The Danger of Caring

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Medical Professionals are an interesting breed of folk. We are not immune from tragedy striking in our personal lives, and some of us are subjected to a constant bombardment of reminders when we go to work.

I love what I do. I get to hang out with the most eclectic crazy group of people almost every day, which allows me to cope with the sadness that comes along with my job. We develop coping skills over time, and eventually we learn how to watch other people suffering with an objective eye. We would not be able to return day after day if we could not keep everything in perspective.

For many of us, laughter is indeed the best medicine. We are full of inappropriate humor, and while it may seem insensitive to some, it is actually just our way of processing the horrors of ICU, and remaining sane. We develop little rituals and we have a plethora of superstitions. (You never say the Q word, observe how slow the unit is, or mention that frequent flyers name.) We trade war stories, and we collect memories that we can use for a quick laugh.

When our loved ones are patients in our hospital, or worse in our unit, the nice little boundaries get blurred. The personal and professional worlds collide, putting us at risk in every area of our lives. It is imperative to remember that we are only human, and it is okay to feel powerless, and to acknowledge our fears. We do not have to be the professional when we are indeed- the family.

I have had this experience a few times throughout my career, and I will remain forever grateful for my coworkers who allowed me the space to be a family member instead of a nurse or nurse practitioner. It helps.

Daddy Issues Part II

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It’s the middle of January *2006. I have been a nurse on the night shift for about six months. My patient load tonight is insane. Part of it is my fault. I ask to keep the patient at the end of the hall even though the rest of my group is at the other end. The thing is, I am worried about him. He is in room *417. *details and names are changed for privacy.*

Mr. 417 has been in the hospital for several weeks. When I first meet him, he is a cantankerous grouch. He does not like being stuck in bed with the tube snaking out of his nostril and connected to suction. He is unable to eat, so we continuously drip nutrients like lipids, glucose, and vitamins into his veins.

I am still inexperienced, and completely naive about the seriousness of his condition. Yes, he is quite old, but has always been healthy up to this point.

I dote on my little cranky man, pick up extra shifts, and ensure that he is well cared for. Mr. 417 is excessively difficult to please. Everything has to be just so, and I have our routine down pat.

It is three in the morning. I have been running from room to room all night. I am doing a bowel prep for a colonoscopy in room 405 and the patients in 402 and 407 are call light happy. I am in Mr. 417’s room about every 20 minutes to check on him, and to try to find some relief for his discomfort- all to no avail.

I am busy giving a bed bath in room 405, and unable to check on him from 0235 until 0300. When I finish my tasks I hurry to check on him. What I find is a new nurse’s worst nightmare. I run to get my charge nurse, and we get an ABG and a CXR. Obviously in shock. I have to call a doctor and get some help for my patient.

I pick up the phone and dial the number. I ask the answering service who is on call that night. When she answers, I promptly hang up and burst into tears. I am one of those annoying people who cry at the first sign of stress.

Oh, the call light is going off. My patient in room 405 has tried to get up and navigate her way to the bathroom without assistance. The Golytely effects hit her rapidly. There is a very large problem all over her room. We do not have a nurse’s aide tonight.

I have to call the doctor. Let’s call him Dr. Snape. Everyone knows that is not his real name. In my hospital, he is infamous. This is a man who does not like to be woken up. Nurses dread calling him, and almost everyone has a Dr. Snape story. His reputation is legendary. He is also known as one of the best doctors.

I beg my charge nurse to call him for me. She refuses, however we do have an impromptu practice conversation. I take notes. I gather his chart, and make sure I have current vital signs, I&Os, and lab work available.

I take a deep breath, and with shaking hands call the answering service back. I sit there and silently rehearse what I am going to say. The phone rings, and the call is transferred to me.

I ramble my rehearsed speech, my words hurried and breathless. The patient’s name, room number, admitting diagnosis, admitting physician, and why I am calling. I do not stop speaking until I get all of that out, then my voice trails off uncertainly because I do not know what to do next and I have yet to take a breath for fear that he will interrupt me.

Dr. Snape is silent on the other end for a few seconds and I am shaking with anxiety. He starts asking questions. He wants details. Not only about tonight, but about the events that have led up to tonight. Who was his surgeon? What did they find? What medications is he on? How long as he been on them? Is he fluid overloaded? Did he smoke? What did he do for a living? When was his last set of cultures drawn? What is the plan from oncology? Where is his family? What does the patient want? Does he know how sick he is? Does he have children? I am fairly certain he asked me who the man took to senior prom. (looking back, it seems that after a minute, he was testing me.)

Then, this exchange:

“What was his respiratory rate before?” I nervously double-check my notes.

