Nurse Ratched’s Place

When I’m at work and I start feeling stressed out, I begin this mantra: “I love my job, I love my job, I love my job.” At first, my coworkers thought I was nuts. I told them this mantra keeps me calm, and if I stay calm, I won’t start screaming in the nurses station.
Don’t get me wrong, I really do like my job, it’s the healthcare system that makes me pull my hair out. As a bedside nurse, I’m frustrated by what I see at work. Our healthcare system is falling apart. It’s dysfunctional, making it harder for doctors and nurses to take care of their patients. There’s a new treatment being used today called “Brief Therapy.” No, I’m not kidding. I think an insurance company came up with the concept as a way of saving money.

When you’re having a bad day at work, do you ever think about getting a new job? Nurses have so many options, the hardest part of getting a new job is deciding which offer to take. Years ago when I entered the nursing profession, nurses had few options; they could work giving bedside nursing care, or work in a doctor’s office, clinic, or school. After a few years, some of my friends left nursing and got married. See our cover girl? She’s trying to decide which path to take. Will she marry Dr. McDreamy or stay in nursing? Only time will tell.

The best thing about nursing is you can quit your job, go into a completely different field, and still be a nurse. Don’t believe me? Pick up a newspaper and look at the want ads, or better yet, go to Nursing Jobs.org for an up-to-the-minute list of available jobs. There are positions available in every imaginable arena.

This is a poem sent to me by one of my former coworkers. She tried my mantra, but it didn’t work for her. She’s now working somewhere else.

I Love My Job
By Dr. Seuss

I love my job, I love the pay!
I love it more and more each day.
I love my boss, he’s the best!
I love his boss and all the rest!

I love my office and its location,I hate to have to go on vacation.
I love my furniture, drab and grey, and piles of paper that grow each day.
I think my job is really swell,there’s nothing else I love so well!
I love to work among my peers, I love their leers, and jeers and sneers.
I love my computer and its software.
I hug it often though it won’t care. I love each program and every file.
I’d love them more if they worked a while.

I’m happy to be here. I am. I am.
I’m the happiest slave of the Firm I am.
I love this work, I love these chores.
I love the meetings with deadly bores.
I love my job – I’ll say it again – I even love those friendly men.
Those friendly men who’ve come today,
In clean white coats to take me away!!!

I’ve been tagged by At Your Cervix. In today’s meme, I am to reveal what five songs I want played at my funeral. I’m sorry, but death is not an option. My employer has forbidden the Grim Reaper from taking nurses who are scheduled to work Christmas. However, just in case Mr. Reaper didn’t receive the memo, here are my top five picks.

To Where You Are, by Josh Groban. This one is a tear-jerker.

Fields of Gold, by Sting.

Over the Rainbow, by Eva Cassidy.

Here Comes the Sun, by the Beatles.

My friends and family may sing any drunken Irish pub song they choose as they dump my ashes into the Chesapeake Bay.

I tag Julie, RN, Sean, Mad Mike, Deacon Barry, and rx850.

Painting by Andrew Wodzianski:

Everyone who wants to work nightshift, please raise your hand. What, you say you hate working the graveyard shift? It’s hard sleeping during the day when your kids keep knocking on your bedroom door and telemarketers keep waking you up. Too bad you don’t work with Dracula. If he worked on your unit as a nurse, no one would ever have to float to nights.

If you’re working an evening shift, you pray that the night nurse doesn’t call in sick. That means you have to work until the next morning, and most of us are not nocturnal creatures. Our bodies complain loudly when we break established sleeping patterns. Patients love night nurses except when a night nurse wakes them up to ask if they want a sleeping pill. Some people have odd ideas about night nurses. Yeah, you know what I mean. A nurse working nights may dream about crawling into a patient’s bed, but just to get some sleep, so get your mind out of the gutter.

I detest working the nightshift, making those who want to work nights my hero. And speaking of heroes, even super-heroes need a nurse, and who do they turn to in time of need? The Night Nurse, of course. According to my coworker’s son who collects comic books, no one knows the Night Nurse’s true identity. He also said that she is affiliated with many super heroes, including Spider-Man, Daredevil, and Iron Fist. She runs Night Medical Center, a 24 hour clinic where super-heroes can go to get treated for the injuries, no questions asked. She never charges a fee for her services, but accepts donations. And like any professional nurse, her focus is on the welfare of her patients.

She’s not just a nurse, she’s the Night Nurse.

