Now, my most recent moral quandry at work. I received a patient from the ER the other night... 90-something years old with severe dementia that made her nonverbal, in with a bowel obstruction. Her abdomen was so distended and rock hard that it was actually distorted in shape. They put a nasogastric tube in her to suction, and used soft medical restraints on her wrists to keep her from pulling the tube out. Her family had decided to make her DNR, and that they would not be operating on her to fix the bowel obstruction.
So why put a tube down her nose, a very uncomfortable intervention... which initiated the need for restraints? The tube was not even draining anything. All night this women was fighting against the restraints trying to get this tube out.
She developed respiratory distress with an oxygen saturation of 85% near the end of my shift. I did what I could to make her comfortable...called the physician and respiratory therapist who bumped up her oxygen and gave her a nebulizer treatment, checked on her every ten minutes while the next shift listened to my taped report, let the nurse taking over know that she really wasn't doing very well and that she should be seen first. I drove home, worrying about this woman and wondering what else I could have done.
When I came in the following night I learned that she'd died half an hour after I'd left that morning. I was relieved for her... but still question what more I could have done to advocate for this woman and her comfort at the end of life.
In other news, aphids have overrun my salad garden. I am livid! I tried a spray that had worked on our pomegranate tree before when it became infested... a pureed combination of garlic, onion, cayenne pepper and Dr. Bronner's soap. The little buggers went running for their lives, I saw them leaping away as I sprayed... but the next day they were back in full force. The greens themselves look beautiful, they are thriving and I'd really like to be eating them... but I'm not thrilled with the idea of dining on aphids and I don't have twenty minutes to inspect each leaf after washing them! If you have any magic cures for aphid infestation, please comment. I've heard of ladybugs, but it might be too late to obtain them mailorder?
The latest additions to our flock seem healthy and happy, and the little Australorps are as big as our Golden Sexlinks now. They'll be popping out eggs before we know it! Recently one of the big girls laid a teensy little egg... here it is next to an average-sized Sexlink egg. We scolded them for slacking off and the next day they were back to laying proper eggs :)
Our tomatoes are thriving and peaking out over the tops of the tomato cages. All of them are loaded with blossoms, and several of them have little greenies! We found one tomato plant growing sideways out of the compost pile and decided to transplant it into the garden... it's doing very well and is learning to grow upright. Several others have come up on their own in the beds, apparently from last year's seed. We've given them proper new homes wherever we've found room. I am crossing my fingers for LOTS of fresh tomatoes this year.
Our potatoes are thriving. We've been "hilling them up" with straw and several of the bags are nearly at capacity, with the tops almost completely unrolled. The plants look very healthy, with strong stems and big green leaves... but who knows what's going on in the dark? I'd love to have lots of homegrown organic blue taters this fall.
We received our first CSA shipment last week. We got microgreens, red lettuce, kale, romaine, scallions, cress, radishes, Hakurei turnips, radicchio, and asparagus. The greens became a big salad and sandwich ingredients, the rest went into a yummy stirfry over rice. It held us over until the weekend, when we visited the farmer's market and indulged in lots of strawberries, rhubarb, sugarsnap and snow peas, brocolli, cauliflower, asparagus and local sharp cheddar. Our next CSA drop-off is on Wednesday this week because of the holiday.
Last night I was scheduled to go in to work for the holiday. LAME. But, I showed up and found that another nurse who was not on the schedule had come in by mistake and wanted to stay... so they sent me home! I was thrilled. My honeybun and I strapped on our FiveFingers and went for a midnight run through the woods, a far superior way to spend the night. At one point my ankle rolled painfully and I heard a "pop!". I was terrified that I'd broken my ankle FOR THE FOURTH TIME... but found that it was just a bit tender and after walking for a few minutes I could still run on it. The tendon must be loose and have rolled over the bone, producing that horrible sound. Ah, the dangers of running with only a headlamp to guide you over rocky trails! Lots of stubbed toes, too... but overall it was exhilirating and great fun. We're training for a 10k two weeks from now... we're in the recreational heat, so we're not aiming to be the fastest... so long as we finish it, have a good time while we're doing it, and raise some funds for a good cause, I'm happy!
It's a hot one out there today, but weeds are calling. Happy Memorial Day!
