You're Hired!

So, I'm quitting my job. Pretty soon.

And I finally got off my duff and decided to look into travel nursing. Within a week of starting the process, I had seven job interviews (some of which I haven't even done yet) and two job offers within a half hour of interviewing. Both jobs come with free, furnished housing, amenities, travel stipends, insurance, and pay around $5/hr more than what I'm being paid now. One position is even a *day* position.

Interviewed unshowered, unkempt, while sitting out of my front porch with my dog on a lovely spring day.

It's like hitting the jackpot.

And I'm on vacation now for two weeks.

Oh life can be good when you make change :).

Now I have to make a decision: where do I want to go?!

Nice to be wanted, as opposed to being shit on, which is how my current job feels.

The Green Hornet

Okay, so today I'm having one of those not-bad-suppose-it-could-be-worse-days. I finally get to take a break around 1:30-2:00p.m. (I walked on the floor at 6:45 a.m.) and I'm using my cell phone in the stairwell. I finally hit ground floor, near the elevator lobby. Three people in hospital scrubs, whom I assume to be some permutation of nurses and RT's, are coming out of an elevator with what looks like a very sick person on the stretcher: five drips, 3 monitors, RT is bagging the patient.

Being a courteous person, and realizing, even while having a business conversation on my phone, "Hey, that patient looks sick!" I wave them ahead of me. Engrossed in my conversation, I am sort of distracted when one of the nurses gives me a very dirty look, as in, "I know you! You're that nurse that sneezed into Dr. So-and-so's sterile field during my patient's thoracotomy, and now he's got god-only-knows-what-kind-of-nosocmial-infection!!"

I've never seen any of these people in my life, when all of a sudden Nurse #1 goes, "HEY! YOU AREN'T SUPPOSED TO BE USING A CELL PHONE HERE!" And then the other lot start chiming in, all Cell Phone Uber Nazi Style. They even protest that some Doctor-so-and-so who claims it does mess up the telemetry, as if the title "doctor" carries any damn authorative weight with me.

Not only are they being rude, they are also being rude assholes. Like, get a grip, it's the fucking lobby floor, with signs posted all over that I can use my goddamn cellphone if I wish. Besides, if it fucked up telemetry so much, why isn't your patient in v-fib?! HUH?! HUH?!

I have no idea why they are harrassing me, but I was quite pissed off about the whole incident. Too bad I was too tired to get into Jerry Springer Memorial Hospital Smackdown 2006, because I was thinking first of all, mind-your-own-beeswax, bitches, and second (and most ironic):

Dude, you've got a very sick patient there, obviously, or he wouldn't be on multiple drips, bagged, with three monitors and three care providers taking him down to some STAT CT scan or whatever. HOW ABOUT PAYING ATTENTION TO YOUR OWN PATIENT AND QUIT WORRYING ABOUT FUCKING CELL PHONE INTERFERENCE, ASSHOLES?!

Incidentally, it would have been classic retribution had they been yelling at me whilst meanwhile the patient crashed. Then I could calmly say, "Uh, did you notice your patient just cardiac/respiratory arrested, or were you too busy screaming at me to notice your patient on three different fucking monitors, you asstards?!"

Priorities, people. Priorities.

Or, I could have just said, all Mary J. Blige-style, "Hey, we don't need no haters!"

It was one of those times I wished I could swear in Spanish, all gansta-style, and say something cool like, "You fucking lazy garbage-ass ho's!"

I was discussing this weird behavior with one of my friends, and suddenly had the epiphany, as in: "Oh my god! Maybe they thought I was a resident, or worse, an intern!"

I was wearing the hospital scrubs that are this sickening surgical green. Surgical residents tend to wear them pretty much to exclusion of street clothes, I expect because they make unparalleled sleepingwear. Nurses get them either because they are OR nurses or because they are floor/ICU nurses who got some kind of shit, piss, vomit, sputum, blood on their own scrubs and had to walk down five flights of stairs in their filthy condition to beg a pair of scrubs from central supply (because they won't tube them up to you any more, probably because it takes them away from their five half hour coffee and smoke breaks per shift as mandated per their union-backed labor contract or whatever). I think I have about four pairs of them myself, and even though they're sized "small" I think they mean this is relative terms, much as say, in the same universe in which Michael Yao qualifies as a "small" person.