Margie from admitting was on the phone. Her usual bright and bubbly phone voice was subdued. My new patient was down stairs ready to be picked up and she added with a whisper to bring a wheelchair. This girl was in bad shape. Her name was Lisa.

I grabbed a wheelchair out of the hall and scurried down to admitting. Lisa was waiting for me with her parents in a side office. She weighed just over 80 pounds and looked like a refuge from a concentration camp. She was weak. The muscles in her neck could hardly hold her head up. Her face was ashen . Her legs were swollen and red. Her blond hair was dry, brittle, and falling out. She could hardly speak. After signing voluntary admission papers for the psychiatric unit, I took her up stairs to her room.

Lisa typifies so many young women in this country who starve themselves to be beautiful. What is anorexia? Simply put it is the refusal to maintain a body weight at or above a minimally normal weight for age and height. There is an intense fear of gaining weight or becoming fat even though the person is under weight. How common is anorexia? There are many idea about that, but no one really knows for sure. It’s prevalence in the United States is around 0.1%to 0.6% in the general population and several times higher in adolescent girls. In this country women are getting heavier each generation while the concept of beauty is getting slimmer. More than half of American women say they are on a diet. In recent surveys of 5th to 8th grade girls, 31% said they were on a diet, 9% said they had sometimes fasted, and 5% had deliberately induced vomiting.

Lisa was more than a statistic. I was new to the psychiatric nursing field and she was my first anorexic patient. Why did this happen to her? Lisa was the only child of highly educated parents that were both highly respected professionals in the community. They treasured her. She had majored in the arts and was on her way to a highly successful career. She had everything to live for – and she was dying.

I worked with Lisa for 2 years. Her disease even baffled her. She wanted to be “normal” again. She didn’t know how she had become sick. She would look at her frail body in the mirror and see rolls of fat hanging off of her withering frame. I remember her saying “I just want to be beautiful”. Her parents felt guilty. She felt ashamed. We worked with the entire family. She would reach 98 pounds, and be discharged. After a month or two she would come back to us, weaker and more depressed then ever. This was her cycle until she died of a cardiac arrest in her sleep.

Lisa gave me insight on caring for patients with anorexia. She and I took our victories where we could. Instead of allowing her to focus on her guilt, for not gaining enough weight to meet her goal, we would celebrate the six ounces she did gain by taking a short walk around the block. We would take this private time to focus on the future,discussing what she wanted for herself. This was how I got her to focus on living another day. When she met her goal we really celebrated. I kept two plastic champagne party cup in the nurses station and we would toast her triumph with Perrier water, her favorite.

The use of visualization worked well at times. I would assist Lisa by aiding her with progressive relation techniques and then have her visualize her body as healthy again. She would tell me later that during those sessions she could feel her physical and emotional energies recharging themselves. Because Lisa found this technique to be useful, I continue to use it with all my anorexic patients.

During Lisa’s illness her parents were fighting two battles – the anorexia and their insurance company. The treatment of anorexia is a long and expensive one. Their insurance company threatened to cut off paying for Lisa’s care. I went to the hospital’s utilization review coordinator to see what the insurance companies target in the nursing notes that would determine the status of a claim. These are points I address in all my care plans. This points assure good patient care, and help patients and their family members when dealing with their insurance company. All entries must show in a measurable way the success or failure of the patient’s treatment. Calorie counts and daily weights are done accurately and documented. Any quotes the patient gives during therapy can be important especially if the patient is depressed and suicidal. Monitoring the patients medical condition including vitals every shift, intake and output, observe for signs of infection, and for any signs of stress fractures or organ failure. All patient and family teaching done must be documented in detail.

I was Lisa’s nurse, but she was my teacher. I keep her alive in my heart by using what I learned from her to help others.

I’ll give that song a ninety-five; it has a good beat and it’s easy to dance to.

When I was a girl growing up in Iowa, I remember watching American Bandstand with my mom every Saturday morning. We would watch the show on our small screen, black and white TV, and Mom would adjust the rabbit ears on the antenna as I danced around the living room in my bare feet. Mom and I listened to the music and critiqued the latest fashion trends. We both loved poodle skirts. I remember my favorite song was something about a one-eye-one-horn-flying-purple people eater. Yes, really! As the years passed the music changed, and I now have a long list of music favorites. I’ve been tagged, and these are my seven favorite songs.

Angel: by Sarah McLachlan. Don’t ask me why I like a song that makes me cry. Even nasty Simon Cowell loves this song.

