Nurse Ratched’s Place

This is Buffy from the 1960s television show, Family Affair. Isn’t she cute? Uncle Bill is sick, and she’s stepping up to the plate as the family caregiver. I bet she gives really good injections to her dolls, too. Do you remember playing nurse when you were growing up? I played with some really cool nursing kits, but I never had a cap. I wonder if Buffy’s kit is an exclusive from FAO Schwarz. This week I’m saluting the children who always said, “When I grow up, I’m going to be a nurse.” Where would we be without these kids? So sit back and relax while you enjoy some of the best posts from the nursing blogosphere at this week’s edition of CoS.

Now this little lady looks like she means business. She has her hand on her hip, so everyone better watch out. I can only imagine what she would have said about stupid hospital policies regarding medication reconciliation sheets. ERnursey from ERnursey – An Emergency Room Nurse Blog has plenty to say about the subject. Needless to say, she isn’t happy. Read her rant.

Nurses are sick and tired of a lot of other things, too. Smalltown RN from A Place I Call Home writes about working another very LONG shift. Her post answers the question, “Why are nurses leaving the profession?”

FetchingGal from Lemon Tree Forest hates her working conditions at work. Read her post to find out why she can’t take it anymore.

5 Wester from 5 West Nursing loves a bargain, but not at the cost of safety. Read how cutting corners puts nurses at risk.

Look at the smile on that little girl’s face. I wonder how she talked her younger brother into wearing a dress. Or maybe he’s wearing shorts and a white lab coat. Give the lad credit for playing nurse with his big sister. He’s one cool little dude. Max E Nurse grew up to be a nurse, and he writes about staying cool and calm during an emergency. Read his post about keeping cool when all you really want to do is freakout.

DisappearingJohn RN is another little boy who grew up to become a nurse. He’s feeling a little guilty right now. Read his post and learn about the downside of receiving a pay raise at work.

This little girl’s body language is saying, “I really love wearing my nursing uniform. I think I look cute in my cap.” An individual’s body language can speak volumes, and Terry from Counting Sheep describes the subtle messages that are communicated in the Operating Room.

This little girl looks so sweet and kind. I hope she was able to handle the stress of being a caregiver. Nocturnal RN from A Float RN writes an emotional story about a very bad code, and it’s aftermath. This type of experience can cause burnout. Hueina Su from Intensive Care for the Nurturer’s Soul writes about the stress of being a caregiver, and how to avoid Nurturing Burnout.

This future ER nurse is caring for a patient that has a leg injury. She is delivering impeccable nursing care. ER nurses deliver care to patients with every illness and injury known to mankind, and they frequently deliver that care under combat conditions. Erica from Blissful Entropy writes about what it’s like to take care of someone that you love while you are working in the emergency room.

ER nurses wish that their patients would take better care of themselves so that they wouldn’t have to come to the ER in the first place. GuitarGirlRN from Adventures of GuitarGirl RN believes in the power of patient education and preventative care, and she tells patients what to do, and what not to do, when they come to the big city.

Kim from Emergiblog gives readers an insider’s look at what it is like to work in an emergency room. Her pictorial essay is very entertaining, and complies with all HIPAA regulations. You’ll see what I mean when you check out her post.

This is a group of future pediatric nurses taking care of their patients. Their nursing kits are full of the latest equipment, and they look very professional as they wear their nursing caps and their saddle shoes. These nurses conduct themselves appropriately because their parents will not tolerate unacceptable behavior. They say please and thank you, and they don’t act like brats when their parents take them to the hospital for medical care. Miss-elaine-ious from The Life and Times of a Longterm Student writes about whimpy parents who let their kids get away with bad behavior. She says that lack of parenting is effecting the treatment children receive when they come to the hospital for care. And speaking of pediatric patients, FitBuff sends in this post about lead poisoning. We’re hearing stories of excessive lead in everything from toys to lipstick these days, but very few people understand the risks and symptoms associated with overexposure. There has never been a better time to be able to recognize lead poisoning symptoms.