But I did probably look tired, and harrassed, and well, Asian, so I suppose I looked very resident minty fresh to bitchy ICU nurses who are more than willing to tear their pound of flesh out of any random PGY 2 that happens to cross their treacherous path. Because of the Bitterness and Anger, you understand.

Meanwhile, I hope I don't get stuck on the same-day stay on my unit, or what I like to call, same-shit-different-day unit.

I must go meditate on the zen of my dog's ass, or something.

And on the Seventh Day...

....Jamie went to work, and saw that work was good.

I had a good day at work today.

No, I really mean it. Sincerely. It was good.

I had three nice, normal patients. I didn't have to admit anybody, I didn't have to discharge any one, I didn't have to pick up extra patients. Everybody had issues I could handle, and the attendings who rounded were superbly nice people who actually talked to you about their orders, like you were a sentient human being.

I even stayed four hours extra (I was only working a four hour shift to begin with) to help out as our numbers dropped at 3p.m., and it still was a nice, normal day. I almost felt I had an office job. it was almost relaxing to be at work today.

Meanwhile, I'm trying to find a new job. I mean I should be. And will.

Tomorrow.

How To Be a Yes-woman

Here's another fun conversation I had on the same patient as below. I'm running around going crazy, when I get a call from the attending. The patient didn't so much fail a barium swallow test from the day before as remain so lethargic no one could do much of anything except sternal rub him with barely visible response, much less complete a full test.

ATTENDING:
Hi, there. I know Pt blah blah blah failed a barium swallow test yesterday, but I was wondering if you could, you know, maybe just sit him up a little bit and see if he'll take sips of water.

JAMIE:

[playing along like a smart nurse as she is now playing a dumb nurse]
Oh sure, doctor, no problem!

ATTENDING:
You know, make sure that you sit him up at a 90 degree angle and just see if he can wake up and take a couple sips of water.

JAMIE:
[finding this very funny, somehow]
Oh yes, doctor, will do. 90 degrees. Gotcha!

ATTENDING:
[now satisfied with self]
Well, great, thank you then!

JAMIE:
[hamming it up, as she has no intention of trying to arouse a lethargic patient to do a dysphagia consult she isn't authorized to do, and wouldn't do as per ordered in her nightmares]
Oh, you're so welcome, Dr. Blah blah blah!

[Time passes]

JAMIE:
[as a joke]
So his attending wanted me to sit the patient up "to see if he could take a couple sips of water." Whaddya think?!

SPEECH THERAPY/JAMIE:
[both break down into gales of laughter]

Crazy Talk

Here's a sample of me getting report from the float nurse on a "heavy" patient I haven't had yet this admission: keotube feeds, IV heparin drip (not on the right IV pump, but whatever), wrist restraints, lethargic yet combative and howling when not lethargic, going for a PICC this a.m., blah blah blah blah blah.

FLOAT NURSE:
So this patient is MMSA positive.

JAMIE:
Uh? Sorry? Is that like MRSA? I've never heard of MMSA.
[asks another nurse standing by]
Have you heard of MMSA?
[talking to float nurse again]
Do you know what it means, is he a contact precautions guy or...?

FLOAT NURSE:
[in tone that suggests it really isn't a big deal, can we please move on now?!]
I don't know. He doesn't seem to be on contact precautions.

JAMIE:

[not trying to be bitchy, but thinking This is starting to piss me off a little bit, maybe I should just read through his chart instead of getting this lame ass verbal report]

Uh. Did you check his labs? Did he have a MRSA swab done or something?
Did they tell you what it means in report or maybe it's in the chart?

FLOAT NURSE:
[listlessly]
I don't know; that's what I got from report. last night

JAMIE:
Uh huh.
[now totally pissed, as she realizes she's going to have to treat the patient as contact precautions even though he hasn't been all night/whenever and it might take half an hour of research to figure out what MMSA means]

Okay, so I go into the room because his tube feeding pump is alarming, and notice he's not on the right pump for his heparin, and it's been running all night/for God knows how long. I have no idea if this guy has a nosocomial infection or not, and now I'm going to have to 1) fix the tube feed pump 2) find the right pump for his heparin gtt 3) figure out whether or not MMSA is some new scary disease that will render you blind or something, in which case I can file a lawsuit against the hospital, or at least fill out worker's comp papers.

