The following post may gross out some readers due to the graphic biological details. Continue reading at your own risk!
I had a nice block of time today to try to brainstorm on an idea for discussion today. So, demented as I am, I thought why not discuss what it's
really like to be in the healthcare profession.
When I was accepted into nursing school I was so excited. I couldn't wait until I could be the one standing there at the patient's bedside, cool wash cloth in hand, and imparting words of comfort. School clinicals did only a little to diminish my rosy colored outlook on my future career. When I finally received word I had passed my boards, I was elated. The topper came when I was told I was going to work in the Intensive Care Unit. This, to me, was a badge of honor. Straight from nursing school, straight into the "intense" zone!!! Yay! I so rock, look out world here I come!!
WELL, let's just say, come the end of day 6 of my orientation, I was informed I was no longer in orientation, I had to take my own load of patients with no one double checking me! I had no further preparation than nursing school and my short orientation. I was shocked! How could they turn me loose so soon? I hadn't even been to class for a code yet! That was the beginning of the end.
Every day I stressed myself out about what I was doing because I had no clue. I was working in a unit where all the nurses had the mentality of "eating their young". They would purposefully tell me wrong answers to questions I asked, they would call me at home about an antibiotic that was labeled to be given at 9pm the night before, which was still in the frig but was the exact same dose and med that was to be given at 9am, I had only hung the time label wrong everything else was correct. They wrote me up if I didn't document to suit them, if I didn't secure the endotracheal tube the way they liked, and if I didn't have everything ready for the day shift (supplies, papers, etc.). I not only stressed about my patients, but I stressed about not making any of the she-devils I worked with mad.
Somewhere around the 9th month of working, I lost my "Nurse Nightingale" attitude. I decided I was sick and tired of being trampled on. I did everything they asked, but they never returned the favour. I went beyond what I should have to make their transition to oncoming shift go smoothly, while they consistently left me in a disaster every night. To say the least, this is when "Little Miss Prissy Pants" nursie nurse showed up.
I came into shift one evening, having been assigned the most complex and demanding patients, and the other nurse was essentially only babysitting. I got report about a patient who had several blood pressure supporting drips, a ventilator, arterial line, etc. Essentially, the patient was what we not so professionally call, "circling the drain". I went in with my report sheet to check the patient's status compared to my oncoming report when I discovered none of the drips were running at the appropriate doses and the art line was lying in the bed with the patient's restraint. I was furious!!
After I made sure the bleeding was controlled, I yelled out into the unit for the nurse who was getting ready to go home. When she came to the room, she was all mad, she said, "I've had a bad day and I wanna go home." I said, "Well, I don't care. You are gonna explain why I found this arterial line in the bed and take a look at those drips; no wonder the patient isn't doing so well. You're not even running them at the dose you claim they were running at. The meds are on a minimal dose!" I guess I was pretty convincing about how I felt after enduring months of their torture and now, I had her by the "balls", so to speak. She about tripped over her own feet trying to fix the meds and clean up the mess she had left the patient in. I was so frustrated I told her to forget it; I would take care of it, just like I always do. Before she left, she had the nerve to ask me to
NOT consider writing this little incident up. I told her I didn't have time to discuss this, I had a patient to care for, and I turned my back to her.
That was the end of the torture. But they had already hardened me from their power play antics. I took every opportunity to look up information about disease processes and treatments and began to question them why these things were not being done for the patients. I turned the tables, so to speak.
I wish I could say I never had to go through another "initiation" but that would be a lie. Each time I went to a new unit or hospital it was the same, more or less. But it never takes long once they realize you can dish it right back. I decided if I ever had a student to teach, then I would never treat her the way I had been. Now that's the end of my rant; let's talk about the stuff that is TV worthy. LOL!!
Ok, there are several non glamorous aspects of being a nurse, but I will try to only select the most entertaining ones.
First of all, patients who are admitted as drug overdoses are not always the kind who you can just let them "sleep it off". I can't tell you the number of times I have had a bedpan hurled at me which contained a bunch of charcoal induced diarrhea stool. Actually, I learned how to quickly dunk, step behind a door, or essentially "play catch" when one was hurled at me. Sometimes, the patient is so out of it that he will think he's figure painting and literally smear it all over his body, the bed, and anything else in reach. Fun times.
I've had patients who have been very polite overdoses and informed me that they wouldn't bother me; they just needed to sleep.
