tag:blogger.com,1999:blog-252384677934094802024-03-19T03:33:59.758-07:00Licensed To iLLWarning:This Blog is for Mature Readers.It is copyrighted.Patient Privacy is protected.LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comBlogger51125tag:blogger.com,1999:blog-25238467793409480.post-34203883597191484562010-04-01T17:33:00.001-07:002010-04-01T17:40:15.483-07:00My People, R.N.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS4L0BHJLtOw_ykxB-EGQI6P79ivfM6Y8NVC79NKVrlIwtg7x59HujFDG59ELsXnQ0mA_7PNPGlLGHOJIszUbm8qNHt4tYDDfOwbhWw5DMAGjmdJKZpWyH0dkIRRtFJn3LfknZCe9fcg/s1600/Sinead.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 265px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS4L0BHJLtOw_ykxB-EGQI6P79ivfM6Y8NVC79NKVrlIwtg7x59HujFDG59ELsXnQ0mA_7PNPGlLGHOJIszUbm8qNHt4tYDDfOwbhWw5DMAGjmdJKZpWyH0dkIRRtFJn3LfknZCe9fcg/s400/Sinead.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5455333150145320642" /></a><div style="text-align: center;">Wouldn't Sinead be a great R.N.? Maybe she is. "Drink before the War" rocks.</div><div>
<br /></div><div>
<br /></div><div>
<br /></div><div>
<br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>I'm still alive. I'm still in the game. I'm straightened out. <script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><div>Found some great co-workers.</div><div>I'll meet their excellent standards in time.</div><div>
<br /></div><div>How many nurses are survivors of abuse, drama trauma, rough lives, chaos, sadness, death?</div><div>
<br /></div><div>How many nurses are healthy strong people, have a competent sense of boundaries, a technically up to date and proficient and STILL have the time to function with an aura of the hollistic/empathic?</div><div>
<br /></div><div>A bunch. A fuckload.</div><div>
<br /></div><div>Ready and happy to be back. Start my new gig on 04/12. For keeps.</div><div>
<br /></div><div>RN's ROOOAAARR!</div></div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-25039804006668637922010-02-27T19:42:00.000-08:002010-02-27T19:53:40.520-08:00They're Winning<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmwuzQubOsIUcdhEqbtTceSKMvxlBid9gwsChwSdRljNqcH0iTqG-ELBKBS7z61VbiR6iohtvM0MwrhzNwnwjD5W_wHM145xUPs37ppH37dMrRiLJkx42j4lZmzqMhdZycVSw9dR4YqA/s1600-h/calm.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 143px; height: 107px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmwuzQubOsIUcdhEqbtTceSKMvxlBid9gwsChwSdRljNqcH0iTqG-ELBKBS7z61VbiR6iohtvM0MwrhzNwnwjD5W_wHM145xUPs37ppH37dMrRiLJkx42j4lZmzqMhdZycVSw9dR4YqA/s400/calm.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5443136950933663714" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><br /><br />I live in the Pacific Northwest now. They view Californians the same way one keeps track of a bee that is buzzing around the picnic. If it gets too close to the food or the kids WE-WILL-SQUASH-IT!<br />I bring plague. I bring experiences they have not had. I bring experiences they cannot believe. I bring psychological trauma. I bring hurt. I bring a profound narcissism that make constructive criticism impenetrable. I bring stories that are funny in ways they couldn't have figured. I bring disgust of hierarchy. I bring open wounds. I bring contempt for myself. I bring the hope that this will all wash away.<br /><br />I bring the notion that I know more, but I accomplish less, I don't care for their structure. I bring the shakes, pale faced adrenaline rushes, I bring old trauma.<br />And its not their job to see that I make it through.<br /><br />I bring experience that has left me pondering the purpose of my knowledge the tangentiality of coincidence, I bring my hunger for numbness.I bring the idea that after you've met me you know something isn't right. Somehow, you want me to succeed.<br />Somebody let me in.<br /><br />I bring greetings tucked in with apologies.LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-56103561244083336632009-12-17T18:23:00.000-08:002009-12-17T18:34:27.397-08:0030 Seconds to Mars: A Lifetime of Vanity<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCu9gmGGZWwGESMRMxah4cxrygBcijqZlDJ7cifVb6Xp8N8P72sOBCdQtEme7oDlqktasaWH93tzoMPZ6wKw1DWp5Nhq4tX7r_uAyOtCXoOL3xUU9ezBL0Sq-fXfeukObVMGzizSNdYw/s1600-h/jared-leto-transformation.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCu9gmGGZWwGESMRMxah4cxrygBcijqZlDJ7cifVb6Xp8N8P72sOBCdQtEme7oDlqktasaWH93tzoMPZ6wKw1DWp5Nhq4tX7r_uAyOtCXoOL3xUU9ezBL0Sq-fXfeukObVMGzizSNdYw/s400/jared-leto-transformation.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5416398516085497986" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><br /><br />Look, I know many of my readers don't know who this poopy concoction of turd rockers are- mainly the band features visual prossy Jared Leto, yeah the heart throb from "My so called life", Jared Leto who can't LET GO. Dude, you stop trying to get attention. Find out why you need the attention so bad and remember, creepy narcissism is not cool!<br /><br />Figure this as your rock bottom: Your band sucks and your talent is questionable. I know you asked yourself this when you made that shite movie about John Lennon's killer and the answer slapped you in the face: Yuppers, you lack all talent. <br />Dude, leave media alone and find your soul. I saw you on Kimmel two years ago. The audience was comprised entirely of morbidly obese 17 year olds. Ponder that, dude.<br /><br />Now that your new album is out I see your advertising budget has shrunk but still I feel harassed. Please, get a job and fuck off.LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-25952330857708088912009-12-14T18:15:00.001-08:002009-12-14T19:12:38.628-08:00NursingPUNK<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpX9MVjnH-IBEgcDRnE4Gz6mhX23_FMG3WXr99TBKnQahXVaYvVy3FK0mk-XRqU8GE8Ca5RLdHWLf4DOUSfMIEt-wcU_yhQPDBlZcXO7Y1SaxsbjDxq4VrKS7CoENe6gQ0GGjmuBOieg/s1600-h/Steve+Jones.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 93px; height: 117px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpX9MVjnH-IBEgcDRnE4Gz6mhX23_FMG3WXr99TBKnQahXVaYvVy3FK0mk-XRqU8GE8Ca5RLdHWLf4DOUSfMIEt-wcU_yhQPDBlZcXO7Y1SaxsbjDxq4VrKS7CoENe6gQ0GGjmuBOieg/s400/Steve+Jones.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5415290424241934018" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><br /><br />http://www.gallup.com/poll/124625/Honesty-Ethics-Poll-Finds-Congress-Image-Tarnished.aspx<br /><br /><br />Gallup's annual Honesty and Ethics of Professions Poll<br /><br /><br />83% Y'all. We just smoked pharmacists. <br /><br />Feels good to be America's most TRUSTED profession.<br /><br /><span style="font-weight:bold;">MY</span> patients listen to me as I have my their best interest at heart, in my heart and they sense that. It is a position I love being in. Black and white. Right and wrong. <br /><br /><span style="font-weight:bold;">Nursing is punk</span>. Like Yoko Ono, Dennis Kucinich, Elmo, Don Rickles before us...We keep slogging through that losing battle to prevent hospital care from being transformed into a greased out fast food restaurant. Nurses don't want you to have to ask for ketchup, napkins and refills! You fucking deserve it for free! We try to fight the M.B.A. belief that patient care can be transformed into a goddamn Marriot for those with insurance, a lowly motel 8 for those with medicare and a two bit YMCA for those without any medical back up.<br /><br />Fellow nurses you can deny it, choose to not observe it- but we are in a weird professional position. Our very existence costs hospitals money- our code of ethics is nothing but an irritating expense. But without us, a visit to the hospital would be an expensive an absurd form of rape. We are hard steel screws, holding tight in a time of cheap unreliable surgical glue. If you think infrastructure will be reinforced with quality materials think again...<br /><br />Keep advocating for those in our charge, keep fighting the faceless cowards who are trying to destroy our salaries, savings and whatever meager pension is left. Stick together, stop gossiping and start collaborating. <br /><br />THIS IS A STREET FIGHT GUYS!! AND EVERY YEAR THEY GET ONE BLOCK CLOSER TO TO OUR SACRED TERRITORY: OUR WAGE AND SCOPE OF PRACTICE. <br />EVERY YEAR WE GET MORE RESPONSIBILITY, MORE LIABILITY, LESS SUPPORT, LESS RESPECT AND IT'S OUR FAULT!<br />HAVE YOU ENJOYED AIR TRAVEL RECENTLY? WE ARE THE NEXT INDUSTRY TO BE COMPROMISED BEYOND ALL RECOGNITION. THE ASSAULT IS COMING. MINIMIZED AND TERRORIZED. INSTEAD OF SHAME THEY HAVE PROFIT MARGINS.LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-65318843023731803072009-12-03T14:53:00.000-08:002009-12-03T14:59:23.492-08:00<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiskrDii5Ge1lf51p-vJRzLQOtINOxCno-ik4WsV4eGTZTTmGPhoiQR-MnArMSDgDAim953RvI4ISp3PF2eFwvYJjtp5p6Mtc1EF9ueJYGsfnW2GPCTymgdKV7-Hj-Ehg7zxT2_xO-v5A/s1600-h/imgres.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 131px; height: 98px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiskrDii5Ge1lf51p-vJRzLQOtINOxCno-ik4WsV4eGTZTTmGPhoiQR-MnArMSDgDAim953RvI4ISp3PF2eFwvYJjtp5p6Mtc1EF9ueJYGsfnW2GPCTymgdKV7-Hj-Ehg7zxT2_xO-v5A/s400/imgres.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5411148241684720162" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><br /><br />I'm busy learning how to be an E.R. nurse. I find it especially challenging, and especially rewarding as well. Funny how two different departments can be so incredibly different.<br /><br />I think I like the E.R. I love the constant mix of people, the sheer number of personalities that present. I love the instant gratification of working in the E.R., being able to help someone as suddenly as they have come in. <br /><br />Here's to the E.R.!!! And finally a little peace...LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-67975448808955106422009-11-10T13:40:00.000-08:002009-11-10T14:17:19.218-08:00Kick Against the Pricks: dOCTORS iN sHORT sUPPLY<div style="text-align: center;"><span class="Apple-style-span" style="color:#0000EE;"><span class="Apple-style-span" style="text-decoration: underline;"><br /></span></span></div><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbn0L1CIvZJPgwQMfn4j5IfxeVmG3BqU-2AWtksAm2yWhbl_med-6jgw-EiXWc7rlaY-LMYkXQ_MeCwjikNml8uGiqKLDmcemNjg2ygjA1F-xyQlpQc4ckidUOAeVZy9lWsaC02S_Jtw/s1600-h/asskicker.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 96px; height: 96px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbn0L1CIvZJPgwQMfn4j5IfxeVmG3BqU-2AWtksAm2yWhbl_med-6jgw-EiXWc7rlaY-LMYkXQ_MeCwjikNml8uGiqKLDmcemNjg2ygjA1F-xyQlpQc4ckidUOAeVZy9lWsaC02S_Jtw/s400/asskicker.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5402598944577697762" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>I love kicking ass on allnurses.bomb. An article shows up stating a fact that Nurse Practitioners are going to be in higher demand soon to come. No fucking shit. All of America is about to get a free insurance card to score Vicoden, endlessly.<div><br /></div><div>Wait...Here it comes...Uh.Uh. Rant: Has anybody in Obama's government spoken to a single healthcare worker on this new healthcare shit?</div><div><br /></div><div>Let me make a prediction RIGHT NOW:</div><div>When everybody gets insurance there is going to be a tidal wave-no fuck that- a goddamn epidemic of opiate abuse. Maybe even Adderrall speed abuse. Instead of going to the streetoofr oral candies, the people are going to figure out what to say to the NP to score. Here it comes America. If you thought our appetite for illegal drugs was bad-wait till you see how truly fucking obese we are when it comes to LEGAL DRUGS! </div><div>Rant finished-</div><div><br /></div><div>So anways I'm a kicking ass on allnurses.bomb. Some dorky little troll pops on and tries to say that tired absolutely bizarre and insane argument that doctors are inherently smarter, they spend so many more hours on the floor (which is always a rather naive argument cuz everybody knows residents walk around in a sleep deprived, stoned stupified daze for the bulk of their training). Nurse practitioners are so stupid we couldn't figure out, we are simply utterly incapable of sending out for referral. So all of our patients are going to die. Here's the link.</div><div><a href="http://allnurses.com/nursing-news/doctors-short-supply-437419.html">http://allnurses.com/nursing-news/doctors-short-supply-437419.html</a></div><div><br /></div><div>And here is the link to my response. <a href="http://allnurses.com/nursing-news/doctors-short-supply-437419-page2.html">http://allnurses.com/nursing-news/doctors-short-supply-437419-page2.html</a></div><div>I've also kindly provided you with the text. Seriously, I should have been a goddamn writer cuz this little letter (I still call them that) is a whopper. Even my response on allhearses.barf has been good.</div><div><br /></div><div>I know this post is way too long but I expect more out of you, my readers. I know you can handle long posts. But the post is also about my impressions as a new E.R. R.N., into how my first days as are going (Gulp!):</div><div><br /></div><div><span class="Apple-style-span" style=" border-collapse: collapse; line-height: 18px; font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="font-size:medium;">"I paraphrased you there but the problem with your logic comes from what appears to be your obvious inexperience. The primary flaw in your logic is is the fact that despite the numerous hours of experience med students and residents put into their training, the quality of their care is often comical. How often do I see med students and residents standing around, gossiping, studying? Completely oblivious to the goings on around them? How often are they really part of the hospital team? Not much. Just because you are inside of a hospital doesn't mean your are learning anything that is actually useful. Massively piling hours up sounds like a recipe for incompetence to me.<br />Since very few doctors have ever gone to nursing school and most to this day truly don't know what a nurse actually does, the unknown fact is that nursing school is at minimum a two year crash course in how TO RUN A HOSPITAL FROM THE GROUND UP. On the flip side, nurse's have to know what a MD does to do their job. MD's frankly consider 90% of the necessary functioning of a hospital someone else's problem. This makes MD's weak and ineffectual. I find med students and even up to R2's utterly clueless on how to contact the resources available to them (i.e. lowly custodial staff, dieticians, social workers) to efficiently wrap up a case and help expedite a patient's care.<br /><br />In addition, I regularly meet physicians with numerous years of experience who find that when other members of the team ask them to do something a certain way, like writing orders, to follow the standardized procedure, they simply will not do so. The primary reason why MD's are so spectacularly ineffective in their roles is their utter arrogance to admitting the fact that 1) other people are as important as they are and 2)that every time a physician decides to do things "their way" it costs untold man hours to rectify the problem and get the patient back on track.<br /><br />Nurses are responsible FOR EVERY SINGLE PROBLEM THAT ARISES. WE KNOW HOW TO FIX PROBLEMS QUICKLY AND WITHOUT NURSES DOCTORS ARE UTTERLY UTTERLY USELESS. NURSES ARE ALSO RARELY GIVEN CREDIT FOR SAVES, EMOTIONAL THERAPY TO DE-ESCALATE ASSAULTIVE OR DISTURBED PATIENTS, ALL THE LITTLE FIXES, THE THINKING AHEAD. IT IS EXPECTED OF US. NURSES DO NOT EXPECT TO GET CREDIT. DOCTORS DO. DOCTORS HAVE CREDIT SEEKING BEHAVIOR.<br /><br />When a nurse decides to transition into the practitioner role, if in their practice they are treated with the same professional respect as MD's I have found them to be far more effective, getting the job done with out so many displays of tantrums and blatant disregard for the job everyone else has to do. MD's have the luxury of being told they are so very very important from day one. Nurses are taught we are not as important from day one. We have learned to diagnose and treat in a round about way, integrated into our standards of practice so as to not dare cross over into the "medical" model and dare speak a diagnosis. As if what nurses do isn't "medical" from the second we step into a hospital. Being trained "in the medical model" doesn't make you a jedi warrior, it's hilarious when a M.D actually brays that from their lips. What nonsense.<br /><br />The bottom line is that this change in roles, this impending tidal wave of need has been brought on by doctor's themselves, who for the last 60 years have been running around touting their incredible powers of mind and yet have been in fact, accomplishing extremely little.<br /><br />Prime example: Last night I worked registry in a local E.R. The on staff, full time physician ordered a bladder irrigation for a patient, s/p bladder resection from bladder CA. Large amount of spraying blood, gross hematuria, fair amount of blood loss. M.D. refused to consult pt's urologist. I asked the wife to call. She did. We did this without E.R. M.D. knowing.</span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggNv6bOd4LBgdtgER85JCSVHLmL_Rfwc4fXgZ6SKhVaDI76ntElLnif8FNxH8T-im6s7K8siLj_dYM3NkvJJcFSuxiSoJ22GmpEHxeANvIfEzEZXvnZLXMJ_6UR2_bswYeEg5Guq98DQ/s400/blood.jpg" /></span></span></div><div><span class="Apple-style-span" style=" border-collapse: collapse; line-height: 18px; font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="font-size:medium;"><br />E.R. M.D. didn't know what type of fluid to use for irrigation. Didn't know how much. Didn't know how fast. Wasn't worried about blood loss. "Have to get the clots out" was his mantra.<br />Didn't want to pay to have coags drawn. Didn't want to type and cross. Patient nearly died. Pt didn't die because I: 1) drew coags, drew type and screen and broke the rules when I put two on cross later. 2) I called a darn urologist cuz I didn't want the patient to bleed out. 3)I started an 18 guage IV without permission. 4)I demanded he get a uro consult. When uro consult came he admonished moron doc in front of all of us and 5)pt was rushed to or where HE DIDN'T DIE. Doctor didn't thank anybody, was oblivious to THE HOURS OF MANHOURS HE wasted when it took 5 RN's to get the show on the he road and get the work done. AND THEN HE PROCEEDED TO ATTEMPTED TO TAKE CREDIT FOR THE WHOLE SITUATION IN FRONT OF UROLOGIST WHO THEN ADMONISHED HIM. THIS IS A REGULAR OCCURRENCE. I was expected to clean up an incompetent doctor's mess.<br /><br />I can tell you, no med student on earth would ever, will ever, know how to handle that situation. A nurse with one year of experience will. Your argument logically looks great, just like a nice lab coat and a clean pressed shirt with a tie. But the argument is own by the reality of what happens, day in and day out in every hospital in America. No matter how smart the doc is, they simply cannot fix all the problems with any level of efficacy that they think they can.<br />And I'll tell you something, because of that experience, because of this article, so help me god, I'm going to NP school. And in three years I'll be healing people the right way, with HUBRIS, but I will not hesitate to take or give credit when it is and where it is deserved."</span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;">Okay Licensed to ill fans- check out this young reader reply:</span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;">"</span><a name="post3966837"><span class="Apple-style-span" style="font-size:medium;"><img class="inlineimg" src="http://img.an-file.info/statusicon/post_old.gif" alt="Old" border="0" title="Old" style="vertical-align: middle; " /></span></a><span class="Apple-style-span" style="font-size:medium;"> </span><span class="time" style="color: rgb(102, 102, 134); "><span class="Apple-style-span" style="font-size:medium;">Today, 12:32 PM</span></span><span class="Apple-style-span" style="font-size:medium;"><br /><br /></span><div><div id="post_message_3966837" class="KonaBody" style="display: block; width: 600px; overflow-x: auto; overflow-y: hidden; padding-bottom: 15px; "><div><span class="Apple-style-span" style="font-size:medium;"><img src="http://img.an-file.info/icons/document.png" alt="Default" border="0" class="inlineimg" title="Default" style="vertical-align: middle; " /> </span><strong><span class="Apple-style-span" style="font-size:medium;">Re: Doctors-in-short-supply-responsibilities-for-nurses-may-expand</span></strong></div></div></div><cite class="smallfont" style="font: normal normal normal 11px/normal verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif; "><span class="Apple-style-span" style="font-size:medium;">Originally Posted to </span><strong><span class="Apple-style-span" style="font-size:medium;">sonnyluv</span></strong></cite><span class="Apple-style-span" style="font-size:medium;"> </span><a href="http://allnurses.com/nursing-news/doctors-short-supply-437419-post3962839.html#post3962839" rel="nofollow" style="color: rgb(0, 51, 102); "><span class="Apple-style-span" style="font-size:medium;"><img class="inlineimg" src="http://img.an-file.info/buttons/viewpost.gif" border="0" alt="View Post" title="View Post" style="vertical-align: middle; " /></span></a></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;">WOWOWOWOWOWOWOW!!!!!!!!!!! probably one of the most amazing posts I have ever read, on any subject/topic or discussion board, hands down. Period. I'm not even a nurse (yet)...and you have rocked my world!!! You will be a fabulous NP...best of luck to you. "</span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;">No shit, friends. I rocked her world. It appears she had some kind of literary orgasm. I love changing lives. </span></span></span></div><div><span class="Apple-style-span" style="font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse; line-height: 18px;"><span class="Apple-style-span" style="font-size:medium;">Off to therapy!