Thursday, December 27, 2007

Stacked and not so Angry anymore

Aaahh my people. My fellow nurses, healers, friends, nemesis's, those I adore and admire, those I can't stand.

One more semester to go. So much to tell. So many thoughts have furrowed my brow, like a crashing thunder storm on a hot summer afternoon, passing as quickly as it obscures the sun.

I got real depressed this semester. Every afternoon, around 1530, after school and on the way to pick my son up from day care. I felt so empty. Tired and empty. I have never felt depression like that before. It was like, physically painful in my gut. I felt no joy. And let me tell you, picking up your child, and feeling depressed, joyless, really makes one feel ashamed or guilty. It can be a very destructive cycle.

So AMN, what was bothering you? Why so blue?

The critically busy 7 days a week schedule, the lack of sleep, the monotony of obligatory rotations that have questionable value, the constant degradation and mind games at the hands of perpetually insecure instructors. Friends, I was bummed the fuck out.

You know what I realized? I'm not Angry Male Nurse anymore. I realized I had become:


But I'm cool now. I rested. I contemplated my sadness. I contemplated my anger. I wandered the hallways of my mind, pondering the meaning of a nursing career, directions to take, units to work in, mistakes NOT to be made. My friends, I pondered!
My wife and baby (he's doing great by the way) are visiting family out of town. Last night was the first night that I had slept alone since June 26th. It was the first time I did not wake up two or three times during the night in a very long time. And I realized: "Dude, your depression was secondary to your incredible exhaustion. Who the fuck wouldn't be depressed?"
I think Everybody, I think I was just really really tired.

I'll keep this relatively short:
I was working in the ER a month ago as a Student Nurse Worker. Basically an overworked NA. Two Samoan- American kids came in from a popular local rave. Roller #1 was a small guy, about 20, shaved head. Roller #2, was a pretty buff young dude, maybe 19, looked like a rugby player. They were under arrest for possession. They were handcuffed to their gurneys. And they were ROLLING THEIR SAMOAN BALLZ OFF! Dilated pupils, chewing their jaws like they were made of gum, rubbing their heads on the pillows of the gurney in ecstasy. Looking back, they probably had just ingested several pills prior to arrest to avoid more prosecution. Probably a good thing they got arrested because, frankly, I have never met guys their age with such warm, open, and funny dispositions. Such vulnerability. (It was also abundantly clear that neither of these guys should be behind the wheel) Maybe it was the E. Proably it was the E. Maybe they were just nice dudes. They got cleared after my shift was over, I worry about what happened to them in County lockup. But ecstasy only lasts a couple of hours, so by the time they got cleared they were probably more hungover than anything and got their sense back. (VS stable, both had fevers probably related to pharmacodynamics, no immediate cardiac or respiratory distress- though they both were hypertensive and diaphoretic.)

The following is a rough transcript of the conversation that made my soul feel better:

Roller #1: Hey man. Where is your wife? Your baby?
(I don't know how he knew that I had a wife and baby)

AMN: Home.

Roller #1: But you are here.

AMN: That's right. I'm working.

Roller #2: You can do it. Man. Keep on with yourself.

AMN: Gotta pay the bills. I'll see you guys in a couple of minutes.
( I came back fifteen minutes later. They watched me while I worked with other patients.)

Roller#1: I know you're tired. I can FEEL how tired you are. Keep on though. Keep on.

Roller #2: I'm not embarrassed to say it. Right now,I think I love both of you, dearly.

(His eyeballs kind of rolledback into his head, his eyelids nearly close-then his eyes popped back open. He satisfyingly grinded for a few moments.)

Roller #2: This is true.

Roller#1: Hey nurse guy, we believe in you. It's okay to be tired. You look really tired.

AMN: You guys alright?

This is no joke everybody:

Roller #1 and Roller #2: We're more worried about you, man. How are you doing?

AMN: Well, I guess I'm a bit tired.

Roller #1: I'm open to talking.

Roller #2: That's what we're here for.

I guess I looked as bad as I felt. Tired and blue! But what can you do when the only official protocol, the only mandate available is to Keep on'.

So I kept on. And we talked. Not advocating drug use, but their empathy was wonderful. I know, boundaries, bad idea to burden the patient with my problems, but in this instance, it just worked. I didn't give them intimate details but I summarized. I'm pretty much a closed book to coworkers and patients alike, I guess my soul was cold, and I needed their warmth.

Those young dudes completely shocked me. I realized, nobody had asked me recently how I WAS DOING. And yet another reminder to never EVER judge a book by its cover.

More to come friends!

Wednesday, August 1, 2007

Stay up Late

Fatherhood continues and evolves. For this first month, my wife and I have had a pretty moody little dude on our hands. Gas, poop, and hunger. Limited amounts of sleep. Something to work through. I couldn't hold him without him kicking and screaming, waving his tiny balled fists, trying to swat away whatever it was that was agitating his pain. My little dude was not having a lot of fun with this new life and frankly, I wasn't having a lot of fun, either. The wife did great though, kept her spirits up and worked with what she had. Mother in law came to stay with us for a month and that was immensely helpful. Mother in law left, and we still had the Moody Dude on our hands.


For the last two days, miraculously, for who knows whatever reason, perhaps on of the thousands of tricks we employed to fight colic and fussiness paid off. The last two days have been awesome! Little crying, just a lot of looking around and even a few smiles. A vessel ready to explore the world. A baby that listens to and watches his mobile, as opposed to hysterically shrieking at it, he sometimes smiles at the hanging mobile that to me, is strangely reminiscent of a Pink Floyd concert I went to in high school. The change has been so dramatic, we noticed it immediately. And best of all, we pulled five hours of sleep. I probably shouldn't us "we" because my wife has to get up far more frequently than I do to give him the bizoobs but the change is duly noticed. And it feels great!

SO... to get to the meat, to get to my at work a 29 year old man ran into the ER carrying his crushed 1 1/2 year old child in his hands. When the father was leaving home, the boy ran out and the father backed over him with the massive family SUV. As bad as you've seen it in your experience, it was. I (thankfully) didn't see anything gnarly, I came into the situation as a big crowd of people moved into trauma. Staff came out of the trauma, talking in that glazed sort of way, when the adrenaline is high, the experience is burning into your psyche like a liver fluke into your gut. When your still not sure if what you saw was medically inspiring and challenging or you just voyeured into a devastating personal moment for someone. My co-workers came out of the trauma and I heard grim remarks, saw heads sadly shaking, "blood everywhere" "brain matter" " seriously not looking good". I only saw the father briefly, standing up, his head shielded by his arms as he leaned against a wall and cried, large numbers of family circling him, giving him support that must be baffling and terrifying at that moment. What do you do? What do you think? Are you angry at the father, do you feel sorry for him, do you forgive, do you dare to visualize what his life will be like after the so sudden and immediate death of his child? I was working in triage most of the night so I directed the upset and anxious family members as they poured in, asking how to get to the pediatric ER. I tried my best poker face, almost pretending that I didn't know what nightmare I was about to direct them into, "The pediatric ER is just to the left." Afterwards everyone in triage would also shake their head, what a nightmare.
And of course the Sheriff department tore apart the SUV, police lining it off where the dad had driven up to the ambulance bay doors. Furiously burrowing into the vehicle, under seats, in doors, looking, looking, for some proof that this father was a murderer and needed to be charged with a crime as horrendous as the accident. So weird, this tought looking family vehicle became a crime scene and I don't know the outcome of their investigation nor do I want to. What a shitty job...

I never felt like this before, I couldn't stop visualizing myself in his shoes, I kept imagining picking up my injured child off the ground with catastrophic injuries that I inadvertently inflicted. I couldn't imagine killing my own child. How do you live after that? How do you go to work, how do you be with family, what does your wife do? Does she hate you with the venom that mothers reserve for those who hurt their babies? Does life become a rollercoaster of self destruction, do you give up?
Do you try to die?
I'm so thankful that I wasn't even involved directly with the medical care. I've prided myself on my non-squeamishness around blood, around eagerly encountering the human wasted, the trauma's, the human drama, but I tell you what- tonight, just hearing the details, I thought to myself, "I don't have the stomach for this anymore." One of the most upsetting experiences of my medical career and I wasn't even involved.
Sadly, this validated my fatherhood more than anything else that has happened to me, more than any other joyous or challenging experience I have had with my boy, thus far, in this beginning first month. The thought of the sweetness, the innocence, the innate struggle to survive I see in my boy, for that to be taken away by my own hand is utterly upsetting.