I'm not even half way through report, it's 7:30 a.m., and already I have three issues to investigate and correct on one patient, plus I've got to hang two units of FFPs on another patient I haven't even seen yet. I'm way passed pissed off at this point: I'm angry, but in that muted, repressed, teenage angsty, "Whatever" way I've gotten about shit like this.

Like, okay, I'm not Supernurse. I pass on information that I haven't had time to properly research. But I like to think that when I pass this info on, I'm usually pretty confident that whatever it is I'm passing on is real, legitimate "stuff" and not just "I don't know, someone appears to have made that up and I had eight hours on the floor and didn't bother to check it out. because I was too busy improperly hanging his tube feed and continuing his IV heparin on the wrong IV pump." But maybe it would be valuable to know if the guy has a superbug, as he did present with bacteremia and a UTI for which he is currently receiving, and will continue to receive, IV antibiotics."

Luckily, we had a clinical nurse specialist there to lend a helping hand, and she said, "You mean MSSA? Methallicin sensitive staph aureus?" So she went and researched his labs to find the answer, while I ran around doing other things, acting like a brand new nurse two days off orientation with her head stuck up her ass. (I found it ironic she had to go through all his blood cultures, and it looked like this information was eight days old, and wondering for how long had we been passing off MMSA bullshit in report and everyone just shrugging and going, "Uh, I don't know. Whatever." And the next nurse going, "Okay. Whatever.")

But seriously, with nosocomial infection rates soaring nationwide, you'd think you'd take the time to check to see if the guy had some superbug we don't want giving to every other patient we touch, right?

Whatever.

A horse! A horse!

A kingdom for a ten cc syringe (or horse, if you're Richard III).

So, how's about this: we're down over a dozen nurses, down two unit clerks (meaning we work days and evenings without one) and now we've gone through a third float unit clerk (she fell at work yesterday, and being quite pregnant, wasn't allowed to come back, poor thing). Nothing gets stocked in the med carts, and today I ran around trying to find 10cc syringes to push fucking Lasix.

I can't even tell you what wandering around and around and around and around the floor like some poor lost soul trying to find a chart that wasn't put away properly is like.

Actually, evening shift has been quieter without our regular unit clerk (who responds to the phone ringing with a frown and a raspy, "What's the noise?! " or "Oh that phone! I wish it would quit ringing!" This is the same person that every time you ask her how to use the fax machine, or some unit clerical duty, she frowns (again) and says, "Oh, I don't know." This is an employee of [community hospital] who's worked here for 27 years, interestingly enough.

We don't actually pay people to do their jobs as stated in the company manual. We pay them to do "other stuff" like chat on the phone with family members and close friends, make coffee, watch t.v. in the solarium/family room, etc. etc. We also pay them to say, "Oh, we don't do that."

Nurses are also, ironically, paid to do things that likewise seem out of our scope of practice, like answer phones, put together charts, mop floors, and strip beds of dirty linen (we've actually had umpteen conflicts with Housekeeping over whose job it is to strip beds after a discharge. Housekeeping likes to think it's our job.)

I'm getting to the point where my response to anything short of a real code is, "Whatever." Because basically, when I get someone on the phone to deal with the issue, their response is "Whatever."

Fruit Loops

I've figured out all my frantic posting today has to do with sublimating my fear at going back to my job. Sad, pathetic, etc. etc. Not only am I afraid I'll get run down and sick again, but I'm also not looking forward to interacting with management over my absences. Being legitimately sick does not constitute valid contrition so that one's transgressions against management will be forgiven, apparently, as discussed in depth elsewhere. So I have to run around and get more paperwork to prove "See, I was really sick!" so some bureaucrat paper shuffler can have a job to do and I can continue in my current "grovel and supplicate" act of perpetual contrition "job" until I find something "better." Or different, at any rate.