</span></span></span></div><div><br /></div><div><br /></div><div><span class="Apple-style-span" style=" border-collapse: collapse; line-height: 18px; font-family:verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif;font-size:12px;"><div><br /></div></span></div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-79504731384840218042009-10-27T08:33:00.000-07:002009-10-27T09:34:18.090-07:00Paper Planes<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhr0BTF2LjuNlbjh1QJ33rQdOXmpxty8zkqnBD2Xr_ZHeSwBTCwlSszHWdapQLTVEy2GLRe2-LsS8sBnLgzkNG1yEr21vQPm33ZfzgvvLeKQV6TLwDDymrhjFOKm-VnX1QVLCElQUvLyg/s1600-h/paperplane.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 126px; height: 84px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhr0BTF2LjuNlbjh1QJ33rQdOXmpxty8zkqnBD2Xr_ZHeSwBTCwlSszHWdapQLTVEy2GLRe2-LsS8sBnLgzkNG1yEr21vQPm33ZfzgvvLeKQV6TLwDDymrhjFOKm-VnX1QVLCElQUvLyg/s400/paperplane.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5397316304573080850" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><div><br /></div><div><br /></div>Nice to be the 4<span class="blsp-spelling-error" id="SPELLING_ERROR_0">th</span> most popular dude R.N. in the universe. <a href="http://www.lpn-to-rn.net/blog/2009/50-best-blogs-for-male-nurses/">http://www.lpn-to-rn.net/blog/2009/50-best-blogs-for-male-nurses/</a> <div><br /></div><div>I start out in my new E.R. next week. I'm really lucky to get the job. Over 150 applicants, five picked, I made the grade. As much time as I spent in the E.R. as an E.M.T., I am not an E.R. nurse. I have not worked with babies and kids as a R.N. The thought of putting an I.V. into a little guy makes me nervous as hell. <script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><div><br /></div><div>I miss the E.R. Quick movement, patients in and out, more volume than detail. I am also frustrated that an I.C.U. nurse with one year of good trauma experience can't get an I.C.U. job. The market is tight. Enthusiastic career minded new nurses are treated like a plague. We work cheap, we don't bitch as much, and we take abuse we probably shouldn't. </div><div><br /></div><div>I have found that a lot of experienced nurses didn't really apply themselves to the books when they first started. They didn't need to. It was more about volume, families, more patients died. It seems that I.C.U. nursing is more about science now, memorization of facts and numbers, understanding deep <span class="blsp-spelling-error" id="SPELLING_ERROR_1">pathophysiology</span>. I feel like I never got out of nursing school. I went straight to I.C.U. , my head up the arse of a book the whole time. For the last year and few months I have been given book after book, taken test after test, all of critical care knowledge. I learned it because I enjoy it and have passion for critical care. </div><div>That knowledge is an absolute detriment to my career because experienced nurses are quite savage and vindictive to anyone who might know more than they. My <span class="blsp-spelling-error" id="SPELLING_ERROR_2">pathophysiology</span> and technical knowledge is far more deep than the average veteran I.C.U. nurse (20 years). However, it is the veteran's practical skills and experience with outcomes that makes her captain of the ship or general of the cluster fuck. Veteran nurses run circles around me because they don't follow the same rules I am expected to follow. They write their own orders, they dismiss labs. They are so bitchy and obnoxious to residents that the residents wait until they are gone to write orders which means 7 pages of crap for me. Basically, they do what they want to. </div><div><br /></div><div>I had to take and pass a critical care exam to work in my last I.C.U. I was told that I scored higher than anyone before me. When I got on the floor I was EXTREMELY careful to not flaunt my knowledge or act like I knew better than any senior nurses. I was a good boy. Instead, I got labeled a "new nurse" by everybody. The manager told me that if I didn't ask question she would be worried. If I asked a question any of my 5 preceptors in 5 weeks (scheduling bonanza)and they knew the answer to it- what a a stupid question! I'm really <span class="blsp-spelling-corrected" id="SPELLING_ERROR_3">surprised</span> you didn't know that! If they didn't know the answer they would tell me it was not of any importance. I got quizzed constantly about drip rates we never used, nursing interventions for problems that didn't exist, I must have been quizzed 60 times on why we deep suction every two hours. So annoying, all these hags so proud of <span class="blsp-spelling-corrected" id="SPELLING_ERROR_4">themselves</span> because they can say the word "<span class="blsp-spelling-error" id="SPELLING_ERROR_5">VAP</span>" and know how to minimize it. Never mind the fact I already was suctioning q2 hours with oral care. I even wrote it into my daily plan of care before the shift started for them to see. Never mind I was taught in nursing school how to reduce ventilator associated illness AND THEY JUST STARTED SAYING "<span class="blsp-spelling-error" id="SPELLING_ERROR_6">VAP</span>" LIKE QUACKING DUCKS A MONTH AGO. Not one time did a preceptor say, "Clearly you understand." and leave it. Their insecurity manifests in hours of wasted time.</div><div><br /></div><div>I didn't want to be argumentative, so when one of my preceptors decided I didn't know the onset, peak, and duration of fast acting insulin she went to the hospital's intranet and showed it to me. "This is the <span class="blsp-spelling-error" id="SPELLING_ERROR_7">IntRAnet</span>!" she said , proud of herself. I nodded like a puppy. I appreciated the fact that she was taking the time to help me out so I said thank you for the information. But the bottom line is I had never heard of <span class="blsp-spelling-error" id="SPELLING_ERROR_8">Aspart</span> insulin, the last two hospital systems I worked at used <span class="blsp-spelling-error" id="SPELLING_ERROR_9">Lispro</span>. </div><div>My preceptor pop quizzed me-"What is the onset, peak, and duration of fast acting <span class="blsp-spelling-error" id="SPELLING_ERROR_10">Aspart</span>?"</div><div>"You mean <span class="blsp-spelling-error" id="SPELLING_ERROR_11">Lispro</span>?" The <span class="blsp-spelling-error" id="SPELLING_ERROR_12">PDF</span> she showed me just said "fast acting".</div><div>"I said <span class="blsp-spelling-error" id="SPELLING_ERROR_13">Aspart</span>!"I was 30 minutes off the peak time, I think I said an hour and a half. The rest of my times were correct. I recited from rote memory. Mind you that my preceptor of course had no fucking clue the onset, peak and duration and was also writing her own order for insulin. I was trying to get her to tell me what THE BRAND NAME OF <span class="blsp-spelling-error" id="SPELLING_ERROR_14">ASPART</span> WAS when she decided I was incompetent.</div><div>Two weeks later the I.C.U. manager called me into her office and told me, "I was told you don't know what fast acting insulin is. I'm very disturbed that Janice had to explain fast acting insulin to you."</div><div><br /></div><div>I told her that just because Janice had explained it didn't mean I didn't know as people were explaining things to me all day that I already knew. Oh the catch 22. I think it is beginning to dawn on a lot of senior nurses that the game has changed and is in the process of becoming a whole other game entirely. I think it profoundly bothers old nurses that I'm coming out of school with one year of I.C.U. experience and I am able to demonstrate more clinical knowledge then they ever had. It's not their fault, nursing education is different now. Better research is out there. But they hold us responsible for their aging. And I need them, which they know. They have the experience to put it together. They know what rules to bend and which to ignore. They know how their particular machine works, they helped build it after all, but the machine has been redesigned. </div><div>Nurses get paid for how long they have been in, not what they know or are capable of.</div></div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-83499157641063203172009-10-17T16:36:00.000-07:002009-10-17T16:46:38.901-07:00It Eats Raw Meat<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwtThA5R2S8bgEsR6Qc21QCqWnMWe9GlESC4IJbyoN3i7E0-6SHi6-kGHewBNGUw7lFjOLzzsIkmOQU-6OaXyfMjqktPEiOdxfQWXogQEx-et-eOVMi13NiiN9Y-sufJkib11ay0gQQg/s1600-h/Great+Bundini.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 134px; height: 115px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwtThA5R2S8bgEsR6Qc21QCqWnMWe9GlESC4IJbyoN3i7E0-6SHi6-kGHewBNGUw7lFjOLzzsIkmOQU-6OaXyfMjqktPEiOdxfQWXogQEx-et-eOVMi13NiiN9Y-sufJkib11ay0gQQg/s400/Great+Bundini.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5393719326374367026" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><div>Now I'm no boxer, not much of a fighter. I'm an unemployable loud mouth knowitall know too much dumbass jacked up to the grain R.N. but...</div><div><br /></div><div>This speaks to me:</div><div><br /></div><div>The great cornerman BUNDINI maybe once said:</div><div><br /></div><div>"God don't care about you! Don't</div><div>care about me! In all of everything,</div><div>we mean nothin'. He don't know us.</div><div>We be. </div><div>And that's the onliest</div><div>thing he did. </div><div>And that's good</div><div>'cause that's why we free. But</div><div>free ain't easy. </div><div>Free is real.</div><div><br /></div><div><b><span class="Apple-style-span" style="font-size:large;">And realness is a motherfucker...</span></b></div><div><br /></div><div>It eats raw meat.</div><div><br /></div><div>It walk in its own shoes.</div><div><br /></div><div>It does not waver...</div><div><br /></div><div>Yeah..."</div><div><br /></div><div>Fuckit, if it takes boxing movies to get my soul back in gear, well then, that's what it takes.</div><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-18410610776135612352009-10-06T08:45:00.000-07:002009-10-06T08:57:08.707-07:00Death of A Star<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLvm0dLZdiQdHIGvOYnICzYAhjAJHfnho4pX5pFWhqdtWoRpSz7FXZnyMm-WlBwhT0u4UTNB3q1BzRR2lsnMdxs4qwDr08AWrkRiHvx7_BKucRz3w5Lt86suJYV0v9771-2T09T5g3WA/s1600-h/goodnight+j.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 324px; height: 253px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLvm0dLZdiQdHIGvOYnICzYAhjAJHfnho4pX5pFWhqdtWoRpSz7FXZnyMm-WlBwhT0u4UTNB3q1BzRR2lsnMdxs4qwDr08AWrkRiHvx7_BKucRz3w5Lt86suJYV0v9771-2T09T5g3WA/s400/goodnight+j.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5389516227721650514" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>"Tucked In"<div>By Licensed to ILL<br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><div><br /></div><div>Good white Soul</div><div>Righteous indignation</div><div>Carnage Deluxe</div><div>A Symptomatic Soul</div><div>Watches the Elite Burn</div><div>Saying Goodbye</div><div>Saying Goodbye</div><div>Saying Goodnight</div><div>Let's put ourselves to Bed</div><div>Peer Out over the Covers</div><div>Soak the sheets with Our Sweat</div><div>Baby's Dream is Baby's Whispers</div><div>Loving the Sweetest thing</div><div>It's okay to Say Goodbye</div><div>Saying Goodbye</div><div>Saying Goodbye</div><div>Saying Goodnight</div><div><br /></div><div><br /></div><div>I got diagnosed with PTSD relating to a patient of mine who got raped</div><div>No one would touch her because she was a dirty homeless meth addict</div><div>I told the resident She had a punctured lung</div><div>Her left midaxillary chest snap crackled and popped with subcutaneous emphysema</div><div>He just shrugged his shoulders</div><div>What happened to her?</div><div><br /></div><div>So my recent co-workers pointed out that I seemed symptomatic.</div><div>They told me they were there to help.</div><div>My manager fired me three days later.</div><div>They saw another nurse who needed help and then they fired me</div><div><br /></div><div>I no longer live in L.A.</div><div>I no longer live in California.</div><div> And now I have no job.</div><div><br /></div><div>And I'm not feeling so good.</div></div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-3528872856951362862009-08-29T18:04:00.000-07:002009-08-30T22:04:37.610-07:00Conan the Barbarian<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVXZzR5O-C4S5VBzWSPPBKn4CfDP2TTKb_VEWQ718XxxLywAuNxdLCaYQf-tf2UbB5V9xV4xdJQDUZI8DHpCVWnCP2Y2wKOCsDovim62freaka-hoeXbEpz6BM8aQg3Gbo7gQiusMhYw/s1600-h/conan+%3DGJ.jpg"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 400px; DISPLAY: block; HEIGHT: 300px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5375988516798759746" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVXZzR5O-C4S5VBzWSPPBKn4CfDP2TTKb_VEWQ718XxxLywAuNxdLCaYQf-tf2UbB5V9xV4xdJQDUZI8DHpCVWnCP2Y2wKOCsDovim62freaka-hoeXbEpz6BM8aQg3Gbo7gQiusMhYw/s400/conan+%3DGJ.jpg" /></a><br /><div></div><br /><div></div><div><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br />I have left Los Angeles. Moved to a smaller, more chill city. Northern city. Bought a house in the suburbs. Kind of a blue state, kind of a red state. People seem nice. A lot more white people walking round than in L.A. That's kind of weird. Wonderfully color full, diverse pockets but mostly white. It's weird blending in. I like the anonymity. Why do I notice race? I spent my High School years in a predominantly Caucasian area. Spent my entire 20's as a racial minority. It tends to give one reason to pause and reflect when racial makeups around you change as well as pervasive attitudes and outlooks.<br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script><br /></div><div>How will I be perceived here? In L.A., some people could care less about race. Some people were openly prejudice. Some people hid their feelings until a moment arose when a preconceived notion was activated by some behavior or incident, some conflict that confirmed the belief they thought they secretly held to themselves. Some people were abnormally nice to me because of my race. Usually because they held ill feelings towards another race and would rather associate with mine. Call it racial motivation. Most people don't think that it exists. But it does. Race is the seventh patient identifier and everybody should goddamn know it. The people that did not care about race were the people that acknowledged these feelings existed in themselves and everyone around them and then simply moved on to more pressing matters. Like building a team, making a friend, finding support. </div><br /><div><br /></div><br /><div>I do not think I was one of these people. I felt too vulnerable. Been attacked physically and professionally too many times cuz in the summer I look like Opie, with all my freckles and red headed step child hair. I always tried to test the racial water first, to see if the person I was talking to believed that we are all in the same boat, that sinking one, called the USS Middle Class, the one with all the working class people, of all different sexual orientations, creeds, religions, colors, hanging onto the side of the boat for dear life. If they knew this, recognized that this sinking boat also served as a trough to be tossed scraps by the uniform One Raced Management. Management is one race: How can I fuck you without telling you? race. If my coworker knew this, well then, I made a friend.</div><br /><div><br /></div><br /><div>I am aware that I am damaged goods. I am prone to disgruntled status. I've been burned. Left to fend for myself. Didn't have help way too many times. What I experienced on a daily basis does not seem to happen here, in hospital of the insured land, where they want the "customer" to be happy. Everyday I realize that the abuse I took in the name of "trauma" and most likely also in the name of large corporate bonuses was wrong and hurt full to my disposition, my ability to give a shit about my patients. Right now, I'm grieving. I ache for my naivete, for my spen last honest intention, for my foolish belief that my unit supervisor actually BELIEVED IN the mission statement of the hospital. I am mourning over the days and nights my wife and son had to deal with nightmares that I futilely struggled to not bring home. The drama and the disgusting behavior, the utter maliciousness, usually in the name of an older nurses fragile ego, I brought it in right along with the MRSA and VRE, a prescence that no happy home should ever see. I am so sad that I was so right and so naive enough to think that what was "right" had any meaning or impact on policy or behavior.</div><br /><div>I left my hospital in good standing. No official writeups or patient harm issues. I worked hard. Did my job. Got a good referral from a supervisor. Took a lot of abuse, in the name of making it through my first year as a new grad I.C.U. nurse in urban hell. I did my time. I paid my dues. Again. But with my dues came the knowledge of how to shut up, what to say and not to say and how, above all else, to keep the mind sharp and decisive despite the thunderous din that 20 A type I.C.U. nurses make as they watch you take on their workload, their trade and pride, acquired with years of experience AND NOT FAIL much to some of the bitter one's chagrin.</div><br /><div></div><br /><div><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 198px; DISPLAY: block; HEIGHT: 163px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5375857339144369554" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLemqJz5P3bX2TpSbqNijT2rrEutbGpO-JEEWQm9drPZcehmwmJYhyerQ2oNmDkXBrXCFUT6hW0bv0MmfACeKlVky9o75bl4liR0h9lpGi7ZB0dj0RXtVNgi6oFepPn9ig5GxkZnPptQ/s400/Conan+the+Barbarian+-+What+is+best+in+life.jpg" /></div><br /><div><br /></div><br /><div>I feel like Conan the Goddamn Barbarian. Especially right at the end of the movie, where he sits on his throne, queitly tough from battles, everything conquered, pondering what made him hook up with Grace Jones. Nothing for ol' Conan to do but reflect on moments of war where he showed true grit but didn't even realize he was doing it at the time. Now, I've only finished my rookie year and my conquering days are far from over. I have many many more battles to fight, lessons to learn, plateaus to reach and ascend from. I'm just getting started.</div><br /><div><br /></div><br /><div>But in this market, I'm a veteran. And really, I'm more embarrassed for what I went through and saw. I'd rather not talk about it. Cuz when one of the experienced nurses here tells "this one time" story it just pales, in the same way my stories paled in comparison the Old schoolers who taught me. </div><br /><div><br /></div><br /><div>I don't know what nursing is now. Is it an exact field where everybody has all lab values memorized and we practice over and over the documentation and techniques required for conscious sedation? Or is it a field where you have O2 ready, make sure the patient is on monitor, have an intubation kit ready and just keep track of the fent and versed in your head while you pensively look between the patient, the monitor and the Doc? Is nursing duct tape or a text book? Is it hardcore bullshit or is being a critical care R.N. over studied, over trained, alphabet soup CCRN credentials but with insufficient application experience?