Nurse Ratched’s Place

In Buddhist teaching, the law of karma says only this: `for every event that occurs, there will follow another event whose existence was caused by the first.’ The Karma Gods are very angry, and they are kicking butt at our hospital. The hospital administrator, Mr. Grinch, is telling the staff that the hospital is having financial difficulties related to the hospital’s expansion, yet, his office is now decked about in opulent office furniture. I found this out from a housekeeper who couldn’t believe her eyes one morning when she went into Mr. Grinch’s office to empty his trash. She reported the sudden appearance of butter-soft leather furniture and a large flat-screen plasma television in Mr. Grinch’s lair. She also said that his new private office came with other amenities, including a private bathroom that came complete with granite counter tops and a seven-foot window that allows Mr. Grinch to peer at staff and visitors coming and going from the hospital as he sits on the crapper. It’s good to be King!

A couple of weeks ago, the Karma Gods took revenge on Mr. Grinch. They obviously have a wicked sense of humor. Somehow a drainage pipe somewhere in the hospital’s plumbing system backed up and spewed raw sewage that ended up in front of Mr. Grinch’s office door. According to one of my friends who witnessed the eruption, it stank to high heaven, and Grinch ran out of his office like his pants were on fire. Of course he left it to the underlings to clean up the mess.

I wonder what the Karma Gods are planning next. Stay tuned.

American Humorist and Author, Sam Levenson once said, “Insanity is hereditary; you get it from you children.” It seems as though that Dr. Davenport would agree because his daughter, Elizabeth, is stressing him out and he feels like he is losing his mind. Elizabeth has decided that the frivolous life of a “deb” is not for her, and she has made up her mind to embark on a nursing career. For some reason, Dr. Davenport doesn’t want Elizabeth to become a nurse. Maybe he knows that being a nurse is hard work. It looks like Elizabeth is very frustrated about her father’s attitude. She thinks that her dad is an idiot. After all, doesn’t he realize that not every girl wants to sit around all day eating chocolate bonbons while waiting for Prince Charming to come sweep her off her feet? I bet Elizabeth wins this argument. She looks like she has spunk, and her friends are backing her up.

Although we know that some mental illnesses, such as schizophrenia and bipolar disorder, may have genetic components, medical science once believed that all mental illnesses were caused by primitive drives related to heredity. In other words, mankind comes from a bad seed. According to the book, Modern Home Medical Adviser: Your Health and How to Preserve It, published in 1935, mothers could avoid raising someone who would become mentally ill by using sound mental hygiene techniques. These techniques included hitting and shaming a child into submission, and telling them that they were going to hell if they are bad. The author said that the child would grow up to be mentally ill if the mother did not use these techniques to suppress her child’s “evil primitive impulses.” According to the author, these impulses were genetically based, and to keep a child from becoming mentally ill as an adult, it was the mother’s duty to turn her child into a quivering psychological mess. I know it doesn’t make sense, but I didn’t write the book.

Dr. J. H Kellogg, the inventor of cornflakes and the Chief Medical Director of the Battle Creek Sanitarium believed that “bad breeding” played a big part in the development of mental illnesses. In his book, A Thousand Questions Answered, published in 1917, Dr. Kellogg writes, “Mental defectives have increased within the last fifty years at the rate of 900 percent in a century. That is, at the present rate of increase, in one hundred years from the present time, 9 percent of the total population will be insane, idiotic, or imbeciles. Mental defectives now constitute 1 percent of the population. The recognition of a new class of mental defectives, the moron, gives us the key to a large number of social problems and explains the rapid increase of a certain type of criminal of the growing army of ne’er-do-wells. Of all classes of mental defectives this class is by far the most dangerous because they are not easily recognized except by experts, and so left to reproduce and increase without restriction.”

In order to save the human race from mental illness and other social ills, Dr. Kellogg advocated the use of eugenics and euthenics, and he also advocated the use of a eugenics registry in order to keep the “races pure.” Thanks to Dr. Kellogg and his followers, many states tried to pass legislation mandating the sterilization of mentally ill patients and other “undesirables.” That’s code for people of color. The idea was to keep the insanity gene from polluting the general gene pool. After reading his book, I’ll never be able to look at cornflakes the same way again. I’m sticking with Quaker Oatmeal for breakfast.