Sunday, July 1, 2007

Licensed to Ill

Sorry I've been gone for awhile. It's not good blogger etiquette to only write sporadically, it doesn’t bode well with my legions of fans and fanatics. But what can I say? Personal life has kept me busy and I needed a certain amount of time to decompress, because Angry Male Nurse was becoming Burned Out Angry Male Nurse as does happen from people who invest everything they’ve got into their career form time to time. I’m okay with that, I just need to make sure I have the tools, the support, and the time to chill when I need to. Which I do.

Finished off 2nd semester. Did okay. Made it through with virtually no personal drama, until the end when the students who failed the most absolutely ridiculous and unreasonable final written in the history of Med-Surge got pissed and started manipulating student and staff to get their way. I really felt bad for the students who didn’t get through, I felt that some of the blame did not lie on their shoulders, that teachers who couldn’t even write questions with 8th grade English skills should be held to count for it. But then I saw how the failed students played games and threatened and eventually turned on each other, and I saw that perhaps that the reason for their failings their failure lay more with their lack of professionalism and maturity than anything else. So I backed off, let the chips fall where they may and began to recoup.

My wife and I had a baby on Tuesday. He is the most enigmatic, beautiful, and poopy little dude I have ever met. I’d like to tell you his name but there are some haters out there so I can’t. But it is a fitting name for such a cool dude.
Labor was 30 fucking hours long. The epidural was too strong for my wife so at about 20 hours in her contractions basically stopped, which relieved her so she could rest but scared the shit out of me because the thought of C-section after my wife’s valiant efforts would have broken my heart. I have no problem with C-section, just that my wife wanted to go natural and her spirit was into it. 2 1/2 hours of pushing and the use of Pitocin and suction and my little baby boy came out. I cried when he came out, a good cry, tears that contained my fears, my stress, my anxiety. Also with it came utter joy and amazement, love for my wife and relief that we were all safe. The nursing profession, nursing school, became small dots in my mind, like light coming into the opening of the end of a distant tunnel. Put things into perspective.

I love politics. That’s who I am. But a game is a game is a game and even though it involves human lives I am not responsible for the millions of unbelievable outcomes, for all the incredible personal tragedies I see and some that I am involved in. When I am working I am in a state I call, “In the Mix”, meaning I float from one living to dying crisis from the next, I hear all the other nurses working alongside me performing in the mix, applying their knowledge and intangible personal skills, putting out fires, fucking starting them, dealing with it, I exist in all the noise and I can apply myself one situation at a time. Brains here, not breathing in the ambulance bay there, relieved discharge here, comforted by morphine here, change the patients diapers there. I am in the mix, talking to my mind, listening to the noise but being part of it, too.

I love becoming a nurse. I feel like I am becoming something useful and functional. Skills develop and flourish, unique skills that I am very proud to possess. Some nurses wield them with confidence, other dish the skills out in utterly small insecure amounts.

Sometimes I think about the Beastie Boys from “Licensed to Ill”. Their ZaZen in the mix of 1980’s partying, music industry, cultural racial significance wrapped around them like a blanket

Let it flow let yourself go
Slow and low that is the tempo
Let it flow let yourself go
Slow and low that is the tempo

Have you ever felt water pour on your head from a small waterfall? Not that I get to that often, truly I live in an urban jungle, but I have been in nature a few times. The waterfall is surprisingly loud, and forceful, all that water pushing down on your head and neck, feels like your skull might cave in. But it doesn’t, and after a few moments you realize that the tension in your shoulders is being worked out and you are bending to the will of the water and sort of being with it. That is how I feel in the ER. Stretched out but adjustable. And when the bull shit politics starts to overstretch me, when the patients bullshit becomes a bit too odious, when the doc decides that he or she will revert to pissy 14 year old nerd mode, I put my clasped hands over my head, like a shelter, and shunt off some of that cold water pouring onto my head from the waterfall, and I look around, catch my breath, and let the beating begin again.

Let it flow let yourself go
Slow and low that is the tempo
Let it flow let yourself go
Slow and low that is the tempo

Rainbows, waterfalls, and unicorns, bitches.

Bring it!

Sunday, May 20, 2007

They sue doctors, they send nurses to jail

I just saw this in the LA times. Even though its like 2:30 AM and I'm study the umbilical placement of the fundus, this got my goat.,0,6057993.story?coll=la-home-center

Attached is my letter. Dig it!

Subject: you idiot tool
Date: May 20, 2007 2:38:09 AM PDT

This is off the record...
Good job moron. By focusing your blame on a callous nurse and by publishing her name, you have now not only endangered her personally but you have done the bidding of various county supervisors who make unaccountability an art form. Your story is so full of holes and misinformation, all the details you forgot to include while you made a case against the nurse and police.

Incidents like this happen from time to time in the ER world. Somebody cries wolf and when it really is their turn nobody believes them. ER nurses know this better (and should know better) than anybody. So what can a nurse do in a situation like this, repeated discharges and the patient is still returning? Had they performed a full workup, or did they just send her off with Vicoden? All the triage nurse can do is check the patient in, monitor vital signs every 4 hours, as is county protocol, and let the patient do whatever the hell the want in the lobby (scream, cry, threaten, use drugs, fight). Which she did, followed county protocol. Doctor's decide when to intake the patient.

So there were no doctors involved in this situation at all? What about the too busy to be bothered doctor who couldn't figure out that she had choleolithiasis or a bowel obstruction. How is it that YOU PUT THE BLAME ON A NURSE WHO IS ONLY ALLOWED BY STATE LAW TO CHECK IN, MONITOR VITAL SIGNS, AND TRIAGE ACCORDING TO SEVERITY OF ILLNESS.
A nurse cannot order ultrasounds or pull lipase blood panels . A nurse cannot order laproscopic surgery. All she can do is check the patient in and inform a doctor of the situation. Do you think her getting a workup for the third time that day was on the top of the physicians list? Should it have been?
Obese lady is yelling that her gall stones have exploded and is carrying on. Number 30 for the day. Abdominal pain is the number one complaint in the ER. It is also the most difficult to treat and diagnose. It takes time, because all those people ahead of you with heart attacks, gunshot wounds, and diabetic ketoacidosis are in more danger than your vague (but vocal) complaint.
Junior Blogger: there was nothing the nurse or any medical professional could do for her. You know why? Because LA County DHS is run by a crew of egomaniac rich politicians. As an emergency professional, I can tell you, County Emergency medical care is fucking scary. Its called a lack of reasonable resources. That's not the nurse's fault. But guess whose it is?

You are a tool because the nurse is the most expendable member of the health care team, and as you may now be noticing, DHS is going into general quarters, taking their doctors with them into a protective PR wagon circle. You chump. And just so you know, other than increased pulse, decreased blood pressure (if the perforation was bleeding), and a temperature greater than 101, a complaint of severe abdominal pain means nothing. Ms. Rodgriguez was nothing special in the ER because half the people in the ER were waiting with the same exact complaint. Unless you are involved in a trauma or have an identifiable life threatening situation,you have to wait in the waiting room, just like everybody else at county, you wait your turn. HEY CHUMP! PAIN IS NOT AN INDICATOR OF LIFE THREATENING EMERGENCY. SCREAMING DOES NOT GET YOU BACK ANY FASTER, BECAUSE THEN EVERYONE WOULD SCREAM TO GET BACK. HEY YELLOW JOURNALIST, EVEN HER OWN BOYFRIEND LEFT TWICE TO GO "RUN ERRANDS." AFTER MIDNIGHT NO LESS! She must have been really bad then right?

