My last post "Plea For Clemency" makes me think of the relationship between President Bush and the leaders of the Democratic party. Regardless of how hard President Bush works or what he does, all the leaders of the Democratic party want to do is to bitch and obstruct.

PLEA FOR CLEMENCY An attorney got home late one evening, after a very taxing day trying to get a stay of execution for a client, James Wright,who was due to be hanged for murder at midnight. His last minute plea for clemency to the governor had failed and he was feeling worn out and depressed. As soon as he got through the door at home, his wife started on him about,"What time of night do you call this? Where have you been? And on and on. Too shattered to play his usual role in this familiar ritual, he went and poured himself a shot of whiskey and headed off for a long hot soak in the bathtub pursued by the predictable sarcastic remarks. While he was in the bath, the phone rang. The wife answered and was told that her husband's client had been granted his stay of execution after all. Finally realizing what a day he must have had, she decided to go upstairs to give him the good news. As she opened the bathroom door, she was greeted by the sight of her husband's rear end as he was bent over naked drying his legs and feet. "They're not hanging Wright tonight," she said. He whirled around and screamed, "fOR CRYING OUT LOUD, WOMAN DON'T YOU EVER STOP?"

First let me appolize for not having been posting any new things as of late,but thank the good Lord and the Department Of Veterans Affairs( the VA Gulf Coast Veterans Health Care System) primary the Biloxi eye clinic, where I had my eye surgery. Now I enjoy close to normal vision due to the fine doctors and nurses.

