Monday, November 12, 2012

A Year In

Where do I begin?

A couple of weeks ago, I realized that I badly missed blogging. There has been so much going on-- being a first year nurse, getting my oldest kid off to college, working crazy amounts of overtime. And dealing with the death of a friend.

So where do I begin? Let me start at today-- and a year ago. Just about a year ago, I was turned loose to do patient care on my own. Yes, I had finished nursing school. Yes, I had passed the NCLEX. Yes, I had finished the two months of training for the company I worked for, learning the ins and outs, ups and downs of dialysis. But I had a lot to learn. I thought a lot about one of my first days actually working as a nurse a year ago-- a really shitty work day-- and today. More on that later.

So, in May, right after they celebrated Mother's Day, my son and my ex got into an argument. It ended with her telling him to move out and move in with me.

Needless to say, both my son and I were very happy about it.

There were some problems to work out. The main one was how he was getting to school. His high school was just a couple of miles from my ex's house-- he would take her car, about a ten minute drive. I live about eight miles from his school, and did not have an extra car. We decided that since it was only about three weeks, that he could take the bus. It was two buses, and took nearly an hour, but it beat renting an extra car for those three weeks.

At the end of May, he graduated from college. My mother drove up from Tennessee for it. At the graduation, the parents sat with their sons (my son went to an all-boys school), sitting on either side of them. It was weird-- I'd spent so little time with my ex. When I met her, she was 24 and I was 31. Now I was 50 and she 45. We both have a lot of grey. It was funny to see him between us; I'm six feet tall, very white and lived it up a lot in my life. She's five foot one, Asian and didn't drink and only dated a few people. And there was the result of that union in between us.

He got a summer job selling home security systems door to door. He did quite well at it. He learned a lot about people through both his interactions with the homeowners he talked to and through his co-workers. I also realized that after years of letting out a little rope at a time, I was about to cut the ties.

In August, he asked me to talk to my ex; she wanted to drive him to his college, in Buffalo, New York, but he wanted me to go as well. I talked to her, and told her I would drive and pay for gas, etc. She agreed.

It was really strange spending 10 hours in the car with she and him. The first couple of hours, she and I caught up on family. And then had not much more to say. I realized that there were good reasons I left 15 years ago.

There were a few activities that weekend that we all participated in. I met two of his three roommates; they seemed like very nice guys. I kidded my son that he had the "diversity room;" he's a mix of Asian and white, and his roommates are African-American, Latino and White. I kidded him that the college recruiters would drag prospective students by his room to point out the diversity at the school, which actually appears to be about 90% white.

When it came time to leave, I had to drop something off for him that my ex had forgotten to give him. He came down from his dorm room to get it, but I could tell that he was ready for me to leave. It was time.

My ex, to my relief, had planned to fly back home. I didn't have to deal with her alone for ten hours, and had some time to decompress. My wife had pointed out that this-- and another thing-- were going to be really hard on me. And she was right. The other thing, just about a week before this, was the death of one of my closest friends.

My first day of my new job, August 7 last year, we gathered in the corporate office in a suburb of Chicago. Over the first couple of days, I gravitated to Neal, who it turned out lived near me. Another guy, Brent, annoyed me at first. He was way too eager.

I came to realize that the reason Brent was so over-eager was that he was extremely proud to be a nurse. He's struggled, like I did, to go to nursing school, paying for it himself like I did.

A couple of weeks into our training, he and I were at a hospital that our unit was covering. It was annoying. For me, it was a nearly 50 mile drive. For Brent, who lived in the in the suburbs to the south of Chicago, it was an 85 mile drive. At the end of the long day-- we worked about 15 hours-- we walked out to the parking lot and got in our cars. I was about to drive off, but noticed that he had gotten out of his car and put the hood up. Something was wrong.

I turned off my car and went to see if I could help. Turned out that his car battery had died for some reason. I kicked myself, realizing that I'd given my jumper cables to my wife and had forgotten to replace them. We thought that the security guard could help; he had one of those portable starter devices. Unfortunately, it didn't help.

I couldn't leave him up there stranded. I would have driven him home-- which would have meant about 150 miles of driving-- but his live-in girlfriend agreed to pick him up at my home, which was about half way between the hospital and their home.

