Wednesday, June 4, 2008

Love My Way II

Hey medical professionals-

I graduated. Without honors. As two year class president. Raised more money for my school than any class president before me. Fund raised like a phoenix, out of the ashes and into a nice prepaid banquet for everyone and half of their partner at a decent venue in the moist Armenian hills of lovely Burbank. Fucking paid by me. 75 grads. 42 a plate. I spent $175 of class money on presents for our advisors. I set aside $300 for a class legacy. I bought the class and faculty lunch, twice. I wrote a grant for re-imbursement of PDA's for all union affiliated students, which was approved. Champion. I formed a yearbook committee intentionally made up of the most jealous haters in my class. The turds who talked shit about me the WHOLE FUCKING TWO YEARS BECAUSE I DIDN'T HAVE THE ENERGY TO PRETEND TO THINK THAT THEY WERE DECENT ADULTS, WITH POTENTIAL NURSING CONSCIENCES SO I IGNORED THEM PERSONALLY. I ENGAGED A CLIQUE LIKE MAVERICK AND GOOSE ENGAGED A BUNCH OF COMMIE MIG-28'S. (Wow, that's a delightfully psychotic paranoid rant! With an 80's reference. Awesome.)
I alienated myself because this group of students, I’ve worked with many nurses that they will become. It was too obvious. Lazy, egotistical, vengeful, punitive, dishonest. Always interupting lecture to tell a story about how they went out of their way to help a patient, like "I'm gonna hold up everyone's time so I can kiss some ass with a story about something that Ididn't even do!" Or gasping dramatically whenever one of the instructors would use an example of a situation with a negative outcome. And always, always, laughing haughtily whenever an example of what-not-to-do was given, "Pshhh! I would never do that. How stupid!"
All of them instructors favorites. All of them full of utter shit. Basically stated: this was the clique of students that I found most unappealing as one of the many cliques swirling around 75 students. Just not good peoples. But I still wanted to put them to work and I did. Ironically, these were the same students that got all the awards that I did not. Very Tao. Just goes to show, Haters don't change. You can find them in their embryonic state even at nursing schools. Perhaps the old addage is true: Don't hate the player, Hate the game. I hates the way the game is played and I hates the the haters. Fuck you both. At least Players negotiate, compromise, collect rewards for everyone involved.
Informed by my faculty advisor that I was not given scholarships and awards because "Most of our clinical instructors feel that you are arrogant, don't take criticism well and are paranoid. And just so you know, the class awards are a popularity contest anyway and you are not popular with faculty."
To which I said, "I don't disagree. But do you think I would have been able to accomplish half of the things that I did if I wasn't arrogant, oblivious to criticism and paraniod?"

"No. Probably not. You will be a leader in nursing." My instructor smiled. I smiled. A little bit of candor, a little bit of real conversation goes a long way. And what did I do to receive this tid bit of discretion free conversation? Let me share...

I had brought my wife and baby to the awards ceremony only to have us sitting there with our thumbs up our keisters while some of the most relentless ass kissers and thinker-in-the-boxers received scholarships and awards. My name-definitively not called. But I was told by faculty advisor that i was a shoe-in? A fucking coup? What gived?
As fate would have it, after the ceremony I somehow managed to get my sweet little family into the elevator with the same cadre, the same junta of 4 instructors who shot me down. It was me an all of my old clinical instructors, and I was pissed. Fucking nursing games.
I said to my faculty advisor as the elevator unsteadily creaked up to the lobby, "So what happened with those awards?" The hens abruptly shut up.
She replied in the most possibly fake "I give a shit" patronizing voice ever uttered from a nurse, "Oh, honey, those were just nominations." She must have liked my wife's shoes because she wouldn't look at me in the face. My last clinical instructor, Ms. Perpetual Cell phone Coffee Break was standing next to her. She briefly glanced up and smiled at me, a hateful smile, a subtle sneer so snide that only a very hurt, vindictive person could make it. Then she looked away moments before eye contact. Steam came out of my wife’s ears. Well at least the wife saw firsthand some of the bullshit. At least she knows.
But I actually liked my faculty advisor, despite her insincerity at that moment. And I really do appreciate that a week later she told me what the real deal was with the awards. They no like me. Oh well. I no care.

I was told these realities one week after not getting said awards, one week before I gave the commencement address at graduation, in front of all the faculty instructors of the school, in front of the CEO of one of the largest healthcare organizations in the world. In front of the director of the SEIU for this healthcare system. Maybe I'm paranoid but how fucking stupid are they?

But I gave a nice speech. I sent a copy of it to one of the authors of "From Silence to Voice- What Nurses Know and Must Communicate to the Public", Bernise Buresh. She wrote me back.

ˆDear AMN,

Thank you so much for contacting us and for your kind words about our work. I read your commencement address with great interest and especially liked: There is a fine line between “taking stress home with you” and letting your family know that your intervention saved a patient’s life that day.

I am saddened, though, by your description of the attitude of your nursing instructors. It made me want to go right out there and do a workshop with the faculty. I’m pleased to tell you that I come in contact regularly with instructors and working nurses who are quite different from those you describe.

Whatever specific path you choose, I hope that you will have a fulfilling career in nursing.

With respect and best wishes,
Bernice Bureshˆ

That's nice. I could of used some more of that kind of attitude during school. Pretty cool that she wrote back, though.

I take the NCLEX on JUNE 24. Fuck me. I'll pass. I 've been asking other nursing students what their schools were like. "Easy"
"Sooo much fun", "Okay".

