Once was a maid/now am an aide…

…on the path to becoming a nurse.

Maid, care aide, nurse…that’s some old timey traditional female roles right there, isn’t it? What a track record. Well, whatever.

In Canada, if you’re in nursing school, you can register as a Health Care Assistant. When I found this out I decided to go for it. I’m hoping to pick up a shift here and there at a local care home. Something to defray school expenses and gain experience. While it’s been many moons since my personal checking account has held much more than $2.86, my main intention is to familiarize myself with the hands-on work of nursing. I have to admit I find the notion of HCA work intimidating, so this is all the more reason to embrace it. HCAs are the heavy lifters of the care environment, literally and figuratively. The wakers, the changers, the bathers, the feeders, the friends. They are the ones who interact most with clients (all the preceding observations are based on my experiences in long-term care).

But the night after I submitted my application to the registry, I had a terrible dream. I dreamed of a ward full of people (friends, classmates, former patients), bedbound and waiting for me to change their shitty pants. One and all had shat their pants and the ward was a cacophony of plaintive grumbling. A cacaphony. I did not know where to begin. Patient nearest to me? The loudest patient? A nice clockwise direction? Before I could decide, my waiting patients began to hurl handfuls of it. Like monkeys!

Advertisements

first patients

Well, not patients – “clients,” as we are taught to call them. “Patients” sounds too sick-y, not empowering. Yet to me, “clients” are something call girls have.

(But either one of those is better than “consumer.” Ugh!)

Anyhow, first patients. First clients. They stand out so powerfully. Maybe they stand out because the student nurse does not have enough experience yet to get a good mental blur going. Our class is structured so that we have 3 – 4 weeks of clinical experience toward the end of each semester. So months pass between “real patient” times. The rest of it is just asking the dummy with interchangeable genitalia how s/he feels today.

Today I recalled my guy from Level II. I think of him because I’ve always had a dread of jail, of being trapped. When I have nightmares they involve locked doors and black corridors. This man’s body was his jail. Full body immobility except for a little bit of movement in his neck and left arm. A bad mood guy but who can blame him? I still think of him at random moments. I think of how, no matter what I’m doing, he is there in that building…

Today I hiked up to the old abandoned railway and walked along the tracks for miles. The fall colors waved against the blue October sky. He came to mind, in his bed which might as well be an island. I thought of his experience of the world coming to him through his one good eye that can see the television, the remote control strapped to his hand, that little invisible laser his last bit of power in the world.

He is not the worst or the sickest I will meet. And I better get used to it now, because I will be exposed to people when they are ill – my perceptions/memories of them will not always be accurate or holistic so I should learn to jettison the emotions once my time with them is over. Is that how it is done?

sorry fucks

Some days I practically burst with compassion. The way an off-brand toaster strudel can burst in your microwave, spewing weird cherry filling. On such days I want to get out there (ie out of the classroom and pell-mell into the greater world!). I want to be the voice that assures someone they are not alone. I want to be kind to people at the end of their ropes. I want to be the rational voice I wished for in my worst moments.

Even in the vulnerability of sickness, we should know that someone knows and cares. This doesn’t seem like too much to expect. That a nurse is there as advocate, listener, and pain relief if nothing else. That we are not just a file #, a bed, a ticket from the “Now Serving…” dispenser, or just a diagnosis.

But every so often a day crops up.

A terrible, crappy, dejecting day.

A day not necessarily even provoked by external events. Just a low day. My own navy blue seeping through the cracks of reality.

A day with no compassion for all humanity’s drips, leaks, and sickness. Do you know these sorts of days?

A day where I ask myself, Can I “nurse” such sorry fucks?

Humanity!

destination to be decided

I have to admit that accessing the healthcare system, looking for a diagnosis, often reminds me of the log ride at the fair.

Why the log ride and not a roller coaster, you ask? Or the teacups? All of them go round-and-round, up-and-down, and once you’re strapped in you’re stuck for the duration.

