Tag Archives: coping

The Worst Patient

When I was delivering direct patient care, we were given a two-hour window during which to administer medications. If a med was scheduled for 1 p.m. (1300 in hospital-speak) it could be given between noon and 2 p.m. (1200 to 1400). It was one of the ways Administration acknowledged that we nurses had a lot on our plate and the day was only so long.

I don’t know if this is still the case at the bedside as I’ve been gone a long while now, and I don’t expect to ever return. The curtain has lowered on those days, but I am reminded of that window every time I take my own meds late. Or forget to take them at all.

These days I have only one patient’s needs to meet. There is only one patient for me to give primary care to. Only one patient whose meds I have to keep straight in my head. Me.

And I find that it’s not any easier. One does not simplify things, especially when that one researches and investigates every little thing. And at times does not even comply with the treatment.

I once confessed to the Nurse Practitioner taking my history that I was noncompliant with one medication. She paused in her note taking to look up at me, then we locked eyes and laughed. It’s common knowledge that doctors and nurses make the worst patients.

As it stands, the nurse in me is trying to come up with a workable plan of care for the patient in me. For a while now I’ve been toying with the idea of making a MAR for myself (Medication Administration Record). Or would that be on myself?

We used to get the MARs every day from the pharmacy; they covered 24 hours’ worth of documentation. I don’t need to get as specific, but I would at least need to list all my meds and the times they are due. That way I would be able to check them off, sign off on them so to speak, as I take them. And thereby no longer wonder did I take that calcium this morning? Or that Gabapentin last night?

As it is, there’s no way to tell. I have so many things on my mind, so many things that need to get done. And subconsciously, I don’t want to take my meds. Or more accurately, I don’t want to have a reason to need to take my meds.

But alas, I do.

I already have my phone set to alert me that Wednesday is Methotrexate Day. Unfortunately, every day is Plaquenil Day and noon seems to come around all too quickly. I swear there are less than 24 hours between noons. Or maybe it just seems that way. It’s that old noncompliance thing tugging at me.

So I’m thinking a “MAR” should keep me on the daily straight and narrow. Back when I supervised three separate nursing units, my last task each day was to list all the things that needed to get done the next day. Those were the steno-pad days, before the now ubiquitous computers. I would leave the hand-written list on the center of my desk so it was the first thing I saw upon opening my office door.

And it really worked. I got so much done that first year; it still makes me tired just thinking about it. But they do say that if you write down your goals, they are more likely to get accomplished.

It’s definitely come time to make myself another action plan. I just have to decide on the form, or the format. A dry erase board comes to mind. But I don’t think I can find room on the wall for one that big. Anyway, I don’t want it front and center, spoiling the “décor” of my home office. So I’ll design it on my laptop, then print it out so it can join the jumble on my desk.

I’ll program my phone to remind me to look at it. Or for it.

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I have RA, but RA doesn’t have me

Fingers

Image via Wikipedia

I woke up this morning, thinking. I do that a lot. Both wake up  and think! I consider myself lucky; I have the ability to do both. My hands are the first things that enter my consciousness. Can I move them without pain, can I flex my fingers normally? I hold hands with myself. I exercise and manipulate my fingers, get them to loosen up. It takes a few minutes, sometimes more than a few minutes.

This is a daily ritual for me and I’m sure for many RA sufferers, but this morning my hands took second place. I had something more compelling on my mind. Writing. Words. Lots of words. 15, 000 glorious words.

Tapping on my keyboard is a good workout for my fingers, but more importantly it is a good workout for my brain. Writing is therapy for me. It is a creative outlet. Writing about my illness helps. I find that if I personify it, it is easier to deal with. I can face my enemy and laugh in its face. I am the Black Knight who, though armless, refuses to give up the fight, “It’s just a flesh wound!” (Monty Python and the Holy Grail, 1975)

Yes, RA, you are just a flesh wound to me. You may stalk me while I sleep, but you cannot hold me captive for long. I slither from your insidious grasp with morning’s first light. And I hold you at bay all through the day. You cannot keep me from doing what I want to do.

And what I want to do is write those 15,000 words, complete my work in progress. I will concentrate on exercising my vocabulary as well as my fingers. I will throw myself into my work and let it suffuse my mind and spirit. I will go where you can’t reach me, RA, for my novella is not about you.

I may have you, but you don’t have me!