The New Job, Three Months In

So my blogging has been scarce, lately, largely due to my being exhausted, working insane hours. We'd lost a couple of people on our team-- one moved to Nevada and one went back to his old job. This week, I worked a more normal schedule-- only about 40 hours. A couple of people who were training came online this week, easing our workload a bit. I'll miss the overtime, but love catching up on sleep.

Where do I begin? My first couple of weeks were terrifying. No matter how many situations arose while I was training, there were bound to be things that came up that I hadn't seen yet. Fortunately, they are wise enough to make sure to schedule us "newbies" with a veteran dialysis nurse nearby for the first couple of months so that we can get some help if needed.

The first patient I did dialysis on my own was a bit eerie; he was born the exact same day as I was, May 11, 1961. It was strange thinking about the paths our lives took since that day-- here he was in an ICU with renal failure and a bunch of other problems, and I was the one treating him. It made me glad I have taken pretty good care of myself healthwise.

Since then, I have learned a ton. Things that were difficult or made me nervous have become routine. Problems that pop up have solutions-- I've seen them before. On Friday, I found myself helping out one of the new "newbies." Still, I've still got a lot to learn-- I'm still trying to master "cannulating" a patient when I have to use a needle to do the dialysis, rather than a catheter. One of the veterans, Jojo, gave me the advice that I'll feel fairly comfortable doing this when I'm six months in. I'm looking forward to it.

A month ago, something happened that I knew was going to happen sometime-- I just thought it would happen later, rather than sooner. I was called on my "call" night to do an emergency dialysis. I got there to discover that they had come close to cancelling the treatment. The patient was extremely unstable. Most of the family members wanted to forego any more treatment; only one, the woman's oldest child, a daughter, wanted to go ahead with treatment. I huddled with the primary nurse and a the physician. The physician had done a consult with a neurologist. The woman, who was only 48 years old, was brain dead. I asked the primary nurse, and experienced ICU nurse, if he believed that the patient was stable enough to undergo dialysis. He said he did.

The primary nurse gave the patient some meds to raise her blood pressure temporarily for treatment. I proceeded with treatment, but was still having trouble keeping her blood pressure up. The primary nurse, who was training someone, was in and out of the room a lot. About an hour in, I started having a lot of trouble with the blood pressure. The primary nurse popped in and looked at the cardiac telemetry and told me that the patient had "coded" the last two times she had shown the cardiac pattern she was presenting. I decided to take her off treatment. I hurriedly returned her blood, and as I disconnected her from the dialysis machine, the "crash team" descended on her. She "flat-lined"-- after I got her off the machine, fortunately. They got her heart going for about 20 minutes, but they knew she was dying. Family members were called in. I left the room to allow them in, and to go notify the night supervisor of what was going on. He reminded me to make sure all the paperwork was filled out to the nines.

The woman died right in front of me and 8 or 9 other medical professionals, and a dozen family members.

Later, as I filled out the paperwork, I had to find out the admitting diagnosis-- abdominal pain. It sounded to me like she might have had a ruptured aortic aneurysm. If that was the case, dialysis-- or almost any other thing any medical professional-- was not going to help her.

I was pretty shaken, but when the night supervisor asked if I would come out to where he was and finish a treatment for him, I jumped at the chance. This is what I do. I'm a nurse.

A lot of my patients are in bad, bad shape-- they have "co-morbidities;" other things wrong with them medically. For a lot of my patients, the dialysis I'm doing is only managing the end. Sometimes, though, something happens that makes you realize that you're doing some good.

About two months ago, not long after I finished training, I got called out to a hospital that's about 40 miles away-- the same hospital as my patient who died. It was a "stat" treatment-- one that needed to be done right away. I got there and assessed my patient. He was in "fluid overload." His kidneys, ruined by diabetes, could not take water out of his body. He was gasping for breath-- when someone is in fluid overload, the fluid backs up into their lungs. He was miserable. His family stood around his bed, obviously very worried. As I got set up, the family said good-bye and told him they'd come to see him tomorrow.

