Happy dog.

 

We spent the day at beaches.  It was really foggy in the morning but burned off as the day progressed.  Miles of beach, literally.

 

Poor Lucy's back is acting up and no vet available.   I checked online and gave her baby aspirin.  Hopefully that will take care of the pain and inflammation.   She has spinal spondylitis from damage done during her hunting years.

I saw the news from Kabul and wept.  Jesus,  it never ends and it breaks my heart.  The real world exists even here.

We made it to Ucluelet and it's lovely.  We took the dogs for a walk on the beach.  Heidi has never seen the ocean.

I'm feeling much less tired and stressed which feels good.  I read an excellent book on the way here.  "Professor Chandra Follows His Bliss".  Loved it. 

I have four more books to read and hopefully all of those books are equally as good.

We had supper with my sister and her husband last night whom we haven't seen in two or three years.  My sister is shrinking.  She must only be five feet tall now.  I always forget how odd she is until I see her again.  She has a brain injury and never stops talking, ever.  She's a good person though.

Five days in paradise.

 Kamloops Lake.

We made it to Cache Creek without seeing any fires.  In fact it's been raining since we left home, which is good.

The big guy tripped on some stairs this morning in the dark and has hurt his knee which is painful but nothing broken. 

I'm enjoying our time away and I'm consciously working on not complaining.   I think before I speak.  I feel better too.  Yay for me.

 I start holidays tomorrow.  No Katie, no Jack, no work.  Tonight my employer invoked emergency work rules for nurses in the province which means nurses can be called back from vacations.

Alberta's nurses may soon be forced to work mandatory overtime and cancel holidays in response to a chronic staffing problem worsened by surging COVID-19 hospitalizations.

Alberta Health Services notified the United Nurses of Alberta in an email today that it was invoking a clause in their collective agreement that allows AHS, in an unforeseen emergency, to impose longer work days and direct nurses to other hospitals in order to address staffing gaps.

Fucking hell.  I'm not answering my phone.

Another one of my photos, transformed.  I quite like it.  I wish I could paint and perhaps one day I will, but until then I can use Corel.  

Covid cases are continuing to rise in Alberta, thanks to our useless premier.  He likes to blather on about rights and freedoms but makes no mention and doesn't seem to understand responibilities or obligations.  He is a waste of skin in my opinion and an embarassment to Alberta.  He is widely disliked by both conservatives and liberals, quite a feat in itself.

Work is busy.  One of my coworkers, the one who drives me crazy, has carpal tunnel syndrome and has been off all summer which has been nice for her but means that we work short often.  This woman has no credibility though and nobody believes she actually has carpal tunnel syndrome.  She often takes long periods of time off or calls in sick as revenge.  She booked off sick when her church moved and she couldn't get the time off.  There is history there.  The upside is that she's not at work so nobody is irritable or pissed off.  She has that effect on people.  We're all working well together.

The nurses in Alberta are being asked to take a 3% pay cut which is offensive.  Young nurses are leaving the province or the profession and there will be a shortage of nurses in the near future, thanks to no long term planning by our provincial government, see above.  Nurses have been working short for the last eighteen months, stressed out about Covid and generally overloaded.  Now summer vacations are being denied because of self induced nursing shortages by our employer.  

The nurses in my department have an amazing manager though and she realizes that we will break without vacations so she has moved heaven and earth to make them happen.  The big guy and I leave on vacation on Sunday and as I said to someone, I am almost giddy with the idea of no responsibilites and no obligations.  Gracie and her mother will have to sort out childcare for Jack, or in other words, be adults.

Gracie is struggling again, or still.  It's hard to keep up.  She works nights and it makes her tired.  Shocking, I know.  I worked nights for years because of a lack of childcare and was tired for years.  Tuesday at supper time, just as we were going to sit down, the daycare called to say that Jack had not been picked up by Gracie.  The big guy went to get him and we fed him supper.  Gracie called and said that she hadn't woken up.  Jack was supposed to stay with us anyway that night so we just kept him.

Last night we picked up Jack on the way home from work because we hadn't heard from Gracie.  She texted me later and said she had just woken up and would come get him.  So I fed Jack supper and we waited.  When she did come over she looked awful and seemed dazed.  The big guy told her that we would keep Jack again last night and she went back home to sleep.  Hopefully this afternoon she will be awake to care for her son.

I'm not sure what's going to happen while we're gone but she will have to deal with it.  Jack wants to spend less and less time with her as he grows up which I'm sure must be heartbreaking but can you blame him?  

