About You, and Kindness, and Me.

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You may not know this, but 2014 was one of the worst years of my life.

I lost my son in 2011.  That was the 2nd worst year of my life.  The worst year in my life wasIMG_0039 2012, which was when I figured out that my son was never, ever coming back. I know, you don’t get that.  I am glad you don’t. Hey, this is my son.  I don’t share a lot of pictures of him. He is intensely personal to me, and at the same time I want to show him off to everyone.

Alex was brilliant, but more importantly, he was the embodiment of kindness.  His best friend is on the autism spectrum.  He lives with me now, and he is going to college. Because Alex would have wanted me to take him into our family and love him. His friend didn’t receive a whole…

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To Hollywood, From nurses everywhere

I don’t watch medical shows. Why?  Inaccuracies everywhere and nurses walking around in the two dimensional background. Do they even have medical consultants anymore? If so, I want to go live in the white tower they come from and watch doctors ambulate and reposition the patients and have the residents always hanging around. Where the doctors and nurses always have outside coffee and don’t drink the floor swill the patient’s families are expected to choke down. That’s how we keep the visiting hours strict. Shhh don’t tell anyone.

Nurse Jackie was about nurses, and addiction. Do you know the most commonly addicted health care professional? Physicians. Nurses are second. They made it way too easy for Nurse Jackie to gain access to drugs on that show. It was laughable. It’s not that easy and much easier to get caught. Not that I’ve thought about it. Sadly, I’ve personally caught a co-worker.

Plus, the punishment for a nurse getting caught is a heavy hand, as it should be.  A doctor getting caught, the whole process is very different. In the real world Nurse Jackie would have been quickly noticed, lost her license and ended up working at her husband’s bar. The end. We aren’t even allowed to get DUI’s. I haven’t seen anyone bother being medically accurate on a TV show since Joss Whedon. My Mother says, “Orange is the New Black” is medically accurate for prison. I wouldn’t know, I’ll have to take her word on it.

 

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But, I digress. I want to see a show that is central to nurses. It doesn’t have to be ER. How about ICU? Seasoned nurses mixed with first years, dealing with residents and physicians. Then going home to various family problems. Some of them could be going to night school, finishing their BSN. Some could be pregnant. One could be the nurse who married a well-known doctor after having an affair with him and is now shunned by the others. These things all happen. One could have a husband that is deployed, single Mom’s and Dad’s. We have the works.

This is gold people. I am handing script writers drama and humor on a silver platter. The nurse techs? They can add a whole aspect to the story. The nurse who was never an “aide” who talks down to them. The seasoned bitter tech who tells the new nurses how it is done. The newbie tech that is taught to breathe through her mouth the first time she changes a an ostomy bag. Then throws up outside the room.

I have so many stories without breaking HIPAA, just about “the hive”. The collective hive of nurses that works together, sees each other more than their own families. Here’s a tip for the writers in Hollywood, we work WITH the doctors. They are not our boss. We collaborate with them about the patients care. We are no longer pill passing, cigarette lighting, hat wearing, “Yes, Doctor” women. We are men and women working together to make sure the plan of care works until the next round of doctors (or God help us, residents) comes around and tries to change it.

The residents do not figure out where the infection comes from like you see in “House”. We do. The Doctors do not reposition patients in bed like on Grey’s Anatomy, we do. Hollywood has become a joke to nurses. Most nurses you talk to will tell you the last remotely accurate show about a hospital they saw was “Scrubs”. Even that show betrayed us when Carla wanted to become a doctor. Here’s another secret. Most of us, don’t want to be doctors. We find it insulting when people ask us why we didn’t become doctors.

Because we wanted to be nurses.

Give us something new, Hollywood. I can guarantee you would have an audience.

Your loving nerdy nurse

 

 

 

 

Guest Post, Dr Gregory House on Addiction

showmeyourstethoscope

Today’s guest post is by

Dr Gregory House.

Good evening, healthcare.

The truth we see again and again is that Patients lie. I’ve found that when you want to know the truth about someone, that someone is probably the last person you should ask.  It’s a basic truth of the human condition that everybody lies. The only variable is about what. Embarrassed people lie, stupid people lie, but you know who really lies?

Addicts. 

Addicts lie constantly.  It’s like they are ashamed or something.  Or maybe they are afraid that they will be treated badly, or not treated at all.  Or that they will be judged and whispered about by the healthcare team.  Or something equally pathetic.

Janie Harvey Garner actually just hit me with my own cane.  

Ok, yes.  I am an addict.  But I am not pathetic.  I can stop anytime I want to.  Just ask…

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Online ACLS – Save OMAR!

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You know him

That Guy.  Second-To-Last in the ACLS patient scenarios.  He is so famous that there are YouTube videos on how to save him.  He is the bane of experienced critical care staff everywhere.

Omar Bashandi…..or as I like to call him….

  • EVIL Omar.
  • Omar who should be a DNR.
  • Omar-that jerk-Bashandiomar
  • Cannon-Fodder-Omar
  • Omar the time suck
  • Hold my beer Omar.

From Evil ACLS Hell

Nobody likes Omar even a little.  One of our members said that she saved Omar on the first try.  I became so angry that I nearly drove to her house to ask for verifiable Omar transcripts.  Because everyone thinks they are a smart nurse until Omar rears his ugly head.  And groans.

Creepily…

You can’t do a damn thing rightwhen Omar arrests.  And there aren’t enough people. And you fail 2 IV attempts, and the Code Team is never coming.  And…

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The Code You Never Saw Coming

Nurses all have those points in time. The code that shouldn’t have happened. It’s not fair. They were too young, too healthy, a treasure, an angel of the community.   Or it was too sudden, you weren’t mentally prepared for how bad it really was, and they had family that depended on them. The code blue that stays with you, that makes you question everything.