She was seen by two doctors for full consultations and yet you blame the nurse who evaluated her at triage. Now some media horny DA is ruminating over filing criminal charges, we're not sure who yet, but we do already know that because of your brilliant piece of heart felt investigative journalism it'll probably be the nurse. But that's good for you, right? This ridiculous story goes on and on. Hey, maybe you'll win a Pulitzer.

Mr Ornstein, let me tell you what you are now the cathartic enema for. Nurses will be afraid to properly assess people, patients who like to scream will get moved ahead of people who are really dying (idiot, Ms. Rodriguez was the exception, most people are dying quietly in the waiting room because they are too sick to scream and carry on). When nurses become the flavor of the month for stalled out DA's, any shot of recovering the American healthcare system will be permanently destroyed. You think doctors are afraid of getting sued? Imagine a nurses fear of being sent to jail, for having the strength to do her job, to not crumble under the mountain of LA's worst stories. If a nurse is afraid to do his or her job you won't even get in the door.
That's right chump, people are dying in the waiting room everyday because there aren't enough beds, hallways, tables, to put the bodies on. If someone has the energy to scream at me, I tend to think they aren't dying. Ethical Journalism Reject, you have enabled LA county DHS supervisors to shirk off some glaring reminders of their managerial incompetence, yet again. A morbidly obese Latino woman (Hypertension + Diabetes endemic) sadly crashes after a life time of giving her shoes to people and basically being kindest, sweetest greatest person on earth, well aside from those warrants, and you want to hang the nurse whose job is to categorize and put the patient in line and attend to any life threatening situations that might arise.
I wonder why the whole night shift ignored her, lying there, screaming in pain, and no doubt in real agony. Why would they do that, I wonder...

"I am completely dumbfounded," said county Supervisor Zev Yaroslavsky. Ya think?

Good job.

Monday, April 23, 2007

Positive Role Model Found!

A breakthrough! My OB instructor is great! Honest, sense of humor, argues with doctors during C-sections, is open about the problems with the hospital she works at, lets us make mistakes without humiliating us, and seems to take a genuine interest in my performance. Best of all, she believes in the absolute competence of the nursing profession, and pointing out the bad habits of uninvolved nurses.

I feel like Michael Banks in "Mary Poppins" when the two kids write a letter requesting a new nanny, and FUCKING MARY POPPINS SHOWS UP. Before you know it she starts giving them hard core drugs laced with spoonfulls of sugar and making rooms fucking clean themselves. What a relief! I just needed someone to give me some guiding light: a nursing instructor that acts like a normal person!

I'd like to write more but I've got a serious PEDS/OB test manana.


Sunday, April 1, 2007

Go ahead and squeeze a little harder why don't ya?

Sorry, it’s been awhile. Super busy. Super fucking busy. Got through the competencies pretty good, I got the “easy” instructors, i.e. the ones that are remotely normal and secure enough with themselves that they don’t feel the need to torture a student.
As of right now, the majority of my class is on academic warning. The 2nd semester faculty is a lot like the Bush administration: No matter how bad the classes grades get, no matter how many inappropriate acts the instructors carry out, it’s the same shtick. “We’re just trying to figure out why you guys aren’t getting it.” Never a mea culpa, no responsibility whatsoever for the fact that a group of extraordinarily driven and intelligent ADULTS are failing everything thrown at them.
No, my dear instructor, you saintly middle-aged woman in your 40’s with no kids, no husband and 20 cats. YOU’RE not getting it. You’re fucked up! And when your sole purpose for teaching is to humiliate, bully, and fail students well, you get what you pay for. A class of 72 students with the majority on academic probation.
Fuck off!
I make no apologies. The observation has been made, I shall pontificate here but lord help me if I say this in class.
If you are middle-aged, not in a relationship, don’t like young people in general, and have a freakishly large assortment of pets put a red flag on your scrubs because you’ve got some serious fucking issues and shouldn’t be anywhere near the next generation of nurses.
I’ve come to this conclusion as I have come to realize that the violently nutty nurses, the happy-sad, maybe I’ll get weepy during a lecture and then scream at a student for not wearing the right color socks (black shoes=black socks, white shoe=white socks. I’m totally serious the hard asses will send you home if your socks don’t match.), the ones who tell the students they don’t like that they should maybe think about quitting school, these are the ones who aren’t married. At my school a couple of the foul tempered instructors have been married but are now divorced, but in general they have been single for a considerable amount of time. Like, I can’t believe the huge assorment of spinsters that are instructing at my school. Somehow, they all found each other, united in disdain and contempt.
Nothing wrong with being middle-aged and single, middle-aged and divorced, fuck half the country is past 38 and divorced. But are you still in the game? Are you trying? Have you given up on the opposite sex entirely and have resigned yourselves to your sister’s kids, pretending they are your own? Do you still believe right before the increasingly shitty and bizarre blind dates you’ve been finding yourself on that this might be love?

Don’t give up. The opposite sex hates you as much as you hate them. So just fucking bite the bullet and let it go, accept someone for who they are and go make some love. As long as they respect you, treat you right. And ladies, don’t tell me you’ve tried and good men are hard to find. Because they are not. There are roughly 75 million single men in America. They may not come in the form you fantasize about, they may not treat you like shit just the way you like to be abused but goddamnit they are out there. And for the divorced middle-aged guys: PAY ATTENTION TO YOUR WOMAN. WOMEN USE SINCERE ATTENTION LIKE FUEL. JUST A FEW MOMENTS OF YOUR TIME AND THEY ARE ABSOLUTELY FUCKING STOKED. LAYOFF THE SPORTS TALK AS YOU PRIMARY METHOD OF COMMUNICATION. AND TRY AND STAY AWAKE 10 SECONDS AFTER THE NUT YOU CHEEKY BASTARDS.
Excuse while I step off this soap box.
I mean, if it’s this obvious what the bad nursing instructors’ problem is, that they have been dicked over by some of the worst taste in men this burned out society has to offer (see: firefighter, paramedic, cops, used car salesmen) they have no one to blame but themselves. I didn’t fuck up your dude radar! You should have gotten it fixed!
They act on their own bizarre experiences so often I can see their bitchy wheels turn, “Should I be supportive of this student in their time of need, should I encourage them, let them know that its okay to make mistakes when you are learning how to do something that requires immense technical finesse, great emotional intelligence, and serious attention to detail? No. Now its time to lay down some serious institutionalized abuse and sting this student good.”
How fucked up are they? You know they must have hated their patients. Probably despised them. Did fucked up shit like withheld pain medication when in a foul mood to “punish” their patients for being needy or irritating them.

Hey! You nurses out there who play the withholding pain meds till absolutely as late as possible game: you make me fucking sick. Who are you to judge and punish? Don’t do it. Don’t abuse like you’ve been abused. Cause you’re playing with fire and baby you will get burned. It’s like scratching the mosquito bite of hate: you only hate more.

Some nurses hate black people.

Some nurses hate men who remind them of their father.

Some nurses are uncompassionate to women that remind them of their mothers.

Some nurses don’t feel what a patient is going through because they have a higher tolerance for distress because of what THEY have gone through.

Some nurses are traumatized from their line of work and suddenly snap at people or patients they may care about.

Some nurses have drug problems.

Some nurses are jealous of American nurses.

Some nurses hate men.

Some nurses hate women.

Some nurses loathe white people.

Some nurses do what they are told to do too much to please the powers that be.

Some nurses like to be part of a machine that crushes people, that keeps down the dusts of change.

Some nurses are just looking for a spouse.

Some nurses are absolutely incredible fucking people who have great technical knowledge and are still emotionally capable of making someone that they wouldn’t otherwise relate to or interact with feel safe, clean, and capable of healing.

Some nurses have heart.

Some nurses know what the fuck is going on and aren’t afraid to act on it.

Some nurses could really give a shit what arrogant, pissant residents think is a “quick” procedure.

Some nurses walk the line between insubordination and always advocating for their patients as a method of humility, integrity, and keeping it really fucking real.

