May, 2007 Archive

it was a few days overdue, but i did it. a few hours ago, i set up an appointment to talk to our nurse manager about the incident that happened last week, and we had a short but serious chat.

i spent the past days mulling over my feelings, my thoughts, and my fears, that i had to delay the actual reporting. i totally understand how some commenters felt that the relief charge RN involved should be fired. i honestly get that, but i don’t share that opinion. 

some might find this attitude disgusting about me, but i am all for second chances and keeping family peace. if i may elaborate on that, i would like to say that although D (the relief charge RN) definitely crossed the line with the hateful joke he did, it was the very first time, at least in my knowledge, that he did cross the line. i don’t know, he may be homophobic, and not conscious about it, or he maybe a total jerk just waiting for his time. whatever he is, in my opinion, he deserves at least a second chance.

i want him to be reprimanded and be enlightened, that he did something wrong, and that it is not acceptable. if he does it again and i find out? you can bet all your inheritance money that i will do everything within my little power, for him to be fired, and that he will be fired with the worst record ever, he will regret ever messing with me. or, if it doesn’t happen, because let’s face it, i have very little power, you can bet your remaining inheritance money, that i will be out of our unit as fast as i can, and will warn every breathing person to avoid him like a plague.

secondly, and this might be more disgusting to some, i personally know it will greatly affect his family if he gets fired like that without warning. he has a preteen daughter from a previous relationship that he supports, and a new baby with his new wife. despite the fact that there is a nursing shortage, it is not like you can get fired today and start on a new job tomorrow. in as much as i want him to learn a lesson, i don’t want to teach him that lesson in such a jolting way that it will create a major havoc to his family.

those are the two other reasons why i kept quiet for a while. the first one was of course figuring out if i just needed to lighten up and get myself some sense of humor. i discussed it with fellow nurses, who all agreed, in an instant, that what D did was indeed very unprofessional, inappropriate, and definitely not funny.

then of course, there was the majority of YOU…who commented and shared your thoughts with all honesty. that made me realize i am not alone in being an “uptight” person or nurse, who believed helping the sick should go beyond the boundaries of how we feel towards people who are different from us. thank you guys!

that doesn’t mean i am not grateful to those who disagreed with me, because i respect your opinions too. i would like to thank you for your thoughts too. it’s just that after thinking about it, i don’t agree with you. i’m sure we are all adults to agree to disagree.

anyway, as i was saying, after all the internal debates i went through, i made my decision. i sat in that office and honestly expressed how the whole situation shocked, angered, and disgusted me. i emphasized that i was reporting it not for him to be fired, but for it to be addressed, so he will not do it again. ever. i trust that the nurse manager will be true to her words when she said she will “address it accordingly”.

one thing that is worth mentioning here, is the lesson i learned from our nurse manager. she said she totally agreed with my conclusion that it was inappropriate. however, she was much more concerned with the possibility that if i didn’t have the insight to question the said order, and did it without asking, i would have done what could have been very inappropriate  as a nurse.

a good number of people who knew about the incident shared the same view. they were not so concerned that it was a hateful attitude towards gay people, but they are focused on the patient, simply as the patient. to quote the nurse manager, summing up our talk… “anything that involves patient care should always be appropriate. period.” unlike me, she was very objective, and sort of disregarded my all emotional line…”i just can’t believe how some people in our unit can be so hateful”. she acknowledged the fact that there are a lot of phobias/prejudices about race, sexual orientation, or religion, and that fact didn’t shock and bother her. she was all for patient safety. all in the name of PATIENT safety. period.

what can i say? i maybe a bit naive but i shouldn’t be that hypocritical. our nurse manager was right and i think she has the right attitude. there are certain generalizations about certain groups of people that all of us form or embrace over the years. i have seen these everywhere, and i have seen that it defies social status, education, or background. it doesn’t matter who or where people are. everybody carries a sense of prejudice about other people at a certain, although varying degrees. i do acknowledge and accept that now.

needless to say, i have been at the receiving end of discriminating racial remarks and insinuations  a number of times in my life, and it isn’t such a nice place to be.  but the truth is, despite that fact, there were many times when i have tolerated and participated in the same generalizations myself, even if it was only in my head. i may have gone through the process of learning to respect every person’s choice, and am very comfortable in accepting and facing all sorts of different people for a long time now, but that doesn’t give me the right to be mean to other people who are still going through their own struggles, at their own pace.