So much for the good old days of medicine when you could blame someone else for all of your problems. It really isn’t your mother’s fault.

Two of my nursing colleagues were sitting at the nurses station the other day while having a conversation about things going on at the hospital. The first nurse said that she was frustrated about how new hospital rules are making it harder for nurses to give quality patient care. She said that she had been thinking about things, and that she’s unhappy because the new policies don’t make any sense. The second nurse quipped, “You would be a lot happier if you just stopped thinking.”

Perhaps unhappy nurses should take a lesson from the Stepford wives. Imagine a hospital filled with mindless, Stepford type nurses, blindly following hospital policies. Everyone would be happy. Nurses would gladly work double shifts, every weekend and holidays, and never request a day off. No one would use their critical thinking skills, and nurses would never protest about poor working conditions or about how patients are being shortchanged by the health care system. The creation of such a nurse would be a hospital administrator’s dream.

Maybe I should keep my mouth shut. I don’t want to give someone any ideas.

Back in February of 1999, I attended a fundraiser benefiting a local community counseling center located in Virginia. I went with another psychiatric nurse, and we were very excited about our night out on the town because we were going to meet a famous doctor. Little did I know that I would be getting into a war of words with a clown.

The event was held shortly after the release of the movie, Patch Adams, and Dr. Hunter Adams was speaking at the gathering. There was a small turnout at the event, and this allowed us to meet Dr. Adams in a small, intimate group. He chatted with each person, and then he approached my friend and me. He was very happy to meet nurses. He said he loves nurse, who doesn’t, right? Then he asked us about our work. When we told him that we worked in a psychiatric unit, he glared at us. I saw rage in his eyes. He snarled, “Psych nurses! So, have you drugged up anyone today?” Then he turned and walked away. We were shocked, and my friend burst into tears. This guy wasn’t like the character that Robin Williams played in the movie, and his comment was a slap in the face. I walked up to Dr. Adams, tapped him on the shoulder, and demanded to know what his problem was, but before he could answer, I asked him if he had been treated badly on a psychiatric unit in the past. He gave me his speech about how love can cure mental illnesses, and then he called me a pill Nazi because I give people Haldol. I stopped and stared at him, and then I started laughing. I told him that he wasn’t the first doctor to call me a name, but he was the first one who had the balls to say something so ridiculous while wearing a clown suit.

In his book, House Calls: How We Can All Heal the World One Visit at a Time, Dr. Adams talks about caring for the mentally ill. This picture is an illustration from the book. Dr. Adams writes:

“ So much of what is called “mental illness” is really a consequence of our troubled society—one that promotes loneliness and conformity in a world whose gods are money and power.”

Dr. Adams goes on to write that mental illness is curable if patients are provided with a loving, creative, and communal environment. I don’t know about you, but I thought much of what we call mental illness had something to do with neurotransmitters. Maybe Dr. Adams would have a greater appreciation of psychotropic medications if he had to care for extremely ill patients on a daily basis.

On the way home from the fundraiser, my friend told me that she thinks that Patch Adams is bipolar because he was loud, verbose, and labile. She also pointed out that not too many grown men run around wearing a clown suit. Whatever he is, I just wish he would stop telling patients that they don’t need to take their medications.

The pill Nazi has spoken.

This poster is from World War I, and it shows a wounded veteran who needs help. Back then our government made a pledge to care for our wounded men and women in uniform. Now the military is pledging to punish anyone who talks to the press.

It looks like my friend that I talked about in this post got out of Walter Reed just in time. She never would have survived in this environment. According to an article published in the Army Times , the patients at the Walter Reed Army Hospital are paying the consequences for talking to the Washington Post about living conditions in the infamous building 18. They are being watched very closely by the government, and have been ordered not to talk to the media. As a nurse, and as an American, I think this policy is despicable. How can we as a nation address problems if we don’t know about them. The doctors and nurses at Walter Reed are doing a phenomenal job in caring for our troops. It’s too bad that our government can’t do the same for those who have given so much for our country.

