Over my Dad body!!

Some of my more astute followers may have noticed... aww who am I kidding? All of my followers are astute! So, all of you may have noticed that I have been missing from twitter lately. I tried to sneak a tweet in now and then but mostly I've been absent. The reason for my absence is that my wife has gone back to work after a little over a year off, most of which was with our baby girl. Here she is being choked by an RT.

So, in the classic role of Father/Provider I continued to work as much as possible to allow my wife to stay at home. My wife has never really worked as a nurse. She did some part time med passing at a NH as an LPN during school. So, naturally she was nervous about stepping out into nursing for the first time. I, on the other hand, was petrified about the idea of being alone to care for our infant daughter without anyone else around to help. So, lately, (If you can excuse my country colloquialism) I've been busier than a one-legged cat trying to bury a turd on a frozen pond. I don't mean to ignore twitter, but most of the time spent between witty posts/rejoinders before was spent at work which is my best Muse. Now that my wife is back to work I'm down to 3 days a week instead of 5-6. In addition to the new responsibility, it seems that more and more there is an ever increasing number of Nursing Anon accounts out there and they aren't coming up with much that is original. They may think they are, but they aren't.  I've started to have some of my older tweets stolen and my account copied and now my Avi is being used. I'm ready to evolve into something greater andI  have that in the works.  

It is no secret that I am a founding member of the @MurseMafia. We, as an organization, are planning to help change (or at the very least improve) nursing. Especially for men.  We are in the early stages of development now and are trying to earn enough capital to take off. We have a website, and we are selling merchandise for which we earn very little profit but each T-shirt or coffee mug we sell is advertising gold.  So, please make your way over to our store and take a gander at our inventory. I know the shirts are expensive but there are stickers and buttons that are pretty cheap. I'm networking right now with a freelance artist who creates designs and I'm hoping to get him on board for some new tshirts that we can ship ourselves 

We have big plans in store for our little project and I am excited about its future. If any of you have an over abundance of money and feel the need to donate email me and I'll let you know how. Otherwise, go buy some Murse mafia merch and we can all benefit. 

-@MurseWisdom

Does Nursing make me a better father?

Seven months ago, give or take a few days, my wife and I became members of a not-so-exclusive club referred to as Parenthood.  We did so willingly and, contrary to common practice for our area, we did it after we were married instead of getting married because we were pregnant. This is a meaningful distinction for us and it speaks volumes.  It says that we made this decision as two adults and were prepared for the consequences.

CONSEQUENCES shown below:

 
 

 

 Not bad for my first try. Wait until I get some more practice.

{Quick background on my wife because I'm pretty sure I've never really mentioned much about her. We met while taking pre-reqs for Nursing school but we had both went to high school together. I started Nursing school a semester ahead of her at the same school. Which led to a very rocky first few years of our relationship. However, we saved a bundle on books, or at least she did. We married in nursing school and she spent her last semester pregnant. Now back to the story.}

I started thinking soon after we found out we were expecting our little bundle of joy (see above) and aided in this thinking by current parents who relish the opportunity to tell you the hardships. Some of the more common things were as follows:

1. You would no longer sleep-in and possibly may never sleep more than a few hours at a time.
2. The amount of stress you will encounter is unlike anything you have ever felt before.
3. All the crying.
4. All the pooping.
5. All the diaper changes.

But then after the horror stories they would a the caveat... but it is SO worth it!

I made the correlation immediately!  I flashed back to my first year or maybe even first week in nursing school. When all of the seniors would see us and tell us of the horrors that awaited. Such as:

1. You would no longer sleep-in and possibly may never sleep more than a few hours at a time.
2. The amount of stress you will encounter is unlike anything you have ever felt before.
3. All the crying.
4. All the pooping.
5. All the diaper changes.

  Look familiar? My wife and I agreed that if we could both survive nursing school, at the same time no less, that this baby business would be a breeze. So, we went in to the final stages with very little stress about the imminent changes.

We discovered that raising a child is more difficult than nursing school in many ways, but it is also easier in many ways. 

Here is what I know, I know that my ability to function on 3 hours of sleep is legendary, and a newborn sleeps approx 20 hours a day. Unfortunately, my newborn did this sleeping 15 min at a time for the first 2 months. 

Baby: 1 Nurse Parents: 0

Despite a near disaster in the sleep department, I had developed the ability to perform everyday tasks without sleep. This is where performance enhancing drugs came into play. I'm not talking about anything illegal like cocaine, hell, I'm not even talking about Adderall these youngsters depend on to tie their damn shoelaces now-a-days. I'm talking about Caffeine. The real Vitamin C... I'm talking Monster, Coffee, Espresso,  Red Bull... you get the picture. I drank so much coffee the first week I gave myself an ulcer.  

