Tuesday, February 28, 2006

Deal or

No deal? c'mon,c'mon..deal or no deal?
I think I love this show. It is so awful you cannot look away. It's a potential car crash with a body flying out the windshield.
If you haven't seen it the premise is wickedly simple. You pick a numbered suitcase, potentially a million dollars could be in that suitcase but you can't find out until you open a whole bunch of other suitcases with money amounts inside. Each time you open a suitcase that amount gets taken off the board. After each round a weird man in a booth ominously calling himself "the banker" tries to buy your suitcase.
If you have been lucky and picked the suitcases well with lower dollar amounts stripped from the board your bribe from the banker goes higher and higher. If you have crap luck and every suitcase you pick had huge amounts hidden inside? well the banker doesn't offer you much.
So the thing that is imperative in this game is overwhelming GREED.

The game offers you a hundred thousand,two hundred thousand, five hundred thousand or a million or five bucks or even worse a penny. It's a brutal odds game that no one except the most nongreedy can win. You have to be willing to lose to be able to win. Hilariously greed just overwhelms the brains of normal working people.
If I had walked up to them on the street and offered them ten thousand dollars they would have grabbed it and ran but when an imaginary million dollars gets added to the mix? They will refuse the same ten thousand....GREED wills out.
So the best part is they get to have their friends and family sitting right there, Wives begging for them to stop and take the money and fathers in law telling them to go for it. So what happens when dear old father in law is wrong? What if his exuberance leads to the loss of a few hundred thousand? man I wouldn't want to be in the car on the way home.
Tonight Donald Trump was the financial advisor..Trump..Mr Bankruptcy himself. Even he finally said Deal, take the money and the guy did. I think it was more the sick look on his wife's face that settled the argument though. She looked like divorce was a real possibility if he kept pressing his luck.
So , the guys lack of greed made him a winner. The next contestant showed every sign of being the complete opposite..she was there for the million so we all knew she was going to lose and badly.We won't know until tomorrow and I am going to be there to see. I love watching human nature in action.

Over at Dooce she was talking about some idiots rantings about how just terribly awful it is when educated women stay home to raise their children. What the hell is wrong with women? Why are they such complete assholes? It is only women that spend so much time bitching about other women. It's just gossip and bullshit, what some women excel at.I know this because I am a woman and I went to highschool. This author and I use the term very damn loosely is one of those women..we all know them. Unhappy about the state of their life and looking for someone to blame. Ofcourse it's those damn women who stay home and raise their children so they don't end up behaving like wolves that are to blame. Raising children yourself is bad you should hire some 0ther woman to raise your children..hopefully an illegal immigrant you can pay slave wages for right? Go to hell you nasty woman.
Some of us get to stay home,some of us can't.We ALL want to be home with our children but sometimes our kids need us to make enough money so they can wear clothes and eat food.
If you don't need the money and want to work? Do it. Drop the guilt and go and work okay? I promise not to care as long as your children aren't wandering unsupervised outside with no shoes in January.
No one cares anymore whether women stay home or go to work. It was a nineties issue for insecure women. Get over it already. No one cares about this anymore except Linda Hirshman and she is only pretending to care because she finally finished the crap book she started when the subject was actually relevant.

Why is it that when I was a kid every mom I knew had a job? No one made it a big deal..moms worked sometimes and sometimes they didn't..no teeth gnashing and wailing about guilt and all that bs. The moment some woman announced that work was a luxury, meaning you had no need for that money the "guilt" crap started. Why? it's insulting that a job gets this much attention..people are starving,wars are raging and all women can do is moan about each others luxurious choices.

I did both when I could and enjoyed both as much as possible.No guilt. Any woman that bitches about another womans choices is setting back the womens movement a thousand years. The whole damn thing was meant to make the world a place where women had choices dumbass..way to completely miss the point.

If you have a moment wander over to Way out Auctions.com..they have a 28cm anatomically correct penis for auction to practice putting on a condom!
Or you can spend some of your hard earned cash to hang out with complete strangers or even better bid on a twenty year old lucky chicken leg named "Ole Dusty".
I think that some people have way too much free time and scary imaginations. Maybe it's because their moms stayed home to raise them instead of working right Linda?

