Don't Curse the Nurse!

Sharing support with stories & humor

Thursday night dinner with a nurse

“Hello. I’m here.”

“Honey, she’s here. Ooh, subs from Jersey Mikes!”

“Yeah, at the last minute my plans to cook went south.”

Salad packaging opened, subs unwrapped — minutes of silence a sign of a well-made choice.

***

“Mmm, good choice.”

“Thanks. Hey. Did I tell you? Seven vials. Seven vials to find out what all I’m allergic to.”

“Fourteen.”

“Fourteen what?”

“My last lab draw. Fourteen vials.”

“Oh.” His sandwich looked better than mine, at least juicier. Always picking turkey is getting old.

“Could I have a little slice? Yeah, there you go. Thanks.”

***

Almost full. Saved room for dessert.

                                                            ***

Where’d she go?”

“Getting the mail.”

***

“There you are. Sit down. Did I show you what the cat did? Some do selfies. I document injuries.

“Yep. Saw the bruise and the swelling.”

“Um…oh…what’s that? You two got Guiac tests in the mail?” Solicitous mail for finding blood in stool — I have to turn sixty-five before I can have a free Guiac test…

“They’re always coming up with ways to get us to go to the doctors more often.” She gave her classic eye roll.

“Give me the mail then. My diarrhea issue is not resolved. Hey. New Subject — how was the MRI?”

“Amazing having an open MRI! Space on each side. Still louder than hell, but you don’t feel like you’re shoved in a tube.”

The one for my back wasn’t long ago. Yes, loud. Ear plugs helped little.

“When is your results appointment?”

“Two weeks”

“I want to go.”

“No, it’s fine. You don’t need to go.”

I pulled my phone from my purse and set a reminder.

Some things don’t wait for Thursday.

 

 

 

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Au Natural

     “Your gown needs to be open in the back and right here is a belonging bag to put your clothes in. This blue cap… Whoa! Hold on. Let me pull the curtain and step out.”

The shirt is off and he has dropped his shorts while I was partially turned to him and pointing to the items on the bed.

     “Miss, let me just get my shoes off the floor here.”

I pulled the curtain closed a half a second before patient #2 walked by and saw my 7:00 am client from an incredibly unflattering perspective.

I don’t know what to make of the patients who see nothing unusual about disrobing before I draw the curtain. There doesn’t seem to be a thread indicating it’s a cultural thing, gender thing, or age thing. The closest I’ve come to is that it’s a surgery thing — the more surgeries they’ve had, the less they want to hear my “Welcome to Bay 4” speech.

It’s less than two minutes. It used to be three minutes long. I eliminated the “Have you had surgery here at _________ ___________ before?” I shortened the ‘It must have been difficult waking up at 4:00 am in order to get here” to “Did you sleep at all last night?”

Please understand, to me the human body is the human body. And yep, it’s true, nurses have seen a lot. But it doesn’t mean we care less about respecting privacy. And it doesn’t mean everyone in the pre-op area wants an impromptu peep show.

Word to new nurses:

Pre- op patients are rarely chatty and some don’t care about showing their wares.

Keep it short and sweet and think fast on your feet!

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First Impressions

 Image via alluniformwear.files.wordpress.com

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.

Image via alluniformwear.files.wordpress.com
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For Your Consideration

Dear Blog family,

I am about to send the piece below off into the wild world of critics/ lovers of fiction. First I am going to drop it here. You’re family. I’m thinking you’ll help me one way or another; a sweet comment, a personal reflection, and possibly a nudge out the door

 

Reshuffling

Image via wikihow.com

                   “Start over!”

                   “No.” I know what is coming, a declaration that we have missing cards, she has one too many, or something like that.

                   Callie pauses and purses her lips. I ignore her. It’s hard to do when your Canasta opponent is a bald-headed- ten- year- old wearing bright orange pajamas and Donald Duck slippers. Last year it was Goofy slippers, just like a pair I’ve had since I was a kid. I told her about them, and we’ve been friends ever since.

                   As I watch her face, I can see Callie picking her next words. She’s eying me, waiting to see if I’ll crack. I get more comfortable among the bunched up blankets and sort my cards.

                   “I don’t think you shuffled well enough.” Callie says in her naturally squeaky voice.

                   I give her my I’m not messing around look.

                   “It’s Canasta sweetie. You’re gonna have all sorts of matches no matter what. Now wrap your tiny paws around your cards, and lay your melds on the table here.”

                   Callie gives me a harrumph and a bugged-eyed look before redirecting her attention.

                   For Callie, I normally would reshuffle the deck, but I’m planning to meet friends after work, and if I want to get out on time, I can’t dawdle. One person in the group is an old friend — to be more exact, a hot guy that I regret casting aside. I’ve been dateless for four long months.

                   Callie slaps the bedside table with her hand so the stacked cards tumble sideways. I can’t help smiling. When Callie’s trying to be obnoxious, she just gets cuter and cuter.

                   “Temper, Callie.”