This Florence Nightingale in training looks like she is only two or three years old. I bet there were nurses in her family, and that they were hoping that she would follow in their footsteps. Why else would you dress up a toddler as a nurse? Entering the the nursing profession is a tradition in many families, and people who come from that tradition understand the sacrifices that they must make in order to get one of their own through nursing school. It can be a stressful time for everyone, including the family pets. Caroline from Brain Scramble talks about how her time in nursing school is affecting a four legged member of her family. There is a website that will help ease the stress of nursing school. Jimmy Atkinson presents The Ultimate Guide to the NCLEX Exam posted at Nursing Online Education Database.

According to the information provided on the back of this picture, this photograph was taken around 1918, during the time of the Spanish flu outbreak. Pandemics are very scary. Beth from PixelRN is rolling up her sleeves and is giving flu shots to her coworkers. She’s asking that we roll up our sleeves, too.

I wonder how many of these kids actually became nurses. This picture is from 1918, and these kids are all junior members of the International Red Cross. I bet a lot of them went into nursing. They look very serious about what they are doing. The gang and I want to thank you for stopping by CoS. Kim from Emergiblog is serving as the host of the next Change of Shift on November 15th. Don’t be shy. Start working on your submission, and I’ll see you at the next Change of Shift.

Remind me not to schedule elective surgery on Halloween. Meet Dr. Chain Saw. I believe Dr. Saw attended the University of Transylvania. He planned to specialize is hematology, but his professor, Dr. Dracula, was a night owl, and Dr. Saw did not want to attend night classes. I use to have a lot of fun working at the hospital during Halloween. A hospital that I use to work at let us wear costumes until a patient freaked out. The man coded, and the first thing that he saw when he came back was a respiratory therapist dressed up as the devil. The whole experience was very unpleasant. Too bad he didn’t notice the nurse who came to work dressed up as Florence Nightingale. It would have worked out better for all of us.

Dr. Saw’s associates, Dr. Dedwin and Nurse Necro, want to wish you all a Happy Halloween.

Please indulge me today; it’s been a rough week. This is a picture of my dog, Diva. She’s my angel and my little girl. My husband and I rescued her about 8 years ago. Diva had been abused in a puppy mill. We spoiled her rotten. She traveled everywhere with us, and she was the star of the show. She was always full of energy, but last month something changed. Diva started slowing down, so I took her to the vet. She was diagnosed with congestive heart failure. We’ve been giving her Lasix and other medications, but today it was clear that she was suffering. She was struggling to breathe and she was in pain, so I had her euthanized. According to Wikipedia, the term euthanasia come from the Greek words “eu” and “thanatos” which combined means “good death.” I looked into her eyes as she took her last breath. Indeed, it was a good death. I’ve seen a lot of death throughout my years as a nurse. I wish that all of my patients could have died so peacefully.

My husband and I are crazy animal people. We also have two other dogs, two cats, and we are on a first name bases with all of the employees at our local PetSmart. I’m sure that another little angel will find their way into our home, but not today. I’ll spend today remembering Diva.

This record cover takes me back to my youth. I first saw the Beatles on the Ed Sullivan Show when I was eight years old. I thought they were dreamy. My father thought they were the most ridiculous act that he had ever seen on television. He hated them, and he kept griping about their long hair. He said that they needed a (expletive) haircut. I adored their cute moppy hair, and their cool British accent. My poor parents went insane shortly after they bought me a record player for my birthday. I kept playing Beatle records over and over again until the records wore out. The song, “I Want to Hold Your Hand,” entranced me. I knew every word in every verse, and I even heard the song in my sleep. That song still comes to mind every time I have to tell patients that they can’t touch each other while they are residing on the psychiatric unit.