Tomorrow is the annual pilgrimage to the doctor to beg for prescriptions, I cannot explain how much I hate going to the doctor and allowing the probing and prodding and the complete lack of interest. I feel like a old dog up for adoption, all grin and wagging tail ... pay attention to me, to me!!! Sigh..Whatever.

Sunday, February 26, 2006

How arrogant is your doctor?

I sometimes need a place of refuge. I guess we all do. Because I have a daily challenge of overcoming pain I like some company for help. I like to read the chronic pain and spinal disorders forum at BrainTalk. Brain Talk is a huge forum for just about every disease you could think of. Millions of people exchange information,education and more important support.
Every once in awhile we get doctors who visit the board. We have two resident docs who have been with us forever.One is a great chiropractor with an amazing website Chirogeek.com . The other is a pain specialist. We have adapted to their idiosyncrasies as they have adapted to ours.
Now we have a new doctor and I think he is an ignorant, mean, bizarrely uncaring twerp.
So, he is ruining my support network, he is pissing me off..what do I do?
I want to go on a rant ripping this guy but I stopped myself because I realized this jerk couldn't care less. He is there to make people feel bad, he gets off on belittling real distress so why fall into his trap? He wants someone to rage against his misogyny, hell he wrote in is his signature about his "narcisism". I decided that he needed to be ignored. For some people being ignored is the most painful punishment they have ever experienced. He needs this experience so he can understand what it feels like to be his patient.

Some mornings I wake up terrified to move. I know instinctively that things are going to be really,really bad. I move anyway. The pain is like broken teeth with the roots exposed. I stagger down the stairs, rush in to pee and then put the kettle on. I start with a handful of pills and a cup of tea and then I wait on the couch. I watch television mindlessly..waiting,waiting,waiting. It usually takes an hour for the pain to subside enough to make a shower feasible. This is how I start every day.Sometimes the pain is bad and sometimes it's worse and sometimes I cry and beg for relief and bargain hard with a God I don't believe in.
Today was a begging day. My husband is a good man and holds my hand and waits with me until the pills work and wipes my tears. He never tells me it will get better or it will be over soon. We both know that it would be a lie. Most likely it will get much worse.
I am not prepared for worse. No one can prepare for worse. I plan to bail and go for surgery..the last hope for any spiney. Ofcourse surgery is a crapshoot but there are people out there who have had success and are maybe not pain free but maybe mostly pain free and that would be wonderful.

My injury involves the lumbar spine. Most people have lower back pain sometime in their life. We all move at the waist, we twist when we lift when we are told not to, we lift that ridiculously heavy box because we are too impatient to wait for help..we grab the toddler right before they fall. Usually it's some awful muscle spasms that go away with a little rest and some ice and heat. Just a muscle pull nothing more.
I ruptured two discs. The nerve damage from doing this caused sciatica...
I think everyone has heard about sciatica, an elderly aunt always taking to their bed, novels that talk of characters with a touch of sciatica..
Sciatica is agonizing.I look back at that elderly aunt who had no access to modern medications and suffered in silence bedridden (and bitter I bet) and try hard to be thankful for the handful of pills I have access to everyday.

I wish that back pain didn't have such a negative history. I wish that every asshole trying to rip off the government and workmens comp wouldn't use "back pain" for their scams. I hate it when I see some insurance company undercover tape of the "back pain" guy hauling construction material and building his new deck with spa.
It means that when my pain rockets off the charts I can't go to the emergency room because everyone there slaps the "drugseeker" label right on your ass and they ignore you for hours. Even though I am a nurse with surgical scars and MRI's I will not go to the emergency room. I refuse to be humiliated. I have only been once, the very first week into this new life, I was treated initially with skepticism and if it weren't for my favorite doctor wandering through the er at that moment I believe I would have been left to suffer.

I want to say to every asshole out there looking for a scam so they never have to work again leave back pain out of it. Try alcoholism or heroin addiction or how about I am a sociopath that can't work because I can't help my need to hurt everyone around me.

I must say the itchiness has become manageable. I have a new cream that cuts it down to just itching a lot instead of compulsively trying to burrow a hole through my shins. It's the little things ..

