Baby Boom

Ibrahim and I have this weird thing where we both dream about the same stuff. Like one night we both dreamt about (don't laugh) Harry Potter. (I said don't laugh). And recently we both dreamt I was pregnant/about to give birth.

This disturbs both of us, because while we talk about having kids, we definetly aren't going to have them now or probably any time soon. We are all very Planned Parenthood that way.

Still, the baby dreams bring us ever closer to uncharted territory, because I've wondered for a very long time what it must feel like to know you want children, either now, or someday, because I'll let you in on a not-so-big secret: I've never had a desire to have a kid.

For one thing, I like to sleep, especially on my days off. And kids are so much work. I also feel anxious, neurotic people such as myself probably shouldn't have children any way, because people like me worry the fun out of Disney World trips and Winnie the Pooh movies. I have a feeling I'd be a shitty mom, too, the kind that's busy micromanaging their children's educational activities from conception onward and ends up all clueless and out-of-touch, thinking she has these great, smart kids when in actual fact said kids are smoking weed and drinking beer at their friends' homes whilst I think they're working on their science fair project or practicing for the national spelling bee championship.

Not that I haven't been curious about the whole parent/baby/child thing. For example, I've always wondered what it's like to be pregnant and give birth (I've seen several births, and they've always struck me as extremely painful, messy and miraculous). Then I remind myself I don't do so well with pain, and the whole Birth Experience aside, you have this terrifying baby that's like, all yours and no one else's, and if it doesn't work out the way you planned, you can't just find another home for it like a pet that kept displaying annoying character flaws like peeing on the sofa.

Everyone with kids seems to make it sound like it's so great, but I wonder. Is it really all that great? What if you lose your job, or your house, and now you've got to drag your poor kid through poverty? What if the kid has a horrible disfiguring accident? What happens when the kid becomes a raging ball of petulant hormones and starts listening to rap music and staying out all night, starts smoking, and dating and doing the same mortifying stuff you did as a teen? What if you just plain don't like the kid very much (it's been known to happen)?

I trace my trepidation back to the fact that I was a very small kid when my little sister came around, and too young to really take care of her until we were much older (around the same age when siblings begin to resent things like parents putting the eldest sibling in charge of the younger one). I've never really dealt with babies or small children, except for some babysitting as a kid, and during maternal/newborn nursing school rotation. Pediatric rotation was living hell for me, because I could barely figure out how to give a healthy baby a bottle, much less gavage-feed premature twins with poorly developed suck-swallow reflexes.

The only thing close to proving I have an inkling of maternal instinct resides in the fact that I managed to raise my dog from puppyhood, and he seems pretty well adjusted. Of course, he also doesn't require a college tuition account or driving lessons, or a sweet-sixteen party, or brand new Nikes every six months, so maybe he doesn't really count.

A Month of Sundays

I'm disoriented today; working Saturday but not Sunday makes me feel like today is Saturday, and I keep thinking it is, not that I've been properly vertical enough for the entire day for it to make a difference one way or another.

Yesterday at work wasn't too bad. For me, any way. Everybody else had a discharge and took an admission, because they booked the beds at five minutes to five and started sending them up at regular fifteen minute intervals thereafter.

I woke up today feeling distinctly weird, like my body's trying to decide whether or not to come down with a cold. I sure as hell hope not. Maybe it's some allergy exacerbation, or a mild case of sinusitis. Any way, I feel vaguely lousy and achy, and slept most of the day, and I still feel headachy and bleah in general.

I'm going to go make some tea now, and go dig around in the cupboards to see if I have any medicinal remedies to counteract the effects of my vague symptoms of malaise.

Cheney's Got a Gun

Okay, so the world is probably way, way over the fact that while hunting, the Vice President mistook a lawyer for a quail, but this is my homage to world events in a blog full of self-indulgence and egocentrism. (As one of my friends at work pointed out, the time is ripe for someone to spoof Aerosmiths "Janey's Got a Gun." Why hasn't it happened yet, why?)

So, uh...

The Olympics. They are happening, currently, from what I hear. All I know is that Michelle Kwan bowed out due to a "groin injury" and someone named Sara(h) Cohen is all stoked to become America's New Skating Sweetheart, or whatever NBC Good Morning America will dub her.

And uh, other stuff is happening in the world, too, the end.

Ugh. If I were to nursing diagnosis myself on a nursing care plan, I would write "Knowledge deficit related to occupational narrowmindedness, as evidenced by inability to form coherent time table of relevant current events, both national and international." And for the "plan" part I'd write, "Patient will verbalize understanding of at least one major political or social current event per day, giving an accurate, brief synopsis of said event."

Oh no.

This reminds me strongly of when I did my inpatient psych clinical, and they would do daily "Life Strategies" modules for the crazy people. And one of the things they did is talk about what day it was and some of the major events in the local and national news. I think the whole therapeutic point was not toteach history, but rather to direct some of that navel-gazing/sociopathic/schizophrenic/bipolar behavior outward and reorient them to a sense of person, place and time.

OH NO.

I have become "that patient" needing psych interventions.

And now back to our regularly scheduled programming, which includes today's Pointless Thesis Topics With Jamie. Today's topic, "Popeye the Sailor Man: Political and Cultural Implications For Depression Age America."

(No seriously, like just about any non-relevant-to-the-real-world topic out there, while watching some old school Popeye cartoons this weekend, I delved back into my graduate school, deconstruct-a-peanutbutter-sandwich-if-you-must mode, and figured there's something going on with Popeye, some connection with a primal American morality... An anti-hero precursor to the Marvel Comicbook superhero, perhaps. Any way, ideas like this is why I belong sequestered away from normal people with day jobs and good work ethics.)

The Eighth Wonder of the World

Work continues to suck unabated. We've got new phones at work, and no one seems to be able to operate them, much less carry on a decent conversation as the phoneline tends to randomly cut out, which I can see being a very useful feature in an emergency. I honestly think the administration should have just saved us money and poked bits of twine in paper cups and routed those through the hospital rather than spend enormous amounts of money on a system that neither works properly nor has any aesthetic appeal at all, as I also happen to think that the new phone system was probably awarded The World's Most Annoying RingTone, Ever Prize.

In the meantime, I dreamt the other night that I was in the jungle alternately chasing/hiding from King Kong. With my dog. Who kept barking at King Kong, like a little bite-size fluff of popcorn that he would be to a remarkably large, ferocious gorilla/whatever. King Kong kind of looked around for a second, but then there was this public restroom (the kind you see on interstates with the vending machines and the security guards dutifully dozing in their cars) and we took shelter there.

I don't know what a public restroom was doing in the middle of a jungle, but I woke up at that point any way.

And I really have a headache today, and I hope to God I didn't get sick from working with a flu patient yesterday (yes, I used droplet precautions! It's MRSA and VRE contact precautions I routinely blow off. JUST KIDDING, JCAHO. JUST KIDDING.)

Everybody's Bitch

Okay, so a few days ago I was standing around at the nurses' station with another nurse, and we were doing something really no-brainer and I-can't-believe-they-actually-pay-you-for-that-shit(!), like reading the telemetry monitors, when a patient family member comes up to within a few feet of us and claps at us to get our attention. Exactly like you would clap to get a dog's attention. I'm surprised he didn't also whistle and say, "Here, girl, fetch!"