I know that you are wondering why patients can’t touch each other on a psychiatric unit. After all, look at John and Paul. They are in each other’s personal space. It’s no big deal, right? It can be a really big deal if you’re touching someone who is paranoid. They may think that you are trying to hurt them. I’ve seen a lot of paranoid patients become violent because they think that they are being attacked. And then there is the issue of abuse. Many patients have been physically and sexually abused in the past, and they really don’t want to be hugged by someone that they have just met. They have boundary issues, and it might be hard for them to tell you that they don’t like to be touched. And let’s not forget about unit romances. I occasionally see patients engaged in a major lip-lock, or trying to slip off into each other’s rooms. The nursing staff never tolerates this. You are on the unit to work on your issues, not to find a date. I remember watching two teenagers who were planning to have sex on the unit. My colleagues and I enjoyed watching their mating dance. It was entertaining. Then the girl made a big announcement at the nurses station that she was going to go take a shower, and that she didn’t want to be disturbed. We watched the boy sneak down the hallway into the girl’s room, and we counted to three before swinging the door open to the girl’s bathroom. BUSTED!!!!!!!

Take John and Yoko’s advice: Don’t hold hands on a psychiatric unit, and give peace a chance.

Isn’t that sweet? The patient is showing his gratitude for all of the great care that he received while staying at the hospital. In fact, I think that he has fallen head-over-heels in love with his pretty nurse. It’s not surprising. Nurses care about people, and we are patient advocates. When I was a medical-surgical nurse, I remember finding oodles of candy boxes and bouquets of flowers everyday at the nurses station. People showered the nurses on my unit with gifts as their way of saying thank you.

Things really changed when I became a psychiatric nurse. It’s rare when psychiatric patients give candy and flowers to nurses. I’m not saying that we never get goodies from our patients, but psychiatric patients have unique reasons for not giving goodies to their nurses. Paranoid patients are not going to give gifts to nurses who can read their mind and who are trying to kill them with medications. We understand that, and we accept the logic of the situation. We also accept that we aren’t going to get candy and flowers from patients who display inappropriate behavior on the unit. Psychiatric nurses have no problem laying down the law when someone is being a jerk. This makes us unpopular with drug seekers and individuals who are using the hospital as a hideout from the police. And then there is the issue of money. Most of our patients are broke. Many of our patients can’t afford food or decent housing, so we certainly don’t want them spending their money on us.

The nicest gifts that psychiatric nurses receive are homemade thank you cards. Our patients make them for us in art therapy, or when they are watching TV in the dayroom. We really enjoy these mementos. We hang the cards up in the nurses lounge, and in our report room. We keep them up on the walls long after our patients are discharged because they keep us going when we are ready to throw in the towel and quit nursing.

Thank you everyone, and please keep those cards and letters coming.

Heads up everyone, Kim from Emergiblog has just posted the latest edition of Change of Shift. The nursing blogosphere is full of great writers, so go check it out. Then dust off you typewriters and start working on your submission for the next Change of Shift. I’m serving as host, and I want to hear from YOU! Please send your posts to nurseratchedsplace@yahoo.com. The deadline for submissions is October 31st at 8 a.m. EST.

Please standby for a commercial message from Scrubs Gallery, a proud sponsor of Nurse Ratched’s Place. Scrubs Gallery is providing nurses with a great shopping experience, and they invite you to visit their new and improved website. Their remodeled website is easy to navigate, and it’s full of great looking merchandise. It’s too bad that psychiatric nurses don’t wear uniforms to work. I look good in scrubs. Bummer!

We now return to our regularly scheduled programming that is already in progress.

Doesn’t he know that it is impolite to point? I guess he forgot because he is excited about this week’s edition of Grand Rounds. Go check it out at NY Emergency Medicine.

I picked this book up last week at a church thrift store. The book is about a girl named Emma. She’s the girl on the cover. Emma is a caregiver. She is making sacrifices in order to care for a loved one, and unfortunately, she isn’t getting a lot of support.

“Emma had given up her job in London to return home to look after her father, but that annoying Corby Kempson declared that she was wasting her time. But what did he know about it? And what business was it of his anyway?”