</div><br /><div><br /></div><br /><div>What brought all this up, you ask? During orientation a PACU(post anesthesia) nurse told her super intense story about how a 80 year old woman had to be restrained. Okay whatever. For her, it was scary. But later on, when we were talking about thorough documentation in the unfortunate sentinel event you get called to court I told a story about how my charge nurse got choked out unconscious by a crack head who was coming down and wigging out and how hospital management blamed her for the assault telling her, "You should of known better than to tell a drug addict to please keep her voice down and not go into other patients rooms." Management was mad because they had to hire lawyers to impose a permanent restraining order against the patient from ever intentionally coming to the hospital again. She got blamed for even going to court. </div><br /><div><br /></div><br /><div>My new co-workers were horrified. Jaws open. I could see one guy giving me the "You're so full of shit" look. But I didn't even tell them the whole story. How the crack headed lady skillfully grabbed my balls while she scratched the face off my charge nurse, how ten nurses, male and female dove head first into a brawl with the crack heads family members who immediately accused us of HURTING HER. (Right?) I didn't tell them how the cops came, en masse, five white cops (Of course it's a predominantly African-American neighborhood) billy sticks out and mace drawn, ready to kick some ass-the offended "You pissant" look the Sergeant gave me when I told them to put their clubs away because we had finally gotten the family isolated in a room and they were going to freak when they saw the clubs. I didn't tell them how I wasn't afraid of the crack lady, I was afraid of her 20 year old son, ghetto brawler who slyly stepped just outside the room when we went in (yes you do have eye balls on the back of your head cuz it wasn't Yoda squeezing my sac) and to a lesser degree her husband, right hand in his pocket, gawd jeezuz I can only imagine what lethal weapon was going to come out of that fucking pocket. </div><br /><div>The PACU nurse said to me, "Oh my gosh you have been hurt! It sounds like you've had a pretty rough introduction." </div><br /><div><br /></div><br /><div>Yeah. I am disgruntled. I'm pretty sure I was thrown to the wolves but they only got an arm or a leg. </div><br /><div><br /></div><br /><div>And I need to get over it, fast because the medical world I'm in now, it may actually be the Disneyland of hospitals. I mean don't worry, I always find a way to be horrifically outraged and crank out master rants of disgust, don't you worry, my literary scoobie snacks will prevail but- I've got to stop mentally wanking on my post scary situation bitterness. </div><br /><div><br /></div><br /><div>Later the PACU nurse said some very nice, sincere things to me. She told me she was glad there was people like me in the field. She said I seemed like a good nurse. She told me never to take nursing bullshit home. She hasn't worked in five years. She's never been a critical care nurse. She doesn't know.</div><br /><div><br /></div><br /><div>But she is right. She is right.</div><br /><div>We are all here. We are all here. </div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com0tag:blogger.com,1999:blog-25238467793409480.post-42941650765958188912009-07-30T23:00:00.001-07:002009-07-31T02:19:25.882-07:00To Live and Die in L.A.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQmTEe9MuKPUGxqwBiCd30rMkMMuevQusEDOcV90E2l9SM4PMaQ_70DDfMhVkkXJiaEmykHz9KipZc-PfbjpJHuXMfNegWzUj0yBJ6S3Qaze1pvwV0ZB9xulyxpX1vQNxxklbL01nDMg/s1600-h/CharltonHestonTheTenCommandmentsC101021021%5B1%5D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 323px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQmTEe9MuKPUGxqwBiCd30rMkMMuevQusEDOcV90E2l9SM4PMaQ_70DDfMhVkkXJiaEmykHz9KipZc-PfbjpJHuXMfNegWzUj0yBJ6S3Qaze1pvwV0ZB9xulyxpX1vQNxxklbL01nDMg/s400/CharltonHestonTheTenCommandmentsC101021021%5B1%5D.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5364549434680769922" /></a><br /><div><br /></div><div>I have just resigned from my first nursing job for a number of reasons. I gave three weeks notice. Sadly, I do not feel relieved. I feel scammed and ripped off, exhausted and abused. I don't feel free. I'll expound more on that next week. First, I must share my lessons learned so that others following in my footsteps can remain modestly protected. Thick skin is understandably and necessary requirement to nursing, however it appears shank proof skin is more the order of the day.</div><div><br /></div><div><span class="Apple-style-span" style="font-family:'times new roman';"><b>THE RULES OF STAFF NURSING AS I HAVE COME TO KNOW THEM:</b></span></div><div>1) Even the "cool" experienced nurses you think you can trust will jab the knife in deep given the opportunity.</div><div><br /></div><div>2) Everybody has a family and obligations, just like you do, they don't care and as a new nurse, even with identified potential you are still a flash in the pan.</div><div><br /></div><div>3) Experienced nurses (+8 years) absolutely cannot tolerate being identified as having made a mistake or doing anything that might reveal they are human and not perfect. If you stumble across a nurse who say, has proudly announced that she thinks restraints are unnecessary and cruel while her patient is now holding their yanked out portis subclavian central line DO NOT WANT YOUR HELP</div><div><br /></div><div>4) An experienced nurse who suddenly befriends you has fucked up amongst the other older nurses and is using you as a surrogate friend until the old guard accepts her back.</div><div><br /></div><div>5) If you ask for help from an experienced nurse and actually receive it, the service comes at a cost: they will then take credit for all of the work you have performed on the shift until that point, with no shame. <b>N</b><b>OTE:</b> The exception to this rule is older male nurses. I don't know why but they seem pretty stoked when anyone will just listen to them.</div><div><br /></div><div>6) If you are suicidal enough to point out an error in logic, intervention, or treatment with an older nurse dumbly thinking they will appreciate this then you will forever be labeled as a "know it all" and "dangerously arrogant" despite the fact that usually, the only patients dying from lack of informed and or supervised care is their own. (Hence the constant phrase: "oh, but he was old")</div><div><br /></div><div>7) Sadly, the one way to break down most fucked up nurses is to ignore them and be openly hostile. I myself hate behaving this way, it makes me feel dirty and sticky in my soul but after a month the same nurses that would literally ignore a question to their face will be hugging you and be delighted to see you.</div><div><br /></div><div>8) Escape into patient care and knowledge. When in a confined environment surrounded by jackal infidels the only place to go to is work. Might as well do it well. Do not ask questions from senior nurses as they are inherently insecure and confuse genuine curiosity as an inquisition and threat. One question too many may shatter their fragile sense of competence. REMEBER QUESTIONING IN NURSING SCHOOL? IT WASN'T ABOUT WHAT YOU KNEW BUT HOW WORNG YOU WERE. The field hasn't progressed, trust me. </div><div><br /></div><div>9) It's a great idea to make allies with interns and residents, usually because they relate more to younger novice nurses than older snappy ones and working together to help a patient becomes an effective, educational , and rewarding experience.</div><div><br /></div><div>10) If the older crew see you relaxed and making jokes with physician staff they will call you "lazy" and will accuse you of ignoring your patients despite the fact that is exactly what they are doing when gossiping about you. Never mind that. Nobody wants a letter of reference from an old crabby nurse who treats the latest evidenced based research and knowledge with the same disdain as she would the newest thrash metal album from Slayer. She aint buying it.</div><div><br /></div><div><br /></div><div><br /></div><div>I wish instead of a LA TIMES 20 part news story about 80 whacked out nurses and how they have fallen through the cracks of diversion, I 'd like to see a story on the tens of thousands of tax paying Californian R.N.'s who get regularly scammed and shorted on their paychecks by gloating big bonused hospital management. (Again next weeks topic)</div><div>I feel fucking violated. Not only were their staffing ratio's absurd, but when I found out how my new hospital staffs their ICU I got choked up. Seriously, I choked up.</div><div>Patient with a balloon pump: 1 to 1.</div><div>Patient on ventilator with ANY pressor going:1 to 1</div><div>Patient on CRRT: 1 to 1</div><div>Patient returning from any invasive emergent cardiac procedure:1 to 1</div><div>Seriously, it made me cry. I've had assignments so unbelievable and harrowing while three morbidly obese shit talking multiple personality snackers loudly predicted any possible negative outcome to my patients. ONE TIME IN A YEAR did I have a 1 to 1. Septic, over 300 pounds, active MI, central in groin and central in R IJ, Multiple blood products, fucking 14 PUMPS! NO shit. At 0430 the supervisor literally grumbled all right, make it a 1 to 1 at which point my other co-workers literally stopped what they were doing and demanded I thank them for RECORDING THE VITAL SIGNS ON MY OTHER PATIENT. </div><div>Friends, I have had patients code during report and then been barked at by my supervisor for taking too long to get report on my second patient.</div><div>After the interview at my new hospital. I, a man, a dude who is semi-permanently disgruntled, prone to the negatives, a man who relishes the positives when they come, a nurse who gives a shit about his patients because it is the only way to stay sane and true of heart, a father, a husband. </div><div>Well, I cried. </div><div>I cried for my exploitation, I cried for my patients who got just -enough-to -keep-you-alive-care night after night. I cried for the thousand and thousands of times I signed my names to documents that no one will ever look at, selfish documents to cover some lawyers ass that took unreasonable time from patients rotting with bed sores and their own shit. I cried for my co-workers who just don't get how disgusting it is that one ICU manger can cause so much human suffering and distress to get a fat bonus. Cuz that's the bottom line and it always will be. If you need someone to create abrasive, unethical policies that save substantial money in an environment that requires vast resources, well your soul has a price.</div><div>The last few weeks I have been blaming foreign nurses. But I may be wrong. I don't know. I do believe foreign nurses don't bring a whole lot to the profession as a whole. I think they inadvertently bring standards down to the standards they are accustomed to. </div><div><ul><li>My new unit has no foreign nurses. Not one. 60% of the staff R.N.'s have CCRN certification. As opposed to NONE in my last I.C.U with 20 more beds , a staff of 60, and most nurses with easily over 10 years experience residing in a level two trauma center. I will never hear report in Tagalog at my new hospital. My supervisors will communicate in English. </li></ul></div><div>I hope that the racial divide that is burning like napalm in nursing will not be present in my new unit. I hate how discussing the fact that foreign nurses is in no way good for American nursing is considered racist. </div><div>I have left Los Angeles. I have left my home state of California. Surprisingly, the money is better in a more affordable state. It appears, on first glance, the care is better. It also appears that the treatment I will receive as a professional R.N. will be commiserate to the demands and complexities of my job.</div><div>This all, of course, on first glance.</div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.comtag:blogger.com,1999:blog-25238467793409480.post-76841750324712267982009-07-13T22:19:00.000-07:002009-07-13T23:00:55.881-07:00You fucked up, you REALLY fucked up.<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiO1iowLEbOo6mDv9W66MYdIECD-MSeU6y6BcBTh3PfXOPs_E6ML0yXzJLt78cqW8t93aS5BoUIzydkNbV6Kz50zWM70qfoT0tXj42k8Lz8iHHBpRPdQiBrgMkE39E6K5LRlKaaIkNUqQ/s1600-h/kicked-out%5B1%5D.png"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 336px; DISPLAY: block; HEIGHT: 400px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5358190713861078946" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiO1iowLEbOo6mDv9W66MYdIECD-MSeU6y6BcBTh3PfXOPs_E6ML0yXzJLt78cqW8t93aS5BoUIzydkNbV6Kz50zWM70qfoT0tXj42k8Lz8iHHBpRPdQiBrgMkE39E6K5LRlKaaIkNUqQ/s400/kicked-out%5B1%5D.png" /></a><br /><div><strong>FUCK YOU BRN-NOW YOU HAVE SOMETHING BETTER TO DO THEN HARASS NURSES WHO HAD ONE TOO MANY WINE SPRITZERS.</strong></div><br /><div><strong>HOW ABOUT CHANGING NOT JUST WHAT NURSES DO BUT WHAT OUTSIDE FORCES DO TO NURSES?</strong><br /><br /><script type="text/javascript"><br /><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br /><br />pageTracker._initData();<br /><br />pageTracker._trackPageview();<br /><br /></script><br />Man I wish the media would come up with a better tag line than "due to the ever increasing nursing shortage this hospital now has...."<br /></div><br /><div></div><br /><div>From there we fill in the blanks: "Due to the ever increasing nursing shrtage this local hospital has..."</div><br /><ul><br /><li>Happy go-lucky MALE NURSE perverts working for them. </li><br /><li>Drug stealing junkieusers working for them. </li><br /><li>Shameless overpaid nurses on overtime falling asleep on the job recklessly killing patients and laughing all the way to the bank.</li><br /><li>A male nurse who molested every single female who came into the 500 bed hospital and managed to used the prolapsed anus of a 90 year old woman as a cigarette holder for him while he peed on her dog as he was insanely high the very last pills of ambien and colace she had,etc.</li></ul><br /><div></div><br /><div>It's never real shit like: nurses don't get breaks anymore, management harasses R.N.'s who have a conscience, nurses seem to be making LESS money despite this incredible shortage...</div><br /><div></div><br /><div><br />As a R.N. I see nurses everyday who shouldn't be practicing in a perfect world. Some because of their atrocious attitude towards patients (burn outs), others with obvious mental problems who probably wouldn't be safe to handle fries at Burger King (related to traumatization and abuse on the job), and some who simply came to this country to make more money then they could in their home country. (sorry Pinoy but 6 out of 7 of you guys do a disproportionately large amount of the fucked up shit I see. Your ambivalence towards human care is as horrifying as it is somehow culturally ingrained)<br />There is no nursing shortage in the U.S. That's nonsense propaganda created by hospitals to get cheaper foreign labor. Only hospitals that are so hellish in their treatment of nursing staff have staffing problems and experience a "shortage".<br />The AMA and hospital associations have enabled tens of thousands of nurses to come to this country from other countries for the sole purpose of making money on cheaper, more obedient labor. These nurses not only leave their home countries in a void of health care but also leave American R.N.'s to take up the slack. At least four of my coworkers don't speak English adequately enough to carry a conversation but know how to perform medical tasks. Some were able to take the licensing exam in their native language. I am constantly covering their butts just to make it through the shift. If I were to complain I would lose my job, union or not. I would be called a racist. A hundred years ago they would have called me a "nationalist" but nobody knows what that word means anymore.</div><br /><div>Nursing is an unbelievably complex job that is constantly being put down by media, hospital administration and physicians. So many nurses have drug problems because the people who take care of you HAVE ABSOLUTELY NOBODY TAKING CARE OF THEM.<br />The article that led to 6 out of 7 BRN members getting tossed on their ass demonstrates how absolutely crucial the job the R.N. performs is.<br />The effectiveness of the BRN is severely limited because the BRN is inundated with three types of complaints: 1) My nurse doesn't speak English. 2) Hospital managements lodging erroneous complaints against nurses in retaliation for sticking for themselves and their patients. 3) Complaints filed by hospital management to cover up mistakes of arrogant physicians.</div><br /><div></div><br /><div>The largest reason the BRN sucks is because its staffed with hacks and non-nurses. Go figure! Political payback is tasty.<br /></div><br /><div>Nursing practice has changed so much in 20 years- the job that older nurses were trained to do simply doesn't exist anymore, nursing is truly not "nursing" as people know it. It is an incredibly complex, demanding, and intensely challenging job that requires dedication and- the nursing profession still doesn't recognize this- it requires talent.<br /></div><br /><div>Nurses are treated so poorly by physicians, hospital management, and most certainly the patients that they treat that a dangerous nurse is easily overlooked because everyone walks around in the medical field thinking "another dumb nurse did this".<br />True bad eggs like the ones in the article would be cracked and disposed of more quickly if quality nurses were recognized, and nurses who have no business being in the field were rooted out.<br />Bad nurses get away with it because, frankly, it seems that the public is quite happy with the stereotype of nurses being angelic, mothering, brainless assistants.<br />I don't think the public or the media comprehends the importance of the nurse in the disease and healing process from a technical and clinical standpoint. At all.</div><br /><div></div><br /><div>Right now, bad nurses run the show. The pathological liars, the borderline personality disorder bullies, the perpetually immature 14 year old girls breaking hospital units down into clique war zones. Right now, everything that is wrong about nursing rules the roost. Nobody complains about anything that means a fucking thing. Nothing about patient care, nothing about pay, nothing about safety, nothing about the blatantly redundant paperwork. Everyone feels like they can't change it so on Tuesday lets gang up on Tina and whisper behind her back and start some shit. Then we'll complain that she was mean to her patient, "no it's true, she was soooo mean to her patient cuz I was on like priceride.com getting a hotel room for vegas so I like heard everything..."</div><br /><div></div><br /><div>Oh well, tonight I sleep good. For the first time in many moons, the nursing gods have hurled in some political 18guages that pull blood out like central lines.</div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com2tag:blogger.com,1999:blog-25238467793409480.post-14217748071460688642009-06-17T04:54:00.001-07:002009-06-17T05:54:35.363-07:00One thing Leads to Another<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsm-FmPzATodgRQ0Zal_OObErkGYLejNWC4F_H1NbXllYDsI69A11k9x9ZEveVd0WU28WFiyl9AEAC2KwRzdJ1LA-hoiBEYFQRJaf9kQP39AzM6z5nqxPZVEytApy2OnvR4Cd5vDmPXQ/s1600-h/stacking+up.jpg"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 276px; DISPLAY: block; HEIGHT: 400px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5348276052403123906" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsm-FmPzATodgRQ0Zal_OObErkGYLejNWC4F_H1NbXllYDsI69A11k9x9ZEveVd0WU28WFiyl9AEAC2KwRzdJ1LA-hoiBEYFQRJaf9kQP39AzM6z5nqxPZVEytApy2OnvR4Cd5vDmPXQ/s400/stacking+up.jpg" /></a><br /><div>One thing led to another, that day in the late afternoons of early summer. Holding hands on an unchaperoned date led to heavy petting which then led to some very heavy anal sex.</div><div> </div><div>That little toke off that marijuana cigarette led to IV heroin with dirty needles. Like shooting hoops on the city court with some friends leads to the Lakers winning ANOTHER goddamn championship (along that plump vein- a team winning a championship leads to numerous cars getting rocked off their fucking shocks and stores burned wide open). Billy shooting a pistol at the Beverly Hills Gun Club leads to Arnie "Ahmadinejad" Iran posessing nuclear weapons. Like sending your kids to college leads to Bernie Madoff, like telling your Mom your love her leads to homosexuality if yur a dude, lesbianism if you're a chick and it's yur dad. One thing leads to another. One small thing leads to the motherfuck of all things. </div><div>Pre-WWII German's wanted government subsidized healthcare and ended up with six million jews dead, 3 million of them doctors so that fucked that whole thing. </div><div>An enthusiastic go-getter of a Jedi, Anakin Skywalker, thought he was being passed up for promotion too often so he turned into Darth Vader. </div><br /><div></div><br /><div>It's a scary fucking world.</div><br /><div></div><br /><div>A few weeks ago a pharmacy tech at Long Beach Memorial Hospital in Long Beach California killed two employees (both of whom were his managers). I used to work at that hospital and I knew that man. Not well, but it was he who handed me my first few bottles of legal speed, Adderall. One pill of Adderall leads to a blog called licensed2 ill. </div><br /><div></div><br /><div>Management at Long Beach Memorial is positively viscious. Disgusting. What did it take for him to snap? How much dignity did they make him dole out in handfulls before he found out that they were going to ditch his already overworked ass. One thing leads to: BOOM!