May, 2005 Archive

i hate you.

i know. “hate” is a very strong word. i am hoping to conclude with a kinder one.

i don’t know how you prepared for it, but you mastered the craft. you are rude, and it boggles me how someone so educated well beyond what is necessary can treat other human beings with such arrogance.

when i told you to look at miss S because there’s a change in her LOC; that i’m concerned why she falls asleep in the bathroom, in the middle of emptying her bladder…i didn’t do that just to wreak havoc to your already hectic night. i don’t go to work with the agenda of just messing some intern’s life.

were you not paying attention? you called (no, “yelled” would be more appropriate) her name three times, and all you got was a soft moan. when she was finally able to open her eyes, and she appeared like she was gagging, was that enough reason for you to sarcastically roll your eyes like i’m stupid just because all she needs is a shot of nausea medicine?

were you even listening? i told you very clearly: “dr. B, i didn’t give the med that the AM RN requested because i came here when my shift started, and she was so out of it i can barely wake her up. i asked her if she is still nauseated and she said no. (and i believed her. she was out, not nauseated, that was very obvious!) 15 minutes later i checked her again, and she was still the same and still claimed that she was not nauseated.”

“i don’t understand YOU people. you call for nausea meds and you never give it, then you call because the patient is nauseated.”

dr. b, i didn’t call you because she was nauseated. the patient was stoned! that’s WHY i called!

and really, storming out of the room like that, and talking to yourself, loud enough for all the people in the room to hear anyway. that wasn’t very nice, was it? you sounded so sarcastic, even “miss S’s roomate looked at me saying, “what was THAT all about?”

it’s crystal clear to me now why after almost three weeks of being in our unit, i have not heard a single nice word about you from any RN. not a single nice word.

however, this is the real world. you don’t need RNs to be a doctor. you will eventually finish your internship. maybe you will end up doing your residency somewhere, or maybe not. i don’t know what will happen to you two or three years from now. one thing i’m sure, it terrifies me to think about how you will treat your patients.

oh, it won’t surprise me if you won’t have that many patients.

i don’t hate you. hate is such a strong word.

i feel sorry for you. you and your magnified self.

p.s
i believe you are one of the reasons why R finally quit. she did “went home”. for good. the night you were your “usual” self, was her last night at work. she can’t take that much humiliation and frustration from all knowing yet never available interns like you. she’s never coming back to our unit. i hope that makes you happy. then maybe, we will finally see that elusive smile.

R is a newbie. i was not being mean when i asked her if she was outgoing shift. she did look worn out.

her face had been screaming for help since the shift started. i conscioulsy ignored it, i had to attend to my own patients. when i finally had time to start my charting, i didn’t start. i can’t ingore her any longer. i helped her with some meds and told her to tell me if i can help her with other things.

at 2 am, she was ready to give up. she pulled me inside one of her patient’s room, and she cried.

in between sobs she gave me an overview of her night. patient A has blood sugar checks every two hours. she calls the doctor every time because it is always high. patient’s B’s temp was 103.7, and he was throwing up like crazy. patient C’s urine output was very minimal. and patient D had no output. to make it even more challenging, the on call intern is never returning the pages on time, and when she does, she doesn’t really sound helpful.

R didn’t know what to do first, or do last. give the insulin to patient A, give the phenergan to patient B and help clean him up. give the IV bolus to patient C, do the bladder scan for patient D. when she finally figured our what to do first, patient A complained of chest pain. another RN called her because patient B looked like he was having seizures. she found out the bladder scan is new and she has never used one.

i was overwhelmed just listening to her. the pressure of things happening at the same time, coupled with the lack of experience in prioritizing things to do easily turned a single night at work into a major life changing event she can’t handle.

i gave her a quick hug. she wiped her tears.

she apologized for being such a baby.

apologies are uncalled for, i told her. “you’re trying to save lives, it’s okay to get overwhelmed”.

this is a true story. you can check with the guy who was sitting next to me last saturday, on that bench, on one of the hallways, in one of the regional hospitals somewhere in california.

a family friend was in the hospital after a leg surgery. she was hit by a speeding driver while she went walking with her husband. although the hit and run incident is a good story, i’ll save that for another time.

if you observe well enough, the hospital hallways are always beaming with stories.

while waiting at the hallway, one of the call lights went off. i heard the conversation very clearly. this was the exchange of words, verbatim:

“yes, may i help you?”