Greys Anatomy..oh where to start?
George poor George. Meredith is just so awful..if Mcdreamy knew what she had just done I don't think he would want to be her friend at all. Meredith made no effort to even apologize. Who breaks into tears and tells someone who loves them to "go ahead and finish"? Who would go ahead and finish under those conditions? I think she is a brat, a vampire , self absorbed,selfish and cruel.
I loved Addision and Bailey..what wonderful actresses..I love Sandra Oh( I'm Canadian it's the law) but I think the actress playing Bailey was equally deserving of an award. Addison became a human being tonight. I wish that marriage could work but I still think it is too broken..I am hoping that Derek finds out about George and thinks better of Addison.
I just don't want Meredith and Derek together, Meredith is just so awful Mcdreamy would be forever tainted.
How much did I love Burke taking George home and blaming it on Christina? way too much..he's your friend hee..
I am not at all impressed with the ooh Izzie hearts the heart transplant guy but she's having sex with the other guy story line..it's too much selfishness..selfishness overload tonight.
Made me want to do something nice for my husband so I baked a cake and didn't burn it this time! I heart Duncan Hines.

I admit that I am actually looking forward to the Amazing Race this time. The pathetic "family" edition really put me off but the commercials keep promising new countries! new adventures!..it's hard not to hope.....please don't have the asshole and wife please,please,please.

I am really enjoying the American Idol recaps over at Television without pity. Jacob and Joe are doing a wonderful job at being really funny and spot on.I love trying to figure out what drug Paula took before the camera started rolling..she may in fact be a chronic pain patient..alot of our drugs induce brain fog..a condition she demonstrates well.

Saturday, February 25, 2006

back then

Why is it people always say it was better "back then'?
I was wandering the blogs and stopped to read some nursing blogs and oh god..how boring. The never ending Nurses should be better dressed argument is back again. Nurses of a certain age have complained about this forever. Hospital infection control services banished the nurses cap a million years ago because it was a filthy, germ filled,virus laden ugly thing. The cap fit no one and so it took constant repositioning and repinning to keep the ridiculous thing on the head..meaning nurses were constantly touching themselves.
A million years ago it was considered an insult to the patient if you wore gloves while providing care..some old nurses cleaned up incontinent patients bare handed with the comment "you don't wear gloves to change a babies diaper do you?" all smug and condescending.
Nowadays if you got caught trying that you would get fired for being a moron.
Times change and there are reasons for it.
Nurses don't wear white anymore because it is stupid to wear white in a profession that involves close contact with the entire spectrum of human byproducts, waste and otherwise.
We wear scrubs in certain areas because on occasion we are required to operate at the bedside.

I have no idea why other nurses not involved with the OR wear scrubs or colourful imitation scrubs. Why medical professionals need to wear pseudo pajamas is beyond me..maybe they did a study and found we all had difficulty with zippers and buttons so they went for the stretch waist .
Seeing so many morbidly obese nurses lately I think the scrubs may be because nothing else will fit.
We are supposed to be able to teach our patients about safe and healthy habits and this obese nurse is telling a heart patient how to manage their diet.
Boldly lecturing on the evils of fast food and candy...it would be funny if I wasn't a nurse.
You hear patients talking amongst themselves and laughing at the irony .

When I try to tell people how physically demanding nursing is the obese nurse stands in mockery. How do I make anyone believe I work hard when all they see are fat nurses eating at the desk.?

Having self respect is a the heart of the uniform controversy I think. Nurses should look like professionals,clean,neat..presentable. What I see now is not a uniform problem.We have nurses that look slovenly and it's not the uniforms fault. They don't take the time to care for themselves, they are unkempt,overweight and look like they just rolled out of bed.
No dress code is going to fix that.

I think there are a hundred reasons why some nurses can't get their acts together. Maybe it's the twelve hour shifts and terrible schedules that leave no time to do anything but sleep and eat. Or it could be the heavy patient loads with much sicker patients that increases stress and unhappiness. Nursing pays just enough to give the illusion that you can "make" it but not enough that you actually can. So stressing over money and time and throw in family commitments and it is a recipe for disaster. Wearing a fancy uniform with a snazzy cap isn't going to solve a damn thing.

