In a quest to prove that I have a life outside of nursing, there's a new catchphrase..."nursing, it's not just a job, it's a lifestyle!" Too pretentious? Maybe a bit. Anyways in pursuit of that goal, I have been getting on my bike and riding. Nothing clears the smell of poop and yeasty nether regions better than a spin though a polluted urban core. Mmmmmm, smog.
Being the altruistic guy I am, also figuring I could do the ride for free and get a free T-Shirt (note the theme here...), I signed up to be a medical rider. Really all I was to be was a quick triage nurse, maybe a fixer of minor issues, but for anything major I was to call EMS. No heroics. It was a leisurely jaunt through urban Portland on what is usually and historically one of the hottest days of the year here in Stumptown. Not this year.
I got off the MAX in the morning and it was drizzling. Nothing to even worry about, just that damp haze of a fall morning here in the Northwest. But it was chilly, for summer. Got all settled in, picked up my fancy traffic vest and free t-shirt and headed back towards the back of the staging area. In front were the 40 milers, who were the usual group of hammerheads and folks who believe spandex is a fashion statement. Not us in the back. We were the cruisers. Families, folks hauling trail-a-bikes and kid trailers. We were there to have fun. Which I sure did. Were my medical skills needed? Nope. Only saw an issue once and it was all taken care of by the time I got there. I put my mechanical skills to work, once again wishing for the fable 3rd arm I was supposed to have been issued after nursing school. But that was it. No crises. Never had to call EMS. Never really got out of breath. All in all a fun ride. Even had a free sundae after the ride. How can you beat that? It was too early to grab a pint, so a sundae was the best I could do.
The funny thing is the difference 10-15 years can make on an area. Even though I had spent time in the neighborhoods we rode through before I left town for nursing school, I didn't realize how much of a change had overtaken some of the areas. It can only be described as the inexorable advancement of "progress", or as some will call it, gentrification. I earned my first degree in the middle of the 'hood. Right around where the ride took us. We had drive-by's and stabbings on the nearby blocks all through school. I regularly rode my bike through these neighborhoods, quickly. I got hollered at. I had to high-tail it a couple of times. Saw drug deals, hooker deals, stolen cars, knew the local crack houses (by reputation only!), it was not a great place. But it had a soul, a certain life to it. There was a bright side tot he darkness.
Now approx. 12 years later, it has changed. There has been an influx of folks snatching up the houses whose prices were depressed by the rampant criminal nature of the area and slowly changing the character of the area. The park where you could not walk at night and folks lit up crack in broad daylight in the benches now has families playing there. It's a different 'hood. Folks are more likely to roll the Prius than an Impala. It felt kind of weird being back there. The flavor has changed, but maybe not totally for the better. What happens to the folks that had traditionally lived there? Sure the bad element was pretty overpowering, but mostly they were good folks. I know they've been driven out due to rising housing costs that come along with gentrification. I understand that this happens in urban cores, but it made me feel bed for the vibrant community that had been displaced. But it was nice to be back. It was nice to ride on a grid versus the winding mayhem of suburban hell. I felt right at home. It also made me realize I need to move back there, suburban living is bad for my soul.
I have another couple of posts brewing...I just have to re-read and edit them until I'm happy. Til' later...
Nope you don't have shingles. Hope you don't have what this guy has!
About a week and a half ago, over at BikePortland.org, I saw a blurb about mountain bike short track racing. After reading and watching the videos, I said, "That looks like a blast. Maybe I should give it a shot." So Monday was my very first mountain bike race, of any kind (unless you count racing traffic to the next light). But first a little background.