2000: 22

2100: 24

2200: 22

2300: 22

0100: 24

0300: 39

I respond “Between 22 and 24.” Without skipping a beat Dr. Snape asks “Wouldn’t that be 23?”

I have been on the phone, shaking, and speaking in rapid, unsure answers for what feels like an eternity. I miss the joke. “Ummm. Yes, sir. That would indeed be 23.” The nurses are gathered in a curious and supportive circle around me. There is a titter which feeds my anxiety. I wish I were anywhere else in the world at that moment.

When Dr. Snape asks who the respiratory therapist and charge nurse are- I am so relieved. I hurriedly respond “*Nurse Ratchet, would like to speak to her?” and without waiting for an answer, I abruptly put him on hold, transfer the call, and burst into tears. I am convinced I am an utter failure. I contemplate switching careers. Then, I rush off to take care of Mr. 417. I have to transfer him to ICU. I see Dr. Snape in the unit when I am dropping off the rest of the patient’s belongings, and I avert my eyes and scurry away.

The rest of my night is a mess. I worry about my patient, and I have a ton of things to do since my routine was interrupted. I go home that morning feeling like a terrible nurse, and wondering if I am even capable of this job.

The next day, I walk into the break room at the beginning of my shift, and find this in my mailbox. *It has been edited to leave out identifying information. *IMG_7835Well, that is weird. What does this mean? Isn’t that my job? Oh, well I am flattered. Obviously. I still have it after all these years. It lives in a metal box. Along with a copy of the recommendation letter he wrote for me when I was applying for a fellowship after grad school.

This night is one of the defining moments of my career. It is the beginning of my relationship with one of my mentors. It took me years to get over being too intimidated to speak to him, but once I did, I was pleasantly surprised.

Night shift nursing brings about a completely different relationship with physicians than day shift. You typically only see physicians when there is a crisis. For many of them, they have been awake all day working, and this is the time they should be at home asleep. It makes it difficult to foster overly friendly relationships.

However, given enough time and exposure, you eventually do. Over time I learned how to be prepared for my encounters with them, and that made their job easier, which helped reduce some of the stress. I learned how to see them as people instead of doctors. I like them a lot more as people. Totally less scary.

One day, after I had been working closely with him as part of my clinical training for nurse practitioner school, I mentioned that night. He immediately remembered. He did not know it was me though.

He was an awesome teacher while I was learning how to be a mid-level. He sought out chances to challenge me, and he was quick to correct and to give me feedback on the job I was doing. Now, to be honest, I hit the jackpot when I chose preceptors. I picked them for their willingness to teach, and they all gave their time and expertise generously. I am so grateful for these physicians and nurse practitioners.

But, this is about Daddy Issues. How on earth does that apply to this nursing story. Well, duh… because it is my story. Remember me? The girl with daddy issues?

I started noticing a trend to my relationships with a few of my mentors. Especially with ******* (you know, Work Mommy) and the one who became Work Daddy. The two of them were the ones that I sought out for advice. I respected their opinions, and felt that they understood my goals and aspirations. The joke became that they were Work Mommy and Work Daddy. (Don’t worry- Work Mommy has a story too!)

Now, while it was initially a joke, I see how it is applicable. As I mentioned in Daddy Issues Part I, parents are our first mentors (or they should be, anyway) and when your mentor is also somewhat responsible for you as an employee, it is easy to see how mentorship could be similar to a parental role. These are the people I come to when I need help. They are the ones who offer guidance and recommendations for my future.

It is their opinions I trust. I feel like they have my best interests at heart when they offer me advice. I am never afraid to tell them when I do not know something, and I am not afraid to take chances and risk looking foolish for asking questions.

Mentors are so important in life. They are coaches who develop skills. They are people who are interested in how your career affects you personally. In some instances if you are lucky, they become friends.  — although, that may change if Work Daddy finds out I called him Dr. Snape.

***I would like to point out that Alan Rickman is a very commanding presence. Also, Professor Snape did kinda turn out to be a hero in the end- He always looked out for Harry, and tried to protect him. This is where the pseudonym came from.

One last thing, I am so grateful for the experiences I have had with my mentors, and I would not trade any of it for anything. Quite basically, I am a lucky girl.

 *** update. Work Daddy is no longer my employer, however he remains a treasured friend and mentor. ~10/29/2015 ♥️LQ

Dating nurses- a rebuttal to “The Blogger”

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Let me first point out, this is written in response to something a man wrote. Yes, I know he was probably trying to be clever, however what he wrote struck a sour note with me.

So, short synopsis: nurses are mean dates because they have to spend all day caring for others, while attorneys are nice dates because they are sharks all day. While I am convinced that he was trying to be clever, and to find some way to justify his large number of first dates, he ended up making some asinine comments that I wanted to respond to.

