July 18, 2006, 3:41 pm

Thar She Blows!


What on earth is she doing here?

Dancing a jig?

Fighting off a sudden urge to do the Macarena?

Throwing Santa Claus off a cliff?

What is around her ankles?

Did her underwear fall down?

Whatever is happening, that old man looks like he is ready to punch out his nurse!

And she doesn’t look too fond of him!

Perhaps he’s a wee bit too fond of his Depends changes.

Still a rather drastic response, tossing the poor guy off a hill…..


Calling all mid-life folks!

Dr. Peg at PegSpot and author Sheila Key are writing a book about mid-life entitled 50 Ways to Leave Your 40s and are looking for YOUR stories.

Ironically, I heard of this right after I wrote my post on Scared to Health about turning 49 and I sent that post to Sheila.

How are you handling this stage of life? See Dr. Peg’s blog or the book website linked above and let them know!


I lost it.

At work.

For no reason.

I ripped someone a new one, if you get my drift.

And they didn’t deserve it.

And none of the usual excuses/reasons apply.

  • Were we busy? Nope!
  • Was it “that time of the month”? Uh….no.
  • Was I feeling particularly stressed? No.
  • Did I have issues with this co-worker? Never.

It was a sudden rage that came from nowhere and surged out with a vehemence that still makes me shake when I think of it.

As you read the following, remember that the person I went postal on was doing nothing wrong….


The patient was a highly functional elderly woman, maybe in her late 80s.

But she was a very vague historian.

Lots of nice conversation and very little information. No question was answered with a “yes” or “no”, but with a five minute dissertation that went off on at least two tangents and never returned to the question at hand.

I’ve had root canals that were easier than trying to piece together this woman’s history or even why she was in the department to begin with.

But, if you pushed too hard, she became flustered and it was even harder to get information.

Of course, her grand-daughter had only given Granny a ride and didn’t have any info on what was happening. Can’t blame her, it wasn’t easy to figure out!

Oh, and let me mention here that the patient had a list of medications.

Two pages long.


Now that particular shift was not hellacious, so I didn’t feel particularly stressed or tense as the patient gave the 40-year history of her swollen legs.

And the reason why the shift was not bad was that two very fast, very efficient guys were running the show. One an MD, one an RN/PA who I had worked with for a long time. We’ll call my PA colleague “Dave”.

Now when “Dave” is on with one of the rapid-fire ER docs, our department moves. There is no backup.

You want to work when “Dave” is on.

Which makes what happened next all the more off-the-wall.


“Dave” came in to begin assessing the patient, while I was at the bedside trying to do the same thing.

This is not unusual.

We have this system called “rapid/immediate bedding”. It means that if a bed is available, the patient bypasses the usual triage area and is taken straight to a room where triage and registration are done, often at the same time as the ED doc (or PA) begins their evaluation.

When it works, it is quite efficient.

So, after a decent interval of 15 minutes or so, “Dave” joins me at the bedside, where he begins to assess the patient, asking much the same questions I did.

Only now the patient is confused by who she should be talking to and even when “Dave” realized this and turned to the patient’s grand-daughter, the patient was straining to hear what was going on.

I lost her attention and no way was I going to get it back.

The skin on the back of my neck began to crawl.

And then “Dave” did the ultimate no-no.

He had the audacity to reach over and write the patient’s age on the nursing notes.


My notes.


Mount St. Helens looked like a gas bubble compared to what happened next. I placed my pen down (a wee bit forcefully) on the chart and left the room.

No, I may have stomped out.

And then I began to seethe.

Unbeknownst to poor “Dave” who is now trying to get the info he needs to start the orders, Miss Priss here (me) is waiting for him.

Just like Mammy said in “Gone With the Wind”, waiting for him “like ah spidah!”.


“Dave” emerges from the room and I ask him if I can have a moment of his time.

No, I think I demanded it.

I go into the breakroom, kick a drawer shut, spin around and give “Dave” the “what-for”.

I said some pretty insulting things about being a nurse or a PA but not both and how DARE he write on MY chart and how DARE he interrupt my patient assessment and how DARE he enter the room while I’m working and how DARE he write on MY CHART and how DARE he take a breath and how DARE he write on my chart…..

