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.