Nurse Ratched’s Place

Can you guess what this nurse and I have in common?

Answer: We both work in a factory, and we both frequently check our watches to see how many more hours we have to work until we can go home. The difference is that she gets two 15-minute breaks and lunch. She works in a union shop and I don’t.

I bet you have figured out that my weekend didn’t go too well. I work in a health care factory. The admissions kept rolling in, and there were hospitals from all over the state calling our unit asking if we had any open beds. Sure, we had beds, but we didn’t have enough staff to take care of the patients, so I threw down the gauntlet. I CLOSED THE UNIT FOR ADMISSIONS. Then I told administration. Sacrilege, heresy, blasphemy! When I was asked to explain myself, I said, “I am keeping the unit safe. My first priority is the safety of the patients on the unit.” Keep a mental note of these phrases and make them your mantra. Administrators have a hard time arguing with logic.

I’m sure Mr. Grinch and the administrative bean counters are going to put their heads together this week and figure out a way to make sure that we never lose money like this again. In all fairness, my boss backed me up. She sounded sad when I talked to her over the phone—I’m sure she’s catching hell about this today at work—but she backed my decision about closing the unit.

My plans for today:

Sometimes a picture is worth a thousand words.

Gentlemen, I want to share this with you because the information it contains may one day save your life. I received it in an email from my mother the other day, and I think every man should carry a copy of these instructions with him at all times. By following these directions you will survive “that time of the month.”

Buy a bottle of wine and enjoy your weekend.

Photo from Salon Magazine. AP Photo/ Vadim Ghirda.

I’m not sure what Dr. J. thought of me on the first day that we met, but I’m sure he was wondering what he had gotten himself into when he agreed to take weekend call at my hospital. He knocked on our unit’s front door, and I told him that I wouldn’t let him in unless he was bringing breakfast for the nurses. I said that all the other doctors brought us food on Saturday, and we weren’t going to make an exception for him just because he was new. He believed me, and I had to run out of the unit and catch him before he walked onto the elevator and left for the hospital cafeteria.

Dr. J. was a Navy man, and he was earning some extra money by working weekends on our unit. Ordinarily military personnel aren’t allowed to freelance, but our community desperately needs more psychiatrists, so the military allowed Dr. J. to work weekends during his time off from a local military hospital. Dr. J.’s first day on our unit didn’t go well. In fact his first day was pure hell. Dr. J. had gotten a shabby orientation to our unit, and every nasty patient in town had decided to check into the hospital. They all demanded narcotics, and they threatened violence on the unit if they didn’t get what they wanted. During his first day on the unit, Dr. J. broke up an altercation between two patients, and a food fight in our kitchen during lunch. He also helped the nurses subdue a patient who was about to throw furniture in the dayroom. I thought Dr. J. wasn’t coming back after he abruptly left our unit after working 8 hours straight without a break. The nurses had ordered Chinese takeout, and when Dr. J. finally came back to the unit after calming down, we offered him dinner. He sat and ate with us and he teased me about the eating arrangements. He said he expected dinner from the nurses every weekend and we told him what we wanted for breakfast next week. By the end of the day, we adored our new doctor, and he liked us, too. We made him promise that he wasn’t going to quit, and that he would be back the following week.

Dr. J. worked weekends with us as the war in the Iraq escalated. More young men from our area were shipping out for the Middle East every week, and we worried that Dr. J. might be next. He said that the military needed him stateside, and he promised that he wasn’t going anywhere. I think he said that because he knew that we were really scared, and that we didn’t want to see him leave. Then one weekend he announced that he had great news. He smiled broadly when he told us that he had been promoted, and as part of his new job, he had volunteered to lead a team of mental health specialists going to Iraq. He said that he was going to be stationed in the Green Zone. We were stunned. I was speechless, and we were all fighting back tears.

I asked Dr. J. for a few minutes of his time after he was done seeing his last patient for the day. I shut his office door and bluntly asked him what he was thinking when he volunteered to go to Iraq. He smiled and said that I sounded just like his mom. He explained that he needed to see the front for himself so he could better assess the needs of the troops. He also told me that the government wasn’t telling the American public about what was really happening to the troops in Iraq, and that troops were trying to commit suicide in the battlefield at an alarming rate. Dr. J. said that he and his team needed to go to Iraq so they could teach frontline medics how to handle depressed and suicidal soldiers in the field. He confessed that he didn’t really want to go, but that he felt it was his duty to go and care for the troops. He predicted that military hospitals wouldn’t be able to deal with the onslaught of soldiers returning from Iraq who would need mental health services, and that his ultimate goal is to improve the military’s mental health system. I hugged him and made him promise that he would come back home in one piece. He was deployed to Iraq the following week.