FAMILY MEMBER:
Hey you! Where can I get some ice?

NURSE:
Down the hallway to the left.

JAMIE:
[whips head around]
Did he just clap at us?! Like you would a dog?

NURSE:
Why, yes he did!

JAMIE:
[examining name badge dubiously]
I think they've got it wrong, here. It says "Jamie." Tomorrow I think I'll go down to security and have it changed to "Bitch" because that would be more the truth around this place.

NURSE:
[keels over laughing]
Oh my God! You're right!

Unfortunately, yes.

True Lies

...and other things Human Resources will tell you.

I had a funny dream last night. I scaled a pyramid at the top of which was a stack of books that I then had to arrange into some kind of pattern... I'm not sure what was supposed to happen after that, except I was supposed to scale back down the pyramid, and it was then I lost my nerve, because I am afraid of heights, and having to go back down anything (like a set of stairs, for instance) in my dreams is sheer terror.

I'm sure this is some sardonic parallel to my real life, something about having climbed to the pinnacle of crappiness only to realize the only way off said high spot is either a) to jump to certain death b) climb right back down the uncertain descent of doom.

I also had a Lost World type sequence with a T. Rex, I think, but maybe I have an improperly digested bedtime snack to blame on that one.

I don't quite know what to do with myself any more. Professionally, I feel disillusioned and am trying desperately not to feel bitter and resentful, but maybe I should just feel bitter and resentful and get on with it. Personally, on an intellectual level, I feel starved and belittled, and crave some kind of recognition of my right to free thinking (this having to tow the corporate line, 'round the clock ass-kissing wasn't what I was cut out for). No wonder people much smarter than me are perceived as lunatics and off themselves; I can't imagine being truly brilliant and having to explain yourself to a self-serving, self-promoting corporate entity without committing at least metaphorical suicide. I myself am having difficulty swallowing the fact that years worth of college and graduate school could have been effectively bypassed, because what the real world wants of me is not free-thinking and critical judgement but effectively to sit down, shut up, and not ask questions of the establishment.

Being true to oneself is a lot more political than one would think. It actually requires a duplicity I outright reject on a philosophical basis but as time goes on am finding more and more necessary to survive/not get fired for budging my toe out of corporate line. I personally think I've already been blacklisted as the "not a team player" type because I've managed not to be able to keep my mouth shut about the indignity of having to kiss arse when being abused by whoever sees fit.

So the trick to survival is to nod and smile, and in your mind simultaneously conjure an image of you on a beach in Malibu sipping a mai tai and watching the sun set. It's completely repellent, not to mention antithetical to my nature, but the fact is no one gives a shit about what I think, and never will. Cherish true education, people, because I think it is the only means I've ever encountered that actually validates and nourishes one's intellect and critical thinking skills, as opposed to ruthlessly oppressing same.

And if you ever think being in health care would be a great career because you would get to "help people," remember all the assholes out there that have ever given you the bird after they've cut you off in rush hour traffic, broke into your car, wrenched out your brandnew stereo with a crowbar, embezzled stockholders out of millions, commited adultery with your spouse, and pronounced "nuclear" incorrectly and realize it would be your honor-bound professional duty to save their scumbag lives, even as they call you a "motherfucking idiot" before they crash their pressures and code.

Sometimes I think I should have just been a police officer. At least I'd be able to tazer a few of the assholes in the world, instead of defibrillate them back to life.

Running on Empty

There are periods of my life (this happens to be one of them) when I can physically feel myself crumple into a depressive-funk.

Yesterday, a patient screamed at me and followed me down the hallway (he was demanding something while I was trying to remember what comes after the lyric "and I don't e-ven know her (la la la la la la) crim-son and clo-ver") . He must have stood there and screamed for about five minutes, while I extricated myself from the situation, ignoring him.

Then I was told by management that "it's sometimes part of our job to take abuse like this" and how badly I had botched up our "customer service initiative" by walking away from screaming angry man rather than saying "I'm sorry."

Where did that line of management policy come from, I wonder, Mao's Little Red Book?

Some days I'd rather work taming pitbills or draining sewer lines.

Honest to God.

While I'm knocked on the floor, let me just coment on how much laundry is down here, and maybe someone should do something about it, lest we all start swimming through a sea of clean laundry to get from point A to point B in the place.

No more Nice Happy Jamie at Work. There's only going to be Work Jamie, who steps. away. from the. angry. patient. at the earliest convenient time possible and makes my charge nurse deal with it. I shall be a robot, pretend I have no feelings. I'll have to channel Data of Star Trek: The Next Generation android fame.

It's sad to think this job is turning me into a ruthless bitch with a stone heart and set , silent jaw. That really wasn't my nursing version of myself when I started, funnily enough.

Any more, I'm only here to make the money, honey. No else gives a damn about me, so why should I give a damn about any body else?

Proof Hell Does Freeze Over

I must be a very, very bad Buddhist with a crappy understanding of dharma because I can't seem to get past the First Noble Truth lately, if ever. Especially here, in this G-dforsaken hole that is proof that hell froze over years ago, only the damned were too busy gnashing their teeth to take notice.

Since my first car at age sixteen, I've never had my car broken into or stolen from, let alone totaled. In the past two and a half years of living here, however, I've had one car totaled by a speeding car, and two different cars broken into/vandalized/burglarized. Today I received a dubious addition to my resume of Life Experiences That Suck when a Target customer deliberately rammed her cart into my car bumper/trunk multiple times. She claimed we'd stolen "her" parking space you see, her rationale being she has a baby (she ended up parking two slots further away from the store), and we were, in her studied and well-practiced words, "motherfuckers" for parking our car, depriving her children of fifteen fewer seconds in the shopping cart.

I know what you're thinking. You've got to be kidding me. Really, this sounds much more like a Walmart story than a Target story, Jamie.

I stopped listening the moment she jumped out of her car and started moving her mouth. It's a nursing-born reflex. The moment patients start shouting at me, I stop listening and start playing that Strawberry Alarm song 'Crimson and Clover" in my head, "Crimson and Clo-oo-ver, ov-er and -ov-er!" I usually don't even get to the cool echo/voice distortion part before I'm out the door. It probably makes me look slightly glazed-over, but I love that song and it makes a whole lot more sense than the anger and the yelling and the noise.

We simply walked away, and Ibrahim didn't think she'd do anything, but I hung around the inside Target lobby in front of the door motion sensor (after taking down the make of her car, color, and license tags) and watched her come up to our car, take her baby out of the shopping cart, set the bassinet on the ground and ram the cart into the rear of our car, one, two, then three times. What about your baby, lady? It's twenty five degrees out! In the time you took to damage our car, you could have been in the store, warming your fat ass and that of your child!

She was almost arrested, but she had the baby, so the police wrote her a ticket (her license tags didn't even belong to the car) and sent her to court. It's too bad, really. I've actually never had anyone do anything to me that I could have them arrested for (well, I have, but I've actually never witnessed willful destruction of my own property and been able to do anything about it). I mean, hello, the car didn't even have valid license tags, so you'd think she would have at least had the sense to limit herself to something that she couldn't be arrested for, such as hurling ghetto invectives.

Meanwhile, my poor car has a small dent in the rear trunk area that wasn't there before. And that poor officer had all that stupid paperwork to write up. I know it's his job, just like it's my job to document the amount, color and consistency of fecal material, but knowing what the job is like, I felt a little bad.

