Reflections from the Joplin Tornado

As I start this off, I want to make one thing perfectly clear please.  I’m not a “Hero”.  I never have been.  Please don’t call me that.  I’m a man that did what anyone else in my role and my skillset would have done.  @MurseWisdom is a Veteran that served in a war zone.  @MurseWisdom is a hero.  Both of my parents proudly served in the military.  They are heroes.  

Dr. Kevin Kikta is a hero.  He wrote a story called 45 seconds about his night in the ER that night.  It’s a chilling read.  http://statemagazine.org/?p=531

Dr. James Smith is a hero.  He was doing surgery when the tornado hit and ran over 7 miles home to check on his family.  http://www.outpatientsurgery.net/news/2011/05/24-Operating-Through-the-Tornado

The countless, unnamed nurses, RTs, Rad techs, and all the medical personnel that covered both hospitals that night and continued to staff them until everyone was taken care of are the heroes as well.

Please save that prestigious title for them … they deserve it.

With that being said, here we go.  I’ve debated the last few days what exactly I wanted to say. I figured I would say, what I felt, what I did.

It was 5:41 p.m. and it was 32 seconds that would forever change the lives of people that lived anywhere near Joplin, MO.  I was watching the coverage on The Weather Channel.  There was discussion that Joplin and possibly a hospital had taken a direct hit; however, I knew this to be true well before it was confirmed on the air.  Facebook literally blew up.  I knew that St. John’s had taken a direct hit because of Facebook.  But when the weather channel cut live to a Mike Bettes standing in front of what used to be the hospital; my heart sank.  “I have friends and classmates that work there” I thought and then Mike came on the air and pleaded for doctors, nurses, medical personnel to please come to Joplin.  http://www.youtube.com/watch?v=r8kg2dEJo_Y&feature=related

It was all I could take, myself and several other nurses loaded up to make the drive to Joplin not knowing what the hell we would find but knowing that we had to do something.  We arrived about 4 hours post touchdown and went to Memorial Hall where the medical triage was.  Upon arrival there, we found them fully staffed and they suggested we go to another secondary site.  We got there and waited about an hour before I finally was able to get through to the Red Cross.  They basically said that if we were already in Joplin that we should go to Freeman hospital.  

Driving to Freeman hospital was problematic to say the least as we had to drive past what was St. John’s hospital.  We were stopped 3 different times at three different roadblocks, one being right next to St. John’s hospital.  I do have to say that this was one of the most amazing experiences as a nurse.  The police officers stopped us, I said “We’re nurses” and they screamed “nurses” and opened the roadblocks for us.  Once we got to St. Johns we had to drive around the back of the hospital. Pictures will NEVER do this justice.  I’ve heard it described as what pictures of the atomic bomb in Hiroshima looked like and I’d have to agree.  It was complete and utter devastation.  People were wandering around aimlessly obviously in shock of what had happened and the place smelled of strong, strong natural gas.  We arrived at Freeman hospital finally and walked into the ER lobby.  It was one of most surreal scenes I’ve ever seen.  The lobby was literally overflowing with people and I would estimate approximately 1,000 people waiting to be seen.  I found a friend of mine that worked there and he said they were out of most every supply except gauze and gloves mostly so if we could do some basic first aid and try to find the most ill patients to be seen first.  We walked around and spoke with people, treated and cleaned bumps and bruises, and found severely injured people to pull back the moment ER beds opened up.  On the ambulance side of the ER they had a convoy of over 100 ambulances and they were literally loading people up and dispatching them to hospitals in a 200 mile radius.  There were buses loading up less severely injured people and transporting them as well. 

The looks on the faces of the people in the lobby is something I will never forgot.  It was disheartening seeing the look of pure shock at what had happened and trying to make sense of it all.  How could 32 seconds completely change their lives like that.  While we treated the bumps, bruises, and lacerations; we were not able to treat the mental issues that were filling that hospital and that town.  We stayed until about 4 am and then went home knowing that as much as we felt we did we probably didn’t do enough.  Little did I know at the time, but my ex’s brother was frantically searching for his daughter who was working at a local restaurant at the time.  Unfortunately, while they found her; her injuries were too severe to survive.  However, she died a hero as well.  She was working to keep customers and other employees calm before the tornado hit the establishment… she wasn’t even 18 yet.  