I've been biking in one form or another for years. My involvement has waxed and waned as did my time. When I had no time, I didn't ride. When I had time I did. Then I moved to Flagstaff, Arizona. For those who haven't been there, Flagstaff is a near mecca for mountain biking. Plenty of trails, great weather, close proximity to places like Moab and great riding all over the West. I never rode. Granted, this was during nursing school where a little recreational riding would have done me a lot of good, for both stress relief and to start dropping the weight I had earned flying a desk for 4 years. But I didn't ride until the last summer I was there. Even then, I didn't ride much. After moving up here to the NW, I figured I would have time to ride. I did. But more it became transportation. A discount transit pass provided by work was a far cheaper alternative to $3/gallon gas, with a little bit of exercise thrown in for good measure. Unfortunately my off-road riding has been limited to very few dirt tracks I have found locally, nothing more really than shortcuts through fields. Not at all real mountain biking. But I figured I had a built a pretty good base fitness to at least give the race a try.
Yeah, right. Who was I kidding?
I got there on a balmy Monday afternoon with wife and MIL in tow. From the start I was surrounded in a sea of spandex. Nothing says "fashion" like glaringly gaudy neon colored spandex outfits. I nearly went blind before the race even began. Not me though. I was a little more "blue-collar". Granted, I had spandex bike shorts on. Underneath my baggy shorts. I'm not letting that freak flag fly, nobody needs to see that.
So I paid the entry fee and went out to pre-ride the track. Around the second turn hit a unseen divot, launched off the seat and jammed my crotch, just a little north and east of the jewels. Except for damaged pride, nothing to worry too much about. I thought, "At least I got a crash out of the way early." But thanks to the wonderful efficiency of public transit I only had about10 minutes to see the track, not a lot of time. So I headed to the starting line. The gun went off I started quite possibly the most painful 20 minutes of my life.
I didn't hurl. Thought I was going to. I didn't crash. I didn't pass anyone. Everyone passed me. I thought about dropping out. But I didn't. I made it through the 3 laps that my class (beginners...they didn't have a fat ass class) ran. I was the last off the track. In fact, they nearly had to shoo me off so that the next class of racers could think about getting going. The course was great. I had a blast. But I learned a couple of things.
- Get there early to pre-ride. That way you can scope where you can puke and no one will see. Also, it helps to crash early, thereby getting it out of the way.
- Train for the race. You go all out for 20 minutes or more. If you're not used to that, it becomes a very painful experience.
- Line up near the front of the group. If you don't, when you start you end up sucking down everyone's dust. I spent the next 12 hours post-race hacking and coughing like and asthmatic COPD'er with black lung.
- Realize that you will get passed. I got passed by everyone, including the 7 year old it seemed like. I even think some passed me twice.
- Have Fun!
I ain't racing if you ain't bleeding. Nice farmer's tan, huh?No fooling. My desktop widget shows 91 degrees outside. I moved from Arizona a year ago and I still think this sucks. Yesterday we hit over 100 and it isn't even August yet. And they say global warming ain't real...
I'm just glad I'm off. I've been biking and using public transit to get to work and not pay $3+ a gallon for gas. Only problem is that I get hot, sweaty, sticky and stinky on the way, so when I get to work I smell just like many of my patients. Shadowfax over at Movin' Meat had this post about cycling. I feel his pain. Thinking about moving to the Midwest to get away from them. Ok, not really.
Funny though, since I've started this bicycle commuting thing in April, I've only driven to work twice. Not that I've lost any weight though. But my blood pressure is better. At least until I hit the floor...
A while ago GruntDoc had a great post about "The End of the Code" wherein he describes his actions as a team leader in the midst of a code. IT shows the true meaning of leadership. Luckily on my floor, the codes are usually quick, the patient well on their way to the Unit before most interventions can occur. One of the charge nurses said basically, "get a rhythm, get an airway and get off my floor." We neither equipped nor truly capable of handling complex interventions unless completely necessary. No thoracotomies, invasive monitoring lines, transvenous pacing (all of which have been done...) on our floor, the Unit is much more suitable for this kind of heroics. This is not to say that we won't in the emerging situation, but the reality is that we need them off the floor and down to the Unit quick.