JUST A TRAINEE







As you enter the dialysis center, which is a part of the renal division of The Dept. Of Urology of Shands Teaching Hospital in Gainsville, Fl. you are awe-struck at the sight eight Century dialysis machines, all in operation with their green and white lights flashing on and off,with their blood filled tubes pumping blood back and forth between the white faced patients and the machines, saline bottles hanging from their stands with their tubes running to the patients. you notice three nurses, very efficiently connecting and dis-connecting the patients to and from the machines, drawing blood samples, administering medicines, and comforting the frightened and nauseous patients, taking vital statistics and charting them every hour on each patient, ever alert for the flashing red light and howling sirens alerting them to a malfunction of one of the machines or a patients vital signs indicating on the monitors of a pending heart failure or a patient going into shock or a blood clot, any one or all of these emergencies, and when this occurs you can only be amazed at their quick response to stabilize the patient, acting as a well drilled team of experts, reflecting their over thirty years of handling emergency situations. Here I stood, Gideon like, totally unprepared for anything like this and with no apparent aptitude for it. I was to report to Karen, the Home Training Supervisor for out-patients on home dialysis. My wife was fighting a life threatening kidney disorder, requiring dialysis 24 hours a week, this meant that we had to make a three hundred mile round trip to Gainsville, three days a week, leaving home at three thirty in the morning and getting back home at nine that night. I was to be trained to operate the dialysis machine at home in order to lighten the burden on my wife and myself. The first week I was instructed on the technical operation of the machines, assisted by Karen and Cookie(one of the other nurses) and helped to become comfortable with the patients and in general familiar with the procedures. I studied the instructional booklets on the machines and various medical manuals on kidney disorders and the various treatments. The second week I spent monitoring the machines and the patients for malfunctions of the machines and signs of problems pending with the patients. Karen would secretly create malfunctions to test if I would respond quickly and would take the necessary steps to correct the problems. Then Karen hit me with it, Monday , I was to begin to learn how to connect the patients to the machines!!! This was the part I knew I could not do,you had to thread a long needle under the epidermis and into the blood vessel for about an inch, being very careful not to puncture the outer wall of the vessel thus causing a horrible hemotoma,bleeding under the skin. I had seen these large pockets of blood swollen up under the skin,with the patients becoming nauseous and going into hysteria and shock. Renal patients, particularly females, have very small blood vessels and the disease along with the continued insertion of needles into the arteries and the veins causes in many cases the vessels to collapse or to partially collapse, making it very difficult to complete the procedures,thus increasing the trauma to the patients and to the nurses.. The dreaded hour, 7:30AM Monday morning!!!was upon me and Karen handed me the needle and instructed me , one more time on how to thread it under the epidermal layer of skin ,on about a 280 decree angle and into the vein for about one inch thus insuring a good flow of blood from the machine back to the patient. I very tentatively put the needle up to the skin on the artificial arm that lay before me, then I froze, the needle would not go any further! Karen then told me that I would have to exert more pressure to get the needle through the epidermal layer of skin, then it happened! I shoved the needle through the skin, through the vessel, and out the other side of the arm!!! I stood there sweating and dumb-founded, Karen was exasperated, she told me that I was the clumsiest , most back-ward person that she had ever met and this had never happened with all the other people that she had trained and my God even when I opened the packages to remove the absorbent pads, the instructions were very clear on how to open them , but! I invariably managed to turn them over and open them from the wrong end. Now by God , as unfortunately I was the only person available in our family, that I was going to have to apply myself, read and follow the instructions on the procedures, control my emotions,overcome my fears,and do the job that the Lord had put me there to do. That night I prayed hard, for the first time in my life, I asked God to help me do this one thing that I knew I could not do and if he would help me I would not quit and let my wife down. The weeks passed and I met Dr. Robert Cade, the inventor of Gatoraide, and the head of the Urology Dept. and I found him to be the most humane, humble,down to earth person you could ever meet, you could talk to him like a long time friend. Karen, my supervisor, finally felt that that I was ready for my final test!! The doctors and nurses referred to this as your "solo" test. You are put into a private room with the patient at 6:30 AM. You are all along with this very sick person and you are still half asleep and not feeling too good yourself, and in my case the patient was my wife!! Without supervision, first, check the machine to see if it is functioning properly, check your utility table for the required medications and equipment necessary to complete the required procedure and necessary in case of emergencies. Now prep the patient, prepare a sterile field, draw blood samples to send to the lab., now thread the needles into the vein and then the artery , thus connecting the patient to the machine via the blood lines. Now for the next eight hours,monitor the machine, take and chart vital statistics every hour on the hour, comfort the patient and tend to her needs, and finally disconnect the patient, complete tests and charts,clean machine and area,and now after ten hours you may call a nurse in and take a break. As I had finished drawing the blood samples that were routinely required, Cookie came into the room and informed me that she needed and additional 15 cc sample, I started to draw the sample but the plunger stuck and Cookie was telling me that if I had loosened the plungers during my prep period this would not happen and she would return later for the sample and left the room , as by this time I had jerked the plunger clean out of the back of the syringe and blood was spurting all over . Now I had to withdraw the needle, stop the bleeding,calm down the upset and nauseous patient, clean up the mess and start all over. I had lost my sterile field, my composure,and was visually shaken and sweating profusely by the time I had the needles retreated. Then Dr. Cade wa next to me, gently wiping the sweat from my brow with a absorbent pad and saying" there, you go,Doctor Palmer!!!" and having said only this, he turned and left the room, and me with my confidence and composure restored completed my "solo" with no further mishaps. From that day on I was called Dr. Palmer by the nurses and amazingly I had become very adapt at inserting needles and drawing blood samples for the nurses ,even on the most difficult patients. Then one of the most rewarding experiences of my life occurred, I had befriended a nine year old boy,named Greg, who was fighting a blood disorder. he would just tear at your heart, his little arms and legs were hardly larger than a silver dollar, and his blood vessels were for all practical purposes non-existent. He had seen me over the past months in the hallways and etc., and I had always stopped to talk to him. This morning he was up stairs in the Urology Dept. to have blood samples taken . two nurses had attempted and failed , one of them fainted from the trauma, and an intern was called and he also failed to draw the required sample, Greg kept calling for Dr. Palmer and by this time was crying and fighting hysterically, finally the intern asked the nurses who the hell Dr. Palmer was and told them that he had never heard of him, the nurses informed him that I was just a trainee down in the dialysis dept . He told the nurses to go get me and when I got there I put my arms around Greg and told him that I would help him. Greg calmed down and stopped fighting and I was able to draw the required samples. In conclusion, I came away from this period in my life with two facts that I know to be true beyond any doubt. One is that the most valuable asset the medical profession has is the contribution made by the individual nurses and two is the fact that with God's help you can overcome all adversities. Zarc