Dr. J. left a year ago and we haven’t heard from him since. He’s in my thoughts and prayers.

Will wars ever end?

I’m a big fan of Change of Shift and Grands Rounds, but did you know that there are so many other great carnivals online thanks to Blogger? I’ve enjoyed reading and submitting post to these carnivals.

Check out these carnivals:

Carnival of bloggingboomers at LifeTwo – … Midlife Improvement.

Catholic Carnival at Cause of Our Joy

Carnival of A Different Prayer at a Different Prayer

Lutheran Carnival at Living Sermons

Carnival of Medical Surrealism at American Center for Surreal and Paranoid Life.

Hear ye, hear ye…….

Liana is hosting this week’s edition of Grand Rounds at Med Valley High. There are a lot of great submissions this week, and I really love the solar system theme. Go and check it out.

It’s another lazy Monday morning and I’m so glad I got to sleep in today. I’m really beginning to hate working the weekends. I tease my prince that if I ever get married again that I’m going to marry for money. That way I could quit my job and I would never have to work again. He laughs and tells me that I’m stuck with him for life. I’m not complaining. This princess would be lost without her prince.

I met our two new doctors who will be taking over our unit at the beginning of June. I don’t think they know what to make of me. I’m outspoken, and they looked at me as if they were thinking that I needed to “stay in my place.” Yeah, right!

It’s time for another edition of Go Ask Mother. I’ve had a busy couple of weeks and I’m just now catching up with my mail. I’m sorry that I’m such a slowpoke about getting back to everyone. Sometimes I think I need to hire a personal assistant to help me get through my day. Does anyone know someone who wants to work for free?

Here are some of the questions that I’ve received from my readers:

In response to the Virginia Tech Shootings, Forty Two asked:

“How do you differentiate between someone who suffers from a mental illness and someone who’s adolescent experiences have led him to believe that people are cruel, indifferent, and must be punished?”

Hi Forty Two:

You ask a very interesting question. Where is the line between genuine hurt for reality based offenses, and insanity? I guess the answer lies in the second part of your question concerning punishment. I think an individual crosses the line when they are all consumed by hatred and the need for revenge.

Let me give you an example of what I mean. I have a very good friend who spent 5 years in a Nazi concentration camp, and lost his entire family at the hands of Nazi murderers. He has every reason in the world to hate the human race, but he refuses to be consumed by hatred. He told me that he has been able to give meaning to his suffering and that this is what keeps him sane. He said that he’s known a lot of survivors that can’t get past the hatred and the lust for revenge, and that these people were eventually driven into madness by their loathing of humanity. Today, my friend is a rabbi, and a founding board member of the Holocaust Museum in Washington, D.C.

I don’t believe that people are born evil, I believe that they are created by what happens to them in their lives. I have a feeling that Cho’s problems started long before he entered school and was bullied by his schoolmates. His great aunt in South Korea was interviewed, and she said that Cho’s emotional problems started to manifest themselves in his early childhood. It’ been reported that some of his writings revolved around the subject of sexual abuse. I hope I’ve been able to answer your question.

Cliffie from Canary Feathers asks:

“Oh Great Mother of All Nurses:

In your last edition of Go Ask Mother, in which you discussed Post Traumatic Stress Disorder, my eyes bugged out when you said, “we are what we think.” That’s right out of James Allen, Napoleon Hill, Earl Nightingale, Norm Peale, Robert Schuller,
Wayne Dyer, etc. This leads me to my question. Mother Jones, what do you think of that whole positive thinking movement that sells so many books and seminar tickets. Do you ever use it at work?”

Hi Cliffe, thanks for writing me. I’m flattered that you consider me the Greatest Mother of all Nurses. *I’m blushing*

I’m amused when I see new books touting that their pages hold the never before told secrets to finding happiness. The information in these books is usually valid, but it’s not new, it’s recycled wisdom that’s been repackaged for an updated look that generates a lot of revenue for the authors.

