We all have some phrases, chain of words, or saying that just makes our hair stand on end, our heart beat raise a bit, and our mouths get dry. These are the dreaded things we must say at times to move on in life.
I have had six words that I knew I would have to speak soon, and I also knew the time was coming much faster than I pictured it; yet two decades ago when I became a nurse, I never thought I would have to say the phrase.
"I Have To Go On Disability." I made this choice, no one forced me, (although I feel that my back and the pain has forced me, for I have no other road to go down), yet it was a phrase I truly did not want to ever really have to utter.
This is changing my life completely. Not just immense financial issues, but the fact that I have to leave my patients. Although I was having trouble working, I never expected the rise in pain over the past year. It has been exponential. I adored my nursing jobs, whatever they may have been, and I adore my patients.
It was the Hospice patients in the two companies I did Hospice work for, that had grabbed my heart and never let go. I had found my niche. Where I belonged. I was one of those nurses that could say, "I understand", regarding your loved one being on Hospice, for both mom and dad died on Hospice, and I was the main caregiver for both of them. I stopped mid 2nd semester of school to further my nursing career, to take care of my strapping, strong 6 ft. 4 in. dad, that became a little patient, right in front of my eyes over a 2 month period. It all went so fast.
My dad, who won the body surfing championship in 1992. The dad that was the Senior Division Triathlon winner in Orange County. Hit the gym 3-4 times a week for hours. Ate the 'perfect' foods, and especially, didn't eat certain foods. So all that great food, and depriving himself of his old favorites, and keeping his body in awesome shape at 63, had no chance over the genetic power of Colon Cancer straight from his mom.
My professors were very empathetic, yet I could not keep any of the work or test scores from my 4.0 hard work of 1 1/2 semesters. I just wanted to help my father, the way he had helped me. Ah, life. Begins and ends. A circle that never stops. We played 'The Circle of Life' by Elton John at his funeral, (along with Eric Clapton's: 'Tears In Heaven'), to a packed church that stunned me, at how many people my father's life had touched. This was one year before my first surgery and one year before the pain started in seriously. I have been an 'adult orphan' for years now.
So, I have left nursing. I am a Disabled nurse now, and I suppose the correct term is 'Retired nurse', or how about 'Retired Disabled Nurse?' I just have trouble writing any of those words.
My life is so different now. I appreciate the little tiny things that I never paid that much attention to before. The bills keep on coming in. We all know that never stops. But the fear in me that I feel when I see them is new. I don't like this. But I knew I had no choice than to go on
Permanent Disability. My pain won. The battle is over.
Ironically, a new Showtime series called "Nurse Jackie", starring Edie Falco, had a preview showing on my free Satellite station last night, it is due to premier on Showtime tonight. I heard the intro, and it shocked me. I think that this show will bring up some heavy feelings in pain bloggers.
She said, "I am a nurse. And I have back pain. What is my choice..Unemployment?" And not to give the show away, but she then is shown taking all kinds of drugs throughout her shift, just to make it through the pain. Hmmm I'm not quite sure what I think of all that, but I will keep watching the show for now. It does give a very negative look at a nurse who is in pain. Why doesn't she go get an appointment with a Pain Management doctor? Why does she have to be shown illegally using meds that are supposed to be prescribed, not given from the doctor she 'knows' at the hospital, giving them both bad names? ***Will there ever be a show that chronicles the life of a nurse in pain that must stop nursing, and go through all the hoops and dances that have to be done, to be a self-sufficient 'disabled' nurse with back pain? I guess that doesn't make for such great TV.
"I Have To Go On Disability." There. I wrote and spoke it out loud again. Maybe the more I do so, the easier it will be to accept. My PM doc told me it is one of the hardest decisions for his patients to make, (I was in tears for days after I told him that was my final answer), and that I would soon feel a sense of acceptance of the entire decision. Along with that acceptance was to come that feeling of, "I did the right thing." THAT I know. That has been something I have needed to say for years, but I just kept pressing on. Leave nursing?? Me??
Yep. I have left. And now I am a Disabled and Retired Nurse. I hope that when I write my own life's happenings, there will be others who can relate. I have already met one online blogger who had to do the exact same as I have. Nurses have the largest percentage of back injuries of any occupation. But no 'injury' here. Just a back that is so messed up and in pain that it gives me no other choice. I will continue to write the posts that come from the view of a nurse; as once a nurse, always a nurse.
And I know in my heart, I did the right thing.
Saturday, May 30, 2009
Monday, May 25, 2009
Words To Use To Describe Your Pain
Sometimes, even for those of us that love words, love to write, or journal, or anything with words; may find ourselves at the doctor's office, with tongues that are still and silent.
