Wednesday, November 23, 2011


Happy Thanksgiving! I work tomorrow, the real day, so Spencer and I decided to celebrate on Sunday, instead. (Yes, the hospital offers a free turkey dinner for employees, which is very generous. But...shoveling down canned turkey, canned green beans, and cardboard mashed potatoes between med passes and bed baths just didn't cut it for me).
So we invited over Spencer's cousin and his friend. 4--it seemed like a reasonable number for our apartment. It eventually grew to 7, which made for cozy quarters and some creative seating, but also for a lot of fun. We had Andrew, Paul, and Lizzie Early (all Spencer's cousin) and Andrew's friend, Mona, with her niece, Anisha.
Thanks to my sister, Martha, for her AWESOME recipes and to Lizzie who sat on the rocking chair since we only own 4 chairs. (I also have to brag about my creativity: you can see the size of our table and of our kitchen. There was no way we would be able to serve all the food we had off the table or out of our little kitchen. So, I dressed up our ironing board with a table cloth and did buffet style. Not bad, huh?)
While we were eating, Spencer asked us all to name something for which we are grateful. I was so busy making sure everyone was getting fed, etc., that I never said mine. As cheesy as it sounds, I am so grateful for Spencer because he makes nights like that one not only possible, but so fun. From the shopping to looking up recipes to carving the turkey to chatting around the table, even while doing the dishes, he was as excited as I've ever seen him. It would be such a bummer to have a spouse who didn't love traditions and holidays as much as I do! You're the best, Spencer J!
I hope y'all enjoy your holiday as much as I did!

Sunday, October 9, 2011


I have been so happy this week for so many reasons:

this (Tucson in the fall):

and this (Cooking Light's monkey bread recipe...mmmmm!):

and this (I read it for the third time and can't get enough of it):

and this (our forecast for double, rather than triple, digits):
Sunday, 9
83 | 52 °F

and especially this:
where we heard things like this:
"Brothers and sisters, the most powerful Being in the universe is the Father of your spirit. He knows you. He loves you with a perfect love.
God sees you not only as a mortal being on a small planet who lives for a brief season—He sees you as His child. He sees you as the being you are capable and designed to become. He wants you to know that you matter to Him."
(President Uchtdorf, "You Matter To Him")

Saturday, June 18, 2011


This week I ended up with three days off in a row (or so I thought...that's another story) so Spence and I ran away! We got a fabulous deal on a little room  and we spent three days

riding our bikes through vineyard country
hot tubbing
eating McDonald's soft serve icecream
laying out on warm rocks by Crescent Moon Ranch River
enjoying the, pink, and green everywhere
eating cranberry walnut french toast
enjoying our balcony
talking politics 
talking everything else
soaking in weather below 100 degrees

Thanks Spence

Saturday, June 4, 2011

RUPTURED AAA...and my awesome co-workers

Last post expressed my amazement at medicine. Thursday was an epitome of a medical miracle! My patient had a "ruptured AAA," meaning her aorta (the main vessel from the heart running down the abdomen) ripped open. She was taken to immediate surgery, where she lost 5.5 liters of blood (the human body only has about 6). The surgeon opened her up, patched the aorta together, gave a bunch of blood and sent her to us. The next 4 hours we frantically dumped in 31(!) liters of fluid, gave all kinds of medication, ran tests, etc. 2 or 3 times my blood ran cold we almost lost her. But the intensivist kept giving orders and she made it through her first few hours...
The night shift ran all through the night, doing the same. When I came back the next morning, she was basically stable--maintaining blood pressure (with medications' support), looking (almost) pink, perfusing to the point of palpable pulses, and making pee (the things we get excited about as nurses! But that means her kidneys were getting blood). That lasted the whole day. She is not out of the woods, but doing fantastic considering her condition.
I was reading a study (USC center for Vascular Care) that says almost half of patients with ruptured AAAs die before reaching the hospital. Of those who make it to surgery, between 50-70% die. Not surprising, since they open the biggest vessel in their body! So, she is quite a miracle and I'm totally amazed at medicine, again!

