know how to deal with things like this is to write about it. i've never shown this to anyone so whether you consider that luck or misfortune, i won't be offended. it's more for me to vent and decompress.

i am a registered nurse in an adult intensive care unit. a large quantity of my patient population has some form of cancer. partially due to age and also in part to having a major cancer centre adjacent to the hospital that i work at. this week marked a first for me... not highly unusual being that i've only worked here since january. on wednesday i met a 14 year old boy who was brought to us after a 20 hour surgery to remove a huge osteosarcoma from his thigh. in order to salvage some of his leg, his lower leg was rotated 180 degrees (called a rotationplasty) and reattached to his hip so that his ankle and foot could be used as a knee joint for prosthesis. let me tell you it's very strange to look in a room and see a backwards foot peeking out of the blankets. sadly limb reattachment surgery does not always heal the way we like. in order to hopefully save the limb, our team started leech therapy to help restore blood flow. while waiting for our 11 bags of leeches to arrive we this poor kid to the hyperbaric chamber (again to give the limb the best possible chance) but not before cutting his eardrums so the pressure in his head could equalize during the dive. it is now saturday morning at 4 am. leeches on for one hour every three hours for the last 4 days. rapidly infusing blood products to replace his huge losses. pain medication continuously pumped into an epidural in his back, frequent boluses to try and control the excruciating pain, IV boluses of narcotics we use for surgical and procedural pain... maxing out our dosing because it wasn't even coming close to relieving it. just turning him to change his blood soaked sheets... his screams still echo in my head. "its not fair", he screams. "why?? why are you doing this to me??". all four of us nurses look at each other and at his father and at him with helpless eyes. soft words of encouragement and guidance to calm him, a hand stroking the peach fuzz that has grown back on his head since he finished chemo. squeezing back tears that burn my eyes while i support the dusky backwards half leg. i thank the higher powers of above that i work in an adult ICU instead of a pediatric one. this is not something i could handle on a daily basis. at least with adults, the end usually comes as a relief. but this, this i don't know how to deal with. i have 2 more nights next door to this little man. i had to write it down... this is how i cope.

in lieu of my recent cancer experience i'd just like to bring to your attention something that i think is super important for both men and women. education and prevention are our two best defenses against cancer. i think the statistic now is 1 in 3 people will be diagnosed with some form of cancer in their lifetime. so i though i would post this. i was happy to find it the education section of the skate4cancer website which advocates for donations to the princess margaret foundation, the centre of cancer research excellence for all of canada. i used to work next door to PMH and it's an amazing hospital. 2 of my family members have been treated there and thankfully both are in remission. so... read this and do it once a month. dudes.. that goes for you too only with your scrotums (ballsacks, if you will). although you should probably check your man boobs... men CAN get breast cancer too. if you find anything at all... ANYTHING out of the ordinary... DO NOT WAIT... PLEASE GO SEE YOUR DOCTOR. even if it turns out to be nothing, at least you know what it isn't.




oh.... and this is this is amazing.

this is how neurotic i am...

so i'm going to be a huge bitch for a moment and rant about the kind of bullshit we as nurses deal with in our jobs... 

today is one of those days that nurses dread across all teaching hospitals... the changing of residents. for non-medical folk, this is the day that our old (2 months), well trained (not all of them) and molded (verbally beaten into submission by ICU nurses... jokes... sort of) docs leave and are replaced by new, green, some fresh out of med school, never stepped foot in a critical care setting residents. 

what does this mean exactly? well... of course... i'm going to tell you. it breaks down (not all of them are like this) to incompetent, useless, inexperienced new docs trying to tell you how to do your job OR attempting to do invasive procedures that they've only read about in books. granted... they're learning... its a teaching hospital but for fuck's sake it seems like they're getting dumber with each new group.

for example:

- my patient today had three chest tubes. two to suction, one to gravity. so during my excruciatingly boring rounds with all 7 new residents occupying our bedspace (pet peeve #1... get the fuck out of my way. DO NOT block my view/pathway to my patient, my monitor or my ventilator... you will get knocked over)... the staffman (intensivist) ask me to turn off the suction to the remaining chest tubes... so while he was slowly explaining something inane i walked over to my bed space (SERIOUSLY GET THE FUCK OUT OF MY WAY... second time) and proceeded to turn off the suction. piece of cake. flick of a switch. check my 2 pleur-evacs for air leaks and quietly return to my chair. before they start to leave i say, "there is still an air leak with the suction turned off". so as an experiment the team decides to turn up my PEEP without the RT i might add. so they play with my vent, crank the PEEP up to 10 from 0 and see what kind of effect it has on my aforementioned air leak in chest tube #3. when blondie pipes up... "when the floaty thing is up that means the suction is applied. well.. i don't see any floaty thing... is the suction on????"
trying not to pull my hair out, i calmly and sweetly say... "there is no suction. i turned it off because you asked me to." meanwhile in my head im screaming "YOU FUCKING TWIT". pull your skirt down sweetie... it's cutting off the circulation to your brain.

i was thisclose to gouging out my eye with a pen.

another example...one of my buddies today needed a new arterial line in her patient... a skill that is so crucial to critical care. no nurse wants to sit around "assisting" some asshole resident who's stabbing her patient's wrist 42 times because he can't insert a fucking catheter into an artery. FUCKING RT'S CAN DO IT... and they have like 8 years LESS schooling than you do, you twat. ANYWAY... so her resident is at the bedside needle in hand, sterile gloves and gown on wiping the cleaning solution off the patient with a dirty towel. keep in mind this procedure is supposed to be done under sterile technique. 

so my buddy says "um... you've just contaminated your sterile field." 

and he replies "oh.. this is supposed to be sterile?". 

YOU ARE INSERTING SOMETHING THAT BREAKS THE PATIENT'S NATURAL SKIN BARRIER TO INFECTION.... YOU DUMBASS... OF COURSE IT'S SUPPOSED TO BE STERILE.

eyes were rolling... let me tell you.

but... that wasn't even the best part...

so he finally gets the catheter into the artery and says,

"what do i do now?"

EXCUSE ME???? YOU"RE DOING A LINE INSERTION AND YOU DON"T KNOW WHAT YOU"RE DOING????  

(the proper answer is: make sure there is flashback, feed the guidewire past the black line so it's fully in the artery, then pass the catheter through skin in a twisting motion OVER the guidewire into the artery, remove guidewire, look for blood return, connect to pressurized monitoring tubing, zero system, check/confirm waveform, suture it nicely, clean up the site with saline and top it off with a nice tegaderm dressing)

instead... we got this:

he says to our fellow (intensivist in training)..."well.. i got it in the artery... i just didn't know what to do next."

so gord says... "um... maybe ask for help?"

ARE YOU FUCKING FOR REAL THEY LET YOU A) GRADUATE MED SCHOOL and B) NEAR PATIENTS??????

neither my buddy nor i could believe it.

unacceptable in an ICU setting.

amazing. absolutely amazing.

ilovemyjob. ilovemyjob. ilovemyjob.

oh.. and my patient blew a pneumo 20 minutes before shift change....

sweet.

shake it...

i'd forgotten how much i like rjd2...




for calla.
i miss you woman.