I hate those 1-to-1s sometimes...

I babysit a 69-year-old with Alzheimer's tonight who tested my patience to the extreme. The highlight was when she spit a mixture of applesauce and pills directly into my face. : /

Good part is, I got a lot of great quotes from her!


Henrietta: "Give me back my liver!"


Henrietta: "Look at my pretty bottom..."
 

Henrietta: "Can you reach my pumpkin? Or am I going to have to do it for you?"

For the Disturbed

85-year-old Patient admitted for 'Change of Mental Status': "Help! Help me! I don't know where my husband is! He isn't here with me at home, and I don't know where-"

Me: "Do you know where you are, dear?"

Patient: "Of course I do."

Me: "Tell me where you are."

Patient: "I'm... I think I'm in a place for the disturbed."

Me: (bursts out laughing)

Other Aide: "Oh, she has no idea..."

Shuffle Shuffle

Me: "You're funny, huh?"

89-year-old Patient: "Oh, I'm not just funny, honey, I'm hilarious. My friends would say, 'Marlyn, you're a card.' And do you know what I would say? I would say, 'No sir, I'm not just a card, I'm a whole deck, and you should take care how you shuffle me!'"


Our hospital is loaded up to full capacity right now, so they brought in a tray of pretzels for the staff tonight. We descended on it like vultures on a carcass. I love it when they deliver guilt pretzels. Guilt pretzels are the BEST!

Ohohohoho!

Had a horrible, horrible night that ended where me and one other aide were on the floor. Each of us had 20 or so patients apiece and a huge percentage were incontinent.

We set a goddamn record: Ten diaper changes, three of them necessitating a complete bed strip-down, in one hour and fifteen minutes. Beat that!

Plus, this:


Elderly Insane Female Patient, as we pull back her diaper to get her cleaned up: 

"Ohohohoho, cover my balls up!"

That's Why!

Sorry for the absence! I've been sick as a dog.

Or one of my patients...

Patient: "I'm a drinker!"

Me: "Why do you drink?"

Patient: "Because I have leukemia and I'm Irish, that's why!"

The Final Defecation

We need some background to this quote. I was taking care of a 98-year-old man yesterday who was firmly determined to die. Not only that, he kept telling me, "Today will be the day. I am going to die. I can feel it." It was freaking me out a little. I felt much better by the time I left because, of course, he hadn't died. We had quite a few nonsensical conversations about life, but the following is the best.


My 98-year-old Patient, sitting on the commode: "This is it. I can feel it. Here it comes."

Me: "Here comes what, Sam?"

Patient: "...I am having the final defecation." (strains like he's having a baby instead of a bowel movement)

Corn, I ask you?

Me: (creeps into a patient's room to try to empty his catheter without waking him)

Patient: (drowsily) "What are you doing down there... are you- are you pulling corn?"

Patient Type: the Paralyzed Patient

You hear a patient yelling "Help! Help!". Naturally, you walk in and say, "Can I help you? Why didn't you ring the bell?"

And they go, "I'm paralyzed from the neck down."

Right about there is the point where you feel like a douche.

Stereotype Characteristics:
- Patient requires constant readjusting and has a "system" for it. For example, you start out by straightening their hips, and then you fix up their legs, then their feet, then you arrange their hands in their lap and on and on.
- The bell rings every five minutes for things like "Could you push the water cup three centimeters closer so my lips can reach it?"
- There are constant moisturizer requests. It's like they have nothing else to think about. You will be moisturizing their face, feet, and butt, along with putting chapstick on therr lips.
- Every now and then, one of the patient's bells will be answered by another aide before you can get there. He or she walks out a half hour later vowing never to help you out with call bells again.
- Patient drinks/eats only organic items because it's "healthier." You feel like asking, "What's the point?" since the patient is in renal failure, liver failure, and oh, BY THE WAY, is paralyzed and can't move this "healthy" body anyway.
- Meal times are a nightmare, involving multiple towels, spoons, and extremely slow feeding. Forget about getting anything else done.

Typical Results: 
a. You begin to delay or ignore their bell and think of it as ambient background noise.
b. When they ask you to adjust something, you do it crappily so that the next time they see you, they'll settle for a mediocre fix instead of perfection.
c. You ask the unsuspecting nurse if she can provide pm care while in the room with the paralyzed patient if you promise to do all the rest. She happily agrees. You dodge away before she can realize her mistake.