**Here I put in a plug for my co-workers. There were 3 other nurses on the unit, each with 2 sick patients of their own. Yet all 3 rushed into my room when the patient arrived to help me get things going. 2 PCTs ran tirelessly: getting supplies, running labs, and making calls. Even my manager popped in (shirt, tie and all) to see if he could help. One nurse stayed with me until the end of shift, hanging blood, checking lines, etc. Another stayed not only until the end of the shift, running tests and helping the doctor insert lines, but he also stayed 2.5 hours(!) after our shift to help me check orders and chart. We finally finished with that patient and he was ready to leave. But, he learned I still had to chart on my other patient and that I was parked 1/2 mile away. He insisted on staying until I finished to ensure I reached my car safely. Wow! I feel spoiled!**


Lately I've been amazed at what medicine can do. And how fast it can work. Here are some of the things I consider medical miracles:
  • I had a patient go to surgery and "code" (meaning her heart stopped beating and she lost all perfusion). While doing CPR, they brought the patient to me in the ICU (I was told later I looked the same color as the patient when I saw them coming). We quickly found the patient had a "tension pneumothorax" (pneumothorax is a collapsed lung. It becomes a "tension" pneumothorax when the pressure from the collapsed lung pushes the heart and vessels. Hers was bad enough that they were too far shifted and compressed to pump at all.) A surgeon put a chest tube in to relieve the pressure and walaa! She had a blood pressure, a heart rate, and her color went from dusky to rosy. Within a few minutes she opened her eyes and was trying to talk to us. Wow!
  • Another patient went into "a-fib with RVR" (atrial fibrillation with rapid ventricular response. Basically, his heart was beating twice as fast as it should and less than half as efficiently). I called the doctor and got orders for an amiodarone drip (a strong heart medication) within 3 minutes of onset. I let the pharmacy know and within another 3 minutes I was giving it. Another 3 minutes, his heart rate was back within normal range and he had a blood pressure. Again, Wow!
  • Still another patient had lost almost all circulation to one foot. It was cold and white as white can be. And she had a sore on her ankle that had been there weeks, unable to heel.  She was taken to surgery. They took a little piece of a healthy vein, hooked it on to the artery and "bypassed" the blockage. She came out of surgery with an incision from her hip to her ankle, but with a pink foot. And she could feel when something touched it--a sensation she claimed to have not had in months. (And this was just for a foot--imagine doing that to the vessels of the heart!)
I could go on for hours. Every time I titrate a "pressor" (medication to improve blood pressure), I'm amazed at the immediate effect. When I watch a patient get electrically shocked out of a dangerous heart rhythm, when I give sedation and suddenly the patient is out cold, when I give a little fluid to a patient whose numbers just aren't right and they suddenly all's always amazing to me. (It's daunting, too, as I realize the impact a mistake can have.) But I love having some immediate gratification in my job!

Friday, May 27, 2011

camping...attempted again

Last January, Spencer and I went camping. At 5am, we were both icicles, so we bailed. We packed up and hurried home to our hot tub. Ever since then, we've wanted redemption! So, yesterday, we packed up the car and headed up Mt. Lemmon only to find out we couldn't have a fire. Bummer, but we figured, being May in Tucson, we didn't need a fire anyway.
Wrong! The sun hadn't even gone down yet and we were shivering. We thought we'd troubleshoot and sleep in the car so we could at least have the morning on the mountain. But then it was dinner time and what had we brought? hot dogs! Have you ever had a cold hot dog? After 4 wretching episodes and having to turn the car on to warm up the car to stop our shivering, we bailed again! 
So maybe we aren't as tough as we'd thought we were. But, we definitely still had fun. We had gone for a beautiful hike, seen a great sunset, and we got to end the night--rather than freezing and hungry, tossing and turning in the car--eating McDonald's soft serve icecream and watching "Man From Snowy River" in our cozy apartment. 
But just you wait--Spencer and I WILL have a successful camping trip one of these days!

It happened!

All through nursing school you hear about doctors yelling at you over the phone. I didn't believe it could actually happen. That's just a bad stereotype, right?
Then there was yesterday. My patient had a tracheotomy last week. When I came on shift, site was red, swollen, and angry and the patient's white count was up (an indicator of infection). After consulting with some other nurses and the pulmonologist, we figured we'd better let the surgeon know. So he was paged....His response was, "I've been called about this four times, now! How many times do I have to say I don't care what the site looks like! I'm coming over to talk to your manager and to post a big sign on the patient's chart warning all future nurses NOT to call me again" and so on.
I put down the phone and laughed. Call me terrible, maybe I should have felt bad about it, but it was just too ridiculous! He was blowing a gasket over my doing exactly what my job is and his NOT doing what his job is!
He did in fact come talk to my charge nurse, our medical director, and post a note on the chart to NOT call him again. I like to think maybe he had been up all night doing emergency surgery, saving a life, and did not have his wits about him....and his dog had just died....and his car was stolen....and he had stubbed his toe...that's why he yelled at me.