I wish nurses would stop bitching about hats and start trying to tackle the hard questions. A hundred research papers have made it clear that shift work will cut years and years off your life but nurses are still expected to flip from days and nights as if it is completely natural. Twelve hour shifts are barbaric and health destroying but we make no complaint.
We are taking on more and more patients who are sicker and sicker..all of them old with at least five different things wrong with them that have nothing to do with their admission but we still are expected to manage them. We have a patient that comes in for a knee replacement..they are also hypertensive with out of control diabetes, COPD and heart disease. This is our normal patient. On top of all this the patients don't want to work at anything, they refuse to do the exercises, they wont get out of bed..they want to be sick and we want them out of the hospital because a hundred people are waiting for their bed so they can get their knee replacement.
It is our job to force these adults who were completely educated prior to their surgery to get up and to do what they committed to do. These are adults who we have to bully and push all the while trying to control their pain to perfection,keep their wound from getting infected, keep the blood pressure down so they don't stroke out, keep their sugar under control so they don't fall into a coma...blah,blah, blah ...it's ridiculous.
Hilariously it's not just one of these people,most of the time it's five or six..with at least one of them that doesn't speak a word of english.......
So how about we as nurses demand a schedule that doesn't kill us? How about a reasonable patient load so we don't kill you? How about some help? After that I will consider wearing a hat and a starched white uniform.

Thursday, February 23, 2006


Figure skaters on my television. I have a nasty secret..I laugh when they fall on their ass . I know it is wrong, very,very wrong okay? But it's their monstrous soul deadening seriousness that brings the laughter on. They seem like ill tempered robots smiling only when commanded and the smiles? oh they are chilling. So I laugh when they fall because it's shocking, that these machines that have no life except spinning on ice fail .
They try to warm us up to these skaters by creating heartbreaking back stories for them and we would eagerly buy into it if only these skaters made an effort.They obviously have read their script but follow it in a monotone..they know that all this "backstory" happened years ago and has nothing to do with their lives now but hey,anything to get on television and pick up that coveted Nike swoosh.
For a moment I thought I saw raw emotion in Sasha Cohens eyes, terror and defeat but then I realized it wasn't there..I thought I saw it because the commentator repeatedly mentioned how he saw those emotions and more importantly he talked about how inconsistent she has always been, how she always fails when it counts..how she "cannot handle the pressure".
I wondered if he had been following her around all day asking her if her plan was to choke tonight? cause she choked really bad there for a second but hey she is a good robot and got back on her feet and carried on because we all know good robots aren't allowed to cry, or quit.
I used to feel sorry for these little pageant girls on skates until I actually met one. They are willing partners in their own subversion. So I get to laugh when they fall on their ass because that is the agreement they made when they joined that ridiculous sport. Damn I called it a sport..like calling Miss America an athlete..ick

Well, I love the original CSI but I was baffled tonight. Last time I saw Grissom he was holding a sobbing Lady Heather in his arms after he found her whipping her daughters murderer ( while wearing a stylish whipping outfit too!) I like that CSI does its best to stay away from making its characters interact like bad soap opera stars but there is a line to this fetish. If you refuse to finish a story you encourage viewers to engage in bad acts like fan fiction. There is something horrific and hilarious in fan fiction. Some of the internets best porn is hidden in the fan fiction world. If you feel obliged to investigate that claim be careful. Reading about your favorite television characters engaging in sex acts that would shock most hardcore movie writers can be uncomfortable.You may never view the relationship between Grissom and Sara the same, it will forever be tainted with the thought of are they doing it? Even when the television show makes every effort to show that in fact they are not doing it and have never, ever done it you may still think to yourself..I think I am sure they are doing it and the writers just aren't telling us..heheh.
Thus begins the delusion of the fanfiction writer.

I remain itchy.I went to see another doctor and dumped off a few gallons of blood for the lab to play with and most likely lose. I have some cream that doesn't work but I pretend it does..I am flirting with the placebo effect except I think it works better if you believe in your placebo.

