Nurses Aren’t Very Nice People

That was the search engine term on my blog site stats.

That’s the perception of nurses by more than a few people (including myself at times when I’ve been a patient).  I have some definite opinions about this, and most of it relates to the move towards a more ‘concierge’ industry with those blasted ‘customer satisfaction’ surveys that emphasize the trivial things (hot coffee, visitors happy, everybody cheerful and fit for a ‘Leave It To Beaver’ episode) and not whether or not the person got out of the hospital in better shape than he/she entered it. If people want customer service, they need to go to a spa. If they want professional healthcare, that sometimes isn’t all warm and fuzzy, they want nurses who know their jobs and do them in spite of the nastiness of some of the patients and inadequate training of the newer nurses from SOME schools (definitely not all of them, but I’ve heard many newbies talk about things they didn’t do in school… ‘old school nurses either did it or didn’t graduate).

I haven’t met many nurses who don’t genuinely want to give good care.  Now, there are those who go into it for the relative job security and decent base pay.  Nursing isn’t for those who have no compassion, and compassion isn’t teachable.  I apologize for those nurses. They don’t belong in the field.  But for most of the nurses I worked with over 20 years of being an RN, and for the additional 8 years that I’ve been in and out of hospitals as a patient (and seen a lot of good young nurses, and a lot of ‘do-nothing’ nursing students….not their fault- it’s how things are done in some schools), most really do want to do a good job.  That also may mean that having perfect coffee, enough chairs for visitors, and other ‘maid’ duties aren’t on their list of priorities.  If someone is going south in the next room, YOU may not be at the top of the list of people to please at that moment.  So sorry.

You may not realize the pressure put on nurses to make those satisfaction surveys glow, which demeans the professional aspect of BEING a nurse.  Raises and yearly evaluations include those stupid satisfaction surveys, so your coffee not being hot enough (which the nurse has nothing to do with- or may not know how you like your coffee as some inborn knowledge) becomes more important than whether or not you lived through your illness or injury.  Throw in some unprepared new nurses, a cranky doctor or ten, and your nurse may struggle to get through the day doing her JOB- not being your waitress.  Does she want you to be happy? Of course she does !  But someone down the hall who is trying to die twenty ways to Sunday comes first…and is stressful to care for.  Your nurse became a human long before she became a nurse, so cut her some slack.  Chances are she hasn’t peed once in the six times she’s hauled your butt to the bathroom.  She probably hasn’t eaten during an 8 hour shift while bringing you at least 2 meals, and maybe grabbed something in the breakroom during a 12-hour shift.  Yeah, you’re the patient, but the nurse can’t run on fumes with urine backing up into her brain.

What you don’t see are the nurses who have to wipe away tears when they leave your room because they know the diagnosis your doctor is going to tell you in the morning and it breaks her heart knowing that you’re going to leave a young widow with three kids under 10 years old, within the next year to year and a half.  You don’t see the nurse make six phone calls to find one person who will talk to her about getting some discharge planning help that social services, who is usually very good, can’t seem to get anywhere with because you don’t have the right insurance, and you need some specialized care (like alcohol rehab)…but the nurse knows some people in the business.  You don’t see the nurse who has spent the last three holidays at work without her kids or family because another  slacker called in. Again.  You don’t know that your nurse is being bullied by her boss because one time she said she couldn’t cover a second extra shift that week, and she’s just trying to keep it together long enough to find another job and keep a paycheck coming in.   Basically, your nurse is human, and has her own stuff to deal with- and you.  And five more along with you.  She knows that you are the center of your universe when you’re sick… but she has to watch out for all six of you.  And generally ignore herself. Yep- it’s the job.  But sometimes it gets old when there are just more people complaining.

SO before wondering if nurses are nice people, ask why they should be when they get crap from both ends of patients’ bodies, peed on, slapped, yelled at, belittled and demeaned, and complained to non-stop, and then search engine phrases sounding if all nurses are like Nurse Rachett from ‘One Flew Over The Cuckoo’s Nest’- when all she wants to do is sit down and talk to you about how the hospitalization is affecting you.  She WANTS to spend more time with you.  She wants your coffee perfect and all of your visitors there after visiting hours to be comfortable.  She wants you to get well and have a wonderful rest of your life- but unlike you, she has to deal with the reality of however many patients she has assigned to her, and the responsibility to keep you all in viable condition until  the next nurse shows up.   Even if you have an IV and multiple IV antibiotics going, and tubes in more than one orifice, fresh surgical wounds, and oxygen, YOU may be her easiest patient.

Make sure your needs are met, and hope for the ‘wants’- but understand that you aren’t the only one that your nurse is looking after.  She does care. She wants you happy. But she’s only human. ❤


The Psychotic State University School of Nursing

I must say that the vast majority of nurses I’ve worked with over the years have been wonderful.  Some were a bit on the side of displaced sorority sisters in need of a house (annoying and way too old to be stuck in an early 20-something mentality). And there were some that just left me with my jaw dropped through to the floor below me or backing away in fear.  The graduates of Psychotic State University’s School of Nursing. A frightening lot of the eternal mystery of  WHO LET THESE PEOPLE GRADUATE?  I understand someone needing to be at the bottom of the class, but puhleeze….

One of these miracles in self-survival worked with me on an acute neurology floor. Most of our patients were at least partially dependent for just about everything. Everybody helped each other out when moving these patients up in bed, cleaning them up, or transferring them to recliners or chairs.  One ‘special’ nurse (I’ll call ‘J’) was nothing short of mind-boggling.  I’d gone in to help her move her patient up in bed, and since we all had helped each other do this a bazillion times, there was an unspoken ‘dance’ in getting the job done. Put the side rails down, put the head of the bed down, move the patient up, put the head of the bed back where it had been, make the blanket look spiffy, get the side rails back up, get the call light within reach, and leave. Done.  Depending on how tall the bed was, we’d raise it to a ‘working’ height (to save our backs).  Anyway, I had started putting the head of the bed down (it was still moving) and noticed ‘J’ fiddling around on the other side of the bed, mumbling to herself.  I asked what she needed and she replied “I’m trying to put the head of the bed down.” 😮   I’m sure my eyes bugged a bit.  Another night, a bunch of us had decided to order burgers from a nearby place, and I asked ‘J’ if she wanted to order anything. Her reply:  “I don’t like Chinese food.”  Alrighty then….no Chinese burgers for ‘J’.  *shaking head* While she never smelled of a particular herbaciousness, there were suspicions.