A visit to our Pain Management doctor's office can be overwhelming. No matter how long it has been since the last visit, we know that each day has been unique, up and down even within that one day, and then to gather one month's worth of days into words to give our pain doctor that answer to the question(s)," How have you been feeling? How is your pain?", is a daunting task.
My answer to this problem has always been to keep a daily journal of each medication I take, when I took it, how long before the meds were effective on my pain, and I try to use words to describe that days pain. When It is time for my doctor's appointment, I look back over those daily entries, and not only bring it with me, but to keep time at it's most effective for the visit and not sit and flip through each page while sitting there with my doc, I prepare a page that describes that month's daily pages into one.
From this, I can tell doc how my pain has been, same, better, or worse, (general), and how long it takes for the medications to be effective-- helps us to know if the meds are prescribed correctly, the med itself, the mgs., or the time they are to be taken.
It is when the WORDS are needed to answer what the pain FEELS like that I scrape that daily med log for the words I wrote to describe my pain that day that really helps me to come up with something for the doc. I'm listing some words that describe pain for you, in case you need some words to consider for your next doctor visit.
Does your pain feel or have the sensation of:
Hot-- Cold-- Warmth-- Periods of these?
Piercing-- Piercing with any of the above?-- Does it spread or stay in one place?
Deep-- Surface-- Pounding-- Seems to go with heartbeat?
Grinding-- Bone against bone-- Pulling-- If any of these, what are you doing, (if anything)?
Muscle-Involved-- Pulled muscle-- Tendon/Ligament-involved......
Squeezing-- Like a hand is inside squeezing area-- Twisting.....
Constant-- Intermittent-- Consistent-- Relentless.....
That's a start to help you pull some words if you are at a loss, or possible give you a new one to describe your pain.
I hope this helps.
Gentle Hugs!!!
A visit to our Pain Management doctor's office can be overwhelming. No matter how long it has been since the last visit, we know that each day has been unique, up and down even within that one day, and then to gather one month's worth of days into words to give our pain doctor that answer to the question(s)," How have you been feeling? How is your pain?", is a daunting task.
My answer to this problem has always been to keep a daily journal of each medication I take, when I took it, how long before the meds were effective on my pain, and I try to use words to describe that days pain. When It is time for my doctor's appointment, I look back over those daily entries, and not only bring it with me, but to keep time at it's most effective for the visit and not sit and flip through each page while sitting there with my doc, I prepare a page that describes that month's daily pages into one.
From this, I can tell doc how my pain has been, same, better, or worse, (general), and how long it takes for the medications to be effective-- helps us to know if the meds are prescribed correctly, the med itself, the mgs., or the time they are to be taken.
It is when the WORDS are needed to answer what the pain FEELS like that I scrape that daily med log for the words I wrote to describe my pain that day that really helps me to come up with something for the doc. I'm listing some words that describe pain for you, in case you need some words to consider for your next doctor visit.
Does your pain feel or have the sensation of:
Hot-- Cold-- Warmth-- Periods of these?
Piercing-- Piercing with any of the above?-- Does it spread or stay in one place?
Deep-- Surface-- Pounding-- Seems to go with heartbeat?
Grinding-- Bone against bone-- Pulling-- If any of these, what are you doing, (if anything)?
Muscle-Involved-- Pulled muscle-- Tendon/Ligament-involved......
Squeezing-- Like a hand is inside squeezing area-- Twisting.....
Constant-- Intermittent-- Consistent-- Relentless.....
That's a start to help you pull some words if you are at a loss, or possible give you a new one to describe your pain.
I hope this helps.
Gentle Hugs!!!
Thursday, May 14, 2009
Telling Your Doctor Your 'Subjective' Symptoms
This post will be a crossover between the medical field, and the patient in pain. I chose Pain because it is the one (out of many symptoms, yet pain is strictly subjective--only what the patient says it is.) Pain is a symptom (and a disease of it's own also), that can not be given a "simple" answer to the infamous question, "How have you been, and how has your pain felt?"
We, the patient, are giving a *****Subjective View, (***can only be given by the patient themselves.) No one else can be involved in the subjective question, unless you need someone to help speak or communicate for you. But these are questions, and your answers, that tell the doctor what YOU are feeling.
To let you in on exactly how the doctor or nurse asks you questions; if you ever remember your 98 second visit, (J/K) see someday if you can see this pattern in how the doc asked you questions during the visit. In Pain Management, the FIRST question is THE question that will let h/her base your plan of care on. Docs need to have a plan. And the first bunch of questions we patients answer supplies most of the information they will use in that plan.