Just to be Loved: by Al Jarreau. Listening to smooth jazz while sipping a glass of wine. It’s heaven.

Peacekeeper: by Fleetwood Mac. This is the best anti-war song recorded since Woodstock.

Imagine: by John Lennon. World Peace.

Sad, Sad, Sad: by the Rolling Stones. I like it because it’s loud, loud, loud!

Simply Irresistible: by Robert Palmer. Cool clone chicks.

Bolero: by Maurice Ravel.
Do I really need to explain this one?

Scapel, you’re tagged and so is anyone else who wants to play:-)

I just started learning about blogs a few months ago, and I’m still learning new things about the blogosphere everyday. Emergiblog is one of my all time favorite nurse blogs, and I want my sidebar to look like emergiblog’s, but I don’t know what to do. Where do all those cute little icons like “My Yahoo” and “newsgator” come from? And what is a RSS feed and how do blogs get hooked up to them? How do you increase traffic on your blog? In a modified version of Dr. McCoy’s famous Star Trek quote, “I’m a nurse, not a computer geek.”

Is there anyone out there willing to help an old dog err… nurse learn some new tricks about blogging?

There’s a tradition on every nurses station when a nurse gets engaged. You know the drill, the bride-to-be prances into the nurses station and whips out her hand, revealing her engagement ring. Then, with great fanfare, everyone at the nurses station starts jumping up and down, and squealing with delight. Soon after, there’s a stack of wedding magazines spread around the nurses station as preparations for the big day begin.

After watching this tradition for many years, I’ve learned a bride must possess three qualities when planning a modern wedding: she must be organized, have nerves of steel, and very deep pockets. But thanks to Vera Wang, a popular wedding gown designer, planning a wedding is now easy. Wang not only designs stunning wedding gowns with equally stunning price tags, she has a full line of wedding products to meet your every need.

To make planning easier, Wang sells her own line of china, crystal, flatware, footwear, lingerie, cosmetics and perfume, and jewelry. Needless to say, none of this stuff is sold at Ikea, so you can expect to go broke if you buy Wang’s products. And remember, no wedding is complete without an expensive honeymoon, and for $4,000 a night, the happy couple can stay in the Vera Wang suite at the Halekulani resort in Waikiki, Hawaii.

Every time I see a stack of wedding magazines in the nurses station, I toss a Home Depot catalog on top of the pile, and tell the bride-to-be that if she picks out a ladder, I’ll buy it for her so she can elope. So far, no one has taken me up on my offer. Maybe they would if Vera Wang designed hardware.

Nursing: It’s A Guy Thing

Nursing isn’t looking for just a few good men, our profession is looking for a lot of good men. Being a nurse doesn’t make a guy a “sissy,” it’s for anyone with intelligences and integrity that’s willing to work hard to care for others. Look at this group of guys. Do they look like girly-men to you? This poster is a favorite of mine and was published by the Oregon Center for Nursing.

Descriptions of the above guys, from left to right:

Sang Kim RN
Cardiac Telemetry Nurse
Snowboarder

Terry Misener RN, PhD
Dean, School of Nursing
Retired Lieutenant Colonel, U.S. Army

Yuri Chavez RN, CRNA
Nurse Anesthetist
2:54 LA Marathon

Roland Jomerson RN
Post Anesthesia Recovery Nurse
Decorated Vietnam Combat Medic and Retired Major, U.S. Army

Don Mucciprosso RN
Poison Specialist Nurse
Harley Rider

Walter Moore, Jr. RN
Intensive Care Unit Nurse
U.S. Navy Seal Team One

Bill Maddalena SN
Student Nurse
3rd Degree Black Belt Kenpo

L. Rey Ariola RN
Cardiology Nurse
Rugby Right Prop

Jason Scott Carrick SN
Student Nurse
Basketball Power Forward

Since this post is about men in nursing, I wanted to show you that not all trashy nurse romance novels are about loose women who want to marry doctors. Meet Nurse Gigolo. He’s not only the man of the month, he’s the man of my dreams. He sure is cute, but I wonder what his nursing skills are like. Silly me, I’m sure his “other skills” make up for whatever he lacks in the nursing department. (*Blush*).

A Note to Nurse Recruiters

Move over GI Joe and classic Cylon Minimates, there’s a new action figure in town, and he’s rough, tough, and ready for action. He can do things no other action figure can do; he can work double shifts and save lives without breaking a sweat. And while he doesn’t kill bad guys to make the world a safer place, he’s everyone’s hero….he’s a nurse. If nurse recruiters start passing these out at daycare centers, we will get more men into the nursing profession within the next fifteen to twenty years.