I was seriously considering returning to a different field of nursing until I remembered why I quit it last time. Trauma is a specialty that involves caring for the completely broken among us. That car wreck with those smashed teenagers? That is your patient population. It is incredibly , soul destroyingly depressing and I have a sneaking suspicion I am trying some self sabotage just entertaining the thought of going back. The learning curve is huge and it is incredibly challenging and sometimes you win incredible victories but is the cost worth it ?
I had a patient who coded so regularly it became mythic and he lived and returned to visit and thank us. I couldn't believe this vibrant, funny, hell intact teenager was the same person whose chest I pounded on so often I began to believe we were willing him to live out of our own sheer stubbornness. I don't know if that stubbornness still lives inside me and you need that to survive that service.

I think I will just stick where I am for a little while longer.My patients at least made the choice to be in my ICU..well the majority anyway, I have had a few that can't speak a word of english and seemed more than a little surprised to be there..gotta love a family that lies to their mother because they didn't want to worry her..like waking up in an ICU isn't worrying at all right?

That is a pet peeve of mine. I imagine it can sound racist but I don't think it is really. I think it's about respect.
If you move to a foreign country the very least you can do is learn some very basic words of that countries language. If I move to a nonenglish speaking country I have to expect that I will need some basic words to maintain my safety.I think out of respect you need to make an effort. I don't think every immigrant needs to speak english fluently on arrival. I think they need to know enough to ask for help,say they are in pain,feel like being sick, need a washroom, are hungry. That is about it. Those are the words I would be practicing if I came to your nonenglish speaking country. My grammar will suck and my pronunciation will be terrifying but you will know when I need a hospital, a policeman or a bathroom.
How about when you choose my country as your new adoptive home you do the same okay?

And if you are the child of an immigrant that has been in Canada for thirty years and they can't speak one word of english be ashamed of yourself.I know we Canadians made it way too easy to get away with not bothering to show any respect but enough is enough. I am sick of seeing Canadian citizens who have been here my entire lifetime and don't know the word for bathroom. If that is your parent then stick around the hospital and do the translating, you brought it on yourselves. You could have taught your parents one word a week for ten years but no one bothered and know they are defenseless in a hospital unable to communicate with the people that hold their life in their hands.
Why should public institutions provide services in fourteen languages when this country has two official languages? We didn't make our official languages a secret either.
I just don't see any other country in the world bending over like this. They have enough self respect to say learn our language if you want our services.
Why can't we have that kind of self esteem?
Why don't we feel like this country of ours deserves some genuine effort to be a part of?

Oh Canada

Oh hell we lost the hockey game. I think I may have already mentioned that the only organized sport I can stand is English soccer but I do still feel some sympathy for our rabid fans.
I have sympathy for our players because they are young and wanted so much to do well.
I have no sympathy with this garment rending teeth gnashing blame shit. The Olympics are GAMES dammit. These kids are supposed to be having fun.Instead they are getting the crap beaten out of them in the press and commentators spend all their time talking about "can they overcome the pressure".The only pressure they should be feeling is the pressure they feel to do the best they can, learn new cool things and have a great time meeting great people.
This is why the snowboarders are the only real Olympians there. They don't care if you want to sponsor them and wrap them in Nike swooshes, they are going to be snowboarders whether or not anyone is watching.Because it's FUN.

Too much of the evil pontificating I know but damn..the Olympics are feeling so desperate this year especially those figure skaters. Jaws clenched,fake smiles in place..that painful sigh of relief at the end..where the hell is the JOY?

This must be the worst American Idol ever. Those guys can't sing either and long,soulful fake sexy looks into the camera are just skeevy. Once again Simon was right.I think Paula is smoking pot for her chronic pain because all that talk of "you make me beam" and the like seemed hilariously incoherent. I did like Seacrest finally getting a little pissed off and honestly asking these idiots for some actual musical criticism. Why he was asking these three seemed bizarre because they picked this group of caterwalllers.

I am exhausted today after a good work day. I had the joy of caring for a patient and his family who were deeply pleased with the changes his surgery has created. Their appreciation for socialized medicine and being citizens of a country that says health care is your right and a priveledge was wonderful. I rarely get patients that understand that socialized medicine is a priveledge. Abusing this system creates waves that backflow onto the truly needy. Everytime you go to an emergency room with something any walk in clinic could handle sucks precious resources away from someone who needs that care. If you have to wade through fifty patients who really have no business being there to get to the one patient who does that poor patient could have been waiting for hours.
I think people should really stop and think about why they use the emergency room. Are you there because you don't have a family doctor? Then use the forty billion walk in clinics on every corner.
If you have a cold and want drugs for congestion try your pharmacist. I think a lot of people just want a doctors note and they don't get that a walk in doc will give the same note.