The other night I had my first real code. Not a Rapid Response. A Code. Dude was dead. Wasn't my patient though. Here's how it went down:
We were all hanging around the nurse's station, in that twilight time of 0500, early AM vitals were done, folks were just starting to wake up. The monitor starts the high-pitched binging of a life-threatening alert. Look and see the patient in V-Fib. As we head down the hall, we hear that it's back in sinus rhythm and the pacer had taken back over. So the nurse heads in, starts checking the patient out. I'm almost back to the station when I hear frantic yelling from the end of the hall and that binging again. "I need the cart!" She hollered. I'm closest to the code cart and run for it. Mind you, our unit is big, it's nearly and quarter mile round trip from end to end. I've never made the trip so fast in my life. Hauling ass down the hallway to the very end (yep, it's always the room furtherest away) with the code cart. Into the room, the patient is laying in bed, back arched, mouth agape like a recently caught fish, "oh sit" I said to myself. Then my mind went blank. All that time in ACLS, all that time in previous situations. Nothing. It was like those moments in the Matrix where time s l o w e d to a crawl, my mind was trying to remember what to do next. The arrival of the next nurse behind me shocked me back to reality. He jumped in to start CPR, I went looking for the ambu bag to get an airway. But it wasn't there. I thought, "Isn't it supposed to hanging from the outside? Wait a sec, I checked the cart myself this evening...was it there?" By that time more people were flowing in the room, breaking open the cart (where the bloody ambu bag was...) and getting things going. At this point I got out of the way. Let the pros take over. They shocked twice, after the second the patient came back yelling and cursing. Which all things considered was a good thing. Not soon after, with a rhythm and a patent airway, they went off the floor to the Unit.
After this though, amny realized that we needed more training. In spite of the nature of the floor, we don't do many codes. This was the first I had been in since I started back in December. Sure, we've had them, but not anywhere near me. So we're going to get mock codes and a chance to see inside the cart so we(me) don't freeze trying to figure out where things are. At least I learned one thing: Ambu bags are inside the cart.
Oh yeah, the patient? Was a frequent flyer and this was not the first time they'd coded. Ends up they came back tot eh floor 2 days after the code and went home a week later. Guess it wasn't their time.
Once again, thanks to Digg for an insightful (I know Digg and insightful rarely appear in the same sentence, but sometimes the less puerile part of the community comes out on top) and somewhat enlightening article. Titled "What's Up Docs" it digs a little deeper into the lives and psyches of some docs currently practicing. My favorite part comes at the end where in a poll of 50 nurses, in speaking about arrogance and doctors, it came across that surgeons were the most arrogant of the lot. Not saying anything here. Just found it entertaining.
Over at Musings of a Highly Trained Monkey, she points out this gem of an article about a group of folks I had a little exposure when in nursing school. A little background here. Basically, Colorado City in Northern Arizona and its counterpart, Hilldale across the border in Utah, are the refuge of the Fundamental Church of Jesus of Latter Day Saints - in other words a fundie group of Mormons. They engage in polygamy, child rape/molestation through the marriage of extremely young girls (like 14 years old) to older men, and among other things they control the entire town. The whole place is owned by them. Not outsiders allowed. In effect they are a law and community unto themselves. The interesting thing is the stagnation in the gene pool which the article focuses on. Through rampant interbreeding and crossing of genetic lines, they continue to pass on genetic defects with alarming regularity. Again, not saying anything here. Just found it interesting.
Thanks to Suicidal Tendencies for the title...
Went shopping with my wife the other day (yes, besides work and sleep, I try to find time to do normal human things) and like always there are plenty of people on their Bluetooth headsets. You know the kind, talking to themselves and carrying on a loud conversation at the same time. You have to stop and wonder, "Are they altered? Schizo?" No, just inconsiderate.
I read this article ,via Digg the other day and was met with the news that now it is going to be even easier to link up Bluetooth devices. Yes, there are good things for this...maybe even some that apply to the health care environment. Like vital sign machines that transmit data directly to the computer chart without wires and without the interference of us worn out nurses, or that send the data that a lab has been collected instead of replying to the docs that, "Well, I saw phlebotomy here...they were in the room, so I have to assume they drew the AM Labs, they'll probably be up in a couple of minutes."
I try to remain positive, but I really know that what it means is more people on headsets, talking out loud to apparently no one in particular. I'm just going to have to try harder to not answer them so much...
