Fighting the present moment –Dad’s transfusion

Last week I visited my family on the East coast for a pre-holiday visit to celebrate my niece’s birthday and visit my Dad in rehab, recovering from pneumonia and a new diagnosis of leukemia. He has become all too familiar with physical rehab centers as he approaches 80. I’m sure he doesn’t know who Amy Winehouse is, but he channels her lyrics on a regular basis.

Fortunately my four siblings are around to help care for my aging parents, with my brother at the helm coordinating the care. I was in town to help out. My sister and I attended a discharge-planning meeting with my Dad, in which the date of expected discharge was three weeks away.  This was met by an eye roll by my Dad – he wanted to hear the discharge date was now. Patience is not one of his strong suits.

I get it. I want things now too. We all do - material things, relationships, answers, outcomes met, things to change or things to stay the same. It is hard to embrace the uncertainty of not knowing. I wanted a medical provider to explain why my Dad’s hemoglobin of 6.9 went untreated for the last three days. I wanted one of the three medical providers (NP’s and MD)to be on site, rather than visiting just a few hours a day. I wanted cancer cells out of my Dad’s blood. I didn’t want to wait 8 hours in the ER to confirm his blood levels, type and match his blood and watch the blood drip ever so slowly over 4 hours. Sometimes the present moment is not what we want but it's what we've got.

Life is full of opportunities to see reality as it is and how we want it to be different than it is; Whether it is a car breaking down, ants invading your home, a failed relationship or a challenging health condition. Everything changes even if we try to force it to stay the same. We can either fight reality or attempt to make friends with it. Even our red blood cells get replaced every120 days. Nothing stays the same.

I watched my mind vacillate between contentment and wanting to be elsewhere. I had a wide open schedule with nowhere to go and I was psyched my Dad was getting new blood cells to oxygenate his muscles in rehab. We needed a bit of a boost to ambulate 125 feet to get him home and we needed every little red blood cell on our team.

While my dad napped, I did some reading. A watched pot never boils, nor does a watched blood transfusion. I longed for the days of gravity tubing so I could speed it up a wee bit. I’m used to transfusing blood rapidly on healthy young women experience a postpartum hemorrhage, so this four hour business felt like molasses. I realized how silly my thoughts were but this was my mind. We had an awesome nurse, my Dad got great care, he got every last drop of those energetic red blood cells and finally was ready for discharge from the emergency department. The nurse arranged for transportation back to rehab.

It was 10pm, the nurse announces that the ambulance will arrive in two hours. Yes, two hours. I should be home by midnight. This was turning into a 14 hour event.

Dad naturally met this with an eye roll. 

I settled back into the uncomfortable metal chair and watched a whole new set of thoughts.

Trauma Nursing to Traditional Chinese Medicine - meet Amy Petrarca

Amy Petrarca has been a registered nurse for 21 years.  She started her career on a Head & Neck/Thoracic unit at The Cleveland Clinic Foundation in 1993 before moving to Emergency Nursing in 1995, where she stayed for 18 years.  She left the ER briefly in 1996 to work in CVICU recovering CABG (coronary artery bypass graft) patients for two years.  She got great experience and learned something vital…that she is meant to be in the ER!

The nurses at Jackson Memorial Hospital in Miami generously mentored her during a difficult transition into the ER.  This gave her the foundation to be a travelling nurse, where she honed her skills to become a “seasoned nurse.”

 Amy unpacked her bags in San Francisco and settled in as a staff nurse at San Francisco General Hospital in the Trauma Center in 1999, where she stayed for 15 years.  Not only is she crazy enough to work in the heart of trauma, she actually embraced night shift. She chose to stay on night shift for the majority of her career!  It wasn’t until 2008 that she finally moved to the day shift.

Amy has spent over ten years studying Traditional Chinese Medicine and founded BiaoHealth in 2007.  In the ER, Amy learned that most of the patient visits were actually for chronic health complaints.  Although she loved the “true” emergencies, she wanted to experience a clinical setting that would actually be more suited to deal with patient’s long-term health issues – especially those people longing to engage with a provider who was personally dedicated to their health care journeys and outcomes.  Amy found that in private practice as an acupuncturist, she could accomplish these goals utilizing both Functional Medicine & Traditional Chinese Medicine, both of which promote getting to the root of the patient’s clinical problems before initiating a treatment strategy.

photo courtesy of fourseasons

photo courtesy of fourseasons

Check out what she does here: www.biaohealth.com

Here are some words of wisdom from Amy Petrarca.

Tell me your biggest pet peeves about nursing:  

The culture in every Emergency Department I’ve ever worked includes a real desire to bond with each other through unhealthy behaviors.  It is great to bond with each other -- but perpetuating this culture of “junk food” binging (with donuts, bagels, pizzas and cookies) is not healthy – and there are so many other ways to nurture healthy behaviors to cultivate friendship.

Tell me what you love most about nursing:

Being able to connect with a person (or their family) on an intimate and meaningful level from the beginning.  There is no “small talk”, only “REAL TALK.” Nursing gives me VIP access into the very gritty parts of people’s lives, allowing me to connect with them and advocate for them, often at the most challenging times in their lives.  Being a nurse is a privilege, a responsibility, and an honor that I will always be grateful for.

 What throws you off balance?

When I become SO attached to a particular event that happened at work; so engulfed in the trauma that it takes me hours or days to personally debrief or diffuse from the event. This would often manifest with hypersomnia, insomnia, or “ER” work dreams.

What brings you back into balance?

Talking with other nurses.  Other nurses are the only ones who REALLY understand this work and these stressors. I also need to get out of the city and into nature.  Being in nature is grounding and powerfully transformative for me to restore balance.

What advice do you have for new graduates?

Cultivate Intuition. Everyone has intuition.  We can listen to it or suppress it. DON’T dismiss your “gut” feelings about something.  You will be able to know when something “isn’t right” – or the patient “just doesn’t look right.”  Act on this!  You could save someone’s life.

Find a mentor. Choose a particular clinician that you would like to emulate and ask this person if they will mentor you.  Maybe this means that you meet for tea once a month and talk about how things are going; somebody you can count on as you navigate your early years in nursing.

Be patient. Accept your “newness,” be willing to learn, adopt an appropriate level of confidence.  What does this really mean?  You are new.  No one expects you to know everything!  In fact, if you are overly confident and already “know everything” – this is a major red flag for your peers, your charge nurse, and your manager.  Be comfortable with not knowing.  Practice saying, “I don’t know, but I will find out the answer.”  The first six to nine months as a new grad are the most challenging.  I think I cried every day for nine months at my first nursing job!