Don't Curse the Nurse!

Sharing support with stories & humor

First Impressions

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Last week I was going to my first PNC meeting — that’s Professional Nurse Council. I brought edited notes from the subcommittee of which I’m part of. I put on my game face. I even wore my good scrubs — the $50 dollar ones, wrinkle free, tailor fit. And initially, I was glad I did.

The facilitator, a PACU nurse, and her sidekick, walked in looking immaculate. With their white monogrammed lab coats, they looked like they could be models for the cover of a Nursing magazine. They both carried notebooks, and wrapped around the edges of the notebooks I could see well-manicured fingernails. As the group leader sat down at my right, she surprised me with her first comment.

“I don’t have an agenda.”

I sat back in my chair, relaxed my shoulders, and took a second to note the hair extension she was sporting. With it clipped below her banded ponytail, waves of auburn hung down below her shoulder blades.

Uh-uh. That’s a hospital no-no. I’m taking off points!

She went on.

“But, we have Nurses Week coming soon, so there’s plenty to talk about.” Our fearless committee leader then pushed her notebook away and facilitated 45 minutes of conversation around food, ice cream, themes, and more food ideas.

I’ve been on the other side of this, meaning simply the recipient of these selected calories, lots of calories, calories that I don’t need or don’t have the self-discipline to say “No” to. I wanted to suggest passing out granola bars, but thought twice, these were the cool nurses in here.

When the meeting over and jobs delegated, I walked away with a better appreciation of the work that goes on behind the scenes, the conviction not to be intimidated by a committee’s title, and a little superiority complex because I would never dream of wearing my hair down at work.

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Dirty Little Secret

Although I have a passion for my work, I still sometimes walk around feeling like I have a dirty little secret. And I want to let it out.

It took me almost twenty- five years to truly love my work.

Here’s the story.

When I applied to nursing school, I didn’t care how I was going to earn my future paycheck. I just wanted a grown up job, and three close friends were applying so I thought, Why not. I had no particular interest in studying health sciences, changing bloodied dressings, or holding an emesis basin under the chin of some puking patient. In the three months prior to turning in my transcripts, my only interest had been to land my back handspring on the balance beam. My dream had always been to keep tumbling, to let my feet fly up over my head and watch the world spin around. I was never happier then when tucked into a ball, rotating on my own axis, my focus on my core and nothing else. Gymnastics was my religion, the gym — my church.

Then graduation came, teenage love turned into marriage, and my “Why not” attitude turned into a carrousel ride on the local college’s nursing track program.

There were at least three occasions I thought about quitting. Microbiology was painstakingly boring. Krebs Cycle — don’t even ask me about it. (Go talk to Victo at https://doctorly.wordpress.com.) There is at least one nursing instructor that put such a fear in me that I will remember her name with I am ninety years old.  But I made it through.

Twenty-five years to love my job.

Half of my waking hours are spent at work. So, if I choose to, I could surmise that twenty-five percent of my cumulative consciousness has been time wasted — time — a commodity I find precious. At first, it saddens me to immortalize this fact by typing it on the page.  My only consolation is having pondered my career path from its inception and now understanding why it took so long to love what I do.

In the early years I was afraid — afraid the patients wouldn’t like me, the doctors would belittle me, and the seasoned nurses would find my mistakes before I could double back and check my work. I panicked when given a new task and turned the other way when I saw a doctor coming my way. Much time passed before I was confident of my skills. I maintained a cautious reserved attitude at work, only loosening up a little when I transferred to an OB position on the night shift. The one thing I never found any value in, even after a decade of nursing, was the patient “chat time”. Being pulled to the bedside to hear a story from years gone past was, in my opinion, minutes wasted. I didn’t know what to do with all the emotional purging that transpired each time I was at the patient’s bedside. Talking was time consuming. And when it was all done, I still had as much work to do.

I learned to listen when my daughter reached middle school and became socially active. Now, my hearing didn’t improve because she and I were becoming best buddies. That was hardly the case. I went into case management to accommodate her new schedule (and my additional responsibilities as a single parent). The job involved hours of telephonic work. Listening, patience, and asking the right questions accounted for fifty percent of the time.

My little princess, she grew up and I went back to clinical nursing.

Enough time had passed and with the changes in healthcare, I essentially had to start over. Relearn everything.  Yes, I was nervous at first, several years had passed. One thing is different. I am excited every day I go to work. Knowing I have an opportunity to listen, connect, and be there for someone else, it means everything to me. So in summary, this is what I think happened:

I fell in love with nursing when I was mature enough to love the profession like a woman loves a man, unconditionally, cherishing the moments of synchronicity and enduring the trials that test the relationship. Nursing is not a job for people that don’t want to grow up. Nor is it a job for those that might be considered heavy in the “self-focus” department.

The career crush happens when you can connect with your patients. The connection with the patients comes when you’ve experienced the same sense of vulnerability you see in the eyes of your patients, when you realize you are no different than them…when you know what it means to be human.