Degree of Difficulty
 Definite hard mode. While you may be incredibly pissed that they ask for the eighth time in one hour for you to readjust something they can't even feel, you can't show it. Besides that, you feel guilty for feeling it. For shit's sake, this human being can't move from the neck down. That's terrible. You know what's even more terrible? Giving in to rub lotion onto their corn-encrusted feet in a half-hour foot massage while your other thirteen patients are completely ignored.

In conclusion, paralyzed patients are never good unless they are your only patient.

Pink Elephants

Me: (after taking a 190/114 blood pressure) "Oh, wow. Do you usually run this high?"

Patient: "No, I'm not high. Though this one time, back in 1967, I did some crazy shit. Seriously crazy. I saw pink elephants. You've never seen pink elephants until you've done the shit that I did. Have you ever seen pink elephants?"

Me: "... no. But I said that your blood pressure is high. Do you have a history of high blood pressure?"

Patient: "Oh! Oh. Yes, I do." (laughs nervously)


(headdesk)

Mock Schedule

Yesterday, my charge nurse asked me to create a nurse's aide schedule for the 3 to 11 shift that they could use to teach new hires. I made up a simple one that turned out really boring. It was all, "Vital signs between 1500 and 1600, blood sugars at 1600, set up patients for dinner at 1700" and etc. Basically Yawn McYawn, hailing from the town of Yawnsville in the country of Yawn. I couldn't stand it. It wasn't even true.

That's when it hit me.

It wasn't even true.

Here is my real schedule... enjoy.