Some nurses think for themselves.

Some nurses are so fantastic and inspiring to me that I personally want to equip myself with the “identity” of a nurse.

Keep doin what you’re doing.

Mazeltov. Happy Passover,

And to all the haters and status quo addicts, the trick ass marks, mark ass marks, punk asses, ho's, heffers and hulahoops, skeezers, skanks, skig-scags, scallwhomps, I want you to ponder exodus from slavery you dickheads, you disgruntled bitches.

I’m coming to gitcha.
(Thanks D.C. for that rant)

Monday, February 19, 2007

How many nurses are victims of domestic violence?

I posted this on

Re: intimidation by nurse manager?
Originally Posted by Cat Nurse
"I have a male nurse manager. I have worked with him for many years. I am not agreeable to some of his hired staff. I think his hormones get in the way of his judgement. But many people feel intimidated by him. Many have quit and say it is because they don't feel comfortable around him. Most, probably would not have been confortable any place or with most people!"

Is this really a gender issue? People have quit because they don't feel comfortable around him? Like, he'll hide behind around a corner and attack you? There are so few male nurse managers, please don't take the most obvious route and imply that he is a pervert. Its hard enough being a male nurse as it is. Same goes for male school teachers. Not all men are pervs. Some are, yes. But it sounds like this dude is just being a manager, which means to say he is trying to control you because most managers are too insecure to work with their staff, instead they work against them. BTW, I work in one of the largest ERs in California and the head nurse and nurse manager are both female. More of the nurses here have breast implants than don't. No joke.
Don't blame your male manager for unprofessional nurses, please. If your manager wants to act like a child let him. If patients get turned away, its his rear end.

Cat Nurse (red flag right there), feels that she's not allowed to go fulltime PRN because her nurse manager is a hormone driven scumbag. Thanks Cat Nurse! That must be it. What a bother.

Nursing school is seriously kicking my ass. Mid term tomorrow. I think I'm prepared. You never know...

I've been looking at all the first year residents, second year residents, all the residents. They seem so happy. They're so loud on the floor, joking with each other, high fiving each other. Then I look at the nursing students: Scared, painfully quiet, expressionless. The second me or one of my fellow nursing students does ANYTHING there is another nurse and our nursing instructor immediately in our face threatening us with expulsion. Seriously, I asked my instructor how many clinical days we were allowed to miss, and she fired back at me, "If you miss more than two on your first rotation you are out of here. You will be dropped from the program." What the fuck lady? I haven't missed any days, I just wanted to know.
You know what I just found out? That one of the other 2nd semester instructors, a passionately pro-American ex-army nurse, I call her Chris Farley, (I wrote about her about three posts back) she makes faces at you, tsks her tongue, shakes her head, while you do the clinical competency. Not like goofy faces, but furious faces, disgusted faces. She might as well call us "maggots" That's fucked up. And don't tell me that as a nurse you have to be tough and do it right under pressure, blah, blah,blah. We're fucking students for Christ’s sake! Most students haven't even seen an NG on the floor, what the fuck do they know? This is not the military. We're not in WWII. We're college level nursing students getting a degree and planning to join (what I hope is) a professional work force. All this constant threatening, the persistent mood swings of ALL the instructors, "today I like you but tomorrow I won't" It all dehumanizes us, sucks up what little self confidence my fellow nursing students have, makes them more timid. Afraid to confront asshole doctors, afraid to tell the manager the shift they got is bullshit, afraid to switch to a better department where their co-workers at least attempt civility, afraid to say "this pay is shit and I'm going to quit and work at a hospital that treats me how I deserve to be treated!" How about instilling professionalism in the new nurses of today, which is to say, support them and treat them respectfully. CAN WE AT LEAST ATTEMPT TO BREAK A CYCLE OF OPPRESSION?
Chris Farley fails at least ten students on NG competency every semester. For stupid shit lie forgetting to tape the tube to the cheek, even if its already taped to the nares. That's great for the confidence building!
I cannot believe how hard my school works to keep us from thinking for ourselves. Every instructor loves to shout "critical thinking" about 30 fucking times a lecture but all they're really doing is enforcing protocols. I have no problem following the rules, but do you have to tell me I'm stupid while I do it? Why is this old school, oppressed female nurse shit allowed to perpetuate? Why not make everybody where the fucking white hats while you're at it?
Long shoreman makes 100K a year, to start. They don't do shit half the time. So don't tell me about the gravitas, the noble responsibility of nursing. OLDER NURSES! Most of you have failed in your careers! Your lack of respect for yourself has cost you the safety of the patients and left a smoldering hole where you once held an acorn of self confidence.

I do not mean to be crude, but I ask this question in all sincerity: How many female nurses suffer spousal abuse, be it intense physical of emotional. I'm totally serious. You think about this question, then we have the root of our problem.

Friday, February 2, 2007

Sack Launch

Not a big story teller. I mean like, ER stories shit like that. I think its in bad taste. It's basically like saying, "I'm cool. I'm cool. You're not. I'm cool." the whole time you tell the story.

BUT in this case, check this out.

We're starting out with one patient for clinical. Next week we get two. This week I had a dude with an abcess on the inner aspect of his thigh, closer to the cup of his ass cheek. Monster abscess. My patient was kind on nutty, sort of a strange dude. Hispanic, spoke pretty good English. He told me that he had the abscess in early January, it went away then came back, like a tumor. He was so resistant to listening to any medical advice, I think that that he still thinks the I&D was a benign tumor removal. Anyway- here's the fucking story.

Resident comes in with medical student. Resident is a giant white goober from Idaho. Like, 6'4. Ugly and arrogant. His medical student assistant was short, obese and African-American. It was abundantly obvious from their interactions that they did not see eye to eye on many different levels. All three of us are in the patients room, preparing for another incision and drainage of the abscess. His boss, a female jewish doctor, told him to go deeper with the cut. He protested. She ignored him. Tall goober stuck between a female Jewish boss and an female African-American med student. You could see it was driving him in red state agony. I loved it.
Pt. was lying prone. Part of his nuttiness was sort of these jerky movements, so when he lay down, he sort of flopped down and his ball sack was sticking out underneath him, like a little bag or, I don't know, a bunny rabbit tale. Dude wasn't embarassed or bashfull at all. "Fuck it," the pt. was probably thinking, "might as well air out the huevos."
Doc Goober begins to numb up the 6 cm long x 2cm wide x 2cm deep wound. He starts talking to me, the lowly male nursing student. I took it as a perverse political statement. I'm way low on the totem pole but in his eyes, better that than the black or the Jew women. So he's talking at me as he inserts the needle into the wound. Of course the poor bastard patient is completely unmedicated and biting his pillow.
Dr. Goober's pain med: "This'll just take a minute." Asshole.
So instead of walking the med student through the procedure Goober is actually looking at me while he's injecting Lidocaine. The inevitable happens when you give an arrogant conservative control of a resource: Goober loses control of the syringe.
I've never seen anything like this in my life: As if in slow motion hand ballet, like a magician winking a coin through his fingers, Goober struggled to regain control of the needle. Over the top of his fingers, bumped up again by his palm, up the back of his hand, this needle was all over the place. His germanic-irish mug was shriveled in strain and horror, like the 3rd Reich had just destroyed a potato field in Boise. He made a last ditch attempt to grab the flailing syringe and it hit the top of his fingers and went straight up in the air like a missle, did a 180 and headed straight back down to earth like a dart. Right into the bunny tail. Right into the dude's sack.
I heard him scream into his pillow, "Oh my jeesus! Oh!" I've never seen a sack pierced before. Shocking.
I need to be perfectly honest here, everybody. The pt. was a light skin Latino, had a mullet, and fuck me, he sounded a lot like Nacho Libre. I wouldn't have been suprised if he had said, "That was eeespecially painfull."
Then he started to sob. He didn't like wail, but little girl like shudders, I could here him hyperventilating and moaning. Pretty fucking sad.
The needle fell out of his scrotum and a big old bubble of blood surfaced. The good doc Goober had finished looking at me for good. He turned to the medical student. He looked away quickly. His gaze returned to the burst sack. As he dabbed with guaze, "Oops. That was me buddy." And as he lamely looked at his med student, "My bad."
I would have puked if I wasn't laughing so hard.