I'm convinced the same "people" who spend their days making up reasons why you can't have your vacation and sick time, and why your FMLA papers are invalid so the hospital is going to fire you for being legitimately sick are in actual fact descendants of the same demon spawn exorcised from hell by Lucifer (in a story related through some hitherto unknown apocrphyal text hidden somewhere) because they were just too much of a pain in The Dark Prince's arse and he had his hands full designing his subterranean immolation theme park (known popularly as "hell") and punishing regular, well-intentioned human beings for all eternity, thank you very much.

So now I'm doing the "gerbil-on-speed-scrabbling-blindly-at-the cage-walls in a fruitless attempt to break the bondage of slavery" routine. Hmmm. Must have forgotten to buy my quart of lamb's blood and paint it on my doorsill this year. Damn. Gotta remember to write that one down on the list next year--I totally keep forgetting.

Any way. Not looking forward to another Grow Your Own Twelve Hour Shift Human Eating Plant wherein a twelve hour shift grows up into a big, bad fugly Fourteen Hour Shift. Just provide minimal to inadequate hydration, don't feed it, add a couple of change of shift admissions, and poof! You'll have a fourteen hour shift before you know it, money back not guaranteed, sick time definetely not guaranteed, vacation time... ha ha ha ha! You think you get vacation? What does this look like, America?

And please God, no more codes for awhile. I really can't handle it right now. It's okay if you want to send a couple shitty DNR/DNIs my way as compensation, but no actively GI bleeding, hypovolemic, de-sating COPD full code demented ninety year olds, please. (One of my friends says she dreads the month of June because historically she always has a run of crumpy patients, so she's trying to counter-jinx herself so as to have a crump-free June. So you see how living in Harry Potter's world could help us out a lot.) And this week, if you could just give me some pleasantly confused patients who don't get out of bed and wander around, and some nice ambulatory sane people, that would also be really nice. Thank you. Jamie.

Rites of Passage

I haven't read my Durkheim or Geertz in years (try fall 2003) but the whole idea of rites of passage in nursing kind of interests me. What are they for us? Do we have them? Doctors have it formalized, right down to the hazing, with the whole internship/apprentice medical model.

But what makes a nurse go from grad nurse to RN to experienced nurse? Nursing school loves to get hot and bothered about "From Novice to Expert: Excellence in Clinical Nursing Practice" by Patricia Brenner. I should read it, because I'm probably not saying anything she hasn't said already (dammit isn't there something interesting out there that hasn't been "done" to death that I can get published in popular press and live off the royalities? HUH?!)..

Any way, my random survey of my own brain came up with a couple obvious ones, like pulling your first "double" (two eight hour shifts back to back, or sixteen hours straight. I've done two in my career--one as a nurse from 3pm til 7a.m. the next day. It was to help out, because they were going to do another famous [community hospital] 3 way swap and leave us with a tele float and a non tele float nurse, plus one original staff member, which is a very unsafe situation as each night shift nurse takes six patients.

The idea is basically, as tele nurses, we can float to any other medical unit in the hospital except acute ICU (we can do sub-side, or sub-acute ICU because we are critical care level I and telemetry certified). ICU nurses can float any where within their speciliaty (medical or surgical). Some units only float to a sister unit. However, medical, non-tele nurses can't float to sub-acute ICUs, but can float to telemetry units. Think about it. It doesn't make any sense, does it?

If we were to play this line of thinking out to its logical conclusion, then tele-nurses should be able to float to acute ICU, too (thank God they don't make us do this, by the way). If a med-surg nurse, who doesn't know, much less is certified, in telemetry, can come to our floor, then we should be able to float to acute ICU, because we aren't Critical Care level II certified, right?!

Any way, they send us non-tele nurses, and then we have to "cover telemetry" for them. Which means, depending on how bitter and lazy the float is (most are good; some are downright scary), you could be just about taking over the patient's care yourself, as I did one night, paging the HO half a dozen times on a patient whose "telemetry I was covering" while the other nurse read a magazine for half of her shift.

You think that's scary, wait until you hear this story. So, I'm working an evening, and we get a float. One of the other nurses tells me the non-tele float came up to her and asked, in one of those "Is that a question or a statement?" ways, "So the monitor says asysotle?" And so the tele nurse says, "Uh, I'm assuming your patient has a pulse and is breathing... did you check the leads?" And then she asks the tele nurse what an "ablation" is, because that's what her patient had, and she has no idea what it is.

