the unfairness of it all

I was supposed to by working tonight but I got down staffed, which entails being called at the last minute and told not to come in because the patient census is low. Oh and yes I don't get paid, there goes a third of my weekly pay. So I'm at home, scarfed down some food (because I hadn't eaten since 1:30 last night, night shift makes me goofy in every way) and am watching Pretty in Pink with young, lovely Molly Ringwald and her full full lips and beautifully complex teenage characters. Andrew McCarthy looking impossibly young and earnest, and James Spader his perfect foil, the nastiest richie of 80s cinematic history. I just can't deal with Duckie because I never really liked that character in the film, found him annoying, and his current connection to Two and a Half Men, just intensifies my Dukie distaste. How do people enjoy that show? But I'm happy typing away while half watching and listening the eighties soundtrack of this movie.

Owen is the bacon warrior

So last night I got an admission as soon as I started my shift, I was working overnight. Admissions are time consuming and getting one when you first start work, it's like the kiss of death, it already made me feel behind in my work before I even started. My patient had a DVT (deep vein thrombosis) and would require argatroban (an anticoagulant) which would require me drawing blood two hours after I started treatment in order to monitor the patient's PTT and then titrate the Argatroban accordingly. Nightmare! I've never hung Argatroban, I've had a patient with a heparin drip once. I take any of these meds (insulin, anticoagulants, chemo) where you can basically kill a person by infusing at the wrong rate (one missed decimal point) very seriously. But when I looked on the computer to see what rate to start this medication at it required a dosing nomogram (meaning the rate of the medication is determined by the patient's weight, showing a formula of 2 mcgs/kg/min where the mcg/min = 0.01 mg/ml) I read that and was like what the fuck? Please tell me there's going to be more explicit information on how to hang this. 

Oona & I working on her sticker dolly dressing book
while waiting for the Dr to come and check out my back

I had calculated the rate and determined it would be 12.68 ml/hr but I asked another nurse to help me out because I felt the weight of losing my license if I miscalculated on this, not to mention the patient I could potentially kill. Now this nurse I asked for help, she can be a bit passive aggressive, at least I think that's what she's doing I'm not quite sure. She said to me 'I don't mean to insult your intelligence' when we were going over the calculation, which I did correctly (although she has said 'I don't mean to insult your intelligence' to me before, also at times when I don't think I'm being outright stupid, maybe it's her version of a non sequitur dig?)  Then she got short with me, like mother with kids having a meltdown short, because I was shaking my head in frustration at having to calculate this stuff, she was like 'You can't become this frustrated over this.' My response was 'I get worried when I could potentially lose my license and this isn't safe to just send up a label with a rate of 0.01 mg/ml and expect me to figure out the rate.' This belief that you truly learn and become better organized and handle stress well in these healthcare pressure cooker situations is absolute bullshit and I'd really like to see the culture change with the thinking. This nurse was very helpful in helping me call pharmacy to cover my ass and have the pharmacist verify that that was in fact the correct rate and then when he saw that the label didn't reflect this he said he'd correct that in the computer if I could get the doctor to resubmit the order so that it would reflect the patient's weight. Needless to say it got corrected and made a lot easier to figure out but yes I was very frustrated having to deal with that within the first three hours of my shift. Fortunately two hours in the patient was in the goal range for PTT and the patient was still in goal range with morning labs so I didn't have to titrate at all - phew.

I am a robot, well really a dinamap at the dr.'s office.
 Owen loved this contraption and took many a pic of it

I think all of my major issues at work are things that can affect patient safety and what I see as ambiguity or unclear things that can affect the nurse, especially the very busy overworked nurse, why not make sure the the actual rate is calculated and very clearly labeled on said medication rather than send it up and leave it to the nurse with four patients, one an admit, another about to get chemo and a third needing constant pain management to figure it out?! Let me go back to my Amazon example that I beat like a dead horse, they make it basically idiot proof to order a book and I think the same sort of idiot proof steps should be used in healthcare software systems, especially when it comes to high risk medications (meaning you have to have another nurse look at the meds with you).  I know that we as nurses have to think and be able to do math but for God's sake make the job a wee bit easier considering the stresses we're under every day.

Red white and blue day at school and I had nothing patriotic for my kids so
Owen decided to use a soiled cloth napkin as he red around the neck

In other unfairness news. Last week I came home from working night shift to be greeted by cat puke as soon as I opened the door. My cats are trying to kill me, with each and every darting step in front of my path as I walk downstairs. They are trying to break me. Not really but I am really having a tough time having them of late and am counting down the days til they expire. Cruel? Yes but I just don't have the energy for them with my present life, which feels a blur.

Oona's Winter Wonderland game, land on a yellow snow square and you lose a turn

Ooh, it's just at the end of Pretty In Pink where Andrew McCarthy spies Molly Ringwald across the room over the strains of OMD 'If You Leave'  and all will work out in the end even if that pink confection of a dress Molly designed is a nightmare, hopefully she didn't get the scholarship for fashion design. And Andrew McCarthy tells her he loves her, what did they have two dates? Ah, impossible young teenage love.

my never ending hair envy runs deep

There is other unfairness that I want to write about but can't. Unfairness isn't really accurate more 'the hurt of it all'? I have a very hard time if anyone thinks badly of me, strangers, friends, coworkers. I want people to like me and think good things of me; that I'm nice, bright, pretty, funny, helpful. I don't think this terribly strange, don't most people want to be viewed favorably by others? And the way I want to be viewed, well none of it implies power, or trappings of wealth, I think it's all pretty tame. My hair envy, yes I covet that blonde twisted hank of beautiful hair on the girl above but I would be pleased as peach just to have a decent head of shoulder length hair instead of the mange on my head. But then I look at the patients I work with and think maybe I should be happy with my dishwater mange.