So much for keeping my blog a political free zone. Silence is bad medicine.

Our good friends at NJO are giving away three nursing school scholarships totaling $5,000, and today I’m posting the essay of one of the contestants. Stella wrote about why she chose to go into nursing. If more young people like Stella enter nursing, I know that our profession will thrive. I feel honored that I’ve been asked to showcase this wonderful essay.

All of my life I have been fascinated with medicine. I watched as my mother cared for other people, and marveled at the way she just knew what to do and how to do it. I used to go to work with her from time to time and “help” her on her rounds. Most of the time, I was just providing company to the residents of the geriatric ward that my mother worked in, but sometimes I got to help out at mealtime.

My mom was always such a gentle soul, but she was fueled by passion. She loved what she did, and did what she loved. Her passion spilled over into every area of her life, and I treasure the memories and know that I have truly been blessed to know a person as wonderful as she is.

If I had to choose any one reason for why I chose nursing, she would be it. Words cannot express the dedication, honor, integrity, and love that I found in my mother. I chose nursing because I want to live my life like she did, with purpose and conviction. She made the world a better place one person at a time. I want to do the same. I want to make this world a brighter, better place just one person at a time. I want to be a nurse.

Thank you, Stella, for entering NJO’s contest. Your essay is inspiring and I’m sure your mother is very proud of you. To find out more about contest rules, visit NJO’s website today. Deadline for entering the contest is March 19th.

It’s snowing like crazy outside, and I’m getting ready to go into to work. Ordinarily, the bad weather wouldn’t bug me, but I just got a phone call from my unit. I was told that my boss wants me to be prepared to work throughout the night if the next shift can’t make it in. Of course, my boss isn’t interested in coming in to help us out. That’s not her management style. Perhaps I’m being too judgmental, but good leaders don’t ask someone to do something that they aren’t willing to do themselves.

I’ve worked under some very good nurse managers in the past, and I’ve worked under some who must have read this book. Actually, this is a good book, but as you know, Attila the Hun has a bad reputation. He always got the job done, but it was always at the expense of his followers. He was a heck of a guy.

I’ve been receiving mail from my some of my readers, and they have been asking me some very interesting questions about the nursing profession. In today’s edition of Go Ask Mother, I’ll be responding to your questions.

When describing the ideal job, many nurses talk about the softer attributes of nursing such as teamwork, managerial attitudes and feeling valued. Why do you think that is?

ANSWER: Nursing is a touchy-feely profession, so it doesn’t surprise me that nurses would describe the ideal job in those terms. Yes, teamwork is important. Look at the two nurses in the picture. They look like they can beat anyone because they are working together as a team. Like I’ve always said, nurses have to stick together or they hang separately. If a manager were smart, he or she would understand that if they treated their nurses with respect, they would get hard working, loyal employees in return. Unfortunately, it’s been my experience that managers “don’t get it.”

What do you look for when you are looking for a job?

ANSWER: The type of work is one of the most important things I look at when considering a new job. I have to like what I’m doing or I won’t stay in a position. But I also take a critical look at staffing ratios, and how acuity plays into staffing numbers. Frankly, when I leave work, I want all my patients to be breathing. I’m not being sarcastic (OK, maybe a little) but I’m a psychiatric nurse, and I don’t want a suicidal patient to slip off and hang himself or herself because there wasn’t enough staff to watch everyone. The nurse in this picture looks happy. I wonder if her hospital is hiring new staff.

What is the single greatest attribute in a boss?

ANSWER: A good boss is someone who acts as an advocate for the nurses on his or her unit. I’ve been in healthcare for almost 30 years, and during that time I’ve had bosses who were saints. I’ve also had bosses who reminded me of Satan’s older, meaner sibling. In the view of most hospital administrators, bosses don’t need outstanding clinical skills to run a unit. Hospital administration wants managers who are good bean counters, and someone who can stay on budget and turn a profit for the hospital. I think that to be truly successful, bosses need good people skills, as well as a mastery of the specialty practiced on the unit.