Ten minutes later, the nurse we later dub Scary Asostyle Nurse comes up to me and asks me the same thing about the bedside monitor, about how it says "Asystole" and then she went on to ask about what an ablation was. I was like, "Is he off bedrest, how's his groin site look?"

Okay, so this isn't really to diss that nurse. I think she was a rehab nurse, and to be fair to her, it's a completely different skill set. Pop me up to an ortho floor and I wouldn't know how to set up Buck's traction if the equipment came with instructions. (I would, however, figure if the patient was set up to equipment and clearly had a pulse and was breathing, that "asystole" on the monitor means the monitor and leads aren't set up properly. But who knows. It can be very disconcerting to float, especially out of your speciality in an area like cardiac.)

The point is: you shouldn't float non-certified nurses to units that aren't within their speciality and skill set. Like I said, this could happen to any one of us. It would be as silly as sending me to MICU acute side and knowing how to deal with vent settings and multiple cardiac drips.

Okay, so all that prelude is neither here nor there.

I was talking about Rites of Passage. And I'm trying to think of positive ones and I really can't, sadly. Most of what makes you a good nurse are some pretty crappy situations, actually.

Like working doubles, first codes... I had some other points before I got off-topic.

Whatever. I'm going to get a DVT by sitting on my ass for about five days straight.

St. of the Absurd

In another random, free-association moment , I started to think about Simone Weil, a French non-practicing Jewish intellectual who spent her young adult life in the shadow of the Second World War. She had a fascination with Catholicism, and eventually her arduous academic work compounded with frail health drove her to exhaustion and eventual early death in a hospital (I believe she was in her early thirties when she died).

While she wrote no major works, she did amass a collection of essays and letters to a priest with whom she was close, all of which are quite provocative and yet with so little to work with, most scholars pass her over as a footnote in the history of ideas. I find her fascinating, but I was actually thinking less about the things she had to say about Catholic theology and more about her plans of parachuting herself out onto the front lines of the war as an offering of " womanly solidarity" or whatever, and her childhood self-sacrifice of sugar and sweets "because the soldiers in the war had none, either."

Okay, so mostly I was just thinking about the exhaustion and death part in the hospital, and the similarities between hers and Marie Curie's self deprivation, (she was said to have lived off a handful of dried cherries and nuts per day while conducting most of the research for which she became famous, but don't make me foot note that tidbit, because I don't remember where I read it). Of course, Curie eventually succumbed eventually to radiation poisoning, but, yeah, we know the end of that story pretty well.

I can't wait to go on holiday. I am so very, thoroughly tired. The hell with the St. of the Absurd imagery, I should go find my St. Judas Patron of Lost Causes pendant (note: I don't have one) and do some bended knee begging to find my strength to go on for another week.

I need to go to one of those sanitoriums, with fresh air, fresh food and trips to the seaside. I think that's called "home," actually.

Recipe for disaster

I should totally be looking for nursing jobs, but I just can't get my act together, and here it is April already and most of the GN's have probably already interviewed for ICU positions, so I'll probably be stuck on some telemetry floor again. I can hardly wait.

I'm so burnt out from working telemetry understaffed that the thought of being a brand new ICU nurse (who's had a year's nursing experience and will be expected to pretty much pick up and go with it, detailed orientation or not) makes me almost want to cry. And not in a happy way either. 3:1 ratios are common now (that's three patients to one nurse) in an ICU (yes Virginia, there is such a thing as ugly staffing numbers).

Sadly, most ICU nurses look back rather fondly at the days when ICU = 1:1 care was the norm. I mean, it does sound right, doesn't it? I mean, if you're so sick that you can't breathe spontaneously or your heart can't beat on its own, wouldn't you like someone watching all your drips and vent settings pretty much continuously, especially if you're say, fresh post-op? I would.

Six years ago on our sub-acute cardiac floor, we took 3:1 on days and everyone got all bent out of shape if they had to take 4. Now we routinely work 4:1 on days, and it's always 4:1 on evenings (that's when most of the new admissions come up) and 5:1 isn't as uncommon as it was even 8 months ago when I came off of orientation. Ratios at night? 6:1. And that's on a sub-acute floor. You don't want to hear what the numbers are in plain old med-surg units.