Sunday, May 22, 2011

Marital Advice

Day before yesterday I had a patient who told me he had been married for 66 years. "We met when she was 13 and I was 17--she was 'the girl next door.'" The wife, holding his hand, piped in, "We just knew as soon as we met that it was gonna be. But we had to wait until I graduated from high school. So we got married when i was 16." I asked them what the secret was. They looked at me with blank stares for a few seconds. Then he said, "Well, you just love each other, I guess." Then the wife piped in with some more advice about reading the bible, letting your husband be head of the household, about knowing when to speak and when to stay silent, etc. But I loved that piece of advice: you just love each other, I guess. I intend to follow that bit of wisdom.

Monday, May 2, 2011

"Hey Anna, the nineties called. They want their phone back!"

So says one of my co-workers. But it still works for me and I love it!

(And now I think it's a matter of pride--how long can I make it last?)


Last month, my parents took Spencer and me on a post-graduation trip to Hawaii. It was one of the best weeks of my life! Hawaii is such a gorgeous place--so far removed from stress and worry, but so comfortable. We spent the first four days on Maui. Each day was so memorable.
  1.  Day 1 (Thursday) we snorkeled at Black Rock (my first time snorkeling). It's harder than it looks, but it's amazing to see the whole other world under there. We also walked along the beach a while and went to a great dinner in Lahaina.
  2. Day 2 (Friday) we went snorkeled Molokini. It's a tiny island off Maui's coast with an amazing coral reef. When the boat stopped, I thought the water was about 8 feet deep because I could see the water so well. It was 50! That's how clear the water is! We saw fish in every was like stepping inside "Finding Nemo!" We also went to "Turtle Town" to see the turtles. That night we got to do a Luau. Amazing. That is more food--and quality food!--than I have ever seen. And every bit of it was fantastic! I took Belle's approach in "Be My Guest" taking a bite of everything that went by. I couldn't find anything I didn't like! Plus, it was right on the beach with the water, sunset and sailboats for a backdrop. Sigh....
  3. Day 3 (Saturday) we drove the road to Hana. I wish I could describe how beautiful it was with all the thick green, the flowers, the waterfalls, and the ocean in the background. Breath-taking--literally (and we made it without getting carsick!). It was really fun to have that time to just chat with mom and dad, too. They are two of the funnest people to hang out with. We also got to visit some friends, the Hanks, who have a place in Hana (and got to pick/eat papaya right off the tree. And when it's fresh off the tree, it doesn't taste like dirty gym socks like the ones from the grocery store. It's delicious!) We continued along the road to hike the Seven Sacred Pools and the waterfall above it. That might have been my favorite thing we saw. I won't even try to describe it...just go! We drove back to the hotel along the dryer side of the island (being from Arizona, I wouldn't call that dry, but whatever), stopping for Italian on the way home.
  4. Day 4 (Sunday) we went to the local ward and spent a restful afternoon reading with the waves and birds as background (did I mention you can see the ocean from our room?). We had teriyaki sandwiches and went for a beautiful sunset walk (and saw whales off the coast). 
  5. Day 5 (Monday) We flew from Maui to Oahu. Oahu has a very different feel--a little drier (again, jungle compared to where we're from) and a little more podunk maybe? Roosters were running all over and restaurants consisted of tiny little surfer delis. But I loved going back there since I'd spent a summer living there. We hit up one of those delis for lunch, checked in, then visited Sunset and Waimea beaches (with a Matsumoto's snow cone in between). there anything more relaxing? 
  6. Day 6 (Tuesday) We spent the morning doing a session in the Laie temple (which was packed!) and got to do sealings. It's really neat to walk out of that temple and see the line of palms going straight out to the beach. We also went out on the point (one of my favorite places from when I lived there) and saw my old house, campus, etc. Then we hit up Ted's Bakery (I stuffed myself with the fabulous pies) and ended up at Waimea again for another beautiful sunset (and frisbee game). We finished off the day with pina coladas and "Despicable Me."
  7. Day 7 (Wednesday) We drove the long away around the island, seeing more pretty jungle, then went to Pearl Harbor. It's an interesting place to visit on a vacation like that. It's such a sobering experience amidst such pure fun and relaxation, but there's a really neat, hopeful spirit there. Then we went to the airport and headed back into real life again...

