May 19, 2006, 5:24 pm
Since when did nurses become “tough customers”?
You try to sell me that hideous vehicle and I’ll be a tough customer, alright.
But it won’t have anything to do with my being a nurse.
Nurses obviously held a much higher status back in the 1960s than they do today.
The nursing image sold everything from cars to clothes soap!
These days you might see a nursing image selling sex, but let’s not go there.
That really is an ugly car!
I mean, how many nurses do you see driving Simcas today?
I rest my case.
I know you all may be shocked to know that I was once considered a cheap date.
While I was married!
And it all started with a burst of Nitrospray.
It wasn’t my fault.
My elderly patient was having chest pain.
My elderly patient was deaf.
My elderly patient needed Nitrospray.
To encourage my patient to open his mouth, I leaned over to speak slightly louder into one of his ears.
I pressed the plunger.
I think the patient got more of the dose than I did, but I can’t be sure.
What I can be sure of is that nitroglycerin really does work fast.
I had time to walk out of the room before it hit.
Lightheaded, tachycardic with palpations, somewhere in that twilight zone that lies between the hint of sweat and profuse diaphoresis.
I was gonna go sycopal on their heinies!
Luckily our “trauma” room was empty and I threw myself onto the gurney.
Within ten to fifteen minutes I felt normal enough to get up.
Now what was more embarrassing? Having the reaction to nitro or the fact that no one realized I was flat on my back on a trauma gurney for fifteen minutes and didn’t even miss me!
It’s a toss-up.
I made the fatal mistake of mentioning this episode to a couple of the medics.
Ladies and gentlemen, don’t ever tell an embarrassing story to paramedics.
They will torture you for years.
They will pull out Nitrospray and flash it in front of your face.
They will threaten you with Nitrospray if you do not allow them to partake of your potluck.
They are ruthless.
And worst of all, they said that if all it took to knock me out was Nitrospray, well then I must be fun on a date.
And that is how I got the sobriquet of “cheap date” when all I did was nearly faint.
But I am not a cheap date.?
I can be had for one Venti Caramel Frappuchino with an add-shot and heavy on the whipped cream. That’s at least four bucks!
And my husband has taken adavantage of that weakness on numerous occasions.
Because I’m worth it.
May 16, 2006, 7:16 pm
Just a quick post to announce a new blog by a new nurse!
Student nurse Jen has begun a new blog called Into The Unit, where she chronicles her new experiences as a graduate, and eventually registered nurse.
She’s working in an ICU unit – talk about diving right in!
And check out the cool “pull tab” on the main page. Very nice design!
I’ll be updating my blog list to show Jen’s new status!
By getting interviewed?
Put a reporter in my face and I’d produce so much adrenaline I wouldn’t be tired for a week!
Maybe he’s a detective, but that would only be worse.
Maybe he’s getting her opinion on how well her support hose is working, but then she’d probably slap him.
(Back then women could get away with that. They did it in the movies all the time.)
She looks so happy that someone is talking to her and writing down every word.
She’d gladly break every HIPPA law on the books for her fifteen minutes of fame.
You can just feel it….
There are a million stories out there in the Naked Hospital.
And there are three sides to every one of them.
Perception is everything.
Having had recent experience as the nurse, the patient and the family member, I am in the unique position of seeing all three sides.
Let us examine how the perception of time, place and situation differ depending on which “chair” you occupy.
Episode One: The Perception of Time
- Nurse: Okay, patient is back from x-ray and needs to be re-revitaled, but he’s stable and I have a new admission and need to start an IV on my other patient and start his pre-op antibiotic.
- Family Member, RN: Geeze, he’s been back for an hour and I haven’t even seen his nurse yet. Hmmm….he’s had Dilaudid, I wonder what his vitals are? (Thinks about putting pt on monitor….nah, they might think you’re pushy.) Well, his airway is intact, his respirations are regular, his color is good and he’s sedated. No problem, I’ve got this wonderful three-year-old Time Magazine to help pass the time, obviously written before Tom Cruise had his meltdown. Oh look at this, Britney wasn’t even married yet. How time flies (no pun intended).
Episode Two: The Introduction
- Nurse: Gotta get these vitals done, thank god he’s still asleep, there’s a woman in the room, couldn’t care less who it is. No time for pleasantries. No, we don’t have any results back yet. No we don’t know what the ultrasound showed. No need to tell you who I am.
- Family Member, RN: Ah yes, five hours after arrival and three hours after blood has been drawn, how could I possibly expect any results. Silly me. That’s why I don’t work in this ER; I had forgotten. Now, the ultrasound is another story, they are probably swamped and those results can be delayed. Dang, this chair is giving me a backache….geeze that nurse is a bitch. No one smiles around here. Must..blog..on..paper…towel…to…ease…frustration….
Episode Three: Pain is the fifth vital sign
- Nurse: How could you say your pain is that high, you were asleep when I came in! How can you be in pain and asleep?
- Patient: Huh? What? Oh, it’s the blood pressure cuff…huh? About 4-5. Oh, gee, I must have given the wrong answer, let me drop the number by two and see if I pass the test. I’m sure tired.
- Family Member, RN: I cannot believe she just questioned his pain scale. (Outloud): “Honey, you need to say what the pain is for you. There is no right or wrong answer” (/outloud) Geeze that nurse is a jerk. But at least she started smiling after she found out I was an RN. For awhile there I thought she had botoxed her way to mediocrity.
Episode Four: And the hits just keep on comin’
(Heard via ringdown: possible triple dissecting AAA enroute Code 3
Heard two seconds later, overhead: Trauma Code, Alpha, ETA 5)
- Nurse: Oh (insert four-letter word of choice here)…….!!!!!!!!