What manager attributes do you think younger nurses prefer compared to the seasoned? For instance, do you think younger nurses may seek a manager to help them with their clinical skills while a seasoned nurse likes a manager to have good listening skills?

ANSWER: New nurses need a boss that won’t eat their young. This boss looks like he is about to yell at the new nurse. Hey, you, get your hands off of that young woman! I’ve seen so many kids get run out of the profession because bosses were too harsh. Bosses need to support new nurses while they learn new clinical skills, but they also need to mentor them on a more personal level. Reality hits new nurses right between the eyes when they take their first nursing job. A boss needs to be supportive, not a bully. I think older nurses just need to be shown respect, period!

What can administrators do to make nurses feel valued?

ANSWER: If you haven’t noticed yet, I’m full of opinions. I feel valued at work, not because of what the hospital thinks of me, but because I value myself as an individual, and because I’m valued by my co-workers. A few years ago, the morale on our unit was in the toilet. The hospital routinely put the psychiatric nursing staff in a dangerous working environment. One day, after telling hospital administration we needed more staff because of the unit’s acuity, I was severely beaten by a dangerous patient on the unit. Instead of crawling into a shell or quitting my job, I took action, and found a mentor who taught me how to legally protect myself while making changes on the unit. The nurses on our unit were the first to use our state’s whistleblower law to improve the safety on our unit. Things still aren’t perfect, but I no longer feel powerless.

Remember, you don’t need anyone’s permission to value yourself as a nurse. Every nurse deserves a trophy.

Doesn’t Madonna look adorable in her….by the way, what is she wearing? When I was growing up as a little girl in Iowa, no one told me that a girl could become rich and famous by wearing her unmentionables in front of millions of peoples. Obviously, someone forgot to fill me in on that little secret.

Shane from NJO has started a meme that asks the question, “Name four things that, as a nurse, you can’t live without, and one thing that you covet.” I have to admit that I’m having a problem compiling a list. Outside of my book collection, I’m not really a material girl. My father once told me, “If you can’t eat it or wear it, you don’t need it,” and the older I get, the more I understand what he was saying. Things can’t make you happy; it’s the intangibles that are the most important things in life. With that in mind, allow me to list my items that I can’t live without.

Knowing that there is something bigger outside of myself helps me get through a bad shift. A cornerstone of my life is the belief in a higher power, and that everything happens for a reason. I stop and ask myself what the universe is trying to teach me each time the shift is falling apart around me. Sometimes I think that I’m being taught patience, and other times tolerance, but sometimes I think the universe is pulling a prank on me, and it makes me laugh.

I can’t imagine life without my family, and that includes the members of my nurse-girl posse. Life is incomplete without a girlfriend you can share secrets with, and no one understands a nurse like another nurse.

This is the Cambridge University Shield. I’d love to take a class there, and meet my friend,The Angry Medic. People can take away all of your possessions, but they can’t take away the knowledge that you hold inside your mind. To keep from going stark raving mad, I indulge my intellectual side by taking classes at my local community college. The classes allow me to focus on things that I’m interested in, like writing and photography, and they serve as an escape from the stresses of work.

I could not live without the wisdom and knowledge of those nurses who came before me, and taught us through example, how to lead extraordinary lives.

If there were one “thing” that I have to covet, it would be Curt’s book collection over at The Groovy Age of Horror. You know I LOVE books!

Now it’s my turn to tag two people, so I’m tagging Nurse William and Deacon Barry. Tag, you’re it!

Here’s a nurse that I can relate to. She’s mature. That’s code for “old as the hills.” She is in the medication room, getting ready to pass medications to her patients. Look at the frown on her face. She’s not happy about all the new technology she has to deal with at the nurses station and in the medication room. Mature nurses occasionally wish that they could dump clumsy glumeter machines, and go back to checking a patient’s blood sugar by using urine dipsticks. Sometimes we yearn for the good old days.

