Nursing and waitressing

I waited tables and bartended to pay my way through nursing school. I remember thinking, during particularly busy dinner shifts with customers who were high maintenance or angry or demanding or just determined to be unsatisfied, that things would become SO much better when I graduated from nursing school and became a real nurse. NOBODY would order me around, treat me like a servant, talk down to me, attempt to make me feel inferior or repeatedly send me back to the supply area for extra condiments. NOBODY! I would be the EXPERT! I would have POWER! (that I would wield responsibly of course…)

Surprise! Ten years later…I get ordered around, treated like a servant, talked down to, attempted to be made to feel inferior, and repeatedly sent back to the supply room for extra condiments. Except the condiments are drugs. Lots of ’em.

The Devil Wears…Danskos?

The devil doesn’t wear Prada on my unit….he wears old worn out brown Danskos.  Danskos that I wish he would replace, STAT.  He’s our bigwig surgeon.  Dr. X.  He’s arrogant, he’s charming with the lady patients, he’s published like a gazillion papers in peer reviewed journals, he has impeccable outcome statistics and he has expectations of perfection that only Mother Theresa could meet.  But his Danskos? He’s had to have had those things since residency, which must have been ages ago.  They probably smell horrid, like a combination of dog anal glands and epoisses on a hot day.   A lot of surgeons have their “thing”.  A little superstition.  A certain surgical cap, a Mont Blanc fountain pen they’ve used for every paper order and progress note since the 70’s, their alma mater pin etc.

This guy? His ratty brown Danskos.  Now, don’t get me wrong.  I have a love/hate relationship with my Danskos.  I fought the good fight to avoid buying a pair until my aching feet protested after a year of 12 hour shifts.  I caved.  I bought.  I hate.  They’re so ugly!  But they’re SO comfortable.  And the 1 3/4″ heel comes in mighty handy when you have to walk to work in the rain.

When Dr. X breezes onto the floor for rounds, you can see him coming down the hall with his entourage of 4-5 residents, a few interns and perhaps a terrified medical student trailing 4 feet behind.  They flank him like a flock of geese migrating south in  V formation.  And every time I find myself humming “My Posse’s on Broadway” when they walk by.  Usually we’ve had about 23 seconds of lead time before he arrives to round on his patients because his Danskos have a certain recognizable squeak.

You know the scene from The Devil Wears Prada where Meryl Streep’s character is making her way into the building for work?  Scenes of her getting out of her town car, entering the building, getting in the elevators and opening the big glass doors to the fashion magazine headquarters are interspersed with scenes of frantic fashion magazine employees racing around making sure everything is perfect in the office before she arrives.  Cleaning up clutter, touching up their makeup, changing out of comfortable shoes into high stilettos, hiding carbs, taking off functional clothes and putting on haute couture, setting her coffee in its exact proper location on her desk.

That’s what its like when Dr. X comes on the floor.  We race around making sure all his patients are awake, out of bed (“get up now! get in the chair!”), medicated, working on their pulmonary hygiene (“If anyone asks you’ve been doing this incentive spirometry all morning!”)* or…jackpot…just happen to be walking in the hall when he arrives (which he loves).  If they’re asleep and shaking them awake wouldn’t be appropriate, we just shove the incentive spirometer into their limp hands. **

And he buys it every time.

* We normally do all these important post operative nursing interventions anyway.  Many times a day. We’re good nurses.  He just rounds so early in the morning before we’ve had a chance to get everyone going.

** I’ve totally done that before

The surgeon seamstress

The day after Halloween, while my Facebook feed was being flooded by parents posting pictures of their children in costume, I was at work discussing with my friend various tactics for deterring trick or treaters from my front door.  I obviously don’t have children.  And the doorbell scares my cat.  And I don’t appreciate begging, extortion and gluttony, which is basically what trick or treating is.  But I do love a good costume.

So our discussion turned to costumes and the various guises we had inhabited on Halloween throughout our childhoods.  Many of mine had dark and morbid undertones with lots of fake blood and fangs and black fabric.  One year I had a momentary lapse when my mother sewed a sparkly “good witch” costume.  My friend (who is 6’1″ and about 250lbs) was an Oompa Loompa every year.  Our discussion peaked the interest of one of our plastic/reconstructive surgeons who was dictating nearby.  He said his daughter had wanted to be Voldemort that year.  Not Hermoine, but Voldemort.  I liked her immediately.

Now, I like to entertain the notion that I am impervious to gender stereotypes, but when he proceeded to described in great detail the elaborate robe which he sewed for his daughter’s costume, I was at first skeptical.  Yeah right…you sewed your daughter’s entire costume.  Snort.  But then he showed us pictures on his phone.  And it was gorgeous.

