Nurse Follies: How to Make Your Nurse Your Best Friend

1. Call her waitress. She LOVES that! Because after 2-4 years of the hell that is nursing school, we really like being known for bringing you chocolate pudding.

2. Make sure your hand is hugging your penis whenever your nurse enters your room. If you happen to be jerking off at the time: bonus! Make sure you touch their bare skin with your bare, unwashed hand for maximum bonding moment. Their forearm works, so does the hand. Triple bonus if you manage to touch his/her face.

3. If you are fortunate enough to have a significant other, schedule a special visit from them to coincide with nurse rounds. Nurses really like to see their patients getting their freak on. We feel especially blessed when you send the girlfriend/wife out 10 minutes later for a towel.

4. If Matthew McConaughey doesn't use soap, neither should you! There's nothing better than the "I haven't bathed since Woodstock" smell. The crustier, the better!! Bonus points if you have an infestation of some sort. Nurses really like taking little guests home with them.

5. Make sure you tell your nurse all about your "gubment" checks and bennies. It will make them feel a lot better about having to work overtime to pay for them.

6. Got the flu or some other contagious respiratory thing? Caring is sharing! Be sure to cough in their face when he/she is bending over you, looking at your IV/warts/seeping wound. They could use a day off, and sickness is the best excuse to call in to work. Sure, they will be sick at home, but you have at least given them something to remember you by!

7. Nurses love to have visitors, so make sure every member of your family comes to visit at the exact same time...even the relatives you only see during reunions and funerals. Just so your family members can meet your nurse, have them go and find her, one at a time, to ask for a can of soda or a pudding cup. Pull them out of another patient's room if you have to.

8. Make sure you read up on the latest medical trends in Woman's Day and Readers Digest. You can discuss these subjects like an expert and your nurse will be wowed by your knowledge. You may even be awarded an honorary nursing degree.

9. Oprah Winfrey is a God, and therefor anything she says is gospel. Including the time she told you not to take a certain med because it was bad for you. So, when you go into the hospital as a direct result of not taking that particular med, make sure you explain to the nurse that Oprah directs your care, and not your doctor.

10. Don't touch those pimples/blackheads/boils. Save them for the nurses!! The bigger, the better. Nurses love to pop those suckers. It's like bubble wrap to them.

11. Call lights are for wieners. Send your family members out on a search party to find your nurse, even for the most trivial things...because there is no such thing as "trivial" to a nurse. It's all important!! They really want to know when you want your television dusted off and are eager to help.

12. Code Blue situations are really exciting. Like the television show!! Make sure you get a bird's eye view by standing right in the doorway, especially if it's not even your family member that's coded. Remember to ask questions. They really like that.

13. Don't designate one family member to call and check on your loved one, have them call all at once. Nurses are not busy at all and love to talk to all 20 of your family members in the course of their entire shift, including your ex-husband who lives in Ohio. Who needs a privacy code? You're love for said inpatient trumps any kind of federal privacy laws, and the nurse frequently needs to be reminded of thus.

14. Hospitals have the best free snacks! Make sure you ask your nurse for a round of Pepsi and pudding cups for all your visitors. Your guests will be impressed at your generosity and how much clout you have for such free service.

15. Hospitals are the perfect places for sleepovers. And when there isn't a sleeper chair available, have your significant other crawl in bed with you. Snarling at the nurse for waking your special little somebody with their menial lifesaving tasks is perfectly acceptable. Nurses frequently need to be reminded that your sweet wubbin-nubbins has been very stressed out about your hospital stay, and should be allowed to have uninterrupted sleep.

16. Your needs should take priority over everyone elses! Go find that nurse and remind her that your loved one's hamburger needs reheated. She can code that other patient after she's done...it's not like they are going to get any deader. Go into other rooms if you have to find your nurse. Your family member's dinner is at stake!

This has been a public service announcement.

Nurse Follies: What A Nurse Is...And Isn't

There are a couple nurse-specific sites I frequent, but usually just the message boards. One particular area that captures my attention is nurse activism. I'm not talking about lobbying for safer nurse-patient ratios. No, that's a good thing and I'm all for it. I'm talked about those obsessed with the image of nursing. I go between rolling my eyes, laughing out loud, and just wanting to find the ninnies and beat them with a bedpan.In 2004, Sketchers ran a series of ads featuring Christina Aguilera. She was dressed as a cop/criminal in one, a sexy teacher/student in another. And then there was this ad. It immediately raised the ire of nurses everywhere, and then some who wished they were nurses. There were letters, threats to boycott, and blah, blah, blah. They claimed that this ad was demeaning to nurses and all that other feminist bullshit, and the end result would be that no one would take nurses seriously because this ad portrayed nurses in an unflattering and undignified way. Eventually, Sketchers caved and pulled the nurse ad. The cop and teacher ads were not pulled because, apparently, teachers and cops are no where near the prudes that nurses are.

Those shoes are entirely inappropriate for floor nursing.

I personally loved this ad, and I could only wish I looked half as good in a nurse get-up. Anyone who makes a decision to view a nurse poorly because of a shoe ad has the IQ of a cat turd. Anyone with half a brain knows that Christina Aguilera in a nurse outfit does not equal a real nurse. When you've managed to blow your meth lab up with you in the vicinity, who do you want to take care of your stupid, crispy ass? Naughty Nurse dressed in lingerie? Or the veteran nurse in wrinkled scrubs who knows what the hell she is doing? Wait...don't answer that...


In our flannel pajamas, perhaps.


Say the word "nurse" and someone will inevitably put the word "naughty" in front of it. Tell a guy you are a nurse, you will get the whole "give me a bed bath" proposition (and the answer is still no).