I'd only been in the hospital once before, while training, so it took me a little time to figure out where everything was. I finally got my patient on and treatment proceeded. About two hours into the treatment, I could hear he was breathing much easier. I was astonished at how much fluid I was able to pull from him. Toward the end of the treatment, he started chatting-- he was delighted to find out that I speak Spanish pretty well (he was latino). He even managed to crack a smile and laugh a couple of times.

Later that night, as I drove home, I remembered how irritated I'd been I'd been called from the hospital I'd been at, which was five blocks from my home, to a hospital 40 miles away. I thought of the family-- how happy they were going to be in the morning when they visit my patient and discover him to be feeling much, much better. And I realized that I was pretty happy to be in my profession.

The "Christmas Approaches" Friday Random Ten

Been busy as hell at work; worked 65 hours last week, 55 the week before. This week I came in at a more modest just-under-40. It's good to rest this weekend.

Got the last of my Christmas gifts ordered yesterday. It'll be nice to be sharing the overtime I'm earning with my family, who had to tighten the belt along with me while I went to nursing school.

1. Back On The Chain Gang- The Pretenders
2. You're a Big Girl Now- Bob Dylan
3. Cities In Dust- Siouxie and the Banshees
4. Hey, St. Peter- Flash and the Pan
5. Red House- The Jimi Hendrix Experience
6. Ain't That A Kick In the Head?- Dean Martin
7. Memories Can't Wait- Living Color
8. Kitty's Back- Bruce Springsteen
9. Fisherman's Blues- The Waterboys
10. California Girls- The Beach Boys

Notes:
1. Imagine being a member of the Pretenders in the eighties-- they had a 50% death rate
2. From "Blood On the Tracks," Bob Dylan's divorce album.
3. Oh to be 25 again and in 1986 again and have this one blasting at the Exit...
4. Seventies New Wavy one-hit wonder by a couple of former members of the Easybeats ("Friday On My Mind")
5. I'm pretty sure this song got played by the band at every party I was at in high school in the seventies.
6. How I somehow missed this song until a few years ago is beyond me. Love this one.
7. A great Talking Heads cover by one of my favorite bands from the nineties.
8. From Springsteen's second record.
9. Title track from one of my favorite records of the nineties.
10. Just heard today that the surviving Beach Boys are reuniting for a tour.

To the Goalpost Friday Random Ten

I know I've been threatening promising to post more often, but as a guy with a kid about to go off to college, it's hard to say no to extra work shifts, especially when they go into overtime-- and time and a half pay. Just got a text asking me to come in, and am still deciding; I'm already working doubles tomorrow, Sunday and Monday.

But the work news is good. I had my 90 day evaluation a couple of days ago. I had forgotten about it, or I'd have been nervous; at the 90 day evaluation, they decide whether to keep you or not. They don't have to have any reason in particular to let you go. I think it's their way of being able to get rid of people who may be competent, but have personality problems or something. In any event, my phone conference with my boss was short and sweet. She told me I was doing a great job. It was nice to hear that.

After dealing with the crap I did when I was a teacher-- a principal who was openly hostile toward me for unknown reasons-- it is nice to be appreciated for taking my work seriously and constantly trying to improve. And after four years of horrendous financial stress, it's been nice to be able to do little things, like treat me family to Chinese take-out, go to dinner with my wife, give my daughter a few bucks when she's going out with her friends or take my son to a museum. Every day I'm reminded that I made the right decision-- and an investment-- when I made the decision to go to nursing school. With my positive 90 day evaluation, I've passed the last goalpost in that journey. I'm where I set out to be four years ago.


1. Pleasant Street- Tim Buckley
2. Long May You Run- Stills Young Band
3. Make Your Own Kind of Music- Mama Cass Elliot
4. Superstition- Stevie Wonder
5. Lean On Me- Bill Withers
6. Nebraska- Bruce Springsteen
7. You Can't Be Too Strong- Graham Parker & the Rumour
8. Mastercharge- Albert Collins
9. Always Something (There To Remind Me)- Naked Eyes
10. One Last Kiss- J. Geils Band




Notes:
1. Jeff Buckley's father. Like his son, he has attained cult status and had an early death. Great book about them, David Brown's "Dream Brother: The Lives and Music of Jeff and Tim Buckley"
2. On the Decade collection, Neil Young dedicated this song to his first car and last girlfriend.
3. Got a soft spot in my heart for the Mamas and Papas.
4. Pre "I Just Called To Say I Love You" Stevie Wonder
5. One of R and B's great voices.
6. Title track from an album that is tied with "Born To Run" as my favorite Springsteen album.
7. From "Squeezing Out Sparks," one of my favorite albums of the seventies.
8. I was lucky enough to see Mr. Collins perform a couple of times while he was still alive.
9. Still love this song. It's on my daughter's ipod too these days.
10. One of the great break-up songs. Ever.