I’ve talked to employees from both hospitals and some still have trouble sleeping or still have mental issues relating to that 32 seconds.  

So there are a few things that I learned from this event: 1.  Social Networking is a must.  As I said, I knew that Joplin and St. John’s was hit long before it was announced.  Facebook was also a lifeline for people looking for loved ones at that time because if you couldn’t make a phone call you could send texts a little easier and a text to a loved one or facebook was a welcome sight for families.  2.  If you don’t know how to text – learn.  And teach your parents, grandparents, anyone with a cell phone to text.  To put it into perspective, I tried over 100 times to call the Red Cross that night.. I got through once.  Text messages were going after only a few times of trying to send.  3.  NO HOSPITAL IS PREPARED FOR A DISASTER OF THIS MAGNITUDE.  Freeman was out of supplies initially within a few hours.  Our hospitals are trained to keep supplies on hand for anticipated need.  Not for 1,000 people showing up in your lobby to be treated in a few hours.  I have disaster training and used to work in that field.  This last one scares me the most because I used to think our hospital is ready, but I think we would run through supplies in a matter of hours as well and then would have to get inventive like Freeman staff did.

However, Joplin doesn’t want to be known for that.  They want to be known for their drive to rebuild and they have done an amazing job.  It should be an inspiration for everyone of how to overcome adversity.

@that1murse

Defense Mechanisms

Sorry it's been a while.  You know how it is with finals and all.  

So I’ve posted some “#BeingAnERNurse means” and it got me thinking about ER nursing.  One of the things that came with working in a smaller community is that there is a better than average chance that I’ll know my patients, their families, or will see them out and about.  This can be a double edged sword. 

Every time that ambulance rolled through the doors, there’s a piece of me that wondered if it was someone I love.  I heard a story of a nurse working in an ER like mine and the ambulance rolled in with a severe trauma… It was her husband.  She literally went catatonic and woke up several weeks later in the hospital. 

With this fear comes the point of my blog post tonight, defense mechanisms.  One of the defense mechanisms that I have (and I only know this cause I can willing admit it) is that I don’t look at faces, unless the injury is specific to the face.  I know this sounds weird until I explain it. Hell, then it might still be weird.  If I don’t look at the face then I don’t know whether I know that person (yes, I know you literal people will say look at the name and to you I say shut up, LOL… Actually, traumas come in John Doe so it doesn’t help anyone).  I have literally taken care of people for 2 hours and when they get admitted to the hospital I realize that I know and recognize them.

This does make for two strange situations though: 

1. I’ve had people come up to me in Wal-Mart and say “Thanks for taking care of my husband so well”  and I look at the them and how no idea who they are.  But if they tell me what room they were in and a little about the case, I can tell them exactly what we ordered, the diagnosis, and the disposition… Strange I know
2.  I have a hard time recognizing faces outside of work.  I see people and think.. shit I know them from some place but I can’t pinpoint where.  It usually takes me seeing the person 5-6 times consistently before I can remember their face.

Again I have this defense mechanism in place to protect myself from the inevitability that I will probably work on someone that I know and love. 

So do you have any defense mechanisms in place? 

As always comment here or tweet me. 

And of course follow the me and the rest of the #MurseMafia on twitter.  

@that1murse

Know Your Role

I think it’s important in nursing and life in general to know your role and know your qualities.  Are you are leader or a follower?  A critical thinker?  Someone who just wants to get by and draw a check?

I think the lack of knowing this beforehand can contribute to nurse burnout and people with Nursing Degrees working in banks or not working at all.  There are some jobs based on your qualities that may not work well for you.  For example, if you are going to work in a nursing home or an inpatient rehab your leadership qualities will probably be for naught.. and from the time I worked there the most critical thinking that I did was making sure I didn’t give Gertrude the medicine for Olive.  (Now I’m not knocking nursing home nursing, just saying that if you are a person that wants to grab life my the balls and drag it down… nursing home nursing…probably not for you)

I’ve always seen myself as a leader.  I think this is why I gravitated toward ER nursing or critical care nursing in general.  I knew that when the shit hits the fan, I would have to potentially take control of a situation.  We’ve worked multiple MIs, multiple GSWs, and this with one doc in the ER.  I’ve had the doc approach me ask me to assess a chest pain and decide if it’s legit or not.  