I don't know when nurses became "naughty". I don't know what it is about my profession that makes us "naughty". While it's nice to be in a profession that is considered "sexy", most days, when I'm in my wrinkled scrubs covered in various body fluids, I feel anything but. I once dated a guy who went out with me just because I was a nurse, and he thought that was hot. It amused me because he had a high-profile job and he thought he was teh shit because he bagged a nurse. In fact, he was always begging me to wear my nurse cap. I never did (packed away).

Even so, this shoe is totally awesome!

Just because I'm a nurse, doesn't mean I'm automatically naughty and sexy. I was naughty and sexy long before I became a nurse.

When I am at work, I am the furthest thing from naughty and sexy. And in the end, that's best for everyone.

Nurse Follies: Overheard During Report

Nurse: Mrs. Bread has a yeast infection in her butt. I don't know how she got it. I don't want to know either.

Nurse Follies: The Race Card

Here at General Blather, we don't shy away from the controversial topics. No, we embrace them as the head cheerleader embraces the entire football team on Homecoming night. Not everyone likes what they read here. If you do, hooray. If not, hooray...and don't let the door hit you on the ass on the way out.

Racism is alive and well in the good old U.S. of A. Now that I have established Obvious Day at Camp Stupid, I would just like to delve into the subject just a teensy bit further without starting a riot.

In the 30-some years I've been converting oxygen into carbon dioxide, I can honestly say that I haven't had a lot of direct dealings with issues of race. That is, until I started working as a nurse.

Yes, I encounter lots and lots of incidents of patients/family members pulling the race card, as in, "You only (fill in the blank) because I'm (pick a race, nationality, etc)."

I don't particularly care for these people because it undermines my nursing abilities. It's impossible to do anything right. I even encounter white patients who only want to be taken care of by white nurses. I hate these people even more. We once had a patient who was so outraged that her nurse was African, that she pitched the biggest fit that she wanted only white nurses to take care of her.

Now, sometimes we get that from ancient people. While unacceptable, you can sort of understand that archaic mindset. Different generation, different way of thinking that they never grew out of because they are old, ignorant, rednecks. Whatever, just die off and let humanity progress. Not this patient. She was young and should have known better. But instead, she was harping on me because she was a shameless bigot. Sadly, I changed the assignment. Not because I wanted to make the patient happy. She could have kissed the fattest part of my lily white ass for all I cared. No, I did it because the nurse deserved better. And, in an act of which I will wholly own up to being a complete asshole, I assigned her the dumbest fucking nurse on the planet.

Your nurse may have the IQ of a bologna sandwich, but, hey, at least she's white!

But I digress. I'm not here to discuss patients and family members. Otherwise, I'd be blogging about this subject until I retire, and really, it's not worth the effort. People are idiots, I recognize that, and I move on.

No, I'm just here to discuss the other end of the coin. Those employees who pull the race card.

I personally don't care what color you are. Black, white, red, yellow, titty pink with big, purple polka dots. Hell, add a horn growing out of your forehead for something interesting. I don't care. I hold all people to the higher standard. Understand that we are here to do a job, and I don't give two shits about whatever chip you have on your shoulder about something done to your ancestors long before I was a twinkle in my father's eye.

That being said...

I've encountered more than my fair share of employees that use this whole race card thing as a crutch. It's just another form of avoiding accountability, if you ask me. Frankly, it's getting to the point where I'm this close to going postal. It's almost a normal, everyday occurrence to come down on one employee for neglecting their patients, only to have them turn around and cry to the Bosshole that they are being picked on because they are black/red/paisley. No, you are getting reamed on a regular basis because you are a lazy twit and patients deserve better.

I was charging one night, and there was some sort of issue with staffing that was long, complicated, and confusing. It had one staff member floating to another floor while someone from a different floor floated to us. It happens, and there is usually a reason for it. As long as staffing is covered, and everyone gets their hours in, it's usually a non-issue. Right? Not according to the person who had to float. I explained to this staff member the reasons for doing what we did. She looked me in the eye and asked, "It's because I'm Asian, isn't it?"

Seriously???

I sighed and told her that her ethnicity had nothing to do with the larger picture. I reassured her that management screws us all equally regardless of reed, creed, or color.

And that's the truth!

You Know What Sucks About Being a Nurse?

Last month, my older stepbrother was taken to the hospital with intractable back pain. He wasn't able to walk at all. A scan shows some unusual spots in his lungs. A biopsy reveals it's cancer. Further testing shows it has spread to his brain, his spine, and his adrenal glands. Stage Four Large Cell Carcinoma with Metastasis.

As a nurse, I know exactly what this means.

I have confided my professional opinion to some, but not to stepbrother's wife or daughters. They still have hope. They want to pull out all the stops for treatment. I can't blame them. It's human to want to fight. To want to at least try. Because when the dust settles, no one can ever ask, "What if...?"

Seven rounds of radiation with chemo treatments starting soon.

As a nurse, I know that while these things may buy some time, they will not buy a cure.

The picture gets bleaker and bleaker. Now, he's in the hospital with pneumonia, which is never a good thing when you have lung cancer. Everyone offers prayers. I gave up on prayer long ago when the words felt like sawdust in my mouth. Instead, I offer self. I have skills. I have knowledge. I can contribute in some way and leave faith to those who still have it. All the family members who are not in my field have hope and faith in unbundance. I don't begrudge them for it. I don't scoff or leer.

But as a nurse, I know that hope and faith are exercises in futility.

I see it everyday. Families, desperate for hope, cling to the words of the professionals. Looking for the faint glimmer of a silver lining. Anything they can use as a call to rally to fight. I see it in my family now. I see the set of their jaw and hear the determination in their words as they vow to "beat this".