if i may be bold enough to ask, assuming everyone can be brave enough to admit, who can say they’ve never been down that road? who can say they just woke up one morning and realized we all belong to one earth, and we are all the same, therefore they just accept everyone without any amount of reservation? who can say that they have never looked at a person differently because of his/her unpopular traits, choices, or orientation?

so now, it doesn’t upset me that people can be so hateful sometimes. more than anything, the thing that upsets me is the fact that people take their fears, hatred and prejudices to work. especially in the medical field, where we deal with live, feeling human beings just like us. 

in nursing school, we have been taught countless of times that when we face our patients, we have to make sure we take with us our heads to know, our hands to do, and our hearts to care. nothing else. not our hatred, not our fears, especially not our prejudices. i believe it is but natural for human beings to feel afraid, or feel ambiguous about other races, or sexual orientation, or beliefs, but it is also possible to leave all those ideas at home and go beyond all those things once we step into the patient’s room. 

i am not saying this is not difficult, because it is. the thing is, it does not matter that it is difficult, it only matters that we are aware we owe it to our patients. it is unprofessional and inhuman not to do it. at the end of the day, all patients are human beings, and they deserve to be treated with respect and care regardless of anything that they are, or that they are not.

i understand there may be people who will be disappointed with the course of action i have chosen. whether you think i have made a mistake by taking this all so seriously when all it is is a freaky joke, or you think i was not brave enough to rally for the charge nurse being fired, i won’t question any of that.

i will still welcome your thoughts, and will respect them. it is in hearing other people’s voice that we learn to listen to ours and keep or change them. it is in hearing your voices that i learn to listen to mine, and keep or change it.

“measure, digitally access, rectal tone and circumference q 30 minutes, x 6 hours. document results in the chart.”

i saw this phone order entered by our charge nurse 3 hours after it was written. the intern of the primary team who was assigned to the patient was the one who ordered it, and i know for a fact that she was gone.

concerned that it took me that long to see the order, i was determined to carry it out right away. i was actually a little bit guilty for not looking at the chart a few hours ago when another nurse told me that the charge nurse left a message that my new admission has a new phone order. only, the more i read it over, and over, the more it didn’t make any sense to me. i asked the charge nurse what exactly was the order all about. he told me to wait for him when he finished his break, and he will explain it to me.

while waiting, the on call intern came over. while he was charting, i asked him to look at the order and tell me what exactly it was all about. i told him i found the whole order confusing and that i am clueless as how exactly did the primary team intern wanted me to do it. i told him i sort of have a concept about the order, but it doesn’t make sense to me. i mean, how exactly, and why exactly?

“i have never heard an order like that in my entire life!”, the intern said.

“i know, it sounds like sexual harassment to me. is that even legal? am i even allowed to do that kind of thing? and how am i gonna explain it to the patient, if i myself am clueless as to why i am doing it? and most of all, why am i being asked to do this embarassing thing?”

“wow. i have no idea what dr. blank is thinking, but who is this patient and what was the admitting diagnosis?”, the intern asked.

“he is a 24 year old male. here for pneumonia, unexplained weight loss, and they are suspecting AIDS.”
wait a minute…my very own answer clicked somehow, and it made me feel very uncomfortable. was the primary intern trying to insult the patient by writing this order? what was she thinking? what?

“so? why would she want that inappropriate thing done? i have no idea. let me get back to you, i will ask other doctors”, the intern said, shaking his head.

before the intern came back, the charge nurse was done with his break. i told him i have not done the order yet, and am very uncomfortable about it. was he sure that was what the primarty team intern ordered?

by this time, he was completely cracked up and couldn’t hold it any longer. he whispered “it was a joke”, and that he made up the whole order.

i honestly didn’t know what to say, so i didn’t say anything while he was laughing his head off, so satisfied that his so called prank was very successful. i had to emabarassly tell the on call doctor to forget the whole thing, because yeah, it was just a crappy prank. “it was a bit funny, but very inappropriate”, the intern said.

talk about being inappropriate! when the shift ended, i talked to the charge nurse. i told him: “i don’t know the exact word for what you did, but it was almost like being racist about gay people.”

