Saturday, July 1, 2017

more walrus, last day on the island

 i suspected that was what would happen though i wasn't sure yet.  i think I'd gotten mentally prepared to not be too disappointed.  figured if i didn't play the game with the boat captain and return on this day it could be another week before he actually picked me up.  part of me worried that it was personal. he is not too keen it seems on the state controlling this place nor is he keen on the camera's being out there.  he was pretty outspoken. I'm sure my being an advocate for the just never know.
 enjoyed watching these walrus on flat rock. it was pretty active.  would i have enjoyed a few more days of sunshine out there...not sure.  from the cam it did look like i would have continued with pretty decent weather for a few more days.
 bloody tusks.
 all my nights of work this week were in the adult ICU.
 my first night i just never stopped.  kept anything really bad from happening which is always the goal but i ran from one room to the other and then back again.  crazy.  i did order food early on and it was brought to my desk but that was it.  never touched it and in the morning i just tossed it out, uneaten.
 most nights i really feel like my patients feel safe with me.  like i am liked by my patients.  that i even add some humor to their hell. that night. I'm sure the one guy wasn't happy with me.  i was trying to be patient with him.  always amazing....people focus on these things and try to control them . often it's stuff like their ice chips. as a nurse, in the crunch of it, i gotta focus on things like how high your heart rate is, you blood pressure, that you are on max of oxygenation and will probably end up intubated again.
 many don't see or even understand how ill they are or at risk.  he kept shaking his cup at me to let me know it was almost empty....demanding his refill.  most nights i am patient.  we are paid to be nice, but i was so busy i could feel myself being totally irritated.  in those situations i just am more quiet...better to just zip it than to say what is really on your mind in those moments.
 i did get through. the rest of the unit seemed pretty busy as well that night.
 i requested a change. my next two nights went much smoother. i suspect they would have been fine if i hadn't switched..the tube was back in the one guy and the other had a new ativan drip.
 we were laughing in our huddle before we headed out. sometimes there are shortages of certain meds or forms of meds.  i was all, if they ever have a shortage of ativan we may all just walk off the job.
 apparently a baby in UK has been on life support for the bulk of it's like...perhaps all of it's life.  this poor boy is 10 months old and has a rare disease and it appears he has a most devastating form of the DNA depletion disorder.  it's not really what it's made to be in some of the conservative coverage.  not sure what the European Court of Human Rights is exactly but it doesn't sound at all like the government is making the decision as it's reported.  the doctors have all said this poor child has no hope despite this thought of potential experimental treatment in the US.  it sounds from all the medical accounts and this counsel agrees that it would only prolong this poor baby's suffering.
 he is to be removed from life support and allowed to pass. this battles will get worse as medicine is quite capable of keeping even folks declared brain dead alive on machines.  this seems to be enough for some folks.
 we are born, we live and then we do die.  it is a part of life.  many, especially in our country seem hell bent of fixing death.  yes, death is tough, especially traumatic deaths and deaths of the young.  it seems so unfair.  it is unfair.  life is not always going to be fair or feel right.
 if  people can have faith in a God, they should also have faith that their God has a plan and that death is included in that plan.  that things maybe happen for a reason.  that we are here on this earth to experience and learn certain things.
 i think one of those things we are supposed to be learning is compassion.  we are supposed to learn to let go of loved ones and allow them to move on to what is to come next for us all after we pass.
 on a purely practical note it's always so odd to me that those who do not feel health care is an entitlement for all of our citizens because health care is expensive and why should tax payers have to foot that bill. we don't have all that money for that..yet, often those are the same folks who would have people remain on life support beyond any reasonable quality of life.  it is expensive to keep people alive...for each case like this adds up quickly in costs, especially in this nation.
 i work in these units, i take care of these people.  i see death.  I've seen some deaths that were planned for, accepted.  where families seemed to be able to make these decisions with kindness, honesty and even an element of practicality.  some are just better at this.  not sure if it has to deal with their religious convictions, whatever they are, or if just some people cope better with end of life issues.  i can tell sometimes having a good palliative care team can help people come to terms with what they are facing.  some people never seem to though and that makes it all so much more stressful on all of them.
 i think that poor child that was declared brain dead after a tonsillectomy in CA is still being kept going on machines.  at great costs, but more i think where is the kindness and the compassion for your family member in this situation.  each situation is different but at some point i have to wonder if part of all of our own "tests" as it were, has to do with how we do handle these sort of situations with our loved ones.  do we keep our family/friend alive because we can't bear to lose them?  or do we allow them the dignity in the inevitable death that we all deserve.   in some of these cases I've seen myself or read about...i have to wonder if when those family members pass themselves they may be surprised to be met at the pearly gates with God saying, "what the hell were you thinking?".