But still. My car.

It's too bad we can't all just get along. There'd be a lot less paperwork involved, for one thing.

Curious George

So the other day, we're all sitting at the nursing station, doing whatever, when all of a sudden a code is called. On our floor.

For some reason we didn't all get that horrified look of startled panic that well-trained professionals and deer-caught-in-headlights get in moments like these. Maybe because the fire alarm has randomly been going off in patient's rooms (without a fire) lately and the fire alarm (at least to me) sounds suspiciously like the code alarm, except, you see, a different color flashes on the call light outside the patient's room, indicating that we should instruct everyone to stop, drop and roll rather than run for the code cart and start CPR on the patient. (Note to JCAHO and state inspectors: I am making this entire story up for fun. Any similarity to real persons, places, and incidents are entirely coincidental and are not intended by this author.)

Also, contrary to what medical shows would have you believe, most people on a medical floor don't just randomly code (notice I said most--flash pulmonary edema ain't called flash pulmonary edema for no reason). A lot of times, if/when a code is called, the code cart has been sitting outside the patient's room ominously for minutes or hours, and whatever has been happening to the patient has been monitored and treatment already initiated, and about a jillion people are already in the room, waiting for It to happen.

But this particular time, well, we all went running (I think it makes us feel like we're doing something useful) and the nurse that got there first took one look at the alert, oriented, independent, ambulatory and relatively young patient standing there out of bed, and at thirty paces we could all hear her say, "DON'T EVER TOUCH THAT BUTTON !!" At which point the priority became to call the operator and cancel the code, lest the code team come crashing onto the floor for no reason.

Suffice it to say the patient was fine, and, in some of the finest reasoning processes I've seen in my years since divinity school, stated, " Well, I was just trying to figure out how to turn on the lights, and I just wanted to see what would happen if I pushed that button." You know, the one at the very top of all the other buttons, the you can only reach if you're standing at the patient bedside on your tippy-toes. The blue one that says CODE. Because, I don't know, maybe s/he thought CODE = LIGHTS, unlike the little switches by the patient bedside and such that say LIGHTS.

I don't know. If I squint to make the word blurry and/or render myself completely blind, I can kind of understand where the patient was coming from, can't you?

Not Cut Out For This Job

So, yesterday I went and had my pihrana mole sliced off. It looked all sad after it was done, a little piece of me sitting on a sterile field, becoming blanched from the lack of perfusion, looking very resigned to its fate as a pathology lab specimen. I felt really sorry for it, even if it could have one day grown up from a cute baby dysplastic nevus and turned into a nasty adult malignant melanoma, spread through my lymphatic system, and killed me. Future psycho killer of the skin cancer world or not, I was still sorry to see it go, because I liked that stupid little mole. It made me feel special when I was a kid, and now I have to settle for plain old stupid little skin tags and cherry angiomas like any other person over twenty five.

I also got to feel what it's like to be the patient in a very different way than usual.

I'm pretty good with pain, and after the lidocaine set in, I thought I'd observe a little procedure, the way I do at work, watching people go through uncomfortable/painful procedures while lying through my teeth, "This will only pinch a little." Pinch a little my ass. The surgeon even warned me, "You can look away if you want; even people in health care get a little woozy when they're on the other side."

I nodded politely but thought, "Yes, but this would be interesting learning experience for me, so I'll watch, because I've never actually watched any one slice off a mole and then stitch me up before, and I can handle it, I've seen/done a lot worse."

The comparison to Lot's wife is striking, isn't it?

Well, at least I didn't turn into a pillar of salt, but I did discover that the surgeon was right about that bit about what happens when the slicing and sewing is happening on you, rather than performed by you on someone else.

Yesterday, even after the lido had kicked in, and the blood started to ooze, the realization finally set in: this man was actually slicing into my skin with a sharpened--although presumably sterile--object, and though it wasn't painful, it just looked... well, grotesque.

Perhaps it was even more creepy because it didn't hurt, and Oh my god, is that a little layer of subcutaneous fat , my subcutaneous fat that just spurted out of that red 1cm gash? Oh Jesus, now he's going to stitch me up. Must. look. away. Must. fight. urge. to. pass. out. Because then the surgeon would probably laugh at me (after he'd revived me with smelling salts, or whatever they use in offices to wake up weak-stomached idiots like myself who don't take their provider's suggestion seriously and look any way from the messy nevus excision, please.)

So I stared with great, focused interest at the poster of The Human Intestine, honing in on the nice pink colored colon as if it would some how give me the strength to go on through the next five minutes of the procedure as (I had to peek, ok?) he proceeded to stitch me up sans one dysplastic nevus. (Well, we hope it's that and not malignant melanoma.)

And for the first time ever in my life I finally figured out what people are talking about when they say they get lightheaded and faint when watching certain procedures or what not, because I realized that funny lightheaded, I must-now-go-to-my-special-place-and-think-happy-thoughts feeling was related to watching someone cut a piece of skin off of my arm.

Lesson learned: next time, when someone is about to place a scapel to my skin tells me to look away, I'm going to listen to him/her, and think about something relatively pleasant, like cleaning up C-diff diarrhea.

Zombie

Today is my day off, and I am supposed to be doing real, grown-up things, like scrubbing kitchen counters fastiduosly and planning heart-healthy-meal-grocery shopping lists.

Instead, I've slept in until nearly 11a.m. and can't remember what I'm supposed to do today other than a) go to a dermatology appointment later on this afternoon to have my suspicious mole looked at. Yawn.

Yesterday was Valentine's Day. I worked a twelve hour shift, came home exhausted, and presented my husband with a granola bar--yes, still in the package-- I'd nicked off a plate in the nurses' bubble (lounge is much too luxuious a word for that room). He responded by saying, "Oh shit! I forgot the flowers at work!" Then we both ate our granola bars in exhausted silence, and went to sleep.

And that was pretty much married Valentine's Day #1.

Last year we went to New York, walked around in the miserable stinging cold rain, caught pneumonia, ate Chinese food we could have eaten in Anywhere, USA in a claustrophic basement restaurant, and then took the train home. I also got a dozen roses.

But you see, that was before we were married. Now it's all work, work, work and sleep is one of the best free entertainment/gift in the whole wide world.

I do admit to feeling slighted by Valentine's Day in the past, as it was basically my parents who sent me Valentine's day cards and chocolate. Now that I have Ibrahim, one stupid little day isn't a whole lot. We give each other little gifts all the time. Not big gifts, not signficant things, more like something funny or silly or trite.

Ibrahim, incidentally, is much better at giving gifts than I am; he recently bought me a Swatch with an inside-joke-theme (it's a long story). So he actually did buy me a Valentine's gift, whereas my gift was working two twelve hour shifts back to back and coming home cranky and tired.

My gift wins.

Snowed

So this was yesterday, a foot of crappy snow. CRAPPY snow. I hate snow. It's cold and requires massive amounts of man power to shovel away from walkways, porches, sidewalks, driveways, cars, whatever else. Then you have to drive to work through it, and YUCK, that sucks, too.



You see when I said manpower, I meant man power. Although the way this picture was photographed makes it look like Ibrahim has a white hole almost smack dab through the middle of his chest.