I don't want to scare people off using the ER. If you are feeling really sick and it has you scared..go but only if you tried the walk in clinic first. Most clinics are open til eight at night, the wait is much shorter, most of the time docs who staff walk in clinics staff Er's..the quality is there. So from eight am til eight pm you have clinics..use them and listen to what the doc says. The doc will tell you if you need ER services.
If you are bleeding you need the ER, if you think you broke something you need the Er...chest pain,shortness of breath,speech problems, dizziness all that stuff you need the ER...have a bad cold? you may need a doctor but you don't need an emergency room.

Try to think of your emergency room as a resource like gasoline..the more you use it the less will be available and the more expensive it will get.....so think before you just default to the Er..look in your telephone book under clinics you will be shocked at how many there are all around you.
When you really need us hopefully we wont have to pick you out of crowd of "I have a cold,I have constipation,I hurt my arm six weeks ago, I cut my hand two weeks ago.."
I have a million stories of people showing up at three o'clock in the morning complaining about a pulled muscle from a month ago..What makes this an EMERGENCY?

Tuesday, February 21, 2006


I just became irrationally irritated while reading some of my favorite blogs. I stopped to think about why and it hit me.It's because I just found out they were "popular". I had thought they were my secret, my find and they aren't. Someone , hell thousands of someone's have been reading my favorites for years.
It's weird reading someone else's blog.Reading about the goofier parts of their lives or sadly when bad things happen and they struggle.It's nice to hear that other people are facing some of the same issues you are.I like to read blogs that show that their writers are handling new scary stuff with humour.
I wish I was funnier.I can be in real life but my writing is still too basic to try it. Sometimes I think we are inadvertently funny, when we get too pretentious, when we get overwrought and the whining is too loud. I can imagine someone giggling and thinking "oh man, get a grip". I know I do when I come across a blog that is all about the crazy girlfriend burning stuff on the front lawn. I once followed a set of links that brought me to a livejournal full of the most bizarre breakup fights I had ever heard. First it was funny but after awhile I got a little freaked out when the orders of protection started flying. All over an old couch and "kitchen set".It was so Judge Judy.
Some blogs are just wrong.They reveal too much about a person and their real life.The writer has no censor button and all I can think is you are so going to regret all those pictures and essays on how I hate my mother,father..family dog. What is weird is usually these people are adults. Teenagers seem to have a better sense of self protection,survival than some of these twenty two year olds with "arty" nude pictures of themselves on flickr. I guess everyone has the right to self expression but man..how about not printing your home address on your business card?

American Idol, it left me cold. Not one of these girls could sing. it was all about hiding the fact that these girls couldn't sing. Weird clothes, loud, loud backup singers,weird dancing whatever it took.
I hate the fact that I agree completely with Simon Cowell, I don't agree with the fat jokes but I agree with the sentiment. The music business is about how you look. No one cares if you can sing..see Britney Spears,Jessica and her lip synching sister Simpson, half the rock bands that exist right now...can Mick Jagger really sing? Let"s be honest here. So cowell is right. Little tweens don't buy records from singers, they buy the records of the girl they want to be.
So these girls really can't sing so we need to look for the "Britney" factor..and I couldn't see it. The youngest of the girls seem over rehearsed and they aren't sexy. I think American Idol is about selling records. The only way anyone can say they were successful is to point at record sales and longevity. Kelly Clarkson is it. She has the sex appeal, the false "innocence" and the pop singing voice, she was cleverly marketed and manufactured but not by American Idol.It wasn't until she separated herself from Idol that she made it.
I think Idol has become tired and pageant. They all sing and dance and perform like a bad fifties beach party movie. It's just too manufactured. I will wait and listen to the guys but I think the show is burned out.