And then I realized…he sews skin better than Buffalo Bill.  So naturally he can sew an elaborate wizard costume.  Naturally.

Didn’t your mamma ever tell you…

My mom taught me a lot of things. A lot. One of them was that I should keep my fingers out of my nose. Which was hard as a little kid with inquisitive tendencies.   Actually, as an adult with seasonal allergies it’s still a little hard. But usually there’s a tissue involved nowadays.

Sometimes at work I run across patients that I have to assume have been raised by wolves.  It’s really the only logical explanation for some of their behavior.  Take, for example, my most recent foray into the world of pediatrics in the form of an 18 year old boy with a spontaneous lung collapse.  Now, I don’t really care for teenagers.  I do realize that I, in fact, was one in the not too distant past.  But I still don’t like them.  They’re loud, obnoxious, try to attract attention to themselves, rude and I’m afraid one of them is going to accidentally bump into or touch me when I have to walk past them at the mall.

This particular teenager wasn’t too bad though.  Maybe he spent only about 50% of his time with wolves.  Despite his low pain tolerance, poor grammar and propensity to mouth breathe, he was okay.  Now, I see a lot of grody things in my line of work.  None of which particularly bother me.  At all.  I can be up to my wrists in someone’s flesh eating bacterial laden abdominal cavity, pulling out yards of smelly gauze packing all the while chatting about the chicken fricassee I made last night to my nurse aide who’s holding the wound open for me.  Its called compartmentalization, and its my second most used psychological defense mechanism.  Try it sometime.

On this day, however, the teenager ruined my groove.  He did something that almost made me puke my coffee all over the floor.  I happened to be standing in the hallway outside his room, doing some computer charting and I glance in to make sure he’s still breathing with the morphine I just gave him for…wait for it….10/10 pain!!  He looks okay, is watching Judge Judy on TV (he must be an old soul…)  Then I see him reach with his middle finger of his right hand into his right nostril and start searching.  I’m standing in the middle of the hall, hands still on the keyboard frozen mid keystroke, watching him and thinking to myself, “Middle finger?  Who uses their middle finger?”  Then, almost in slow motion, he removes his middle finger and it slowly descends down his face and makes a pit stop at his lips.  As I’m screaming “Nooooooooooooo!!!” inside my head he proceeds to use his bottom teeth to scrape whatever it is he’s found up there out from under his fingernail.  Once, twice…and then a lip smack and a swallow.  Frozen, I can’t avert my eyes.  They’re stuck.  And I can feel my coffee rising up in my throat.   He does it again.  My eyes start to water.

Finally, as if sent by God Himself, my pager goes off telling me I have a phone call.  Blessed phone call.  I want to gouge my retinas and rinse my eyes in peroxide, but for now I have to take verbal on a patient coming back from Interventional Radiology.

And I’ll never be the same again.  Judge me if you will.  We all have our idiosyncrasies and nose picking and eating just happen to be mine.  Good day to you.

Dirty floors

It kills me when little kids visit a family member in the hospital and their parents let them run amok on the unit. Especially if they’re running amok sans shoes. In my head I’m seeing the little old man who just ambulated down the hallway leaving a nice little chocolate trail behind him as his anal sphincter failed him. A nice chocolate trail that we hastily mopped up with towels while waiting for housekeeping to come and give a proper clean to. But not before little Tommy runs over it in his bare feet as he’s screaming and running around the halls! Yay! C.diff for everybody!!

Put down the chicken strip…

If you had a paper cut, would you ask for a slice of lemon to rub on it?

If you had just burned your mouth on scalding pizza cheese, would you quickly grab a swig of hot coffee?

If you had a fresh blister from a new pair of heels, would you put them back on right after it popped and exposed the raw skin?

If your butt smells like something crawled up there and died, would you fart on an elevator?

No?

Then why would you order chicken strips right after you’ve just asked me for a dose of phenergan to take away your ‘nausea’?

Oh yeah…because you’re not really nauseated. And because phenergan makes you feel good. And I must look like I graduated from nursing school this morning before shift change.

Television

I can peg a Maury Povich or a Judge Joe Brown watcher from a mile away. Or really, just from the doorway to their hospital room.  My accuracy is around 97.82%.  I could write an entire Sociology textbook around the television shows that various demographics watch while in the hospital.  I work with adults.  Some adults watch cartoons, like Spongebob.  Some watch the Disney Channel.  A lot watch trashy talk shows.  Some watch judge shows.  Some even watch FOX News!!