coffee Archives » The Thin White Line

Metaphorically and literally, we are crispy in California right now.

Last weekend was hot with crazy storms that set off a chain of many wildfires. Most of the fires have new types of names to symbolize this new catastrophic cause: “lightning complex” fires. Many lightning strikes hitting dried out & ready-to-ignite brush (it is wildfire season, after all) and then the small fires come together quickly, fueled by high winds, to form the larger “complexes.” I certainly wish I’d never had to learn that.

And back in the ICU, we are full of patients and short on nurses. For three of my regular shifts this week, I’ve been doing the work of 2 nurses (actually, more like 5– but that’s impossible so I focus on doing 2 and let the chips fall where they may). I’ve also worked extra shifts.

The amount of overtime I’ve seen people working is truly astonishing. In many ways, our team is really pulling together and doing the best we can with what we’ve got. This is what we’ve always done as nurses, and will continue to do. Even when it means no one gets a lunch break. Or the charge nurse is also the rapid response nurse is also the code blue nurse is also the break nurse is also the resource nurse….

You know what gets us through? Laughter! And kindness. I always end my shift huddles during times of high stress by reminding everyone to help their neighbors and be kind…

You know what else helps? Food and beverages! We order boba, pizza, fried chicken, sandwiches, Thai food… and if the coffee runs out? Omg, a national disaster!

It’s Sunday morning now. I’m preparing for a new week by washing my scrubs, washing and chopping my face work snacks: celery carrots and apples. If they’re not precut, I won’t be eating them… I made three sandwiches for three nights of work, and I ground some coffee beans to take with me tonight!

I have my go bag packed, in case I have to evacuate because of a fire. Last year, one jumped a body of water near a bridge (the wind carried it) and came within a few miles of my house. I pack for work the same way, like everyday is a small disaster— scrub cap, face masks, stethoscope, food and water supplies. Today the main difference is that the smell of fire and the poor air quality is here to remind us that emergencies will continue to occur— now we just have COVID too.

It took me a whole extra day to recover from my three night shifts this week. And, no, I’m not being sarcastic. I usually sleep for the greater part of 24 hours after three 12+ hours nights in a row because you only ever get to sleep about 5, maybe 6 hours, in between if you’re lucky— and nursing is just a physically and emotionally exhausting job. This week, though, it was more like 48 hours.

Covid19 patients are back in force, and just like the news reports say, it is mostly young people this time around. Don’t let your guard down!!! This is not over, everyone! There is no safe place to just take off your mask and relax, maybe not even at home, depending on what your “housemates” are up to….

This week, a colleague had her last day. She’s moving back to the east coast and I’m going to miss her like crazy! We’ve been wishing her goodbye in crazy ways for weeks now— because you get really close to your workmates when it feels like you’re at war together. Sunday night was Filet o’ Fish night. I can’t even explain the in joke really, just that there were piles of sandwiches and lots of hilarious fish jokes to be had.

We were all pretty surprised that McD’s fish is hand caught, lol

Monday night was like an old fashioned flogging. One admission after another. And the patients just got sicker and sicker. It took all night, and more, to stabilize a patient who came out of the OR (operating room) with a new liver but also possibly no blood in his body. We used a rapid infuser to push nearly 40 units of combined blood products into him in 2 hours while starting dialysis to correct his metabolic acidosis, drawing labs every 30 minutes, and then identifying the source of his bleeding—- preexisting esophageal varices (which bled nearly 4 liters once we put in a tube to suction his stomach!). And so, I had a “first” in the ICU— hard to do after more than a dozen years. We put a Minnesota tube in a fresh liver transplant patient. If you’ve never had the luxury of working with a Minnesota tube, it’s like an octopus you wrangle down someone’s throat and then inflate the head and one leg to put pressure on bleeding areas of the upper stomach and esophagus. It’s a hot mess.

Ok, it doesn’t really look like an octopus… but it’s red and slimy when covered in lube and ready to insert!

When I got back Tuesday night, my Last night for the week, I was happy to find our liver patient doing well. He was still critically ill, but it looked like the liver had started to function— so he had stopped bleeding. As we like to joke in the hospital, we blamed all his problems squarely on the anesthesiologist for “under rescuitating” the patient during surgery. Of course, the course of a surgery, especially a transplant, is much more complicated than that…. but we like to joke about someone being to blame and since anesthesia is never there to defend themselves…. hahaha oh. I may have even said we should make an anesthesiologist voodoo doll. Is thus taking it too far? Hmm, seems memeworthy to me!

When it’s my last night, I need extra coffee. Extra to wake up, extra to keep going at midnight, and extra for the ride home. There is literally nothing I love more than coffee. Luckily, we have a way of showing each other the love at work by making coffee and sharing a little love note by the coffee machine too. Keeps us going!