At this same hospital (which really was a nice place to work- these examples were the flukes of nature that joined us for a period of time), there had been some budget cuts and an associated long term care portion in a free-standing building across town was being closed down permanently.  The staff nurses there were being dispersed throughout the hospital, ready or not.  Long term care nursing is its own animal.  I’ve worked it, and loved it- but it is NOT the same as acute care nursing.  The skill set is much different- and in some ways much more varied than the specialty floors set up in that hospital.  Well, our ‘gift’ from the defunked facility was nearly a fossil herself. She had to be older than many of the patients she took care of.  She was pleasant enough, and easy enough to get along with, which was always tricky in a group that had worked together for any period of time and knew each others’ strength and weaknesses’.  But she was a bit ‘thick’.  Normal conversation seemed to be a bit of a struggle for her. And her hearing was fine. Evidently normal nursing skills were also a bit difficult.  We had a policy that all insulin doses were double checked by another nurse.  One day she asked me to check the dose she’d drawn up.  No problem. Glad to help.  I nearly passed out when she showed me a 3-cc syringe with the insulin in it.  For those not in the medical loop, insulin is drawn up in very specific insulin syringes with 1-unit increments marked on the side of a ONE-cc syringe.  I was dumbfounded. I think part of my jaw may still be on that hospital floor.  I asked her how she knew how much insulin she had in that thing.  She had crickets and the deer-in-the-headlight thing all going on at the same time. She didn’t know.  And it didn’t seem to bother her that she was about to kill someone or leave them in a vegetative state. I’m not sure exactly what I was supposed to check, but I checked my butt on over to the charge nurse after taking the syringe away from Nurse d’Permanent Sleep.  Oy.   Needless to say, Einstein was sent for some ‘remedial’ education. We never saw her again.

At a drug/alcohol rehab place I worked at, many of the nurses were primarily psychiatric or chemical dependency rehab nurses. No problem since that’s what we dealt with %99 of the time, and the medical complications that came up were usually pretty specific to detox.  But…we had patients who had some ‘side effects’ to their years of drug usage that were emergency situations when they happened.  One weekend night nurse (a ‘traveling’ nurse- who were also good for the most part) was giving me report one morning about a new patient who had a high fever earlier in the shift (let’s say 103 degrees for some reference point).  This nurse was SO proud of herself that she’d been on top of things with Tylenol, and the guy’s temp was now hovering in the 97-degree range. That was NOT good news. When someone becomes septic, the body fights with a fever as a way to help heal itself; when the temp goes sub-normal it means the body can’t cope any longer and is decompensating. The train to dead has left the station.  I couldn’t get out of report fast enough to see if the guy was even conscious anymore.  He was, but looked BAD.  I got the OK to send him to the local ER to get labs done (and I couldn’t imagine them not admitting him to ICU). I was pretty sure he was in septic shock.  The local ER didn’t like drug patients, and sent him BACK to us after drawing the labwork.  Scared me to death.  I’m not sure what we did that day to keep him from dying, but the next morning I got a call from the hospital telling me his blood cultures were bad. Ya think?  He was an IV drug user with a massive infection around his heart.  The drug rehab doc arranged to send the guy back to the hospital where he stayed for a couple of weeks on IV antibiotics before returning to complete his drug rehab, with another 4 weeks of IV antibiotics every 3 hours (at a facility where the nurses weren’t used to giving IV meds, or dealing with a PICC line- I didn’t mind).  He was a great guy who got a second chance, no thanks to the Tylenol dispenser.  He should have been shipped out while his fever was high.  High fevers were not typical of what we used to see, and in an IV drug user should be a huge clue that something is wrong.

One of my nursing student compadres was ‘interesting’.  He reminded me of Waldo from ‘Where’s Waldo’ fame, sans striped clothes and beret.  Tall, skinny, huge glasses, and screamed “I’ve got uber-geek genes’. But he was very sweet. I got paired up with him to do a report on riboflavin during our Nutrition class. We had arranged to me AT the library at a specific time.  I got there a bit early, and waited.  The arranged time came and went.  OK, maybe he got hung up somewhere. SO I waited a bit longer. Nada.  I peeked inside of the library, and he wasn’t there. I wandered around, looking around the library and inside of the library, and never found him.  The next time we had class, I asked him why he hadn’t shown up. He looked baffled and said “I was there !  I was in the back in one of the cubicles.”   Really?  I was supposed to find him in the library’s equivalent of a cave?  I asked him if he crawled in the trunk when someone told him to meet him at the car…   I did my own report, and got an A. 🙂 This guy- sweet as he was- didn’t make it through the first class that newbie RN students take (Fundamentals of Nursing).  God looked kindly on patients everywhere.

I’ll think of more ‘special’ nurses to write about.  I learned something from each of them, and wondered how they ever got through the nursing schools they went to, or hadn’t been reported to the nursing board for being dangerous (even if unintentionally- they weren’t ‘killer nurses’, they were idiots).  I was scared for their previous patients; maybe they were no longer able to complain about the nurses in question… 😮

Freak Magnet

Sometimes I’ve wondered if I’ve got a sign on my forehead that screams “ALL FREAKS, C’mon over” !  I’m sure that everybody has experienced the same sorts of people in different ways…and some days I’m not so sure.  Maybe some of it has to do with being a nurse. People see nurses as helpful and nurturing, when we’re just as weird as everybody else- we just get paid to take care of the lost and vulnerable. And then there are the folks who would fit nicely  on the side of ‘Criminal Minds’ that either gets shot or lengthy prison sentences. The spooky people.  Not all are dangerous to others, but the danger to self thing eeks in there. Regardless, they don’t fit well into a ‘normal’ life.