2:45pm: Arrive in the break room. Deposit dinner in fridge. Query the previous shift on whether it was a good day or a bad day.
2:50pm: Help self to a cup of water and write name on it. There won’t be time to hydrate once the shift starts.
2:55pm: Accept assignment from the charge nurse. Fill out patient sheet with information.
3:05pm: Search frantically for free blood pressure machines so that blood pressures won’t have to be done manually. Curse Aide #2 and #3, who have commandeered the good ones.
3:10pm: Begin taking vital signs on Patient #1 out of 10.
3:11pm: Call bell sounds. Answer it. Patient #4 asks for covers to be straightened.
3:20pm: Return to taking vital signs. Now on Patient #2 out of 10.
3:21pm: Call bell sounds. Answer it. Patient #8 would like a cup of ice. Fetch cup of ice.
3:40pm: Return to taking vital signs. Finish with Patient #3, #4, and #5 out of 10.
3:49pm: Call bell sounds. Ignore call bell and continue taking vital signs. Finish with Patient #6 out of 10.
4:01pm: Be accosted by Nurse #2 demanding to know why the 4pm blood sugars aren’t done.
4:10pm: Finish vital signs on Patient #7.
4:20pm: Finish vital signs on Patient #8.
4:30pm: Finish vital signs on Patient #9. Patient #9 needs her diaper changed.
4:50pm: Leave room scarred for life by the amount of diarrhea one elderly lady can produce. Give up on final vital signs and begin blood sugars.
4:51pm: Realize machine needs to have quality controls done because the night shift neglected to do it earlier.
4:55pm: Rush to complete blood sugars before dinner arrives.
5:06pm: Dinner arrives.
5:11pm: Last blood sugar is completed.
5:12pm: Interrupt Patient #10's dinner to take vital signs.
5:25pm: Note that five out of ten patients are incapable of sitting up for dinner and must be helped.
5:55pm: Finish setting up every patient for dinner. Pause to take a sip of water. Call bell sounds.
5:06pm: Answer call bell. Patient #8 has slid to the bottom of the bed and needs to be repositioned.
5:07pm: Search for Aide #2 to help in repositioning.
5:12pm: Learn that Aide #2 has taken a smoke break and is unavailable.
5:14pm: Request Nurse #3's help in repositioning.
5:15pm: Get denied by Nurse #3 because Aide #2 should help.
5:20pm: Find Nurse #4, who does not have Patient #8, but is willing to assist.
5:25pm: Finish repositioning patient and remove tray.
5:26pm: Round floor searching for dietary cart.
5:32pm: Assume that the cart has been removed.
5:40pm: Give up and go to place tray in Soiled Utility Room despite blatant sign.
5:42pm: Open door only to have it slam into the dietary cart three inches away. Drop tray and dump spaghetti over self.
5:45pm: Alert Martin (housekeeper) to the mess. Martin is not amused.
6:05pm: Return to floor in new scrubs. Rush to take a 6pm blood sugar.
6:15pm: Circle floor and update charts on ingestion and excretion, including meal percentages. Receive basic report from nurses on the patients that have been cared for, by you, for the past three hours.
6:30pm: Take dinner break. Get interrupted by nurses three times with requested tasks "for when you're finished".
7:00pm: Return to floor and check updated assignment. Nurse #2 has left, replaced by Nurse #3, and an aide has gone home sick. Pick up 4 additional patients for a total of 14.
7:10pm: Answer call bell. Patient #4 needs to be walked to the bathroom.
7:20pm: Answer call bell. Nurse #3 needs help coaxing Patient #9 back into bed.
7:32pm: Fetch bed alarm for Patient #9.
7:45pm: Assist Aide #2 in changing a 400 lb patient who does not bathe regularly.
8:15pm: Check blood pressure on Patient #1 to find it 65 over 30. Search for Nurse #3.
8:21pm: Fetch Nurse #3 to Patient #1.
8:25pm: Answer call bell. Patient #5 will be discharged and needs personal items packed.
8:27pm: Finish packing personal items.
8:50pm: Finish listening to Patient #5's stories about the war.
8:51pm: Begin 9pm blood sugars.
9:01pm: Get accosted by Nurse #3 demanding blood sugars.
9:18pm: Finish blood sugars.
9:21pm: Take a water break. Breathe.
9:24pm: Answer call bell. Patient #10 would like a snack.
9:30pm: Deliver snack. Patient #10 would also like a blanket.
9:36pm: Deliver blanket. In addition, Patient #10 would like help with the urinal.
9:45pm: Patient #10 requests marital status.
9:46pm: Patient #10 is denied.
10:07pm: All patients’ charts are updated, completed, and handed in to the charge nurse.
10:11pm: Patients are quiet. Nurses are busy. Lower self into chair.
10:12pm: Call bell sounds.
10:13pm: Answer call bell. Patient #6 requests Nurse #2.
10:15pm: Check desk for Nurse #2.
10:17pm: Check med room for Nurse #2.
10:19pm: Check supply room for Nurse #2.
10:22pm: Check hallways for Nurse #2.
10:23pm: Ask the desk if anyone has seen Nurse #2. Predictably, no one has.
10:24pm: Call bell sounds. Answer call bell for Patient #6, who demands to know where Nurse #2 is.
10:36pm: Discover Nurse #2 in break room. Inform her of Patient #6.
10:40pm: Empty catheter of Patient #2. Accidentally wake him and listen to him say he wants to die.
10:45pm: Comfort Patient #2 and reassure him that no, he does not. He argues and makes valid points you must not refute.
10:53pm: Back out of Patient #2's room, slowly.
10:59pm: Plop into chair in break room. Breathe sigh of relief. Respond incoherently when asked by next shift how the night went.
11:01pm: Call bell sounds. Call bell is ignored by both the departing and the arriving shifts.
11:02pm: Run like a bat out of hell!

My First Code

Finally, finally, finally. After working at a hospital for ten and a half months, I have witnessed my first code.

Every other time before when the monitor tech paged a "Code zero room so-and-so," I've been trapped in a room somewhere. One time, we had three separate codes on my floor and I missed them because I just so happened to have been sent to ICU for those four hours. Where no one had the decency to code, I might add.

So this time, I was really and truly excited. No patients needed my attention. I wasn't on the wrong floor. When they called "Code zero room 324," I dashed in there as fast as my little legs could carry me.

The patient was a 60-year-old male with various extensive health problems, including diabetes, MRSA wounds, kidney failure, and on and on. The nurse had told me that he lived in the nursing home across the hall from his 85-year-old father. How sad is that?

Anyway, I was standing there agog as two nurses took turns doing chest compressions. Then suddenly the doctor was there, and anesthesia, and four more nurses, and the other nurse's aide on the floor, and we all worked on him. They shot him full of fluids and epinephrine, but the poor guy was just not destined to make it. We worked for a solid half hour to establish normal sinus rhythm and a firm, solid pulse with no luck. We would get a strong pulse.... only to have it slip away. He would go into vtach and we would shock him... only for him to lose it again.