The Two Weeks in and a Day Late Saturday Random Ten

I just finished my second week as an official working nurse. I've got some reflections on that coming. But for now, I've got to get my Friday Random Ten posted, a day late.

1. Telstar- The Tornadoes
2. Welfare Mothers- Neil Young
3. Deep Purple- Nino Tempo and April Stevens
4. Baby Love- The Supremes
5. Yellow Submarine- The Beatles
6. 1969- The Stooges
7. All-American Alien Boy- Ian Hunter
8. Hejira- Joni Mitchell
9. Come On Eileen- Dexy's Midnight Runners
10. Right Place Wrong Time- Dr. John

Notes:
1. I heard on the radio a few months ago that the Beatles were not the first British group to have a #1 hit in the United States; it was this group with this one-hit wonder.
2. Love this rocker from "Rust Never Sleeps."
3. A sweet little one hit wonder from a brother and sister duo.
4. One of the many great Motown hits written by the fabled Holland-Dozier-Holland songwriting team.
5. Hey, they had to let Ringo sing sometimes, right?
6. Is 1969 okay, all across the USA?
7. Gotta add seeing Ian Hunter in concert to my bucket list.
8. The title track to one of my desert-island albums
9. This one-hit wonder might have been followed by other hits if singer Kevin Rowland wasn't such a dick.
10. One of many great songs put to good use on the "Dazed and Confused" soundtrack.

Johnny Yen's One-Hit Wonders: "Pillow Talk" by Sylvia

I'm apologizing for maybe the dozenth time for my dearth of blogging the last year or so. You've heard all the excuses already-- the second and final year of nursing school, now having two kids in high school, the unexpected move and the exhaustion from learning my new nursing job. No excuses today. I finished with my training on Friday-- on the floor by myself tomorrow. I'm in the last day of a three-day weekend. It's a beautiful, cold, sunny October day here in Chicago. I've got Little Steven's Underground Garage streaming on the computer, playing great tunes. No more excuses. Back to blogging.

Just to remind about the "One-Hit Wonders:" speaking of Little Steven, he once pointed out that it's harder to create an immortal three-minute song than to create an elaborate orchestra piece. Rock and roll One-hit wonders have fascinating stories; the stars align for just a moment in the universe, the elements come together, and a rock and roll gem is created.

I keep a list of future "One-Hit wonders" on my computer. The little Mac Powerbook that got me through two years of nursing school prerequisites and two years of nursing school itself crapped out just after the move. Fortunately, my friend Greg had shown me how to use "Time Machine," and I was recently able to retrieve my list. I decided my next one would be either Sylvia's "Pillow Talk" or the Kingsmen's "Louie, Louie." Recent events prompted me to do the former.

Sylvia Robinson's "Pillow Talk" was her only solo hit, but not the only hit song she was involved with. Born Sylvia Vanderpool, her first brush with the Top 40 was at the dawn of the rock and roll era, 1956, as half of "Mickey and Sylvia," with the song "Love Is Strange," which was written by rock and roll legend Bo Diddley, along with Jody Williams. Ms. Robinson continued until 1959 as half of the duo, when she went solo and married Joe Robinson.

She wrote the song "Pillow Talk" for Al Green who passed on it for "religious reasons," and ended up doing the song herself, releasing it in 1973. It hit Number 3 in the Billboard pop chart and #1 in the Soul charts. In retrospect, it seems like a no-brainer; Ms. Robinson's smoky, sexy voice was made for the song. The "climactic finish" anticipated Donna Summers' "Love To Love You" a few years later. The song is also cited as one of the first disco hits.

