Holiday Gathering

Christmas eve. A blanket of snow is sparkling under the moonlight bathing the city in a pale frigid blue light. Families and friends eating, drinking and dancing can be seen in many ochre hued windows on a quick glance. A lone woman is lying face down in a puddle of dark icy water and snow in an alley. She is brought to the ER for acute alcohol poisoning and hypothermia. Her daughter and husband are at her bedside crying because they know that this is not the first time she has done this. They are crying because they know this is not the last time she will do this. There is blood on her shirt. Her clothes are quickly cut away exposing a minor stab wound. Her family keeps to the side crying softly while nameless faceless scrub clad men and women start to fix her body knowing her spirit is broken. She starts to seize and vomit leaving behind an acerbic stench of stomach acid, bile and alcohol. Her family keeps to the side crying softly while monitors beep and hum. Maybe this is the last time she will do this.

Drunken Sesame Street

Maha to Drunky: Take this – its thiamine
Drunky: (slurred) What’s thamamine?
Maha: Its vitamin B
Drunky: Vitamin B for booooooooze!
Maha: You just destroyed my will to live.

Marriage Proposal

On a rare night, I looked surprisingly less haggard than usual (perhaps the new haircut helped) when I received a new Drunky-McD. He was naked waist down – EMS removed his pants because they were covered in snow and replaced them with a sheet. Poor bastard was under the impression that I took of his pants so he kept leering at me. He wasn’t giving me a particularly hard time except repeatedly asking for vodka in his orange juice and trying to guess at my ethnicity. His guesses ranged from Chinese to Spanish to Middle Eastern to East African (keep in mind, he’s DRUNK). When he finally gives up, he clumsily grabs my double gloved hand (because he’s got some dried vomit artfully decorating his shirt) and asks me, “baby marry me” before vomiting up some more bile. My coworkers’ barely suppressed laughter and snorting provided the soundtrack to this touching scene. After I told him that I don’t consider men with EtOH levels of greater than 20 suitable husband material, I could do nothing but laugh at how I had to reject my drunken suitor! Only in nursing.

An Unjust Punishment

Last week I was called into my bosses’ office for a work performance evaluation (ie: encased in a small space that might as well have had a little demon with a pitch fork nudging me forward into a pit of open flames). Long blog post short, I’ve been told that I’m unorganized and anti-social. Usually there is a grain of truth to any criticism (especially the anti-social part) but this time I’ve been wronged!

I realize that since I’m new I have a bit (fine, a whole hell of a lot) of work to do to improve my organizational skills but being placed in the drunk tank almost every shift with virtually no equipment doesn’t help to improve organization – especially when I’m running around the department trying to find a freaking IV pole or a vital sign machine. Terrible.

I just got an email saying that she needs to keep a closer eye on me so she’s putting me in the psych/drunk tank area for the next several shifts. Hopefully I’ll have some fun stuff to post about but in the meantime, I’m going to relish my last several hours of freedom before being placed in my most hated area for the next 3 nights. Hopefully the massive snow storm and -20 windchills will keep people indoors and away from my area!

Ideal vs. Real

Sometimes during shifts I imagine what my ideal day involving work would be like. At this point I stare dreamily into space (or start doing the sleepy head bob) and start going through ideal scenarios. After many hours spent trying to avoid work, I’ve come up with the following as my ideal day.

Wake up thoroughly refreshed and run for 45 minutes. Take a shower, get dressed, have my hair arrange itself perfectly and merrily walk to the train station. When I get to work, I’d give the Starbucks guy a winning smile while ordering my latte and perhaps flirt a little (he’s cute!). When I get to the ER, I receive a perfect report that only includes what the patient came in with, the plan for the patient and what I have to do. I complete my assessments and interventions flawlessly while amiably chatting with fellow coworkers. I receive patients who are pleasant and don’t ask for narcs every 10 minutes. The docs write sane orders in legible handwriting and understand if there are delays from the lab. At the end of the day, I merrily go back to the train station after meeting up with friends for a treat before going home. When I get home, I’d shower, eat a delicious yet nutritious dinner and then crawl into bed and sleep a peaceful and restorative sleep.

Unfortunately my real day goes something like this:
I wake up 30 minutes late and first words out of my mouth are ‘OH CRAP I’M GONNA BE LATE AGAIN!’ I blindly find my way to the bathroom and stub my toe unleashing another deluge of profanities and then get dressed. I run like a madwoman to the train station and barely make it on only to face the glares of the commuters who made it on time. I catch a glimpse of myself and look something like this but am too drowsy to care. I glower at the coffee guy when he gives me a large instead of an x-large and wish a pox on his house. I stumble my way inside to be assaulted with a needlessly boring and drawn out report and then realize that there’s a boat-load of stuff that needs to be done. When the doc decides to be bitchy about a lab delay I utilize my proxy vernacular of passive aggression and steal his pens before passing out during my break. After wishing I chose chocolate-taster as a career I give a scathing smile to the narc addict while telling him/her that they can’t have another dose while the charge nurse brings me a patient with a chart that might as well say colostomy bag explosion. At the end of my shift I pass out on the train (probably drooling) and count-down to when my next set of days of begin. I get home, shower and furiously stuff my face before crashing and repeating the whole thing again the next day!