- Family Member, RN: Oh (insert four-letter word of choice here)….I feel sorry for the staff….bad shift….this means it will be another two hours before we see anyone or get any results. Good thing I’ve got this Family Circle from 1963 to keep me occupied. Hmmm….look at this article that states some women actually work outside the home….and a great recipe for lard-encrusted deep-fried cake! Dang, my back aches in this chair.
Episode Five: The Change of Shift@1900
- ER Doctor: You have gallstones (Ed note: diagnosis=seven hours in the making). Your blood sugar is up. Do you have a doctor? Do you have insurance? (Ed note: oh yes, he did say that! And this is the only time I saw him.) You’ll be followed up by the hospitalist and surgeon. Looks like you’ll have to stay in the hospital tonight.
- Nurse: Hey dude! I’m your totally cool and energetic new nurse. Let me introduce myself to your wife! Why she looks familiar. Why, we know the same people! Dude, how’s the pain – can you deal? You call me if you need more of the good juice, man, okay?
- Patient: I’m awake and okay. Good to meet you. Do you think we can put this off until after my son’s graduation?
- Family Member, RN: Thank you, God. He’s in good hands now. Probably laparoscopic chole and we’re good to go! This is the second time someone has mentioned blood sugar. And now they’re giving insulin……is this true diabetes or a fluke response to cholecystitis. Pancreas numbers normal. Hmmmmm…..
Episode Six: The Pain Returns With A Vengeance
(Heard overhead: Trauma Code Alpha, ETA 5)
(Yes, this is another one!)
- Nurse: Oh (insert new four-letter word)….Man, this is frustrating, I have asked the doctor to write another order three times but he hasn’t gotten to it yet. My patient is hurting worse and can’t find a comfortable position. This isn’t fair. We are so freakin’ busy!
- Patient: The pain is worse and I can’t find a comfortable position. I need more of the medication, I’m almost at the same level as when I came in, and I am now wide awake and cranky (when the nurse is out of the room). I think you should go home and check kids.
- Family Member, RN: Oh (insert two four-letter words here)…now we are that much more behind in getting anywhere. (Reminds patient that kids are adults.)Where the hell is the pain medication? Forty-five minutes have elapsed so far from the time of the request. Gee, watching a clock is a pain. Here, I’ll put the call bell on your siderail instead of five feet away from you and if the pain gets worse I want you to call. I’ll go get Son and we’ll switch cars and get yours home. Yes, I have your wallet. No, we don’t know about surgery until you see a surgeon. I’ll stay until you get your shot. Okay, I’ll go now but only if your promise to call the nurse prn. That means as needed. Sorry. Nursespeak.
Episode Seven: The Hospitalist
- MD: Hi! I’m Dr. Young-Enough-To-Be-Your-Son. Looks like you have gallstones and your sugar is up. Let me take a comprehensive history! Yes, you can have a sip of water! Nice to meet you!
- Patient: Okay! (I would be sedated but someone is talking to me. It took an hour to get medicated and now I am and no one will leave me alone! So this is what “high” feels like.)
- Family Member, RN: Wow. He’s young enough to be my son. He’s cute, too. In a theraputic way, of course. I’ll pull the curtain so there is some privacy for the exam. We still have to wait for the surgeon. You’re just the introductory doc. Good thing I brought this book called “Cutting Remarks” about the life of a surgical resident in the ’70s, to read while I wait. Only a nurse would bring this. Haha. I crack myself up.
Episode Eight: THE SURGEON
(Time elapsed since patient arrival: Ten Hours)
- THE SURGEON: Hello, I am THE SURGEON. You may bow in my presense and call me GOD! I am about to take an extremely thorough history and I will take no nonsense from that woman in the corner, nor will I engage in any nonsense. I may be small and female, but so help me, ME, I have more authority in my little finger than you’ve had your entire life. Answer the following questions. They will come fast, they will come succinct and they will help me save your life. Let me finish discussing the surgery and risks before you barage me with question about if you will be able to travel to your son’s graduation. (Raises eyebrow at Family Member, RN, who shuts up immediately). I will use this detailed model I have just drawn at the bedside to explain exactly what I am going to do. We don’t have to do surgery right away if your pain is better and your liver enzymes are down tomorrow. If they are not, we will have to do surgery. You are a diabetic and fooling yourself if you think you are healthy. I will now depart with my flowing scrub jacket flapping behind me.
- The Patient: Oh man. I’m tired and want to go to sleep. You go home, you need some sleep.
- Family Member RN: I love that SURGEON! She’s’ tough, she’s cool, she rocks! She has the bedside manner of a screwdriver but in the OR, it’s her skills that you need and she used to do trauma! Hella cool! No, I’ll stay until you get up to your room. I’m a night nurse, remember? I’m used to this. (I’m exhausted. My back hurts. I’ve read the same paragraph four times, but you don’t need to know that.) I’m fine (smile, girl, smile – get your Academy Award later).
Episode Nine: The Admission
- Nurse: We have a room assignment, we’ll have you up by 2330. Change of shift, you know.
- Patient: Thank god. I’ve been here 12 hours. Honey, you go home.
Family Member, RN: (It’s change of shift, you won’t be outta here until 0100). I’ll go so you can sleep. Love you, too! (Keep smiling…..lose it in the elevator….don’t lose it in front of him). See ya tomorrow! (I’m gonna go home and blog)
And there you have it.
The view from all three sides of the health-care triangle, from someone who’s been seen it all.
But no matter where you sit, the goal is the same.
The health, care and comfort of the patient.