Throughout the whole thing, I was excited rather than disturbed. I gathered the courage to do chest compressions and pumped on his chest for four or five minutes before I needed a break. It's astounding to think that you have the power to keep someone closer to life than to death just by doing that.

After that half hour, the doctor called it and everyone settled back. One of the weirdest but most heartening things was how the relief shone through in that moment. Everyone knew they had given their best, and it hadn't been enough, but they were all cracking jokes as we cleaned up the room. They all kept asking me if I was okay, and I would tell them, "Just fine." It hadn't disturbed me at all. Maybe this was because the patient wasn't one I had taken care of before? Maybe I am just a cold-hearted bitch? I'm not sure.

Now I look forward (not really, but you know what I mean) to a code on a patient I know so that I can see how I react.

What is it with me and catheters?

Me: "Listen. The catheter has to stay in. It's draining your urine. You can't pull it out."

Stuck-Up Old Woman: "Actually, I was trying to pick it out. Shows what you know."


WHY YES. THAT DOES SHOW WHAT I KNOW.

7p to 7a for the WIN

I have been working nonstop the past week because I am determined to buy the iPad. Today, it's a 12 hour shift that is completely overtime. (Woohoo!)

7p to 7a is about the easiest 12 hour shift you can do because of a couple things:

Number one, you only have to do vital signs once.

Number two, your people are asleep half the time.

Number three, it starts harder and gets easier.

I have 17 patients at this exact moment in time and no bells have gone off for two full hours.

Ahhh. That beautiful sound that is silence.

You're hurting my penis!

Last night, I was babysitting a one-to-one who was a 93-year-old, confused, nearly deaf old guy. He was really very cute, but he had to have a foley put in and just couldn't understand why the hell a tube would be in there. All night, he kept scrunching around in the bed and trying to fiddle with it. I let him play with it a little, because he would get very agitated if you tried to stop him, but when he went to give a great big yank, I grabbed his hands and had to pry it out of his grip. He started trying to punch and kick me. While I was avoiding the blows, a male nurse came in (no doubt attracted to the noise) and went, "John! What's the matter?"

The old guy sits straight up in bed, rips off the sheet, points to his VERY exposed junk and exclaims "She's hurting my penis!"

I had to try so hard to keep a straight face while the nurse explained (yet again) what a catheter was.

"I don't care!" the patient kept saying, "That girl's dangerous. She's hurting my penis! She should be in jail!"

How to...not annoy your nurse's aide (as the patient)

I think that this post will be the first in a how-to series. Much like the patient profiles, you can expect one of these every now and then (aka, whenever I come up with one).

1. Don't ring the call bell more than once every hour and a half to two hours- unless it's for something urgent.

If you're a heavy call bell ringer (something we've discussed), I, the nurse's aide, won't come check on you at random. You know why? Because I know you'll be ringing that damn bell soon anyway, so what's the point of stopping in yet again?

To get on my good side, ring the bell infrequently for things like water, gingerale, cover-straightening, etc. I'm doing rounds. I'll come by to check on you for those things anyway. There's NO NEED TO RING THE CALL BELL ABOUT THEM.

Things that qualify as urgent, for which you should definitely ring the bell: chest pain, heart-racing, and bathroom/bedpan requests. Nothing else.

If you dropped something- do you really need it now? Right this second? Can it wait twenty more minutes til I come in by my own volition? At least consider it.

2. Keep the room parties to a minimum.

We love it when your family stops by. There's nothing better than some reassuring company in the hospital so that you won't break down crying later because you're eighty-nine and nobody who's alive cares, boohoo. The thing is... when you're sharing a room with someone else and have more than four other fussy, doting people in it at one time, there's a danger of overcrowding. An inevitable danger, I should say. The average hospital room size is smaller than a college dormroom, and you're STILL SHARING IT with a roommate.

Please. Limit the partying, and make sure those visitors don't stay past eight. You're in the hospital because you're sick. Sick people should go to bed early, or at least let their roommates do so.

3. Understand my job position.

I am not the nurse. I am the aide of the nurse's position. I do the grunt work, and I'm cool with it.

Therefore, do NOT ask me to explain the effects of Coumadin, or why your doctor took you off this medication or increased your dosage on that one. A nurse's aide's basic mantra is the following: 

I have no fucking idea; I just work here.