Clearly my ideal and real days are lacking some congruency but for the most part, my real days don’t have quite such an acerbic flavour as the one I’ve described above! What’s your version of an ideal day? What’s your real day like? Share please!

Special Delivery at 0230

During yet another night in which I was estranged from my lavendar-vanilla scented bed, I was overhearing two nurses discuss their pregnancies and asking me when I was planning on having a child of my own (not any time soon considering I'm currently lacking a suitable donor for the other 23 chromosomes :P ). I politely excused myself to undertake a frivolous and potentially risky adventure to the 24 hour coffee shop when a slightly crazed man bursts through the doors and screams, "my cousin is in the car having her baby RIGHT NOW!" Sure enough, I see a car outside with a woman whose face is grotesquely distorted with pain and a man looking stricken with panic. The charge nurse sees this and gets into super-nurse mode. He starts barking orders left and right and screams at me to bring a wheelchair. For once I was (slightly) ahead of the game and wheeled one over to the car and opened the door for the woman. Turns out her cousin was right - she was having the baby right now. Right now as in the head was out! The wheelchair was useless. I ran to get a stretcher and some blankets for her. By this time, the paramedics were helping and security was calming down the waiting room. We got the woman on the stretcher - my charge nurse was on the stretcher assessing the situation, the ER doc was barking orders that I didn't hear, the dad was saying something about the water breaking and I was holding on to the side of the stretcher trying to put in a saline lock. We wheeled her into a room just as the the OB-GYN, L&D and neonatal mafia swarmed the room. Within 10 minutes we were admiring a beautiful pink and shrieking baby girl! Some of the patients came out of thier rooms to see the commotion and applauded when they heard the baby crying! Mommy and daddy were crying tears of joy while the cousin was just beaming. The family was quickly taken up to the L&D floor while I was left thinking that nights like this make night shifts worthwhile. The adrenaline rush also kicked coffee's ass in waking me up!

The Honeymoon is Over

Lately I’ve been feeling down about work. Despite the fact that I’ve been working more independently, I still feel like I either work only slightly faster than a speeding slug, get caught up with other nurses’ bullshit and/or get stuck with asshole drunk patients. I also feel like I’ve hit a plateau in my learning and I’m stuck in the endless cycle of scut-work.

The other night I got a set of admission orders that included a dose of IV Cipro. I fax the orders down to the pharmacy and get a requisition ready to order it from central dispatch (drugs that are not stocked on the unit are sent to us by central dispatch during night shifts so a form has to be faxed to them – they deliver whatever is needed in 5-10 minutes). I get everything ready and start walking towards the fax machine when another nurse walks over with the bag, hangs it up and tells me that there’s a ‘secret stash’ of Cipro in the back rooms. Great. But how the hell was I supposed to know about secret stashes? I got irritated because I just wasted my time filling out the damn forms when I could have resited her IV and saving me a hell of a lot of time.

Yet another nurse that was preceptoring me has a thing against ‘fussy’ old people who ask for things when she’s busy planning her upcoming wedding. I’m mighty pissed at myself for giving into her way of working when I really should have had the balls to stand up for myself and the patient. This nurse had me convinced that since the patient was 99 years old and had a history of bone mets, she was not able to walk and she could not get hot water for tea (even though we were sitting on our asses doing nothing). She told me that if I tried to make her walk and she fell it would be my problem when our manager finds out about it. Fair enough. Except I never gave the patient a chance to explain herself and she ended up sobbing in her bed. I was aghast at myself for having made an elderly lady feel this way. I know that the ER is a busy and fast paced environment but I sure as hell would not want to be treated like a crazy piece of crap by a kid with 3 months of nursing experience when I’m elderly.

Since I can speak two other languages (besides English), some of the docs also ask me to translate for them. When this happens during a time when I’m really busy, I tell them to hold off for a little while unless it’s an emergency involving the ABCs (yes the nursing school basics), In that case, I quickly tell the patient what’s going on and when I can return. I know that I can’t be abandoning my own patients to run away and translate but that’s what we have float nurses for. When a situation like this came up, another nurse got pissed at me for taking too long translating! She told me that I should have told the doctor to hurry up with his assessment. Again in some cases that’s fair. But this was an exceptional case because the patient that I was translating for was a suicidal refugee who lost his wife and daughter in a bombing. That requires some diplomacy, tact and sensitivity – it most certainly is NOT the time to tell the doc to hurry up because I have to go triple chart on some mundane intervention. When I tried to explain this to her, she just mumbled something along the lines of ‘you weren’t hired as a translator’.

On top of this, I feel like a glorified babysitter when I have to deal with belligerent and violent drunks that constantly come in every Thursday, Friday and Saturday nights. I’m so sick of calling security to wrestle them down so I can put in yet ANOTHER line into them, hydrate them, give them a sandwich and kick them out in the morning just to have them come back the next week. During my last night shift, I was particularly infuriated with my entire patient load because you guessed it – they were all bloody drunks. I don’t feel like I’ve gone to school for 6 years just to babysit violent 300 lb men with drinking problems with ensuing incontinence and send them away with a smile and a breakfast at the end of my shift.

Not surprisingly, I feel the happiest at the end of my set of shifts because I know it’s the longest time before I have to come back into work. Likewise I feel the most depressed the night before my next set of shifts starts. The honeymoon is most definitely over. Work sucks something mighty fierce.