I think this is also why I’ve decided to pursue my Nurse Practitioner.  I want to be the guy in charge.  I want to be the giver of the orders not the taker of the orders.  But I know that’s a quality of mine.

What I think you should do, it take a few moments assess the type of person that you are and learn what qualities make you up?  It will pay off and hopefully make nursing a more enjoyable experience.

And as always, follow me @That1Murse and my blog co-author @MurseWisdom.  Feel free to post questions, comments, bitches, whines, moans, groans, and complaints.

Special shoutouts: 

            @BigWesYall and his website www.weshelton.com  - Thanks for the link to our blog.

@jorrrrd_ (Jordan) and her class at LCCC.  Thanks for posting a link on your FB group page.  Enjoy the read.

The Last Straw by TMFS786

By far the most asked question I am asked is why would I choose to go from police officer to nurse? It's a legitimate question, because some people have see NYPD blue and think we get to throw people around and why would anyone want to leave that. The truth is a series of events in stories that are way to long to put into one blog. I have been able to isolate what may be the three biggest facets of my decision: 1) the justice system sucks, 2) aspects of the jobs themselves, and 3) specific events that happened as a police officer. Before we go any further I think it should be said that I love being a police officer (I still do it part-time) and the officers are great people. Nothing said should be seen as a reflection of the people wearing the uniform and doing their job.

The justice system is broken. I hear a lot of complaints about the health care system and everything that is wrong with it. Well, it looks like a diamond shinning in the sun compared to the justice system. Health care is flawed and I doubt there is a good way to fix it that will satisfy everyone. The justice system just seems to be screwing over most people involved with it. Health care still essentially does it job. If you are sick, most likely, you will be fixed. Yes, there are tragic stories of insurance companies turning down people that need an operation or procedure. Do I feel for those people, of course I do and it sucks. The difference is those are isolated scenarios that need fixed. The justice system has a systemic infection that can't be corrected easily. The joke is lawyers are to blame and in essence that's not a joke. It is heart breaking to stand in court and the suspect say he is guilty and the judge tell him to reverse his plea, because he may be able to get a better deal. Especially when you have put in back breaking hours and manpower into finding a thief, then you have to go to court and then that happens. Afterwards the family inevitably blames the police even though they know we arrested them. When I take care of a patient they get better or they get worse. I get to see it and I can deal with that, but to have a win taken because a judge doesn't care is just heartbreaking. Defense attorneys are another breed of slime that's hard to deal with on a daily basis. They are doing their jobs…blah, blah, blah. A person that can defend another person who admits to molesting children by trying to insinuate that the police officers were wrong is pretty disgusting. Imagine a person that just stood in a room and every time you went to start an IV moved the persons arm.

People hate cops. It's a fact of life any police officer will likely tell you depending on how much complaining he wants to deal with after they are honest. People want us out busting crime, enforcing traffic laws and making society safe. That is until we start asking them questions then we are nothing but worthless and harassing someone. It always has to be that they are black or a woman or they drive an expensive car. Nobody has ever said “I realize you stopped me because I match the description of the person robbing houses and I happened to drop my wallet in their house” or “I know I was in the wrong going fifteen miles over the speed limit.” In the end it's always our fault that they did something wrong. A nurse is seen as something in society that represents what people aspire to be. We are trusted and thought of as capable by the public. I want to do my job and do it the best as I can without people hating me for doing it. Another officer and I responded to a child drowning. It was at a house party and accidents happen. The officer and I arrived to find the girl and began doing life saving measures and actually got the young lady to begin breathing again even it wasn't pretty. The party however never stopped and I yelled for the music to be turned down and people to step back, because silly me I wanted to let EMS know what was going on and to have room to work. After the incident several family members came up to me and demanded an apology. I wasn't expecting a thank you, but I certainly didn't see this coming. They said it was obvious since I was the only white person there that the reason I yelled for the music to be turned down was because it was rap music and I was racist. It never occurred to them I guess that I wanted to relay information to the paramedics who were on their way to get the daughter. That was a hell of a way to end that call. The other day, working as a nurse, a parent thanked me profusely for saving their kids life, even after I told them repeatedly that I only helped and I really didn't do that much. That everyone else around me had done much more. It's hard to argue with an appreciative mother with tears in her eyes. That is another reason to leave being a cop and become a nurse. Not only was I thanked, but I was thanked for just being there.