Then I started thinking about something that happened when I was two months off of orientation, and discovered another layer of wrong about the situation. They send a patient down to an emergency non-invasive procedure with transport and the primary RN, right? So okay, the patient goes down on a monitor/defibrillator and a med box. The RN stays with the patient.

But then I started to think about something a former ICU nurse told me about their vented patients going down to a procedure manual bag only, and how it was basically between the RN and RT (bagging the patient) to code the patient until help comes.

Uh. So I'm not sure where you hit the code button in the middle of the hallway; I guess you just scream really loudly like a maniac so at least security comes?

Any way.

So then I started thinking back to my patient, and how they sent me, a new grad, fresh off of orientation, down with the patient and transport (who quickly left, leaving her alone with her patient in the hallway. I didn't think about it at the time (or tried not to, any way) but now I'm wondering about a few things. Like how a BLS certified, non-ACLS certified nurse is supposed to perform BLS in a hospital without an ambu bag, and what in the world good a med box does for a nurse who isn't certified to push the emergency meds any way. I'm not even sure we can push them ourselves without a PA or doc in the room/hallway, ACLS certified or not.

And how long would it take the code team to get to the code? (I remember once having heard a code called twice because apparently no one came the first time, and another nurse and myself watching the ICU interns down the hallway from us stumble out of their respective units looking completely clueless and like, "Uh, so where's the SICU?" or wherever they were supposed to go.) Not only was it not particularly reassuring to me that half of the code team didn't even bother to respond to a code call the first time, I started wondering how you'd designate which hallway you were stuck in, all alone, doing BLS, until they came. Code-calls aren't optional, "if you have the time, come up and check this GI bleeding patient, pretty please." kind of thing, people.

Not only that, transport was nowhere to be found, and I wanted to get my patient back up to the floor without waiting around, so I transported the guy back. Alright, so leaving alone for the moment the whole "nurse does everything" thing, how safe is that? I'm supposed to be watching the patient and the monitor and yet I'm acting as transport?!

HUH?!

Sounds like a recipe for disaster to me, dear.

Free-association moment.

I have this habit of free-associating everything; I listen to a lot of music (wow, there's a statement that should put me right up there with 99.9% of the American population) and have randomly connected the line from the Talking Heads, "Psycho Killer, Qu'est que c'est? Fa fa fa fa fa fa fa fa far far better /Run run run run run run run away!" with Ludacris's "Move, Bitch!" and thought... hmmm, my music choices are giving me advice and counsel on my own life. What does this say about me? Am I having auditory hallucinations?

Okay, so the Talking Heads are talking in my head telling me it will be far better to run away, away, and Ludacris is bitch-slapping me out of complacency with his more urgent and violent, "Move [back south already] bitch."

Coincidentally, just as I began writing this blog, the church bells somewhere (I'll have to investigate exactly where) started playing the theme to Beethovan's last movement of the 9th, commonly known as the "Ode to Joy" so I'm going back now to my highschool days when most of the music appreciation class went around muttering the Schiller poem in German because they were supposed to remember the refrain, or first stanza, or I can't remember, wasn't in the class. "Freude Schoner Gotterfunken, Tochter aus Elysium" is about as far as I can get offhand without cheating and googling it (and shut up, I haven't learned how to do HTML umlauts, so shut up, already.)

Shit. Now I'm going to have that stupid refrain stuck in my head all day. And it's very frustrating not to know any more than the first line of the poem, which is probably why they tortured highschool kids with it, right? (Probably not, but I wasn't in that music appreciation class, and I still learned, well, a sentence fragment of it.)

Also, prior to this whole musical melange, I was also just thinking about how adult life is like highschool, with its own versions of stupid hallpasses and condescending requirements like sick notes. Then I thought, "Wait, but you did really well in highschool, what happened?" And then I realized I must have matured, unlike a lot of the people who now control the size of paycheck and so forth.

Oh God, this is sad.

Now I'm thinking of that little Hoops and Yoyo card I sent a bunch of people with one of the little characters sitting in an office cubicle screaming hysterically "I'm in a CAGE! THIS IS A CAGE!"