I don't know exactly when things began to change-- the order in which nurses and docs ask a patient during their visit. Whatever acronyms Healthcare Professionals use, it evokes the same responses they are looking for. In the late 80's to early 90's, we used the acronym: SOAPIE, FOR:
S ubjective
O bjective
A ssesment
P lan
I Implentation
E valuation
Ok, so we know what order these words are in. Yet what are the providers attempting to elicit from you by using this acronym?
"Subjective"-- (Remember we are in our DOCTOR'S VISIT). This becomes OUR observation(s) of our symptoms and how to communicate them to our doc.
Doc: So, Shauna, how have you been feeling? How is your pain? (OH---Loaded Questions, right??) This is where I answer about the pain; telling doc that it is "Deep in my spine", "It is as if there is a hand squeezing the cord", "it is like when I had labor, my back was in such pain", and here is where I have finally found a way to explain to women whose back hurt during labor----**(THAT IS MY PAIN!! THAT ONE-TIME, QUICK PAIN DURING BIRTH. MY PAIN JUST KEEPS ON GIVING BIRTH.) SOUNDS quite 'ODD', BUT NOT TO A PAIN SPECIALIST WHO IS SEARCHING FOR THESE TYPES OF DESCRIPTIVE ANSWER TO THE QUESTION: "HOW HAS YOUR PAIN BEEN?"
"Objective"--What the doctor observes as h/she listens to you as you rattle off the Subjective part...trying, searching for words, any words, that will explain to the doc just how you feel in pain. They will observe how you appear emotionally, compare your rating on the pain scale to what they expect to see, although Chronic Pain patients have lived with pain for so long, that they can seriously be in an 8 out of 10 on the pain scale, and be just kind of starting into space. We have learned to cope with our pain in different ways, and unlike those with acute pain, we don't always have the screaming and crying when our pain is rated high that day. Crying, for me, is one thing that I show when it is high, go outside and stare at the mountains, but the chair won't let me sit there more than 3 minutes....you get the picture.
"Assessment"-- this is what the doctor/nurse sees, hears, feels, and smells, and they make notes according to THEIR observation of you, through the steps of assessment, taking your vital signs, palpating different areas, checking parts of the body; and the trained eye of a professional will allow them to find out where you are at in their eyes.
"Plan"-- which is when the doctor/nurse has to devise a plan of treatment for you, write any orders for needed blood tests, X-rays, MRI's CT Scans, etc. These are the plans of the doctor for your treatment.
"Implementation"--This is the action phase, when the doctor's plan is carried out. Tests are taken, and the reports sent back to the doctor. If physical Therapy was ordered, that is attended, and the Progress Notes are sent to the doctor. If medication was ordered, you will be taking it.
"Evaluation"--Time to see how your patient is doing. How did the blood work come out? The MRI's, etc.? Physical Therapy--did it help? You will both decide for the most part if the medication ordered is working or not, and I am still talking mainly about a pain patient visit.
These are the steps some docs follow--they are old school, some just use SOAP, and there are many other new acronyms that have come up since the years I spoke about. We had no computers at that time, nurses used SOAPIE, or SOAP, so did docs.
Just try and remember the SUBJECTIVE part of your visit. What you tell the doctor. Sometimes I'll have a friend that knows my life very well go with me to a doctor's appointment. And I go with them. As support, and also to help remember certain things that they had forgotten. Yet we can not speak for them. ***PAIN JOURNAL, remember!!!
I'll talk soon about some great words to use when you may be grabbing for anything that will describe your pain.
Gentle Hugs.... <3
We, the patient, are giving a *****Subjective View, (***can only be given by the patient themselves.) No one else can be involved in the subjective question, unless you need someone to help speak or communicate for you. But these are questions, and your answers, that tell the doctor what YOU are feeling.
To let you in on exactly how the doctor or nurse asks you questions; if you ever remember your 98 second visit, (J/K) see someday if you can see this pattern in how the doc asked you questions during the visit. In Pain Management, the FIRST question is THE question that will let h/her base your plan of care on. Docs need to have a plan. And the first bunch of questions we patients answer supplies most of the information they will use in that plan.
I don't know exactly when things began to change-- the order in which nurses and docs ask a patient during their visit. Whatever acronyms Healthcare Professionals use, it evokes the same responses they are looking for. In the late 80's to early 90's, we used the acronym: SOAPIE, FOR:
S ubjective
O bjective
A ssesment
P lan
I Implentation
E valuation
Ok, so we know what order these words are in. Yet what are the providers attempting to elicit from you by using this acronym?
"Subjective"-- (Remember we are in our DOCTOR'S VISIT). This becomes OUR observation(s) of our symptoms and how to communicate them to our doc.