I have been in way worse situations as a police officer then I will ever be as a nurse. That doesn't mean there isn't stress, there is a ton of stress as a nurse, but it's not the same in the field when you are involved in the action. One of the boring but safe reasons for being a nurse over a cop is there is dramatic drop in the safety of being at work. Never has a room burst into flames while passing meds. Nobody has pulled a gun on me while adjusting them in bed. I have seen a lot of things that have made me different than I was before them. Some things can not be unseen or changed in your memory no matter what you do. Trust me I tried and tried. I don't know how I became so unlucky but I had a habit of being at the wrong place, at the wrong time, a lot as a police officer. Over time these incidents wore on me and they still place a weight on my shoulders. It is expected and it hasn't inhibited me in any real sense of measure. A lot of times I am asked essentially “what straw broke the camel's back?” A story that I will keep brief and I have been told may be too graphic for many is the answer. A structure fire was reported and then it was dispatched that children may be in the house. If I had drove to that house any faster I would have went back in time. I had been in some tough situations before, but anything involving kids always seems to hit harder. The house was hot…real hot when we arrived and I knew it was going to be bad. The flames had busted out the front and sides of the house and were extending pretty far into the air. It's something I don't know if I can explain with a thermometer but looked like something out of a movie. I just didn't think it could be real. Eventually we were able to get one child out of the house and into the hands of paramedics who took the child away. One was still reported in the house. I screamed and inhaled black smoke at an alarming rate something I am sure my lungs will repay me for in the future. In the end we got the other one out but it wasn't enough. At the hospital helping the coroner, I saw all the nurses standing there. They were upset but they had done everything possible to help both children which was way more than I had felt I had done. I was envious of the feeling of being able to help and I wanted to feel it more than anything else I could imagine. Hopelessness is the absolute worst feeling in the world. So I made the decision pretty much right then and there. As nurses we affect lives directly and indirectly and we do so from the moment we clock in till the moment we clock out. I am proud to be a police officer and I would never trade this time for anything, but I look forward to the time spent helping others and maybe someday someone will remember that one murse that helped them.

Dealing with Grouchy Nurses

So several people have requested that I write about how to deal with grouchy nurses… and some of this is not going to be cheerful news.  First things first, you are going to deal with bitchy people in any profession… There are bitches in nursing, bitch doctors, bitch lawyers, bitch mechanics… hell even bitches in the Burger King.  The idea is to learn how to handle the situation appropriately so that you remain sane and don’t become the bitch yourself. 

If you are a nursing student and the nurses on the floor are being grouchy… sorry but it’s best to keep your mouth shut, keep your head down and survive the day.  If you butt heads with a nurse on the floor as a student… you will lose every time.  Every clinical day should be a job interview because you never know if you will be colleagues with these people and if you snap on the floor you will get blackballed in that department… hell maybe even the whole facility.

If you are a new nurse, you need to do a few things to deal with the grouches.

• ·         Realize that nurses eat their young.. It’s not pleasant but it’s true.  Put yourself in their position. As they get older or grouchy, they figure their days are going to be numbered.. so to them they see you as the replacement (and they have to train you). In their clouded sense of judgment, if they run you off they won’t be replaced.

• ·         Learn how to deal with that specific grouch. 

o   Some of them are dealing with problems at home or general unhappiness.  If that’s the case either it will get better eventually or they will stay a grouch and you either try to friend them.. or avoid them.

o   Some may be grouchy, but only at work.  These are those grouches that are horrible to work with, but when you go hang out away from work they are fun, relaxed, and a joy to be around.  These nurses typically have been “the bitch” for so long they feel obligated to live up to that role.  Nurse Ratched is a bitch… but Becky is fun to hang out with.  Once you figure out this type, the grouchiness at work won’t bother you near as much.

o   Last common type is those nurses that are trying to push your buttons.  They want to push you to see how far you’ll go and to test you.  My dealing with this type of grouch was about 3 months into my time of working there.  I worked the night shift and this nurse came in and without asking about my night she immediately started complaining about me not stocking.  Finally being pushed far enough, I stood up and yelled that if she’d like I’d stay after my fucking shift and stock the ER.  From the point that I stood up to her, we never had another problem.  She wanted to push me to see if I would stand up to it and once I did, we were fine.