                   While she’s straightening out the deck, I start to lay a row down, but I’m distracted by a flash of purple on the inside of Callie’s right arm — the beginnings of a bruise right in the bend of her elbow. Around the edges it’s pink and green.

                   “What the…?” I reach for her wrist, but she’s already snaked her arm back under the blanket.

                   “Why didn’t they use your port, Callie?”

I point to the spot below her collar bone where the quarter size implant protrudes from under her skin.

                   “My Chlorambucil was still running and they said they didn’t have time to come back.”

                   The way medical jargon tumbles out of her mouth — for a second I forget she’s only ten.

                   “Call me next time, O.K?” I say it casually. I don’t want to be overbearing. Callie’s parents are major helicopters, hovering over every single staffer. Callie confided that she finds it embarrassing.

                   When I was twelve, I had Mono and was in the hospital for six weeks with my mother making everyone nervous.

                   I get it.

                   We resume playing.

                   Swish-swish. Thump-thump.

                   The speed of our card slaps gives our game a hip-hop rhythm. With each card I pull, Callie adds body moves by bending at the elbow and drawing her fanned out deck to her chin.

                   We pull and discard as fast as we can until there are two in the deck, Callie’s got three, I’ve got four, and it’s my turn to draw. She’s wiggling around on her bottom and singing before I get the card in my hand.

                   “I’m gonna win. I’m gonna win,” Callie chants.

                   I drag one of the two remaining cards slowly toward me and hold it to my chest before looking. With a deliberate “hmm,” then an “ah,” I add it to the pair of fours in my hand and with a grin, lay the threesome on the table. “I win,” I announce.

                   Callie responds by sticking her tongue out at me and scrunching up her nose. I’m thinking about what I want to wear tonight.

                   Then she leans over and grabs my forearms. My resolve crumbles.

                   “Please. One more round. Come on Aubrey. You’ve only been here, like, like, twenty minutes,” she whines.

                   I resettle at the foot of her bed and deal new cards.

                   Soon the tempo of card slaps and swooshes returns until Callie’s oversized Kidoozie clock alarms.

                   It’s 3:00 pm.

                   I snap my head up and put my cards down. “Callie, I have to go.”

                   “But the game?”

                   I think the crestfallen look on her face is a little much, a tactic she uses. Guilt creeps up from my subconscious but I push it away. Tonight is too important. Callie’s too young to understand. Jumping up from the bed and walking towards the door, I talk fast. “I’ll see your tomorrow. If I win again, I get your slippers!” I hike up my scrubs belligerently, mocking the threat. Callie smiles and I know we’re okay. I run over, give her a quick hug, and leave.

                   A lab tech passes me in the doorway and I think about Callie’s bruised arm, but I want to get ready. I’ll leave it for tomorrow.

 

 

Everyone I pass is quiet. Not I haven’t had my coffee quiet, but the kind of quiet that demand immediate pause. I quicken my pace and reach the unit just as housekeeping walks out of room 467.

                   Callie’s room.

                   “…clot…pulmonary artery…,”I hear, and then nothing but the ocean pounding in my ears. Thirty minutes later, I sit on the bathroom floor. My boss gives me the day off, but by the time I’m in my car, I’ve decided to transfer.

***

Adult Oncology. Three months. I do overtime in the radiation lab. If I learn the medicines, I’ll fit in, I think. It’s not working. When I’m in a patient’s room and his grandchildren are there, I feel displaced, like an outsider.

                   I set up a meeting with my old manager.

***

                   “Hi, I’m Aubrey. I’ll be your nurse today.”

                   The twelve-year- old sitting cross-legged on the bed has a deck of cards in her hand. She has an Osteosarcoma and will have surgery in two days.

                   “Playing Solitaire, huh.” The triggered memory shakes me.

                   “Yeah, but I’d like to have someone to play with. You could fix that.” She says it to me matter-of-fact. I avoid eye contact. I don’t want her to see my eyes getting red.

                   “Can I sit and talk to you while you play?”

                   “Sure. Wanna play Crazy Eights with me?”

                   “Sure.” It’s only one word, but it sticks in my throat.

                   I just stare. She probably thinks I’m nuts. “Yes” might be moving forward or back, I don’t know which.

                   She cups the deck in her left hand, then grabbing a handful in her right, I watch her position her thumbs to fan out the cards. They fall with a dull thwack when she arches the piles back between her thumb and index finger.

                   “That wasn’t very good.” She lets out a sigh of exasperation and pushes the cards to where I sit gingerly at the edge of her bed. “Here. You do it.”

                   I miss Callie.

                   “No, I think you should do it.” I pick up the cards and place them back in front of her.

                   “Split the deck and try again.”

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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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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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Biting My Tongue

My only thought was to get in and out of work as fast as possible.

It was a beautiful Saturday morning. Not a great day to be on call.

When I saw the age of the patient (17) and the reason for the D&C (dilation and curettage), my focus changed.  What a tough thing to go through, and she was so young. I miscarried my first pregnancy, but I was twenty-four and married. What I mean is that I was in a different place in life— that being basically, years out of high school and with a ring on my left hand which magically transformed social critique into initial rounds of congratulations followed by heartfelt sympathies.