Monday, January 29, 2007

Horizontal Violence

This is what I have been feeling. I read this and freaked. This describes the medical industry to a t.
I realize there is a lot of text here but I am so pleased and relieved I found this tidbit- check out the website.

Definition of horizontal violence

Horizontal violence is hostile and aggressive behaviour by individual or group members towards another member or groups of members of the larger group. This has been described as inter-group conflict. ( Duffy 1995).

Talk to all staff members about the phenomenon, break the silence.


Horizontal violence is non physical inter group conflict and is manifested in overt and covert behaviours of hostility (Freire 1972; Duffy 1995). It is behaviour associated with oppressed groups and can occur in any arena where there are unequal power relations, and one group's self expression and autonomy is controlled by forces with greater prestige, power and status than themselves (Harcombe 1999). It may be conscious or unconscious behaviour (Taylor 1996).

It may be overt or covert. It is generally non physical, but may involve shoving, hitting or throwing objects. It is one arm of the submissive/aggressive syndrome that results from an internalised self-hatred and low self esteem as a result of being part of an oppressed group (Glass 1997; Roberts 1996; MCCall 1995). It is the inappropriate way oppressed people release built up tension when they are unable to address and solve issues with the oppressor. (Administration and doctors)

In the majority of western cultures, a dominator model (Eisler 1993) of social organization enables workplace hierarchy to limit autonomy and practice of various groups of workers and therefore acts as an oppressive force. Workers are socialised into the oppressive structures and unequal power relations of the workplace system.
Some groups of people within each particular workplace unconsciously adopt inflated feelings and attitudes of superiority. Some groups adopt unconsciously submissive attitudes, learned helplessness, within the workplace.

Horizontal Violence is a symptom of the dynamics around oppression and a sense of powerlessness. It is to the workplace culture like water is to fish. It moulds, shapes and dictates the behaviour of those within the workplace culture.
It is a form of bullying and acts to socialise those who are different into the status quo.

Horizontal violence in the workplace is the result of history and politics in western society and the ideology and practices associated with the socialisation and stereotyping of males and females in western culture. Horizontal violence is a systems and cultural issue, a symptom of an emotionally, spiritually and psychologically toxic and oppressive environment. Horizontal violence is not a symptom of individual pathology, although individual pathology flourishes in a climate that supports and condones aggressive behaviour.

Horizontal violence includes:

All acts of unkindness, discourtesy, sabotage, divisiveness, infighting, lack of cohesiveness, scapegoating and criticism

For example:

Belittling gestures e.g. deliberate rolling of eyes, folding arms, staring into space when communication being attempted - Body language designed to discomfort the other
Verbal abuse including name calling, threatening, intimidating, dismissing, belittling, undermining, humorous 'put downs'
Gossiping (destructive, negative, nasty talk), talking behind the back, backbiting
Sarcastic comments
Fault finding (nitpicking) - different to those situations where professional and clinical development is required.
Ignoring or minimising another's concerns
Slurs and jokes based on race, ethnicity, religion, gender or sexual orientation
Sending to 'Coventry', 'freezing out' excluding from activities and conversation, work related and social.
Comments that devalue:
people's area of practice;
others that are different to the 'norm'.
Disinterest, discouragement and withholding support
Limiting right to free speech and right to have an opinion
Behaviours which seek to control or dominate (power 'over' rather than power 'with')
Elitist attitudes regarding work area, education, experience etc "better than" attitude
Punishing activities by management e.g. Repeatedly sending someone out of area; bad rosters; chronic under staffing; lack of concern with mental, emotional, spiritual and physical health of employees
Lack of participation in professional organisations (a subtle form of self-hatred) however, busy family lives can preclude participating in professional organizations.

Sunday, January 28, 2007

Nursing Student Hell: Real fast

Nursing Student Hell: Real fast

I just want my R.N., lady.

Alright- my second semester of nursing school is in full swing. Getting my butt kicked, trying to figure out baffling electrolytes, trying to jam all this new info into my brain. All in all, its pretty fascinating. I'm happy in nursing school. I'm enjoying the mechanisms, gears, and gadgets of nursing healthcare.

Alas, someone has thrown a wrench into my enjoyment of education.

Some of you nurses suck. You are unbelievably childish, and all of my instructors and more experienced advisors tell me to just ignore it. FUCK ignoring middle school level attitude, FUCK not having conflicts over stupid things.
Hey experienced nurses- How far has ignoring unprofessional behavior got you? Congratulations! Have another serving of being looked down on and a side dish of co-dependant unacceptable behavior. Nursing needs to change.


I go to a nursing school that is part of the county system. There are several hospitals in my county. For the first time, my 10 person clinical group is doing clinicals at a farther away county hospital that has relationships with public and private nursing schools already established in that area.


It's completely baffling. Why do the nurses give a shit what school is doing their clinical rotation at their hospital? It's all the same nursing students. We haven't bumped any schools. All we do is come in there two days a week, wipe someone's ass for them, if we are lucky, plant a Foley, put down a NG, set up an IV. (None of which has happened yet.)

Here is the response my clinical group has gotten from the nurses:

Really nice nursing student: "Could you tell me the name of the nurse manager? This is our second day on the floor and I'm filling out a scavenger hunt of who everyone is and where everything is at on this unit."

Shithead Coordinator: "You don't know who the nurse manager is? That's really sad. Really sad."

Me: "Excuse me. Could you help me access the labs on the computer system?"
Nurse Manager: "You don't have access to labs. That would be a liability. You are a liability."
Me: "We have access to the same system at county. We need the labs to fill out our clinical write-ups."
Fucking Nurse Manager: "No you don't. There’s no way you have access."
Me: "Of course we do. We also have to chart on the computer as well. We can even access labs from our college."
Nurse Manger: "What?" she looks around the floor to make sure everyone is watching, "That's a HIPPAA violation. That's wrong."
Me: "Our college is on the hospital campus."

My instructor introduces the nurse manager. She does not say hello. She does not say welcome. She says, “You may not use the nurse break room. You may not bring backpacks to this unit. You may not use the conference rooms. If you want to access labs find the nurse for that patient and have her sit with you while you record your information.”
Walks away.

Hello. Fuck you. Goodbye.

I am not a liability to any of the nurses on that floor. I am a liability to my fucking liability insurance company and to my instructor. duh. Telling me I'm a liability is childish bullshit. Something else is going on.
Then they snuck in the LVN students. Now we "share" patients. The LVN's come from a rip-off private college. (35K a year). We come from the county, same as the hospital. What the fuck?
None of the nurses will answer questions.

Does anybody out there know what is going on?
How can nurses act like such children? So remarkably unprofessional.

And the best part: As county student nurses we are eligible to be student nurse workers. The nurse recruiter (who is so passive aggressive she is basically just aggressive) schedules the THREE DAY SITE ORIENTATION THAT WE ALREADY WENT THROUGH AT THE MAIN COUNTY HOSPITAL on the first three days of my nursing schools semester. She actually told me that she knew my instructors very well (which is a bold face lie, they had only met once) and that she was sure they wouldn’t mind if I didn’t show up for the first three days to attend orientation. Miss any of the classes the first week of school and you get yourself dropped from the roster. This nurse has 3 masters degrees. NP, MSN admin, MSN education. She looks like she is on the tail end of a 2 week vicodin run. Nodding eyes, tiny pupils, unbridled hostility. 3 masters. What a waste.

Not a single male nurse on the entire unit I might add.

Sometimes nursing, you really bother me. Nurses are so quick to behave so bad, so easily. A true disappointment.


Tuesday, January 16, 2007

Is that nursing in your pocket or are you just happy to see me?

Started second semester today. 4 classes. 6 hours of lecture. My ass seriously hurts, like my tailbone hurts.