As we drove home, we had a chance to talk. I can't even remember now what we talked about, but I realized two things: we were both happy with the career change choice we had made, and we were now friends.

As our Brent and my year as nurses and co-workers rolled on, my wife noticed something-- that I'd gone from having about 100 text messages a month to having over 1,000. It was mostly me and Brent. We texted back and forth about work related stuff-- some of it serious, much of it not. He and I could not be much more opposite. He'd been a blue collar worker before, running the printing presses for one of Chicago's papers. I'd been a teacher. And we were opposites in that most Chicago way-- he was a lifelong White Sox fan, I was a northsider, and a Cubs fan.

But for all that we were opposite in, we were also a lot alike. In the end, we were huge baseball fans, beyond our team loyalties. We were both fathers first, everything else after that. Both of us had been badasses in our lives before having kids had settled us down.

On August 7 this year, he, Neal and I had all sent similar texts to one another-- "Happy ^**^%%% Anniversary!" We had all come up together, all of us loved being nurses, but all three of us had become increasingly irritated with the stupid shit that came with working as nurses for a corporation. And we were all good friends.

The next day, I was working at a hospital near my home. Brent, who was having an interview the next day to possibly replace our boss, who had announced her resignation, stopped by that hospital to take care of some paperwork regarding our dialysis machines. He knew I was there, so popped his head in to the room I was working in to shoot the breeze for ten minutes or so. He was looking forward to going home afterward, having a couple of drinks, then getting up the next morning for the interview. He told me what his plans were if he actually got the job-- he doubted he would. He had a ton of great ideas. Which was probably why he wouldn't get it, both of us joked.

The next day I got a text from Aaron, a young guy who came in a couple of months after we did. He knew Brent and I were close, and wondered if I'd heard what he'd heard-- that Brent, who was only 43, had had a heart attack.

Since everybody knew that Brent and I were tight, I started getting calls from everybody in our unit as word spread that something had happened. Problem is that I knew nothing.

I finally called his phone, hoping that he'd had some kind of scare and was in a doctor's office, or being held at a hospital for observation. About ten minutes later, Lisa, his girlfriend, who I'd only met once for a moment, the night I gave him a ride home when he was stranded, called me. He had collapsed that morning. Her teenaged son had heard him fall in the bathroom, and gone in to check on him. He was not breathing. Her son ran to get a neighbor, who quickly called 911 and started CPR. The paramedics arrived within a few minutes and "bagged" him-- started artificial breathing for him. He had a heartbeat, but never breathed on his own again.

Lisa and I started burning up the cell phone lines. As she knew anything, she called me, and I called a few people to put the word out; everybody loved Brent, and wanted to know what was going on.

It turned out that Brent had had a brain aneurysm that had burst suddenly. The doctors were telling Lisa that there was no neural function. Lisa asked Neal and I to come out to see him and to assess him and confirm what she was hearing.

That Sunday morning, Neal and I drove down to the hospital, which was in Evergreen Park, where my mother had grown up. When we got to the room, Lisa, who had been keeping a 24 hour vigil, happened to have run out for coffee. It was a weird scene-- the three of us together, but now Brent was intubated and unresponsive. Lisa arrived, and Neal and I began our assessment. I opened his eyelid and shone a light into it, checking for pupillary response. There was none. I took his hand into mine and told him to squeeze it. No response.

We talked to his nurse and asked about various things. She told us the assessments they had done. It was clear to us that our friend was clinically dead.

We talked to Lisa about Brent's last wishes. He was an organ donor. If they were going to harvest his organs, they had to take him off the ventilator and do so within the next 48 hours.

On the way home, Neal and I talked about the irony-- that a the death of a dialysis nurse was going to result in two people being able to get off of dialysis.

A few weeks ago, I got a text from Neal. A few months ago, he had applied for a job at a hospital near the area he and I live in. He'd gone through the interview process, and had gotten the job. He was leaving.

Today I was sent to a hospital I rarely go to, doing dialysis on a patient for a doctor I rarely deal with. About a year ago, I was doing dialysis on a patient in this hospital, and had a lot of trouble with that patient; he was what we call a "stick" patient-- a patient with a graft or fistula, rather than a central venous catheter. We have to put big damned needles into these patients in a fistula or graft that was created surgically by attaching an artery and vein together. They're considered

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