</div><br /><div></div><br /><div>Last night my patient was an 88 year old man. Shortness of breath leads to intubation> leads to sepsis> Leads to ARDS> Leads to sedation with fentanyl and versed>leads to levophed> leads to CPR> leads to death.</div><br /><div></div><br /><div>But lets back up. This 88 year old man happened to be one of house anesthesiologist's father. </div><br /><div>Here's the kicker: She wanted everything done to her pop possible to save his life despite the fact he was a DNR. Do Not Fucking resuscitate Under Any Goddamn Circumstance unless you want to lose your license, get sued, go to jail. But when push came to shove, and even though the old man had the DNR because he saw his wife go the same way a few years ago and a) couldn't live without her and b) didn't want the same treatment. But when the time came and death grabbed the old man by the ballz the daughter, Dr. anesthesiologist did what she could only do in a moment of grief. Jump in and intubate his demented ass. (He may have dementia as well no one knows). Fuck me. </div><br /><div>Here's the other kicker. The two pronged double kicker: She is an anesthesiologist-the stoner of medical specialties-she orders no sedation, no pain meds, nothing to make him more comfortable. Father is totally on ventilator, restrained, cannot move shitting in bed with not a single opiate or benzo for his ass. For those of you who don't work in the field, being awake on a ventilator has got to be one of the most hellish and violent experiences a human being could go through. A machine tells you when to inspire and expire, every hour some dipshit like me is sticking a tube deep inside your lungs to suck the mucus out. It is excruciating. But no pain meds. Per her strictest orders. </div><br /><div></div><br /><div>So at 0400, after asking him 20 times all night if he was in pain, each time he said yes, each time I asked him if he wanted pain meds he said no, I said is it because of your daughter he said yes, I said does it feel good when I have to reposition you every two hours he shook his head no. Enough.</div><br /><div></div><br /><div>Enough. I could help but feel in my heart to the it of my gut, my son, my two year old in thirty forty years making this decision. Me old, sick, dying in bed. My life, my youth robbed from me by the same clock that has taken it away from all others. A selfish scary view of mortality that keeps knocking me upside the head, more and more lately. <strong>Enough</strong>. MY sweet boy. Her father. His age, his eyes, they looked like the anesthesiologist's eyes, his nodding and shaking his head. MY job. My license, my beautiful wife. Her body is still young, so is mine I guess, HOW LONG HAVE WE GOT?</div><br /><div></div><br /><div>But here's the second part of the kicker: He came in filthy with bed sores all over his body. He was being neglected at home. He had over nine documentable wounds - wounds severe enough we had to document them with pictures on his 88 year old body WHY KEEP HIM ALIVE WITHOUT PAIN MEDS? Enough. I called the intern. Gimme morphine for the old man. Hell no the intern said, it was his ass. Give him tylenol intern tells me. Fuck you Brian. I gave him tylenol. It didn't do shit. Silence. 2mg of morphine slow as fuck. Thank you. Done. I gave it like sloe gin joe. He slept for the first time in days. </div><br /><div>Jesus on vent, nailed to the Hill-ROM ICU bed with nothing for pain or sedation. The next day he did so well on his CPAP trials he was extubated.</div><br /><div></div><br /><div>How did his daughter know? How sick is it she knew the drugs of her own trade, given in our protocol doses would have killed him, kept him from getting better.</div><br /><div></div><br /><div>How did she know there was a lonely isolated male nurse taking care of him who eased his own futuristic uneasiness by medicating her pop. Whatever. That's the second time I've seen a train wreck come back when the physician parent declares a "no opiate rule no matter what" with the patient and a miraculous recovery is scored with in days. <strong>Like going from your deathbed to cooking breakfast for every nurse in the ICU.</strong></div><br /><div>God there is so much I don't know, like waking from the nightmare in a room with your eyes open but its still too dark to see. </div><br /><div>Like Ben n' Jerry's Cherry Garcia leads to morbid obesity.</div><br /><div>Like depression and burnout lead to apathy and disgust.<br /></div><br /><div></div><br /><div>(I know the holocaust joke is a bit much but goddamn it people- the shit I see- thie shit I see)</div><br /><script type="text/javascript"><br /><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br /><br />pageTracker._initData();<br /><br />pageTracker._trackPageview();<br /><br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com1tag:blogger.com,1999:blog-25238467793409480.post-80143886603995839882009-06-10T05:15:00.000-07:002009-06-10T05:39:42.509-07:00AMA makes me go AMA (aint got nothin' on me)<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjT0TgGNniyPY-IOdjG_nBWsSQrmR69MF33uXGncsNTjPQLrrKUL2OjN6Tpouu7wCxjJbZr5qW6nDLR8uPlStfR7_Md7Dzj1vzAuT3Kz7FnN5-ULkyl7Rkddamlem9BDXGWfCPTrMDUFA/s1600-h/Cameleon_big%5B1%5D.jpg"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 400px; DISPLAY: block; HEIGHT: 295px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5345677240372882706" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjT0TgGNniyPY-IOdjG_nBWsSQrmR69MF33uXGncsNTjPQLrrKUL2OjN6Tpouu7wCxjJbZr5qW6nDLR8uPlStfR7_Md7Dzj1vzAuT3Kz7FnN5-ULkyl7Rkddamlem9BDXGWfCPTrMDUFA/s400/Cameleon_big%5B1%5D.jpg" /></a><br /><div><br /><br /><script type="text/javascript"><br /><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br /><br />pageTracker._initData();<br /><br />pageTracker._trackPageview();<br /><br /></script><br /><a href="http://www.ama-assn.org/amednews/2009/06/08/prl10608.htm">http://www.ama-assn.org/amednews/2009/06/08/prl10608.htm</a></div><br /><div></div><br /><div>I posted this response on allshmurses.com. The AMA is pissed that the new nursing doctorate program exit exams are touted to be as challenging as the third level of USMLE. Seems MD's are worried that these fake doctor's will obtain REAL doctorates, then call themselves doctors and thus will give physicians a bad name by providing excellent care, actually listening to the patients, and actually giving a shit. Outrageous.</div><br /><div></div><br /><div>This is a long post- my posts always are- that's how I roll- but I'll end the argument right here. </div><br /><div></div><br /><div>This one is important. I think the DNP is waaaay ahead of itself. Certified nurse specialists are hardly recognized. I work on the floor with N.P.'s who are kicking themselves because the payoff for 20K to 40K in loans and two more years of time and effort has been NOTHING. Having a BSN's doesn't guarantee diddley squat professionally, either. I don't think R.N.'s need a doctorate to prove their worth. It's like an industry wide lack of self esteem. The ability and potential of a minority of educated and motivated nurses is like medicine's dirty little secret. </div><br /><div></div><br /><div>"<a href="http://allnurses.com/nursing-news/medicine-decries-nurse-398958.html" target="_blank">Medicine decries nurse doctorate exam being touted as equal to physician". </a>Uhhhh-so what if it is? There are many different kind of nurses. Many different kind of doctors. Lawyers. Sales people. Pool cleaners. Judges. Some people in their chosen profession choose to take it as far as they can. YOU WANT TO ENCOURAGE THESE PEOPLE. Some nurses I wouldn't even let take care of my pet turtle. Same goes for everything. So what if the exam is equal to the USMLE? </div><br /><div></div><br /><div>Whenever I talk about my job people ask me if I'm a doctor. I proudly tell them "no, I'm a R.N."- I usually get a quizzical look implying the person asking the question thinks that if I'm not a M.D. I must hang around slinging bed pans all day, their look clearly says: "Why is this guy talking about HIS patient like he makes decisions about their care?" So I politely explain that M.D.'s make disease diagnosis and are in charge of plotting a course of treatment for the patient. I explain that is is my job to not only understand the course chosen for treatment- but I am the one who institutes the treatment and I manage it's physical run. Yes, doctor's prescribe medications and order diagnostics. But in my I.C.U. they sure as heck don't give medication. I start the I.V. I give the medications, I assess the patient and if anything goes wrong I need to catch it before it happens and give the doc a heads up so they can re-plot the course of treatment. If this is not true then why do I need to have a license? Why am I held accountable for an adverse reaction to treatment or a change in patient status?</div><br /><div></div><br /><div>Last night- I admitted a patient from the E.R. with a primary diagnosis of pneumonia, c/o chest pain-with an extensive cardiac history. The cardiologist who ordered the admit had full privileges at my hospital as he was standing in for an intensivist who had a family emergency. The cardiologist was responsible for the admit and all other standing orders. Other than the insurance the patient had, the cardiac history, and the fact that the patient had received nitro and morphine in the E.R. the cardiologist didn't know anything abut the patient OR WHAT TO DO WITH HIM. He had no clue how to address the possible pneumonia and or sepsis. (Apparently he hadn't heard of Joint Commission) </div><br /><div></div><br /><div>So I walked the cardiologist though activity, diet, fluid type and rate, antibiotic regimen and all other diagnostic procedures to rule out sepsis. I wrote the "orders" as I gave them with his consent. Apparently the patient had thrown up in the E.R.- I asked for an anti-emetic-all I heard on the phone was,"uhhhhh" So I suggested a medication with rate and frequency. I asked him for cardiac parameters. The cardiologist asked me how the patient looked. I gave him my the results of my cardiac and pulmonary assessment. He thanked me profusely, gave parameters, and kept apologizing that he was just moonlighting, he hadn't done this in a while. </div><br /><div>He asked me for my interpretation of the chest xray. </div><br /><div>I told him "Sorry, out of my scope." But I had seen bilateral infiltrates in lower lobes when I read it. So I again encouraged that we follow the sepsis protocol. No problem. It was nice that he was pleasant. But when push comes to shove-yeah, M.D.'s don't find the R.N.s so incapable after all. And then I began the paperwork.</div><br /><div></div><br /><div>Later that night, the attending came by and said, "Wow! Dr.--- can still write ICU orders like he works here everyday." I'm not a doctor. I sure as heck don't know as much as one. But how much education combined with clinical experience do I need to know as much as one? No doubt, a lot. As a brand new nurse I got chewed out by the attending physician right along with the interns and residents for flubs that we all should have caught. </div><br /><div></div><br /><div>You see, it's role reversal, plain and simple-without the exchange of authority. I want to learn more about the disease and cures while many of those interns, now residents, want to develop their bedside manner. Seems the smart ones have figured out that it increases the odds of a better outcome to be able to communicate with one's patient. Nurses learn this immediately. Some doc's never get it, or care to. In my opinion, they are the ones who are doing the most damage to physician's. Not a DNP. It appears that the few nurses who choose to pursue advance training, pushing the envelope of our assigned role is clearly terrifying to M.D.s. Perhaps a bit of "man behind the curtain", huh? </div><br /><div></div><br /><div>They can call us dumb nurses, wanna-be doctors, whatever. MD's know very well that as treatment becomes more rapid, more complex, more demanding, nursing education is becoming a dynamic new modality in itself. If I don't understand or anticipate treatment then I am useless. </div><br /><div></div><br /><div>And as frightening as it is to the A.M.A., I am rather inclined to learn as much as I can about the science behind my work so I 1) don't hurt my patient 2) continue to bring enthusiasm to my career. That may include advanced degrees. And I'm gonna say it: In my area of specialty, it certainly appears that experienced and well educated R.N.s know absolutely as much as physicians do, in that specialty area, and physicians know it. Much in the same way a cardiologist doesn't know what to do with an admit. You want evidence to back that statement up? Ever watch a new intern ask an experienced nurse a question? Tell me who is giving "orders" to who. What doctor hasn't been shown the ropes by a R.N. at some point? From the basics "he needs a fluid challenge" to "write an order to start a levo drip at 20mcg/min and start a central!" </div><br /><div>But to know as much as an expert, takes a combination OF YEARS and education. Expedited by education but you can't be an expert without some serious time laid out. </div><br /><div></div><br /><div>According the the A.M.A.-this is simply impossible.The A.M.A.'s argument is essentially,"If you didn't start your career with a M.D. then you can't ever be as capable as one." Look how they treat D.O.'s? Childish. The truth is that the A.M.A. is concerned with the bad publicity they will receive when advanced nurses start taking the equivalent of the USMLE. THEY WILL DO OUTSTANDING. Nothing like the motivation of those with something to prove.</div><br /><div></div><br /><div>Example: My old hospital was a teaching hospital affiliated with a major university. It has a C.R.N.A. program. The S.R.N.A.'s have to retake anatomy and physiology along with the med students. Scores were posted in doctor's break rooms. Most of the med students pulled C's and D's. The nurses all scored above 80%. The hospital promptly stopped posting scores in the break rooms. </div><br /><div></div><br /><div>This is a turf war, plain and simple. MD's can't operate without us. Let them waste their time fighting nurses. Nurses don't fight for turf with doctors. We fight for respect and autonomy. Meanwhile- insurance companies- the real turf monster, are wiping the floor with what used to be the physician's salary and medical authority. </div><br /><div></div><br /><div>IT DOESN'T TAKE A DNP TO PROVE "M.D. level" COMPETENCE. ALL NURSING NEEDS TO DO IS INSIST ON RECEIVING CREDIT FOR THE WORK WE ALREADY DO. SPREAD THE WORD. WE ROCK. </div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com0tag:blogger.com,1999:blog-25238467793409480.post-538486382117426122009-05-31T01:16:00.000-07:002009-05-31T01:37:24.320-07:00I guess that's why they call it the Blues<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZzpLoJN_3hUK0pXYpr31CUOn1MyjqkXz9jGQNqfNc3KeT0gBa3i-f9NEo2Wx2Kan32QAn8MZyfVqJWMEY3XviEHBv2phOHEQ3rCEX6DyO3yRWEMdVG1qN6T4r-2iTJF3Q-WyJetUSTg/s1600-h/blues.jpg"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 162px; DISPLAY: block; HEIGHT: 178px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5341904254670739970" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZzpLoJN_3hUK0pXYpr31CUOn1MyjqkXz9jGQNqfNc3KeT0gBa3i-f9NEo2Wx2Kan32QAn8MZyfVqJWMEY3XviEHBv2phOHEQ3rCEX6DyO3yRWEMdVG1qN6T4r-2iTJF3Q-WyJetUSTg/s400/blues.jpg" /></a><br /><div><br /><br /><script type="text/javascript"><br /><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br /><br />pageTracker._initData();<br /><br />pageTracker._trackPageview();<br /><br /></script><br />Keep getting called off. I had three shifts this week- called off on one of them- put on call for the other to which I was never called in. This keeps happening.</div><br /><div></div><br /><div>My ICU normally holds 32 patients. Right now we have 10. Can't get a new job. Nobody is hiring and I'm still too new. I don't have any PTO. Management could care less. I asked if I could pick up shifts in the E.R. or med surge and they bluntly said "no". I wish they had said "Go rot" because then it would have been completely unambiguous. Ridiculously, the other units are still using registry! WTF? </div><br /><div></div><br /><div>My shift starts at 1830. I get put on call at 1630 until 0030. Whopping 48 bucks. </div><br /><div>I'm planning to leave Los Angeles with my family. Move to another state up north. I certainly don't expect the job situation to be any better. </div><br /><div>Gosh everyone, I'm bummed out. I wish my company cared. I wish they at least pretended to give a shit, or at least would help us get more certifications while we sit on our duff like CCRN or PALS or something. One big thing about California: Nursing is remarkably uninterested in education of any kind. </div><br /><div></div><br /><div>I mean, only in nursing does the R.N. have to pay for the C.C.R.N., probably get more responsibilities once obtaining it, then get abused and harassed by the perpetually insecure older nurses for getting the cert but get not one cent more for having the credentials. </div><br /><div></div><br /><div>The only thing I like about nursing right now is my patients and their disease processes. And they like me.</div><br /><div></div><br /><div>Don't you feel like you retreat into the job of nursing, into healing and working with your patients to avoid all the bullshit? As if I'm hiding from the drama by doing my job. </div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com2tag:blogger.com,1999:blog-25238467793409480.post-25218291295845372792009-04-14T00:34:00.000-07:002009-04-22T02:04:18.828-07:00Soft Shelled Soul<div>My life is good. My son (now almost 2!) is more like a little boy than a baby. He's my buddy. I often think about his innocence, and the sincere love of my wife for me and him during the drek of some of my more challenging, heart stopping, tedious, or humiliating shifts. I endure the ebbs and flows of an often scary, dysfunctional career choice for them, and through my family, I get stronger when the tide ebbs and flows.</div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4xwsVzD2-BulOD1dNTDqFXWmyYP3Fs1LTaY7GCj9_F6YMdaHUu9d6oEUCnXoPu7lzSjwqi1Ptrc7rekehkRBiczSQy5KUgzpMsEAoPFTjJu2o0LJIkjJ5nMm0QRgMwZYyF9F4ErNA-Q/s400/imgres.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 128px; height: 96px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5327434362118520162" /><br /><div>Nursing is fucked. At least in the beginning. New nurses in my unit are treated like sub humans. Everything we say or do is mocked and considered stupid. And in all honesty, a lot of the things that we new nurses do is pretty darn mockable and stupid. But more often than not our treatment is excessive and has no purpose other than to amuse bitter, older nurses who feel resentfull that the profession has moved ahead and sky's the limit. It is no longer a career choice for those who seem to have chronic, deep self esteem issues and hide behind "a calling". I hear abot the chaos of their personal lives: divorce, or other wise never married, twelve cats, vacation money spent on taking the dog to the vet.. Nurses are smart people, not particularly intellectual, observing some rigid hierarchy that takes at least 5 years to climb on and carve a niche of protection for oneself. I don't get to work with the other 12 new grads they hired into the ICU. It seems I am on the opposite weekend schedule as almost all of them. I work except for two or three almost exclusively with senior nurses. I've spent a lot of time wondering if I am still paying dues, or if I am the young being eaten (frustrating at 32-ooh they hate that. Second career er's). Perhaps they are just foul tempered in general-and this seems to be the case. But an especially vicious, degrading venom is saved for new comers to the field. I would take this venom with no complaint if it came with information on how to do my job better but the majority of the time I am sighed at, snapped at, loudly gossiped about, IGNORED COMPLETELY I am not privy on how to do my job better. The worst part is that all of the experienced nurses do the same task differently and if they do bless you with advice, solicited or not and you choose to not take it, shit-you're fucked and MAN they resent that.