Monday, February 18, 2008

How Soon is Now

Prefice: I don't want no moral highground responses from this okay? And don't threaten me with the BRN alright?You can say what you want but be real. I want you to think, don't judge and try to understand that people come from all walks of life and in this profession you are in contact with them. Take off that white dress for just a sec okay, baby?

Alright friends. This is where I cross the line. Its time for the truth. Just because they don't teach it to you in nursing school doesn't mean its not out there. Yep. The blacks RN's hate the Mexican RN's. Phillipino's RN's hate the Nigerians RN's. The Chinese RN's hate the Vietnamese RN's. The Korean RN's hate everybody. Vehemently. The white RN's think that they "secretly" despise everyone but as a white guy who is as baffled by white culture as my Ethiopian co-worker during our daily lunch break talk, it's obvious and we can tell. White aint right. Brown doesn't mean its time to get down. Black is wack. What the fuck rhymes with Vietnamese?

Vietnamese don't do what you please?

But whatever. we all know race exists. We're just not allowed to talk about it. American's, technically, aren't even supposed to notice race. That would make us ˆracistˆ. My wife isn't of my race. I noticed. I'll admit it. And now I've got a little mix baby crawling around. I noticed, I'll admit it. But not enjoying the differences, pretending not to notice- bores me. You all bore me.

My friends, The intra hospital race wars is not what I have come here to speak of to you this evening. Oh no. I want to, how do you say, ˆdivertˆyour attention from the minutiae. From the atmosphere of blasé daily affairs, from the things you know you will have to do: assessment, meds, chart, dressing change, IV's, more meds, talk some shit about your fucked up co-workers, take a step back baby and just look around.

Is everybody wasting? or wasted. How easy is it to put that 5mg dilaudid into your pocket-after all your pt that hapless mother fucker with bi-lat ORIF and a glorious GSW to the left butt cheek only gets 1mg IM every 4 fucking hours. For BTP. Good luck with that. Thanks for your compassion you saucer shaped pupil resident. Took me a month to figure out why all the residents were fucking anorexic, jumpy and working 48 hours in a row. Duh! Don't be so naive you fuckers. Just takes an appointment. And its legal.

Diverting is a felony. Fel-o-ny! You are no longer a nurse but a common criminal. High as a kite.

But that’s not where it's really at, my friends. The good shit, the shit you can maintain with and make a 100k comes from your psychiatrist. That pimp dealer. He's a physician but he's a pusher too and you know what? There is no healing with that motherfucker. Where does it end? At what point does the shrink say, "I fucking fixed you with all my drugs, now you are better. I guess I need some new clients!" Doesn't happen. Shrinky dink would never say,"You stressed? Try some of this shit it's called MS Contin. You can shoot it snort, stick it up your ass, its great." That's too easy. He prescribes shit you've never heard of. The latest shit. The French have invented a new drug called "Provigil". Its like speed accept you can sleep on it and don't get the euphoric buzz of meth. Put that on the PPO card, my good man. I'm fucking street legal now.
I don't think most of my co-workers divert. I don't think the idea of slamming high octane opiates has even crossed their mind. Thank god. They get high in other ways. This I know.
The hypothetical:
But getting high has crossed his mind, friends. Up until now, he'd never had access. Now he has access and he thinks to himself, "I look at these patients with fucking unbelievable injuries, when I come on they are writhing in pain, some faking it just wanting chemically mediated release, some really fucked up and hurting. I give them their medication regardless, I am the nurse, IV push, IM, fucking PO, and whoosh-they can't wait for my q day physical assessment. If someone who has been shot 7 times and sporting a brand new colostomy with bloody drainage, if this street fighter, if this man who takes these traumatic insults in his stride while he lies in bed plotting his revenge, his URBAN COMEBACK, if he can tell me that I am the greatest nurse he's ever had- and its only 0830. Fuck that must be some good shit right there.
That shit will take the edge off of the shit I've been prescribed just to make it through this day, it'll make things alright. "
I surmise the high:

Alright. alright...he can feel his own breath hovering around his head, evaporating into delicious ether that can only come from a teeny tiny sterile little bottle with fluid in it that looks like water, that turns to red red wine and feels like some peace is finally cascading up through his antecubital to a royal fuck you all, to let him just lay low. He just smiles and nods and knows.
High, he thinks, "My pain doesn't hurt, in fact it feels good and I have a little bit of time before that fucker called work goes off again. My condo is on the same street as my hospital, I live a few sweet blocks away and in my bliss, blissed out I hear the squads running, flying by with sirens operatically calling, Code 3 is now peacefull and funny, so many times a night YYEEOOOWW, I just giggle cuz they are here to touch my mind, just wrap my skull up in a soft wool baby blanket. To breathe."

The next day- this nurse, this imbecile, rolls up to work and this dumb motherfucker thinks that nobody notices. Most don't. Most of his coworkers are unsuspecting. Some are habitual shit talkers looking for dirt. Some care and have seen it before.
Swear to god his name was Hal. Hal was an ex-army RN. Like that means something. Maybe just that he knows a lot more dude nurses.
"Hurt my knee in the Army." That was his story and he stuck to it. Hal told somebody he shouldn't have trusted that he took Demerol every night for the pain. I don't know how you could work four 12's a week if your knee was all fucked up from a softball accident in the army, I don't know, maybe Hal should have lost some fucking weight and taking the strain off that knee.
Anywhooo-Hal would roll up and work everyday, the same fuckin way. Profusely diaphoretic, extremely irritable, you could say irrational, shaking, looking so goddamn pale. Fucking in withdrawal. 4 long ass days a week. He thought of himself as an honorable and good RN, didn't want to work around patients high, I don't know what his logic was because he was pretty fucking unstable kickin four days a week.

People give me shit cuz I'm still a student RN, and I talk and write like I know so much but what a lot of arrogant nurses can't fathom is that life starts before RN and before RN I was EMT and before that I was a student , and before that was just waiting and it was always my job to obey and do what I was told and watch. And watch I did. I watched Hal's co-workers, most of whom had worked with his failing ass for at least 5 years. None of them every did anything. Is that friendship? Loyalty? Understanding that Hal had a wife and a daughter who probably wanted to go to a college she was not in the right social strata to attend?
There is no dramatic ending to Hal's story that I know of. I left that ER, Hal was still shakin' it up and his co-workers were still pretending not to notice. I'm not an RN yet. But I am an adult, a father, a human. What would I do with a license to maintain? None of my business.
But the way I found out Hal had an addiction to pain meds was simple enough. We were pushing a pt upstairs, the gurney every so lightly bumped into Hal's right leg and he said unto me through gritted teeth and sweat soaked hair matted against his fat face, "I wish I was at home with Demerol right now." Cheers to that Hal. Your girlfriend awaits. Thanks for being honest, dude.

Adderall. Wellbutrin. Ativan. Xanax. Prozac. Vicoden. Norco if you're lucky. Lamictal. Lexapro. Candy my friends. Anything to get u thru the shift. This show must go on, we've got a new star and her name is Super High Accuity. She'll make you a super nurse. Give you some stories to tell at the bar after work or at a lame party but she doesn't do shit for your psychic scars. She doesn't give a fuck about YOUR trauma. Fuck the pyxis. Comedy.

Best line ever in a movie was in Wallstreet. Charlie Sheen, Oliver Stone production.

Buddy (charlie) is about to get arrested for violating SEC insider trading rules. Police and federal agents are wating in his corner office. Right before his arrest he stumbles into one of the older traders, Lou, a kind, wise old stock trader who has seen this young man's unstoppable demise coming for quite some time.
And he says,
"Bud. I've got to tell you something. A man finds himself looking in the abyss, there is nothing staring back at him. At that moment he discovers his character. That keeps the man out of the abyss. "