So much reading to pour over and try to stuff into my wee brain. I already have "The fear." All those nagging assigments like mini mountains looming over a grey horizon. One down, an infinite amount to go. The horror....the horror.

I'm lucky though, I got assigned to a relatively mellow clinical instructor. Fortunately, I didn't get the psychotic ex-army nurse from the south who acts all girly and squeeky when she lectures and then bellows at her students in a voice like Chris Farley, "My clinical group gather at once! You there! What are the 12 crainial nerves and their functions!?"
"How should I know? " the autistic guy Mike blurted out.
"Oh my gawd! I've seen jackabasselopes smarter than you!" She barked like a seal with a fucking cigar in its mouth.
"What the fuck just happened?" autistic Mike said, his eyes darting around the room, trying to get a lock on anyone who offered emotional comfort. But none was to be found in this barren field. Everyone was too afraid to even look at him. I wanted to tell her that Mike is fragile but I guess, ultimately, it's for Mike to sort out.

Sorry experienced women, but 6'2, 50+ women should not talk in girly, squeeky voices, play with their hair, perform shockingly suggestive dances whenever a male student gets one of her arcane questions right and then bellow like Chris Farley after four bong hits. It's unseemly.

It was good to see all my friends again, feels like the class is a bit more cohesive this time around. People seem to have been hanging out over break, carnally.
Finally some lovemaking has been going down in the class. There is like 7 straight guys in my class of 75: 6 gay dudes and 7 straight dudes, 5 of the straight dudes are married. Can you guess who got laid? That's right! The 2 straight single male nursing students co-mingled their loins with the blossomed flowers of a few of the previously betrothed but now broken up ladies in the class. Funny, the women that actually hooked up with dudes over break all SWORE ON THE SACK OF JESUS last semester that they were SO IN LOVE with their ex-boyfriends.
"We're practically engaged!" they felt the need to brag. Then they spent the whole break rebounding like Kobe Bryant on Meth with like the only two available guys around them.
In my limited experience I can't help but notice that nurses are weird people. I'm weird. I like weird people. Do nurses have higher sex drives, male and female alike? Is that what it takes to be a good nurse? 110% on the floor, 110% betwixt the sheets? Robby told me his balls hurt from getting laid so much. I don't know whether to be professionally insulted or proud of the little bastard. I guess I should be proud of the ladies too! Fuck it. They're young and single. Go crazy. Get your rocks off.

The married must live vicariously through the melted heartbeats of amorous, wet, stressed out nursing students.

As one straight male nurse told me about nursing school, "I like them odds."

The way of the dog.

Thursday, January 11, 2007

Nurse Ratched's Place: Change of Shift

Nurse Ratched's Place: Change of Shift

I like women and whine

Just read a post on why are newbies such whiners?

I'm a whiner. I tell you why.

Because like most newbies, I am totally fucking shocked to see the vindictive and apathetic attitude most experienced nurses have towards themselves and their fellow nurses in regards to nursing as a profession on a whole. Shit shifts, shit pay, no significant pay increases in the last six years. Constant cattiness. I got into this field thinking I could support my family. I'm thinking I got fed a load of bull. So yeah, I whine. I whine cause I want this exciting and rewarding profession to change for the better and I want to see women stop blaming men for some "glass ceiling" when all they have to do is unify, stop bitching, and start working towards better treatment.

I love the sacrifice play that nurses often pull. I've seen it twice. We'll call it: You're our hero (you're fucked)!

1) Courageous nurse steps up and says she is willing to go to the union to try and get some things to change.

2) The majority of the staff back her up to her face, (great idea, yeah let's do it!)

3) Nurse goes to the union, confronts management. All the other nurses pretend they know nothing about this when management asks who else feels this way, if anything they condemn her by calling courageous nurse a "whiner".

4) Courageous nurse is either hassled into quitting or is set up and fired.

This is why I whine. Because I am a man now relegated to unempowered woman status. And I think it sucks. All that I know technically about the medical field I have learned from women. Including E.M.T. If my fellow female coworkers could see how capable they are in my eyes, maybe they would stop feeling so inferior.


Monday, January 1, 2007

Where will we live?