</div><div>I have come to find that the constant stream of disrespect is not about me personally, though often the intent is to make it personal, only to make the sting worse. But I work with a group of people who have been together, most for at least five years some as much as 30 and have come to see new hires as management's way of reminding them that there is cheaper, happier, labor out there. To make matters worse, they are forced to "baby sit" us, to teach us, to guide us. They don't want to. Unless precepting they don't get paid any more for it. They are coiled snakes, Iam the urban backpacker, blindly smiling at the scenery, carousing through the grass after dipping my feet in the pool at the bottom of a waterfall when OWWW! I stepped on a snake. </div><div><br /></div><div>I got my first 1 to 1 patient assignment two nights ago. She was my patient again last night.</div><div>During shift assignment I asked if I could have the admit, I told them ,"I need the experience, with paperwork and otherwise." I'm tired of my admits being confusing disastrous affairs. Endless paperwork I never see unless I'm admitting, trying to still balance my other patient. I am here to learn. Practice. I was not cavalier or loud. I stated a plain fact as none of them showing any pretense of liking me, a reasonable request. They got a hearty laugh out of that. The oldest one, Rhonda, shook her head and said, "You'll never want an admit again." More evil laughing. Fuck them. I'm here to learn. I practice the number one rule, applicably to any situation in career, love, life: Do you job well, be the best, no as much as possible- and then you have a foundation.</div><div><br /></div><div>My admit was a direct admit t from the OR, preceded from a frantic call by the OR nurse, with little to no information other than, "I don't know what's taking them so long to close her up." I asked how much blood had been lost. "They said only 300cc's but I counted 20 completely soaked towels." The patient's arrival was preceded by the general/trauma surgeon covered in sweat, writing orders. Telling me to anticipate an anxious family. This struck me as odd because the surgeon doesn't normally bring the family talk to the ICU. "Just get the FFP in her as fast as possible, use whatever vent settings keeps her alive. She's not a full code, no compressions or defib. Other stuff. In the paperwork somewhere." Then he split. RT got ready with a vent. The only other white male nurse on my schedule, Roger (sorry p/c world but you notice these things when you are a minority) with just over three years experience, one foot inside the circle the other foot still dangling out did his best to prep me for battle. "I'll do compressions, you just get drugs." </div><div>He more or less gave me a pep talk which was nice. The patients arrival reminded me of a trauma arrival in the E.R. Everybody happily pumped at first, then within five minutes everyone is sick of waiting, all jokes had been told, just ready to get to work. </div><div>My dyke supervisor hadn't shown her close cropped head yet during the shift, which was unusual. I thanked god. She is a barrage of insults, veiled threats, dirty looks, intentionally confusing verbal directions. She adds the cluster to the fuck. Gross. She just makes life miserable and nasty.</div><div><br /></div><div>My admit was a bowel resection gone on too long, patient too old (past 75 years) to be so morbidly obese at 155kg+, her hernia not dealt </div><div>with for like 40 years. AMS for 5 days, apparently her bowels had been recieving no blood flow for this long-her hernia cut off blood supply. 1500/cc's of dark brown fecal matter suctioned from her NG tube prior to surgery. 50% of her gut had to be removed. She had no neuro reflexes. Levo at an outstanding 20mcg/min to start. 5 liters LR already in. She came to me with a A-line BP of 75/30. HR good. Order for 4 units of FFP waiting. </div><div>I hooked up the A-line to the monitor while Roger got the bed situated, RT started hooking up. The OR nurse looked freaked but I ignored her. She looked to rattled to even figure out how to disconnect the portable monitor. She's always jittery so I tried to pay it no attention. The anesthesiologist starting apologizing to me for the</div><div> chaos and the fact that the patients right IJ line wasn't sutured in place and then I got a little freaked. Looking back, I realize- the OR nurse and the anesthesiologist were trying to give me an updated report from the phone, also going over info I already know-but they didn't really help get her on our monitor or set her up. They both asked, "any questions?" at the same time. How do I know? I'm trying to get the patient at least hooked up- the levo was so high that her extremities were mottled, we couldn't even get a pulse ox reading. Any questions? Yeah. One. What the fuck? What about that category status?</div><div><br /></div><div>Then walks in the supervisor. Fucking EVERYTHING up. Barking orders, pouring on the confusion. Asking for the patient's property sheet. It was so frustrating. I was 50% set up. Getting ready to take a step back and evaluate the patient. Roger had got a little ahead of himself and had put the IV pole on the left side, even though I had told him the IV lines were on the right IJ. I had already set the room up. As the patient came in I didn't notice Roger moving the pole. By the time I did the supervisor had already started her fucking harassment. "The R.N. formerly Known as Angry Male Nurse, why did you put the pole on the left side?" First off, in this stress full situation, why ask me why? Do we really have time to explain? I continued to set up the A-line, I wanted to say, "Roger did it" so she'd get off my back but then I would be ratting Roger out, who while not being the most impressive or experienced nurse around is the only one offering help. So I say, "I didn't move it over there. " Roger finally mans up and says, "I did, I didn't see the line." Supervisor's tone TOTALLY CHANGES. </div><div>"Oh, yeah too many people to see. No problem. Well lets move it back over." WHAT THE FUCK?</div><div><br /></div><div>Then she barks her first direct command at me, "T.R.N.F.K.A.A.M.N. (me) start your assessment we'll move the pole." Fine except 1) my physical assessment doesn't mean shit if I don't know if the patient is alive or not and I'm 20 seconds from having the A-line running 2) Dr. Drugs didn't suture in the Right I.J. and Roger is so fucking scared of the supervisor he's literally YANKING OUT THE LINE. I pull the lines with my right hand to get some slack and I compress the IJ insertion sight with my left. In my head I was thinking - I should explain what I'm doing to the supervisor- but then another part of my head said- isn't it abundantly obvious what I'm doing, focus on keeping the line in, yell at Roger to stop moving- I yell at Roger, "Line!' and my supervisor, I swear to god tries to pipe in "NE!" Like she's got it under control. She tells me to get out of the way again but Roger is too far away to give slack. I don't say anything. I'm literally stretched out over the bed, one hand on the jugular one hand holding the line."</div><div>She literally screams, "Fine! You don't want my help than do this yourself!"</div><div><br /></div><div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2gGIicrd3kYKVTEvQVx1RFyQSsO1Xu0PZPMO8Li7uOybTDg_fcE1W-aQNhHuyl6zAcecKnYTM1I3nfoD82pVt5JUOxm3eyGPXW6Vsl-gNscKMBN_wmyD7QCGjZISuG7vtaCuiWgYKIA/s400/imgres.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 129px; height: 105px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5327432714476661506" />She storms out of the room, no doubt to run from module to module telling any nurses with 10+ years how horrible I am. That's how I know how irritable she is. The more annoyed she is the less years of exeprience it takes her to slander me. I 've had her at the 5+ years before. That's not paranoia, people. Some of the ancillary staff, R.T.'s, the one tech we have until midnight, have told me verbatim the bullshit she tells people about me. I can never win.</div><div>Roger brings the line around. </div><div>"Man she makes things difficult", I say.</div><div>"She can be a bit of a drama queen," Roger replies. But drama queen doesn't cut it. First off, she looks like an old dude. She has the worst case of penis envy ever had, I know she's wearing a fake dick. She slanders, she lies. She cannot have a single interaction with me without making a joke at my expense, rolling her eyes, glaring at me, cutting me off. She's thinking "How come this weird, wrongly confident guy gets to have a dick and I DON'T? I wish I could sit down with her and say," It's just a dick, boss. It's what's on the inside that counts." In her head she thinks life is easier for me because I'm a guy. A white guy. Just like the ones that treated her former Iowan redneck ass like total shit. I can totally picture her figuring out around the twelfth grade that the reason why no guy ever asked her to prom is because she's freakishly boyish, likes to kick football player's ass, and finds the smell of vagina somehow alluring...vowing to hate. Her last ditch attempt at femininity was to become a nurse but she quickly realized that for those with the right moves it was a way to burn to memory her unspoken desires. To this day she lives alone, childless, doesn't have an old lady, loves the 49'ers. So I suffer.</div><div>But this time, like many other times, I have my patient to retreat into, to focus on, to nurse. I get working. It's Roger and me for about an hour and a half. He's grabbing the UA, pulls an ABG for me, relays some lab values, he grabs the four packs of FFP for me. We double check them off together. Team work until 11:00 p.m. when the supervisor comes back into the module. I see her walk in. I hear the older nurses laughing. I hear one of them say, "He'll never want another admit again." Then Roger is gone. Sadly, for the next two shifts he cops an attitude with me. Just like that. I know what happened. The supervisor made it clear. Him or me. Roger has a family, too. Supervisor leaves and the charge nurse says, "They should of just let her go." It's a fucking hernia you jaded psychopath! Being old doesn't mean you should die. The charge nurse is like 65 years old herself. What the fuck happened to these nurses to make them hate so goddamn hard?</div><div>As they are laughing at my fading vital signs 65/30, still no fucking O2 sat because she has no peripheral blood flow. I ask the RT to get one that adheres to the head. "Nope. Can't do it. We are only supposed to use those as a last resort in the case that we can't get a pulse ox reading from the hand and we've tried repeatedly."</div><div><br /></div><div>"I can't get a pulse ox reading and I've tried repeatedly,". I'm getting the vibe she's been Supervised if you know what I'm saying. The intern walks in. "Still no pulse ox? Can you get one of those ones that goes around the head?" The RT sighs and says, "I'm really busy, but I 'll see what I can do." Like it's a personal goddamn favor or something. You'd think the Respiratory Therapist would want to know the saturation of the patient she's setting the ventilator to minute by minute but hey, an ABG once every 4 hours is good enough I guess.</div><div>She comes back with the head band. "TRNFKAAMN, this is it. Alright. I did you a big favor here."</div><div>Is she going against the will of the Supervisor, does she have a limited stash? Or was she just to lazy to go get one? No doubt she's busy, we all are but fuck, we need a goddamn pulse ox reading. Either way, I thank her profusely, I act as if a great personal favor has been performed.</div><div>Intern wants a C.V.P. Got to set that up. Haven't set up an A-line and CVP simultaneously from scratch before. It takes me about 10 minutes longer than it should have. I see the Supervisor an</div>the old Burnouts watching the monitors from outside. "Wait-there it goes, nope!HA-Ha!" It is sport. I plug it in wrong like 5 times but eventually I realized I had the CVP in the right ports, I just needed to zero the monitor out before it would start reading. Low and behold- got 'em both. Now that knowledge is mine. CVP=5. That's low. The written order is to continue bolusing until CVP is above 15. We gots along way to go.<div>My patient B.P. sank then rose as we brought the levophed up to 40mcg/min. The resident walks in. He sees the patient start to move her right arm. The k-hole (ketamine) Dr. Drugs had put the patient in to paralyze her is starting to wear off. I'm relieved. She's got neuro reflexes slowly coming back. So what's the first order form the rez? Fentanyl and Versed. Fucking drip. I literally said, "My BP!" The rez went on some diatribe about how much pain she must be in, I was thinking yeah, but think about how much pain she WON'T have when she's dead. He insists. An hour later, with the smallest rate of Fentanyl and Versed possible, she takes a dive like a bomb over London in 42'. which also happens to be her systolic blood pressure again. </div><div><br /></div><div>And then my friends, the light shone upon me. The gift of experience, the undeniable truth of going-thu-it came to visit me that eve, and left me as excited as a waking seven year old who has left a molar underneath the pillow. The intern and I concluded: She's not dying tonight. We went to town. Dobutamine. Max it the fuck out, to start. Pound a bolus down. Family comes in. Intern and I tag team to stay functioning. I listen to their fears, he gives them the surgical realities. Intern manages to sink a one and a million shot at 4 am with a new triple lumen in right groin. Now I got accesss baby. 2 bags of albumin down the hatch. Next up: Fuck it 25% Albumin.As I'm running by Charge Nurse says, "You asked for it." I tell her do you hear one iota of complaint from my mouth. "No. Nope," she says. Good. Shut the fuck up.No one would help me if I asked. Certainly no one offers. Snickers and asshole comments as I run. I'm sprinting to other modules to grab pumps, bags of saline since I had used all of ours. At 4:30Am the intern says, "This is a lot of work for you isn't it?" </div><div>"Yeah,"I replied, "But great experience". CHECK THIS OUT: ALL THE WHILE I'M STILL TAKING CARE OF MY OTHER FUCKING VENTED PATIENT.</div><div>Fortunately he was over sedated by the day shift nurse who is approaching an increased age and mentation where I wonder if she knows where she is during work, I can't believe she's a nurse in the I.C.U. let alone taking care of people. She means well and is generally nice. Fuck it- that counts. I know the reason why the sedation was up so high because 1) she can't figure out how to operate the ancient "computerized" pumps and 2) she had the observationist tech do it (SEE:LAST ENTRY-dude got me $4K back on my federal tax returns) I pull back on his sedation, tighten his celestial reins and it buys me time. He doesn't have too many meds, he's certainly not shitting after the opiate load he got today, I just duck in and reposition him q2 hours. </div><div>Supervisor tells me I have to take lunch. My turd of a charge nurse takes over which means she parks her fat ass in front of the monitor and calls the other modules to tell them how funny it is I'm running my ass off. "Yeah. One of the new ones."</div><div>While I'm having lunch one of the most vicious of the old guard strolls in on his third lunch break, his assignments are a fucking joke, a facetiously asks me how tonight is going. This fucker never asks me that. I tell him, "Going well. You?" He doesn't makes eye contact. </div><div><br /></div><div>Day break comes. I hear the morning traffic start to blare out from television in the conscious patients' room. At 5:30 AM my experienced co-workers were forced to take over my other patient. I had so many pumps and drips going that according to union rule, or maybe it's in the old testament, not sure which, my patient became a 1 to 1. But never missing the opportunity to insult and degrade I hear my supervisor tell the day shift supervisor, "Well, she's a soft 1 to 1."</div><div>Her tone insinuating, we have to, but we don't want to. Listen friends: I know it, you know it, she didn't want to give me credit, her insult was an admission of truth, there was no sarcasm to decipher no questions without self incriminating answers to stumble through: her dislike of me was a gift of credit. For if she had said "Wow this patient was a fuckin train wreck and you need some good staff on this one"-well that would have done me justice. That would have put my rank higher and I honestly would have thought that she was goofing on me. Her answer was a begrudging admittance of truth: a soft one to one, for a soft new nurse whose shell hasn't hardened yet from years of overwork, abuse from superiors, no breaks, distended bladder so-called friends hating/loving you from one minute from the next. A soft 1 to to 1.</div><div>The patient was mine again the next night. During the day the Attending M.D. had come in, broke some rules and stabilized her with techniques unavailable to the night shift. I can't elaborate but he did what Attendings usually do and ignore patient wishes in the place of his ego's demand. No matter. She didn't die that night either. </div><div>Three people, it's true! No less than three people told me I did a great job of keeping that lady alive. Somebody noticed. And even though the Supervisor apparently heard that one of the people who had told me I was doing well was too valuable to her to have a compliment like that stand. Even though he too stopped mysteriously talking to me 3 hours after his compliment, the compliment had been spoken, like a wish thought out during a birthday, or a coin thrown in a fountain, or victory in snapping the majorous side of a wishbone. </div><div> The RN that complimented me, Chuck, normally works float during the day but was filling in as house supervisor for the vacationing real one. People generally thought it funny that Chuck was House Supe as he normally just does lunch breaks. I needed a compressor for leg squeezers and two of the senior nurses told me to call him to bring one up. My supervisor found out and did her fake drop the jaw thing, parade around the base desk, smacking her fore head, accused me of violating the chain of command by calling the house supe who happened Chuck that night. I detected a faint smile underneath her rant. Happy, he fucked up. Of course the older nurses who told me to do it didn't speak up. When Chuck delivered the compressor he said he was glad he could help out but in the morning when I thanked him again for the compressor he just said "whatever", scowled, and literally turned around and walked away.This is my Supervisor's way. I have experienced this with other older nurses as well when they turn someone against you. "I can't believe he did that to you, who does he think he is?" The person who previously wasn't aware thatthey had been insulted now feels SUPREMELY insulted.)</div><div>The vicory was still mine. And while I do not believe I could ever function in this high acquity without the support of my co-workers, it's too exhausting and inevitably a fuck up will slip that will put yur career's fate in the hand of the Supervisor on duty, well that's it. However, tonight I got one step closer to independence and got just a little bit closer to not being at the whim of those who are so "experienced" as they recipricate the abuse they no doubt at some point endured or continue to endure.</div><div>I never was a bully in school. I moved a lot as a kid, some years I was popular, other years I was shit. But I never broke down an teased others to make myself look better. Now, I talked shit about every more popular, better off, better looking kid under the sun to my friends out of jealousy but this was out of general disgust of human behavior and a deeply disturbing underlying antisocial outlook on circumstances at the time but I never attacked the vulnerable. It's not in me. It wasn't then, isn't now, never shall be. </div><div>The only thing is, is it obvious? or hidden like I like to tell myself that it is. Wanting to consume the biggers power, experience, knoweldge, standing.</div><div>I think of what the only new hire with experience in the group said to me as a friend during orientation, "I may have been a nurse for only six months but these bitches are going to hate you forever, for life. You do just the right things to piss off the older nurses. They hate you because you are right and that's why you don't realize you are doing it."</div><div><div><br /></div><div><br /></div></div><div><div><br /></div><div><br /></div><br /><script type="text/javascript"><br /><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br /><br />pageTracker._initData();<br /><br />pageTracker._trackPageview();<br /><br /></script></div>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com3tag:blogger.com,1999:blog-25238467793409480.post-40774440083242115042009-02-16T22:13:00.000-08:002009-02-16T23:10:21.809-08:00Electrified and Numb<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnf8uUJ1ggGelOL1o8uHNe_AmiF6nkpT2-nekomvbI1kkkyrWkmqJarIui7Spc1ZR_0Yl8VuTfkN56RSBF_PPu2JNx43SNb4a21sOfzPyktEM1VVu0_xIUnvsLrPuyC-z4jWwmbEFMBQ/s1600-h/Intubating+the+snake.