 it's not death panels, though the same who claimed the government was going to be holding death panels don't seem to concerned with gutting medicaid, which ultimately will be a sort of government/ death panel.  the insurance companies have been their own form of death panels in the years past.  refusing experimental meds, refusing to cover procedures or tests that would have found cancers earlier.
 I'd rather these decisions be brought back to the physicians and to palliative care specialists.  we need to have a healthier discussion and acceptance of death in our nation.  it has become a big reason why our health care costs are increasing.
 we have cases on a pretty regular basis....the family members refuse to allow compassionate withdraw.  these folks linger for weeks and months even.  can't say that they are suffering as much physically as i don't think many are capable of physical suffering...they are suffering the loss of dignity though.
 this story just posted on a friends page at the same time as we are dealing with yet another case.
 it's tough on staff as well.  taking care of someone who has no hope of survival for months...
 another good poking shot. love the poke pictures.  they don't seem to suffer at the hands of their fellow least not here when there are no female walrus around to compete for.
 it was raining this week.  it did take a break and i was able to finally get my windshield repaired.  so nice.  people have been complaining that we've had a rainy summer. i hadn't noticed i guess.
 seems it's always stopped when i head out for a walk or it's at least just a drizzle
 the same happened today.  we did the airstrip. lots of bear scat out on the trails. i was out there and i got a text from a friend.  they were just headed on the trail and were asking me how to get to the airstrip as they weren't sure they remembered right.  i was all, "did you pass the outhouse?", "yes", "how about the bear scat in the trail", "yes we just passed that"  then i said, "okay so you just go past the bear scat and then take the next left and that will get you to the airstrip".
 giving trail directions with bear scat included made me laugh. only in Alaska would you do that.  haha.  did see some tracks later.   i also saw a porcupine that came out on the trail and wandered down the trail a bit.  thankfully, the pups did not see that.  they did see birds when we hit the creek so they ran up and down river chasing those birds.
 napped a bit when i did get home again after running a few errands. need to get some stuff accomplished tomorrow and try to plan a little road trip with the pups. maybe Homer with a stop coming and going to peek in on Nugget.
 the pups love beach time.
 the airstrip today was covered with these tall dandelions.  not really sure the name of the flowers but there were thousands of them. had to stop often and snap pics of the pups and i in all those flowers.  so pretty.
 i think we all are a bit on edge with the bear activity this year.  i try and remind myself that stuff does seem to come in waves.  I'm sure if you ask more folks in the hospital they would agree. i can totally remember summers with various common themes of accidents/injuries.  one year we had lots of small plane wrecks with survivors.  another year it was moose/car encounters, then there was a motorcycle year, bear year and now another bear year. there was also a year that it seemed everyone was falling on the big mountain.  another year it may be ATV accidents.  in winters we may have one with several avalanche victims or snowmachine accidents....
 just like those full moon stories. we'd all agree there is more to it than just really can get crazier at the hospital during a full moon.
 don't think walrus are too concerned with a full moon though tides are impacted by the moon and so would be feedings I'm thinking.
 a little fox cruised by as i watched the walrus at flat rock.  he later headed down towards beach at boat cove.  after eggs or something I'm sure.  
 he's spotted me here for sure.
 while i was napping/resting this afternoon i watched a few episodes of "switched at birth" the one girl i kept thinking looked familiar then i realized she'd played Lukes daughter, April, on the Gilmore Girls.
 checked me out and now off he goes.
 the rest are from the first part of the drive from Anchorage to Glenallen as i headed to Kennicott.

 always beautiful and you feel obliged to stop and snap the same pics you did the last time you drove past..just so dang pretty.
 it's kind of occurring to me that Tuesday is the 4th.  i think i was originally thinking i was working the holiday and then i guess that isn't how i signed up. that may alter my Homer plans and all that as it may be totally packed down there.  maybe just try to get some longer hikes in.  I'll try and make some calls and see what is going on. Seward is a mad house on the 4th with the big trail race on Mt Marathon.
 sheep mountains above and lions head below.
 pretty scenes coming into view of the Matanuska Glacier

 the dandelions were looking pretty.  just lots of color
 maybe i should head north....
 a moose sighting.  he just crossed over.  they disappear into the brush so fast.  it's always amazing how these huge animals can be camouflaged so easily.
grateful for: A. co-worker support on crazy nights, even if it's mostly emotional  B.  being able to laugh at the insane parts of the job...the day shift has a poop spraying incident...too gross and a major clean up required.C.  my sweet puppies who snuggle with me and are so excited when i get home.  I'm in puppy love

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