“i need my nurse”

“this is your nurse”

“i need help to go to the bathroom” (she sounded like she could use some morphine)

“you have a walker there, right? use your walker” (irritated, sarcastic voice)

“well, i NEED help to GET into the walker” (frustration and pain much more obvious)

click. the intercom just went dead. i was there for another 10 minutes or so. no nurse in sight. i fought the urge to go and see the patient. i didn’t work there.

that nurse was heartless, i concluded. i’m sure she has her reasons; but whatever her reasons are, i bet she has never been helpless. i can’t believe she doesn’t even have the decency to say “i have another emergency situation right now, i’ll send somebody else to help you.” i assume she has never been in a situation when her bladder is about to burst, and she can’t go without help. well, i have one word for her: empathy.

also, she better pray hard that she will never be in a situation when she needs a nurse’s help to go to the bathroom.

what goes around, comes around, right? when it comes around, don’t tell me i didn’t warn her, okay?

“…spanish speaking only.”

that line didn’t really scare me. so what if two out of my four patients are spanish speaking? they always know a little english anyway.they always have family who translate for them. besides, i’ve always considered myself good in improvised sign language. it always works.

well, “always” isn’t always true.

first all, senora B, doesn’t speak ANY english. second of all, all four visitors gathered around her bed do not speak ANY english. third of all, i found out i wasn’t that good in improvised sign language. it was a challenging shift. to say the least.

to make matters more complicated, senor G, my other spanish speaking patient was exactly the same.

senora B just had a surgery. there was an order to make her walk around the unit five hours after surgery. it’s been almost eight hours. AM RN’s excuse is the fact that she doesn’t know how to tell her, and being crazy that it is on morning shifts, she really didn’t get the chance to call for the hospital translator.

i smugly thought: “it’s no big deal, i don’t need a translator. i can do this….”

i told senora B that she needed to get up and walk around the unit. i explained why, i assured her i will be with her the whole time, and that we will stop anytime there is a problem. i had no other option but to do it in english, and in my award winning sign language. i will not describe how i did it, but to say i looked pathetic, marching and doing a little drama in front of senora B and her family is to cover up the truth that i looked absolutely ridiculous!

a chorus from senora B’s family: “no habla ingles.”

from senora B: “si….” and a really really sweet smile.

wow! she said yes!

i moved closer to her, offered my hands to help her get up.

“si……” and again, that really sweet smile.

i started to doubt the meaning of that smile. it didn’t matter that it was so sweet.

holding her hands, i started to pull her. i wondered why she felt so heavy, she was a little lady.

“si….” she was pulling against me.

it took a few more seconds for the truth to sink in. she didn’t understand any of my elaborate explanations.

unfortunately, i had three more patients to attend to. i left senora B’s room, contemplating on my next move. i hoped the doctor wouldn’t call and ask how she did in her walk after the surgery. i needed to figure something out. fast.

meanwhile, senor G needed an enema for his coming surgery in the morning. i was still counting on my sign language skills. (yeah, i don’t give up that easy!) enema bottle in hand, i took a deep breath after pulling his curtains. i didn’t want his roomate to see me make a fool out of myself. i explained the enema in action. i swear, it looked almost x-rated.

senor G’s daughter was very helpful. i felt so relieved when he nodded his head after she sort of explained the way she probably understood it. (i tell you, looks are deceiving!)

i stood on his side of the bed. opened the enema bottle, and motioned him to turn to his left side. i can still see the horror on his face when i started pulling his gown up. just before i got hold of his boxers….

senor G sat up and called for his daughter. there was an exchange of questions and answers. i didn’t understand a thing but it sounded like:”do something, that nurse is harassing your father!”

i was standing there. lost. in translation.

to make the short story even shorter….senor G didn’t really understand anything that i said…his daughter? i concluded she thought the bottle was something for her dad to drink to relieve the pain in his ass. oh well. at least she got the ass part.

when the shift was over, i had a collection of tales ranging from funny to ridiculous and from embarassing to downright humiliating. it was a memorable night.

with a spanish speaking RN from a different unit, senora B walked around the unit wearing that sweet sweet smile; senor G pulled his boxers down, and his daughter was ready with the bedpan.

looking clueless amidst the encounters….another RN with spanish speaking patients gave me a patronizing look, “i hear you girl……”

i didn’t need sympathy. spanish lesson would have been more appreciated.