“that was not racist, that was a joke”, he answered. i explained that i didn’t mean he was a racist, but that it has a similarity. i can’t really find the right word. homophobic seemed like a very light word to describe it. he laughed out loud and waved goodbye, “it was a JOKE!” he repeated.

was it really?
well, i don’t think it was funny. seriously.
please help me clear my mind and tell me…
am i an uptight person who doesn’t have a sense of humor?
do you all think i just need to loosen up?

if you think you can handle the truth…you are welcome to read these 8 random things about me. if you dare, tell me afterwards if you really think i should seek professional help, just for being me

1. my very first job was in the entertainment industry. 
         when i was four or five, people will let me either sit or stand on a table, ask me to dance, sing, recite a silly made up poem, do silly monologues, or make up stories from either a book or a magazine…and they will give me money. i never knew what happened to my earnings, but if you want to know the truth, i know somebody else spent it. if i have the face and body of catherine zeta jones, or the voice of shania twain i could have pursued being an actress/singer. fortunately, i didn’t. so i decided i wanted to be a nurse instead. i’m glad i did, because whether you accept it or not, i’m one of those nurses who really love what i do.

2. i have a self diagnosed mental illness.
         seriously. how do you explain the fact that i have to press the remote/lock of the car three times everytime? three times! or that all my clothes face a certain way, and on the same color of hangers? or that i try to wear all my clothes even if i don’t like them because i feel like they will feel sad if i don’t? okay, explain that to me and tell me i’m not a loony.

3. i am still not over the fact that i only breastfed my two boys for only a few days.
         if you want to make me feel guilty, just mention that i didn’t sacrifice enough to give my kids the best by sticking with breastfeeding. remind me that even if my breasts were bleeding and i cried buckets of tears in pain everytime i tried, i should have persevered. if you dare, you can be totally blunt by telling me that i should have kept on trying until my nipples or breasts fall off, because motherhood is all about pain, and it was just plain selfish of me to just give up. i might end up riding on the “i-am-a- terrible-mother-for-not-breastfeeding-my-kids guilt trip for the rest of my life, but i am not complaining. really.

4. i am annoyed by people who ask “how are you?”
         the ones who are gone just when you are about to open your mouth and answer their question. i once answered a guy who asked me this overused question with a gloomy “i don’t feel good”. already a few feet away from me, he said “that’s great!” i could have strangled him, but obviously, he wasn’t worth my time. or my touch.

5. i fasted for 14 days just before i turned 18.
         not for spiritual healing or enhancement, but for selfish, stupid reasons. i had problems with my menstrual periods which only came once a or twice a year since i was 13. i was so scared there was something seriously wrong with me, but i did not want to go to the doctor for two reasons. one: we didn’t have money, two: i was extremely terrified of what the doctor might do to me. i heard of fasting from a self proclaimed filipino scientist/inventor who talked about it on TV and over the radio as the cure all for any physical problem. i thought about it for months, and finally did it out of desperation. i don’t know if it was a coincidence, but since i was 18, after 14 days of taking ONLY water, my period has been very regular. by regular, i mean every 28-30 days, not earlier, not later. on the dot. for almost 20 years now.

6. i have a lot of weird ideas.
         once, entertained the idea that my oldest sister, who is 15 years older than me, was actually my mother. she eventually found out about my ridiculous thoughts and almost died laughing. also, when i was a kid, i believed that being a grown up is definitely the coolest thing in the planet. weird, because now that i am a grown up, there are a lot of times when i just want to be that innocent, carefree kid.

7. i believe in God, creation, and faith.
         i am not smart or eloquent enough to explain my beliefs to those who are geniuses in proving that God does not exist, or to those who think creation is just a lazy excuse to be stupid, but at this point in my life, i still choose to believe it. it will take more faith for me to believe otherwise. i have nothing against anybody who does not share my beliefs. i am only against people who believe they can take other people’s lives just because they don’t agree with their beliefs. i have a tiny brain, and for the life of me, i will never understand how killing can prove anything.

8. i almost gave my sixth grade english teacher a heart attack. 
         i boycotted our final elementary graduation play rehearsal. it didn’t really matter that i did it, but she was completely caught off guard by the idea that i attempted to take the whole cast with me. what can i say, i didn’t really mean to be mean, but if you’ve ever been to one of those small philippine island beaches, (we had one, just a couple of minutes away from our elementary school) on a warm summer afternoon, you’ll know what i mean, and you’ll definitely give me some slack.