I have to struggle through The Shipping News written by the same lady that brought us gay cowboys. I don't like reading books after having watched two separate movie versions of the same book. The movie(s) sucked. The Canadian version was a little less suck, the American version had Kevin Spacey. I loved Spacey after The Usual Suspects, even American Beauty but the relentless gossip about his sex life and the weird cell phone /gay trolling incident? and his love for musicals has destroyed his credibility for me. Unfair? Probably ,but that is the way my brain works. I will be watching him being all drama and dead serious and all I am thinking is why did he give some kid in a park at 2am his cellphone? What is unfair is that only happens with certain actors. Other actors get off scot free and their offences are likely much worse. I can't help it.

I must admit that I have no interest in the Brad and Angelina thing.I know I should just throw out my television and become a hermit. But they don't do a thing for me. I liked brad pitt just once,when he played a great stoner in True Romance a truly underrated early Tarantino.
I saw Angelina in Gia.She was fine. I get that they are both good looking and are having the uber pretty Hollywood baby but so what? I like that Jolie is trying to make a statement about third world poverty, I think that is what the world should be focusing on..instead they all want pictures of her "bump"And what cretin started the "bump" thing? When did the very sight of a pregnancy mean news?

I wish I could understand where the world was going in it's news collection.It seems news has become the "human Interest" story.It's all about one person or one family..a world perspective is missing. I think the media continuously underestimates the intelligence of the viewer.As if we wouldn't be able to understand budget cuts or health care cuts without basic illustrations and a courageous family that colourfully demonstrates the effects of said changes. It all" let's look at the Smiths:", they are living in a trailer without health care..do you get it ? Yes, we got it when you said they were cutting budgets....but hey! what happened to the Smiths? They are never heard from again. It's why I hate Oprah, she invades peoples privacy and exposes their suffering and then walks away. What did those families of katrina get? Did Anderson give them a check for being the hapless characters in his story?. Ofcourse not..because it's "news". Did Oprah find those battered old women using buckets for bathrooms and change their lives?
No, she left them there, humiliated on national television told that 'we are telling your story" "we are doing you a big favour",don't you dare ask for money after being exploited for my agenda. It sucks.
To go to these places and do nothing to help but take pictures of their grief is exploitation.
Oprah should give every dime she makes on these stories to the victims. She has so far made four that I know of...That should be at least four million dollars.
Pony up Oprah.

Monday, February 20, 2006

being itchy

I have a special kind of pain. My pain is nerve pain. It is an incessant burning and tingling. Try a little experiment for me. Try to remember the last time your foot or hand fell asleep. Try to recreate it. Feel the numbness? and now change positions and let the blood flow back to that foot or hand. Feel the tingling? The burning? Yup, that's what I feel except turn the volume up on that about a hundred plus.
So , we all can agree no one can actually function with that right?
So, I have to take drugs. I made a choice to add a new one and slowly get rid of an old one.
Lyrica(pregablin) was going to be my new best friend. It held out the promise of a better,smarter,skinnier more painfree me! Who could resist? Not me.
I started it after researching the hell out of it and researching people who had already had a go with it. The worst I could find was it could make you itch, cause skin problems.
I thought that's beautiful. The last new drug I tried I spent hours contemplating killing myself until it wore off..itching was so ..pussy.
I have to report that itchy ain't pussy at all if it's you that's itchy. Damn I am itchy and after two trips to the doc for steroid cream I can honestly say I am beaten.
For a few days I looked like a chicken pox victim. And to those who kept saying "stop scratching you're only making it worse"..shut up okay. I know I am shredding my skin , I can't help it. It itches.
Lyrica is not the drug for me> I can't really know if it works because I could never get to the therapeutic dose..too damn itchy.

I am signed up for acupuncture. I researched that too. The clinical trials are really supportive and the upside is there are no side effects. Unless your practitioner is reusing needles and being gross but I am seeing a hospital based pro. Well,I will be seeing her. As soon as I get the courage to go. It's the needles.I hate needles. I had an EMG study where they inserted these huge needles into muscles and it hurt very badly. I can't get that memory out of my head. I know that the acupuncture needles are finer than a hair but still? They're needles right?

