Writing to The So What?

First of all, I apologize to my friends and family on Facebook for the uncharacteristic political updates.  Thank you to those  who continue to follow me, whether or not we share   viewpoints.

xxx

Detail/artist: JParadisi (2009)

Since I began publishing JParadisiRN blog, I strive to maintain a balanced voice. Drama is not my thing, not as a nurse, not as a blogger (with the exception of The Adventures of Nurse Niki). Before hitting the “publish” button, I use my So What? filter, as in “Why did I write this, and so what?” It is my practice to write to the So What?

At least part of this instinct as a writer is traceable to my former role as a pediatric intensive care nurse, where I learned to report my concerns about a patient in concise, direction-oriented sound bites, in the middle of the night, by phone, to a doctor I’d just woken. For instance, if I assessed fluid overload, and suspected the patient needed a dose of furosemide, I presented the numerical values of fluid intake, urine output, central venous pressure, blood pressure, heart rate, etc, sometimes finishing the report with, “Would you like to give an extra dose of Lasix?” Most often the answer was, “Yes,” and I received an order for the desired dose before the doctor went back to sleep.

So what, all nurses do this to some degree,” a reader might respond. They are right.

However, there’s another kind of nurse-call to a physician. It’s born of anxiety, a feeling that something isn’t right; that an otherwise stable-looking patient is on the verge of  downward spiral. Their vital signs are within accepted limits, the lab values unchanged. But, standing at the bedside, “eyeballing” the patient, a subtle change is noted: they’re just a little dusky, a touch mottled. Sometimes those are the only signs warning a perceptive nurse of her patient’s declining status. It’s intuitive: The heart monitor still beats a normal sinus etching across its screen. The numerical values of pulse, blood pressure, and respirations remain unchanged. You keep a watchful eye on your patient, perhaps pulling a bag of normal saline, and a bottle of albumin to keep at the bedside, just in case.

As I grew into my PICU role, I learned to trust this intuition, my nurse’s gut. It saved more than a few lives. I joined the ranks of my more experienced colleagues, nurses who, when they call a doctor and say, “You need to get in here now,” the doctor does just that. He or she can’t explain our intuition either, but once they know a nurse has it, they listen, regardless of what the numbers say.

“So what?”

Here’s what: My nursing intuition is going berzerk in the current political climate. I can’t shake this feeling of impending doom. I am not an anxious person by nature; it’s my training to maintain order and calm. But I can’t shake this feeling: Where there’s smoke, there’s fire.

So what?

Shift Observations: On Luer Locks, Voting, Taxes, and Thanksgiving

While tightening a Luer lock connector to its mate after starting an IV, I curse myself once again for not playing with Legos more as a child. Working with the catheters and tubing used for delivering intravenous medications requires combining fine motor skills (action) with the ability to see how they connect.

Instead, my childhood preference for playing with dolls foreshadowed a love of the human body in my dual roles of artist and nurse. I’m more interested in muscles, ligaments, and the miles of vasculature and nerves connecting the anatomy of a human being, than the plastic bits and pieces carrying medications into them, yet they are tools of my trade. I secure the caps and connectors snuggly, while carefully keeping their tips sterile.

Likewise, I am more interested in relationships, the way human beings connect to one another: nurses to patients, coworker to coworker, artist to model, family member to family member. Would connections between people be more resilient with some sort of psychosocial Luer lock, or would we chew at such connections with the single-minded determination of a wolf gnawing off its paw (or someone else’s paw for that matter) to escape a trap?

Someone has said,

“The building block of society is the individual, not the family unit.”

This statement conflicts with what I was taught,

“The family unit is the building block of society”

It seems to me that the problems of adult life, everything from, “At which family member’s home will we spend the holidays?” to, “Does this issue deserve my vote for funding from higher taxation?” arise from the conflict between these two statements.

Seriously, whose bright idea was it to combine Election Day, property taxes, and Thanksgiving during the month of November? Are they trying to put people in a bad mood?

Politics and holidays: at times they bring out the worst in us. Whether making decisions in the voting booth, or negotiating family holiday plans, I’m learning, with difficulty, that people are more important than the Luer locks connecting us.