The names have been changed to protect my ass...
I'm pretty sure I was ridiculously naive. Upon entrance into the medical field. Even in E.M.T. school I had such ridiculous expectations about what working in as an E.M.T. actually entailed. I didn't think my job would be running around doing dramatic heroic things, I didn't think everyday I would pull people out of cars or something cheesy like that. I don't have a hero complex. I just thought I would be more useful than I actually ended up being. Performing a really valuable service. I didn't expect to being turned into a cog for such a dysfunctional health care machine so quickly. The ambulance company that I worked for didn't have a 911 contract so we only provided transports to and from different facilities, such as convalescent homes, mental health facilities, and halfway houses.
From day one: I encountered a human condition that I couldn’t believe was imaginable in compassionate America: My job was to transport filthy, covered in unbelievable bed sores, low BP, catatonic, elderly or unstable patients to either dialysis or a doctor's appointment. During the doctor's visit we would travel at light speed with lights and sirens blaring (code 3, totally illegal to do unless someone is truly unstable in the back but the dispatch manager was always bellowing at us it was our butt's if we didn't) to grab another patient from another facility and get them to their appointment and then dash over to pick up the first patient hopefully before their visit was over. Constant mad dash, load and go, load and go. No lunch. Ever. 12 hours and more of this every shift. My first trick of the trade: Learning that most ambulance crews are under he same stress. Any time you see a non-fire ambulance crew running with lights and siren and two uniformed employees sitting up front, they are breaking the law. You can go code 3 after you get the patient, but before you pick the patient up all you can do is get there as fast as you can. When an ambulance has a patient the only uniformed employee to sit up front is the driver. The one in attendant role is in the back.
The ambulance company was run (and still is I hear) by an ex-crip and a questionable Russian lawyer. The E.M.T's I worked with were, in general, somehow oddly suited for the job they held, maybe because the all seemed resilient to life's beat downs or perhaps were just enduring them. Being an E.M.T is meant to be a stepping stone for other career aspirations, at least in Los Angeles. The crew was comprised of people who sat down on the stepping stone. Wanna be firefighters, strip club addicts, drug addicts, Ultimate Fighting Championship half-assess and all around scandalous people.
A shining example of someone who seemed to be missing out on life was Paul, the only other white guy working the day shift was a hardcore burnout who got kicked out of the L.A.P.D. police academy for reasons unknown. (Well unknown until you spoke to him) In his mind, he was actually a cop, a super cop, and claim he had a mysterious ability to read the intentions of everybody we passed on the street from his "intense police training". Ridiculously scary statements like, "once you get that training it never leaves you. See that old lady there waiting for the bus? I've identified her as a drug mule." To bad that training didn't get him a decent job. Paul was 40 when I met him and still living with his mother. She'd call him at least 15 times a day and every time he acted like he was getting a call from the goddamn president. Transports would wait for these epic conversations, mostly about where random objects had been stored in their pack rat ancient apartment. Thank god I never had to go for a visit to Mummy but I had heard stories. One of my partners, Geena, told me "It's like, still 1985 in there. I can't explain it."
Geena was a morbidly obese dyke who was actually pretty good at her job. She could talk to patients and put them at ease and did a pretty good job of disregarding the bullshit that came from "base" which was The questionable Russian lawyer’s office and the ex-crips place of residence (Dudley). His office was his bedroom at night, but during the day his bed, a lovely white futon made his office look spacious and comfortable. As if he had clients that could casually comein and relax on his ikea futon couch. But at night:Dudley would bring out what he called "My passion." A red sating sheet would drape the corners of his bed. And the dude had chicks. Every night a different girl, every morning a bleary eyed regretful young woman would leave his office/chamber of earthly sin.
We rolled pretty much in the African-American parts of Los Angeles. Inglewood (which is actually a pretty cool little city with some great history), Hawthorne, Compton, Carson. All the cities surrounding South central. We weren't ever supposed to go into Los Angeles City proper because we didn't have the mysterious and difficult sticker that would grant us city privileges. We went anyway, quickly, the driver usually repeating the mantra "I don't want to lose my license. I don't want a $1000 fine" over and over. Maybe the fine was a threat, but everybody I worked with had expired E.M.T. licenses anyway.
The ambulances themselves were death traps. The rigs were from a dealer in Louisianna that Dudley knew. They had outlived their service in that quality healthcare state so they made their way to Los Angeles, to our sweet company. The only medical device inside was a stethoscope, a bp cuff, and an O2 tank that were all almost always out of gas. The tires on the rigs were always blowing out, they were made to handle the weight of a family van, not an ambulance. I myself blew out two tires by carelessly driving over the edge of curbs. Mechanically speaking, as far as I know, the ambulances were maintained by a team of mystical ambulance engine trolls who would "make adjustments" as the questionable Russian lawyer would say, right when no one was around to see the work being done. At least once a week one of the company’s 3 ambulances would break down on the 405 or the 105, usually with a patient inside of it. I found the possibility of breaking down with a patient inside it nerve racking. But I got lucky, I only got stranded because of blown tires. My coworkers took it as a minor annoyance. Break time I guess. I remember when I quit the company I called the Highway Patrol to report the company, typical dramatic behavior for a pissed off E.M.T. who wants revenge, for the crappy pay, the shame of transporting sick people in ambulances that were unfit for usage, the doctor's who would passingly look at a patient with decubitus ulcers to the bone and write orders that he knew would and could never be met. The cop in charge of ambulance safety at the CHP said, "Look, they just assigned me here, I don't really know what's going on. I'm sorry I don't know what to tell you." He didn't want to take the complaint. He didn't care. Another bummer lesson: I WAS THE LAST PERSON TO FIND OUT HOW COMPLETELY FUCKED UP OUR HEALTHCARE SYSTEM IS.
How could I ever forget the stupefying realizations that one could ascertain about what happens to some poor old people in American culture. The frustration of having to pick up a nearly dead patient from a con home, 7 CNA's sitting down having lunch, talking about anything but what is going on in front of them. Meanwhile the patient we were there to transport to her clinic appointment had a non-rebreather mask on at 2 liters when at minimum they function at 8. She looked sleepy and would only respond with mumbles. The shock of having to get report from the nurse in this con home, the only nurse in this con-home who, coincidentally spoke ABSOLUTELY NO ENGLISH AT ALL kept my jaw to the floor the entire time I was there. The poor nurse presented as an extremely upset Korean woman who kept pointing at the CNA's in horror but was never able to say anything. My partner Mark, didn't want to take the patient. 75/30. 50 pulse. Rapid respiration's.
"We shouldn't be taking this patient. She's about to code." Mark, a very dignified and compassionate African-American, whose goal was to be a screen writer, looked at the patient, looked at me, pushed the nurse aside and said, "Fuck it. Load and go. Let's go now." We didn't have O2 on our gurney, whatever she wasn't getting any anyway. No report, just a pile of papers. Mark loaded her up into the rig with one hand. As I was closing the loading doors one of the CNA's came running out of the con home. Some useful information? Hell no. "Ya'll have any gloves? There aren't any gloves in this whole place!" I tried to say something in disbelief but all that cam out was "whaaa?" in a hushed whisper. I thought about telling her to go to hell but Mark grabbed one of our two boxes and tossed it to her. Then we took off. I was too inexperienced to see how sick the patient was. After a while of working around sick people you can sort of look at a person, scan their vitals and figure out how stable they are, a reasonably accurate guestimate. Mark had developed this ability and took his guestimate, I just followed. My skills were too new, too inadequate to get a good BP while we were cruising at breakneck speed to what I thought was her Doctor's appointment.
"What's her BP?" Mark yelled back to me.
"80/60, I think. I think she's crashing." She wouldn't respond to my calling her name, "Mrs. Mayfield! Can you hear me?" The sleepy eyed look she had at the con home was gone. Her eyes were just closed.
"Look, you need to tell me what it is exactly. If you need me to pull over so you can do this then I'll pull over."
"all right pull over." A gray cloud was coming over me. I knew I wouldn't be able to take this BP. I was too stressed, too new, and I just couldn't seem to slow myself down enough to do what I had been taught.
"Just do it over palp, man!"
I blurted out, "What's that?"
Mark jumped over the driver seat into the back of the rig, ripped my bp cuff out of my hand.
"Inflate, when you feel a pulse over her wrist you have systolic. That's all we need right now. 70. She's holding." Off we went. We rolled into a now closed Gardena E.R. The ambulance bay doors opened, and... jammed up. We were number four on the wall. An absolute gurney traffic jam everyone waiting for rooms to open up. And in a 16 bed ER this was probably going to take a while. Graffiti marked the 80's brownish colors of the peeling wall where we waited, staring at our patient who was becoming what I now recognize as ashen. "22 crew waits you hard!" "Bad timing." "Who's fucked?" engraved into the wall by the same ballpoint pens that would no doubt write the transfer reports detailing a perfect drop off, enabling the voracious ambulance companies to secure their medi-cal payments.
Mark tells me to go find the charge nurse and to tell her that our patients bp is below 80. I find a woman who looks like she is in charge. I tell her exactly what Mark told me to say. I'm too stupid to be freaked. I think because we are in an ER that everything is cool, not our responsibility. The truth is that until the hospital takes custody of the patient, the patient is still yours. The charge is steady, calm, and collected. "3 ahead of you, two are county paramedic runs. It's gonna be awhile." I walk back over to Mark. He's found a portable BP. Holding at 70 over something freakishly low. The sun was coming down, shining through the lookout windows on the top of the bay doors, starting to turn orange. Mark continually runs the bp, 65 systolic.
"Tell the charge nurse her BP has dropped." Mark is calm. So I am calm. I tell the charge nurse. She stares at me for half a second. She walks over to my patient. The charge nurse looks at her and quietly says, "2".
The county firefighters give us hate stares as we walk by. Mark reminded me to switch over the 02 to the house tank, especially since we took our over size tank from the rig and put it on the bottom of our gurney. Too new to realize how totally obvious it was that we were working for a shit company and how ill-prepared we were. I still didn't get the gravity of the situation. Things had happened so fast that it didn't even occur to me that we had just dropped our patient off at an ER, not a clinic. E.M.T.'s do not make code 3 ER runs straight from a con home without a paramedic on board. We got back to the rig, I got on the radio and obliviously reported the run we had just finished. The manger, Tara, a very attractive, very psychotic spaz who couldn't speak to anybody without screaming "You fucking listen to me" first bellowed accordingly, "You fucking listen to me! You were supposed to drop her off at Ce---- Clinic not the C------ E.R.! I'm telling Dudley. I want your asses fired." Somewhat typical speech blaring from our banged up nextel, although this time her screech was a bit more murderous. I sat staring at the nextel. I wondered what other horrible shit would come out of its speaker. Mark calmly took the nextel out of my hand.
"Tara this is Mark." He paused, held down the speak button so she couldn't respond, "She crashed. What should we do, drop a half dead woman off at a clinic for a 45 minute wait?"
"You fucking listen to me! Yes, you should have!" Mark told me to hold down the speak button and not let go. I didn't, not for 15 minutes until we got back to the station. Dudley was there. Waiting. Dudley and Mark had what I later called, "the cool black guys conversation." Mark and I were punching out when Dudley appeared from seemingly out of no where on our left hand side. He was leaning on the closed office door. I didn't even hear it open.

Dudley: Say Mark, you guys got a minute? What's up? all right. You should have taken the patient to her clinic appointment.
Mark: Yeah man, you right, but see, she got bad in the back , you know what I mean?
Dudley: all right. Don't pick the patient up next time, cool? Take them to their appointments and that's it.
Mark: My bad. Thanks.
Dudley evaporated in front of our eyes, like he walked into the office backwards, turned around and closed the door behind him. I never seen anybody disappear without actually disappearing but Dudley did it. I'd never seen Dudley pissed off, he was quiet and sleazy most of the time. As calm as he was, you could tell this guy could go just as hard the other way, scary.
And that was it. A million rules broken at a million miles an hour and there was no hell to pay. Just doing the job.

