September, 2005 Archive

“i did not give all these meds because they were not in the med box. I WAS SO BUSY and the pharmacy did not send them… i did not replace the NGT the patient pulled out, I WAS SO BUSY!… no way i will suction that patient’s secretion every two hours! i was not trained to do that, that’s why there are respiratory therapists, that’s their job, besides, I WAS SO BUSY… and oh, i have not given the 1800 scheduled meds because she just came back from dialysis. etc. etc. etc…”

well S, here is a piece of my extremely irritated mind: you have three patients. you have 12 hours. one of your patients went off the unit for dialysis for more than four hours, which means you had four hours when you only had two patients. what did you do then?

you have not given meds scheduled at 9 AM because they were not in the med box? come on! you had 9 hours to negotiate with pharmacy about this. i know they are a pain, but see, that’s why you are a nurse, you have to deal with all these people who give you a hard time, so that your patient can get what they need. there are phones, elevators, people who are supposed to get these things. if you can’t drag your sorry self to the pharmacy to get those meds, at least ask somebody to get them!

again, if you didn’t have time, ask somebody to reinsert the NGT, even the charge nurse! they are helpful, all you have to do is ask, especially because YOU WERE SO BUSY, for sure others have seen how busy you were. don’t be embarassed to ask help, after all, it’s the patient’s only source of nutrition.

you were not taught to deep suction? okay, let me make this clear. if the patient is drowning in secretions, and you know there is only one RT going around four other units in the hospital, you will wait for the RT till the patient dies? no, i am not asking you to do something you are not confident to do. all i’m saying is, at least do something. that’s why there are other RNs. was it very hard to ask somebody to show you how to do it once, and then try doing it next time?

the patient who went to dialysis was back at 1700! you had one hour and a half to give the meds. opening the med box, checking the meds, getting water, and giving it to a totally alert, no swallowing problem patient, will take less than three minutes! less than three minutes!

and oh, thank you for letting me discover all the other stuff you did not do: you only had one patient who needed a bath; and i know, YOU WERE SO BUSY to do it. you mean you just expected a miracle and wished that her gown which you soiled with a gallon of tube feeding will just dry itself? well, it did, and it got stuck to her skin! the least you could have done is at least change her gown!

and for crying out loud. do your intakes and outputs like everybody else. zero your IV and tube feeding pumps like you are supposed to!

i worked AM in our unit for almost a year. back in the days when we didn’t have two CNAs to help us do other stuff, like getting non-narcotic meds from the pharmacy, and assisting with baths and feeding. it was hard, but getting things done is not rocket science. it wouldn’t bother me if these stuff happened once or twice, but you’ve been doing it habitually, that all other RNs have been complaining. now i’m thinking we need to form a support group to cope with your excuses. do me a favor. please don’t give me that “I WAS SO BUSY” argument. i know BUSY, and i know LAZY. believe me, you are the latter.

just to let you know, the only reason i do not agree in writing you up is the fact that i will feel bad for you if you get fired and go through all the trouble of looking for another job. you have a little baby to think of and you have no friends to support you. (yeah, it amazed me that you were so proud to proclaim “i don’t have any friends!”) that would be horrible.

right now, you make me sick. and angry. and hope, that if ever i, or any of my family, or friends, get sick, you will never be my nurse. also, it makes me pray that after years of nursing, i don’t do the same, exact things you’ve been doing, and recite that overused excuse of being busy. please God, help me!

there should be a law that says: “S will never ever be allowed to give report to May again. ever.”

then i will live happily ever after.

didn’t mean to be mean, just tired.

rant over. now i feel better.

i have been reading michelle au’s blog for a while. she is a new anesthesia resident/new mom. she writes with such honesty and wit that i find really entertaining. her latest entry (”weekend catch up”) was interesting. a part of it was about her “dilemma” of the OR freezing. she has to choose between wearing the expensive disposable gowns, or wearing a nurse’s jacket. a little conscientious about the cost, she is considering wearing the jacket, but was concerned that people will think she is a nurse. what to do?

a nurse was offended by that issue. some doctors were offended that the nurse was offended.the comments section was unbelievably entertaining. doctors and nurses laying their cards on the table is a fascinating read.

i honestly don’t know how i feel.

what is it about the letters after our name? are we arrogant or proud if we insist on making sure people notice it? or do we truly deserve to validate the fact that we went through our own hells trying to get that license and actually add those letters to our name?

the issue left me in a retrospective mood.

if you are an RN, are you offended if people thought you are a CNA? is it the same offense if you are mistaken as an MD?

if you are an MD, are you offended if people thought you are an RN? is it the same offense if you are mistaken as a president of a hospital?

or should we even think about this stuff like it is something important?

i bet you some RNs or MDs do not really care.

the unit was particularly quiet.