The dog didn't know what the hell to do with snow either, although he's lived through three winters up here, he still gets disoriented by it every single winter snow storm. I leash him up, we plow resolutely outside, only to have him wag his tail halfheartedly once we get through the door. Then I get this disdainful doggy look like, "Why in samhill did you force me out into this crap, stupid?!"

Which, incidentally, is exactly how I feel about the situation, too.

Triumph: The Insult Comic Dog

I mean a lot of that title in jest, of course, but it does work on multiple levels.

I had one of the most pitiful, yet triumphant of all nursing moments at work today, when after being roundly insulted by two doctors over my refusal to pass a certain med based on a borderline lab value without valid labs being drawn first to confirm the safety of adminstering the medication. Of course, at that point, it started one of those fun, doctor-initiated "You're a stupid nurse/ I am the smart doctor so do my bidding and shut the fuck up" pissing matches I find so undignified and frankly, a waste of my time. Four hours of my time, in this case, and I had to float at 11a-3p, and then come back and pick up my assignment at 3p-7p, so you know, I really could have done without AMA SmackDown 2006 this morning.

I found it, errr, ironic that both docs insisted that I give said med and yet, when I stated I was uncomfortable due to borderline labs and no orders for further labwork to confirm the safety of administering the med, both refused to come to the floor and give the damn med. First of all, let me backtrack a bit and explain it's within the nursing scope of practice and protocol to refuse to pass a med we deem may be harmful to a patient, even if an MD insists. If we feel uncomfortable for a valid reason, it is perfectly acceptable practice to ask the MD to come and pass the med, and they may bitch and moan, but ultimately, a nurse doesn't have to give med s/he has a reason to believe may be harmful to a patient. Period. End of story. It's about patient advocacy, and double checking each other, because everybody isn't always right all the time, and we're supposedly here for the patient, not our egos. No, seriously. Can you imagine patient care being about the patient? Apparently that idea gets outmoded at some point in some peoples' lofty, mistake-free career. (Snarf).

So really, I shouldn't have to explain myself half a dozen times to two different doctors, and if they are so damn sure the med is harmless, why not come and give the goddamn thing and be done with it already? Huh? HUH?

Any way, the triumph came when a third attending was called in, a specialist, who had the labs drawn and made notes to the tune of, "Huh. Maybe we should make this an every-other-day drug, yeah?"

YEAH. MAYBE.

So you see how the title fits. Triumph: I stood my ground and didn't let doctors intimidate me into giving a med I thought would harm my patient. I was a patient advocate today. Insult: Should be obvious by now, huh? I actually had a doc say, "You've had two doctors tell you to give the med, so what do I have to do to bypass you to get the med passed?!." It was, oh, so tempting to say, "Come up to floor, lick the floor clean, write a ten page public apology to all the nurses you've insulted in your career, apologize in person to every single one on bended knee, buy us all lunch at the Four Seasons, and then maybe I'll think about passing it." It was also very tempting to say, "I don't care if two goats in rubber chicken suits told me I had to give the med, I still wouldn't do it." Comic: It was funny, kind of. In retrospect. And especially after the med was held. Dog: Well, that should be plainly obvious.

In other news, I floated to an ICU for four hours and discovered how terribly endearing a medical intern can be. Interns are my age, or younger, pretty much, and some of them actually don't get all arrogant and snotty. They actually appreciate your help and say please and thank you. It's like some kind of culture shock. Mostly, they aren't rude because some of them still don't know stuff like the standard orders for loading doses of Digoxin and have probably learned by now that nurses, even brand new ones, actually know a thing or two about medicine and are more than willing to help you out if you just ask nicely. And it flatters me just a little bit, because well, interns and new nurses start at the same time of the year (in June) and being able to help an intern with loading dig orders and clarify attending orders for them shows me just how far I've come in six months. And it's nice to hear thank you from an MD every once and awhile. It was all a warm-and-fuzzy moment, believe me.

And all my patients today were cute and sweet. Almost makes me wish I was back for tomorrow, save for the pending snow storm.

Good Will Hunting

Alright, so I decided to take a slightly different tack with this post, and ask my readership (now threatening to climb to the astonishing census of maybe four or five devotees) what are your three most influential classes/teachers of all time, and why? (Post on your blogs or leave comments if you don't have one).

Mine, from undergrad, in no particular order:

1. Orientalism, taught by Professor John Newman, who was rumored to have had the honor of hosting the Dali Lama at this house (I actually believe this urban New College legend) is an extremely cool Buddhist and scholar. Despite disagreeing with E. Said on several points that I won't go on about in length here (I wrote an essay critiquing his weighty tome Orientalism and no one is probably interested, given there are real, legitimate scholars out there who have actual published papers that are probably one hundred times more illuminating and thoughtful than my Courier-font-1.5-inch-margin-twelve-page undergrad paper). Any way, the discussions in this class confirmed some of the nagging inklings I'd been having for quite some time regarding the academic and cultural hegemony of the "West." That class provided some of the most influential and deeply impressive formative influence on my worldview ever.

2. German Theology and the Historical Jesus, taught by Professor Mike Michalson, who I have always respected and admired as a teacher and a person. He's the quintessential professor, all wise and learned. Like, what Socrates-was-to-Plato/ Dumbledore-is-to-Harry-Potter kind of influential/mentor. (Okay, so I'm sure there are better philosophical-to- pop culture references out there, I just can't think of any at the moment.) That class opened up an entire new world of critical thinking and sparked a deep appreciation for the disciplines of philosophy and theology. Not to mention Professor Michalson was one of the first undergraduate professors whose kind and constructive comments on my pithy essay work (on Kant, actually) gave me the confidence to keep on in a class full of terribly intimidating third and fourth years (how wise and learned they sounded!) when I was just a meek and scared-to-death first year. And the whole Kant mania thing I developed I have to credit to him, too, which makes me quirky, at least in my current profession. And he never, ever laughed and made fun of my stupid Kant thesis--at least to my face--which must have taken some doing on his part, considering he is a Kant scholar, and how thoroughly mediocre and unoriginal my thesis was, despite my really hard work and fun I had with the footnote feature of Word proccessor.

2. Elementary Latin, taught by Professor David Rohrbacher. To tell you the truth, I can't remember why the hell I thought taking Elementary Latin in my final year at New College would be beneficial (I certainly didn't need it for my concentration) and I was one of only two seniors in a sea of first years in that class (the other being Rachel Corkle, who went on to win a Fulbright and do PhD work in French and did need the class to complete her fourth year). I think I took it because I needed to fill up my course load, and I refused to take any more French, my skill level having been a horrid affront to the francophone culture for years. I don't know what it is I like so much about Latin, actually; maybe I enjoy the relative strategic simplicity of memorizing hundreds of declensions and conjugations of verbs and Latin translation is like figuring out a puzzle, kind of like the verbal equivalent to solving a math equation, except one at which I can actually succeed. And the class/teacher was funny and not scary at all, and mostly full of endearing ickle firsties, like Michael, who was a really nice kid and deserves a nice life. Go, Michael! Any way, because Latin was so academically rewarding in ways French was conversely not I of course was a total Classics convert. And now I go around and scream and point like a Beatles-fan when I see Latin I can translate, which I'm guessing is probably one of the highest compliments you can pay a Latin professor.