One of my favorite guys to work with was an old dude named Ronny Master's. He had been working with the post office for a long time but quit for reasons unknown, not even rumors existed about why he quit, so maybe he just got sick of it. So he was now a 50+ E.M.T. showing me around where he was from. Mostly Inglewood. We'd be driving in between calls and he would suddenly bring the rig to a stop and say, "See that house right there? Earth, Wind, and Fire used to hang out there before they'd do a show at the Forum. That was the lead singers mother's house. The spot."
He also showed me a house that Sammy Davis jr. used to live in, "When he had a black wife. Before the KKK poked out his eye for marrying a white woman." He took to his mother's house in Inglewood, a beautiful home that was large for LA standards, well kept and contradicting every image I had of Inglewood. In fact, every partner that I worked with was local and went out of their way to show me the community that they were from in Los Angeles. Eager to dispel the myths they knew I had in my head about their homes. They all went out of their way to contradict them. As if I was the token white guy they could speak to and hopefully change everybody's perceptions.
One of my partner’s was a meth addict. This is where my naivete came into play. I knew my partner, Julio, was addicted to speed, that much was obvious. Losing weight, getting irrational, terrible skin,I couldn't comprehend how he didn't get fired, how he kept getting the day shift with the important repeat clients, why nobody ever said anything about his drug problem. First realization: Everybody, no matter what their job title says is a human. Lawyer, doctor, judge, firefighter, just people performing duties that have been branded with expectations of performance by the prevalent culture that may not actually represent the reality of the actual jobs. Our collective image of higher profile jobs frequently seen in the media are so wildly grandiose and in no way based on reality. Everybody has a job, no matter how unusual, glamorous, or demanding the job may be. When it comes down to it, if you work it full time and you need to pay your rent or mortgage, it's a job. And that means bullshit from above and reality engulf you like fire from a kiln.
Julio was just doing his job when he OD'd on meth and cocaine and Ronny had to pull the rig over, take the O2 off the patient in the back and put it on Julio. Ronny said the previously comatose patient sat up and said, "Uh Oh. He doesn't look too good." Julio came around, did another line and they finished the shift. I worked with Julio the night after this happened. He hadn't gone to sleep or stopped working for that matter, so while on a run to a county psyche ward with a scary ass spaceman in the back Julio started to make ponderous statements like "Do you see the spiders on my face? I think they're crawling into my eyes. Puta Madre! Do you like maple flavored ice cream? These spiders are all over me. I just gotta keep driving."
These statements were particuarly alarming because up until that moment, eight hours into the shift, all Julio would talk about was his visiting family from Idaho and his concerns that they wouldn't do the dishes after breakfast. Keep in mind this was already 11:30pm, not only had I been listenting to his concerns all shift, I was starting to get really worried about how he would react when he realized they would have to contend with the left over dishes from lunch and dinner as well.
“Damn,”I remember thinking, “I should have sat in the back.”
We finally dropped the patient off and instead of heading back to the station we had to drive around East Los Angeles for another hour looking for some fucking maple ice cream. Which he did eventually find at a 24 hour drug store and kindly bought everyone in the store a scoop.
My perception of noble, divine, honest mobile medical service had been permanently fractured. My eyes were opening up...

Put your boobs on!

Hey! It's the New Year! Happy New Year. I just gave my wife a New Year's smooch. She loved it. I loved it. Happy New Year!
The mariachi band coming from the Latino neighborhood behind us has just stopped playing as firecrackers have taken their place. Sounds festive and fun. Smells good, too. I smell carne asada, barbecuing meats, even now. The wife and I thought about just going over there but our neighborhood isn't the safest. Plus these parties, while large, are usually private anyway. All the tagging that seems to be popping up with greater frequency, more and more ambulance runs every night, cop cars parked in front of houses with the light bars pulsing anxiously back and forth- nope, we'll just stay put and watch the New Years celebrations in Spanish, Korean, Japanese, English. First year of my life I'm laying low on New Year's. I'm not even drunk!

My friends are working in the ER. I quit after I started nursing school. I had to quit. Management said I had to work 24 hours a week or leave. They blamed the contract the hospital had with the union. I think they knew that not having total control over my schedule gave them less manipulating power. Last semester I was in school four days a week, what could I do? Borrow and quit.
So my friends are working, getting double time and making fun of the drunks. I feel like a war veteran pining for action.
But as I remember, I was pretty burned out anyway and nursing school was a great reason to get out. But still, I miss working with my friends.
I reread my 1st post. Man, working with that ambulance company was a fucked up experience. And that was only the tip of the iceberg! I didn't even get to the hookers on Century Blvd. by LAX or the drunk driving yet! But we will save that for another time...

Angry Male Nurse wants to be angry, constructively.

You know lady nurses out there- I want you to listen to my brief encounter I had with an ex-coworker at the store today, ponder it.

Went to the store with the wife to pick up some goodies for a party tomorrow. Bumped into an old coworker, Thom. He has just finished nursing school at a community college and a preceptorship. Plans to take the NCLEX as soon as possible. Thom worked in my old ER for about two months. He left as soon as he got wind of the culture dynamic of the ER. Snobbery, gossip, and fake tits. Everyday was like a goddamn fashion show while patients sat in clothes soaked in urine, had medical complaints that never came close to being addressed, meanwhile they pranced about in ridiculously tight shirts, braided their hair, knit!, work on getting laid by your average misogynist firefighter. Sadly, a lot of them are in my age group. No fucking pride. Just bitchery.
HEY YOUNG NURSES, IF YOU SPEND MORE THAN AN HOUR GETTING YOURSELF READY FOR WORK THAN YOU CAN PRETTY MUCH BET THAT YOU AREN'T DOING YOUR JOB WHEN AT WORK. If you spend all that time and money on titties, hair, nails and inappropriate work clothing I seriously doubt you are going to be wiling to fuck all it up in one fell swoop by changing a homeless, septic, elderly code brown. Think about it. I've seen hotty nurses put foleys in like they are goddamn darts, and not because they are so busy that they have to hustle. They think they're too good for it, which is a tragedy. I never felt so good about myself as when I help an incapable human feel clean and dignified again. I'm not saying its the highlight of my shift or anything, but I know when I help clean someone up they appreciate it. I'm not above it, it's just good for my soul.
The tech's took up the slack of the sheer snobbery and incompetence of many of the young nurses, ADN and BSN alike, who were to busy living out a fantasy from the tv show "ER" to do their fucking jobs. We counted. We did the math. Out of all nurses under 40, half had fake breasts. Out of the charge nurse crew all of them except one. Seriously, 6 out of the 7 charges had fakes. Great working environment. Angry Male Nurse was born.
But I digress...

Here is the crux of my conversation with Thom:
Me: Where are you going to work? Have you picked a specialty?
Thom: I did my preceptorship in oncoIogy but I want ICU. I've checked out c------, h-------, t-------, and a laser dermatology clinic, I hear the pay can be really good on the side.
Me: Don't forget to check out C-----, they're opening up a new ICU ward, should be some great opportunities to get into management or charging, if you want.
Thom: Yeah, I heard they start new nurses at 4800 a month.
Me: Well, they just renegotiated, 5200 for new nurses.
Thom: That's what it's about, I'm not waiting to get recruited, I'm finding out the best there is.
Me: Exactly. See my beautiful wife's pregnant belly? I'm fucking paying for it.
Thom: Patient care starts with decent pay.
Me: Fucking A right.

So my point is, young female nurses, some of you, DEFINITELY NOT ALL, need to get with the program. Forget the typical

For the sake of my family, please dress professionally, not suggestively, and recognize your worth. What about your children, family. What if you become the only source of money?
Thom and I talk money. It's okay that we talk money. What will enable me to not burnout is my ability to distance the drama, the tragedy, and the stress from work and keep it from my personal life. I may give everything I have at work but it stops there. I am not an angel. I am a man with debts and obligations and a skill set that enables me to provide.