Let me start with a director of nurses (DON) who had been one in a line of them at a very nice nursing home after the ‘good’ DON had gone on maternity leave. He happened to come along during a time when a new administrator was also getting used to all of us.  Initially, he seemed a bit intense, but not pathological.  One of my duties when I was working on the weekends as the RN Supervisor was to log in the discontinued medications that did little but take up room in the storage cabinets in locked medication rooms. I counted each pill on each card of pills (packaged at the pharmacy for nursing home med carts), bottle of loose pills, or made sure injectable medication vials had a reasonable amount left for what the sign-out sheet said it should have.  Narcotics (or ‘scheduled’ drugs) had to be accounted for separately and documented on specific forms.  It was mundane, but necessary. At one point, the DON asked me for the keys to the file cabinet  in his office where we kept the ‘logged’ drugs.  He was the boss, so I handed them over- no problem.

A few weeks went by, and the nurses on the floors said that nobody had picked up the growing piles of discontinued cards and bottles of medication for a while; they wanted them out of the way. I asked the DON if he wanted me to log the meds in that coming weekend ( I think this was either a Thursday or Friday). He looked at me and closed the door behind me in his office.  Gulp.  He then pulled out a .44 semi-automatic handgun out of the desk. That alone was a huge, HUGE problem. Texas was pretty gun-friendly, but in 1994, guns and old folks weren’t a good pairing.  He pointed the barrel at me as I sat down (which I decided to do before I keeled over), and asked me if I was going to tell anybody about our little talk.  Nope. My lips were sealed. Everything was very cool (as I’m imagining my body being found after the weekend, ripe and smelling up the place).  He handed me the keys and told me to go ahead and log in the meds that were piling up.  NO problem. Happy to do so.  Can’t wait to get started. Did he want coffee with that?

But that weekend, I noticed that every last narcotic form I’d filled out had been rewritten in his handwriting, with no way to figure out what had been removed from the lists I’d been keeping. I had a very specific way of tying the bags when I was done, and how I kept the narcotic sheets separate.  It was a federal law that this all be done according to the rules. I liked following the rules 🙂   I didn’t like having my work screwed with by a gun-weilding nutjob of a boss.

I  didn’t like even knowing about the gun. But I was also initially scared enough that he would shoot me, run off with piles of drugs, and nobody know why I was found belly up until they start looking at the paperwork. By then, he’d be on some uncharted island in the South Pacific, in some hut powered by a bamboo bicycle generator and drinking coconut drinks. The new administrator didn’t know any of us that well, and I wasn’t super tight with the assistant DON, but I had to tell someone. The ADON ‘G’ was outside smoking late that next Monday afternoon after nearly everyone had gone home. I told her about the gun.   She knew me well enough to know I wouldn’t come up with some sordid story about someone.  We agreed that we’d both go to the new administrator in the morning, before the gunslinger got to work.  We did, and told the newbie administrator. By that time, the DON had turned in his resignation, and it was decided he need not complete the two-week notice. He was free as a bird.  I have no idea what else was done about reporting him to the board of nurses (not sure if mandatory reporting was in place at that time), but I was told (after he left)  that before he left, he’d taken it upon himself to just stop some lady’s order for morphine- pills and injectable- and they were never seen again.  That created a HUGE mess with calling the doctor and getting the stuff reordered from the pharmacy for the poor little lady who still needed the stuff. The floor nurses were going nuts counting everything that wasn’t nailed down, and making sure their names were clear (they were).  I’ll never forget the business end of that .44 charcoal gray gun ‘looking’ at me.  “Two in the chamber, ten in the clip”…. whatever that means, it didn’t sound good.

Another time at this same facility, there was a sweet certified nurses assistant who was noticeably quiet, but she got her work done and wasn’t an attendance issue. Those sorts tended to fly under the radar. She was probably in her early 20s, and a member of the ‘fashion isn’t my thing’ club (I also belonged to that club- no judgement from me). We all worse scrubs while working, so looked pretty much the same (in different colors and prints, depending on the department), but when she came to get her paycheck, she dressed ‘depressed’. That was my first clue. I’d talked to her several times, and we had a decent rapport. I could tell there were things going on, but didn’t have any reason to pry. Her work was acceptable. I was part of the nursing management bunch, but did patient assessments and staff training/infection control- not the hiring/firing/counseling stuff.  Anyway, I kept an eye on her.

One afternoon, I got a call from the next door emergency room. They had the CNA there. Her friend wanted to talk to me.  Seems this CNA had slit her wrists. I wasn’t sure why I was being called, but the friend asked if I could talk to the staffing nurse (ADON) and let her know that ‘L’ wasn’t going to be there for her next shift; ‘L’ didn’t want to talk to anybody. I asked where she was going when she was done at the ER (as in what psych facility is going to evaluate her?). She was being discharged home.  With sharp things. By herself.  I didn’t like that at all. I knew ‘L’ lived alone. She never mentioned any family or support system.  OK, not good.   When they left there, I needed to see ‘L’ with my own eyes, so asked them to come over to work, and I’d talk to her.  She agreed via her friend.

In the meantime, I tracked down the social worker (from hell, normally) who was still there; I needed help with this one. And she got nice about it all, which I was thankful for. She got on the phone and started making calls re: acute psychiatric facilities who would do an impromptu assessment as soon as we got ‘L’ over to their facility.  I don’t remember who the DON was at that time, but I think she was gone for the day (it wasn’t gun-boy).  ‘L’ got over to the nursing home in a little while (wrists wrapped in gauze), and agreed to go with the social worker and me to the psych hospital, just to see ‘what her options were’.  I was hoping they’d keep her for a few days, so she’d be safe.  She was worried about losing her job if she checked in to a psych facility, but I told her that being checked out, and getting help was going to help her keep her job. Our administrator (before the one with gun-boy) was very compassionate.  ‘L’  agreed, and the psych facility did decide to admit her. She was in and out of there over the next few months (once after I sent the police looking for her as she had uncharacteristically not shown up for work), and ended up getting shock treatments.  She came back to work eventually, and while a bit subdued, she was doing better.  I learned more about her past, and she had reason to feel overwhelmed and hopeless.  Everybody has a history…