4.) Honorable mention must be made to my sixth grade teacher, Mr. Mark James, who taught English that year. We all thought he was like, totally cool because he was young, unmarried and wore jeans to class every day. I think half of the girls in my class had crushes on him. I didn't, but any way, I was a weird kid who liked reading books and read more of them than I had friends. Any way, one day he pulled me aside and pressed a copy of "Strunk and White: Elements of Style" in my hand and told me I should continue to write, because I was good at it. Every time I pass that particular book in a store, I think of Mr. James, and silently vow to one day publish something and dedicate it at least partially in honor of him. Meanwhile, I'll work on my comma usage and try not to split my infinitives so often.

Okay, fess up folks... who/what influenced you the most during school?

The Sixth Sense

So those ST depressions found on 12 lead? My ST depressions. Well, I'm having an echocardiogram next week. Probably only because my doctor is thorough, but, I don't know. I think of people with actual heart disease as needing echos. And also, I'm not that stoked about it, because I know it means lying really still for about a half hour with your left chest covered with goop and probed with a probity-probe.

I'm. having. chest. pain. (Remember that Life Alert commercial? It's actually pretty funny/cheesy, but then you have a patient with real chest pain and suddenly it's not so funny, except every once in awhile the I-must-distance-myself-from-the-horror-of-mortality function in my brain goes haywire and I think of Life Alert, whilst I sprint to the pyxis for the sublingual nitro.)

Meanwhile, work-stuff again has me half way toward some kind of psychotic break. I was up last night at two a.m. walking the dog and smoking a cigarette. (Great, add lung cancer, COPD and emphysema to my future diagnoses). Then I went and sat on the kitchen floor, ate half an apple, drank a bottle of Ensure (because I'm ninetfy five pounds and can't seem to eat a full meal any more). I didn't feel worthy enough to sit at the table, so I sat on the floor. Then I curled into a fetal ball in bed and tried to wake up my husband to torture him with my angst (because a relationship is all about sharing, isn't it?) but he wasn't having any of it, so I got to lie awake with my own demons for several hours before drifting off into a weird dream about water slides like they have at Orlando theme parks.

There are days (okay, weeks) when I just don't feel cut out for the job, and wish I was cloistered somewhere, maybe in academe, teaching undergrads all Dead Poet's Society style by jumping up on desks--or feebly climbing up on them giving the state of my back--and making them rip up their textbooks (which kids probably do now any way, at least in public schools, without teachers actually encouraging them to do so). There's no possible way to screw up teaching kids about Dickens, Poe, or Emerson, is there? I mean, I'd never have to get to class, survey my charges, and develop this ominous feeling I'm privy to now, that nurse's sixth sense of, 'Oh boy. This patient's gonna crump, and crump soon. I hope s/he doesn't do it on my time.' And I'd never have to go home and feel like, "Shit, if I could have just done that one extra magical task which would eliminate all his/her medical problems in one fell swoop and s/he could go back to living life and enjoying a beer every now or then."

And never, ever would I have to feel the agonizing, neurotic feeling of maybe I could have done more. I don't know what it's called, but I think it's something akin to survivor's guilt. It's obviously not, but it feels similar.

The cliche about having to find distance between yourself and your patients in the nursing profession is true, but it's devilishly hard to attain. There are days when I wish I was not so new to the profession, and could take it all in stride, the good and the bad and the ugly, and attain the desired goal of leaving work at work. Goddamn that type A, Catholic guilt, inferiorty-complex, pre-installed personality of mine, I can't.

I should have known a long time ago, when I was in highschool, and spent an average of four to five hours a night studying to classical music, that I was doomed as a grown up, because what the hell kind of a kid takes stupid highschool homework that seriously? I was a geek then, and I am a geek now (although I'm more comfortable with the geek aspect of my personality) and still somewhat socially awkward, but, well, I don't know if astrology plays into it, but I'm a Cancer (crab) and my little pincers want to hold. on. for. dear. life. no matter what the issue.

It's ironic, this feeling of being an over-achieving failure. It's sad to feel like the only thing you were good at was school, and turning in your homework on time, and having nice professors write nice comments on your lame essays about Middlemarch or Pelagius. And maybe at one time you were kind of good at playing the piano, and in highschool you won some stupid first place district award for playing a movement of a Mozart concerto (No. 23 in A major, K. # I forget, but I think it was 488.) And you won a full scholarship to graduate school, and uh... it all still doesn't matter, because you feel you suck at your present job, and who the hell cares that you've read most of George Eliot's and Kant's major works? (Adam Bede, any one?)

I really wish this whole feeling of inferiority would let up, though, because there's only so many martinis I can consume without also adding end-stage liver disease to my future diagnoses list, too.

Okay, so on a more positive note, here are things I'd love to be able to do or achieve but probably won't happen in this lifetime (in no particular order):

1) Understand Kant's philosophy. And Hegel's. And maybe Schleiermacher's. And Tillich's.
2) Speak, read and write Latin fluently.
3) Play the piano like Rudolf Serkin (or even his son Peter). Or Vladmir Horowitz. Or V. Ashkenazy.
4.) Learn how to play the violin and cello.
5.) Understand Chemistry, Math, and Physics (this will definitely be in another lifetime).
6.) Be photographed by Annie Leibowitz. With my dog.
7.) Meet Anne Frank (obviously, never going to happen, but I still wish I could.)
8.) Ask the pope why the hell he wants to abolish limbo. I mean where are all the unbaptized babies going to go?
9.) Write a book. Maybe a kid's book. About my dog.
10.) Have perfect pitch (unfortunately, you have to be born with it, but whatever).
11.) Think up scathing witty repartees when people piss me off. Also not going to happen.
12.) Figure out why I seem to be presently breaking out in a rash on my forearms and trunk. Seriously.

The Heart is a Lonely Hunter

So I should be studying how to interpret 12 lead EKGs, because sadly, when it comes to interpreting them, my speed is far from Dale Dubin's expectation of "rapid" as his book title claims I ought to be.

Instead, I nod politely quelling a semi-horrified look when I notice ST depression on a patient with current chest pain when the house officer/PA says, "That's some pretty significant ST depression. Let's call the attending."

(I'm embarrassed to admit I'm better at reading lead II and v1 telemetry strips: " Ooh! There's a bundle branch block! oooh! 1st degree AV block! Look at that pretty atrial flutter.... my, isn't it textbook? Oh shut up, telemtetry monitors, for the fifteenth time in twenty minutes that's not V-tach, that's simply Mr. Confused Man picking off half of his leads and wriggling out of his posey." Or, my favorite, overhead from one nurse to another, "Oh yeah, well your little ten beat run of V-tach doesn't have anything over my 21 beat run of Vtach. Check it out [presents longish strip of impressive V-tach] My Vtach is better than yours." Of course we weren't talking about our own lethal arrhythmias but rather those sustained by patients as evidenced by some fairly nasty looking telemetry strips. And no, we're not horrid , evil unfeeling people, just somewhat desensitized to the general population's concept of "sick." And yes, we went to check on our patients, or they had the runs overnight and were already in the chart. )

I know nursing school and divinity school and a humanities background in general is supposed to teach you compassion and (snarf) cultural sensitivity and stuff like that, but after awhile that stuff only works on a personal, face-to-patient level, everything else becomes gallows humor.