I was seventeen years old and working in a very rural, tiny community sponsored ER. The locals called it the “band aid station”, an accurate description.  It was the nineties and our lone ventilator was the size of a deep freeze. We shipped most major traumas out by helicopter. The ER had four beds counting the “trauma room”. The staff included one RN, one LPN (sometimes 2) and me. I was the triage secretary/respiratory therapy assistant. I had taken a correspondence course to get my respiratory therapy assistant certification. Yes, this was actually legal back then.

The ER was attached to a small twelve bed hospital unit. It had an “ICU” which consisted of two beds next to the nurses station. Majority of the time they were used for hospice patients. Most of the nurses had worked there for years and knew the hospitals quirks. Like that the last room on the left was used as storage because one of our nurses sons had passed away in that room. It was permanently closed out of respect. Or that the county we lived in was “unincorporated” and had no laws on the books about burial. Many locals came to collect their dead in pickup trucks on the back dock, to be buried in family plots. This was where I cut my teeth in health care and where I grew up.

Our staff was a perfect combination of sass, kindness, knowledge and dedication. One nurse in particular I admired so much. She was so kind, never lost her temper, or had a hair out of place. I knew I could never be that nurse, but I still watched her like she had the secret to life. She still took the time to fluff pillows and give back rubs, even to the most surly of patients. She had the perfect nurse face for head lice, backwoods sock feet, maggots in wounds and rope chaw mouth.

Her daughter was beautiful and worked as a physical therapy assistant. French Indian high cheekbones and skin like her mother, she was as gentle and soft spoken as the woman who raised her.

It was a typical Sunday morning in the ER. People waiting to be steri stripped and hoping for pain meds for brawling the night before, a couple of drunken backroads accidents. Poor Odie (not his real name), an emphysema patient waiting on his almost daily breathing treatment and enjoying our air conditioning and cable television. The only thing different about that morning was that normally we used a temporary Physician’s Service from the nearest city. They didn’t have anyone available, so one of our own surgeons worked extra to accommodate the staffing.

Then the call came over the scanner from the local EMS. We thought it was a bad connection, we could barely understand them. Then we realized they were crying. They burst through our doors and it was her, our own precious angel, in full arrest. Her daughter was right behind, followed by the physical therapist to help support her.

She had complained of a headache before church and sat in her recliner to rest, then had a massive aneurysm. We coded her for nearly three hours  amidst our tears, pleas and prayers. I bagged until my arms were jello, then mustered up the strength to do chest compressions. Finally, one of the nurses laid her hand gently on the doctor’s arm and shook her head. He called time of death and then went to the call room to cry.

I put on my “nurse” face and went back to triage. I worked the rest of the evening along with the other staff. We had a job to do, the other patients in the waiting room were just as important as her and we all knew she would have understood that.

We all have that moment, where we swallow our own trauma and move on to doing our job. But, there are some of those bitter pills we never forget.

monabear

My grandmother Mona with a bear. I guess taking a picture of a toddler with a dead bear was all the rage when you were nearly starving to death.

 

I’m sorry….

I’m sorry that the previous shift judged you, a young addict admitted with pericardial effusion. In healthcare, the patients who are addicts are often so needy. You were one of those, pain impossible to control, cursing and demanding to smoke. You smoked in your room and got caught. Then your girlfriend shot up junk in your IV and it blew. It took the entire line team to start another one on your abused viens. The patience limit of the previous nurse had reached critical mass. You tried your best to put up a wall with me, I was just another nurse.

I walked into your room, looked you square in the eye as I gave you some PRN narcotics, “You are an addict. I’m not stupid and don’t deny it. But, It’s not my job to question if you’re really in pain. Ask and you will receive. I’m not your sponsor, a cop, or your judge and jury. All I ask is you to respect me in return and be honest with me. Stop shooting up in your IV, whatever crap you keep shooting up crystallizes and I don’t want to kick your girlfriend out and start another one. My only other request is stop asking to smoke. It’s not happening. I’m going to take care of you, I promise. But, I need your help. Please work with me.”

You stared at me for a couple of seconds as your girlfriend slinked out of the room, I told her when she returned to leave her purse in the waiting room. Slowly you started talking while I assessed you.  You even laughed. While you were relaxed and I was actually able to get a good assessment on you.  You told me about your pregnant ex and the little girl she was carrying in the waiting room. How you wanted to sober up for her. Then you paused and your youth cracked your voice, “I’m dying and I’m scared”

I don’t know if you had feelings of impending doom, or if I couldn’t hide the the fallen look on my face as I suspected Beck’s Triad. I didn’t tell you, “You’ll be fine.” because I don’t lie. I excused myself and quickly pushed the crash cart outside your room as I paged your doctor and the house supervisor. Several minutes later, you went into tamponade. They transferred you to the CVICU next door.

You coded immediately upon transfer. They sent me over to help, you saw me and screamed my name. The physician asked me to leave and I complied. You were conscious while they worked on you and I could hear through the thin walls as you begged them to let me come back. You wanted me to hold your hand, you were scared.  This was not possible, there was no room without breaking the sterile field. You died crying for me, like I was some kind of miracle worker. You thought I was going to do something spectacular just because I did my job.  Your Mother thanked me later, just because I was nice. They named your daughter after me.

I cried guilty tears for you and I cried each time your Mother came to see me. I didn’t deserve her devotion.

I was doing my job.