April, 2006 Archive

…and there we were, in our silly scrubs, doing this silly dance.

the dance of joy. a celebration. very early in the morning.

we were mindlessly enjoying the imagined music when all of a sudden, the door opened. like scared, trembling little insects, we appeared frozen as she spoke to no one in particular. her voice was really loud. the confused, yelling patients kept quiet, obviously intimidated.

“HOW COULD YOU DO SUCH A THING TO A MAN WHO DOES NOT TALK BACK?” WHO IS RESPONSIBLE FOR THIS?”

HRH (her royal highness) is the very involved wife of a patient who was admitted in bed 2, a few minutes after i admitted my patient in bed 1.

the first commotion started when a few minutes into their arrival, the supervisor was summoned to see HRH. she demanded a change of attending because she “definitely does not want to have this doctor touch her husband again.” the supervisor, plagued with the dilemma of staffing concerns, was physically staring at the queen’s face, looking like she was listening, but she was actually going through her mind list of people who might just be interested to work an extra shift. after a litany of enumerated reasons why she wants to switch doctors, HRH wrapped up her monologue with a slowly,but sarcastically narrated climax, emphasizing every single word, making it sound like the supervisor does not understand english. she assumed the supervisor is deaf, and she hoped that at least she knows how to read lips. “so. you. know. it. is. not. as. an. insult. that. i. say. this. but.there. are. a. lot. of. valid. reasons. why. i. should. not. trust. my. husband’s. care. to. anybody. especially. those. who. do. not. know. what. they. are. doing!”

then…

she wanted the antibitotic started STAT, because the WBC is 10.8, and threatened to go AMA if it was not given pronto. no, she would not hear of any “stupid” reason of waiting till the blood specimen for culture is drawn before starting the antibiotic.

then…

she checked her husband’s temperature with her own thermometer every ten minutes. no, i’m not exagerrating. she would go out of the room, tell no one in particular that the antibiotic needs to be started ASAP because the temperature is alarmingly increasing at the rate of .2 degrees every 10 minutes. yeah, from 98.6 to 98.8!

then…

she demanded that the charge nurse call the nephrologist. now. to make her point very clear, she had both of her hands up in her waist, chest out, stomach in. she intently watched the charge nurse’s every movre, as the page is being entered in the computer. no, she didn’t care if it was 1 in the morning, the doctor knows her, and she wants to talk to him. now.

then…

she took all the names of nurses who stood at least a foot away from her husband, because you know, she comes from a family of lawyers. also, she asked “why are you looking at me? do you have a problem?” when your gaze happened to meet hers.

etc. etc. etc. boring. tiring. boring. tiring. boring. boring. boring. boring.

then, opportunity knocked very loudly…

the supervisor wanted a telemetry bed for another patient in the ER. unfortunately, (fortunately if you are one of the lowly mortals who have to deal with this clearly deranged, but very powerful entity called HRH) her husband does not need the monitor. our charge nurse, not wanting to miss this once in a lifetime opportunity, did not waste any precious second.

while HRH was out for 15 minutes, the transfer happened. the husband, who got all our sympathy and admiration for putting up with this ideally dysfunctional relationship, softly apologized to his nurse, and assured her that like her, he is “very drained emotionally, because of this.”

all i have for this poor guy was pity. unknown to HRH, who declared she is immuned to the visiting policy because she MUST be with him all the time, i witnessed a lot of their private moments. the time when she was constantly rechecking his temperature, and he would say it was just checked, and she would whisper “sssshhhuuuuttt uuuupppp!” the time when she forced him to tell the doctor he wanted to go home if the antibiotic is not given right away. and all those little moments in between, when she was playing the whole situation like a pro, making it look like a romantic endeavor.

i was not being nosey. everything was just a coincidence. i was giving 4 units of blood to my patient who had a hemoglobin of 4.3. he was too weak to participate in the whole length of the movie, but was totally feeling the guy’s pain when he murmured “and when is her drama gonna end?”

this is an accurate account. the curtain was the only thing that separated me from the couple in question. i did not turn the light on everytime i checked my patient’s blood transfusion. and like most of the night nurses i know, i can enter and exit a room without making a single sound. it didn’t come as a surprise that HRH was oblivious to my presence when she was doing her monologues.