Robinson never had another chart hit of her own, but was hugely influential in the record business. She continued to write and produce music, founding Sugar Hill Records in the 1970's; Sugar Hill was a pioneer in hip-hop music. Working with Nile Rodgers and the Sugarhill Gang, she released "Rapper's Delight," the first big rap record. She also co-wrote and produced the socially aware rap song "The Message," by Grandmaster Flash and the Furious Five.



Ms. Robinson eventually divorced Joe Robinson, but remained in the record business. After Sugar Hill Records folded, she formed Bon Ami records, which had success with the group "Naughty By Nature."

Sylvia Robinson passed away recently, dying of congestive heart failure in Seacaucus, New Jersey at the age of 75.

The Payoff Friday Random Ten

The last 48 hours have been some of the most hard-working, exhausting-- and rewarding-- two days of my life.

Yesterday, I worked 16 hours. Two patients, two different hospitals. Lots of problems, a good preceptor helping me deal with them and learn for future patients. I worked from 7 am to 11 pm. I had to go home and grab a few hours of sleep-- I had to be back at 7 am for my last day of training, and a test-- working with two patients at once. Since dialysis is pretty much like working in an Intensive Care Unit (in fact we work bedside with a lot of ICU patients), it's intense. But things that were difficult to do are now effortless. The voluminous paperwork and charting is now easy. And physical skills like changing a dressing or putting a needle in a patient to do dialysis are getting easier and easier every time I do them. Things that terrified me are run-in-the-mill now. At the end of today-- only a twelve and a half hour day-- I felt like "Wow-- I can do this."

I feel really good for not only having overcome fear, anxiety, money problems, out and out exhaustion at times, but have come to realize that this was great for my kids to see: that if you set a goal, and don't let difficulties stop you, that you can reach your goals, goals that bring great rewards-- financial, self-respect and just discovering just what you're capable of. And that is the payoff.

1. Shoot Out the Lights- Richard Thompson
2. Gimme Gimme Shock Treatment- The Ramones
3. I Keep On Dancing- The Gentrys
4. Norman- Sue Thompson
5 Play That Funky Music White Boy- Wild Cherry
6. Willpower- The Replacements
7. Louie, Louie- Motorhead
8. Can't Stop the Rain- The Washington Squares
9. Sausalito Summernight- Diesel
10. With God On Our Side- Bob Dylan and Joan Baez


Notes:
1. One of the most brilliant, harrowing songs about a marital breakup. I also have a brilliant live cover of this one by Bob Mould.
2. Most groups would be happy to write one song as great as this one. The Ramones wrote about 25 of them. And they can all fit on one cd.
3. Rock Critic Dave Marsh listed this one in the "Rock Book of Lists" in "Songs That Have a False Ending."
4. A weird little one-hit wonder
5. One of the great one-hit wonders of the seventies.
6. From the great "Hootenanny" album.
7. I think I have about ten versions of "Louie, Louie" on my Ipod.
8. The Washington Squares were three people from the New York punk rock scene who formed a "Peter, Paul and Mary" politically-oriented group in the eighties. Their first album is wonderful.
9. Lots of one-hit wonders. This was from 1981 by the Dutch group Diesel.
10. Steve Jobs' obits mentioned that Steve Jobs had dated Joan Baez when he was young; remember reading that years ago, but had forgotten about it.

The "Overdue Day Off" Friday Random Ten

I was working yesterday-- in the midst of my third double of the week-- when I realized that I'm not actually done with my training despite the fact that I'm pretty much working as a dialysis nurse at this point. My unit is so short of people that they're trying really hard to accelerate training so they can get us on the floor working. Not a bad spot to be in. I like the job a lot; it's interesting and I work with a lot of nice people. And it sure is nice knowing I'm helping people in the process of making a living.