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 214px; height: 162px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnf8uUJ1ggGelOL1o8uHNe_AmiF6nkpT2-nekomvbI1kkkyrWkmqJarIui7Spc1ZR_0Yl8VuTfkN56RSBF_PPu2JNx43SNb4a21sOfzPyktEM1VVu0_xIUnvsLrPuyC-z4jWwmbEFMBQ/s400/Intubating+the+snake.jpg" alt="" id="BLOGGER_PHOTO_ID_5303656168458242130" border="0" /></a>Occasionally, my coworkers are serpent-esque. Dealing with them is as challenging as handling this intubated snake.<br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br /><br />I’ve been busy. Bizzzee. Dizzy. Running around. Puttin’ out fires. Starting fires. Paying my dues. Because in nursing you think you pay your dues in nursing school but this most certainly isn’t true. You pay your entrance to the show dues in nursing school so you can pay your <span style="font-style: italic;">real </span>membership dues, dues to the V.I.P. lounge once the fun begins. And then you pay your dues for at least the first three years of being on the job in all sorts of painful, alienating ways. Cuz every step you take, every move you make, some bitter nurse with more years of experience then you is there to tell you how <span style="font-style: italic;">completely stupid</span> you are to do what you did. I can’t help but identify with Shaolin Kung Fu monks or Jedi Knights. When it gets bad or heavy, I think of Luke Skywalker as a R.N. being reamed becuase he didn't turn off the occlusion alarm fast enough for the older, more irritable Jedi's who perpetually have Jedi migraines from using the force all the time. Someone is always more experienced than you and not nice about it. Even your good moves show weakness.<br /> “Didn’t you do this with your preceptor?” My first admit from the E.R.<br />Yeah. In September. But my preceptor didn’t really let me do it because she thought I wasn’t up to it, i.e. it’s such a tedious mindless procedure with pages of redundant paperwork that my preceptor didn’t even want to bother. And none of my 10 preceptors ever did. I was going to do an admit last week but the charge nurse said loudly, “He’s new. Brand new. No way.” Except I’m not <span style="font-style: italic;">brand new</span>. I’m off orientation for about a month. I’m past brand new. Perhaps you could call my current stage: <span style="font-weight: bold;">I’m really new but still held accountable for everything goddamn thing that happens regardless phase.</span><br /> Last week the charge nurse thought I was too new to admit a patient. This weeks charge nurse feels I’m not so new to admit a patient, who happens to be the fucking E.R. doc’s father V.I.P. patient, so I’m pretty much shit out of luck. So yeah, I did it with my preceptor but I didn’t do it. Impossible to explain to the current charge nurse without sounding like I’m throwing out excuses. So I asked for a quick rundown of the necessary admitting paperwork. She makes a face like I asked her if we could try and resuscitate Adolfe Hitler. Her face says:<span style="font-style: italic;"> How stupid!</span><br /><br /> Two shifts ago I had a patient on a ventilator. He coughed so hard while I was repositioning him that he popped the oxygen tube right off the connection point at the ventilator. I couldn’t figure out how to get the thing back on because the respiratory therapist put a “tester hose” right in front of “the real hose” which didn't fit the oxygen tube. So my patient now has no oxygen source and I’m trying to connect a fake hose to a real one and it’s not working. And my patient, without an oxygen source is desaturating to the low 80’s. Meaning he's not breathing. <br /> Uh-oh time. My supervisor, Murphy’s fucking Law, happens to be walking by as this is happening. My supervisor has already told me she thinks I’m “weird” and “will make life real hard” on me. I’m not sure if she despises me in particular, possibly just any other living human being. My supervisor smiles when they pronounce someone dead. She giggles during CPR. She admires the pain on a patients face when a NG tube is being placed. And she loves pussy. She huffs and curses at you under her breath when you don’t know the location of the bacteria that has gotten your patient into isolation.<br /> “Why is your patient in isolation?” she asks everybody at the beginning of the shift, because you know, fifteen minutes into the shift R.N.’s have time to go through the chart in a leisurely manner and find out facts that are only useful to her. (funny because now I make time to find these facts out cuz I’m sick of her cursing me beneath her breath.)<br /> “Because he has MRSA.”<br /> “Where?” She asks impatiently.<br /> “I don’t know.”<br /> “Son of a mother huf gab dubda…”<br />And that face. Oh, that hateful frown. That look like <span style="font-style: italic;">You utter piece of shit, now I have to do my job</span>. Personally, I don’t give a shit where my patient has MRSA. I’m wearing gloves, gown and a mask no matter what this mother fucker has. Who gives a shit if my patient has MRSA in the nares. I’m not going to be picking his nose anytime soon. I won’t be licking his nostrils for pleasure in the immediate future. What the fuck lady? What…the…fuck?<br />So the ventilator alarm is screaming. The monitor alarm is shitting itself. Hell is starting to break a little loose.<br /><span style="font-weight: bold;">Enter</span>: The know it all nursing assistant. He walks in and cops what I call the “observationist attitude.” And attitude, I must say, I have been guilty of plenty of times. The observationist attitude is where you are watching a stressful situation unfold and you feel free to predict the outcome of the situation before there could even possibly be an outcome. CNA’s are especially guilt of second guessing nurses. Nurses are especially guilty of second guessing doctors. Doctors are especially guilty of second guessing specialist MD’s. The observationist has several qualities that make him/her an observationist. They are:<br />1) The Observationist has no actual responsibility in the situation.<br />2) Feels comfortable enough to openly judge the performance of those around her/him, though he is “below” their position.<br />3) Thinks the solution is easy to fix, having never fixed it.<br />4) Everybody is stupid because the solution is easy to fix.<br />5) Resents the fact that she/he is making one fourth of what the stupid people around him are making because he knows how to fix the problem.<br />6) Is pissed cuz he knows if she/he keeps talking he will be told to shut the hell up.<br /><br /> So I gots this little situation on my hand. I got a mildly retarded CNA who I swear comes to work for the free coffee and to give out tax advice though he makes 10 bucks an hour. I have a positively hateful short haired, dyke supervisor (she prefers to be called a dyke) who openly hates my ass. I’ve got an explosively coughing intubated desaturating patient, and oh yeah, there is a volunteer in the room who looks up to the CNA for some unknown reason (I think she loves free coffee) and is adding to the clutter and general chaos in the room. Could things get worse? Of course they can silly! They can get absolutely fucking horrible.<br />Supervisor tells me to get the hell out of the way. She yells, “Start baggin’ him.” I concur. Except we can’t find a BVM. It’s buried somewhere behind the ventilator. The nursing assistant dives in front of me, in an effort to impress the supervisor, “I’ve got it.” But he doesn’t have it, because he is the observationist, and observationists have nothing. I ask him is there a BVM? <br /> “No!” he says. I stupidly trust the CNA. As I’m sprinting out of the room to my other patients room to grab a BVM my supervisor shouts, it’s right here, it’s right here! The observationist is already back tracking, trying to explain in the middle of this situation why he couldn’t see the BVM. Nobody cares. He tries to hand the BVM off to the volunteer who is jumping up and down like the last kid picked for a kickball game. “Here! Me!” A fleeting thought runs through my mind, <span style="font-style: italic;">You are about to get showed up by two unlicensed coffee drinkers and THIS IS MY PATIENT! I am responsible for the outcome of this situation!</span><br /><br /> “BOTH OF YOU GET OUT OF THE WAY!” They scrambled out of the way. In fact the volunteer ran outside of the room and never came back. I haven’t seen her in the I.C.U. since. My supervisor looked at me for the briefest millisecond ever recorded in humanity with a look of like, <span style="font-style: italic;">Well maybe this guys not so bad cuz he just was really rude to these two lesser human beings.</span> Supervisor hooks up the BVM to oxygen. Now I’m shouting where is the mask? The CNA, with his observationist ego badly wounded shouts back, “He doesn’t need one!” Damn. Duh. I was an E.M.T. in the ER waaay to long. The CNA, now with his mojo back, tries to tell me how to connect the E.T.T. tube onto the BVM but I’ve already done it realizing my mistake.<br /><br /> So this is the part of the story where the dues are paid. I start bagging the patient. Trying to get that O2 sat back up from 70’s land, where it’s been for about 10 seconds. I’m just thinking, <span style="font-style: italic;">Fuck it, I’m gonna fill this fucker full of O2</span>. The sats start to rise. 82% 86%. I was pumping that bag like Arnold pumped iron. My supervisor barks, “He was on 12 respirations a minute, how fast are you bagging? You’re gonna fill him with air.” I start to argue, <span style="font-style: italic;">look I just want to get these numbers up</span> but then I realize I’ve already fucked up enough today so I slow down. I slow down bagging. BUt each squeeze is hard, people. I make those 12 resps. a goddamn wind tunnel. And I shut up. The O2 will go up anyway, just slower. IN WALKS THE DYKE SUPERVISOR’S ARCH RIVAL: THE OTHER NURSE THERE WITH MORE THAN 25 YEARS EXPERIENCE: <span style="font-weight: bold;">The charge nurse</span>. SHE HAS COME TO COLLECT HER DUES FROM ME AS WELL.<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5UGOsj5s9x0bwz7YhTwl-sQZGluXa6CIiKt2Grz1-Z2lz6zT10qH2USCzkdsRnIVUQtCD9Ym_mnB45hxZFGPcqE5BIVYihLueWi9rUDs96eLExACNz2DKTT7R3eIguBvON1OkHFhrAg/s1600-h/Insanity2.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 167px; height: 174px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5UGOsj5s9x0bwz7YhTwl-sQZGluXa6CIiKt2Grz1-Z2lz6zT10qH2USCzkdsRnIVUQtCD9Ym_mnB45hxZFGPcqE5BIVYihLueWi9rUDs96eLExACNz2DKTT7R3eIguBvON1OkHFhrAg/s400/Insanity2.jpg" alt="" id="BLOGGER_PHOTO_ID_5303657778858876274" border="0" /></a> “Why the hell are you bagging so slow, The R.N. Formerly Known As Angry Male Nurse?” Carol, the arch rival, bellows at me.<br />I start stuttering, I’m thinking <span style="font-style: italic;">cuz super dyke told me to</span> but then I don’t want to have that fight right now, I just want everyone out of my fucking room, so I sidestep the confrontation and just say <span style="font-style: italic;">the sats are going up</span>.<br />My supervisor decides to engage the bogey. “You don’t want a belly full of air do you?”<br />Carol switches to guns and fires her canon, “Who cares? Get the oxygen up.”<br /> I manage to sputter out, “Oh look 90%, good, back in business. Where’s that RT?”<br />The arch rival’s stare each other down. Then they look at me. I’m standing there like, “<span style="font-style: italic;">Garsh, ladies</span>.” Pretty fucking stupid. Afterwards they both took me aside to tell me that they were right and the other one was wrong. Supervisor says bag slowly (which is stupid) but she was actually nice about it because technically I took her side during the engagement-Arch Rival Carol says do whatever you have to do to get the O’s back up (right thing to do).<br />Hark, I am at everybodies mercy. And when the mistake is a blunder, whoa baby! Everybody has their two cents to put in.<br /> 2 minutes later everybody left my module to go talk shit about me. <span style="font-weight: bold;">Everybody</span> left. The supervisor left, Carol the arch rival left, the CNA left, fuck even the secretary we have once a week scrambled out of there. Paying my dues. No bizness like show bizness. When I finally got to lunch I attempted to retell the story but when I started recanting the tale, I noticed that everybody looked away and the fellow new grad I was telling the story to just looked down. Then I realized the CNA was sitting right next to him. Oops. I forgot. My story had already been told at least five different times in five different ways by people who couldn't wait to tell of the failure of <span style="font-weight: bold;">this new R.N. What is he doing here if he can't even figure out how to reconnect the patient to the BVM? </span>It takes years among people who feel bad about themselves to give their esteem and respect to others. It takes 6 seconds of confusion to get labeled a doofus for life. I'm glad my supervisor was confused, too. Otherwise, I probably would have been written up.<br /> Turns out the hose that stumped me and my supervisor was a “tester” hose to check the quality of the connection. Why it was taped directly in front of the port connector I’ll never know, cuz the RT sure as fuck didn’t. But then again, RT’s don’t know much of fucking anything. (Sorry guys- I still can’t figure out what you guys do exactly. I guess wearing white lab coats has gone to your head. But I'm more or less an observationist to your skills.)<br /> What a bonehead beginner mistake to make. And of course I received the obligatory lecture on always knowing where your BVM is from my supervisor. Which I deserved. The whole thing was my fuck up. Because I am new, and prone to stupid yet deadly mistakes, I have to pay my dues. Even the CNA’s get a piece. Fuck even the volunteer got a little slice of my pride.<br /><br /> I still love my job. I love getting better at it. I love knowing I will never make the same mistake again. I also like knowing that I am one of the few nurses who checks to make sure that the BVM is hanging inside of its bag and where exactly it is on the bed of every single one of my patients from here on out.<br /> Right now I have to go. I’m meeting up with that Observationist CNA. He said he’d do my taxes for $50 bucks.<br /><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com0tag:blogger.com,1999:blog-25238467793409480.post-2087764993281710362008-12-12T11:12:00.000-08:002009-01-01T23:56:38.843-08:00The Hard Way Pt. 2<script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>Taking me a while to update my posts. Apologies. The learning curve is keeping me busy. Collecting excellent stories to share. Give me more time...<br /><div style="text-align: center;"><br /></div><span style="font-weight: bold;"> </span><div style="text-align: center;"><a href="http://images.google.com/imgres?imgurl=https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPsbp_5V9riMUaY33tcV-YYXNDqkKDfq-1FP8ESPWWu7rK6g4vlDLBG7SMqR-iH0SrNiDZmQs0OKLBhYi6HMn6DdilyFu4r2oGH0d_UKZh5fwEblZDumCxrKvfJIdnRyFGJ1ovGAUKX5I/s400/talking_shit.jpg&imgrefurl=http://rapturousdreamer.blogspot.com/&usg=__yzN2XsAt72oyGxzLJysAP4ciZnk=&h=400&w=400&sz=22&hl=en&start=16&tbnid=enT2S3VsS7Oz4M:&tbnh=124&tbnw=124&prev=/images%3Fq%3Dtalking%2Bshit%26gbv%3D2%26hl%3Den%26safe%3Doff%26sa%3DG"><img style="border: 1px solid ; width: 209px; height: 160px;" src="http://tbn2.google.com/images?q=tbn:enT2S3VsS7Oz4M:https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPsbp_5V9riMUaY33tcV-YYXNDqkKDfq-1FP8ESPWWu7rK6g4vlDLBG7SMqR-iH0SrNiDZmQs0OKLBhYi6HMn6DdilyFu4r2oGH0d_UKZh5fwEblZDumCxrKvfJIdnRyFGJ1ovGAUKX5I/s400/talking_shit.jpg" /></a><br /></div> <span style="font-weight: bold;"><br /><br /><br /><br />Me</span>:“That’s right. I did nothing all day. I fake added up my I/O’s. These numbers you see here, they’re fake.” I was adding up the last hour of I/O’s after report had been given to night shift. They come on at 1830, I leave at 1900, that leaves a half hour gap for me to take care of.<br /><br /><span style="font-weight: bold;">Preceptor</span>: “Ha. Ha. Okay I see. Because if you hadn’t added up your I/O’s I would be VERY angry at you.”<br /><br />Friends, my nerve got hit. Hard. I'm learning. I make mistakes. I make a lot of mistakes. Dumb ones. I don't profess not to. BUt I'm here to learn, not get verbally or brow beaten. Unlike some nurses, I throw back verbal punches. Maybe bad for the career in the long run, but my fists land. And they leave marks. And sometimes they land hard enough where I don't have to go home hating myself.<br /><br /><span style="font-weight: bold;">Me</span>: <span style="font-size:130%;">“I DON’T GIVE A SHIT</span> if you get mad or not. If I had neglected to add my numbers up until the last minute then I would be disappointed in myself for not using my time properly which, apparently you haven’t noticed, I did.”<br /><br /><span style="font-weight: bold;">Preceptor</span>: (Not really sure that he had just got told off): “Uh…ha-ha.”<br /><br />Sorry friends. Preceptors can be jerks, micromanage, hell they can even be disrespectful. But getting angry over not adding up I/O’s as a threat of some sort, sorry. Needed to put him back into line. The blowback? I’m sure he told anybody who would listen how terrible I am but I’m not really too worried about it. For the last few days other nurses have been coming up to me and saying, “How’s M------ abuse treating you today?”<br /><br />Repercussion for my words? I don’t know. I don’t care. His preceptor, 3 years ago, was a notoriously abusive bitch, it’s too bad he hasn’t figured out he doesn’t need to act that way anymore. My preceptor is a good ICU nurse. Obsessive, detail oriented, gives a shit about the patients. He is somebody I have learned a lot from, and he has helped be focus on areas where I need work. Certainly I can be a stubborn fucking mule. Dangerous qualities as a new grad in the ICU. I am aware. But I don’t believe in fear based nursing. I see how my preceptor is afraid of management. He doesn’t understand that kissing their ass has brought him no respect, just more responsibilities that he doesn’t get paid for taking on. The ICU day shift supervisor told my preceptor to “drill instruct me” and have me ready to be solo in 2 months. Well, I’m ready to be solo. Scared shitless about it but ready. But I aint in the military. Call it pride, ego, vanity, stupidity, whatever. I got boundaries and they will not be crossed, as a matter of self preservation. So much disrespect and dehumanization burned me out as an E.M.T. the first time around. I’m not going to let it happen again.<br />As my best friend, who is a S.I.C.U. nurse told me, “Dude, just make it off probation.”<br /><br />Has to be on my terms. This is why I write about my one confrontation as a new grad. Because it has to be done to change nursing. I write to remind myself and other nurses that being disrespected, patronized, condescended to, yelled at, or humiliated in any way is unacceptable by any medical personnel. <span style="font-size:180%;">That HORIZONTAL VIOLENCE is behavior that is truly unbecoming of a nurse.</span> Not having a fucking opinion that differs from the general consensus should not be the impetus for school yard behavior. <script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com1tag:blogger.com,1999:blog-25238467793409480.post-33791763528068896742008-12-12T10:44:00.000-08:002008-12-12T11:11:01.493-08:00The Hard Way Pt. 1<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqSstLxb3tMCkin-5nrDgvt05L74wBQlHND3E-34UdzTwJCn4LzvwOVd-e7yMU0vr6ldTdk6PJGR9bKDSpWr7K1UUSjSywZCmwOEVicskb5yGhPyffh0_soolCvES0JNOgTOYXUIMHZw/s1600-h/hard+way.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 158px; height: 171px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqSstLxb3tMCkin-5nrDgvt05L74wBQlHND3E-34UdzTwJCn4LzvwOVd-e7yMU0vr6ldTdk6PJGR9bKDSpWr7K1UUSjSywZCmwOEVicskb5yGhPyffh0_soolCvES0JNOgTOYXUIMHZw/s400/hard+way.jpg" alt="" id="BLOGGER_PHOTO_ID_5278980466558940386" border="0" /></a>This is a long ass post, my apologies. I know shorter posts are easier and more fun to read. But I don't have much time these days, so I crank it out when I can. I seperated it into two parts so you can take a break, go to the bathroom, make some pop-corn, grab a beer, make love to your signifigant other, WHATEVER YOU NEED TO DO, so you can read the whole thing. Tally Ho!<br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><br /><br />Hard thing, to be a new graduate in an I.C.U. Trying to acclimate to steady stream of new information, theories, styles of practices, sometimes mellow- sometimes brutal clash of personality. It’s a hard thing. I’ve grown a lot these last few months. It’s been a wholly healthy experience, trusting a hospital unit to mold me into a functional nurse that can be trusted to take care of a very sick human being. So many defenses pop into my head when I trust my unit. I work for a corporation, it’s image or brand is that of Catholicism. I am precepted by various instructors, of all nationalities, sexual preferences, mentalities, experiences, I am open to their criticism, their warnings that something I may be doing is not working or will lead to more trouble down the road. I am even open to the ever stinging and painful attitude adjustment. I put trust into my I.C.U. that it’s interests are getting me up and running, not degrading my worth as a nurse and person.