The Hanks' backyard.

By the Seven Sacred Pools, you hike through a bamboo forest to reach these incredible waterfalls. These picture don't begin to do it all justice. Again--just go!

Climbing trees :)

Seven Sacred Pools-ish. Again, no comparison to the real thing

Sunset walk and whale-watching with Lowli.
Sunset Beach

Waimea Bay 

I can't thank you enough, Mom and Dad! And thank you Spencer for making sure every minute of it was bliss for me! We WILL be back someday!

Saturday, March 26, 2011


Thursday was so lucky! I started the shift with my patient's wife frantically telling me we had lost her husband's iPhone. "When I left last night, it was in his front pocket and now it's gone!" Remembering the night nurse had changed his sheets and gown during the night, I looked in his laundry bin--easy. But it was empty. No problem, I could just look in the units' laundry room--just a few different bags, on biggie. But it was empty. Panicking, I called the laundry room for the whole hospital, warning them I was going to have to come look through the whole hospital's last 24 hours' worth of laundry to find this iPhone. I even gave report to my charge nurse, thinking it was going to take hours. I asked the wife the pt's number, just in case maybe it was on and the sound could help guide us. Down in the laundry room, there were about 100 bags of linen. Then they opened up the chute that had last night's laundry. About 50 more bags piled out. I was laughing so hard--mostly to keep myself from crying. "Well, let's get to work," I said to the laundry worker helping me. But first, I thought I would try calling the number, jsut to see. And I felt a vibration on my foot...I ripped open the bag right at my feet. And sure enough, there it was! My first thought was, "Jesus loves me!" (quoting my freshman roommate).

P. S. A few hours later, that patient spiked a fever of 107! Can you believe that?! I couldn't, so I tried 3 different thermometers. Sure enough: 107.4. Crazy--I about had a stroke!

Thursday, March 10, 2011

"tender mercies"

Today my patient passed away. She was very sick and had a poor prognosis. To keep treating her would have only prolonged suffering. But stopping treatment is always unsettling for me. Just the fact that I have some kind of responsibility in the death leaves me with a lump in my throat. 
However, today I felt like the Lord sent some "tender mercies" to help.
First of all, she was a wonderful woman. Raised a few beautiful daughters. Then when one of the daughters passed away, she raised her 2 orphaned grand-daughters. According to her sisters, she was the one always helping their mom when she was sick. She had a sweet disposition. Each member of her family knew she loved them.
Second, our chaplain was there. She carried the family (and me!) through the day with her calm and reassuring words.
Third, she was comfortable the whole time. Granted, she was getting dilaudid every hour. But she didn't get that agonizing breathing or the anxious look. The family commented more than once on how little pain they saw in her.
And finally, the look on her face in the end. It sounds cheesy, maybe even morbid. But her face was the calmest I've ever seen someone so soon after passing, almost a smile--eyes and mouth closed. She was beautiful, honestly. I might be linking emotions/spirituality with work too much again, but I felt like her peaceful expression was the Lord's way of letting me know she was happy and the right thing had been done.