One of the newest books hyping happiness is called The Secret, edited by Rhonda Byrne. The book is based on the movie of the same name. In the beginning of the book, Byrne writes that the book’s pages reveal information that has been hidden from the common man throughout time in an effort by the rich to maintain the social and economic status quo, and that by following the book’s philosophy, the reader can create the life they want, whether that means getting out of debt, finding a more fulfilling job or falling in love. Bryne has compiled the writings of many new age hip and trendy gurus who have also made tons of money by recycling ideas of the people that you mentioned in your letter.

Talk show hostess, Oprah Winfrey has embraced Byrnes book, and the book is currently being showcased on Winfrey’s website, guaranteeing its blockbuster success within the literary marketplace. One of my coworkers bought the book and brought it to work, and as I was flipping through its pages I thought, “Man, why didn’t I write this? I would be rich!” One of the secrets Byrne doesn’t discuss is how to find a great literary agent. I don’t know if Byrne has found the secret to finding happiness in her own life, but one thing is clear, she has found the secret to making a whole lot of money. Maybe it’s sour grapes, but I never use pop psychology books while caring for my patients at work.

If you have any questions or comments for the edition of Go Ask Mother, please send them to nurseratchedsplace (at) yahoo (dot) com.

Do you want to know a secret? I’m addicted to shopping, but I don’t shop at just any store, I shop at Target. You know, the store with big red target logo and the catchy TV ads. Shopping makes me feel better when I’m feeling blue, and since I’ve been feeling rotten for the last couple of days, I hopped into my car yesterday and drove to Target to get some needed therapy.

Wandering the aisles looking at all the great merchandise usually cheers me up, but not even trying on new clothes lifted my mood, so in utter defeat, I left the store after purchasing a bottle of laundry detergent and a container of kitty litter. I never said that I was a big spender, all I said was that I like to shop. As I left the store and started walking towards my car, a young teenage girl walked towards me and began to speak. She looked familiar, but couldn’t place a name to her face, nor could I make out what she was saying because she was looking down the ground as she was speaking to me. She stuttered and waited to see if I was going to respond to her before she came closer. Then she said the words that I dread hearing. She asked, “Do you remember me? I was one of your patients.”

It’s not that I don’t like seeing my patients, it’s just that I have a bad memory for names, and I don’t like hurting people’s feelings. The youngster must have read my mind because she gave me a little smile and reminded me of her name. She became more comfortable as we chatted about her new boyfriend and her school activities, but I got the sense that she was working up the courage to tell me something important. She finally took a deep breath and told me what was really on her mind. She told me that she plans to go to nursing school someday because of me. I felt my jaw drop, and after a few seconds of stunned silence, I asked her why. She said that I had been her favorite nurse because I’m a little nutty, and because I listened to her when she talked about her feelings. She said that I made a difference in her life. Then the girl’s mother walked out of the store and they went on their way.

My mood lifted as I tossed the kitty litter and detergent in the back of my car. It’s nice to know that you really can make the difference in someone’s life. There are days when every nurse needs a little Target therapy.

I’m bracing for the aftermath of the Virginia Tech shootings, and the press has released the hounds.

It’s started in the tabloid newspapers the day after the shootings. The New York Daily News is describing the Virginia Tech gunman, Cho Seung-hui, as a PSYCHO. The words madman, sicko, and crazed headcase blazon the headlines rag newspapers, and those words are running rampant on the Internet. No one is arguing that the gunman, Cho Seung-hui, was ill, very ill. He desperately needed psychiatric help. His teachers knew it and so did some of his classmates. People who knew the boy feared him, and some tried to get him help. My concern is that these tragic events will feed into the belief that everyone with a mental illness is a danger to society. This belief is the farthest thing from the truth, but unfortunately, many people suffering from mental illnesses are going to suffer as a consequence of yesterday’s tragic events.

I’ve received email from some of my readers asking me how something like this can happen. One of the instructors of the gunman went to the police with her concerns, but nothing was done. We walk a very fine line when we talk about mental illness and an individual’s civil liberties. In my last post, The Jesus Three, I talked about three harmless men who were locked up for life because they thought that they were Jesus. They were not a threat to themselves or society. These harmless men were denied their civil liberties, and because of what has happened in the past, the pendulum has swung the other way, and now some dangerous people are allowed to walk the streets. Today people cannot be locked up unless they communicate that they are in imminent danger of harming themselves or others. Nowhere in Cho’s writings did he mention any specific plans about committing a crime against others. The question is where do we draw the line when deciding how to protect the rights of people who just think that they are God while locking up those who have a God like desire to decide who shall live and who shall die.