I'm spending my day off running errands, cleaning and getting things ready for our trip.  We going to heaven, or Ucluelet as most people call it.  Five days and nights spent on the beach and roaming through the rain forest.  Many photos will be taken and there will be many long walks.  The dogs will be tired and the big guy and I will get our batteries recharged thanks to mother nature.

My husband installed a new photo editing program on my computer which comes with perks like this.  I think I'm going to like this a great deal.

My first patient died when I was a student.  I was twenty-three years old and I had never seen a dying person.  I knew how unprepared I was, knew that I had nothing to offer my dying patient, no experience, no empathy even because I was young.  What the hell did I know about dying?

I don't remember how that patient died but I know it was on the same unit my father died years later.  Since then I have had many, many patients die.  Makes me sound like an awful nurse but it's reality.  People die.  Nurses take care of them as they're dying and after they die.

One of my patients was named Laura.  She was an elderly lady who died in the 1980s.  Nobody ever came to visit her and when she died there was nobody to pick up her things.  I took her African violet home after she died, which somebody must have bought her, and I kept that violet for years.  It always reminded me of her.  

On that same unit, I had a patient die and then we coded her.  She was a woman with breast cancer who had never seen a doctor, never received any treatment and she had not told her family until she had been admitted.  She died two days later;  the cancer had spread everywhere.  I remember there was a lot of blood, they had done a cut down to get a line into her.  There was garbage all over the floor.  Her family waited in the hallway while the code team worked on her.  There was probably fifteen or twenty people in the room and one doctor in charge, loudly calling out instructions.  When the code was called and they stopped compressions, the patient still had agonal respirations;  I didn't even know what those were, had never seen them.  It was horrific and I have hated codes ever since.  

I've found patients dead in their beds, dead in the toilet, one patient died while in the elevator on a stretcher.  I've watched them take their last breaths, held their hands, comforted their families and been yelled at by their families.  I've given morphine to patients, knowing it will be their last dose and turned patients early on an evening shift because I knew they would die when they were turned and the fluids in their body shifted;  that particular patient was four hundred pounds and there was no way nights could move his body on their own, so we did it while evening shift was still there to help.

I have washed bodies after patients have died, put beds flat so that the patient won't end up in a strange position when rigor mortis set in ( I learned that one the hard way), wrapped patients in shrouds,  attached toe tags and taken patients to the morgue at all hours of the day and night.  I've packed up belongings, called families and cried.

I've done all of this for the past thirty-five years and never once has my grief been acknowledged by management or even by myself.  I carry all of my dead patients with me, still;  working in a cancer hospital has only increased the number of dead I carry with me.  I think back to ten years ago when I first started working at the cancer hospital and the majority of those patients are no longer living.  There is no memorial, no place for nurses to remember our dead, we carry them in our hearts.  Yesterday when my patient's father invited me to her memorial I cried and realized how many dead there are around us, how many we carry with us. 

Perhaps nurses need to find a way to honour our dead.

My father in law remains in the hospital;  he's been there for a week now.  He keeps having periods of syncope or fainting.  They don't know what's causing it but I'm guessing that's why he fell.  I'm also guessing that it's his heart acting up.  We'll know more tomorrow when he goes for an echo of his heart.

Work has been busy, as always.  We were short staffed today but even though we had to run our assess off, everything went smoothly.  One of my patients died at the beginning of June.  I was fortunate enough to see her before she died and I gave her a big hug and said goodbye to her.  Her father was in today, he's also a patient, and he invited me to her memorial service in September.  I thanked him and told him that I would try to make it.

I'm off tomorrow.  A friend is coming over for tea.  Jack will go to daycare.  I will cut the grass and do the laundry.  In a little over a week we leave on vacation and I am thankful.  Two weeks with no obligations.

We had Jack last night and took him with us when we went to visit Katie.  And I'm so tired and just have no energy.  The visit didn't go well.  Both Katie and I ended up crying, Jack looked surprised and the big guy protected me from Katie pulling my hair while I drove her home.  Fortunately she didn't open up her door until we were at a stop sign, in her neighborhood.  It might not have gone so well if she'd opened it up on the freeway.

It's not working.  We can take care of Jack or we can take care of Katie but we can't do both, not even with two adults.  I'm exhausted and have to go back to work tomorrow.  The weekends are no longer a time to recharge and Gracie's parents don't want to help out with the little guy which makes me feel resentful.  My ex-husband has only visited Katie once in the last fifteen months and he just let me know he won't be coming again for awhile.  He used to visit Katie every other weekend which gave us a break but that's gone.

Right now I've got nothing left.  Tomorrow will be better.  A good sleep will help but changes will have to be made.  We can't keep doing this.

