R-E-S-P-E-C-T

Sing it, Aretha, SING IT.

Because boy, I need it after tonight.

I just worked another 9 hour shift. No break. No food aside from a bagel wolfed down during an inservice this a.m.

I ran around like a goddamn monkey (or limped around, given the state of my back) trying to get my 5p.m. admission settled, meds passed, treatments done, blah blah blah blah. I was supposed to be off at 7p.m. BWAAH HAA HAA HAA HAA.

At 6 p.m., some irate family starts in on the "deplorable care" her family member is being given. And I can't say what I'm thinking, which is, "Goddamn it! Give me a fucking break! I haven't had anything to eat in nearly eight hours, I'm working with an injured back ON MY FEET for all eight hours, I haven't sat down for ten minutes straight, let alone have my mandated half hour break, and all I've been doing is running around trying to give my patients --including your family member--the very best care I can. I AM ONLY ONE PERSON, IF YOU FUCKING HAVEN'T NOTICED, and I DON'T JUST HAVE ONE PATIENT."

NOR DOES LIFE IN A HOSPITAL PROCEED IN A LINEAR FASHION. Meds and labs get ordered at various intervals during the day, consults come in and then disappear without relaying important information, which we then have to decipher from a scrawl in the chart, and then we spend HOURS chasing the requisite folks down to get the job done. Procedures occur routinely during the day and sometimes we have to assist, and then MORE MEDS/TREATMENTS/PROCEDURES ARE ORDERED. IV pumps fail, medical equipment and meds need to be restocked, and again, we spend HOURS chasing down supply and writing up bullshit incident reports, and meanwhile the clock ticks away.

And then there's actual patient care. Because you know, patients require nearly constant monitoring, like rounds and assessments. And then there's the occasional minor or major emergency that requires a great deal of time and energy to prevent something worse happening.

SO DUDE.

Just because your family member decides to spill his urinal in his bed and not tell any one about it DOES NOT MEAN I AM A SHITTY CAREGIVER. It means I AM OVERWORKED, TRYING MY BEST, AND GODDAMN IT, STOP TREATING ME LIKE SOME PIECE OF SHIT WHO SITS ON HER ASS ALL DAY FILING HER NAILS AND EATING BON BONS AND READING GLAMOUR MAGAZINE WHILST HER PATIENTS LIE IN THEIR OWN FILTH.

I mean SERIOUSLY. I'd like to see those people who complain about the care their loved one is receiving try to do my job for one eight hour day without having a goddamn nervous breakdown. I'd like them try to prioritize a multitude of emergent patient needs, all of which could have potentially life threatening consequences if not addressed properly. Keeping people alive and improving their health status is, along with other health care providers, my job, and it's not exactly the kind of job where you sit on your ass, shuffle paper around for eight hours, and go home and the fuck if you make a mistake, because that's what accounting department is for.

I don't have the choice to sit back and say, 'Oh, well, that potassium level of 6.2 can wait until the next shift" or "My patient who's having severe radiating back pain s/p cath can just take tylenol and ride it out because I've got to eat lunch and the hell with the possibility that he might be bleeding into his belly" or "that BP of 60 by doppler can wait a minute longer because I'm due for a fifteen minute break, and oh well if he codes." or "that new admission can just sit there in the hallway until maintenance comes because the bed in her room is broken" or "The hell with his pulmonary embolism, his IV heparin can wait two hours while we wait for CSR to get off their asses and send up a pump that works, unlike the last two they sent up" or "I'll just pretend I didn't just see that 21 beat of asymptomatic V-tach when his 'lytes are all fucked up and he's waiting for an AICD."

Sometimes, these stupid little things, like making sure my patients don't die or suffer irreversible consequences because of some stupid assinine thing that half of the time has NOTHING TO DO WITH MY NURSING CARE (like chasing down IV pumps or getting phlebotomy to come up and draw a STAT lab) is just a little more important than cleaning someone who's soiled himself and doesn't put on a call bell and let us know.

I don't like to leave people soiled in bed, but neither do I enjoy being so pressured and busy with putting out fires that I can't spend more time with my patients. But the simple reality is that with patient acuity being what it is, and staffing ratios being as shitty as they are, I don't have time to do everything, and believe me, it's not because I'm lazy and don't give a shit. And I do delegate, but it depends on who you're working with that night, and how much of a rat's ass they give, frankly.

And you know what sucks even more? Nurses get blamed for everything. Coffee not warm? Our fault. Doctor didn't come up to see the patient? Our fault. Temperature too warm/cold in room? our fault. We can't divulge HIPAA protected information? Our fault. Patient has to wait an extra hour or three because the OR is backed up or someone had to have a STAT procedure? DITTO.

Nurses are the frontline of hospital care, and we do so much for our patients, and in return, often get very little respect. Physicians aside, patients and family members are often rude, demeaning, disrespectful, and it hurts when I get lectured by some ungrateful family member who insinuates I'm giving poor care when I work with all my heart and soul. I do care, and not just because I have a license to protect and a career to further. I give a damn, and I wish I could do more, and HOW FUCKING DARE YOU INSINUATE I DON'T GIVE A SHIT?!

More than once I've worked 14 hour days WITHOUT A SINGLE BREAK OR ANYTHING TO EAT so I can take care of my patients properly and try not to dump on the next shift. I sacrifice my well-being so that my patients can get better, and at the end of the day, I still feel like I could have done more. I go home and the guilt eats me up. So I really don't need Genghus Khan to come and beat me about the head and tell me what a crappy human being I am for not being five people in five different places simultaneously.

I don't ask anybody to say thank you, or pat me on the back, or even be cordial, but it really riles me up when somebody starts about what a lousy ass job they think I'm doing. It's amazingly hurtful. No wonder so many nurses become so jaded and stop giving a damn; they've been fried to a crisp one to many times by this crap.

I've got this weird, perhaps unfounded feeling that the general population thinks nurses aren't very clever, and not smart enough to be in a 'real profession.' In my opinion, folks like lawyers and doctors in our culture receive almost automatic status and prestige by title alone, whether or not they are actually good lawyers and doctors. Nurses, on the other, seem to be viewed as dimwitted handmaidens, only good for passing bedpans and straightening out bed linens, and are often targets for bullying and abuse by virtually anyone and everyone who sees fit.

So, public message: if you are ever in a hospital, and you have the chance, please thank the nursing staff. Yes, the coffee may be cold, the dinner tray late, and the temperature in the room godawful. But we promise, we are doing our best, we do care, and that is why we often times have to make the choice to take care of the medical priority before we proceed to anything else, even if it seems to you that we aren't paying attention to the things that are important to you at that point. We are paying attention, and we do know these things need to be done, but we can't do everything for everyone, all the time.

Please try to put yourself in our shoes. Yes, you may be distressed, in pain, worried, anxious and scared. That is your right as a patient or loved one. If you need to vent, there are appropriate outlets. But remember, we nurses are only human, and we often are just as scared and worried about you or your loved one. We can't argue with you when you scream at us, we can't vent about how crappy our day has been too, we can't cry when you hurt our feelings with your outbursts of rage and indignation, and we must never show how scared we are when you are really sick and in need of help. We want to help you, and that is our job, so please remember that sometimes, we need kindness and understanding to carry us through a day, too.