Another coworker (an LVN at an acute care hospital working on the neuro floor) had some ‘issues’.  At work, she was fine.  Not employee-of-the-month, but she did OK when she was there. We were both fairly ‘young’ nurses- as far as time out of school, and also just plain young, in our early 20s.  ‘A’ had all sorts of respiratory problems- mostly asthma. She had some attendance issues as a result, and the hospital had a ruthless attendance policy. She could be admitted in the hospital on oxygen, and it counted against her attendance record.  Anyway, a few months after I’d been raped and beaten in a very publicized case, ‘A’ calls me and says she had been attacked overnight by a former boyfriend, and needed help getting her dog to the vet. Fido had been cut by the boyfriend’s knife per her report.  I immediately agreed and went to pick them up.  Something seemed ‘off’.  Fido was frisky and happy to see me (his  usual goofy, non-traumatized behavior). There was a tiny cut  on his paw (more worthy of a bandaid than a trip to the vet), and ‘A’ had some odd looking cuts on her neck…the depth wasn’t something I’d expect from someone who had been seriously sliced by a rabid ex-boyfriend, and the way it went from deeper to more shallow from left to right looked kinda self-inflicted to me (she was right handed). But I didn’t want to believe that.

‘A’ told me she’d been whacked in the head, and felt horrible, but after going to the vet, how about we go get some lunch and maybe do some shopping.  😮 Everyone deals with stress differently…but another piece of the puzzle wasn’t fitting well. But, I agreed.  We spent most of the day together, and during that time she told me that the police had asked her for this guy’s photo- but she didn’t feel like getting it for them. WHAT? Not helping to apprehend this guy?  I had no ability to understand that ‘reasoning’ at all.  I’d been held in my apartment for 6 hours, finally escaped and called 911, and police ended up shooting the guy in my bedroom when I’d been attacked less than 7 months earlier. Why was she doing this?

I decided I needed to get home, and she suddenly begins to have symptoms of a concussion.  Puking, head pounding, vision a bit blurry…. so she now needs a ride to the ER for a CT scan and neuro evaluation.  The day was getting so very long (and more and more weird). She ended up being cleared for any sort of head injury, and told that basically she was fine.  I dropped her off at her apartment, drove like a bat out of hell to get home, and turned my answering machine off when I got there. She could dial 911 in a real emergency when she was going to cooperate with an investigation.  I was done.  I was no longer working at the same hospital by that time, so rarely saw her… I’ll never think that she was telling me the whole story- OR stop wondering if the police had ever actually been notified of the ‘attack’.  What made me even more mad was that the dog had been involved.

I got much more jaded when crises came up with some coworkers.  I had my own stuff to deal with, and had also become much better at sorting through when someone needed  help that was appropriate for a friend or coworker to handle.  I had times when coworkers helped me through some lousy times, and most of that was when they offered; I didn’t seek them out.  I was always very thankful for their time.  But,  I got careful about that as well, as crises junkies also like to be on the ‘helper’ end, not just the ‘helpee’.  One in particular had been a huge support system during some eating disorder stuff that was pretty serious, but when I got better, she wanted nothing to do with me. That hurt a lot.  There are a lot of people out there who are taking care of people who need keepers themselves.  Or who help to fulfill their own self worth needs.  There’s nothing wrong with finding satisfaction with helping people (professionally or on a friendship level), as long as the needs of  those being helped are the first consideration- not some twisted need for being needed.  Sometimes it’s a fine line.

I can think of others… these just stood out tonight.  Stay tuned for the continued saga of the  wacky side of nursing, and whacked nurses. :/

Emergency Room From Hell

There is a local emergency room that actually scares me.  I’m not the only one- whenever I mention its name to someone (even my new oncologist who works for the same organization) the reaction is usually “Oh, I know what you mean. I/my brother/mom/dad/friend/ etc went there and almost killed me/them.”  Their posted patient satisfaction percentages have been in the %60 range. That is BAD.  Hospitals run on patient satisfaction surveys (which is a whole other nightmare for healthcare professionals).  Reputations are hard to fix.  What is so bizarre is that the rest of the hospital is fine, or at least survivable. I’ve had many outpatient tests, a couple of admissions from the ER, and also a knee replacement at the same place, and the staff was good.  I did have some complications after the knee replacement that were figured out a bit late, but nothing as bad as their ER.

One time when I was admitted, I had a nurse tell me that I needed to go home.  At the time, I was on a heart monitor because my heart rate had dropped into the 30s and was being erratic. But she looked familiar- I think she was one of the hags from the ER who was working on the cardiac floor.  I never could figure out how nurses could be so nasty.  I’ve had some unlikable patients, and some that were really unpleasant to deal with- but I’d never be inhumane or callously disregard their dignity.

I’ve got multiple chronic illnesses, and I’ve been an RN since 1985.  I’m on disability, but I keep my license current, and I know the appropriate manner in which to speak to and deal with patients. I’ve been a staff nurse, supervisor, charge nurse, and department head.  I’ve also been sent to various ERs over the years, though this scary one has been the worst, hands down.  I was often sent there from work, unconscious, either from being post-ictal (what happens after seizures when people sleep very deeply) or my blood pressure bottomed out from my autonomic nervous system not working right (dysautonomia), and I’d pass out.

Other times, someone called 911 when they were either with me, or on the phone with me, and they could tell something wasn’t right (turned out I had some medication interactions that weren’t figured out for quite a while that contributed to some of the blood pressure problems).  I was labelled a ‘frequent flyer’, which is an extremely derogatory term given to patients who generally don’t have primary doctors and are often non-compliant. Neither of those applied to me. I saw my regular doctor monthly, and all blood levels of anticonvulsants were always therapeutic. I’m on disability because my seizures are not controlled. I’ve had testing done to see if part of my brain could be removed to stop the seizures, and that turned out not to be possible without causing more damage than it could help.  I’m not some joke patient who shows up for the heck of it (I’ve been accused of being bored, and using the ER for entertainment at the bad one).