As a nurse, I know the horrible truth.

As a sister, I can't bear to say it out loud.

Nurse Follies: A Fun New Game

Who says nursing has to be boring? Who says we can't have fun doing what we do?

A nurse revealed to me that a game she and a colleague like to play is to sit in the hospital lobby at the end of their shift and play "Patient or Employee". They watch people enter, and then guess whether they are a hospital employee or a patient. You'd think this would easy...staff usually wear scrubs, patients wear, well, gowns and pajamas. But sometimes our hospital pajamas which look a lot like scrubs.

I suppose you could go even further and say they are visitors, but where is the fun in that.

I suppose I could tweak this game to make it a drinking one, but I'm sure someone would take umbrage with a bunch of nurses lounging in the lobby, doing shots at random times.

For the time being, I'll just fine tune my Nursing Bingo card game.

Nurse Follies: One of the Grossest Moments in Nursing

My job is not always pieces of whole fruit and patient insults. Sometimes, we encounter things that are the equivalent of a neon sign screaming, "Get the hell out of nursing, you idiot!"

This is one of those stories. (Warning: Not for the faint of heart.)

We had a patient once, a paraplegic who had come in with something GI related that required a colonoscopy. As standard with our paraplegic folks, he got himself a nice Clinitron bed. For those who don't know what that is, it's a huge bed, that looks like Barbie's swimming pool. Filled with air around the perimeter, in the middle is a recessed area filled with sand. When turned on, hot air blows into the sand, creating a very soft, pressure-free, floaty environment that is supposed to be ideal to prevent skin-breakdown. Hot air blows up through the sandy part of the bed, but the sand stays in the baffle. The bed itself is a pain in the ass. Heavy to move. Patients hate it. Not to mention you get one tiny hole in the sandy part, your room turns into the beach minus the fruity rum drink with the little umbrella.

As also with patients who are lucky enough to win a colonoscopy, they get a bowel prep. Some places just give you repeated enemas, and you are done with it. Other places, the preference is Go-Lytely. A huge gallon jug that has some sort of additive to it, we fill with water, and you have to drink the WHOLE DAMN THING. The makers of Go-Lytely at one point decided to be a little more sympathetic to the plight of the poor person drinking it, and added little packets of flavoring. So, instead of drinking bland bowel prep, you get a choice of Cherry, Orange, Lime, or Pineapple. I once combined Lime and Cherry and told the patient to pretend it was a Cherry-Limeade from Sonic.

The end, and desired, result of drinking Go-Lytely, is that it cleans out your colon. And by clean, they want you shitting out Go-Lytely without an iota of color. But what if you don't run clear after your gallon? Well, you get gallon number 2, and you will be shitting until Rapture. For this reason, I have renamed Go-Lytely to Go-Lotly.

So, Paraplegic Man drinks his gallon of Go-Lotly because he's a good patient and doesn't want a tube down his nose. I don't remember what flavor he picked, and what's even more important is that I don't care.

Later that night, newish grad nurse pops out of the room, subdued and pale. She waves for me and Red to approach, looking very distressed. We answer the bat signal, and the smells hits us halfway down the hall. Immediately, my eyes begin to water.

"I need help." Newish RN tells us. Red holds her nose. Smo materializes, demanding to know what that smell is. Newish RN wrings her hands nervously, "I don't know how to begin..."

So, me and the others charge into the room like we're the Four Horseman riding into the Apocalypse (which is what the room smelled like). There's safety and numbers, and the faster we can clean this guy up, the faster we can get out of the room. The smell...OH MY GAWD THE SMELL!! A hot, thick odor that hung in the air and made you forget that there are good things in the world worth living for. Meanwhile, the patient, a middle-aged guy, is also holding his nose, and apologizing profusely because he couldn't control his bowels. It's okay, dude...you're a para and you can't be expected to control such things and we're not going to eat you lunch for this. In fact, after this episode, we're not going to eat anything for a long, long, LONG time.

Then, we hear bubbling.

With flourish, I pull the blanket off the patient, "Let's see what the damage is." One sight of the situation, I put the blanket back over the lower half of the patient, put my hands on my hips and stare speechless at the other nurses.

"Holy Mother of God." I mutter.

Smo rolls her eyes at my penchant for the dramatic, and pulls the covers back off the patient. The sight that greeted us was a Clinitron bed literally full of the foulest smelling poop to ever been expelled by a living organism. The entire sand-filled area was covered, and the patient's lower half immersed like he was at a dayspa soaking in a mud bath. To make matters even worse, the hot air from the bed is being blown up through the mattress, causing the contents to bubble and spew like a damn pot of chili. It had the same color and consistency of chili, too.

"It almost looks like an evil moat from Lord of the Rings" someone observed. This was met with groaning.

Meanwhile, a tech walks into the room, gags, and immediately runs out of the room. I assume she went to go fill out an online application to Walmart.

Just out of curiosity, I demand the patient tell me what the hell he ate that day.

The nurses stare at each other, each covering our noses. So is the patient. But because we are a resourceful bunch of of night nurses, we start brainstorming as to the best way we are going clean this mess. Some suggestions included:

- Crafting a suction system where we can suck up most of the mess like a Shop Vac. Unfortunately, our tubing is too narrow and would get clogged frequently. We wonder if Maintenance would loan us one of their Shop Vacs.

- Getting styrofoam cups and bailing out the bed until we excavated the patient.

- Finding some nursing students and making them clean it up and call it a "learning experience". Sadly, we don't get nursing students at night.