Most likely, I don't have my associate's degree yet, let alone my bachelor's. I'm measuring pee, scooping poop for stool samples, and fetching you water to get the experience and cash to go to school so that I can learn the answers to your questions. You asking me these questions is just rubbing salt in the wound.

Even if I know the answer to something medical, I'm legally not allowed to answer it. Nor can I change your diet order to be a hamburger rather than some awful shit they made "mechanical soft." It's not my fault that the doctors think you can't chew regular food, even though you probably can't, seeing as you left your dentures back at the nursing home, and it's hard to understand you through those flapping gums. You need to realize that nurse's aides have little say in anything that goes on in a patient's hospital stay. Do us both a favor, and don't bitch me out. It's incredibly counterproductive. Once you bitch me out, do you think I'm going to answer your call bell more promptly, or less?

4. Get your family to bring in food. 

Not kidding. Either go the chocolate or fruit route. Chocolate, we'll love you. Fruit, we'll love you even more because our entire diet consists of chocolate items donated by patients' families. Whichever option you choose, make sure the box or basket has a card that declares, in large print, your name, room number, and bed position (door or window, also known as bed 1 or bed 2, respectively). 

Extra props go to you if you have your family bring in a large crockpot meal and place it in the nurse's lounge. Make sure to supply bowels and spoons. If you can't get out of bed to do it yourself, have your family declare "Dinnertime, on us!" and begin enthusiastically spooning out portions into bowels, church poverty program-style.

 We won't forget it. And your bell will be answered in fewer than ten seconds, or however long it takes us to bolt from the opposite edge of the floor. Seriously.

5. Send a final I'm-better present.

When you leave the hospital, don't make that the end of your stay. Send some (more) food, and include a card with it that thanks every person who took care of you. Accomplish this by asking every hospital worker who comes in the room to write down their name. That way, when you leave, you'll know who was there even if you were too sick to remember.

If someone, nurse's aide or otherwise, went especially out of their way to help you out, whether by spending time talking with you, or comforting you, or even running down to the vending machine to get a candybar for you, make that person his or her own card. Write a special message inside, and sign your name.

Every aide I've known to get a card like that treasures it. Those are the ones we pull out of our lockers on bad days to read over and over again. It reminds us why we do our job- not necessarily for the money (though that helps), or the experience (though that's what really helps in the longterm), but for the people we meet. 

Remember- nurse's aides don't make tips. The least you can do is make them feel appreciated.

Hard Day's Night

Last night was atrocious. It would have been manageable... had the patient census not unexpectedly swelled to forty-two, from a lowly fifteen two nights before. Oh, and we had two suicidal patients who needed to be babysat and couldn't be placed together.

Luckily, two aides from day shift volunteered to stay until 1900 with the suicides. That left me and Arthur (another aide) on the floor. For forty-two patients. That's twenty-two apiece. That is fucking ridiculous.

As soon as we saw the census, he and I went up to Catherine (charge nurse) and were like, "Yo. We claim the one-to-one's at 1900 when they leave." Then we went to work.

On those kind of nights, I don't feel overwhelmed. I get this strange sense of peace, like the one I'd imagine I'd get if I had just been shot and knew I was dying. Since there's nothing you can do about it, you might as well sit back and relax. No sense in worrying. Just keep on trekking.

The most important things to do between 1500 and 1700 are vital signs, blood sugars, and setting people up for dinner. It would be impossible to do all these things for twenty-two people in two hours. I work on a telemetry unit, keep in mind, so our average patient age is about 80. Sometimes higher. Probably 4 out of 10 patients can go to the bathroom by themselves, and about the same amount can set themselves up for dinner.

So, you know, these are the kind of nights that I expect nurses to do a little bit for themselves. Not much. I go up to them and make a deal- I'll do either vital signs or blood sugars on your patients. Which would you like to do? And do you know what my nurses did last night? Fucking nothing.

"Oh, I can't do that. I'm behind on my charting."

"Oh, sorry. I have a patient whose blood pressure is high as the sky, so I can't really take my attention away from him."

"Oh... well. You can do them still, because if they're a little late, that's all right."

Bitch, it better be all right.