I was on overtime after about five o'clock yesterday, so I got a day off today. I used some of the time to catch up with an old friend on the phone, some of it to catch up on my errands and some of it to rest. It wasn't until I actually rested that I realized how exhausted I'd been; new job, tons of new skills, lots of hours. I still have a bunch of stuff to learn and skills to master. But I was showing a co-worker/trainee (who has himself shown me better ways to do things on many occasions) an easier way to put a tagaderm dressing over a catheter and had a moment where I suddenly realized what I'd done. I realized that I was doing things that I never would have believed I could have done just four years ago. I am trusted to set up a complicated and expensive machine and attach peoples lifeline-- their blood vessels-- to that machine and give them treatment that they would otherwise die without. It kind of blew my mind. And made me feel like I'd done something beyond making sure that I'd get a nice paycheck next Friday. And damn that's a good feeling.

And I have to admit that the financial aspect is something that's been satisfying. I have a nice little pile of debts that'll need to be taken care of in the next six months or so, and it'll get taken care of. But today I actually felt confident enough of my financial future to add internet listening-- at the cost of $2.99 a month over the cost of the basic service (which is $12.95 a month) to my Sirius/XM satellite radio. I got even crazier and signed up for the free trial of the New York Times on my Kindle; I anticipate being able to spring for the $19.99 a month for the service after the free trial is done in two weeks (it also allows me to have unlimited access to it on the computer). After four years of sweating about money, it's nice to be able to ease up a bit. And after 17 years of worrying about where my son's college money will come from, it's nice to stop worrying about that.


1. Twistin' the Night Away- Sam Cooke
2. Why Me?- The Planet P Project
3. It Isn't Gonna Be That Way- Steve Forbert
4. No Feelings- The Sex Pistols
5. TSOP- MFSB
6. Golden Slumbers- The Beatles
7. Time To Kill- The Band
8. I Hate Rock and Roll- The Jesus and Mary Chain
9. Pack Up Your Sorrows- Richard and Mimi Farina
10. Door Number 3- Steve Goodman


Notes:
1. This song always makes me think of the movie "Animal House."
2. A nugget from the early eighties
3. Forbert had a hit with "Romeo's Tune," but has a bunch of other great songs, including this one.
4. God, that one and only Sex Pistols album still sounds great, doesn't it?
5. Great almost-instrumental from 1974 (there's a chorus by The Three Degrees at the end). "TSOP" is "The Sound of Philadelphia," and "MFSB" is "Mother Father Sister Brother." The Three Degrees would later have their own hit with "When Will I See You Again?"
6. From "Abbey Road," the last Beatles album (Though "Let It Be" had been recorded earlier and shelved, it was released later)
7. From the great "Stagefright" record
8. I always have to crank this song to "11" whenever I hear it.
9. Mimi was Joan Baez' sister. Her husband Richard was killed in a motorcycle accident on the way home from the party to celebrate the publication of his book "Been Down So Long It Looks Like Up To Me."
10. Goodman wrote this comic take on "Let's Make a Deal" with his friend Jimmy Buffett.

Seriously, Let's Get A Grip, People

In the last couple of weeks, there's been a big hullabaloo over Netflix raising its prices. Let's put it all in perspective.

First off, to continue the plan I've been using, the ten buck "one disc out, unlimited streaming," will go up to 16 bucks. Okay, yes, that is a 60 percent increase. But let's put in perspective. I went out running tonight and ran 40% further than I ran last time. This meant, in reality, that this fifty-year-old ran 16 blocks instead of twelve. Sounds like a lot more when you say "40 percent," but in reality not much more. The fact of the matter is that at 16 bucks, my plan is still a great deal. My kids stream their South Park and scary movies and I stream my documentaries (many of which are only available this way), old television shows and artsy movies. And I can get my one disc at a time-- usually classics and more arty movies. And we can watch different shows at once, on our big tv connected to the Wii, on most of the household computers and even on our ipods.

I've followed Netflix-- and been a customer (as well as getting my folks started on it) for 6 or 7 years now. They've taken a daring business model and improved on it, as technology has changed. And they've actually been able to turn a well-deserved profit; according to Wikipedia, they turned a $283 million profit on a $2.17 billion gross, a healthy 13% profit. As they expand the percentage of their offerings as streaming, they'll absolutely have to pay more. That's the way the world works, kiddies; if they're offering more service, they'll have to pay a little more for it and so shall we. I still consider the sixteen bucks a month I pay for Netflix a bargain.