Since when did taking care of a loved one become a waste of time? Some people can be so insensitive to the needs of others. Life can get overwhelming for caregivers. Speaking from experience, I know that caregivers need a community in which they can find information and support.

Three years ago I was anxiously sipping on my Diet Coke when my husband’s physician walked into his office and sat down behind his desk. My mouth was dry and my hands were trembling. Something was wrong. As a nurse, I knew that doctors don’t like giving bad news over the phone, and he had insisted that we come to his office so we could talk. The doctor had a hard time looking directly at us as he talked about my husband’s skewed lab tests, and abnormal EKGs. I didn’t know what he was trying to say because everything he said sounded vague and unreal. Then reality hit. The doctor informed us that my husband only had a few more months to live and he said we needed to get our affairs in order.

Nurses care for patients and their family members, and we are expected to be a tower of strength when our patient’s life is falling apart. Now my husband was the patient, and I quickly went into nurse mode after learning about his declining medical condition. I decided that I was going to take charge of everything. I thought that I was invincible. I was trained to know what to do in a crisis, and I was determined to play the role of the stoic wife and nurse. Of course, that isn’t how things worked out. I crumbled and started crying hysterically when one of my friends hugged me and offered me his condolences. My mind shut down, and I felt the energy draining out of my body. I struggled to care for my husband while working a full time job. Fortunately, I had a support system that included many educated and compassionate people, many of whom were nurses. A nurse practitioner gave me words of advice that literally saved my husband’s life. She told us to seek a second opinion about my husband’s medical condition. It sounds so simple now, but I never thought about getting a second opinion back then because I was so overwhelmed. I was lucky. Not every caregiver has a good support system in their time of need.

Caregivers can now tap into a new virtual community for help and support. Strength for Caring, created by Johnson & Johnson, is an online resource for family caregivers. The website is user friendly, and it gives caregivers the opportunity to seek help and share information with others through the use of message boards. Caregivers can also browse featured articles, as well as links to other websites that meet their specific needs. I encourage patients, caregivers, and health care providers to visit this valuable site. And please remember, caregivers need your support.

Now that I’m done hosting Grand Rounds, I have time to start looking again for the perfect job. I’m heartbroken because the man of my dreams, Steven Jobs, never contacted me about a job, or my new iPhone. By the way, Steven, the offer is still on the table, so call me.

This is a job that I could really get into, just as long as I’m not required to get into that dress. There isn’t enough wiggle room in a wiggle dress for my expanding waistline and hips. Nurse Vonnie looks very confident as she walks along the seashore. Maybe she is wearing a coat on the beach because she left her sunscreen at home. I’m not sure that I could ever get use to wearing a cap and high heels during my strolls along the beach. It might get a little rugged on a windy day, and I hate the feeling of sand inside of my high heel shoes. This job looks like it was made in heaven. The sand, surf, and pink flamingos look so inviting, but looks can be deceiving. Vonnie’s heart is troubled as her wedding day approaches:

“Vonnie tried to respond to Tim’s tender kiss, but in her lover’s embrace the unhappy nurse heard the voice and saw the face of another man. It was then that Vonnie realized that she was hopelessly in love with Dr. Paul Greer, and she knew that it could mean nothing but heartbreak. Because Dr. Greer was engaged to marry the woman who was Vonnie’s patient, a maddened alcoholic, driven to dangerous rages in her need for drink. For the first time in her career, the beautiful RN was torn between her professional duty and her own desperate emotions.”

Poor Vonnie, it must be tough being in love with someone when you are betrothed to someone else. Personally, I think Vonnie is better off without Dr. Greer. He sounds like he has some major codependency issues, and I think that Vonnie would be happier living with a man who doesn’t have emotional baggage. Dr. Greer needs to attend some Alonon meetings, and I hope that he dumps his raging alcoholic girlfriend. She is only going to bring him down. Someday Dr. Greer will thank me for my advice.

Vonnie, call me if you quit your job after you get married. I’m a great psychiatric nurse, and I am willing to relocate to Waikiki. I can get use to living in paradise.