We decided the bed wasn't salvagable, so we just transferred the patient to an regular bed, cleaned up what we could off the Clinitron, covered it with blankets, and pushed into the dark recesses of the back hall. I suggested we torch the damn thing, but considering these beds can cost up to $50K, the others thought that might make the higher-ups unhappy, and may affect our whole piece of fruit gift for Nurses Week and leave us with a coupon for a free cup of ice water and bonus bendy straw.

The bed people came the next day and picked up the bed. I don't know what happened to the bed. I can't imagine how they even got that thing cleaned. Maybe they did torch it, but one thing is for sure...

I wouldn't even touch chili for two years after that incident.

Nurse Follies: The Impossible Situation

Mr. Pickled arrives to the hospital on a Friday, sporting a yellow skin tone that makes him glow in the dark. The family, brags that he has come in for a liver transplant that will take place the following Wednesday. Nurses are puzzled. Liver transplants generally aren't scheduled in advance as they are transplanted within hours of retrieving it from a donor. Donors aren't exactly something you can predict. Not to mention that the Transplant Gods refuse to give a new liver to someone who can't put the bottle down for six months before the transplant and promise not to drink after.

The disease process of a crapped-out liver runs its course, and inevitably we come to the part where Mr. Pickled is going to die, and the family has decided that they have no choice but to let him go. Wife and sister hold a beside vigil while Mr. Pickled prepares to transfer to the Eternal Care Center.

Now, palliative patients are near and dear to me. I find it rewarding to help in this transition. To help the patient be comfortable, to help the family cope with the impending loss. It's a highly personal experience, and I am honored that family members trust me enough to share in their journey. It's an area of nursing I am very good at, but have no inclination of doing it full time.

Sadly, I'm not taking care of Mr. Pickled, and get to wear the charge nurse hat. A friend and colleague (Salty) gets to care for the Pickled Family (because it Palliative Care, the focus is just as much on the family as it is on the patient). She is a newer nurse, and somewhat uncertain, so I help her when I am not dealing with the phantom toilet flushing in the staff bathroom that's causing the other nurses to freak out.

Mr. Pickled goes into his agonal breathing pattern, which is to say his breathing becomes shallow and slows to 2-4 breaths a minute. The first time this happens, the family assumes it's his last breath and begin the emotional release that comes with the death of a loved one. Then he takes a breath. The family stops crying, blinks their eyes, and the vigil resumes. This happens three other times. The crying stops and starts like a faucet. Emotions are raw. It's as if you relive the death of a loved one over and over again.

Death is different for everyone. Some go quick. Some like to hang out for a while. Mr. Pickled is unpredictable and no one can be sure how long he's going to keep this up. The family asks us to give them a time frame. We can't.

Finally, Mrs. Pickled cries, "Can't you do something to stop this? Can't you give him more Morphine to end this? I can't take it anymore!?"

Salty and I look at each other, speechless. Narcotics are given to keep the patient comfortable, alleviate air hunger, pain management. Yes, there is an unspoken understanding that it could hasten the inevitable, but never before has a family outright asked us to expedite the process.

Finally, Mr. Pickled passes away an hour or so later, without further nursing intervention. Mrs. Pickled crawls into bed and spends the rest of the night sleeping, for the last time, by her husband's side. It freaks out the younger nurses, but we just let them be until morning. When the wife leaves, she thanks the staff and makes no mention of her previous outburst. I wonder if she looked back upon it and kicked herself in the ass.

There are medications that some patients take that are life sustaining. Any cessation of these meds will result imminent death. Some patients, after a while, opt to stop the drugs, which results in their imminent death. The patient knows that this will be the end result because doctors and nurses make sure they know it. Would this be considered the same as an assisted suicide? Why is this more acceptable than giving someone a high dose of something that is going to hasten the death of a terminal patient? Euthanasia is not legal, but it also encompasses a HUGE gray area that no one speaks of.

Maybe, folks need to start talking about it. And not in the final hour when you want the nurse to do it.

Happy Nurses Week!!

This June, I will have been a nurse for seven years. SEVEN!! The time has raced by faster than a man to the bathroom after having a one-liter enema. In that SEVEN years, I have been hit, kicked, pinched, spit on, shit on, pissed on, vomited on, cursed at, threatened, injured, insulted, emotionally drained, and exhausted physically.

So, how does ACME Hospital honor me, honor us, on this most sacred and holy of holidays for nurses?

With coupons for a piece of whole fruit. We were puzzled it specified whole fruit. As opposed to what? A half-eaten banana? Last year, we got coupons for a service that turns out they didn't pay any money for, but was a promotional card for some spa business that they handed out to anyone who wanted one. For free.

I don't think I want to guess what the higher-ups get for their bonuses. It will probably throw me in a deep depression that ends with a full psychotic break and I run around the hospital lobby. Naked and covered in powdered sugar singing about being a donut in my former life. Trust me...it wouldn't be pretty.

I'm just going to assume they got two pieces of whole fruit instead.

Nurse Follies: Accountants Don't Get to Have These Conversations

Mrs. Needlovin is a frequent flyer in our neck of the woods. She's a scary old woman who apparently needs some attention down there. She tries to use many tactics to get people to poke around down there. She has has tests and exams which have shown nothing wrong with her down there(other than it being a shriveled, old lady muffin). She even once asked the poor soul who brings the dinner trays to help her out.

Mrs. Needlovin: My vagina hurts.
Me: I'm giving you pain medicine for that right now.
Mrs. Needlovin: Can I have an ice pack?
Mr. Needlovin: What do you need and ice pack for?
Mrs. Needlovin: To put in my vagina.
Me: We are NOT putting an ice pack in your vagina.

Mrs. Needlovin takes her pills. I assess, the husband is still sitting at the bedside, clearly embarrassed. I finish my assessment and announce that I will return later.