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Unions – Merit – Safety

Every now and then, I get all highbrow and actually read the professional nursing journals that come in the mail. I think it compensates for the moments when I’m doing something so mundane at work and think to myself, “Geez, I can’t believe they pay me for this.”

So, I’m sitting on the couch after work, feet up, debating on blogging something personal versus something “nursey”, and there in the middle of reading magazine number two, there is a small sidebar about union activity. (Remember last year, I posted twice about Union reps stalking our hospital perimeter.)

Anyhow…

In a place I have visited, even rode the hilly streets, there is discord between nurses and the ever so mischaracterized management, Washington State. Oh my.

I didn’t know nurses had unions in Washington State.

The magazine blurb was small: After six months of negotiation, contract talks between Providence Regional Medical Center Everett (a hospital in the Puget Sound area) and 1,400 registered nurses remain deadlocked.

I did a little looking up of stuff since I don’t know much about Washington State’s economy, unemployment rate, minimum wage, etc…This is an interested tidbit I found.

Under Washington’s current law, the minimum wage goes up every January with inflation. The Employment Security Department said this year’s minimum wage hike affected more than 67,000 workers.

Here in good old Central Florida, we have merit raises. That’s it.

*****

I don’t know what to think about this. I looked up more online about the situation at Providence. I read nurses’ comments about the nurse patient ratio in Critical care being 3:1, about people being held in the ER for 24 hours because there are no beds. Yikes!

I am sitting upright and saying to the computer “Yes, yes, get your voice heard, more staff, more safety!”

Then I remember dabbling in management, the headaches, the pressure that comes from way up there, somewhere, I don’t know, and I understand that everyone is frustrated.

So I’m going to blame POTUS and ObamaCare. It’s probably childish, but I’m going to do it anyway.

I’m going to bed early so I get a good night’s sleep before work tomorrow.

Our department is leading the board when it comes to overtime.

It’s been crazy.

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Pediatric nurses > the rest of us RNs’

Now I know, I really, really know, I could never be a pediatric nurse.

raindrop   Here’s the reason why:

I knew before I met her she had Cerebral palsy. Her date of birth placed her at twenty-four, but since I knew that 30-40% of people with CP have some degrees of developmental delay, her cognitive functioning would be below the average for someone of her age. She was having dental work under LMAC (that means anesthesia wouldn’t have to put a tube down her throat). You tie it all together and what you have is a pediatric case, the only exception being the patient has the BMI of an average adult.

But I’m digressing here – getting carried away with facts when what I want to do stay open- and share.

So, I’ll start by calling her Beth.

Beth arrived in a wheelchair. With her Dad’s help, she could stand, pivot, and move her right arm enough so Mom could change her into a surgical gown.

Dora the Explorer sat snugly under her right arm.  Beth’s affect was that of a six year old.

She smiled and giggled when I said “Mom, Dad, you also have to wear gowns and funny blue hats!” Beth winced when the blood pressure cuff tightened, and when I asked her if she was okay, she shook her head up and down and said “I’m a big girl.”

Then I had to start her IV.

Her father held her left arm straight for me and I went for the forearm. No luck. People with CP have as a result of the disorder, low muscle tone. Veins sit low, not close to the surface

Beth started whimpering at this point. We three were trying to sooth her, giving her encouragement. Her Dad, apparently used to this experience, was gently turning her arm around. He knew I had to find a spot. And I did, right on the inside of her wrist – one of the most sensitive places to start an IV.

Beth’s whimpering turned into crying. She wasn’t  trying to jerk her arm away. She was just lying there crying.  Total Submission.

I had a lump in my throat when I started with some lidocaine under her skin. Then I made the mistake of looking at her. She looked back with pure panic in her eyes. My chest started to hurt (and it wasn’t my arrhythmia).

Now I’m sitting there trying to hold back my own tears. I felt nothing but guilt. There was no this is for your own good – I’m a nurse doing my job kind of feeling. I couldn’t separate. For a moment I froze. I remember thinking I can’t do this to her.

I got the IV on the second try and with some Versed in her IV, Beth got smiley and sleepy.

I hear people say all the time “Nurses are special”. Maybe we are. But pediatric nurses…

THEY ARE AMAZING.

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The Pink Elephant

The pink elephant in the room

I’m not afraid of it.

I’m going to ride it

Climb up there

And

Ride it like a pony

And when I’m done

I’m taking his trough of food away

So he’ll whither away

He’s taking up to much space

No one can breath

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Again

Fun things to say to people that squint and point to the Cardiac monitor you’re wearing:

1. They’re on sale at Macys – had to have one.

2. If you cut the wrong wire, I implode.

3. I can’t hide it anymore, I am battery powered.

4. It’s my #@!* meter. Every step I take toward you – the alarm gets louder.

5. It’s a fad. I’ll grow out of it in forty-eight hours.

And if you don’t find any humor in the experience, just glare at the curious. They usually walk away.

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Sweet Nothings

love

I have the ballet of maneuvering around these pre-op cubicles figured out.