Tuesday, March 8, 2011

One of Two

There were two experiences I had that made me really want to start this blog. They impacted me so much--not just my nursing, but me as a person. I wanted to write them where I could remember them. So here's one.
All our patients are different, of course. They all have their own stories, their own personalities, and even their own responses to treatment. However, they all kind of fall into "groups." Elder people whose bodies can't fight another infection, so they go septic; college age overdoses; middle-aged MIs; teenage DKAs; older people who get vascular surgery (and for some reason almost always happen to be frequent drinkers who go into DTs while on our unit...). These are all so sad. I ache for all of them. But they start to blend together.
But in January I had one patient who totally stood out. She was a young girl, late twenties. She had been married 5-6 years and hadn't been able to have kids due to endometriosis. They had tried all kinds of infertility treatment, etc., with no results. Finally, they decided to try in-vitro. Her doctors strongly advised against it. But she wanted so much to have her own child and went ahead with it. After twenty-one very painful weeks of pregnancy, she came in to the ER bleeding. They admitted her for observation. A couple days later, her uterus ruptured. They took her to emergency surgery. She lost her baby and her uterus, and became septic. She came to our ICU on the ventilator and pressors, in an induced coma. I had her two days after. Right as I came on shift, lab called with more lab results--more infections found in her blood. We would have to change out all her IV lines, A-line, CVP, etc. and start a new regimen of antibiotics.
I had only been on my own for three weeks. I should have been terrified. But, for what seemed like the first time, I was so concerned and concentrated on the patient, I didn't have time to think about it. I just went to work, doing all I could.
The next two days were a blur--two of the busiest I've had. And emotional. Every time I told her story to a new doctor on the case or gave report to the new nurses, I cried. I couldn't help it.
But I think the reason I will never forget that patient is because of the feeling in the room. It was so wholesome. I spent a lot of time talking with her sweet, supportive husband. He would bring his IPOD and play hymns and christian music in her ears. He asked questions about her condition, but never questioned the outcome. Faith, I guess is what it was.
I also spent a lot of time talking to her grandma and her aunts (one of which is a housekeeper on our unit). They were everything you could hope for to support a girl who had gone through what she had. They were so supportive--listening and staying by the bedside for hours and hours. Crying, but laughing, too. And lots of praying. And every time I left the room they would say to me, "Thank you, Mija."
When I came home the second night of being her nurse, I thought for the first time about how tired I was and how inadequate I must have been for the job. But it didn't hit me until then. I spent the rest of the day just caught up in the hope the family carried with them.
Maybe this all sounds cheesy. Maybe I interlock emotions, spiritual things, and work too much. But it was a testimony builder to me of the Lord's support for those who are trying. I know the Spirit was there in that room all the time and gave it that wholesome, hopeful feeling. And I know--I knew it the whole time I took care of her--that the Lord knew exactly what she was going through and was going to pull her and her famliy through, as hard as it would be.
It's not often my testimony is built at work. It was in this case. I guess that's why I wanted so much to write about it.

As far as how she did, she stayed in a coma another few days, then was extubated and woke up. Those were the hardest days, according to the other nurses and the family. That was when it sunk in and she began mourning. She left our unit healing very well physically and starting therapy to work through her emotions. Her family was sad, but very hopeful as she began the process.

Friday, March 4, 2011

what makes long days durable

I sat down to enter doctors' orders into the computer yesterday only to find my computer screen upside down. I kind of tilted my head and tried to get my barrings, then heard snickering the next pod over. Our unit secretary (tied with one of the PCTs for the ultimate prankster) was peaking around the corner laughing at me. We spent the rest of the day laughing at doctors' reactions to the upside down screens as they sat down to check patients' charts. Our favorite was the one who turned the whole computer upside down. We're so lucky it didn't break!
P.S. In case you need this kind of entertainment where you work, just press control-alt-down arrow and see how confused your co-workers get. (and sorry--it only works on dell)

Wednesday, March 2, 2011

the "typical" day

0700: Report from night shift.
0800: assessment. I've given up on the head-to-toe thing. I'm a little ADD for that. I've resorted to "around the bed".
0900: meds. sounds so simple--and it should be! Yet it still takes me so much time. checking and rechecking the MAR. Drawing up the right doses, crushing the pills, getting another nurse to check my heparin/insulin/narc gtts, gathering the syringes/needles/infusion pumps/alcohol wipes/etc. etc. For two patients, it often takes me over an hour!
1000: turning patients. hopefully there's a tech available to help boost, check skin, clean surprises. trach care, dressing changes, bath, oral care, etc etc. The doctors are also coming in at this point. So, through the curtain comes "what was his potassium today? did we replace it? how long has the versed been off? where is the levo? has he had an echo done?" and through my mask and the curtain, as I'm packing sterile guaze between staples in the abdomen, "3.3 and yes. 4am--still no response to verbal stimuli. 8mcg--going down. i don't know." (I'm coming to terms with that last answer.  it's very often the sad but honest truth.)
1100: more doctors. more questions. more "i don't know"s. and more orders.
1130: assessment again.
1200: meds.
1300: entering the doctor's orders.
1400: I open my paperwork. aaahhhhhh! Seriously? all blank? maybe I'll go to lunch instead...
1430: back from lunch. open my paperwork. really? still blank. maybe I'll talk to my pod-partner for just a little bit...
1500: open my paperwork. Blank? I could have sworn I started something! I start scribbling....
1600: assessments again. last one. phew. and meds.
1700: more charting, and some late doctors straggling through.
1800: more meds. empty drains, I/Os, clear pumps, clean rooms, etc.
1900: night shift here! Report.
Mixed in with that is the q2 hr oral care/patient repositioning/restraint check, hourly vitals, the line for the pyxis, waiting for the facilities guy to come fix the pyxis after it's broken down for the 8th time today, answering family member's questions, helping my pod-mate with his/her patients, and the phone calls! oh the phone calls! and, what i didn't understand until I was a nurse, there's always the unofficial assessment. his heart-rate is up--why? should I call the doc? what meds can I give for that? he's not peeing as much as he was--why? she seems more confuse than before. I wonder what her paCO2 is. that's racing through my mind all the time...
even on easy days, I still feel pretty tired by the end!