Mrs. Needlovin: So, you're not going to do anything about my vagina?
Me: That's what the pain pills were for.
Mrs. Needlovin: Oh, but I need someone to squeeze my vagina. Can't you help?
Me: Uhh...no.
Mr. Needlovin: (rolls his eyes) This really isn't something I want to get into.
Mrs. Needlovin: Oh, trust me, there's been plenty of times when you want to get into it!

Nurse Follies: Those Little Things

He was in his 40's, and he had Parkinsons. And he got to spend Christmas in the hospital. No one likes to be in a hospital during Christmas. Especially when you have families. We assume he addressed his frustration by calling the nurse every ten minutes for even the dumbest shit. Some people bring crossword puzzles, some knit, others aggravate the staff.

At the end of the shift, his nurse, a young new grad, was finishing up some last things in his room. Young new grad is a dude in his mid-twenties. Most everything rolls off his back. So far, unphased by what he sees. He will be a good nurse.

Parkinsons patient eyes his nurse, "M-m-m-mer-merry C-Chri-Chris-Christmas". You could tell it took great effort for the patient to utter these two words to his nurse, when he could have just saved his energy for when his wife and children arrive later that day.

Unflappable new nurse thanks the patient and leaves the room. Later, I find him at the desk with tears in his eyes.

Yes, he will make a fine nurse indeed.

Nurse Follies: The Asshole

I'm a self-proclaimed asshole. I don't like bitch because it suggests that there is some sort of hormone that is influencing my behavior, and my life isn't governed by estrogen. No, I'm just a plain and simple, garden variety, asshole.

However, while I may be an asshole, I am an asshole with purpose. There's always a reason, something that needs done, or a point to be made. With great power, comes great responsibility. And I won't waste my talents on just anyone. If you are rude? I'm going to be an asshole. If you are an ignorant derp? Asshole. If you are mean to people for your own personal enjoyment? When I am done with you, you are going to think I am the genesis of assholery.

I mention this, because we have a frequent flyer patient who is also an asshole...but an asshole with no other purpose than to control people. Because of the nature of his illness, he can only come to my floor. Other floors will never experience his charming personality. There are no good qualities about him, and when we see his name on our patient list, a little part of us dies inside. Some people have openly wondered just when he's going to die. He's demanding, degrading, demeaning, insulting, abusive, makes staff members cry, openly hostile, controlling, and just an overall colossal douche.

In dealing with him through the ages, we guess that he has some sort of Borderline Personality Disorder, because no one person could be that evil just for fun. We've also mapped out his tactics and manipulations (all lies), which he switches seamlessly when staff doesn't cave to his terrorism.

Flattery: Oh! I remember you!! You're are my most absolute favorite nurse EVER!!! I even was telling my wife about you the other day. Now give me what I want.

Guilt: I'm a dying man!! I only have months to live! Honor a dying man's last request and give me what I want.

Baiting: You are the crappiest nurse on the planet! If you want to prove me wrong, you will give me what I want.

Fear: My brother's cousin's wife's roommate is on the board of directors for ACME Hospital. If you don't give me what I want, I will have you fired.

Playing Sides: The other doctor/nurse said I could, and it was okay. So, you can give me what I want, too.

Pastor Douche: The bible says that you need to treat all people with respect and Jesus Christ blah, blah, etc. If you were a good Christian, you would give me what I want because Jesus would.

Weaker or newly minted nurses, have been reduced to tears by this man. Everyone who has dealt with him longer have come up with new and creative ways of telling him to go fuck a goat. Figuratively speaking. I try to avoid him altogether because we'd get into yelling matches, which would draw an audience outside the door. Usually nurses, sometimes with popcorn. One time, when he used his entire arsenal and hit nothing but air, he told me that he was happy that I was going home in the morning.

"Trust me, sir." I said before marching out of his room, "No one could possibly be more happy about that than I am."

He's this way to everyone...doctors, nurses, management. There is nothing that can be done to shut him up, short of some anterior pillow therapy. Instead, we get pats on the back, sympathetic murmurs, and maybe a pizza party upon his discharge.

So, he just visits us often, makes our lives miserable for a week or so, then goes home. Lather, rinse, repeat.

During his last visit, when he realized that he was going to get no where with me, he flatly told me, "You're a bitch."

"Actually, sir, if you don't mind," I replied. "I prefer asshole."

Nurse Follies: Say What?

Doctor's note: per patient wishes, if she arrests, do not intervene. But if she has not passed away, do everything, including intubation.

I showed this to numerous staff and asked them to translate. None could. Given the fact that she had no outlined code order in her chart, she was automatically a full code, which rendered the note moot.

You have to love July. The air is humid. The sun is shining. The new residents are out in full force.

Nurse Follies: The Shrink Is In

There must be something about my face that says, "Tell me everything. Even if I don't ask for it."

Case in point...

We received a transfer from Podunk Community Hospital and Tractor Supply Store. The nurse who called to give me report was someone who had apparently been in the nursing game a while, but her exposure to anything outside of vanilla was next to none.

"He has a partner," She whispered scandalously over the phone. "A boyfriend!! And the boyfriend will be coming with the patient!"

I rolled my eyes. Big stinking deal. I almost told her to call me back when she actually had something impressive to tell me, like the guy grew tentacles from his nose or gave birth to a grilled cheese sandwich. Small town corn-holing rednecks. I hate them with the burning passion of a thousand Twilight fans.

At any rate, a couple hours later, the patient arrives, and after five minutes with him, I have decided he's an obnoxious asshole. It also helps that he told me that he's an asshole.

"That's okay," I reply. "I'm a bigger one."