Baby: 1 Nurse Parents: 1

Diapers? Seriously? I can change these little things with just my non-dominant hand while peering out of one bloodshot eye! I don't even need to go into the diaper thing.

Baby: 1 Nurse Parents: 2

Poop goes hand in hand with the diapers thing but I felt I should address it separately.  My baby didn't poop much the first month and a half. While at first this seems like a blessing, to a nurse is spells certain ileus! There was about 50 hours of research done in my household before finally asking a Dr. about this "Condition". We were given specific orders and followed them precisely. Every 5 days we produced a BM. It was nerve racking. 

Both sides get a point. Baby: 2 Nurse Parents: 3

Crying. I didn't cry in Nursing school because I am a Man and we have rules. Don't roll your eyes at me and say "Real men do cry" Because I will tell you that I am not imaginary and am very real, and I DO NOT CRY. However, my baby does, frequently, and I am told she gets it from me. I consider that to be a great injustice and resent even the slightest of comparisons. Regardless, crying is noise, and I can tune out noise.

Baby: 2 Nurse Parents: 4  

This brings me to stress.  There is no comparing the two events and the stress each one creates on its own massive level.  I will say this. When you leave Nursing school and go home, even if you have homework, you are still away from Nursing school. With babies, you are stressed all the time and coming home provides no refuge from the stress. Not even mentioning that Nursing school even if taken to its most extreme wouldn't even make it to puberty in the lifespan of a child.

Baby 3...  You know what, I'm sick of keeping score.  Nursing school is hard. Raising children is hard. Doing both is unimaginable, and yet I was in school with new mothers, old mothers, and single mothers.  My hat is off to you, ladies. I am in no way equipped to take that on. 

This Parenting thing is just starting and I'm sure will evolve from here as will my perspective on this whole thing.  Am I a better father because I'm a Nurse? Absolutely! Is the inverse true? Am I a better Nurse because I'm a father? I'd like to think that it adds a level of empathy. So, yes I am.

Well, I hear my little one starting to cry now. 

Thanks for reading,

MurseWisdom

Check out

www.MurseMafia.com
                and
www.NurseStrong.org

Night and Day

 You've heard that old colloquialism "as different as night and day". Recently I began to believe that this may not be referring to presence or absence of the sun and more appropriately, at least for nurses, as the differences between our counterparts on the opposite shifts.  This has always been an issue I would assume. I have noticed long ago that a certain animosity exists between most shift workers. I feel like I'm just stating the obvious here and that you guys will read this and roll your eyes as if I've been naive up until now. The truth is I'm just now reaching the point where I want to vent about it in a public way.

Let me put a little disclaimer on this. I will be speaking in generalities about hospitals and RNs/CNAs of opposite shifts. It goes without saying that this is about my situation at my hospital and does not reflect the work and professionalism of all nurses at my hospital or in the profession at large.

I work day shift now. I have worked night shift, so you can't pull the wool over my eyes about how "Hard" night shift is. I'm going to be blunt... Night shift is easier in general. Night shift is where we start our new nurses and it's where we keep the ones that are a little bit off. Sometimes a nurse will stay on nights because it's all they've ever done and their sanity surely depends on keeping their circadian rhythm on track. On night shift you have the luxury of not having admin looming around. You don't have to deal with meals, and you have a lot less family hanging around. For the most part, your patients sleep at night. Of course there are exceptions, sun downers being the most obvious. The bulk of medications are given during the day too. At my hospital, which is not a teaching hospital, we do not have doctors around after 5ish with the exception of the OB if delivering, the ER and emergency surgeries. Rounds are done (primarily) between 7 and 9am the exception being new admits who come up after rounds. So, night shift will hardly ever have to interact with a doc in person. Some of our night nurses admit to not even knowing what some of our docs look like. We don't have a unit secretary, at least not the conventional kind. We have a CNA who sits and goes over IV charting and charges for half a shift. We, as day nurses, are responsible for all the orders the providers spew out during rounds. With all of the discharges occurring between the hours of 8 and 5 there are only a couple of night nurses that can even complete a discharge, including house supervisors.

Now for the venting.