<br /><br />I don’t know why nurses feel it is so important to remind newer nurses that they are new. I know only a tiny fraction of the over all incredible tidal wave of information required to run an I.C.U. I mean, I know this. This realization occurred to me my first week: In my career I will never learn every condition and procedure in great depth of detail enough to be masterful in all workings in the unit. This truth was stunning and provoked fear in me. That in itself as humbling as hell. More experienced nurses, however, are so threatened by the fleeting moment of recognition that every new grad has, when training comes together, when that smile comes on our face, “Hey, I learned this. I know this. I know why it happened, I have enough background knowledge and theory to manipulate this situation to favorable outcome because I’ve seen the outcome of this situation before.”<br /><br />My preceptor with 3 years experience says to me, “Yeah, well, I think you just got lucky here.”<br /><br /><br />Then I go into my patient’s room and the noise by the charge’s desk drops. It gets eerily quiet. Cuz they are talking shit. That is the attitude adjustment. Not that I have done anything wrong but the attitude adjustment lies in the fact that the words that come out of my mouth reverberate around the unit and can leave a favorable or unfavorable impact, depending on the disposition of the nurse gossiping. I can control some of this, I must retain the attitude that I know so little and am awed by the skills of those more experienced. Sadly, my true feelings are threatening and infuriating to the more experienced. By claiming some victory over a situation I have hit a nerve with any nurse with more than 3 years of experience. Some of my preceptors let me have opinions let me make the mistakes that change those opinions wisen me up while most are too insecure to let me do so. To the insecure nurses, my attitude has changed. For the sake of peace, and career longevity, I swallow it and oblige their weakness. My attitude has changed.<br /><br />Well sometimes. Mostly, I’ve been good, kept my mouth shut. I know better than to point out the 5000 contradictions that preceptors have amongst each other. I did try to point this out one time out to a preceptor that while I had no problem doing the task they asked of me or the way they asked me to do it, my previous preceptor the night before felt just as strongly about doing it completely different. That never chills ‘em out though. They just feel more threatened and insecure. Secure preceptors don’t give a shit about minute differences. Insecure ones cannot fathom that one single task can be done safely and appropriately 20 different ways. Especially when it comes to charting. That night’s preceptor kept saying, “But do you understand why I do it this way?” I was like- fuck, I understand you rationale is perfectly understandable but DO YOU UNDERSTAND THAT IT CAN BE DONE THIS WAY?<br /><span style="font-weight: bold;">Preceptor</span>: “What’s this?! You haven’t tallied up any of your I/O’s? You’ve already gave report. You’re behind.”<br /><br />The following is my response after 2 months of my 27 year old preceptor acting like a cocky ass, making nothing but negative comments, criticizing my questions as repeats and therefore-stupid, not making any attempt to communicate, looking only for inane mistakes in my paperwork ( I put the MD’s name <span style="font-weight: bold;">after</span> the telephone order as opposed to putting the MD’s name <span style="font-weight: bold;">UNDERNEATH</span> the telephone order), all around being pretty worthless. Acting as if my dumb mistakes are somehow a reminder of my total failure as a new nurse. Each “Tssk" and deep sigh pushing me closer to the edge. Each day he’s got closer and closer to being out of line.<br /><br />END OF PART ONE. YOU GOT 5 MINUTES. HURRY UP. OTHERWISE I'LL START WITHOUT YOU.<br /><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com0tag:blogger.com,1999:blog-25238467793409480.post-10522264266206580512008-11-22T19:29:00.000-08:002008-11-22T20:59:30.221-08:00Cold Cold Ground<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLCwhnvr-34QS_B5uGDmJW6yxzx7bJZqxiO045SOyoHYmmM-XfouE3TOgJ8k60Zgc3Wt_hjN8Z5S8cLTgsxiYfXssAqlk2i9USmLOF5lNC8H8HGka-Fv5CQDmZ92gHLTE90WOSrs-MCA/s1600-h/einstein.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 154px; height: 163px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLCwhnvr-34QS_B5uGDmJW6yxzx7bJZqxiO045SOyoHYmmM-XfouE3TOgJ8k60Zgc3Wt_hjN8Z5S8cLTgsxiYfXssAqlk2i9USmLOF5lNC8H8HGka-Fv5CQDmZ92gHLTE90WOSrs-MCA/s400/einstein.jpg" alt="" id="BLOGGER_PHOTO_ID_5271706353253736082" border="0" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>I could write for days. Days, I tell you! Funny stories, aggravating instances, tales of monotony and terror, personal reflection and the ultimate sad but true truth. Highlights like a hot lady with dark hair and that kind of naughty, kind of cute, light brown streak, the highlight, running across the lateral side of her head. Lateral. Hot chicks with high lights. New grad dude nurse feels overwhelmed for 12 hours can't seem to get it right. When is this shit gonna get easier?<br />Still love the ICU. I'm happy and grateful to be there. My supervisor wants me to be more humble and ask questions more nicely. Reasonable request. Cuz don't forget, experienced nurses can shit all over you but the second you bite back they're moved to tears and outrage and cookies and WILL NOT BE SPOKEN TO LIKE THAT BY A NEW GRADUATE. Sorry. Just don't make up hospital protocol (if a doc writes an order for ANY drug you as nurse have the autonomy, the discretion, to give the dosage you see fit as long as it doesn't exceed the order) and get pissed when I point out that legally, that's asking to get sued. If a doc writes an order for 3mg morphine and you think it might kill your patient, call the bastard up and get a new order for 1mg of morphine, even better, have it written as a sliding scale PRN. That's legit. That's communicating with a doc who probably appreciates the foresight. Now, who wants to be the motherfucker to call at 0300 for that bullshit? Not me. That's when you give a nursing dose. But regardless, we may give the drugs, but we don't write the fucking orders. And don't male up rules on how "it really works". I didn't call you sloppy. I don't even care. I just don't roll that way. So now all 30+ ICU nurses know of my argument and have taken away about 20% of the warmth they initially extended to me. Ahhh, good looks can only get you so far when you come across as an arrogant dickhead.<br /><br />I keep telling them, the experienced ones, till I'm blue in the face, "I understand your rationale, you don't want to overdose your patient but you need to get a new order if you are going to change the dosage and a sliding scale or dosage parameters have not been set." Not that abrasive right? Opinionated, fuck yeah. But I'm not like, " ALL NURSES OLDER THAN 35 WITH MORE THAN 5 YEARS OF EXPERIENCE SUCK AND ARE STUPID COMPARED TO MY NURSING SCHOOL ASS. I WAS CLASS PRESIDENT BITCHES, AND DON'T FORGET IT." My god, I politely didn't agree with your practice and had, what I stupidly thought, was a healthy argument.<br /><br />And with that, my friends, I earned the label "Cocky". It is pretty ridiculous, I mean I'm a new grad, a student with a license, telling them how to do something they've been doing for 10, 15, 25 years. It IS outrageous. What can I do? I'm gracious when they share knowledge with me, my questions come across as a challenge and that's my bad- they aren't challenges-I thoroughly enjoy debates and spirited arguments, I love tumultuous, vigorous conversation. I do not raise my voice, I do not call names, I preface my statements with, "I don't mean any disrespect" or "I'm confused about this order do you have a second to explain it to me?" Even, "What do you think if I was to do it this way?"<br />And then I argue until I understand what they are saying. That's just me. A stubborn weirdo who respects the people who can thoroughly explain their rationale before I implement it into my own practice, so I know why I'm doing what I'm doing, rather than just doing it. My preceptor tells me I don't ask enough questions. God, I must be a prick.<br />In nursing, its just not okay to debate. Nurses are fragile with their truly impressive knowledge. I'm not being sarcastic. I love nursing knowledge. But all it takes is some first year intern to tell them they are wrong and toss out what the nurse considered to be a rule of biblical proportions (give Desmopressin to a polyuric pisser who basically has no electrolytes and is in DI). Intern says no, "Lets keep supplementing with IV electrolytes." Resident backs it up. Attending likes the way it sounds. They all read some study on desmopressin that R.N.'s don't even have access to. She's pissed and humiliated.<br /><br />Nurse: your knowledge is hereby rendered dated and you just lost a little more of your repetoire.<br />I guess I realized this week that new grads aren't allowed to bring new nursing science to the table. It's seen as insanely arrogant and mildly suicidal.<br />Kind of sucks. I wouldn't argue with experienced nurses unless I respected them. But I don't think too many of them respect themselves so they don't really get that.<br />My ICU preceptor and subsequent staff are aware of my argumentative hard headed nature. I tried to hide it. But its been 90 days, I'm still on precepting. I still make stooopid mistakes. I forget to sign off the morphine I gave two hours ago, again. I feel stupid. I forget to transcribe the lab results onto the flow sheet because I've got the hard copy in my hand and I've already shown the critical values to the resident. My preceptors says, "You know, I'm tired of babying you with these lab results, you need to record these on the flow sheet as soon as you get them and intepret them."<br />I ask, "Even before I notify the doc that my patients K+ is 2.5? He says, "Yeah".<br />I don't argue. And I make mistakes. Some preceptors are cool. Some are hard asses. Can't say for sure I 'm making the grade. I think I am. I mean, I ask for the heaviest patients the ICU has, I make 5 million little mistakes throughout the day but I always leave on time. I just woulda thought that if a new grad, a preceptee, asks for the heavy patients then the powers that be, that general hum that runs through a unit, like a positive ion gossip charge pulsating through a rumor bed, I thought they would have cut me a teeny bit o' slack. Guess not. I asked. I received. duh.<br />Yep, there is a lot I could write.<br />But I'm tired and tomorrow I have to be able to tell my preceptor where an MI is likely to occur in someone with right coronary artery failure. Inferior, posterior left ventricle, I think. Got me. They're not gonna let me get near a heart patient for like, 15 years anyway. And understandably so.<br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com1tag:blogger.com,1999:blog-25238467793409480.post-705767844550623782008-11-04T21:28:00.001-08:002008-11-04T21:34:34.181-08:00Cloud Nine<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj79H2AdPgWCXBbydDm-JNAcr_-J63C7rJQYrSuhyphenhyphenCWokl2G1odsQGWiQcttJdy1FgOciLflwESS6jQkgycvDmYz6sY2Xtyn88dwTZi6FrxNaJ_nBq1Wyfch5B2xtFOQxO_7N2K4SzvkA/s1600-h/Barack1.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 165px; height: 211px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj79H2AdPgWCXBbydDm-JNAcr_-J63C7rJQYrSuhyphenhyphenCWokl2G1odsQGWiQcttJdy1FgOciLflwESS6jQkgycvDmYz6sY2Xtyn88dwTZi6FrxNaJ_nBq1Wyfch5B2xtFOQxO_7N2K4SzvkA/s400/Barack1.jpg" alt="" id="BLOGGER_PHOTO_ID_5265042246381607202" border="0" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>I AM OVERJOYED!!<br /><br />CYNICISM, BITTERNESS FADE AWAY.<br /><br /><br />THE 8 YEAR PRISON TERM IS OVER.<br /><br /><br />FREEDOM BREAKS THROUGH LIKE CRACKS OF LIGHT IN A CRUMBLING BRICK WALL BUILT ON THE BACKS OF THE WORKING CLASS SLOGGING THROUGH LURKING POVERTY.<br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com1tag:blogger.com,1999:blog-25238467793409480.post-82858735399933846932008-09-27T09:40:00.001-07:002008-09-27T09:58:22.686-07:00Appetite for Deconstruction<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPwwGi5KvoSkUGwd_BgKORUFtZGHXzkr3nyO9EKLjWZzks0Lr5BiF4AOjfpSfJFjOvtluNcfuU2UTJvqYXUUoa1sXr2B-S4imV9k1HFN3-ovJOU0ed_jvSCIqBT9QDT7Wv-RYycRjSEw/s1600-h/deconstruction.jpeg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 217px; height: 154px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPwwGi5KvoSkUGwd_BgKORUFtZGHXzkr3nyO9EKLjWZzks0Lr5BiF4AOjfpSfJFjOvtluNcfuU2UTJvqYXUUoa1sXr2B-S4imV9k1HFN3-ovJOU0ed_jvSCIqBT9QDT7Wv-RYycRjSEw/s400/deconstruction.jpeg" alt="" id="BLOGGER_PHOTO_ID_5250742880020422146" border="0" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><span style="font-family:georgia;">Better than your brightest lights</span><br /><span style="font-family:georgia;">Because they still can’t penetrate the darkness</span><br /><span style="font-family:georgia;">Of the heart with their song of</span><br /><span style="font-family:georgia;">The ballad of the buried woman</span><br /><br /><span style="font-family:georgia;">Dazed and confused up for nights</span><br /><span style="font-family:georgia;">Soaring in fingertip reminiscence</span><br /><span style="font-family:georgia;">Of larger bore needles bored to tears</span><br /><span style="font-family:georgia;">Once again, you can't imagine the depths</span><br /><br /><span style="font-family:georgia;">Every night, every shift</span><br /><span style="font-family:georgia;">We wade through people who feel like human debris</span><br /><span style="font-family:georgia;">Rendered bed-ridden by too much grease, not enough time</span><br /><span style="font-family:georgia;">And hard earned paychecks that as slim as their chances</span><br /><span style="font-family:georgia;">Of getting out of here alive, this time anyway.</span><br /><br /><span style="font-family:georgia;">You know me, and I know you</span><br /><span style="font-family:georgia;">We both know we are better than that</span><br /><span style="font-family:georgia;">But empathy is in short supply for the perceived</span><br /><span style="font-family:georgia;">The poorly recepted. The gravely misunderstood patient</span><br /><br /><span style="font-family:georgia;">Whose bad judgment has left her on my unit</span><br /><span style="font-family:georgia;">Confined to a giant bed, that rotates her adipose years</span><br /><span style="font-family:georgia;">From side to side, to keep her skin from obliterating</span><br /><span style="font-family:georgia;">And showing us that the color of her soul is a milky yellow</span><br /><br /><span style="font-family:georgia;">She wears a mask during sleep that I would have thought cool as a child</span><br /><span style="font-family:georgia;">But it only prolongs her suffocation, from yearly daily routines</span><br /><span style="font-family:georgia;">That provided sustenance, but coated her vasculature a bulbous insulation</span><br /><span style="font-family:georgia;">And now this mass, my patient, this woman, teeters on the brink </span><br /><span style="font-family:georgia;">Of becoming an empty vessel that five of us can barely move</span><br /><br /><span style="font-family:georgia;">And she suffocates when sleeps on her right side</span><br /><span style="font-family:georgia;">Her lungs squeeze themselves masochistically when we roll her on her right</span><br /><span style="font-family:georgia;">I watch her face turn from turbid fleshy pink, to turpid red, to ending purple</span><br /><span style="font-family:georgia;">She is a human so huge she can't live anymore</span><br /><br /><span style="font-family:georgia;">And she’s a dime a dozen. Well, at least that’s the deal she got every morning she told me with a smile on her face.</span><br /><span style="font-family:georgia;">“In between litigation, and depositions I found time for Chinese. In between discovery and cross examination I had a two meatball grinders with a chicken on the side. And during bathroom breaks during trials I ate boxes of krispy kreme donuts and chased it down with 1/2 gallon of chocolate milk. I don’t think I’ve gone without a soda during my waking hours since I was a 15 year old fat girl. I drank diet coke for twenty years, but that’s like switching form Marlboro Reds to lights, really what does it matter?</span><br /><span style="font-family:georgia;"> But I never did drugs, never smoked, never had sex. I stayed disciplined, dedicated, I listened so well. I am an excellent attorney. I just can’t breathe anymore.” Her Trio cell phone rings. She answers it. I see the custom made three piece suit still on the chair in her room. I see the diamond studded feminine Rolex awaiting security to come and lock it up. Her engorged fingers have many rings with precious bright stones, some colored the same as the incredible amount of fluid I will see leave her cracked open chest later on that night. Like a fortune cookie. What did the fortune say? It said:</span><br /><br /><span style="font-family:georgia;">“We are all here. We are all here.”</span><br /><br /><span style="font-family:georgia;">I think dignity and control are fleeting in any situation.</span><br /><br /><span style="font-family:georgia;">But I have paperwork to learn how to do properly. Blood to draw, progress notes to read, sugar to check, insulin to give. IV’s to titrate, dressings to change, wounds to pack, pictures of wounds to take, charting to chart, labs to ponder, family to let in, sheets to change, a body to clean. And these are the “eassy” patients. The painfully ironic “lighter load” patients. I have to explain that we can breathe for you but the bacteria that traveled from your vagina to your kidneys to your intra stellar galaxy will get you first and I must remark that I never seen anybody with such a rapidly dropping BP answer so many seemingly important phone calls. Never has sepsis had such a soft punch.</span><br /><span style="font-family:georgia;">Later on, something popped in that chest, and the megalomaniac brilliant cocksucker cardiothoracic degenerate surgeon did surgery in her temporary office, the air support bed. And just before she became a live dissection a passerby would have heard one of us say from her room:</span><br /><br /><span style="font-family:georgia;">“So you want to know the life of a mind?”</span><br /><br /><br /><br /><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com0tag:blogger.com,1999:blog-25238467793409480.post-82073711760526350482008-09-11T07:53:00.000-07:002008-09-11T13:19:38.098-07:00The Filth and the Fury<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_kVCEWXhfoWc5dlRbr_aUQ_ZqxTZUzl19hfswscd7XxWnRdWe6936l1fb7d2oz_T0DohTNGrgSmzFgIQw7ds1PGCNluyry5ALAEcGJ0uK9F8rTbKcNGkeFXZWmwCGzFMrYgCslhVX6A/s1600-h/outofshape.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_kVCEWXhfoWc5dlRbr_aUQ_ZqxTZUzl19hfswscd7XxWnRdWe6936l1fb7d2oz_T0DohTNGrgSmzFgIQw7ds1PGCNluyry5ALAEcGJ0uK9F8rTbKcNGkeFXZWmwCGzFMrYgCslhVX6A/s400/outofshape.jpg" alt="" id="BLOGGER_PHOTO_ID_5244827701233871906" border="0" /></a><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>So I've been working as a R.N. in the ICU. Finally. Spent a lot of time contemplating what was fucked about nursing and the medical field. Spent a a few brief moments contemplating what was cool about nursing and the medical field. It revealed some truths about myself and it revealed an uncomfortable amount of truth regarding our culture, race, class status, identity. It has been a lot of painful discovery. I have been misunderstood every step of the way, accused of being a monster, a racist, a dude working in the wrong field. I am working in the right field for this stage in my life, for who I am as a person and the fact I have the integrity and stubborn mule-ishness to stand up for the good ol black and white. Learning to slowly accommodate for some of the grays, too.<br /><br />So far, all my patients have been intubated and either comatose or completely sedated. Frankly, I prefer my patients sedated. At this stage in my level of expertise, I need them to be quiet so I can focus on getting organized and delivering pharmaceuticals in a safe and effective manner as well as the stack of paperworks the depth of the 9/11 commission report on a nightly basis.