• ·         Don’t take it personal.  Do you think they woke up and said.. hmmm I’m gonna be a bitch to Debbie today?   If that’s happening or you’re thinking it’s happening, then those issues go deeper than this blog.  Don’t let their shitty attitude get you down.  There is enough stuff in nursing that can get you down, depressed, or become cynical… don’t let one shitty attitude be the downfall to your day. 

·         Find the positives in your day.  The patient smile, the thank you’s, the pimpin murse, the slurse that you can tell is wearing a thong, the free drink in the cafeteria cause the cashier sensed your bad day, getting an IV on the first stick, or realizing…..shit you’re getting paid for this now. 

Couldn’t end this on a negative note and didn’t want you think I hate nursing.  I love it….. there are times it sucks. But the positives far outweigh the negatives.

Lastly, shoutout and huge thanks to @weshelton for featuring our blog on his website, www.weshelton.com, check it out (We are listed on the partners page http://www.weshelton.com/partner/) .  Dude is a multitasking fool… looking over his site, I think he’s doing a little bit of everything.

And as always gotta do a shameless plug.  Follow me @that1murse and my buddy @mursewisdom

@That1Murse

Stories from the ER

At the request of @MGstudent, I figured I would tell a few stories of the ER and maybe mention a few mistakes along the way.

First mistake is to know the dosages of your medications, particularly sedation medications.  We had a young lady come into the ER with a dislocated joint.  I had been bragging to the EMS staff about the medication.  Unfortunately, the dose of the medication was 0.3 mg/kg and our doc was not wise to the medicine so he took my recommendation of 0.1 mg/kg.  We didn’t sedate her, just got her good and drunk and she started spouting off pick-up lines… “Wanna play lion tamer? You be the lion and put your head in my mouth.” And  “Is that a keg in your pants, cause I’d love to tap that ass.”  Needless to say, I was the laughing stock of the ER for a while and we ended up calling anesthesia to sedate her.

Second was an error on the docs side.  We had an STEMI come in and he ordered TPA so we could ship to a larger facility with a cardiologist.  I mixed it, drew it up, and was walking to the patient when he ran in telling me not to give it.  I realized at this point that I would have to waste a 3,000-4,000 dollar medication.

Last “mistake” would be a word of advice.  Remember that sometimes the patients you think are faking are sometimes the sickest and will make you feel the shittest about your cynical attitude.  Like the mom that had an ear infection that caused a brain abscess or the man that walked into ER that had a spinal tumor (he didn’t know about) paralyze him while in the ER.

So let’s not end on a sour note…   Thorough my several ERs that I’ve worked.  I’ve fought a cranked up naked black man at 5 in the morning in the middle of the ER.  I took care of a guy that danced around with an artillery shell firework and explode out the back and burnt his leg (missed his package by millimeters) and the guy that left a dildo up his ass for 3 days hoping that it would pass on its own.

I’ve known of nurses blowing doctors while on duty.  I’ve walked in on people fucking in the ER, blowjobs in the ER, handjobs in the ER, fingerings in the ER… Not sure what the hell it is about the ER that makes people wanna get busy in there.  

I’m not sure that I had a point to this blog other than to provide a few experiences from the ER.  You will literally see everything from birth to death, crazy to sane, and skanky to slutty.  

But I loved it, it’s a rush not know what’s going to walk in the ER and that you could go from no patients to 5 traumas at once and back to no patients.  If you think you would like to work in an ER, I say try it.  It’s a trial by fire and you get thrown into the shit pretty much instantly but it really is an experience.  

@That1Murse

As always, comment here or on twitter.  Follow me the other author on twitter.  @That1Murse and @MurseWisdom

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