Maybe it’s because the log ride seems especially cumbersome. Also undignified, once you get yourself wet.

I am new in town and don’t have a doctor, have never even been good at knowing how to judge/choose a doctor (not that any are taking new patients) so today I walked-in to the walk-in clinic.

After waiting 1.5 hrs* I saw the doctor on duty.

(I wish they would introduce themselves. Clinic doctors never seem to. Shell shocked from the sordidness of walk-in complaints, probably. They clutch their name to themselves like a teddy bear.)

I’ll digress just for a sec. You know what’s the worst book to read before you go to the doctor? “Summer House With Swimming Pool.” I just finished it the other day. Man, the doctor in that book has so much contempt for humans. He talks about being a ‘gatekeeper’ to keep people out of the system, to send them on their way coddled and placated and diverted, in the interest of keeping the healthcare wheels and gears turning nicely, with minimal sick people cluttering up the works. Fantastic book, Herman Koch is a delicious devil indeed, but it’s just too much cynicism before going to confess your own ailment to somebody.

Anyhow, it took 15 seconds but Dr decided I might have a pinched nerve. I didn’t know that was actually a real thing. I asked him a few other questions, trying to steer the possibilities to the neurological or otherwise, you know, just because I was sitting right there, so…let’s talk options! I don’t want this process to be a slow boat to nowhere, a cumbersome carnival ride (to belabour my original metaphor), until the problem either vanishes or gets worse.

Maybe I just get impatient because I am never sick and I have no gauge for what’s a “normal” pain and what’s potentially stage IV cancer rippling through my bloodstream. Also I am haunted by half-remembered phrases like “didn’t catch it in time,” “…suggest you get your affairs in order,” and “when they finally cut her open, it was all through her.” ¬† It’s science. People born into dysfunctional families who don’t experience a whole lot of nice things for their first twenty years or so? For us it’s natural to go from zero to worst-case-scenario mode in no time flat.

Anyhow, he prodded my shoulder and arm and although I SBAR’d myself and my S&S pretty concisely he still got timelines mixed up and seemed to doze through a lot of what I relayed. His hx seemed mostly to revolve around whether I had kids (“no”) or wanted them (“maybe.” “Well, don’t think about it too long…you’re already 35!” No shit.)

I left with a pass to the X-Ray department at the hospital to check out that pinched nerve.

Going up…

*”What brings you here?” the receptionist asked through a little hole in Plexi-glass. For her to hear me I’d have to yell, for her edification and that of everyone sitting behind me in the waiting room.

“Sore arm,” I said, keeping it brief, leaving out numb, tingling, shooting pain, getting worse…

“Beg pardon?”

“Sore ARM!” I called. God! I should have shouted “Perforated anus!” just to bring a little zazz into the day.

Really they should have little slips of paper that you write on, and slide over to them like a bank robbery note. I know they have to triage and what not, but what about patient confidentiality?

broken leg of the mind

Mental Health 101. The subject of class today. What does manic mean, what does delusion mean. Depressive states. Mood disorders. Suicidal ideation, etc.

As someone fairly well-acquainted with general all-purpose craziness, the class was at once boring and discouraging.

Boring because I remember without much interest the Adventures in Non-Compliancy encountered at the shelter where I used to work, and my own upbringing with the manic highs and depressive gutter-balling of my crazy parents. Plus my own immersions in navy blue, trying to derive some benefit from licking the shitty psychiatric end of the healthcare stick.

Discouraging because although we are future front-line professionals, the responses of classmates kept creeping into the yeah but aren’t THEY basically dangerous? line.