My thoughts and prayers go out to the families and friends of those affected by yesterday’s tragedy.

Psychiatric nurses get to meet many famous people throughout our careers, well sort of. Sometimes we care for patients suffering from delusions of grandeur. When I was a student at a Veterans Administration hospital, I cared for many “A List” celebrities. I met President Harry S. Truman, the Virgin Mary, and Albert Einstein. I also had the honor of meeting three gentlemen on a unit, all claiming to be Jesus Christ. The unit nurses dubbed the trio “The Jesus Three.”

The Jesus Three were a happy trio that spent a lot of time together in the unit’s sunroom, reading the Bible and debating religion. They also walked through the unit baptizing other patients and the staff. I felt a gentle mist of water landing on the back of my neck one day as I was talking to one of my patients in the dayroom. I turned around and found one of the men with a plastic spray bottle. He smiled as he baptized me and said he was saving my soul. I thanked him, and went on with my conversation.

I couldn’t understand how these gentle souls ended up in the hospital. They never yelled or cursed, and they helped out the nursing staff by feeding patients who couldn’t feed themselves. I also saw them writing letters for those who couldn’t read or write, and chatting with patients who never received any visitors. I found out later that their family members didn’t want to deal with “peculiarities,” so they had them committed into the hospital. That sort of thing was commonplace back then, and unfortunately they got swept up in an unfair system.

Nurses are taught never to feed into a patient’s delusions, but on the last day of my psychiatric clinical rotation, I just had to ask them how they could all be Jesus Christ. After all, didn’t the Bible say that there was only one true Messiah? They all looked at me and smiled. One of the men said, “I guess that just proves that the spirit is among us.”

Maybe angels really do walk among us on psychiatric units.

I’m getting word that the name of my blog is upsetting some people, so it’s time that we clear the air and discuss some issues that are circulating within the nursing community.

There are nurses in our profession who are on a mission to elevate the profession of nursing by combating nursing stereotypes. They truly feel that as long as nurses are portrayed as buxom sex-craved women, or women such as Nurse Ratched, the profession will forever be condemned to subservience. I applaud anyone who stands up and fights for their beliefs, however I think that nurses are missing an important point.

Despite prolific stereotypes of nursing within our culture, nurses are the most trusted professionals in America. The public loves us and no one in their right mind believes that these stereotypes are an accurate portrayal of our profession. We are viewed as angels of mercy, another stereotype that many nurses are willing to accept. The problem with nursing isn’t how we are portrayed in pop culture, or how the public views us, the problem is entrenched in how nurses view each other. Nursing is not only a profession; it’s a culture all to its own, and frankly, it’s the most catty and backbiting culture on the planet. I’ve never been able to explain this phenomenon, but I’ve always suspected that it’s because the nursing profession is swimming in estrogen. Yes, my statement could be construed as another stereotype, but come on, let’s be honest, I bet that thought has crossed your mind, too.

Cultural stereotypes aren’t the problem; we are our own worst enemy. We can’t even agree about who is qualified to be a nurse. The great debate about who is educationally qualified to be a nurse rages on. Outsiders with a bird’s eye view of our profession can’t figure us out, or they take advantage of our divisions, and use them to exploit us. For example, hospital administrators have exploited these divisions for years, and continue to use them to subjugate their nursing staff. Other professions, such as doctors, are also stereotyped in the media, yet they are thriving as a profession. Doctors are powerful within hospitals because they don’t undermine their colleagues, and they work together as a united front. Nurses need to take note, and follow the example set by physicians.

Believe me, when Ken Kesey wrote One Flew Over the Cuckoos Nest, he wasn’t thinking, “Gee, how can I insult nurses. I know, I’ll create Nurse Ratched. That will do the trick.” Nurse Ratched is a literary metaphor for a lot of different things, and I make no apologies for choosing Nurse Ratched’s Place for the name of my blog. As an ardent bibliophile, and as a psychiatric nurse, I find her character fascinating and I enjoyed the book. Stop throwing rotten tomatoes, and start focusing on making relevant changes that will empower nurses.

Let the hate mail begin………..