<br />On my first clinical night, I might as well call it "Krystal Nacht" from here on out for the brutality of it. The poor tiny 100 lb female Nepalese nurse across the way from me had a 4 BILL (that's a 400 pounder) RETARDED HUNGRY AS FUCK MASTURBATING BEAR NPO of a patient. The kid was S/P left AKA with the biggest, nastiest dehiscence I've ever fucking seen. As far as I could tell that amputation had never even been sutured together. It had that bright red meat grinder look to it. And you know how scared, mentally retarded compulsively masturbating opiate resistant patients are when they are confined to a bed and are missing a limb that they were partial to. Fuckin' crazy.<br />I felt bad for her, the nurse. She kept screaming, "Stop touchin' your stoof" in a cute accent. At first it was funy. But then he would scream so wretched a response in gutteral grunt language, desperate. Communication was completely impossible. I was kind of cracking up at first, listening to the nurse telling him over and over, knowing his behavior was a matter of self preservation and not anything that could be reasoned with.<br />And then I saw Baby Huey WAS frantically touching his stuff and it was just sad. I mean it was like a statement about man. When man is confined, lonely, missing his Mom who feeds him multiple chickens daily, when man gets down to it, he beats off his Foley'd tiny penis, buried somewhere in the mounds and mounds of flesh with a brutal vigor.<br />Finally, after a shitload of fentanyl, ativan, and fucking haldol the attending decided it was time to put in a central line via his left subclavian. The poor giant retarded kid. The attending turned the patient into a goddamn pin cushion and he must've hit the clavicle on one of his stabbing expeditions because at one point because he withdrew the needle (I swear to god it had to be a 16 guage) and it was completely bent in the middle. So then the attending chuckled in the same way one chuckles when accidentally throwing a gutterball at the bowling alley, I grabbed another triple lumen kit and he started over, gunning for the left femoral. And the attending made it. That's right, he put a delicate, highly invasive line INTO THE KID'S RANK CROTCH. Perhaps the attending is used to lots of male masturbation. One word comes to mind with this type of line placement with this type of patient: Inevitable.<br />An hour later the masturbating bear, in a furious attempt to satisfy his ungodly minotaur urges ripped of the soft restraints, yanked out the femoral line and furiously stroked himself into a brief five minute slumber. The interesting thing about this was that he didn't bleed. The mounds and mounds of fat applied pressure to the torn sutures and open vessels. Lord knows what was now floating around in the kids blood stream but at least it wasn't a <span>bloody mess</span><span style="font-style: italic;">.</span><br /><br />Then it was time to pack up, monitors, ACLS drug pack, more R.N.'s and off to CT to figure out why this retarded kid had been acting retarded. You read me right. Head Ct time. One of the residents decided that this kid's behavior <span style="font-style: italic;">was unusual</span>. <span style="font-style: italic;">His mother said he doesn't act this way at home when he gets hamburger helper intravenously. </span>So naturally the first thing that comes to everyone's mind is: "Yeah, lets take this completely fucked up man/child down into the basement for a CT scan where he could hurt himself/or any number of staff members on the trip down to see if his brain is bleeding. There is no reason why his brain would be bleeding but he is screaming very loudly." Never mind the fact his former left knee looks like a raw, marinated porterhouse steak. That's secondary to whatever else they can bill somebody for.<br />I mean, there's no way the isolation, the drugs, the no mama to grossly over feed him, the missing limb and loss of ability to walk, the tube in his penis might have anything to do with his bizarre behavior. The resident thought it might be a brain bleed because he had fallen two weeks ago after surgery trying to get up at night. This is the same resident who was the first to bail when it came time to get Gigantor downstairs to CT.<br />I made him stay. I don't care if I'm a new grad or not. I don't care if he found it aggressive or pushy or rude. His little pager went off, the resident attempted a lame performance of having to run so I blocked his exit. I stood right in front of him and I said, "You ordered the CT. You will help us get him down to CT and make sure he doesn't get hurt on the way. You push from the head, I'll guide the front." And he obeyed. Easily, just like all doctor's do when you are assertive and don't apologize all over yourself like a fucking ninny.<br />Once we got him in front of the CT suite we couldn't fit him in because the bed didn't fit through the doors. Ultimately, this patient and the word "suite " should never be used in the same sentence. The effects were exhausting. (What's the deal with hospital's building doorways that beds and people can't fit through, is this just me or do you know what I'm talking about?) This kid was in the biggest Hill/ROM ortho giant bed they make, with big steel bars forming a rectangle on top, for a pull up triangle. We pushed, we pulled, we kicked. Couldn't get the fucker through the doorway. Looking back, I don't even know how we got the bed in the elevator. Tran, the CT tech got so pissed off he kicked on metal frame that was above the bed, above my 6"1 head as hard as he could, a beautiful crescent kick, reminiscent of something Bruce Lee may have done except that Tran was Vietnamese. The metal frame shot out of its damning socket and freed itself of the main bed frame. And in we went to take an expensive pointless picture.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsrL_DaJKz5tLZ5Sqydhsx_Stigxshn-yxMLMjmxpbcjNf94ckiY7oHHV2ZqZ9T7h9gjU_u8h6WDbkuOZxM2Vfay0xoNzGCsd1kE7S1abm0lT2zkDPcxdfjRtfo5bhUQPi6O9topqU1g/s1600-h/hard+labor.jpeg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 177px; height: 145px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsrL_DaJKz5tLZ5Sqydhsx_Stigxshn-yxMLMjmxpbcjNf94ckiY7oHHV2ZqZ9T7h9gjU_u8h6WDbkuOZxM2Vfay0xoNzGCsd1kE7S1abm0lT2zkDPcxdfjRtfo5bhUQPi6O9topqU1g/s400/hard+labor.jpeg" alt="" id="BLOGGER_PHOTO_ID_5244838570079710834" border="0" /></a><br /><br />Once we got the kid onto the table I went to the linen cabinet to get a new sheet and when I turned back around the resident had split but that was fine. Because there was no way this dude was going to stop beating off for the CT to work anyway with sedating him to a goddamn inch of his life and maybe then young Master Resident would understand the comedy of futile useless back breaking labor. Nurse Nepalese nailed the Big Kid with another round of Haldol. And if Nepalese Nurse played her cards right, and filled the incident report out properly, Young Master Resident might have to answer for the destruction of his Master's handiwork. (central line). Post Haldol blow dart, he stopped jacking off for like, 15 seconds. Just enough time for a brand new 64 slice Catholic CT scanner to do its thing.<br />We got the kid upstairs, two tiny female nurses, and me: appallingly out of shape male nurse (me) grunted gutterally ourselves, sweating, earning our bucks. What other job do you need to know the intricacies of the science behind the machine that works you to the bone and only get credit for this boggling dichotomy in your head? Sweet nursing.<br /><br />It feels great to be back in the game everybody. I had a good, soulful time getting the kid to CT. To me it was funny and bizarre, and one of those situations where I'm just like, "what the fuck am I doing here at 3 A.M.?" Making money. Practicing my knowledge of how things work, inside and out. Applying past experiences of knowing how and what medically related people are thinking, mostly either 1) how my co-workers can avoid breaking their backs and 2)how patients can get a sense of how suddenly any sense of control has left their lives.<br />And looking forward to learning so much more.<br />I left at 7 in the AM, utterly exhausted, kind of pissed, kind of euphoric. Critical care nursing is going to be great once I figure out what the hell I'm doing.<br />Oh, babies, I am home.<br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com2tag:blogger.com,1999:blog-25238467793409480.post-4689884906713461882008-08-31T13:08:00.000-07:002008-09-01T11:31:38.940-07:00Meet me in the Morning<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEin-I5w1jdybZbVO0v9cAraj10veMLZR5DCEMORyzwt3M9CP_Q-Bdv1cULVNy94XWZrIxlE5OQZsu0M-dX3FQN0u5ykYlkghl5mXP80qAbFu6NcrJucoeXdNGtArjr5AJZx5xq4L3Ta3A/s1600-h/osiris.jpeg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 122px; height: 159px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEin-I5w1jdybZbVO0v9cAraj10veMLZR5DCEMORyzwt3M9CP_Q-Bdv1cULVNy94XWZrIxlE5OQZsu0M-dX3FQN0u5ykYlkghl5mXP80qAbFu6NcrJucoeXdNGtArjr5AJZx5xq4L3Ta3A/s400/osiris.jpeg" alt="" id="BLOGGER_PHOTO_ID_5241122164570303506" border="0" /></a><br /><br /><script type="text/javascript"><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script><span style="font-size:100%;"><span style="font-family:times new roman;"> Made my employment decision. Didn't choose to work at "Your Jew Masters of Beverly Hills Hospital, yeah That's Right We Are Shitting Money". The pay and environment was better at Catholic Mother of the mountains of the everlasting Guadalupe ripe milky breast of the heavenly <span class="blsp-spelling-error" id="SPELLING_ERROR_0">del</span> taco. <span class="blsp-spelling-corrected" id="SPELLING_ERROR_1">Surprisingly</span>.</span> <span style="font-family:times new roman;">Finished orientation. Orientated. And confused. Said, "Okay. I get it. Gotcha. Right." Maybe 50 times. So much critical info.<br />Didn't comprehend the sheer volume of paperwork associated with an ICU unit. Sadly noted that many of my stack of obligatory paperwork filings is to verify that a MD has done their job and filled out their necessary paperwork. Yes that's right. A good 25%, one full quarter, roughly 13 pages of the easily 50 pieces of paper I am expected to completely fill out on a daily basis pertain to me verifying if a doctor has written med orders, bothered to fill out informed consent for emergency procedures, asked about advanced directives, parameters for sedation vacation, instituted any sort of pain management protocols whatsoever, whether or not restraint guidelines have been ordered and a fucking shit load of paperwork regarding abnormal lab values and <span class="blsp-spelling-error" id="SPELLING_ERROR_2">hemodynamic</span> parameters. There is even an informed consent for anesthesia that I, as R.N., am supposed to fill out. Say what? I guess I am an uppity, arrogant new graduate but what business is it of mine to fill out any paperwork for anesthesia? How the fuck am I educated enough to evaluate whether or not a non-<span class="blsp-spelling-error" id="SPELLING_ERROR_3">english</span> speaking patient knows the inherent risks of general anesthesia? It scares me. The physiological responsibility is overwhelming, but the legal/administrative <span class="blsp-spelling-corrected" id="SPELLING_ERROR_4">responsibilities</span> are <span class="blsp-spelling-error" id="SPELLING_ERROR_5">mind boggling</span> as well.</span><span style="font-weight: bold;font-family:times new roman;" ><span style="font-weight: bold;"><span style="font-weight: bold;"><span style="font-weight: bold;"></span></span></span><br />Do you get it yet you pansy <span class="blsp-spelling-error" id="SPELLING_ERROR_6">MD's</span> reading this out there? Do you understand that it pisses me off that it's considered part of my job description is to wipe your ass for you? </span><span style="font-family:times new roman;">and that if the day to day actual maintenance of the patient is not maintained perfectly I have been advised by my manager that you will then "yell" at me? (yeah right, I dare an MD to bellow at me in any situation other than a code. Bring that shit on.)</span> <span style="font-family:times new roman;">I just want to be left alone with a patient and their difficult family members. I want to manage a sick person's health, I want to be a conduit for their families anger and sadness and futility but I don't want to be a secretary for a bunch of socially retarded <span class="blsp-spelling-error" id="SPELLING_ERROR_7">prima donna's</span> that are so smart they can't even DO THEIR OWN JOB. HOW THE FUCK IS IT MY JOB TO MAKE SURE THEY DO THEIRS, AND IF THEY DON'T, THEN I AM TO BE HELD RESPONSIBLE FOR THEIR FAILINGS?<br /></span></span><span style=";font-family:lucida grande;font-size:100%;" ><br />But wait alright, I'll be cool, zen ponies, zen ponies- every nurse out there has to do this too, right? I am just experiencing some sticker shock- a newbies surprise at how things really are, how many things there really are- alright everybody. I'll be cool. And I will maintain my "stay <span class="blsp-spelling-error" id="SPELLING_ERROR_8">shutup</span>" policy and do my job. And do it well. Nothing to be angry about. I have a family. They need me more than my selfish anger does. </span> <span style="font-size:100%;"><span style="font-family:times new roman;"></span><span style="font-family:times new roman;">My first clinical is on Tuesday. </span> <span style="font-family:times new roman;">Thank god I'm going to nights. No other place for this currently angry, antisocial motherfucker. Formerly. <span class="blsp-spelling-error" id="SPELLING_ERROR_9">Heh</span>. <span class="blsp-spelling-error" id="SPELLING_ERROR_10">heh</span>.</span> <span style="font-family:times new roman;">What happened to my zen waterfall with unicorns and pixies and shit? Don't worry friends. It is still there. Every job, every gig, every aspect has its problems. I've got to roll with it. Nursing isn't about bliss. Its about skills, <span class="blsp-spelling-error" id="SPELLING_ERROR_11">ballz</span>, ovaries, and common sense, and <span class="blsp-spelling-corrected" id="SPELLING_ERROR_12">organization</span>. Things are well. I'm employed. I'm learning the ins and outs of a trade.<br /><br />Things are well!!</span></span><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com1tag:blogger.com,1999:blog-25238467793409480.post-80971139550327750522008-08-03T16:05:00.000-07:002008-08-03T17:22:38.303-07:00Everyday People<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqEW8c227sE3aFlLu0lIB2UIAa1dJtEV2TyJhnL4ofbaul6TVvHDfuJRWzoovQ0G5NhebRjvN1RK73Kv-Qyodw6bN-XPRa54gM3JXekLjf8YQpUqF6ANgqKn0x36ZliunLTh1ZviIHWQ/s1600-h/fiddlerontheJEW.jpeg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 178px; height: 147px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqEW8c227sE3aFlLu0lIB2UIAa1dJtEV2TyJhnL4ofbaul6TVvHDfuJRWzoovQ0G5NhebRjvN1RK73Kv-Qyodw6bN-XPRa54gM3JXekLjf8YQpUqF6ANgqKn0x36ZliunLTh1ZviIHWQ/s400/fiddlerontheJEW.jpeg" alt="" id="BLOGGER_PHOTO_ID_5230441960895489522" border="0" /></a><br /><script type="text/javascript">ddddddd<span style="color: rgb(51, 0, 51);">dddd</span><br />var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");<br />document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));<br /></script>Alright. So I gots a license. I gots my ACLS. Now all I need is a fucking job.<br /><br />Gave my heart and soul to the county. Did two internships. Licked the festering bung of the endless stream of managers, assistant managers, nurse educators for the SICU at the the hospital I wanted to get hired in as a new grad. Hard to do but I'm psychotic. Had 3 fucking interviews that were like totally Japanese. It consisted of the unit managers screaming at me: "You are shit! You think you know so much but you know nothing! You pissant. It will be a year before anyone will trust you by yourself for ten minutes. Tell us how you are similar to poop. Tell us! List, starting from the most similar way, to the least similar way, the ten ways your very existence as a nurse is similar to a meaty turd. Begin!"<br />So I get hired. After I tell them what a piece of shit I am and how I will become maybe, a squirt of piss if I follow their SICU tutelage. The following Monday the head manager quits, a new interim manager is named. I calls the new manager, I think she said, "County wide hiring freeze and besides you are 4th in line. Get another job." Click. Fucking click. Or should I say fucking clique. Not a word of thanks, apology, let alone acknowledgement for the internships and multitude of interviews. Anyway I think that's what she said but my Tagalog kind of sucks. I'm sure she has like six cousins and a husband who want the sweet position. So I calls downtown.<br />"Oh no baby, it's not a hiring freeze. It's a <span style="font-style: italic;">hiring hol</span><span style="font-style: italic;">d.</span> Just wait until October and then we can process your paperwork."Just a typical LA County, "I hate my job I'm just here to retire before we find this bitch floating dead, tits up. Go fuck yourself, na-ah, don't you talk to me like a human being, na-ah" attitude. They don't even say "<span style="font-style: italic;">please go fuck yourself."<br /></span>Oh, okay! Great! I'll sit on my duff for 3 months while Schwarzabastard and the stooges from the now totally defunct "Killer King" fuck around. Why pay rent when you can get evicted?<br />Fuck me? <span style="font-weight: bold;">Fuck you.</span><br /><br /><br />So you know what I says friends? Fuck county. 7 days later I got hired at a Catholic private. Even before the interview I knew I was home. Just like county, patient wise. I loved the lobby: Dead bloody Jesus statues on every wall, at eye level. Dude, they nailed that fucker through his hands AND his feet, crazy. Maybe that crazy bastard really did die for me cuz it looked like that shit hurt- and crackheads everywhere. It was like a mid 80's Cure video. I immediately thought to myself while I waited in the lobby for the ICU manager to come down, "Yes. Just like county. These are my people. Broke, dangerous, desperate, grateful, entitled, high, low, furious."<br />They check you out but they don't judge because they are in no place to judge. and neither am I.<br />I immediately accepted a position as a new grad in their completely dilapidated, fully understaffed ICU (no Na's, clerks, RT's, or EKG techs). One commode in the whole unit. ICU designed by Stevie wonder. The manager was like, "I gotta tell you, the nurses up here are a little tired of new grads right now. But do what you're told and lay low and hopefully you'll make it." Fair warning. I appreciate that. Bathing in toxicity. Wouldn't expect anything less nor do I want it.<br />I accepted the position with a non-contract 5K sign on bonus for working nights for a year, and then, the next day, a recruiter for the most prestigious LA private (Hint:they give the babies of celebrities shitloads of heparin) called. When I told him I had accepted a position at St. Mother of Dead Holy Jesus Mountains of the Tired Goat Naked Guadalupe in the Rivers of Nacho Bel Grande he started foaming at the mouth and wanted to talk money right then. Jews. My people. So I hustled him back and tomorrow I gots me an interview with the much coveted hereby named: "Your Jew Masters of Beverly Hills Hospital, yeah That's Right We Are Shitting Money" SICU manager tomorrow. *<br />La' Chiem!<br /><br />The HR building I'm going to tomorrow is named after a very famous director. He's made movies about a sex addict archaeologist, an extra terrestrial that likes little boys, dinosaurs that eat Jeff Goldblume. It's literally called the Steven S------- Human Resource building. Gimme some of that private health care baby, let me see what you taste like.<br /><br />Poor people, my people. Scandalous people, my people. The other clique, on the west side, my people (I guess). I'm not looking for the perfect place. I'm looking for the place where the waterfall beats down evenly with its harsh cold stomp onto the nape of my neck and I cease to exist.<br /><br />Bring it!!!<br />* As a Jew, and a poor working class one at that, I reserve to mock the gaudiness of my own culture<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgRIHSKlfJBASXrlAr8QbR3esyJyWyoVcZgb1nfRpFnVSg-LYrCBLyTtRw_gTj1iHnyD28-cnL5rFzNlbS3kg6ttENjN3VymJVxYCpGCpdaTdBFo8i2aCPGMSK0tdQpRia45Qa5tyDAA/s1600-h/fiddler2.jpeg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 212px; height: 105px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgRIHSKlfJBASXrlAr8QbR3esyJyWyoVcZgb1nfRpFnVSg-LYrCBLyTtRw_gTj1iHnyD28-cnL5rFzNlbS3kg6ttENjN3VymJVxYCpGCpdaTdBFo8i2aCPGMSK0tdQpRia45Qa5tyDAA/s400/fiddler2.jpeg" alt="" id="BLOGGER_PHOTO_ID_5230443838609728738" border="0" /></a><br /><br /><script type="text/javascript"><br />var pageTracker = _gat._getTracker("UA-xxxxxx-x");<br />pageTracker._initData();<br />pageTracker._trackPageview();<br /></script>LicensedToILLhttp://www.blogger.com/profile/12074573944211265049noreply@blogger.com1