But, the nurses and doctors at this ER didn’t care about me as a human at all. They never asked about regular doctor visits.  I was told I was a ‘wasted bed’ because I’d been brought in with seizures.  I was told that it was highly unlikely that I was compliant with anything.  They didn’t understand- or even try to find out- what I was really like as a patient- when I said anything that contradicted their assumptions, it was ignored. They made their assumptions and treated me as the parasite they thought I was.  The dysautonomia isn’t all that common as a given diagnosis.  It causes extremes in blood pressure and heart rates (and for me, heat and pain are major triggers).  My blood pressure would drop to a dangerous level at home  and per my primary doctor’s instructions, I would call 911 when it got below 70/50.  It was often much lower, and the lowest I know it to have gone is 44/16 during a tilt table test.  Even with objective symptoms, I was treated like a head case.

I rarely remember getting to the ER.  I had learned that when I woke up and saw the drop ceilings and bright lights and equipment, I was in the ER.  One night I woke up and a doctor was counting my pills from medication bottles EMS had brought from my apartment when a neighbor called them after I passed out in her apartment.  I asked him what he was doing, and he asked if I’d overdosed. I said definitely not- and asked what happened. It had taken 4 bags of IV fluids to get my blood pressure up to 80 systolic, and the nurses were getting me ready to go to ICU for dopamine (a resuscitative drug to maintain blood pressure). I ended up not needing it, since I managed to stay around 80 systolic, and I was making sense once I regained consciousness. But in the preparation to send me to ICU, a urinary catheter was inserted.  The balloon that keeps it inside was inflated before it got all the way into my bladder, and stretched my internal sphincter (what keeps the urine in the bladder) and upper urethra…talk about pain. I told the nurse it wasn’t all the way in, and she turned to leave the room without saying a word. I pushed it in the rest of the way myself.

Another time, I had just ‘come to’ and saw a doctor walking past the stretcher. I was still groggy, and he didn’t say anything to me, so I didn’t talk to him. I didn’t know what he wanted (or for sure that he was even a doctor for that matter- some guy in a white coat). He proceeded to begin to insert a breathing tube into my airway- something that isn’t done without someone to suction in case the patient vomits, some paralytic drugs to dull the gag reflex (to prevent vomiting) and calm the patient IF they need to be intubated, and without asking the patient if they are awake and know what is going on.  I have no idea why he wanted to intubate me (which more than likely would have landed me on a ventilator). He started putting the metal blade of the laryngoscope down my throat (has a light on it to see where to put the tube), and then the tube, which did trigger my gag reflex and I started to throw up. I turned my head to the right to let the puke fall out, and the metal blade (still down my throat) nicked my right tonsil, and it started bleeding. A nurse came in (finally) and since I was trying to breathe and reflexively trying to get the stuff out of my mouth and airway, they tied me down.  The doctor finally took the stuff out of my mouth and asked if I’d OD’d… I said “No!”.  He said “That’s all you had to say.” I couldn’t believe it… that was all HE had to ask !  I didn’t even know why I was there (still don’t), and it was HIS job to assess me before attempting to put in an endotracheal tube. It could be that because he assumed I’d OD’d that they were going to pump my stomach, and the ET tube was part of keeping my airway safe. But, nobody said anything to me. My medical record would have shown other ER visits with similar symptoms and ‘clean’ drug screens… There was one nurse who was helping me get cleaned up after the throwing up who was kind. She had a daughter with seizures and understood the post-ictal period.  I was just mortified.

I never got on the call light (when I could reach it), and would undo the monitors myself if I had to go to the bathroom, and put myself back on the monitors when I got back. I never asked for pain meds. I didn’t ask for anything.  I was never there for psychiatric reasons (patients who are not thought of well in most medical facilities, mostly from lack of knowledge and exposure to the various disorders). And yet I was treated like I was a total pain in the butt and whack job.

When someone comes out of seizures, there is generally a period of time when they are either extremely sleepy (and even coma-like) or mildly confused for a little while. Not everyone ‘comes to’ the same way. Not everyone has ‘TV seizures’.  I have complex partial seizures that turn into generalized seizures at times (when I end up ‘out cold’ the worst).  When I come to, I can hear things first, and then gradually get back up to speed- but sometimes my response time is slow.  The nurses at this ER from hell didn’t like that, so they’d double team me and put TWO  ammonia inhalants under my nose and hold them there as I gasped for air.  I was awake and knew what they were doing- but I wasn’t ‘all the way back’, so my response time was too slow for them- so they assumed I was a psych case being difficult. Or faking.  They were punitive.

When Social Security was reviewing my disability paperwork, they had over 1000 pages of medical documentation over the previous 3 years, including abnormal EEGs (brain wave tests used to help diagnose seizures/epilepsy) and blood pressure crashes.  But the nurses at that ER thought I was a nut job.  I was horrified that SO many nurses like that exist.  When I’d worked in Texas for 17 years before returning to Illinois, I worked with great nurses. Even if someone wasn’t necessarily going to be a ‘friend’ outside of work, I never saw cruelty or pure meanness.  We had a lot of wild shifts at work- and I never saw one of my coworkers in Texas act like those hostile nurses in that one ER.  I’d worked in another hospital in this town (pediatrics) and then a nursing home- and those nurses were also good to their patients.  But the nurses in that ER of the religiously-affiliated hospital were downright nasty. The docs weren’t much better.

When I was taken in for very low blood sugar one time, they got my blood sugar up with two ‘amps’ of D50 (sugar solution given IV), and then called a cab.  The nurse told me that it would be about 45 minutes until the cab got there, and I should wait in the waiting room. Basic treatment of hypoglycemia instructs people to eat a snack with protein and fat to prevent blood pressure from crashing again once the D50 ‘wears off’, unless their next meal is within the next 30 minutes.  I was sent to the waiting room with nothing (usually a half a sandwich, or peanut butter and crackers is standard hospital fare for low blood sugar after it’s brought back up).  Fortunately, I had my purse with some change for vending machines, and my own blood sugar monitor.  Within a few minutes, I could feel my blood sugar dropping even though I’d gotten a bag of peanuts from the machine.  I tried Coke, and it was still dropping. When I told the person at the triage window, she told me I’d already been treated, and if a nurse had time she’d come and talk to me.  I was safer on my own.