I have two of my classmates with me at the Kaplan review course. Rachel, a 25 year old virgin Pilipino Catholic smoker who manages to say "fuck" more often then me, and my class treasurer, gulf war II veteran Geraldo Rivera. (Yeah I changed their fuckin' names). I asked them how they felt about our school yesterday during break. They just stared at me. Then Geraldo looked away. Rachel went for a smoke and probably to go talk to hurt little baby jesus. Just my luck, I went to the gnarliest nursing school in Los Angeles County. We are the county. So I ate my yogurt and fantasized being home by 1300 so I could take a shit and possibly avoid Hep A, lice, and fresh fresh one minute old herpes for one more day from the insane public bathrooms next to the downtown LA kaplan offices.

Here's my speech: (It's surprisingly cuddly) (grab another brew, glass of vino, or some more pills cuz this here is a 5 minute speech) AND BY THE WAY-IF ANYONE ELSE NEEDS TO GIVE A COMMENCEMENT SPEECH YOU HAVE MY PERMISSION TO RIP THIS LITTLE FUCKER OFF!
Commencement Speech Class of 2008-I
some school of nursing somewhere in LA County,
Angry Male Nurse

I would like to thank my wife for her partnership and understanding, as well as giving me a baby boy one year ago.

What an outstanding day this is! What an outstanding class! To all my classmates, my fellow new nurses, I want to say that you are by far the most intelligent, motivated, and dedicated group of individuals I have ever had the honor of studying and working with.

To all friends and family members in attendance- I hope I can convey to you in the next few minutes the tenacity and scholastic intensity that your loved one has demonstrated over the last four semesters of education, AS IF YOU DON’T ALREADY KNOW! No doubt, you have observed your loved one study long, long hours, memorize seemingly incomprehensible charts and specific functions of the Human body.

During first semester we learned physical assessments which is the cornerstone for all nursing skills and the most important. Around first semester you may have noticed your loved one suddenly take an interest in all the sounds from deep inside your lungs and chest every time you took a breath. We tested to see how well your limbs functioned, we wanted to know what your regular diet was, we wanted to listen to the sounds inside your gut and we asked you about the sounds coming out of it as well. We wanted to know how you felt about your body and we probably gave you some information on how to make it work more to your liking.
We have been studying an intricate human body ballet, a multilayered framework of physiology coupled with responses to the hundreds upon hundreds of situations a nurse may find himself/herself in. So thank you for being the guinea pigs while we learned the fundamentals of the art of physical and psychosocial assessment.

I’m not sure what working as a registered nurse will actually be like. I’ve never done it before. We’ve observed and assisted nurses thousands of times throughout our clinical training in this hospital system )Omission!(. We have been able to assume responsibility for the care of as many as five patients at once and learned that our responsibilities as nurse are so numerous that delegation to nursing attendants becomes a necessity. As graduating nurses we have a pretty good understanding of what nursing will be like on a day to day basis. The nuances and details we will learn as we progress throughout our careers.

So I want to talk about what I know and what your families don’t. I want to make sure that you, family and friends fully appreciate the challenge of becoming a nurse and what clinical expectations are expected of all nurses, including students. Because there are a lot of misconceptions about what nurses actually do. Some people think nurses just give out pills. Others think nurses just change sheets. Some people think nurses are the physical embodiment of angels. Some people think nurses are grumpy. Did you know that according to a study completed by the Institute of Medicine in 1999 86% of medication errors were caught by nurses, not by physician staff?

To me, nurses are extremely well trained, tested for our capabilities in a tough situation, we are taught to think in terms of action and rationale. What we call a priority intervention, such as re-positioning a patient a certain way as a response to a specific medical situation like choking or fainting, others might call quick thinking. Nursing graduates: If your patient suddenly develops chest pain, what is the first thing that you do after assessment? We have been taught that the priority nursing intervention is to oxygenate. And again, what the untrained eye may call quick thinking, to nurses, it is a reasoned response.

So what does priority intervention mean?
Simply stated: I slip an oxygen mask over your head and tell you to take some deep breaths and try to get oxygen to those deprived cardiac muscles. The simplest of actions requires reasoning and training. If the pain persists then I will move to the next intervention which is to medicate you for your chest pain and to further relax your heart and the demands placed on it.

I would like all family members to take what you have seen and heard on TV or movies about registered nurses and replace it with these words: Nurses are leaders in hospitals. Nurses make critical decisions in hospitals. Nurses perform crucial assessments of patients in hospitals. Essentially, nurses collaborate with every discipline the medical field has to offer, from physical therapy to gastroenterology to social work.

NURSES ARE THE LIFE BLOOD OF THE HOSPITAL AND MEDICAL CARE along with administration, doctors, respiratory therapists, dieticians..

You can ask a registered nurse for medical advice. They are licensed to give it. When you are a patient seeking medical attention you can expect a registered nurse to advocate for you, along with every other member of the medical team.You can expect a RN to collaborate with physicians to obtain the best possible outcome, which is the return to optimal wellness.
We anticipate negative effects of hospitalization and counteract its forces by simply walking with you down the hall way to ensure that a clot doesn’t form in your leg, or that you skin stays free of signs of breakdown from being in bed.

We facilitate positive outcomes while healing and do it in a manner that is sensitive to your culture and beliefs.

I would like to ask all friends and family members to inquire of their graduate loved ones what they do on a daily basis once they become registered and begin working. There is a fine line between “taking stress home with you” and letting your family know that your intervention saved a patient’s life that day. Or because of your thorough daily assessment of your patient, your detailed review of their chart and labs you discovered a finding that prevented a serious, life altering event from occurring.

Classmates, we have so much to be proud of, what we have accomplished here at school and what we will accomplish as medical professionals. Please, Classmates, remember to share your experiences
Instructors, family members, administrators, you can rest assured and feel confident that through your guidance and support that this first graduating class of 2008, school name serioulsy deleted here, is ready, willing and able to accept the challenges of the healthcare system now.