We are tolerant of physical infirmity but leery about mental stuff. You’d give a ride home from the hospital to someone who’s just getting out of carpal tunnel surgery, but not someone who’d just been discharged from psych. Because yeah, but. Because well, you never know.¬†

The stats say 1 in 6 be crazy but people still act like it’s a rare thing. Or rather, it’s as if what we “know” about mental illness, what we know about the people we love who have a mental illness, is still nudged aside by the lumbering cliches of essential unreliability, of hidden violence just waiting to blow.

mortality blues

For a month I’ve had a numb right armpit. For two days I’ve had intermittent shooting pains in my right arm and shoulder with occasional weakness in my writing hand. These S&S are at least “go-for-a-check-up” worthy, but it’s all sort of been happening in the middle of relocating to a new city and starting a new school and not having a doctor. A general wish to ignore the Reaper’s sweet lullaby, basically.

Last night my hand suddenly lost strength and I dropped my novel into the bathwater, where I was floating and reading at 11pm. Live from my life, it’s Saturday night!

“Motherfucker,” I said. Because although¬† I am Just a Student Nurse, I know that sudden weakness + shooting pains + general malaise = probably bad.

So I drank a double whisky-lemonade and put on my sleeping mask (this thing works wonders). I fretted myself to sleep and dreamed of monsters that tunnel and creep beneath the earth’s surface.

This town does not have a walk-in clinic that is open on Sundays. Be damned if I am going to the emergency room to be counted among the sinus infected, the drunk, the generally queasy, and other time wasters. My stage 4 cancer can be diagnosed tomorrow when the walk-in clinic reopens for business.

in the interest of science

“I can’t TELL you to catheterize yourself,” the instructor told us at the end of the first class on catheters, “but let’s just say the first person I ever catheterized was myself.” Wink-wink.

Latex Foley Catheter

She rummaged in the box in front of her. “I have a bunch of sealed, sterile Foleys here,” she said. “Just in case anyone is interested.”

A few people went up to collect. I took one, too. What the hell.

I am so going to catheterize myself. The dummies in lab have the most obvious urethra. Like the bore of a shotgun, practically.

This ain’t no thing. Hands-on trumps theory for such things. And I certainly need the practice.

Back in Level 1 I thought administering a suppository would be easy. Well, actually it is totally easy. Lube that capsule and shoop! But I thought it would be obvious. Aim for the asshole. It’s not always obvious. My first client in need was a very heavy, bed-ridden man with surgery scars on his butt from old anal fissures plus bed-sores in various stages. Between trying to repo his body and rogue puckers, it was confusing. I almost tried to jam 5mg of Bisocodyl into a healing decubitus ulcer. There was so much flesh, so many nooks and crannies. More practiced nurses and aides learn how to shoehorn all that aside, zero in for the shoop. I am still getting to that level of hands-on confidence.

So I can only bet the urethra, especially the female urethra, is more sneaky. So I will practice on myself, what about it.

Until I was in my teens I didn’t know females peed out a different hole than your vagina. Yes, I could be your nurse one day. But I am learning.

I can hardly stand to look at my own clam in the strategically-tilted mirror. “Blaaaaah,” I announce, taking a PRN sip of Jim Beam as with the other hand I fiddle with my junk, searchingly. This is a reconnaissance mission. I don’t even have my catheter; I left it in my locker.

To be continued.

Edited 1 day later to add: It burns!

Post 1. School

In a year or two – or ten – you know what would be neat? Having a journal of these awkward student times. It might serve as a useful record of days that will be forgotten all-too-soon once I’m in the daily grind of my future job (<–fingers crossed).

Humans have a tendency to gloss over the past, rendering it insignificant once we’re older and wiser. This blog will remind future-me of all the “firsts” encountered in school and beyond, and bring me down to size once I think I’m hot stuff and all.

I also want to hollow out a little space in the Internet meadows to muse on the status of healthcare and nursing in Canada, particularly the role of LPNs, who sometimes don’t get a lotta respect – hence the blog name. Used ironically.

Actually, the record is already incomplete. This week I begin Level 3 of the practical nursing program (Mental Health and Maternity). So in Levels 1 -2 (Geriatrics) I have already learned the words to such well-loved standards as:

My finger (your arsehole)

The ballad of the exploding enema

Baby, can you name that pill?

Roll out the condom catheter

The what-what goes in the where-now?

And many more!

Stay tuned.