if only there is no such thing as HIPPA, i will actually write HRH’s real full name here. i will not do that just to be mean. i will do it because we are a team, and we are all in this journey together. you, my fellow nurses need to be warned. she is vicious, manipulative, and loud, if not crazy. avoid her, and all those who act like her. avoid them like the plague. at all costs.

anyway, when the transfer was final, and the patient’s bed was out of sight, we started the dance. only to freeze when we were interrupted by the presence of HRH. oh, just when we started feelin’ the groove.

the story continued in the unit where the husband was transferred. where HRH demanded to speak to patient relation. now. and woke up all the other patients with her pleasant, signature loud voice.

at the elevator, we were still discussing if she was indeed of royal descent, or actually the WFH (wife from hell). it was a little difficult to decide. we may be a bunch of unintelligent beings, as compared to HRH who happens to know everything, but we sure know how to turn a rather exhausting situation into a dancing and a laughing frenzy. when she was gone, we all shook our booties, and we laughed like maniacs.

on the other hand, there is something seriously disturbing in this whole scenario. it is the fact that there are people, like this woman’s poor husband, who just allow somebody to manipulate them like they have no brain. they just sit back and watch somebody disrespect them in a very subtle but painful way. why is that?

why do human beings punish themselves like that?

there must be a sensible answer out there.

and i hope it is not love.

“when i was a student, i put up with that crap, but i have been a nurse for over six years now, i am so done with that!”

H was furious. in her other job, she was asked to put up her hair. per policy, her charge nurse said. well, H was not only furious that she was never told of the said policy when she started working there about two years ago, she also made it clear that she will quit if they will ask to put her hair up again.

hair up, or hair down?

is there a difference? is there a point to all this debate?

if you are a patient, or a family member of the patient, does it matter to you if the nurse’s hair is up? does it bother you that she/he has this gorgeous curls that flow down her shoulders, locks that occasionally cover the face, or hair that’s just so long and shiny it affects you sexually when it touches your sheets or your skin?

if you are a nurse, do you look at other nurses with long hair flowing down their shoulders differently? do they look unprofessional to you? do you think that they, and their patients are better off if they put their hair up? or you say to yourself: “who cares?!”

and what is the difference when you were a student nurse? did you just do it because you were asked by your clinical instructors to, or you subconsciously thought that putting your hair up will give you an appearance of professionalism that will make the patient overlook the fact that you are still a student?

and taking this discussion to a different but totally relevant level, let me ask you this out of curiosity. if your nurse is trying to conceal a mark in her/his neck left by some passionate mindless kisses…would you rather see her/his hair up and insinuate about the nature of the kiss, or see hair down her/his shoulder and stay uninformed about your nurse’s sexual life? or you couldn’t care less?

does it matter to you?

when you know that recapping a needle with both hands is a big cardinal sin and is the very reason why you get a needlestick, and you still do it because you think it will never happen to you…you know it is no big deal, but that does not change the fact that you are stupid.

that you are busy, and was thinking about other more important stuff while recapping the needle, are lame excuses, and you know it. you know you should just either toss the syringe with the needle in the needle bin, or just didn’t use it in the first place anyway.

well.

the same is true with hitting a parked car. or cars.

when you know that stepping on the brake, and picking something up from the floormat of the passenger side of your car might lead to your unconscious release of the brake and loosing control of the wheel, and you still do it thinking it will never happen to you… you know it is no big deal, but that does not change the fact that you are stupid.

that you are in a hurry, and there are no cars coming your way or behind you anyway, are lame excuses, and you know it. you know you should have parked the car, removed your seatbelt, before taking care of whatever it is that you want to pick up from the floor.

you go through the tedious process of the needlestick protocol by having your blood drawn a few times, filling up a pile of paper works, and a lifetime of validating your utter stupidity…because you know how simple it is to avoid a needlestick, but it still happened. there are innocent mistakes, and there are stupid mistakes. usually, for a nurse, a needlestick is a stupid mistake.

you go through the tedious process of dealing with the insurance people, of taking your car to the shop, of smiling moronically to the owners of the cars you’ve hit, and a lifetime of validating your utter stupidity…because you know exactly how to avoid hitting parked cars, but it still happened. there are innocent mistakes and there are stupid mistakes. usually, for a person with a little brain, hitting two parked cars, while picking up a small jar is a stupid mistake.