There had been a weird period of time when I was having episodes that were much like the autonomic disorder, and a bit like seizures, but not quite. I had been in the ER (per home health instructions) several times in one month. One night, I was having more trouble with my blood pressure, and went to the ER. The doctor actually told me I’d been there too much that month, and he wasn’t going to do anything. I asked if they could at least check my blood pressure again (it had come up somewhat from being moved from the ambulance stretcher to the ER gurney), and he refused to tell the nurse to simply push the button to do another BP reading.  He never got within 5 feet of me.  Ten days later, I had severe chest pain, and ended up going to another ER (per the instructions of my doctor’s nurse, who was affiliated with the scary place), and it was discovered that I had multiple blood clots in my right lung (all three lobes) and right pulmonary artery that were pushing into the base of my heart, causing EKG changes that showed my heart wasn’t getting enough oxygen (just from the pressure of the junk in my lung).  The clots were of various ages- acute, subacute, and chronic- so would have been present during the time when the doctor negligently blew me off. He could have killed me with that decision.

I’ve written to the hospital with the creepy ER, and got the standard ‘we aim to give the best possible care’ letters. My own doctor was told by one of the few nice doctors at the bad ER that he’d witnessed how I’d been treated. It wasn’t just me being snarky.  My doctor believed me. The ‘new’ ER saved my life.  I had asked the doc at the ‘good place’ that night the pulmonary emboli were found if I could go home and get a few things since I was being admitted for a few days, and she told me she didn’t think I’d live that long; the next night I was in ICU getting clot-busting drugs when I started having the same pain again.  I’d driven myself to the ER… not recommended.

For those in nursing school, new grads, or starting to work with different types of patients,   consider this:  You aren’t going to understand everything about everybody you encounter as a nurse. But just because YOU don’t get it doesn’t mean it’s OK to take out your lack of knowledge on the patient,  who could very well teach you something.  Cruelty during urgent/unstable medical situations  is never justified.  And it’s not something that can be ‘fixed’ later. You represent where you work, and your profession.  It’s not about you when you’re assigned to take care of someone.

Everlasting Moments

When I was 15 or 16 years old, I was into writing poetry.  One of the short ones was titled

“A Minute”

What is a minute in the course of eternity?

Every minute a life begins.

Every minute a life ends.

A minute is forever.

In going to the celebration service for Mary Kay Meeker, who died one month ago, I’ve realized that her lasting influence on me came in momentary interactions.  I first met her as a 8 year old 4th grade camper (I was always young for my grade).  For 7 summers, I looked forward to seeing Mary Kay. She was a constant, and someone who held attention by being attentive.  Then I spent 2 1/2 summers on summer staff at the same camp, and had longer (though still brief) periods of contact- and she never ‘wasted’ time she spent with anyone.  She made people feel as if they were the only one on the planet when she was talking with them.  When I saw her in July of this year, it was the same thing. We had probably 20-30 minutes together, along with her husband Greg, and it was like we had been in regular contact over the years and were simply catching up.  It was a very comfortable conversation that again made me feel like I mattered. And she is the reason I even made the effort to get there; my medical situation makes leaving home precarious- but she reassured me, and basically “told” me I’d get there and be just fine.  🙂

That was one of her gifts that I gravitated to the most over the years.  I didn’t feel much consistency at home, but at camp I could depend on Mary Kay to be her usual  (awesome) self.  She was incredibly talented in various performance arts- music/piano, ventriloquism, drama, skit-writing, etc…. and as much as those talents caught the attention of the campers (and the staff), her ability to interact with people on a 1:1 basis was beyond what I knew from all but a very few people.  During that time of my life, it made a huge difference in my relationship with God.  She was the consistency I needed in order to understand a consistent and loving God- even if I didn’t see her all the time, she was the same each year at camp. Very few people in my life have shown me that so steadily.

She was a solid frame of reference for living as a Christian in a way that started when I was a little kid- in a way that a little kid could understand.  She was able to apply Christ to various developmental stages, and that made the difference between telling a kid a story, and teaching a kid how to apply a life-lesson. The consecutive years at camp built on each layer of teaching from the year before, making a stronger foundation for my spiritual life and beliefs. It wasn’t lip service- it was walking the walk.  I’m still working on being better at that- she is one of a handful of people that I consider my spiritual base and role model.

Her death has been really hard, and I somehow don’t feel the ‘right’ to feel her loss as deeply as I have. I didn’t have a lot of contact with Mary Kay, though we had been in touch on FaceBook over the last few months of her life. And seeing her again in July of this year was like I had been at camp just days before. We had ‘moments’ of a relationship.  But she made moments count.  Her interactions had impact.  She didn’t waste her breath on pointless or unproductive speech.  She could be as goofy as they come, but there was a consistent message that God comes first, and He’s got it all under control. She was incredibly silly at times, but not at the expense of her commitment to God. She could be intensely deep in her dramatic skits- and yet it wasn’t some plastic display.  She was the real deal.

She is an example of how I want to live my life.  I don’t want to waste time on stuff that essentially useless, or possibly hurtful.  I don’t want to be one of ‘those’ Christians, who pushes people away from the faith we have in Jesus, and the promise of seeing each other again after death on earth.  I want to be able to incorporate the silly things into a joyful way of living that lets others know that God has me in His arms. (I do believe God has a sense of humor…. ever look at an emu up close?).  Even in her death, Mary Kay Meeker is showing me how to live.  Each moment counts.  Each moment can impact the rest of someone’s life.  I need to be responsible, and make those moments time that can be used by God for His good.  In the ‘end’, nothing else matters.