I’ve had many youngsters fresh out of nursing school ask me why I’m still working as a nurse. Nursing is a stressful job, and they wonder when I’m going to retire. I tell them that I’ll have plenty of time to rest when I’m dead, and as long as I have a pulse, I’ll keep working as a nurse. Besides, who will teach young nurses what they need to know if all of the mature nurses go out to pasture?

I remember when a guest speaker came to talk to my class during my first week of nursing school. Her name was Minnie, she was 80 years old, and she was working as a nurse at a local nursing home that was located across the street from our hospital. When Minnie walked into the classroom wearing her white nursing uniform and cap, we all gasped. She resembled my idol, Mother Jones. She was barely five feet tall, wore a pair of wire rimmed glasses, and her snow-white hair was tied up into a bun. I thought, “My God, why is she still working as a nurse? She looks like she should be living at the nursing home, not working there as a nurse.”

Minnie was quite a lady. When she was 23 years old, she joined the American Red Cross in 1918 and traveled to France to care for wounded troops during World War I. She told us about her adventures in Europe, and fought back tears when she talked about the soldiers who died in her arms. She also showed us her extensive collection of nursing school pins and explained the history of each school. When one of my classmates asked Minnie what she did at the nursing home, Minnie laughed and said, “I give people hope. They figure if I can still work, they can at least get up and live another day.” She said that since she wasn’t dead yet, she was going to keep working as a nurse. Minnie never married, and her life revolved around the nursing profession. We heard several months later that when Minnie didn’t show up for one of her shifts, the nursing home administrator became alarmed and met the police at Minnie’s house. They broke into the house and found that she had passed away in her sleep.

I don’t know that I’ll be working when I’m 80 years old, but I can’t imagine that I’ll leave nursing anytime soon. I’m glad that Minnie never retired. She served as an inspiration, and taught me about nursing’s history. I hope someday a young nurse will hear my words and think the same thing about me.

Do you remember the Mamas and the Papas? I was listening to them on the radio today, and now I want to go home and find my love beads. I’m feeling nostalgic today. My favorite Mamas and Papas’ song is “Monday, Monday.” That’s because, unlike the rest of the world, I look forward to Monday mornings. I’m sitting in one of the most wonderful places in the world. I have discovered wireless Internet at our local Panera Bread coffee shop. The pastries are tasty, as well as fattening, the people who work here are friendly, and there is an electrical outlet for my computer right by the self-serve soda machine. I’m currently nibbling on a scone, and drinking my second cup of Diet Coke. I’ve died and gone to heaven.

As a weekend alternative nurse, I love Monday mornings. I’m sure if one of the other Panera customers were reading my mind right now, they’d come over and kick me in the shins, but please remember that I’m beginning my first day of freedom after being cooped up on a locked psych ward for two days, working short of staff. I see blurry-eyed people ordering coffee-to-go before they make their way to work. A huge number of people in our town commute by car everyday into Washington, D.C., on what’s called the Beltway. People sit in their cars for hours everyday to go to jobs that they hate. It’s crazy. Road rage is a very popular pastime in our part of the country.

This nurse took the Beltway and she’s now at work. What a good nurse. She is an angel of mercy, caring for a fallen soldier. She’s taking his pulse and he’s asking her out on a date. Some things never change. I hope she keeps the conversation light. If she doesn’t, she could get herself into a lot of trouble.

One of my friends won’t be going into DC anymore. She’s a nurse, and she was forced out of her job because she asked a pertinent question about the war in Iraq while she was at work. She worked at a military hospital, and asked a forbidden question behind closed doors away from the patients and their family members. She asked a group of military nurses why the Pentagon does not count the patients that die in the hospital as casualties of the Iraqi war. The numbers we hear in the media only include those who were killed on the battlefield, and not those who died in hospital beds as a result of their injuries. My friend is a civilian, and her question was not well received. She was summoned by her boss at the end of her shift, and she was basically asked if she was Un-American. The writing was on the wall and she eventually was asked to resign. She won’t have trouble finding a new job. General William Sherman said, “War is hell.” The man knew what he was talking about.

I try to keep my blog political-free, but that’s not happening today. I’m guess I’m just an old hippie with a lot to say. Now, where did I put those love beads?