Add a couple (or three) four letter words coming from a fushia-faced, sputtering RN and you have a pretty good picture of what was happening.

My chest hurts just writing it.


“Dave” stayed cool.

Thank god someone did.

But he was shocked, to say the least.

Trust me when I say I’m not known for my explosive rage. And while I admit to being a bit territorial about my chart, I’m not the type to hide it under my scrub shirt so no one can see it.

My usual attitude when a patient comes in is “the more the merrier” – let’s get as much done as we can as fast as we can.

The scary thing is that it wasn’t “Dave” that was the object of my irrational harrangue.

“Dave” is one of the easiest folks to work with, as an RN or as a PA.

It could have been anyone. Any doctor that had done the same thing would have gotten the same reaction from me at that time.


By the end of the shift “Dave” and I were “cool” as they say but I continued to be (and deserved to be) mortified.

Later that night I was telling the night shift what I had done and we were laughing that my psychotic episode from nowhere would go down in the annals of Superior Medical Facility’s ER history.

There are a million stories in that history. This is one of them.


I worked my first shift after vacation on Sunday and told “Dave” I had taken my Thorazine prior to coming in so he was safe.

He gave me a hug and laughed.

The only saving grace to this whole thing is that I did not erupt in front of the patient.

And I am of the definite opinion that I needed that vacation much more than I realized at the time.

And I hope never to experience that sense of anger or behave like that again.

Realizing you are human really sucks sometimes…….


  • Wendy, S.N.

    July 18, 2006 at 4:46 pm

    Poor you. Poor Dave.

    And don’t you hate it when your panty elastic snaps at the very moment you are trying to save an old man from falling off the side of a cliff?

    W. 🙂

  • Rita Schwab

    July 18, 2006 at 6:36 pm

    Thank goodness! I was beginning to think you were way too perfect…

  • Too Fat 4 Ponies

    July 18, 2006 at 8:41 pm

    Imagine a similar situation…
    Nurse manager loudly & angrily accuses student nurse of fouling up nurse note THEN realizes it was an agency LPN and NOT the student nurse that fouled up the note!

    It takes a big person to accept their blow up. You have character. I wish I could say the same about the nurse manager.

    Thanks for sharing.

    BTW, I love the graphic. Wish I had a copy for a presentation on “The Perceived Roles of Nursing” due in two weeks!


  • MotherJonesRN

    July 19, 2006 at 6:11 am

    There must have been something in the water this week. I also went hyper-crazy on a coworker last weekend, but unlike Dave, she had it coming. She was too busy talking about her love life behind the nurses’ station to notice that her 70 year old patient was soaked with urine and needed a shower. The only thing that could have made the situation worse is if my undies had dropped to my ankles while I was yelling at her.

    Sorry you (and Dave) had a rough shift.

  • unsinkablemb

    July 19, 2006 at 8:51 pm

    I do think that something was in the water. This is why I HAD TO take last Friday off. If I didn’t, then someone would surely have been in my path of destruction! The only thing I managed to destroy was a large bag o’ potato chips. 🙂

    Sounds like Dave is pretty great – and ultimately you were, too, for being a professional and admitting when you were wrong.

    Take care…

  • geena

    July 20, 2006 at 11:19 am

    Are you sure you aren’t pregnant? *grin* I haven’t majorly gone off on anyone yet, but I am so irritated with most things that go on at work – it’s only a matter of time.

  • Sid Schwab

    July 22, 2006 at 3:18 pm

    In talking to some nurses recently, I was reminded of a time I got angry in the OR and chewed out one of the really good nurses. I felt so bad, I called her at home that night. She wasn’t there but her husband answered. Humilitated enough that I didn’t care, I apologized to him and told him to tell her Dr Schwab called to say he’s an idiot. According to the nurse, her husband was very impressed, since he’d heard her describe many such incidents but this was the first time anyone called to apologize. Yeah, being human definitely sucks sometime. Funny thing is, when the nurse recalled the incident to me, I couldn’t remember it…

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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