All in all, I got twelve vital signs in the first hour, which is a stellar record, considering the number of bells that were going off. Between 1600 and dinner time, I took eleven blood sugars. Eleven! And not one, not two, but THREE nurses asked me "Where are my sugars?" around 1615. I hate it so much when they can't even take five minutes to get their own sugars. What took me twenty-five minutes would be about five or six minutes work between all of them.

After that, I managed to set everyone up for dinner just as the trays were being delivered, and I took my last couple of vital signs around 1830. PHEW. Then I took my dinner into one of the suicidal guys' rooms at 1900, stuffed my face, and watched TV with him until 2300. Both the supervisor and a staffer came in and begged me to stay the night, or at least until 0300. "We'll give you a bonus!"

Shiiiiiiiit. If they were offering me a McMansion and the key to eternal life, I wouldn't have stayed. I'm not looking forward to going back in tonight. Maybe they'll cancel me?

(HAHAHAHA, that last part was a joke.)

Patient Type: The Bell-Ringer

Every now and then, though usually on your busiest of days, you have that this one patient type we'll call "the bell-ringer". 

Stereotype Characteristics:

- Patient rings his call bell at least four times an hour, often more.

- Three out of those four times, it's for bullshit like fluffing pillows or adjusting bed covers. 

- When you enter the room, he says "Oh! There you are." Like it's a coincidence that you just happened to show up, rather than the blaring bell ringing throughout the floor. 

- You are thanked profusely after everything, so you can't justify hating him.

- As you back the hell out of the room, you say, "Is there anything else I can do for you while I'm right here?". He says, "No, but if I think of anything, I'll ring!" A comment sits on the tip of your tongue, straining to escape your lips, but you don't let it, because it goes something like this, "Bitch, stop thinking! Just go to sleep or watch TV already!"

- Patient grows frustrated if you do not immediately drop everything you are doing to respond to his call bell.

Typical Results:

a. your response times to their bell grow progressively longer, and when questioned, you mention how, since you were just there, your other patients' bells have priority. 

b. you set up 'busy' tasks for the patient, not limited to but most definitely including: television, magazines, family (by phone or personal appearance), puzzle books, newspapers... 

c. you sit down and have a talk with the patient about how the call bell system works. Sometimes, this works, especially if you promise to stop in every thirty minutes guaranteed, as long as he refrains from ringing his bell more than once an hour. 

d. you bug the nurse for some Ativan, stat. 

Degree of Difficulty:

Like riding a bike- you may not get a bell-ringer for a while, but once he's back, muscle memory kicks in.

Introductions

Hello. My name is Audrey Morgan, and I wipe ass for a living.

(I've always kind of pictured that as the type of thing you could squeeze into the box of a 'My name is' sticker.)

Okay, here's me being serious for a minute. I'm a 21-year-old nurse's aide at a small, community hospital. I've been a nurse's aide for ten months now and love my job. You should know, though- I've always been a sarcastic person with a strange sense of humor. My current job position has only amplified that quality.

I was thinking the other day, while I scooped up a stool sample and bagged it:

There are plenty of blogs written by doctors and nurses. (I myself read Nursing Student Chronicles, a blog I may be echoing when I enter Jefferson University as a nursing student this upcoming fall.) Many people read these accounts and marvel at the stories such wondrous people experience. Oh, this doctor comforted a patient dying of cancer. Oh, this nurse was touched by a life lesson from an elderly woman who desired death above all else. 

And, in all temporary seriousness, these blogs are inspiring to read.

There's just one thing left out: the nurse's aide.

Hi. I'm the nurse's aide. You know, the one who helped you onto the bedside commode when you were too weak to stand. The one who fetched you a fresh glass of ice water and searched the hospital high and low for chocolate ice cream and graham crackers. The one who wiped your butt when you messed and reassured you that accidents happen.

Oh, you thought I was the nurse? It's a common mistake.

My goal in writing this blog is not to anger anyone, nor to completely belittle nurses. The average nurse is knowledgeable and helpful, and many are willing to teach and explain their actions. Then again, there are also many who are stupid, lazy, and incompetent, and ninety percent of the patient's care is left up to who?  Yup- yours truly.

I want to reestablish the nursing assistant, aka the patient care tech, aka the nurse's aide back into common knowledge. We're often forgotten to be mentioned, seeing as we're at the bottom of the medical food chain, but one thing is for certain- we make an impact on patients that many times outlasts that of the nurse's.

Look for updates four to five times per week. I hope you enjoy the following true accounts.