Asshole Patient has sores on his feet, to which I ask what they were from. He shrugs, "I don't know."

"You don't know? What do you mean you don't know? Did you wake up one morning and they had magically appeared with the help of woodland gnomes?"

Other Half arrives and I get the patient settled, but not before listening to his million complaints about everything else. The patient was one of those types who tries hard to be a smartass because he thinks he's very clever at it, when in reality, instead of coming off funny, he comes off like a ginormous douche bag. Every staff member who enters his room comes out with the distinct impression that this guy is a colossal tool.

Other Half leaves to go home, and I go to draw blood on the patient. As I am working, he starts talking.

Patient: Yeah, we've been having relationship problems.

Me: Relationships are challenging.

Patient: I know! But it's my fault because I'm so jealous. I'm the jealous type...and I'm an asshole.

Me: ...

Patient: But the Other Half promised me that he was going to tell his friend that he can't come over to the house anymore unless I am home.

Me: Sounds like you have suspicions about the friend.

Patient: Oh yes! He's after my Other Half, but Other Half assures me that he's just a friend from prison.

What the hell do you say to something like that??? Reassure the dude that Special Friend and Other Half spent their time in the clink just playing dominoes and watching Young and the Restless on the common room??

No, I just kept my yap shut and finished drawing his labs. With my recent relationship failure, I'm the last person who should be giving relationship advice. The best I can do is pat his arm and give him an ice cold Pepsi.

Which was exactly what the staff doctor did for me when she came in the following morning and found out he was my patient. Apparently, Pepsi is the great healer of wounds.

I hate Pepsi. Pass the Prozac.

Nurse Follies: There's a Distinction?

RN: Do you smoke and when was the last time?

New Patient: What? Smoked cigarettes, or smoked?

RN: Cigarettes.

NP: Yeah, I smoke cigarettes. I had some just before I came here.

RN: Okay, do you do drugs?

NP: Yeah. A couple of things.

RN: When was the last time you did drugs?

NP: You want to know when the last time I did just a little, or the last time I did drugs??

Nurse Follies: Lazy Is As Lazy Does

I went to nursing school at a community college. I don't regret this decision. It afforded me the opportunity to get my training done in an expedited amount of time, got me out into the workforce quickly, and I didn't finish with tens of thousands of dollars in student loans to pay off. I didn't feel short-changed in my education as the curriculum was challenging. Four years of training crammed into two years of school, with a heavily emphasis on practical stuff. For the most part, no patient cares where I went to school, just that I know what I'm doing and won't kill them. Six years later, I'm looked upon as a mentor, a leader, and a kickass-take names nurse.

In working at ACME Hospital, I get to work with a crap ton of newly-minted nurses with Bachelors degrees. I have noticed the big difference between ADNs and BSNs is life experience. A majority of those who were able to go to a 4-year college were in their 20's, sorority girl types, whose parents had footed the bill for their education. They come out with an adult title and are working their first real "adult job", but still have their foot in the door of the carefree life they enjoyed as a college student. It was a sharp contrast to those who mostly attended two-year degree programs. Usually a little older, some married with kids, some single parents. They were making a career change for various reasons...laid off, tired of working dead-end jobs, answering a higher calling, or just necessity. These were people who had to juggle mortgages, family life, bills, full-time jobs, and all those wonderful things that sets grown-ups apart from those who only can only claim to be grownups in age only. Don't get me wrong, I'm not saying one is better than the other. I'm just saying they are different.

My contempt of Bosshole is legend. Now, imagine how that changed when I heard that he told a coworker in an interview that he felt "two-year degree nurses were lazy". Lazy in the respect that they chose the easy way, instead of going to four-year colleges like non-lazy nurses.

Really? REALLY??? This coming from a guy who comes in and holes himself up in his office all day, refuses to help his staff, doesn't stand behind his nurses, yet takes all the credit when we do something good. My floor has the highest turnover in the entire hospital, and he has convinced himself because our floor is stepping stone that nurses utilize until they are ready to move on to bigger, better things. No, nurses leave our unit in droves because you foster zero-loyalty to the floor, instead creating a toxic environment. That, and you suck hard as a manager.

To me, degrees are irrelevant. The best nurse I have ever known was an LPN. Meanwhile, the dumbest nurse I knew happened to have a precious BSN, and committed the most heinous drug error that cost the hospital she worked at millions of dollars, AND the patient subsequently died as a result. But thank God she had that degree!!

To break it down, two-year and four-year nurses receive the same training, but with the latter getting more focus on the leadership aspect, and the former the more-hands on stuff. In the end, both take the same damn test, work on the same damn floor, and make the same damn salary. Only BSNs are supposed to be poised for management positions, which might explain why Bosshole couldn't find his way around a bedpan. ADNs are clinically prepared, BSNs administratively so.

To make the comment of the Bosshole even more epic, the person he said this to happened to have finished her nursing school training from a two-year college, eventually bridging to a Bachelors degree (which leads us to believe that he doesn't read resumes). She called him to task for his poor attitude against "her sort", and he back-pedaled, offering some lame story about a nurse he used to work with who had a two-year degree. Needless to say, the rest of his lazy ADN nurses are aware of his comment, and are currently looking for other floors to transfer to. Who wants to work for a manager who thinks they are lazy??

I don't have attitude against BSNs. I know some really great BSNs who could give two-shits what your degree level is. In fact, when I reveal my lowly degree status, most are surprised. In fact, I am going back to school to get mine. It was the plan all along, as with a lot of those who go the two-year route, only Bosshole fails to realize that. A lot of people use community college as a stepping stone to get into a 4-year college. It's not lazy, it's not stupid. It's practical.