Christianity: Ritualistic Religion vs. Relationship

I’ve never liked the term ‘religious’.  For me that invokes mindless rituals and a lack of personal interaction with God.  Sort of a Monday through Saturday apathy, but a false piousness on Sunday when people are looking.  I don’t like that.  For me, Christianity is a relationship- and it’s not about being in a specific place on a specific day.  Going to a shoe store doesn’t make me a shoe.  Going to church doesn’t make me a Christian.  What I do seven days a week makes more of a difference than whether or not I show up at a specified building on Sunday.  Yet I can’t ‘do’ anything to earn heaven.

I grew up in an evangelical church, and for me it was a great experience. The other kids were fun, the youth groups were active and kept us busy with activities and ‘field trips’, and the chaperones were generally goofy enough to not be embarrassing adults, but grown up enough to keep us from getting killed. The senior high choir even did week long tours during Spring Break to Kentucky and Washington, DC, and everybody came back in one piece. We had fun.

The teaching part was also a positive experience.  None of the pastors hollered. I don’t like to be hollered at. If someone wants me to listen, they have to treat me like my ears work, and I’m not in trouble before they even get started. Hollering is punitive to me. Normal volume gets my attention.  Just about everybody who had a pastoral position had a great sense of humor- that was also crucial. I didn’t want to sit through an hour long service with someone that sounded constipated and annoyed.  During the time I went to that church, I was lucky.  Humor was intact.  I learned a lot.

Sunday School teachers were also great role models. I remember several of mine. I even taught kindergarten Sunday School for a while, and it was a lot of fun. We had the curricula all spelled out, and projects to help reinforce the lessons.  There was singing, and with little kids, a fair amount of hugs. One of ‘my’ kids came from a moderately rough background. Her mom wasn’t in the picture much, and I was near the same age as her mom.  She tended to hang out with me a bit closer than the other kids.  I still have her school photo from 1984.

People who don’t grow up in a church often think that TV ‘Christians’ are representative of all of us.  Um, NO !  There is no magic handkerchief, or vial of oil (probably Crisco), or need for someone to pray on my behalf.  I’ve got the direct number. It’s “Hey, God?” 🙂 , or “Oh, Lord” 😮 – depending on the tone of the prayer or conversation.  I don’t always get very formal- sometimes I’m even sort of ticked off. God can handle my anger. He can handle my frustration and He WANTS to hear about my pain.  The Psalms are full of examples of David’s pain- and God used  him to be the lineage from which Jesus was born.  Check out YouTube and Amy Grant’s ‘Better Than A Hallelujah’… we don’t have to follow rules to pray and be heard! Just be open, and let God know what’s going on. Good or bad.

TV preachers don’t work for me for the most part. There are exceptions, but the ones nobody has ever heard of except for the people awake during the 3:00 a.m. time slot used to  suck money out of the desperate and disenfranchised are pitiful in my opinion. But that’s just me.  God gets to judge their hearts, and He holds preachers and teachers of the Bible to a higher standard than us regular folks.   God judging hearts- that’s good news in my book.  What humans think of me is pretty irrelevant, though I’d want nothing more than to be a good representative of Christ- but in the long run, it’s God who will judge me. NO human’s opinion even comes close.

Judgement and being a Christian aren’t the same thing. Becoming a Christian is a choice. It’s an actual ‘event’ of praying to ask for forgiveness, believing that Jesus died on the cross for my sins, and rose again- and He’s coming back one day. That isn’t something that gets ‘revoked’.  People can choose to develop a stronger relationship with Christ- or not.  And nobody does it perfectly. People ‘backslide’ (fall away from their spiritual teachings and beliefs).  I routinely ask for forgiveness for stuff I do.  I will be judged one day before God- but my salvation is secure. My judgement won’t be the same as someone who has refused to accept Jesus.

I was also lucky to have a summer camp to go to as a kid for week long sessions. Between the summers before my senior year in high school and  freshmen year in college, and half of the following summer, I worked there as a nature counselor (and a few weeks of ‘cabin’ counseling).  Timber-lee Christian Center in East Troy, WI was SO much fun- and is still a very important part of my spiritual ‘roots’. People there lived what they talked.  It wasn’t put on for show. We believed what we talked about. For those of us who worked there, it was how we all lived, for weeks on end.  The immersion in 24/7 Christianity out in the open was special.  It wasn’t a ‘real life’ setting- but it was a huge blessing to have had those times there, whether as a kid going to camp, or a summer staff member.  I met people there that I’m still in contact with, and they haven’t become ‘less’ solid in their Christianity when nobody is looking…they were and are solid examples of loving Christians.  We do exist!  But we’re not perfect.

I’m not someone who spends a lot of time talking openly about my beliefs. I think as a nurse, I became less likely to just open up about God. When I was working,  I was at work to take care of patients, not preach.  (And, it could get me fired; being an example of kindness could do more than verbally ‘Bible-thumping’ someone)  It was that way for all religions.  If a patient mentioned something I also agreed with, I did smile and say I agreed. But that was pretty much the limit that was allowed.  I did support patients in their beliefs. For example, an orthodox Jewish patient needed matches (or a lighter) to light candles when his rabbi came on Friday nights. I had no problem finding those for him.  I took trays with pork products back to the kitchen at a nursing home for a Muslim resident.  I didn’t have to believe the same thing to be respectful.  I didn’t see that as a threat to my beliefs.

For me, Christianity is a relationship with God.  I’m physically limited as far as getting to an actual church building, but there is nothing wrong with my ability to read the Bible, pray, and have ‘general’ conversations with God.  I guess it’s a fine line between that and praying, but there’s communication.  I’ve read through the entire Bible a couple of times so I could see for myself what’s in there (and the study notes I had). Mostly what I learned is that I still have a lot to learn.

I also learned that it’s not my job to cram Christianity down anybody’s throat. It’s not my job to be offensive in my beliefs.  Being a Christian isn’t about ‘making’ someone believe something.  To me, it’s more about being willing to tell someone what I believe, and hopefully living in such a way that I don’t push people away.  The Bible is clear about being gentle in one’s approach to nonbelievers.  That gets missed a lot when the sensationalistic preachers are interviewed for TV, or taped as they holler on the streets.