i didn’t have a needlestick.

i hit two parked cars.

and if you are wondering if i’m okay, i am. thank you for asking. will probably be paying twice for car insurance next year, but okay. will probably tell a hundred more people how i am the most stupid person earth, but okay.

i agree with everybody who assured me i should be grateful i am safe, and more grateful that i have not injured anyone. i do not trivialize that truth. i have endlessly thanked God for all the reasons i should be thankful for, but that does not change the fact that i’m stupid.

i have been blaming myself for over 40 hours now, and have angrily tossed the half empty jar of vinegar on the garbage, just before the police came. but still, i cannot get over the reality that stupidity is shamefully painful.

anyway, just so you know, i have made a resolution that i will never pick up anything while i’m driving.

not even when richard gere is calling, desperately begging me to hang out with him. i will not pick up the phone. no. not while i’m driving.

not that the idea of walking in the beach with richard gere does not make me tachycardic anymore. it’s just that i don’t want to make the same mistake, and call myself stupid for the rest of my life.

we got paid two hours to read this book. not only were we paid to read it, but there was a raffle for four free disneyland tickets at stake after the book club style discussion in our mandatory staff meeting last week.

it wasn’t a shock to see the room overflowing with people, everybody hopeful to kiss mickey mouse’s nose for free.

as expected in raffles like this, i did not win. it didn’t matter that i used every possible strategy known to me, including hypnotizing the one who was drawing the names. i still lost to our newly hired staff, and to our charge nurse who was so excited to go, it made me sick.

sick enough to make me just decide like that. i asked somebody to switch shifts with me, and off we went to disneyland yesterday.

i will definitely not bore you about how the almost 15 hours of stay in the happiest place on earth went by giving you all the details, but i will tell you that things are the same since Fred Lee was there.

you see, when he was still in disney, every castmember (that’s what they call their staff) are expected to be happy and really love their job. if they are/do not, and somebody complained, they get fired on the spot. i’m sure the guy who took our ticket, who had this catatonic looking smile, and the lady who snapped at my three year old when he was a foot beyond the mark when the parade was going on, would have been fired on the spot if i was heartless enough to complain about how rude they were to us, their guests. but i don’t really see myself as somebody who would enjoy preempting a scene where a 60 year old man or woman would be asked to pack up from disney after decades of stretching their happy faces. besides, i was drunk in the sweetness of churros and the fact that a medium sized bottle of water is $2.75!

i apologize for digressing. i’m supposed to share with those interested, how the book positively influenced my life as a nurse.

first off, the one that stood out to me is the idea of answering the call light personally. i’ve always believed that if patients call, their call for help needs to be addressed ASAP, and personally. the intercom is such a robotic, inhuman sounding device that make the patients feel like they are being dismissed even before they have asked for anything. it is amazing how a unit full of confused patients who think the call light is something that needs to be tested all the time, and being surrounded by nurses who think that a few steps of going to the patient’s room is a waste of time when the patient can communicate through the robotic device, can change one’s belief in a couple of years. i started using the intercom a year ago, and i regret that now. so, if you get a nurse who answers your call light personally, and you are in a big hospital in a little city in southern california, chances are, your nurse is me, or he/she has read Fred Lee’s award winning book.

another thing that stood out is the idea that “courtesy is more important than efficiency”. yeah, even if you want to be efficient by doing your assessment, vitals, etc. on time, if the patient is clearly having a distressful converstaion on the phone with her husband, be courteous and come back when things have calmed down. and if the patient’s family is staying beyond visiting time, it sure is efficient of you to follow the rules, but it won’t hurt to be courteous by reminding them nicely, or by allowing them to stay a little longer in exceptional circumstances.

and of course, empathy can’t be emphasized more than enough. like, even if you are confused, you don’t want a bath with all the doors/windows open and expose yourself to the public for viewing, right? so why would you do it to your patients?

okay, don’t endure my boring attempt to review a book, go ahead and tell your nurse manager to give you this book for free, and while she’s at it, like our nice nurse manager, she can also pay you. and, to ask her to go the extra mile and give all of you free tickets to disneyland, because really, a raffle doesn’t really mean a thing to those who do not win.

and, if you cringe at paying $2.75 for a bottle of water, just like me, when you go to disney, do yourself a big favor and bring your own bottles of water.