Hell, there are even those who are perfectly fine with an ADN and wish to go no further in their education. It grants them a solid job with a good income to provide for their families. And despite what my arrogant prick manager might think, there is absolutely nothing wrong with that.

When I am finished with the BSN, I plan on going on for a Masters degree. It is my plan to go retire as a teacher for a nursing program...at a two-year college.

Nurse Follies: The Strike Chronicles

I've always wondered about nurses who go on strike. Not because I want to try it out, but about the anatomy of it. The only things I hear about what they are paying those who cross the picket line to work (scabs). Believe it or not, there is an area devoted entirely to scab nursing. Sure, the money is phenomenal, but at what cost?

Anyway, I've been reading Madness for a while, and their experiences with contract negotiations and subsequent strike has been a fascinating read. If you ever wanted to know the inner workings of a nurse strike, go check it out.

Offering words of support wouldn't hurt either.

Nurse Follies: Heterosexuality Confirmed

I called Dr. Dum-Dum to notify him that his patient wasn't producing any urine. None. A severe non-compliant diabetic, the kidneys were marking their farewell tour. And headlining the event, was a pretty bad UTI. I even did a preemptive bladder scan that showed that the patient's bladder was drier than Betty White's vagina.

"Put a catheter in," Dr. Dum-Dum suggested. "So we can measure how much urine she makes."

Because residents are new, and sometimes need a little help, I gently explained that the patient was not making any urine, and therefor, would not be any to measure. And introducing a foley would not encourage her to make any. Not to mention it's not a good idea to put a foley in someone who already has a UTI. Dr. Dum-Dum wanted to press forward because even doing a stupid thing is apparently better than doing nothing at all. I followed the phone call by pounding my head on the desk. Not only was this UTI patient in renal failure, she also weighed close to 400lbs.

If that doesn't cap off the shittiest week over, I don't know what does.

Because I believe in sharing the joy, I enlisted our newly minted Unit Coordinator to help. She blanched when I told her what we were doing, and who we were doing it on. Baptism by fire, I always say.

So, we gathered what we needed, said good-bye to our families, and entered the room.

If some random staff member would have walked into the room at the time, the sight that would have greeted them is as follows:

- Bed raised in slanted position with feet on the air. Every single light in the room turned on.
- Four hundred pound patient holding her belly up away from her No-No Area.
- Two RN's, in yellow isolation gowns, glistening with sweat. You can't see where there hands are. You don't know want to find out.
- Short blond RN is scowling, and possibly looking like she's going to bust out into sobs. Foley catheter tube in one hand, she's muttering about not being able to see anything.
- Bad smell permeating the room.
- Unit Coordinator looking bewildered.

By some divine miracle, I got the catheter in. I really couldn't see where it was supposed to go as the No-No Area looked more like the Fantastic Caverns in Springfield. I'm sure if I would have shouted my name into her vagina, it would have echoed back. At the end, I just hoped for the best and that the catheter maybe had some sort of homing device that would find the bladder, which is where it ended up.

The patient did share later that she hadn't had sex in two years.

ARRGGGHHH!!!! Why in the HELL would you tell your nurse something like that? It's not like I needed to know. You're not on a gynecology floor with a bad STD and I want to know your sex history. I, nor the nachos sitting in my stomach, didn't want to know this little gem of information. Later, I was left with the very unsettling feeling that I may have been her two-year drought-buster, for as close and involved as we were with that catheter placement.

Guys like to think that all women fantasize about being with other women. When you deny this, they accuse you of being a liar. It can be safely said that experiences like this, reaffirm my staunch heterosexuality. I'm all about the penis. And only about the penis. And there is not one thing wrong with that.

On a side note, last week can kiss my ass.

Nurse Follies: Pulling the Plug

I grew up watching Diff'rent Strokes. Everyday. After school. I wasn't such a hardcore fan that I maintained vigil after Gary Coleman died, but when things that you closely associate your childhood with die, it's just another nail on the coffin of your childhood and innocence.

Anyway...

Gary Coleman's life is a sad tale. From what I read, pretty much everyone the guy encountered in his life took advantage of him in some form or another. A lucrative childhood career, and not much left to show for it in his adult life.

So, Gary takes a tumble, is rewarded with a brain hemorrhage as a result. His borderline mentally retarded ex-wife, has him taken off life support two days later.

Gary Coleman had named his ex DPOA. I can respect that she was within her full legal rights to make the decisions she made in regards to his care.

However...it now comes out that he apparently had an advanced directive, outlining that he wanted everything done to prolong his life.

The business of Advanced Directives and DPOA and all things pertaining to them are huge gray areas, and I think I would rather eat at a dirt buffet than deal with them, but yet I am exposed to it more often than I would like. I remember a patient that came in with the most impressive Living Will I have ever seen. Detailed, it outlined to the letter what they wanted, and what they didn't want. We knew exactly where the person stood on life-saving antibiotics, life-sustaining drugs, feeding tubes, ventilators, everything. This person also had terminal cancer. He knew he was going to die, and there was nothing that could be done to stop it. He was realistic about it. Every day he spoke with doctors and reaffirmed his wishes. His supportive wife at the bedside, who was also his legal DPOA, also promised to uphold them in the event he could no longer speak for himself.

His children, however, were not on the same page.

Daily, as his condition worsened, the grown children became more and more frantic. They wanted all the stops pulled to save Dad. They begged the doctors, social workers, and their mother. The husband, having mentally checked out, was no longer able to speak for himself. The wife remained resolute, despite the fact that her children were turning against her. They screamed. They tried guilt. They approached staff to try to sway them to their cause (which made us really uncomfortable).There was talk of trying to get the DPOA changed. The wife never wavered.