I think the makers of the action figure used this nurse as their model. What do you think?

Permabook edition published June, 1956. Cover painting by Tom Dunn

This is a book I recently added to my book collection that was written by one of my favorite cheesy-trash authors, Frank G. Slaughter. A best selling novelist and physician, whose books sold more than 60 million copies, Slaughter said he drew on his experiences as a physician when writing his books. Good grief, if I didn’t know what really went on in a hospital, I’d be afraid to let a doctor touch me after reading one of Slaughter’s books. I’ve never been able to figure out why a guy that studied at Duke University, and received his medical degree from John Hopkins Medical School, Baltimore, would write this stuff, but I’m sure the money was good, or else he would have gone back to practicing medicine.

Today’s selection is about a doctor that had to choose between saving his patient, a sexy surgical nurse, and going to jail. The caption reads, “If Dr. Carter saved this woman’s life, her testimony might ruin him.” My, my, the decisions some doctors have to make. It sounds so stressful.

Here’s our hero, Doctor Don Carter, fresh from the OR, wearing gross red surgical gloves, and looking dazed and confused. The book is about the “special” relationship Dr. Carter had with his surgical nurse, Laura Jordan. She’s the hot blond sitting in the witness chair. She looks appalled that her coworkers let Dr. Carter leave the hospital while he was still wearing his surgical gown and gloves. Didn’t they know he was coming to court? The book describes Jordon as “a grimly efficient surgical nurse,” but a nurse that was “all woman” outside of the hospital.

Here’s the plot:

“Dr. Don Carter opened his gloved palm to receive the scalpel. The steel was cold to his touch. For a moment the knife was poised above Laura Jordan’s skull….

‘If I save her, she may ruin me,’ Don thought. ‘If I don’t, I can never face myself again.’ Suddenly the knife inscribed a long-practiced incision. The operation had begun.

Ever since one of his patients had died, Dr. Don Carter had been tormented by the fear that he might have been careless. Only Laura, his operating-room nurse, could tell him the truth.

Then she lost her memory in an accident. Don Carter faced this terrifying dilemma: could he bring back Laura’s memory and with it perhaps the one fact that could expel him from the medical world forever?”

Like in all of Slaughter’s books, everyone lives happily ever after. Carter learns that he didn’t injure his patient in the OR and the court case against him is dropped, and Jordan gets her memory back and dumps Carter for another man. Now that’s what I call gratitude, but don’t feel bad for Carter, he dumps his bitchy, domineering wife for a beautiful, rich socialite. And so goes the life of a healer.

Nursing school was boot camp. My classmates and I worked long, hard hours, learning how to take care of our patients. Another thing my classmates and I learned was the secret to nursing longevity. Our teachers said that if we followed three rules, we would stay in the nursing profession forever: Wear comfortable nursing shoes when reporting for duty, work together as a team when giving patient care, and live life to the fullest. Even Florence Nightingale knew how to have fun, and we all know what great things she did as a nurse. Here are some tried and true tips on preventing burnout, while enjoying your nursing career.

Does this look familiar to you? Look at these nurses putting out a fire. They are working as a team.

I worked yesterday evening and I all I did for eight hours was run around in circles, trying to keep the unit from falling apart. Everyone needed PRN medications, the phone wouldn’t stop ringing, two psychotic patients tried running off the unit, and one staff member, a tech, went home without telling anyone he was leaving. We didn’t know he had gone home until a patient told us he saw the staff member leave the unit, carrying his backpack and coat. For the rest of the night I looked at the charge nurse and said,“I go home now, OK?” She bristled and then thanked me for at least asking before I eloped from the unit. We made it through the rest of the shift because we could laugh about what was happening, and we worked together as a team.

Life is a balancing act. I’ve learned to take time for myself during the day as a way of preparing for work. Do you remember that yoga class I told you about? I really love it. Yoga makes me feel twenty years younger and gives me more energy. If you want to get through your shifts without pulling your hair out, find the time to do things that make you happy.

Look, it’s nurses gone wild! Ok, so maybe they aren’t going wild, but they look like they’re having a good time. Laugh with your friends and don’t be so serious. So what if people think you’re a little crazy. Do what these nursing are doing, take a walk, climb a tree, and have some fun. Remember, life is too short to be normal.