I once said in divinity school that my want-to-be-a-millionaire scheme would involve marketing a series of action dolls named after certain theologians, like "Tillich: Ultimate Concern included!" or "Kant: Pure Practical Reason Available for Small Surcharge." I don't know why, in particular, I thought this was a clever idea, because in retrospect it sounds pretty geeky and lame (I went to divinity school, okay, quit throwing rotten cabbages/silver bullets my way, please). But I think it was because my Jesus action figure idea was already taken (damn mass marketing) as per below:



Katy: didn't you and I come across a Jesus action figure in Hillsboro division of Nashville once? Remember, in that one store, when we went there over that one summer? You remember, don't you, because it was that one summer that was hot and humid? I swear it was the same action figure, but maybe I'm becoming delusional in my dotage. I've already sustained some short term memory loss, as evidenced by my lack of any detail that would provide you a substantive idea of what the hell I'm talking about...

Any way.

The point of mentioning Tillichian action figures and the fact that Jesus action figures apparentl have found a niche in the pop culture marketing world (glide serenly on wheels! Dashboard Jesus not available at all retail locations, as per packaging) is that I've basically substituted one mania (religious/theological ideation) for another (chronic and acute diseases). So now I'm that nurse that refers to her patients when giving report to other nurses as "CHF Man with COPD exacerbation" or "Hemodylasis Woman" or "Actively Dying, Endstage Cardiomyopathy Full Code Nightmare" or "Obtunded Full Code Man."

And yes, I've actually thought about marketing a line of hospital figures, like "Medical Intern: bright shiny white coat, pager with real beeper number included. Also comes with erroneous order sets for you to find and correct! Clueless/sleep deprived expression free of charge." or "Transport", which would actually feature a box with a stretcher, and DIY instructions, since so many of them can't seem to find their way to our floor on time.

To which I must now end with an "overheard" (honest, it's true):

Situation: Patient obtunded, barely responsive. Needs STAT everything, including an EKG:

JAMIE:
[hurriedly, to newly hired tech]
Hi there, do you know how to do EKGs yet?

TECH:
Yes.

JAMIE:
[fiddling with stupid EKG machine and preparing it to run it down to patient's room by myself judging by the look on tech's face]
Okay, well can I have you do me a favor and run a STAT EKG on the patient in room blah blah blah?

TECH:
[genuinely confused]
I don't understand. What's a STAT EKG?

JAMIE:
[supressing throttle-throat reflex in light of patient in distress]
It means "an EKG YOU HAVE TO DO IMMEDIATELY."
[said while running down hallway with EKG machine towards patient room]

TECH:
[calling down the hall after my fleeting form]
So, you still want me to do EKG?

I love nursing. I LOVE NURSING. YOU HEAR ME? LOVE IT.

P.S. Patient turned out to be fine. Just taking a long, scary-looking, Cheyne-stoking, unresponsive-looking but completely harmless nap, apparently. You have to love dementia.

Clean Bill of Health

Mmmm. Raisin-y tastiness...

That, or rabbit shit.

Or cancerous lesions.

So my doctor checked me out, and thinks I'm doing alright general, except for a suspicious mole on my left forearm that has three out of the four criterion for malignancy as the pretty little picture (Nurses, remember your ABCS: asymmetry, border, color, and size)!

Jumper-to-conclusions that I am (practicing to be a paranoid and anxiety ridden ninety five year old, you remember, so I can torture my family members on holidays when, out of guilt they come to visit me for the requisite "Let's sit in awkward silence for an hour after we've exhausted talking about the weather and then back away slowly and quietely when we think granny's finally nodding off to sleep, the old goat" annual ritual):

OH GAWD. I HAVE SKIN CANCER. Well, at least a questionable metastatic nevi, from the looks of my Physical Assessment book from nursing school. In fact it looks exactly like melanoma picture number one up there, except the shape on my arm is different.

I stay away from oncology stuff because it really scares me. Really scares me. I watch patients with cancer every day and pray it never will happen to me. Because I am whiney wuss, and and would probably be a bad onc patient.

Seriously, I've had the thing since I was a kid, and I always called it my pihranna mole, because it looks kind of like a flesh eating prehistoric looking sea creature, if you squint your eyes and look at it in a certain light at a certain angle.

So probably the worse they'll do is sizzle or slice it off and send it for biopsy. But I *like* my potentially malignant melanoma, damn it. Can't I just live with it? I mean, it's an identifying, albeit potentially lethal trait. Come on, doc, chill out, just let everybody live happily with cancer bits growing on their arms. I'm going to have to remind them to take the mole off of my identifying features on any Missing Person Information surveys, because what a bummer to be caught in the back of some psycho's handy van (it's always the handy vans, isn'it?) bound and gagged but able to show a passerby through a small back window The One Identifying Feature that isn't even there any more, and him squinting into the window and shrugging, like, "Hey lady, no malignant melanoma, no positive ID, no $50,000 for your reward. And I gotta go buy a packet of smokes next to your kidnapper, so I might have at least given a really good description of the pyscho-murderer. See you in the movie Saw III, sweetcakes."

Ooooh... this just gives me an idea. Even if turns out to be something relatively benign with no mets any where, and the treatment was just "put a bandaid on the part we sliced out and try not to get it infected, dummy" I could totally be the jackass equiavlent of Frey's controversial book A Million Little Pieces, except I'd name mine A Million Little Cancer Dots, or something catchy like that. And Oprah would invite me to her show, and give everyone in the audience HumVees and Tiffany necklaces, and we'd all do a group hug/love-in session until it was found out that the whole book is basically a well-written lie, and then she'd invite me back on the stage so that I could recant in front of hundreds of angry upper middle class white women hurling burning copies of my book at me with Oprah in fine Torquemada form orchestrating the whole thing.

And I will presently stop looking at skin cancer websites that say scary things like malginant melanomas account for 77% of skin cancer deaths in the United States. One person an hour dies from metastic melanoma. Stop. Looking. Lot's. Wife.

Oh please, little piranha black/brown/irregular bordered/raised spot, oddity of my childhood, please do not end up make me dead, and just be a nice little dysplastic nevi, quirky like you and me, and not become part of the my epithet on my tombstone. Thank you, sincerely, Jamie.

I am also 5'1/2" tall, and weigh 95 lbs with clothes on, AFTER A MEAL. My BMI is 18.2, which is underweight. Gee I wonder why. Perhaps it's because I spend three 14 hour days out of the week running around and not eating all day. Or my thyroid's been working overtime. Bummer if that's the case, because I don't really mind being thin (although now size zero pants are getting baggy around the waist; thank god scrubs are drawstring).

Oooh! I even have slight ST depressions in leads V4 and V5. Sexy. (Not really, they are often thought to be part of ischemic changes, although it also could be lead placement, and I'm skinny).

And my back is still slightly fucked up, but better. No more transfering patients, I swear. I weigh 95 lbs, which is easily a quarter the weight of some of my obese patients.

Also, doc put me on OsCal d/t my risk of decreased bone density and later risk for osteoporosis. GOOD LORD, I really am practicing to be 90 years old!!

And I even knit, and read books, and become confused from time to time (like yesterday when, overly dehydrated and severely orthostatic, I attempted to head for the kitchen for water, stumbling along seeing yellow spots suspiciously like Sauron's Eye floating in front of me). My husband finally noticed what I was doing and carried me back to bed, all panicked and saying we had to go to the dr.