I wasn't there the day the man died, but I heard it was pretty dramatic, and even the nurses who were working that day were traumatized. There were harsh words, screaming, cursing, threats, and even a physical fight broke out between a couple of the siblings. The wife just remained at the beside, an old woman who had just lost the love of her entire life, and watched as her family disintegrated before her very eyes.

My heart still breaks for this woman.

You may wonder what this has to do with Gary Coleman. Well, I'm getting to that.

So many times, I see patients come in, and they invoke the DNR-DNI. It means if their heart stops beating, or they stop breathing, we let them go. Along the course of their stay, they add components. Yes, I will take the antibiotics. No, I do not want a feeding tube. Yes, I will take this life-sustaining drug...but only for a short while. Usually, the family respects the wishes. Sometimes, they don't. Once that patient enters into a state where they can no longer speak on their own behalf, the DPOA, now large and in charge, can revoke all the previous wishes. Just. Like. That. Only a few times have I seen doctors advocate strongly and refuse, but most go along with it for fear of being sued. I've seen DNR-DNI patients "die", and have their family scream at us to code the patient. If the DPOA is one of them, we have to do it. Patient's own wishes be damned.

You may ask yourself, what is the point of establishing an advanced directive if some asshole family member is just going to revoke it at that one crucial moment? It would seem kind of pointless to even have one to start with if that is going to happen. For staff, it's pretty deflating.

I read an article once about a woman, who had a large family, made her DPOA an unrelated third party, I think it was a lawyer she may have known. Someone who would truly stand firm and defend what she wanted, without their judgement being clouded by emotions or the pleas of family members. I thought this was a pretty good idea, actually. You can make anyone a DPOA, if you are within sound mind. They don't have to be related to you. They don't even have to be a close friend. It could be someone that you trusted enough, knowing that they got your back, right up to the bitter end.

Back to Gary Coleman.

If the story has merit, and he truly did have an advanced directive that said "do everything", then that means his DPOA...his ex-wife who has the intellect of a dog turd, went against his wishes. While his prognosis was bleak, and chances of recovery were slim, and I personally feel that death was a better alternative than spending the rest of your days in a persistent vegetative state, it apparently was his wishes to do so. No matter what reasons she may have had to pull the plug, his ex-wife should have honored those wishes.

Nurse Follies: The Facebook Incident

I know my postings have been sparse. I blame facebook. It's worse than Twitter, of which I never post anything on. I can go, post a brief blurb of my daily life, and look at the pictures someone posted of their dog or their vacation. Or their dog on vacation.

Everyone loves facebook, including people I work with. A few pranks, however, and some staff have found themselves filing for unemployment. Because of such things, I have been careful to edit what I say because no one is anonymous on facebook. Your name is on there for starters. Some pictures. Some people even post their employer AND contact information...which is why harmless pranks can get you in trouble because employers get embarrassed. You can't embarrass The Man and not expect retribution.

So much for free speech.

After a particularly harrowing shift, and a crazy patient who would randomly shout out obscenities, I went home, the sound of said obscenities echoing in my head. Some days, I go home and hear IV alarms long into the morning. Or call lights. Or that patient who underwent a colonoscopy and has been farting all night long. On a whim, and my own personal computer, I left a status update that was the favorite quote of the night from my obscenity-shouting patient, and only the quote. No patient identifiers. Posted off the clock. From my own home computer. My facebook page makes NO mention of ACME Hospital. Safe as houses, right?

Eh...apparently not.

Bosshole charges in one night, some weeks later, prompted by a call from his pet charge nurse who apparently unloaded every incident that happened that night. How one night nurse was mean and yelled at her. How I had casually perused the job postings board while waiting for that same charge nurse to give me report. To state the obvious, no one particularly likes this charge nurse, who will throw you under the bus at the drop of a hat.

After the "mean" nurse is summoned into the Bosshole's lair to account for her meanness, I am summoned. Bosshole, calmer after hearing the story of what happened and feeling better about life on the unit, roots around his desk and pulls out a sheet of paper. It is a screenshot of my facebook page, the patient quote highlighted in orange, and he stares at me expectantly, waiting for my explanation.

So I point out that it was posted on my own time, my own computer, and doesn't violate any confidentiality laws and my page in no way ties me to my employer. Got anything else? No, but Bosshole cautions that ACME Hospital watches out for stuff like this, and they would prefer if we just didn't mention anything about work. At all.

He then goes on to grill me about my looking for another floor to transfer to, which really wasn't a big secret, but I am annoyed that I wasn't the one to tell him personally. (But to his credit, we had a very nice discussion about my happiness on the floor and my future there.)I'm just annoyed that it had to come from someone who apparently has nothing better to do than to look for ways to get people in trouble in an effort to make herself look better. The same person who directed him to my facebook page. I know this because Bosshole indirectly told me who it was (I have days of extreme smartness).

That person now has a sparkling nickname, given to her by a couple colleagues (I can't take credit), that is in no way appropriate for me to say on this blog. But the C-word may be involved. You know....that word.

As a result, I made some changes to my facebook. I removed a huge chunk of my coworkers from the list, save for a few. After hearing what happened, others followed in my footsteps and did the same thing. Some of my removed friends were alarmed, but upon hearing the story, understood, and not-at-all shocked as they are very familiar of the antics of She-Who-Shall-Not-Be-Nicknamed.

Another change was my occupation. You see, I'm not a nurse anymore...on that medium, anyway. Instead, I adopted an occupation that has no ties to the medical field. So, if you happen to be my friend, and see posts relating to agriculture, now you know.

Now if you'll excuse me, I have some goats to milk.