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this has been fun. thanks to student nurse nancy and nurse M for tagging me. it took a considerable amount of self-restraint to stop at #8, but i want to stick to the rules.

on the other hand, i don’t want to stick to the rules too. i am not tagging anyone in particular. if you want to play, leave a comment so i can go and read all about your deep dark secrets too. hopefully, they’re not as boring or as disturbing as mine.

when it happened, i was quite upset. i did everything i knew to change the situation, but the system didn’t let me.

i took a vial of Ativan 2 mg from our Accudose (new version of the Pyxis-a user/password controlled machine where we get meds) for a scheduled order of 1 mg Ativan IV. since i only needed half, i had to get a witness sign in and show that witness i was going to waste the other half because the order was just 1 mg.

when i got to the patient’s room, the patient refused the med. he said he felt like he is getting very dependent on it that he wants to slowly stop it, and just take it as needed. it totally made sense to me, so i tried to return the unopened vial.

the machine won’t let me, because technically, i already wasted half of the content, and it will not let me return an opened vial.

i called pharmacy and explained the situation, emphasizing the fact that i did not want to waste a perfectly usable med. she called her supervisor and got back to me telling me to waste the whole vial because it is too complicated to put the narcotic back to the system. i insisted that there must be another way to avoid wasting the med. she said there was none, and due to legal mumbo jumbos, the safest thing to do is waste the whole thing. i was about to continue to insist but the pharmacist was beginning to sound irritated, almost asking me “what part of WASTE IT don’t you understand?”

i can’t believe it, but what can i do…when in rome, do as the romans do.

it was just the beginning.
in the past four and a half years that i have been working here, in the land of plenty, there were countless of times when i wished i can just take wasted stuff home and put it to better use instead of everything ending in the garbage. imagine the unopened foley catheters or NG tubes being thrown just because it was taken inside an isolation room. how many seconds does it take to disinfect the thing, or to just leave the spare items outside the room, to avoid contaminating them, so they can be returned to the supply room?

when in rome…

i learned to dance to the music so to speak but i must admit i still shudder at the sight of wasted supplies. a waste that can easily be prevented if people just spend a second or two consciously thinking about it. the little things add up and it is because supply is in abundance that people never get the idea. in our unit, if you look in our garbage, you’ll know what i mean. but people don’t look, and i know now that it is because wasting is such a common thing, it has become the norm.

i know. i should get used to it… learn the moves. and dance, if that’s what the romans are doing. i think i am doing well, there have been a lot of times when i don’t even think about saving something anymore. i concluded that this hospital has enough budget, and wasting was just a part of the job.

imagine my shock when i found out the other day that this unnecessary waste of things does not only happen in the hospital…

i was lured into buying a few items to make my face “flawless and prettier” (not my words, the salesperson’s words). after thirty minutes of her efforts to makeover my face, i had no heart of telling her i am not buying anything. after what she thought was her masterpiece, i looked in the mirror and the image i saw literally scared me, because i was unfamiliar with my made up face.

i am tempted to digress, but i won’t. the story of how a salesperson can “brainwash” a grown woman who has never used make up all her life except for a few times to try it on, to buy items she’ll probably never use, is a story for another day.

anyway, i got home and realized i might have been temporarily out of my mind (not because i didn’t like it but because it was way off my budget) when i paid 106 dollars for a lipstick, an eyeshadow, a blush and two small brushes. i went to the store closer to our place, and they were very happy to take it back. unfortunately, they do not sell the items i bought from the other branch, so the manager was called. what do they do with the items after my transaction was completed? the manager nonchalantly replied: ”throw them”.

what? why? if they told me they will throw all of it, just because they didn’t sell those particular items, they should have told me in the beginning. i would have been more than willing to return the items to the branch where i got it so they can sell it again. i found the whole idea so ridiculously wasteful, i suggested to the salesperson that she just take them. i knew she can’t do that, because she will be fired, but i just thought there must be something they can do to avoid wasting everything. 

i raved on and on about the whole thing to my friends and they thought it was ridiculous too, but they all agree that at least, in this country, consumer rights rock.

i don’t know, i need to learn all the other dance moves. you know, to master the craft of wasting, so that i can loosen up and enjoy my supposed rights. after all, this is the land of plenty, isn’t it?

why is it so hard for me to let go of my poor country mentality? how long will it take for me to think, and act, and live like i am in america, because, i am actually in america.