No thanks, I'd rather drink a liter of water in the comfort of my own home rather than sit in the ER for 12 hours only to be laughed at during triage. You're a.... what? A nurse? And you came to us for mild dehydration?! When you could have just had a liter of po fluids in the comfort of your own home? HA HA HA HA.

Honestly though, I need a bed alarm when my B/P is 70/50. I'm going to be a lot of fun at my nursing home already, I can tell.

Car 54 Where Are You?

So, yesterday's about High Incident... (Any one remember that old NBC prime time series from 1996? I loved it, but then again, I somehow hadn't yet discovered Law and Order ... which by the way, I've seen Matt Craven "0fficer Len Gayer on LAO episodes, I think as defense attorney, or maybe as the defendant. LAO is the crime/drama/cop equivalent of the soap As the World Turns: seen them once on one show, you've seen them elsewhere, too. (Meg Ryan and Ming Na got their start on As The World Turns, as did just about everybody else in movies today according to my mother, who was a longtime fan of the soap when we were young children).

So it turns out the big crash and thud I heard was a couch being moved out onto the porch (why? because their porch isn't exactly ground level, and also, who the hell moves a couch out onto the porch in 30 degree weather?!) Sounds fishy to me. They were probably trying to launch the couch at one another, if you ask me.

But they were fighting, and fairly brutally from the sound of it. I was seriously afraid someone was wounded and/or dying from all the blood-curdling screaming and hysterical sobbing. Of course, in a very Petunia Durselyish manner, once the cop arrived, I listened at the top of the stairs to part of the conversation ("Oh! Officer! Yes, well, we're just having a bit of a fight. My son, you see... he's not well liked at school, gets bullied all the time, and we're trying to get him into a school where he'll fit in.")

Likely story. The kid's a punk, frankly, smoking outside the back entrance next door to our porch and leaving nasty cigarette butts all over the damn walkway (I would love to pick them up--gloved of course--and leave them wrapped up in cellophane at their front door. It really pisses me off. I mean, seriously, haven't they seen those waste containers with the weird little stick figure and the enthusiastic "PITCH IN!" signs?)

Speaking of which.... nonsequitar (flight of ideas, they'd call it in psych nursing): Any one remember the little public service message with the cartoon owl, who I think was dressed in a park ranger like little suit and hat and said things like, "Give a hoot! Don't pollute!"

Oh boy. I'm having flashbacks form 1979. This isn't good, folks. Not good at all.

Any way, all's well that ends well, I suppose.

As for me, I got a crappy night's sleep (4.5 hours of tossing and turning) and woke up at 5:30a.m. for a 7a-11a shift which ended up being a 7a-12:30p shift. Honestly, they should never schedule you on for four hours, because you're never there for just four hours. Try five, or six.

The shift was decent, though, despite figuring out one of my lovely patients now has about three more issues in addition to his primary issue, and I don't see how he's going to ever get any better since each issue basically presents a contraindication for treatment for the other issue. It's like some kind of fucked up Rubic's Cube of diagnoses.

Though I've been wrong before, and maybe we'll be able to fix him up a little bit, I am still wondering how we're going to pull the rabbit out of the hat in his case. I sincerely, sincerely sincerely hope he gets a little better (at least back to baseline, which is medical speak for "you don't suck as much as you did on admission, but you're back to as crummy as were in generally before whatever acute issue you had we treated. I don't want to have to send him off to ICU and/or code him, because that would then make the second time in two weeks I'd have cried at work. And coding this poor man, with all his issues would really be an insult to his life, if you want my opinion. I really adore some of my patients; they are such lovely, kind people. It's the special saving grace of working such a frightfully frustrating and busy job.

I mean, here's this guy who is sick (which is not like a cold, which is how you and I think of sick) with chronic and acute onset issues, and he probably feels like a pile of crap, and he's nothing but nice and patient and kind the whole time I've had him. Never complains about a thing. I wonder how much character and nobility of spirit you have to have not to complain when you're that sick, because I would probably be a nasty witchy old hag by that point. I wish nursing weren't so sucky sometimes so I could actually spend more time with my patients. Some of them, any way.

Also, now I have actual proof that the Bride of Chuckie family member really is devil spawn, because apparently she's read the same riot act to three consecutive nurses, one of whom was the charge nurse at the time and apparently went up the chain of command about the obnoxious behavior exhibited by BOC (Bride of Chuckie) on her shift.

I shall be vindicated. I shall. We all deserve a big fat apology, not that we're holding our breaths (because damn that autonomic nervous system, we'd just start breathing again after we'd passed out any way).

Ironically, the patient is very sweet. I go into his room sometimes when Medusa isn't lurking about (read: not anywhere within 5 mile radius of hospital grounds) and say hello, and he's just nice as can be. I think he remembers me, and what happened, and feels embarrassed and wants to apologize, but he's probably too afraid to say anything, for fear she might just plunge a dagger through his already-not-so-great heart if she finds out.

I have a doctor's appointment later on, at which I shall bitch about length about my back, and insomnia issues, but in a nice way, because my doctor is a very nice, good doctor.

It's the Jerry Springer Show

So we have these downstairs neighbors. And they fight a lot. Like scream at each other on a daily basis. Mom and teenage boy.

Well, I just heard a loud thump (several actually) followed by a woman screaming and a boy crying, and then a woman screaming some more.

Hopefully they just knocked over a large piece of furniture, or something, but I called 911.

I'm good enough, smart enough...

And gosh darn it, people like me!

Too bad Phil Hartman had to go and off himself (not to mention his wife) because I could use some self-affirmation Jack Handy right now. I used to really cherish his "Deep Thoughts."

Any way, carefully plotting one's own suicide (ways and means) isn't exactly a healthy way to spend the weekend, but I've just about got it down now: something lethal (obviously) yet relatively painless (rules out shotguns or firearms of any sort, drinking lye-based household products, driving off cliffs, and virtually any or all excessively painful ways people have used to take themselves off the map). I always wondered about people who kill themselves drinking Draino. I mean really you have to be really desperate and really enjoy a very long, agnozingly painful death as your insides basically dissolve into goo and god knows what else.

Incidentally I once watched this Dr. G: Medical Examiner episode in which they discovered that some poor schmuck drank a fifth of whiskey, then shot himself with a shotgun, only to merely shoot off a part of his face and skull. He then stumbled around his hotel room blindly, took one look in the mirror and saw his disfigured face, and then proceeded to shoot himself twice more before he finally got it right. Ironically, he was killing himself because he felt like a loser that couldn't do anything right--must have been an even bigger bummer to find out he couldn't even kill himself properly.

By the way, I really dig Dr. G. I wish I was her, or at least had her job, because then I'd be working with dead people. Who a) you aren't risking your license by killing, because whoever heard of dying twice, other than people who have coded and come back to the light, or soap opera characters who can bend the laws of science and physics to their own liking and come back from the grave five years later as some damn fine looking living corpses b) dead people don't talk to you and make irrational demands.

Any way, then I realized that no matter how miserable I feel right now, it would be silly to kill myself. Especially over dumb complaint made by a stupid family member who I have already decided will end up spending her eternity in the afterworld doing a variety of unpleasant tasks like scrubbing out bedpans and emesis basis, specimen containers and cleaning hospital floors. By licking them clean. And that would be on a good day in Hell. I won't mention what other things I hope Lucifer has planned for her afterworld experience.