Take three steps back, the third being to the right; it’s kind of a waltz, while taking the wall mounted computer tray with me. Then I swing back to my right as the surgery team takes my patient, in bed of course, feet first, toward the OR suites.

“You’ll do great Mr. Doe. You’ve prepared well for this surgery.” I leaned in to give him his Versed (think Valium in a wine glass).

“I love you,” he said wide eyed.

I feelmy face get warm.

Then I notice his wife standing behind my left shoulder.

Ugghh.

I know, I know.

I thought I had a big save when I turned to the wife and giggled, “They normally say that to me.”

My coworkers had fun with it the rest of the day.

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Weighing on my mind

scale While taking a pre-op patient down the hall this morning to get her weight, she mentioned that she told no one about what she was doing. I dwelled on her comment then mused about a fellow blogger’s recent post on society’s definition of beauty.

Now, I do want to preface this post by stating that I am not condoning a total disregard for a conscientious attitude about healthy living. Musculoskeletal and cardiovascular diseases are aggravated by excess weight and a diet high in cholesterol and fine sugars. However, being conscientious (I love the word), won’t bring you anywhere close to looking like Heidi Klum or the barely covered model on the cover of Sports Illustrated. Genetics, people. Genetics.

Back to how this relates to my morning with my pre-op patient (the one who’s weight I needed – needed because she was having a gastric bypass and we have to have a baseline weight).

Where is our 30×30 inch floor scale that takes up to 500 lbs.  It’s in Bay 14 — the same bay where we keep a small linen cart, extra wheelchairs, and IV poles. In the back. In a corner. With a quiet patient whose head is down, the walk to the scale always feels like a shameful secret. And I don’t want them to feel that way.

You have to move everything out of the bay before the patient arrives so they can even get to the scale. And, you pull it out from the corner — pull it out from the wall so your patient is not nose to nose with industrial grade beige wall paper. It’s embarrassing, the arrangement for where this scale is. If we weren’t so limited on space…anyhow..

I do my best and cheer my patient on for all the positive changes to come.

And I’m thinking to myself, while we at the same time elevate the waif-like figures making thousands of dollars for one photograph on an exotic beach, can we say that we support our friends and family just trying to get a little healthier.   So…

Next time your diabetic friend has a birthday, get them one of those cool Edible Arrangements with the flower shaped fruit instead of cupcakes. Someone you know walking every Tuesday night? For-go the idea of a Saturday night dinner out and offer to walk with them.

I sincerely believe that the majority try to make lifestyle changes quietly because to announce somehow implies that they don’t appreciate what they already have in life or don’t know if they will be taken seriously.  And when social events bring on temptations, we backslide. I say we because I’ve done it, over and over again. To decline dessert separates you from the group.

Getting on a scale shouldn’t be an obsession.

And walking toward a scale shouldn’t feel like a death march.

***

Goodnight.

P.S. My patient recovered nicely.

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Merci Beaucoup

This is my two year anniversary and I want to say a big THANK YOU to my WordPress family!

You are such an incredible group of people with diverse opinions, talents, and personalities that far surpassed what I expected to find when I began posting. The blog began as a practice in writing. Now it’s a way of staying connected to people that value expression and teach me to value my own voice.

I think it was Hemingway that said “Writing is easy. All you have to do is sit down and bleed.”

I’m not always bleeding when I post and that’s a good thing.

Thanks again.

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The Honeymoon is Over

rings

The honeymoon is over.

Like the couple who has reached the six month mark — each party starting to add stuff to the mental checklist of habits they find annoying, I’m doing the same with my job.

Don’t get me wrong, it was a great transfer, much needed. There is ten times more diversity in my current role.  It’s just that the job, like the gigantic wedding cake, tasted sooooooo good at first, but after you’ve had three pieces and leftovers, the thrill factor takes a vacation.

I know which doctors bring their H&P’s the morning of surgery – which ones use the dictation system only forty minutes earlier and give me the stink eye when it’s not on the chart. I know which nurses avoid picking up post-op patients, which OR teams get along —which ones only tolerate each other. I know which pharmacy tech doesn’t need a faxed order to fill our supply of Ancef syringes, which one needs to be reminded that we go through thirty syringes a day.

The ballet of preparing a patient who’s about to have a total knee or hip replacement, I’ve got it down pat. The Tramadol/Lyrica/Celebrex cocktail on one certain surgeon’s order sheet — I’m holding the pill cup in my left hand and with my right, putting a big “yes” on the affected joint. And while I’m that close to the patient, I’m checking to see just where I want to put that IV.

I’m not the new girl anymore (ah, it was such a sweet thing to fall back) but now I have to do the grown up thing and strengthen my commitment to my new family and my new home. I am going to start by deciding which battles I want to get involved in, or as my Dad would say, “Decide which mountain you want to die on.” I’m also going to find out exactly why our silly little hospital has farmed out the dictation services to a business in another time zone. The people here that don’t get along, it’ll be fun blogging material.

I didn’t make the change with the expectation that the job would be better.  I made the change thinking that the job would make me a better nurse.

So far, so good.

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