Meet Nurse Prudence Perfect. She is the unit’s refrigerator nurse. It’s her job to make sure that everything is perfect and meets Joint Commission standards because you never know when the old JC will drop by for an unannounced visit. Insulin vials labeled and dated? Check. Refrigerator thermometer easily accessible and log up to date? Check. Hey, who put their lunch in here? There is to be no food in medication refrigerator! Prudence is gearing up. Stand by for one of her Joint Commission inservices.

For you nursing history buffs, the term “refrigerator nurse” goes way back to a time when Prudence was a graduate nurse. The term was coined back when it only took one paycheck to support a family, and when nurses, typically women, quit working once they got married. A nurse who went back to work after she was married in order to buy luxury items for her family, such as a refrigerator, was known as a refrigerator nurse. Some have suggested that these nurses were less dedicated to their patients and to the nursing profession, but this is simply not true. It was a different time back then. Women who went back to work after they got married broke with convention. They were rebels and some of the best nurses I’ve known.

This week, I also became a refrigerator nurse, but not in the classic sense. My refrigerator gave out after 13 years of service, so I selected a new model from Lowes and had it delivered to my home. Lowes uses a company called Big E Transportation to make its home deliveries. The delivery guys were sweethearts, but they looked wiped out. I could tell that one of the guys was suffering from back pain because he walked with a stiff gait, and the other guy looked like he was ready to keel over. It was hot outside so I invited them to take a break and I offered them a cool drink. As we sat together at the kitchen table, I asked them when they were going to get their next day off. They looked at each other and hesitated, then one said to the other, “Should I tell her, or should you?” The guys told me that they work seven days a week, 12 to 14 hours a day, and that they don’t get paid by the hour. They get paid by the day. I did the math and it comes out to less than minimum wage. I also found out that the guy with the bad back never saw a doctor because he doesn’t have health insurance. I asked him what he was taking for pain and he pulled out a couple of different bottles of pain pills that he had picked up from friends and relatives. He was taking a potentially hazardous combination of pills. I quickly did some patient teaching about why you can’t take other people’s medications, and then I gave him the name of doctor in town who charges patients on a sliding scale.

Shame on you Lowes and Big E Transportation for exploiting your workers and for redefining what it means to be a refrigerator nurse.