J and L, nurses whose voices usually bounce off the wall and hit my eardrums like some unexpected thunder, are whispering.

i assumed somebody just passed away.

the meds refrigerator is locked.

the supply drawers are locked.

after 8 pm, the doors of all the patients’ rooms are closed.

RNs laugh; but not out loud. nobody’s eating. nobody’s reading to update on who divorced who in hollywood.

everyone’s moves seem robotic.

and the locking of the drawers seem automatic and practiced.

if i didn’t have a patient who was screaming profanity that will put a sailor to shame; or that other patient whose trach needs to be suctioned every 30 minutes, i would have thought i was in the wrong unit.

the darker the night, the silence gets more deafening.

at 9 pm, i can’t take it any longer.

“what’s up with all these weird silence and JCAHO compliance?” i asked the charge nurse.

she shushed me with her look and puckered her lips, pointing to room 8.

the last name on the patient’s room looked familiar, but it didn’t register right away.

i had to take one more look. then it made sense.

the patient in room 8 is our nurse manager’s husband.

oh.

apparently, there is always a child in all of us.

we sign “RN” at the end of our names so we look and feel professional.

the truth is, we were just a bunch of kids. in scrubs.

don’t worry, the cookie jar stays unopened. because someone is looking.

she wrote “cold” on her little white board.

i covered her with a third thick blanket after i turned up the room temperature to 70 degrees.

trying to keep her warm, i tucked the blanket underneath her shoulders, but she mouthed “no”, nonverbally saying that it will suffocate her little stuffed dog.

she took the white board again, and wrote: “my husband gave this dog”. then she pointed to the guy in the picture. he was wearing a white shirt, she was wearing a white dress, and what looked like a black belt, was actually part of the wheelchair, to keep her from falling off. it was their wedding picture, he was kneeling beside her wheelchair, grinning. she was the perfect picture of a blushing, ecstatic bride.

i stared at the guy in the picture. the day RN was not exagerrating when she told me that the patient’s husband was handsome. i picked up the picture and agreed that he could easily pass as a hollywood star if looks is all that matters.

then i looked at my patient again, who was embracing the little stuffed dog with her left hand, while writing.

“i miss him”, she wrote.

W is disabled. she cannot walk. her legs are short, and the left was amputated below the knee a few years ago. at 26, she looks like 36, weighing about 200 pounds, breathing through a tracheostomy tube, eating through a nasogastric tube, urinating through a catheter. i’m not sure if all these are complications of her spina bifida, but to say the least, she is a LOT of work. even though she just had the trach a few weeks ago, and that she was able to feed herself a few weeks ago, it is still very obvious that to take care of her takes a lot of sweat, not to mention patience and dedication.

Me: you two look great. and your husband looks very young. how old is he?

W: 24.

Me: how long have you been married?

W: one month.

Me: oh, you’re still on your honeymoon basically…

W: i miss him.

Me: is he coming tomorrow?

W: no, on sunday.

Me: well, at least that’s like 48 hours from now. is he at work today?

W: no, no work.

Me: oh, is he in school?

W: no, just at home.

Me: he takes care of you…

W: my parents take care of me.

Me: oh, you both live with your parents…

W: no, i have my own house, but my parents live a block away..

Me: well, i’ll leave you to rest…

W: i miss him. he gave me those flowers.

Me: they’re pretty…

i had to leave the room. my mind was filled with unhappy thoughts.

preoccupied with her own happy thoughts, unable to wipe the smile off her face, W looked relieved to be left alone.

i was charting, but the wedding picture, and the supposed love story haunted me.

why can’t i just conclude and accept that W met the man who truly looks beyond the physical, and loves in the real sense of the word? that he is so in love with her, he doesn’t care that she is paralyzed from the waist down? so what if he needs to feed her, bathe her, carry her, till death do them part? why can’t i just accept the thought that though it is not common, things like these happen? a handsome young guy falls in love with an overweight, disabled woman; no what ifs, no questions asked.

why do i have to be so cynical?

why do i think he has a hidden agenda? why do i think he is after her disability money and her house? and i can’t shake the thought that a few months or years from now, he will surely get sick and tired of caring for her, he will have an affair…

why do i think he is a full blown jerk who will just hurt W and break her heart to untraceable pieces?

is it because i am depressed that i am thinking depressing thoughts?

can i put the blame on depressing events around me?

i am ashamed of my utter disbelief in true love…

i am horrified at the cynicism i so easily embraced.