I had time to take photos last night which I haven't done in awhile, taken the time, that is.  I forget how much I enjoy it until I'm doing it again.  I took my camera and tripod out to the back yard and took photos of flowers.  I was tired as hell when I went out there but no nearly so tired when I came back in.

We picked Jack up from daycare and dropped him off at his mama's on the way home.  He was not happy.  He cried and he wanted his poppa.  Gracie's nose was out of joint because she's his mama and as she said, "I give you everything."  What she doesn't give him though is her attention, which is what he wants most and what his poppa gives him.  She doesn't get that.  Jack is happy at our house.  There's no yelling, we eat at regular times, go to bed at regular times and it's peaceful, or as peaceful as a house with a two year old in it can be.  It's predictable and that's what children want.  I know it's what I want as well.  I don't like chaos.

A couple of days ago I had a patient come in with multiple myeloma.  He's been coming to us for years and his myeloma is spreading.  He has lesions on his skull which he was showing me and it's done something to his right eye which he can no longer open.  I thought, oh fuck, multpile myeloma is showing me something new.  It's not a common type of cancer, even though we see a lot of it, so it can still show me new ways of destroying a person's body and life.
 

The top image is what a skull with bone lesions looks like.  The next image is what the bone should look like.

My good friend has multiple myeloma, or my loma as she calls it, because she won't call it cancer.  I called her on the weekend and she sounded awful.  She's been sick and in bed, coughing, sore throat, congested but no fever.  She didn't get a covid test so maybe it was that, or just a really nasty cold.  Her husband is useless when it comes to caring for sick people and she said she realized she'll have to make arrangements for someone to take care of her when she relapses, when her myeloma comes back with a vengance (that last bit is my thought, not hers).  She knows she will relapse, that the stem cell transplant and the chemo she takes have only beaten it into remission, that it's not a cure.  But that was the first time she's ever said that to me and it caught me by surprise.  And then my patient came in and showed me more of what multpile myeloma can do and it felt like a sucker punch.

Last night after work I went to the hardward store to pick up some wooden dowels.  I ran into a patient's wife who works there.  She's such a lovely lady and her husband has been coming to us for years as well.  He's getting worse and I don't imagine he has much time left.  In the last year the cancer has spread to his brain and he's been on a clinical trial which is a last ditch effort to find something that may help.  The clinical trial didn't work as it sounds like it's spread to his liver too.  He's going for a CT scan today and she wanted to know if I would be there.  I make him smile apparently.  I give him a hard time is what I do;  he reminds me of an older biker dude and he has a good sense of humor.  She told me that she's going off on leave to take care of him for the time he has left.  I gave her a big hug before I left the store;  we both had tears in our eyes.  

We had Jack for four nights last week.  After his mama picked him up yesterday, I missed him.  The house feels empty.  It's nice to have the house to ourselves again but I miss him too.  He's funny.  If I squeeze his nose and say beep, beep, he will say honk, honk.  If squeeze his nose and say honk, honk, he will say beep, beep.  On Friday night he played on the front lawn where I had set up the sprinkler to water my flowers.  He wanted to be naked but I explained the diaper had to stay on in the front yard.  And then an amulance drove by which made his night.  Yesterday he was tired and ended up riding in Katie's wheelchair for a bit which amused both of them.  Katie is starting to get used to him coming with us on our outings.  She prefers to be the center of attention but she's coping.

We drove down to Westaskiwin today after my mother in law called.  Apparently yesterday my father in law had a bad fall.  He knocked himself unconscious, ended up in emergency, and needed stitches and bandages.  He's on a blood thinner for atrial fib so I imagine there was a lot of blood involved.  Then last night he took another funny turn while sitting on the edge of his bed so the paramedics were called again but he declined to go to the hospital.

He looked beat up when we arrived but not as bad as I thought he would be.  He was chatty and making jokes.  He's eighty-seven and I imagine he is coming close to the end of his life.  The last year of life, no matter your age, seems to follow the same path, a downward spiral that becomes more and more impossible to recover from.  He's diabetic.  He's falling.  He's got atrial fib and left branch bundle block.  He's on blood thinners which is just a whole other thing that is bad and often necessary for elderly people.  He's got prostrate problems and incontinence now.

I like my father in law.  He says what he thinks.  I don't always agree with him but he's not stupid and he's pretty easy going.  He also has a very good sense of humor.

My mother in law was having a hard time today.  She's bossy at the best of times and last night she thought her husband of sixty-one years had died, twice, in one day.  She wants to control everything (why does that sound so familiar?) but she can't.  It's hard watching someone you love, someone you've spent pretty much your entire life with, decline.