my first day

Even though it's been six months, i think my first post should still be about my first day. This is an email I sent my parents the next day:
As for my job, my first day was kind of baptism by fire. The first thing the previous nurse said when giving us report was, "I can't believe this patient is still alive." And after report and assessing the patient, I couldn't believe he was either. Even in the middle of report his blood pressure dropped to 60/40, so we upped our norepinephrine until it we had maxed out the dosage. That meant he was maxed out on norepinephrine, vasopressin, and phenylephrine. As soon as report was over, we and the doctors explained to the family that the patient was not doing very well and that it would be wise to consider just comfort measures. However, they said if there was even the slightest chance of the patient living, they wanted to do everything possible. It was hard to be in on that conversation--understanding how much the family must hope for him to live, but seeing how unlikely that was. So, we knew in order to help him, we needed to get him started on continuous dialysis. But we didn't have a vas cath to do so. Our intensivist came to put another one in. About half way through putting in the vas cath, the patient's pressure started dropping again so we started a fourth pressor, epinephrine. That held for a bit. So we scrambled--my preceptor, Lourdes, was setting up the continuous dialysis while I got antibiotics (the patient was badly septic), diuretics, albumin, etc. going. In the midst of all this, he was holding his pressure 60/40, not ideal but we were ok with it. Then all the sudden, after not looking at the monitor for about fiveminutes, I looked and his pressure was 39/31, maxed out on every pressor we coould give. We got the doctor and the family there. Just as we were about to start the code, the family said they did not want compressions, just a "chemical code". So we began pushing bicarb and Ca gluconate. But the pressure kept dropping and we watched the heart rate go from 150's to 40's. Finally the doctor called it, it was done. The family broke down, Lourdes and I broke down, even the doctor had tears in his eyes. We had worked so hard all morning, just to see this! And to see the family have to watch him go in such a frantic, desperate way. It was really sad and really hard to watch. As a tech, I knew this happened, but I was always spread out over eight-sixteen different patients and wasn't as involved in each. So I was emotional. Then the rest of the family came in. One son was slightly handicapped. He came in and as soon as he saw his dad, he fainted and fell to the floor. Things turned frantic again, waking him up and making sure he was ok. He woke up and went hysterical, screaming and thrashing, etc. It, again, was hard to watch and be so close to that. I broke down again, and sobbed for a while. Not helpful to the family, I'm sure but I couldn't help it! Lourdes told me this was almost as bad as it gets and would probably be uphill from here for me. I was glad to hear that! We stayed with the family, trying to comfort them for another hour or so. Then had a couple of hours of paperwork and getting the patient to the mortuary. Finally, about 3:30 we had a break and caught some lunch. When we got back, we got two new post-op patients, one with a AAA, the other with a bile duct obstruction (he was the color of a squash). So we flew, getting them admitted and getting their pain under control. I went home so tired, physically, mentally and emotionally! I hope I build up some stamina for this! (The next day they blessed me with two telemetry patients, both awake, alert, pleasant and uncomplicated. I still was overwhelmed with how much I needed to learn, but it was a very nice break after the previous day!)

here we go...

This may be a crazy idea. After all, a good percentage of my days at work are spent charting what I've done. Why would I want to come home and chart more? But in my charting at work, I don't get to add the colorful, fun, important, or life-changing things. "pt alert and oriented"--I don't get to add that he laughed at all my jokes and gave me the confidence to get through the next twelve hours. "family at bedside"--I don't get to chart the stories they tell me about their family member: "my husband's parents put him in a shoebox to sleep for the first month of his life." "she was a swimsuit model forty years ago." (k--maybe that's not important, but definitely interesting, considering...)  And "femoral arterial line d/c'd, pressure until hemostasis achieved." I don't talk about how hard I pray the whole fifteen minutes I'm holding pressure that there isn't a huge hematoma underneath or retroperitonel bleeding and that they won't vagal down and that I won't pass out like I did that one time...
Anyway, this is going to be my own chart. I get to write what I want to write, not to protect my license in court, but to process the huge gamot of emotions I feel when I work.