I met the mother in the ER when I went to pick up the patient and I tell you, I don’t think the frown on her face was because she was disappointed at the lost chance to be called Grandma. She declined my offer to stay with her daughter in the pre-op area, mentioning she’d be either in the waiting room or going downstairs for coffee. I watched her wobble away on three inch heels and tugging at the cotton t- shirt that kept riding up her waist.

When Anesthesia came to talk, the mom could not be found. Thankfully she’d signed the consent in the ER. Otherwise, I was uncertain how long things would be delayed

Due to OB cases, the Gyn couldn’t come immediately.

My little girl, all 112 pounds of her lay bundled under three layers of blankets and made idle chit- chat with me until her phone rang. I could tell by her affections that she was talking to her boyfriend. I tried to focus on my charting, but what I was hearing was stressing me out.

“We can leave next week hon, stay at my friend’s in Georgia. The legal age for us is sixteen. With both of us working, we’ll be fine.”

Now I’m a sucker for good love story, but my head was about to bust open. And it went on.

“People’ll give us stuff, cus you know, us being together…anyway, yeah, uh huh…I hate her. We don’t need her or much of anyone else for that matter. The stuff they gave me, yeah, it helped the cramps. That girl, she’s not still calling you is she? Uh huh, o.k. I love you.”   

 

Stifling the mom instinct is hard, real hard.

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Nurses – Thick as Thieves?!

perfect

My stethoscope has been stolen.

I looked everywhere, in drawers, behind monitors, on top of cabinets, in our break room, even went to PACU to see if it “floated” over there. I quizzed everyone in a Mafia-like way about my ever so loved work toy.

No luck. It’s really gone.

Someone needed or wanted it badly, my dark green $59 Littman stethoscope, the gift I gave myself when I got my last pay raise. And yes, I’d been told more than once that I should try to remember to lock it in my locker, but here’s the kicker. Our unit is locked at 7 pm.

There is a chest pain clinic attached to us, and the entrance to it, its badge coded. So, you have to be a nurse, or security, in order to get in. The thief is most likely a nurse.

I had an allergy band with my name on it wrapped around the Y connection of the scope. I printed very neatly. I always placed it on the counter in front of our nurses’ station. I expected that it would be used by others during the day. But this, this makes me so #%$@* angry!

Whoever you are, you better be using it and using it right! Listen under the gown, not over it; posterior and anterior, don’t forget bowel sounds, fistula graft checks. You’ve got a pediatric patient – turn it around.

I am going to stay in my bubble and think that you needed this stethoscope really badly, that’s why you took it, not because you wanted it as a trinket, it matched your scrubs, or something silly like that. My attachment to it was because I like my work and want to be thorough, not because I have some juvenile notion that a stethoscope around my neck makes me look cool. They’re bulky and my pockets are big enough to carry it comfortably. It wasn’t an image thing.

I’m going to buy a new stethoscope. This one will have my name engraved on it.

And I’m going to sit it on the desk counter at the end of every day.

Go ahead.

I dare you.

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Are they just letters behind our name ?

Here’s the definition of certified per the fastest online dictionary I could reach:

To confirm formally as true, accurate, or genuine.
b. To guarantee as meeting a standard: butter that was certified Grade A. See Synonyms at approve.
2. To acknowledge in writing on the face of (a check) that the signature of the maker is genuine and that there are sufficient funds on deposit for its payment.
3. To issue a license or certificate to.
4. To declare to be in need of psychiatric treatment or confinement.
5. Archaic To inform positively; assure.

What has prompted a blog with such a boring opening? I’l tell you.

I did not pass the three hour exam I took to become “certified” in my area of speciality. Blah… that’s the general feeling right now, but the glass of wine in front of me is helping. ( Nod to nurse Jennifer for preaching the virtues of a mature Merlot with a taste of plum).

It doesn’t alter my level of confidence or competency in doing my work. Now, more than two glasses of this wine might leave me with a headache dulling my sensitive nature with the patients. One will do.

How many of you out there are certified ? Or just certifiable? If you are still in nursing after 15 years, you’re probably both, haha… forced joke…I really wanted to pass the test.

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What’s Your Story ?

Everyone has one – an experience as a nurse you remember as if it happened yesterday – an experience that changed you, whether for better or worse – it changed you, and you’ve probably shared it more than once.

Mine involved a twenty year old, admitted to our night shift with spotting at eighteen weeks gestation. She had no family with her and declined most of the palliative measures I offered for her cramps – stoic with a weak smile – that’s how I’d describe her. She did want to talk though, and managed to keep me in her room most of the night talking about her family back in Georgia. When she finally passed the thumb sized fetus at 4:00 am, she asked me to pray with her. I was an emotional mess by the end of the prayer.

She had a peace about her that I envy to this day.

 Grace – you can say it and you can live it.

 Share your story. Someone might need to read it.

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