I have encountered a patient, who needed a foley catheter inserted so that I could make her pee to help pass the medication, but she thought I was trying to be intimate with her. She kept trying to "grab my thing" to put it in the "right spot".
Another patient was wheeled into the ICU as an overdose. She was laying on the stretcher as if she was gorked out of her mind. She was limp as the ER nurse and I moved her to the bed. Once the ER nurse was gone, the patient sat up in the bed, bright eyed and bushy tailed. She told me, "Honey, I didn't overdose. I took just enough of my meds to test positive when they brought me in. I'm fine; I'm just up for a re-certification for my SSI check. Could you just bring me a pop and a sandwich? I'll eat that and then just go to sleep. I won't be any trouble. Thanks, you're a doll!"
I have encountered a patient who, God bless her heart, was one of the largest, round individuals I had ever met in my life. And she needed a foley catheter placed. Umm, yeah. I couldn't even move one of her legs by myself. I can remember calling the house supervisor and asking for help. I ended up with 2 people holding each leg, 2 people holding up her belly, while I, adorned with mask, gown, and gloves essentially went deep sea diving to place the catheter. Let's just say, the ghostbusters never saw that much slime.
Then I made the transition to the Burn ICU and that was when the real fun began. Now, I know what you all are thinking, "ew, that's gross!" Well, yes, it was, for about the first year. I think I cried more during giving wound care than the patient did.
But the Burn unit held a lot of entertaining characters. I believe the staff were some of the most unique individuals I have ever met in my life. Every one was just slightly "off-centered" when it comes to a sense of humour. At first I was offended by this, but over time, I realized, it was the way they coped with the reality of what we had to do day in and day out. One fellow loved to play music while he was getting started for the day. A lady, who I will affectionately call a Tazmanian Devil because she moved around so fast from one thing to another, was really a frustrated Broadway performer as she would spontaneously break out in song whenever the notion hit no matter we were doing or who was there. I spent 8 years with them.
Anyhoo, I eventually honed my own "quirkiness" to coping. Mostly it involved me doing scraping of the patients. I particularly loved it if the patient was on a ventilator and sedated because I would be in the room providing care for the patient and I would take up humming a little diddy. Then I would make up silly songs to sing and I would scrape and scrape. I became known as the Queen of the Norsen. I was bestowed the honor of providing extensive wound care to whoever needed it.
However, things weren't always so smooth there either. I was fresh off orientation and providing face care to a patient when his earlobe fell off. I was a little freaked out. I had no clue what the procedure was for this. Uh, do I save the earlobe or do I dispose of it in a biohazard bag? So, I made my way to the other room where my co-worker was and said, "Uh, his earlobe fell off. What should I do?" This resulted in the nurse and nurse assistant bursting out in laughter. I was embarrassed but they finally said, "Just throw it away." Well, yeah, I felt foolish, but hey, I'm not used to body parts spontaneously falling off.
We had one young fellow one was in a serious car accident who ended up as a bilateral above the knee amputee. After enduring much wound care while sedated, when he was finally off the ventilator, he was having a difficult time coping with the pain of wound care, even with pain meds. So, one day, during wound care, instead of screaming, he let out a loud "mooo". I stopped, looked at him, looked at the nurse assistant with me, and looked back at him. He started laughing and said, "I'm sick of screaming, so, I decided to moo." So, from that point on, during his wound care, we would each take turns performing various animal sounds. My speciality was a clucking chicken. I had no clue how good the imitation actually was until I came out of the patient's room and was stopped by one of the medical residents. She said, "Did you just hear a chicken clucking?", to which I replied, "Yes." Then I began to laugh. I explained the situation with the patient and she began to laugh. She said, "I wanna know, who was doing the chicken?" I looked at her and with the straightest face I could muster and I clucked. She rolled and rolled with laughter. So, then I became chicken woman.
I could go on and on with the stories but I don't think you all want to read the book it would be. So, I would like to leave you with one of my favorite stories. How I became the "Turd Wrangler". I know everyone is familiar with enemas. In the hospital, we have various types; the one I was using was called a soap suds enema professionally, but to those of us in the know, it was called a "Triple H" enema (hang it
high, make it
hot, and a
helluva lot). This poor little patient had not been successful be the traditional means of stool softening to have a bowel movement, so, I was to give a soap suds enema.