This all skirts the real issue that gnaws at me, my quest to attain a body like Doutzen Kroes (I think the genetic cards are stacked against me). No, what's really gnawing at me is more reflective, scab picking maybe? I think the dissolution of a marriage is never happy, even if it is amicable. I think things are always viewed from two (usually very different) points of view. He said she said, he did she did or didn't do. There's going to be a world of hurt when people fall out of love. Anger, rejection, criticism, contempt. None of that is happy stuff. There are many extremely positive qualities to my ex, even if we didn't work well together. John Gottman, who's mentioned in Blink and this This American Life link is great at cutting to the heart of doomed marriages, but the inevitability of continuing to interact with that person you failed with when you have children, it isn't always easy. I think if you have children and once loved this person that you have to keep in touch with that, but this can be incredibly hard, perhaps impossible to do if you can't let go of your anger or hurt. I don't have answers. I just know that it makes for many messy, conflicting, strong emotions that might be good for writing fiction or poetry but are incredibly hard to sit with when they're not on the page.

flip turn

I'm sorry but I'm not one for moderation and once I get into something I tend to get tunnel vision and just focus on that thing for a while, which is why I can never ever play Sudoku because the one time I gave myself fully to that brain teasing experience (5 years ago over Thanksgiving weekend) I was ready to ignore my children and just focus on completing my boxes. I get driven in a borderline pathological way when it comes to sudoku, puzzles, well really anything where I feel I must finish it, the pressure I put on myself on things that don't really matter it's just sort of bizarre.

But anyhow, I am officially registered for my triathlon, which will occur on August 12 at 7:30 am - I'm gonna have a real hard time functioning athletically that early in the morning. My knees, ankles and feet have quickly adjusted to my running. I'm getting better with the swimming too. But my hips are in agony right now. I think it's all connected to my lower back pain, because it will radiate out toward my hips, it's like it rides an angry wave across the top of my ass and then veers sharply and goes down my hip and outer thigh, it is really uncomfortable today. I've taken ibuprofen and it isn't putting a dent in the pain so once I'm done typing this I'm going to slather my ass and thighs in biofreeze and go to bed.

A big adjustment for me with swimming has been learning how to do the flip turn, where you approach the wall and somersault then twist yourself back into position so you can swim yet another lap. Now three weeks ago when I decided to start this training I didn't even know how to do a flip turn, well to be honest I wasn't ready for a flip turn because I was catching my breath after each lap, but you can sort of intuit how it should work. None of reading about it on swimming related websites helped me glean more ideas about it. At first I probably looked like a deranged penguin. I was not graceful by any means, trying to guesstimate when I was close enough to the wall, pacing my breathing (that's the absolute hardest thing for me with respect to swimming) and trying not to get water up my nose. My left big toe still feels funny because I think I jammed it pushing off the wall a week or so ago.

But today I felt my flip turns coming together. I'm able to go back and forth four laps before pausing for a quick breather - I do realize I'm not supposed to pause for breathers in my triathlon so I hope to increase the laps I can do before breaking. I no longer hedge in the water wondering am I close enough to the wall or too close. And the very simple but incredibly rewarding part is when I do it perfectly and my feet push off the wall strongly and I'm not too deep so it's easy to break to the surface. It brings me back to the joy I had about swimming when I was a child. I love how quiet it is underwater and the weightless power I feel darting through the lane before coming up for air.

In totally unrelated news I'm already ready to call it a day with match. I went out to dinner with a very nice man who took me to a very nice restaurant (Umi, my Pittsburgh favorite) and he texted me after the date saying very nice things and how he looked forward to meeting me again. But, this will sound silly perhaps, but the man is conservative. I don't know how I can possibly get along with someone conservative, whose ideology is completely counter to mine. I support gay marriage, the right to choose, universal healthcare, assisting the nation's most vulnerable, not ravaging our natural resources by drilling, fracking or anything else that seems focused on short term gains and fucking our future generations. I know this is an incredibly simple way to look at it but conservatives seem inherently selfish to me, there's that inherent 'hands off it's mine' way of looking at life, or looking the other way when those less fortunate come into view. Like they'll blame them for the choices they made that got them into an unfortunate situation, and yes some people just make stupid choices or fuck up royally and repeatedly. But life isn't a level playing field. Some are born with advantages based on race, class, sex or intelligence. I mean Oona is six and she realizes that some people just don't have it as good or as easy as others and is it really fair to treat them poorly when they can't help being the way they are? Like I said before very simplistic but I don't know, what am I going to say on this second date? How will I broach the minefield that is politics? I get exhausted just thinking of it. Whenever I get a response for match it fatigues me. Not a good sign right?

And I started seeing my previous kind, smart, gentle but very passive fellow again. I don't know. I hate that he can lack confidence and basically be a doormat and let people take advantage of him but I feel like the reason I loathe these qualities in him so much is because I see these qualities in myself and I don't like to look at that. Who the fuck would honestly? So is that really fair? I don't have any expectations, in fact I've been explicit with him on how little I don't expect but that I want to remarry and share my life with someone, so tick tock if he's gonna get his shit together it better be sooner rather than later. But he can make me laugh like nobody else can. And he sees me in this light, well it's like he sees this beautiful, idealized version of me, he imbues all my actions with positivity, he doesn't criticize, he sees a me that I want to be, my best self, if that makes any sense. And I'm sort of like doesn't being in a relationship with someone who brings the best out in you trump everything else?

You still with me? So the picture which has nothing to do with what I wrote above. It's the light hitting my wall. It's like an ephemeral rothko, I love the blurry play of colors with the two weird parallelograms of screen. I wish my iphone had caught just how lovely this temporary play of light was on my bedroom wall. It was heavenly.