Which, incidentally, is exactly how I feel when I have to go to work/am at work.

You ain't nobody's 'ho, yo!

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It Burns!

or, "In which we discuss, yet again, Jamie's hatred for corporate policies and those that make and enforce same."

Alright, so I did some calculations (as in counting on my fingers, because remember, I'm just a stupid nurse and therefore don't have the brain matter required for advanced math) and by my estimate, we've lost ten nurses in under one year, not counting maternity leave people, which brings us up to twelve. All but two of these folks are nurses with more than 5 years of practice as a nurse. Factoring in those who went on maternity leave, went per diem/asked to work less hours and you're looking at probably fourteen or fifteen folks.

Apparently the nursing shortage is (like everything else) the nurse's fault. Management doesn't seem to get that if one wishes to retain his or her staff, a better way than laying down Draconian law regarding sick leave and doing the Houdini "now you see it, now you don't" game with people's vacation time is to actually give people a break once in awhile.

Ask any one on the floor--we're burnt out, and still burning the candle at both ends. I think that those that remain do so either because they have to, or because they feel some loyalty to their comrades-in-arms. It's certainly not because we like the way we're treated.

I mean, look at me, I hate the thought of doing nights, but I felt bad because we're so short staffed on nights, so I agreed to do some nights in May when I go per diem. Yeah, I'm stupid.

I won't even get into the metaphysics of the 9,999 t tiddly-winks mind games we have to play to get our sick time, vacation time, whatever. They don't even accept a doctor's note from one of the hospital's own attendings as valid proof of your illness-they rack it up against you and can fire you for being sick too many times. Seriously.

I also love the Catch 22 admonishment: "Don't come in if you've got diarrhea because you could be contagious and we don't want that here on the floor." Then you call in, explain you've got diarrhea and have been up all night, and they say, "Well, if you call in, it still counts against you."

Gee, thanks, I'll try to feel better in the meantime.

I know of nurses who have dragged themselves into work with fevers, chills, congestion, diarrhea, and all sorts of stuff that should be properly left at home so as not to further endanger the health of our already immuno-compromised elderly. Why did they do it? Because they were told if they called out "one more time" in the next X months, they'd be written up, lose their bonuses, etc. etc. These aren't slack-off nurses I know who call out just to go on vacation or whatever, these people were really, legitimately sick.

I've only been off of orientation for eight months, barely, and I'm already succumbing to every little bug out there because I'm so run-down and dehydrated all the time. And I don't have kids or a super huge house to take care of, either.

I probably shouldn't even go back to work until next week, considering what kind of shape I've been in for the past five days, and how I fear if I go back I'm just going to end up sick again and not be able to call in and/or get fired.

Good golly, Miss Molly.

Signs

To be filed under, "My favorite allergy symptoms" as noted by patients. Drug, percocet. Allergy symptoms? "It makes me go crazy."

Note patients can't qualify their statements any better than 'it makes me go crazy.' They can't state whether or not the drug makes them actively psychotic, with visual and auditory hallucinations, or makes them feel anxious, or whatever "it makes me go crazy" means to them. So we just write down, "It makes me go crazy." I think if i'm ever admitted to a hospital somewhere, I'll make someone write down "hospitals" as an allergy with the symptom, "They make me go crazy!" I'll have to wait until I'm about eighty five to insist though, because I wouldn't want to buy myself a psych consult for pulling that shit.

I feel slightly better today. I suppose drinking 4L of po fluids in twenty four hours has done me some good. Now I'm fluid bloated and look and feel 3 months pregnant, but whatever.

I don't have the energy to be productive, but I can (and have) sat up, walked around a little bit, and as far as the illness goes, this is a good sign. I've been up for a whole nine hours today! Amazing!

I do have an amazing headache, which is probably a tinge of whatever Ibrahim got (he's got congestion so we can't figure out if it's allergies, a cold, or both). The Walgreen's brand of Claritin-D seems to be taking care of the headache fairly efficiently, though.

The only thing is now I'm addicted to Gatorade, and won't be able to function without it.. I should try to drink some lemon water though, to combat the bloating. This illness is getting ridiculous.