Doc: So, Shauna, how have you been feeling? How is your pain? (OH---Loaded Questions, right??) This is where I answer about the pain; telling doc that it is "Deep in my spine", "It is as if there is a hand squeezing the cord", "it is like when I had labor, my back was in such pain", and here is where I have finally found a way to explain to women whose back hurt during labor----**(THAT IS MY PAIN!! THAT ONE-TIME, QUICK PAIN DURING BIRTH. MY PAIN JUST KEEPS ON GIVING BIRTH.) SOUNDS quite 'ODD', BUT NOT TO A PAIN SPECIALIST WHO IS SEARCHING FOR THESE TYPES OF DESCRIPTIVE ANSWER TO THE QUESTION: "HOW HAS YOUR PAIN BEEN?"
"Objective"--What the doctor observes as h/she listens to you as you rattle off the Subjective part...trying, searching for words, any words, that will explain to the doc just how you feel in pain. They will observe how you appear emotionally, compare your rating on the pain scale to what they expect to see, although Chronic Pain patients have lived with pain for so long, that they can seriously be in an 8 out of 10 on the pain scale, and be just kind of starting into space. We have learned to cope with our pain in different ways, and unlike those with acute pain, we don't always have the screaming and crying when our pain is rated high that day. Crying, for me, is one thing that I show when it is high, go outside and stare at the mountains, but the chair won't let me sit there more than 3 minutes....you get the picture.
"Assessment"-- this is what the doctor/nurse sees, hears, feels, and smells, and they make notes according to THEIR observation of you, through the steps of assessment, taking your vital signs, palpating different areas, checking parts of the body; and the trained eye of a professional will allow them to find out where you are at in their eyes.
"Plan"-- which is when the doctor/nurse has to devise a plan of treatment for you, write any orders for needed blood tests, X-rays, MRI's CT Scans, etc. These are the plans of the doctor for your treatment.
"Implementation"--This is the action phase, when the doctor's plan is carried out. Tests are taken, and the reports sent back to the doctor. If physical Therapy was ordered, that is attended, and the Progress Notes are sent to the doctor. If medication was ordered, you will be taking it.
"Evaluation"--Time to see how your patient is doing. How did the blood work come out? The MRI's, etc.? Physical Therapy--did it help? You will both decide for the most part if the medication ordered is working or not, and I am still talking mainly about a pain patient visit.
These are the steps some docs follow--they are old school, some just use SOAP, and there are many other new acronyms that have come up since the years I spoke about. We had no computers at that time, nurses used SOAPIE, or SOAP, so did docs.
Just try and remember the SUBJECTIVE part of your visit. What you tell the doctor. Sometimes I'll have a friend that knows my life very well go with me to a doctor's appointment. And I go with them. As support, and also to help remember certain things that they had forgotten. Yet we can not speak for them. ***PAIN JOURNAL, remember!!!
I'll talk soon about some great words to use when you may be grabbing for anything that will describe your pain.
Gentle Hugs.... <3
Sunday, May 3, 2009
A Chance To Educate Others About Pain
I am obviously a couple days late on the 'Blogging Against Disabilism Day", but the author of this day said that knowing we all have disabilities that would be just fine.
This post will be short, as what I have to say is 'short and sweet'.
When I get a famous blue sticker on my car, will I get "The Look" from those that do not understand everyone that uses one of these is not in a chair??
Will I get the looks AND an argument?
NO. And do you know why? Because although I may be the only one that knows that my pain is the reason I need to park close to a store, and that my pain is on the inside and that no one can SEE my reason for the disabled parking sticker, I will never, ever, get into an argument with anyone.
This is a time for teaching. A time to let other know that there are hundreds of invisible illnesses. I can educate them.
And THAT is what having an invisible illness is all about. Educating others.
Gentle Hugs
<3
This wonderful idea came from Diary of a Goldfish. Thanks for doing this, great idea, and there are so many wonderful posts that have been written!!
This post will be short, as what I have to say is 'short and sweet'.
When I get a famous blue sticker on my car, will I get "The Look" from those that do not understand everyone that uses one of these is not in a chair??
Will I get the looks AND an argument?
NO. And do you know why? Because although I may be the only one that knows that my pain is the reason I need to park close to a store, and that my pain is on the inside and that no one can SEE my reason for the disabled parking sticker, I will never, ever, get into an argument with anyone.
This is a time for teaching. A time to let other know that there are hundreds of invisible illnesses. I can educate them.
And THAT is what having an invisible illness is all about. Educating others.
Gentle Hugs
<3
This wonderful idea came from Diary of a Goldfish. Thanks for doing this, great idea, and there are so many wonderful posts that have been written!!
Subscribe to:
Posts (Atom)
