Transitions

Last week I put on my Danskos and went back to work. As ever, it kicked my ass. There is so much to manage, and I was humbled. I was fortunate to have the support and mentoring of my beloved senior friend M for two days as I got my feet wet again.

It was fantastic to have M behind me, reminding me to draw up cord blood (the second time before it congealed), and to help me balance monitoring, to bounce off my clinical skills, and to help me get things done within a resonable amount of time. Even when working on my own with all my skills and faculties about me, I liken my job to riding a unicycle and juggling torches and balancing a chainsaw on a toothpick held in my teeth. Having M with me made returning to work much less of an anxiety fest because she'd see when the chainsaw was about to tip or one of the torches was about to catch the curtains on fire. She is an angel. 

I had two great patients and two wonderful deliveries. The first day my patient was teenager--with the father of the baby, their parents, and a great-grandmother--and it was heartwarming to see a baby so wanted and loved. Managing her emotions and needs was a little harder, as she was still a child herself, but it was a challenge I was up to. The second day I had a straightforward young couple with no complications. 

My third day back was more challenging, as I worked with a young couple suffering from the unexpected intrauterine demise of their first child. I sat with them, admitted them, cried with them, and started the woman's induction of labor. Then, and more painfully, I had to ask the parents to sign papers related to the disposition of their child's remains. Who thinks they will go in to Labor and Delivery to sign a Death Certificate? It's horrifically brutal, and probably the worst part of my job. I explained to them how I, or another nurse, would bathe their baby, take pictures, take footprints, and create a box of memories for them, as well, and how spending time with them is an honor for me. 

A few days later I was speaking to C about being back at work, and I told her that my charge RN had entrusted me with the couple with the fetal demise. I said that the charge RN had probably given me that assignment because I was newly returned and slow. She said no, the charge RN had given me that assignment because I am a kind person who is able to take care of a couple who needed special care. I felt so warm and validated; I think C really gets me. She's right. I am very good at the psycho-social stuff at work. 

So while work has been positive, health issues have not been great. I had a repeat of the radio-frequency ablation of the celiac plexus that resulted in more pain. I ended up in the ED at UCSF on Thursday night with intractable pain following the procedure, and at least the MDs could rule out an internal bleed. It seems that the resident nicked the wrong nerve and caused swelling elsewhere, so now I have pain in two places rather than just one. As two friends of mine put it, "It's you, Kara, so it couldn't be easy. You should have asked for the atypical side effects." I was also incredibly pissed off that the resident didn't seem to have read my chart before the procedure, because when he was asking questions of me, and when I asked questions of him, he was clueless about some very big facts 10 minutes before the procedure. I made an appointment with the attending later this week, and this shortcoming will be discussed. For. Certain. There is NEVER an excuse not to read a chart. I am curiously still Zen about it all; maybe the Topamax is keeping me on even keel, although I am irritated about the pain and wonder what the long-term plan is going to be. For now, I keep putting one foot in front of the other and avoiding known stressors. 

The kids are both enjoying school, and Tobey has taken to Kindergarten in a way I had never dreamed he would. His teacher had sent home a poem for him to memorize and recite in front of the class next week, and we'd half-heartedly begun to go over it. Callum had always been my poetry man, although Tobey had begun showing interest. He came home today waving a sticker, excitedly announcing that he'd already recited the poem and that he wants to sit and read more poetry with me. I had no idea that he'd learned it (he perfected it listening to the other children recite!). That Tobey is a dark horse, and an exciting dark horse he is. Clever one. 

Callum has his first crush and is coping with the knowledge that the girl is moving away at the end of this year; her family is military. We spent the weekend camping together with her family, and then last night, after we came home, he was bereft. He is busy coming up with elaborate plans to show this girl, for the next 10 months, how much she means to him. He told me that I will be busy taking the both of them to the Academy of Sciences, the DeYoung Museum, the Legion of Honor, and other dates. Could be fun for all of us. ;-)