Christ is about love.  John 3:16 is a common verse, and talks about how God sent His only Son to die for our sins and give us eternal life if we believe Him. What gets missed is John 3:17- that God didn’t send His Son to condemn the world, but that through Him the world might be saved…. there are so many more references in the Bible about love in regards to God and Jesus than there are about judgement and condemnation. Will God judge those who reject Him?  Yep… but He also isn’t cramming Himself down anyone’s throat….it’s a personal choice.  Free will.  If you don’t want Him, that’s up to you.

Religious rituals aren’t paths to salvation. It doesn’t take much to repeat an action without thought behind it.  A relationship is personal.  It’s voluntary and individualized.  I much prefer a relationship with  God the Father, Jesus the Son, and the Holy Spirit.   I don’t ‘do’ Christianity exactly the same as someone else, and they don’t do ‘my’ Christianity either- which is the beauty of a relationship.  The big things are belief and faith.  Those are relatively simple decisions.  And continuing to aspire to be the type of believer that will please God is also a decision. I might not get it perfect all the time, but God does know my heart, and that is very reassuring.

Why I Didn’t Die During Nursing School…

I was 19 years old when I started RN school.  And a very young nineteen.  I’d grown up in a conservative church, and was an only child.  I really wanted to be a nurse, and was determined to get through it, but I’m not sure how that actually ended up happening.  I was horribly shy when it came to dealing with the patients when I was a student.  My first semester of clinical classes began in September 1983.  A lot has changed since then…

My first several patients during clinicals were hemorrhoidectomy  patients.  There I was, never  having seen a naked person, and I had to look at their butts.  WAY into their butts.  Uh huh.  I’m sure nothing about me exuded confidence, so starting with the butt was probably a safe place to put me, but I was mortified, especially since most of them were men.  Butts and balls to a naive nineteen year old was almost the death of me.  I finally had a chat with my instructor (a very nice instructor, but she was also intimidating with her knowledge).   I needed a different view.

I asked if I could possibly have a different type of patient.  She said sure. No problem. So when I picked up my next assignment to prepare my careplan, I saw the words ‘esophageal varices’ in an elderly woman.  That meant that blood vessels in her esophagus had ‘blown’ and she’d likely been critically sick from blood loss.  I was sure my mere presence in the room would have her spewing forth all that kept her alive, and I’d kill her within minutes, even if indirectly.  I was terrified.  I asked my neighbor (a pediatric cardiologist) about said varices. He told me that it was possible she could bleed to death in minutes if they reopened.  Not helpful.  I got busy with my careplan,  and  every horrible thing I’d already heard or read was confirmed.  The woman was doomed.

The morning came for me to actually go talk to this lady (this was back  in the day when we did all care for the morning for our assigned patient- not following someone  else around while they did it).  I stood in the doorway trying not to pass out.  My instructor came up behind me and physically pushed me into the room, whispering “You actually have to talk to them”…. I was thinking ‘ just shoot me now’.

What I found was a very alert, sweet woman who was cooperative, and didn’t have any signs of getting ready to exsanguinate in front of me.  I said hello, and she didn’t die.  I did my nursing student assessment, and the woman didn’t seem to suffer any ill effects.  Huh.  So I’d been a bit more freaked out than necessary.  I had the same lady three different days. I even ended up washing and rolling her hair- which she loved.  Anybody who knows me is rolling over in hysterical laughter at the thought of me doing anything positive for someone’s hair. I can barely keep mine brushed.

The next horrifying event was bathing a comatose MAN.  I’d have to TOUCH him.  My instructor seemed to sense my incomprehensible stupidity (inexperience?) and was in the room during the whole process. I didn’t kill him either.  The familiar lightheadedness was with ME the whole time, but most importantly the patient didn’t get worse.  OK. Check that off the list.

On to the big stuff.  I had to give an enema. The ‘serious’  kind with the little soap packet and the big bag that got hung on an IV pole.  My instructor was in on this as well.  I got the soap into the bag, and was getting the water to the right temperature before I filled said bag. I had the clamp on, so nothing would leak before it was supposed to find its way into the lady’s back door.  I put the little packet of lube on the  business end of the tubing.  Gee, this was going well !

Then my instructor suggested it might be more comfortable for the patient  if I let the air out of the tubing before I brought it out to the patient.  Well, that sure seemed like a good idea- no point in giving the woman gas. SO, I unclamped the clamp on the tubing, and waited for the air to exit.  What I didn’t expect was the lube packet being shot across the room from the force of an entire length of tubing full of air.  It was like sniper training in its force and trajectory.  I don’t know where that packet ended up, but I know I was ready to die.  My instructor was very professional, but I think I remember a slight grin. The patient looked a bit nervous, along with slightly relieved to know that everything was being supervised, and this nineteen year old pre-rookie wasn’t being turned loose on anyone.  I got more lube, and the enema went in, and came out, just fine.

I got through my fundamentals class  without killing anyone.  THAT is why I didn’t die in nursing school.  Nobody got worse as a result of my care.  I started out with a negative confidence score, and got to the point where I didn’t anticipate disaster.  That was the biggest perk in getting through fundies.  I had a shot at becoming competent !  All nursing school really teaches is how not to kill someone on purpose.  The experience and finesse come later.  I was at least on track !  I’d gotten through the checklist of skills, and passed tests with solid grades (anything below %85 was a D; I was usually in the %90s).

In the 20 years I worked as an RN before becoming disabled, I got past the shyness fairly quickly.  I just didn’t have time for it.  I needed to get in, get information, give care, and get out.  On to the next patient.  Asking about the color and consistency of someone’s poop was as much a part of my day as parking the car.  I had entered an ‘intimate’ profession.  I had to know things about the patients that they didn’t tell anyone but their closest friends and relatives- and some things that they didn’t even (or especially) tell them.  I had the book knowledge, and I fairly quickly got through the ‘people skills’ that make nursing work.  Without them, there’s no chance at giving good care.  Without getting up in someone’s business, I couldn’t know what they needed.  That trumped my insecurities EVERY time.  🙂