On an almost daily basis, I walk in to find night shift sitting and shopping online or watching TV on their phones or some other kind of shenanigans, with food and drinks scattered about. I am then privileged with a half-ass, substandard report on Pts that, if I had worked the day before, sounds almost exactly like the report I gave them, as if they were reading mine back to me. After they leave, I must scour the patients charts to determine what was left out of report. What meds were left not given or were due at shift change and were not given. And I have to do it fast because the Dr is rounding and will no doubt catch these mistakes and I will be the target of his ire and the face he/she associates with utter incompetence. My shift and I have each other's backs. I will take the heat if my aid forgot to chart or even recheck a temp on a febrile pt. I'm always down to turn/reposition the heavies. And we will answer any call light. That's how we operate, that's our mentality. It is OUR shift and OUR patients. This sense of fellowship or camaraderie was not present when I worked night shift. It was more of an "Us against the world" attitude. Most of them carry some form of chip on their shoulder for the day shift. One reason for this may be because we are generally staffed with more people, but this is only due to the increased work load. Also, recently they implemented a new policy that made night shift responsible for pulling day shifts AM meds (0730-0900) with the exception of any controlled or refrigerated meds and place them in a locked alcove outside of the patients room. This was met with great resistance from both shifts. Nights, obviously, didn't want to have to do it, but the day shift didn't trust night shift to do it correctly and would rather have the extra workload. Admin countered by adding that Day shift must pull night's meds as well from the same time frame. That was met with more resistance. It now stands, at least in policy, not necessarily in practice, that nights pulls AM meds and Days doesn't pull Night's meds. As either a subconscious or passive aggressive form of rebellion it seems that our meds in the AM are almost always wrong. A few nurses absolutely protest doing this.

Most recently, yesterday in fact, I came in for report on 4 repeat patients from the day before and 2 new patients. I noticed in report that one of the repeat patients IV fluids had been stopped and saline locked. Knowing damn good and well that they didn't call the Dr to DC the fluids I asked why the patient was saline locked. I was told that while turning the patient another nurse told her that she thought the patient was saline locked on a previous shift she had worked. So, without checking orders, they simply saline locked the patient and left. WITHOUT CHECKING THE ORDER! Who does that? This is a hospital! This is a new day! Things change, orders are made, treatments are adjusted! This and the STATUS QUO dept! PAY ATTENTION! I know it is a small thing. Hey, it was only running maintenance fluids at 40/hr. But what if it were something else? What if it were vitally important. What if we were running 1/2 NS with 40meq of KCL at 125/hr to correct a low potassium level and they had shut it off and the next shift didn't catch it, then they reported that the patient was saline locked and lack luster noc shift accepted it without question. That's 36 hours at 125ml/hr which is 4500 mls with 40 meq per liter that's 180meq of KCL that the patient didn't get. One day they said, I don't know if the Pt is A/O they've been asleep all night. Turns out they weren't asleep they were unresponsive. THERE IS A FUCKING DIFFERENCE BETWEEN ASLEEP AND UNRESPONSIVE!

Last night after giving report to an eye-rolling, teeth-sucking, sighing, sarcastic, bitter nurse, I began to report off to another and I overheard the other saying that she "wasn't even going to go in a room tonight." ARE YOU SHITTING ME! It's like my whole shift of hard work is negated by their shift of laziness.

Again, I am venting, this is about my hospital, and even within my hospital it is primarily only a few nurses that are responsible for all of this rant.

But it can't be just me that is noticing something like this. I'm not just being negative, right? I feel better already having gotten that off my chest.

Thanks for reading,

As always follow me on twitter @MurseWisdom
Also follow @MurseMafia @That1Murse @JustSomeMurse

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

Kinky, Freaky Nurses

Get into the mind of a nurse and I’d say the majority are kinky, sexually uninhibited, or like to explore sexually… hell they could even be a closet freak and you have no idea.  Why is that?  Well my opinion on the matter is that nurses (and medical professionals in general) deal with death on a regular basis.  We stare death in the face on a regular basis.  Sometimes death wins and sometimes we give a big middle finger to death and save a life.  With all this death floating around, of course we are cognizant of our own mortality.  And with that knowledge comes that fact that we know we only get one trip around this world (unless you believe in reincarnation) and we want to make the most of it.  We take more risks, we drive a little faster, we have freaky, kinky sex.  Maybe you were a freak before you went to nursing school.  Maybe you became a freak while in nursing school.  Maybe it took a few years after you get out… but I truly think that in death we decide to try to live more.  

FYI – Sex is generally a highly pleasurable activity and we want to get the most out of it… and being nurses and having intimate knowledge of anatomy and physiology doesn’t hurt either ;)

The point of this post is if you are questioning why you like kinkier things then you used to blame nursing.  If you are freak already, then at least now you have something to blame it on… If you have kinky thoughts but are afraid to act on them… know that most of the time with nurses you are in mutual company.  So find a slurse or a murse and turn those thoughts into more than thoughts buried in the deep recesses of your mind.

You’d be amazed of the things that nurses at work have talked about doing or offered to do while at work.. Bad slurses ;)  I could talk about it here but it would go from R rated to X rated relatively quickly, LOL

And if you like “vanilla” sex and think you always will, hell at least enjoy it then.   

Agree?  Disagree?  Voice an opinion? Comment?

Follow me on twitter @That1Murse.  Follow my co-blogger, @MurseWisdom