Now, I was going to make this a rebuttal. I am not. I am just going to share some of my experiences.

First of all, most of the nurses I know (and I know a lot of nurses, I AM a nurse) are multifaceted women with outgoing personalities. We tend to be a little no-nonsense, while maintaining a terrific sense of humor. We like to joke and have a good time, we trade war stories, and we spend incredibly long hours with people in various states of health. At the end of the day, it is at times difficult to turn off our nursing personas, and to be regular people.

Wait. What? We are not regular people? Of course we are! We just happen to have an all-consuming career that changes our personalities on a molecular level. (Throwing some science words in there because he likened his experiences with two nurses and two attorneys to valid research.)

One of the more interesting aspects of nursing is the necessity of always appearing confident even in truly scary situations. It’s a captious predicament. (My dictionary app had that as the word of the day, I decided to use it. It fits.) We have to portray the ever cool and in control professional, all while wracking our brains trying to figure out the right thing to do. Oh, and now let’s throw in the fact that we do not want to seem like a know-it-all, and to presume to tell our coworkers or the physicians we deal with what to do. Through out all of this, we also have to figure out what we need to happen, and to make it happen without creating strife. (I realize this paragraph makes no sense, however it is difficult to talk about nursing in generic terms without using specific situations that could somehow impede on patient privacy, and this is a situation I am not willing to risk.)

So, moving on from nursing. Let’s talk about dating.

I am a girl with a rather ummm…. strong personality. I am loud, opinionated, and lacking a filter. This tends to make me a rather polarizing figure. Typically people either like me or hate me. I am not one of those people to inspire indifference. (Perhaps I am wrong about this, but it has been my experience.) So, when meeting new people I have made an effort to tone it all down. I tend to try to read the situation, and to behave appropriately. I often fail.

I am either too quiet, or too loud. (For those of you shaking your head and wondering when I am ever quiet- bite me.) This tends to create a feeling of discontent within me, and then I am irritable. There is no worse feeling that knowing that you are not being cool. I know, I know just be yourself. If people don’t like you for you, then they are not worth your time. The thing is, most of us are many different things, and it is hard to know which personality to use in particular situations. (No, I do not have multiple personalities, I just have a lot of personality. Or not. Depends on who you ask.)

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Excuse ME????

Let me tell you about something embarrassing- the other day, Facebook called me fat. Well, it insinuated it anyway.

I gotta be honest. My feelings were hurt. For one thing, that guy looks like an ass. For another, HE CAN HANDLE MY LOVE HANDLES???? what? This is one of the infuriating things about being a fat single girl. I am no more attracted to men who find overweight attractive than I am to men who find thin and skinny attractive. Not to sound like a hypocrite, but I want a man who sees me as a person, and who supports my goals. If I were to meet a man who is “into big girls,” is he going to find me less attractive as I continue on this journey? It’s quite the conundrum. So, for now I am not interested in dating nearly as much as I am interested in becoming a healthier person.

Oh, that got off track there. Back to generic dating.

There is a real danger of judging a personality on a first date alone. We rarely show our true colors while in a new situation. If you have a ton of first dates, perhaps you need to examine yourself and focus less on the other person. Also, if you have a lot of bad first dates could it be that your personality is bringing out the worst in your potential paramour? Just to reference the initial blog that started this. If your date was thirty minutes late, it is quite possible that she was embarrassed and there is this guy who was about to leave, and now is sitting there tapping his foot in impatient and silent judgment. Yeah, that would put me on edge. I would possibly find myself being defensive and argumentative. After all, some of us tend to lash out when we are embarrassed. What did you do to set her at ease? I would imagine nothing. She was late and did not apologize. How rude. So, there you have it, two people who are feeling unappreciated, and we wonder why the date went badly.

Women are complicated. I have heard that my entire life (out of the mouths of men.) I tend to lean the other way. Women are simple. We want to be appreciated, noticed, and cared about. We need to matter.

Men are complicated. I have said that my entire life. Probably not true. Men want to be appreciated, noticed, and cared about. They need to matter.

Hmm. Maybe dating is not so complicated. Perhaps we need to step outside the box, and stop waiting for someone to respond in whatever fleeting mood we happen to be in. Maybe we should make it more about what I can do to ease this person’s insecurities. Perhaps, we need to lighten up, and just try to have a good time. If everyone spent a little less time waiting for someone to rescue them, and spent a little more time being truly interested in the people who we spend time with, we might surprise ourselves, and find the person we have been looking for.

***This is probably a mess-

***It may have some interesting points though.

***I am about to do a TM with “The Blogger”- So, if you are reading this- It may or may not be a joke. I am noncommittal on this fact. Whatever prevents you from having a defensive reaction. 😉