No, it's not exactly because The World Needs me, or anything, because Lord knows there would be about five people on the planet who would actually care if I died--six if you count the dog as a person, and then he'd probably only care because I am his Source of Dog Food and Expensive Doggie Treats--but then I thought about the people that would care, and how that would be totally unfair to them, because they are the ones I know really do love me. Also, I am neurotic, and kept thinking shit like who would have to pay off my stupid student loans, or take care of my dog?

Well any ways, I'm quitting (soon), and finding a place that will validate and support me as a nurse. So there.

Because, in the words of Tom Petty, you can stand me up at the gates of hell and I won't back down.

And in the words of Jack Handey: I'm good enough, smart enough and gosh darn it, people like me.

And in the words of some biblical writer: Dixit Dominus Domino meo; sede a dextris meo donec ponam inimicos tuos scabellum pedum tuorum. (The Lord said to My Lord: sit at My right hand until I make thine enemies thy footstool. )

Plotting my escape

I'm still in a funk today. This is evidenced by a) I'm drinking an alcoholic beverage and b) I bought a pack of smokes. I never drink alcohol unless I'm celebrating (good) or in a funk about something (bad). Ditto with smoking.

As a nurse said to me last night in consolation, "You know, going from one nursing job to another is like going from one abusive relationship straight into another."

I laughed, but only because her observation is right on point.

The learned helplessness and quiet despair of hospital nurses is eye-opening. And they keep wondering why they have a nursing shortage. Well, let's see... when you reprimand your staff for doing their job and being nice to irate family members, work us constantly short staffed, allow us to be roundly abused by any other department that sees fit (I'd like to see a doctor get written up for "being rude"; the image is just too absurd, sadly), then treat us like five-year-olds with subnormal IQs, what, pray tell, is the incentive to keep working as a hospital nurse? Who the hell wants to be told "work on your time management skills" when they work us short staffed on the floor, book up all the beds any way, and you can't take a lunch and have to work an hour and a half over your shift? Who the hell gives a damn about us, any way?

It's sad I have to look at getting a half hour, uninterrupted lunch break during a 12 hour shift as a bonus rather than a labor law and my right. It's sad that I can be verbally abused by house officers, attendings, residents, interns, dietary, admitting, staffing, laboratory, housekeeping, patients, family members and friends visiting, clinical techs etc. etc., and yet the moment I assert myself, someone runs to the head nurse and says I'm rude. I can't tell you how many times I've run into insubordinance (asking a tech to do something and have them sit on her ass or give me lip about doing it) and rudeness and done nothing, because the minute an RN goes to complain to management, believe me, she gets a tech that really will make her life a living hell. It's a lose-lose situation.

Ergo, I've made the Big Kahuna decision to quit. Not just yet, but as soon as I can work out the details of where to go and what to do next. Being reprimanded (when I should have been supported) for a patient family member's lunatic complaint is the last straw. I am not going to allow myself to be continually exploited, abused, and then reprimanded for doing my job. Just because some crazy family member complains doesn't mean s/he is right, for God's sake. But bother to listen to the nurse's side of the situation? Bother to acknowledge how hard it is to do our job and how hard we work to do it as best we can? Bother to ask us what might help the situation? Bother to LISTEN to us at all?

HA HA.

The saddest part about the whole damn thing is I like being a nurse. I love the troubleshooting, I love learning about medical conditions and treatments, I love (most of) my patients, I love my cohort of nurses (I'd have quit on the spot yesterday if it weren't for the fact that I respect and care for my coworkers), and I love helping another human being who needs help. It's the other bullshit that comes along with the good stuff that makes the job impossible to do without hurling yourself out the window in despair.

Yesterday I even thought about going back to divinity school, picking up an MDiv, and doing pastoral counseling in hospitals. I also thought about becoming a drug rep, even though I'd have to knock myself off my moral pedastal a bit (although seriously, I clean up shit for living, what am I thinking). I also thought about working as a cashier in a grocery store, where all I have to do is zip food products across a little infared sensor. I don't even have to be particularly nice. And never, ever, would I have to save someone's life, worry about killing someone if I make a mistake and the price rings up higher than advertised, or work fourteen hours straight without eating or taking a break.

It's my party and I'll cry if I want to.

So today marks the day I first cried at work. Not just tears-in-the-eyes snuffles, I mean run-to-the-bathroom-and-sob-for-five-minutes-until-another-nurse-hears-me-and-comes-in-to-ask
-what's-wrong.

You know that story from yesterday? The one where Psycho Patient Family Member yelled at me for about five minutes straight about what an incompetent nurse I was because, God forbid, I went in to change up her husband and it wasn't quick enough for her liking?

Well. She complained to my head nurse. And boy, what a fucked up complaint. She complained that I called her "honey" (better than "bitch" I thought) when I asked if she was alright, and that I mentioned I had a back injury. So what was I supposed to do?! Smile and walk out the door when she asked me to do something out of my current job restrictions without a reason?! Who the FUCK complains about a nursing explaining she has a back injury and that's why she can't lift a 200 lb man up in bed?!

On top of it, some hospitalist CHARTED the incident. Without even so much as consulting me and asking what happened, he took what Pyscho Person had to say as point-of-fact. So now it's part of the man's permanent record. Thank God he didn't name names, but WTF ever happened to professional courtesy?

So now this whole thing is a documented incident and goes in my permanent record. BECAUSE I DID MY JOB AND APOLOGIZED PROFUSELY.

FUCKING. INSANITY.

I went to the manager to explain the incident, and, though I managed not to cry in front of her, I immediately went into the bathroom and sobbed my heart out, because somehow, it still ended up being my communication issues that were the problem, not her irrational demanding and rude behavior.

So of course, then I had to go pass medications to the roommate-of-the-patient-whose-wife-had-complained, and despite a kind and concerned debriefing with the other floor nurses (I cried in front of them, too, and was just mortified, but I couldn't help it) I was still crying while I hooked up the man's heparin drip. I apologized for crying but I just couldn't help it; I felt so beaten down, demoralized and frankly, like the biggest piece of shit on the planet at that point.

His wife, who had been happy to see me, asked what was wrong (she liked me, any way), and I told her I couldn't really talk about it. Then, she asked if I needed a hug. And she gave me one. Bless her heart. She was there last night, too, and probably heard the whole thing, and probably knew what why I was crying, because she said, "You are a great nurse, and you've done such a wonderful job." It made me cry even harder.

I then went out and had a smoke with a co-worker. I only smoke when I'm a) depressed or b) freaked out. I was both at that point.

Before I left work tonight, I said goodbye to the patient whose wife had hugged me (he's being discharged tomorrow and I won't be working). I shook hands with him and told him it was such a pleasure to meet him and his wife (they really had been lovely) and he squeezed my hand and said quietly, "Are you alright now?" I said yes, embarrassed I'd made a scene earlier. And then, in a much louder voice (the Pyscho was visiting her husband at the time), "You were wonderful. You are an excellent nurse!" He was a retired medical doctor, of the good old sort, and it made me just glow inside that he had praised me.

And I smiled and said, "And you have been a wonderful patient."

And he was.