So, my lovely nurse assistant and I gathered our materials and set about preparing the patient, who was sedated and intubated (thank goodness). After clearing a few of the little brown boulders at the entrance of the exit, I lubed up the tube and began to insert it. I inserted it to the appropriate depth and released the fluid. Nothing happened. No fluid, no brown boulders, no farting. Nada. So, I adjusted the patient and attempted insertion again. This time the tube went, I released the fluid, and watched...Nothing. I looked to make sure I had opened the clamp, I gently squeezed the bag, and still nothing. So, I had to physically inspect the area.
As my lovely assistant separated the cheeks, I took a flashlight and looked. I couldn't see anything. I decided maybe I could insert the tube a little further, so, I eased the tube in. I watched and low and behold if I didn't see the tip of the tube exiting the entrance. I thought, great, the tube got bent. So, I tried to remove it by gently pulling back on the tube, but, it was stuck. The tube wouldn't move. Try as I might, the tube wasn't coming out the same way it went in. So, after consultation with my partner in crime, I decided I would try to remove it by the tip. Yeah, no, that wasn't successful either. The tube wasn't going anywhere. Now, I was really bumfuzzled. Ok, well, the only other thing, aside from informing the Doc that there is now a plastic tube lodged in my patient's rear end, was to try to remove the tubing by gently pulling on both the tubing and the tip of the tube at the same time.
I released some additional fluid to lubricate the area, then I took hold of the tubing from both sides, and gently pulled. With a little bit of effort, the tubing came out and with it revealing why it was stuck. The tube had went in, through, and exited the brown boulder. In other words, the turd had snagged my tube. Ok, so, I clean my tube, thinking that was a fluke, and now with the blocking boulder removed, things could proceed as normal. Nope, I was wrong. The same thing happened to my tube again. And again, I had to remove it using both hands. I had to repeat this procedure over and over again, hooking boulder after boulder, because the traditional method was obviously not going to work for this patient.
Like I said, thank goodness the patient was sedated, because my partner and I began to giggle. We couldn't help it. Neither of us had ever saw anything like it before. After I finally finished rounding up the boulders, we finished bathing the patient.
As I was cleaning up at the nurses station, my co-worker for the day was sitting at the desk charting, and my nursing assistant came out to the station. We looked at each other and began laughing hysterically. The other nurse looked at us, "What on earth is wrong with you all?" Together we briefly explained what had happened, giggling the entire time.
After that I left to use the bathroom and upon my return I found laying on my keyboard a face mask which had 2 eye holes cut out, and the name "Turd Wrangler" written across the top!!! I picked it up, looking at it, when all of a sudden the theme from the Lone Ranger came playing out of the CD player in the station. I lost it! The other nurse and my assistant came out of the breakroom laughing at me. They had also noted by my name in the assignment book, The Turd Wrangler. Crazy times I tell ya.
So, yes, we may present a professional front to you because that is what is expected of us by our respective professional boards, our employer, and society in general, but we really do have a sense of humor. And I have found, particularly in certain contexts, displaying a bit of appropriate jocularity when interacting with the patients establishes a sense of trust and rapport a lot faster than any of the recommended other techniques.
In the end, everyone just wants to be treated as a human being, an individual with feelings, personality, and not just a number on a graph for the hospital to get reimbursements. So, for me, my practice will not change; for better or for worse, I am who I am. I will not change my approach to providing care. I can guarantee I will get better outcomes than will ever be reflected along some sterilized evaluation tool.
Love a nurse!!!
P.S. I had to come back and tell one more story! I can't believe I left it out. There was a fellow who while in the Burn unit decided he might as well scope out the female staff. He was constantly making comments to us, hitting on us, sexual innuendos. One day I had him in the tub for wound care and the following conversation took place:
Patient: "So, are you married?"
Pippi: "Yes."
Patient: "Are you happily married?"
Pippi: "I don't think that is any of your business."
Patient: "Why won't you answer me?"
Pippi: "Why do you need to know?"
Patient: "Cuz I wanted to know if you would like to take a ride on Willie the One Eyed Wonder Snake."
I left the tub room, walked out to the nurses station, spoke to the Doc about changing up the patient's wound care, and returned. There was much splashing of water and several curse words yelled. Then I returned to the nurse's station, informed the Doc he could examine the patient now. The Doc walked in, looked at the skin floating around, mentioned that the wound looked pretty clean, and then informed the patient he could go home the next day. After the Doc and I left the tub room, the Doc asked me what the patient had done, so, I relayed all the behaviour he had displayed as well as recounted the recent conversation with me. The Doc just looked at me and said, "Remind me to never get burned."