I tried to watch House tonight.The love affair is over.It seems stale and angry. The writers seem at war to me. It is as if they cannot decide who House is. House has become so nasty,so racist,so homophobic, so misogynistic to be likeable. I can't find anything redeemable or sympathetic about him. I have chronic pain but I don't bleed hate. I don't make my co-workers cringe at my filthy thoughts. Sure they cringe when I am short tempered when things aren't going they way I want them to but I don't attack them personally. They are the people that support me, help me when I am exhausted,too sore to finish what I want so badly to do. Why would I or House alienate the very people that make our jobs doable? It rings false and I am irritated by it. Why is this guy getting away this behaviour? Why has no writer gone after him? Why is he untouchable? As far as I can tell he is usually wrong fifty percent of the time, his patients always suffer for his mistakes, his behaviour so why the untouchable shit?

Hugh Laurie is wonderful, a fine actor but I wish he would make a stand in the writers room and say okay that's enough. Let's get back to what made this good and leave the really nasty shit alone . That includes the whole drug addict vs asshole crap. Chronic pain doesn't disappear with psychotherapy or placebo, either play it straight or don't mention chronic pain. This story line just trashed about a million people who would give a limb if a sugar pill and a few sessions with the friendly shrink stopped their pain.

In other news the cat went into heat today and that sucks. I like to wait until a cat is a year old or so to get them fixed. I know most vets say six months but I want my pets to reach full maturity.Shutting down their hormones before they are fully grown always concerned me. But I can't wait any longer. She almost made it and is a good weight,size so I don't think it will be a problem. I do not believe in that ridiculous "they need one litter" crap myth though. Having babies does nothing for growing strong bones and immune systems, in fact it probably does the opposite when they are too young to breed. Heaven knows this world doesn't need any more kittens.

I had to laugh when I saw some maniac had decided to redo When a stranger Calls. I saw that when I was a teenager and thought what crap and my kid went and came home and announced "what crap" hee. Nice to see what comes around goes around. What hurts is it cost me less than a dollar and she spent eight.I want to see freedomLand. It looks good but I am afraid it has a "message". To repeat myself,I hate messages. After Crash I don't think I am ready for another message on white/black relations or the lack thereof.

Oh lord the cats are cuddling, poor boy cat..it's too late for you to do anything about your girlfriends state..it's a cruel,cruel world.

On writing

How I do love pretension. I remember reading Stephen Kings book "On writing" and thinking oh please. Don't get me wrong for many,many years I loved King until he introduced himself as a character in his last series. Then I shuddered and said ick. I just finished reading a blog involved in Grand Rounds a web medical community and this writer urged people to not write every day. I disagree. Oh no here comes the pontification but I can't help it okay? I think you should write every day. I think it makes you a better writer. I think the difference is when you start writing for an audience and try to satisfy their needs and all you are thinking is " am I being witty?" "am I useful?" I write for myself, to say out loud so to speak about the issues that bother or hurt me.
When these issues are down on paper,so I can read them again and again. I can think about them.I can think of solutions or explanations for my feelings. Or sometimes laugh about my own pretension.

Hopefully I can educate or expose but mostly I want these thoughts written down..pinned down so they can't squirm away. I want to dissect them and give them labels.

I watched Greys Anatomy tonight and came to the sad realization that I don't like it anymore.
I don't like the nonlove story between Meredith and McDreamy. I don't like that Addison has abandoned her dignity and is now begging for her husband to love her and he doesn't and that is just too sad. I know that Addison did a terrible thing and personally I believe (as the hateful Dr Phil says) infidelity is a "deal breaker" but she crawled back. She was willing to accept whatever crumbs he dropped for her. She is taking her punishment because she knows she deserves it but enough is enough.
Meredith has made me hate her because I know she will never love George. George who happily trots after her, the carbon copy of Addison except he has committed no wrong. Meredith will punish him for his devotion. I can feel it in my bones that she will find her way back to McDreamy and Addison and George will be left, battered and bruised.
I guess the issue is no one should ever screw with George or they incur my wrath, he is my favorite.
I hate it when my television shows become hurtful things. Writers of television never seem to understand that there is a limit to a viewers sympathy. They always go that one step too far making the watcher cringe and shudder. Making it impossible to continue watching because the box has been completed and even the very best writer can't write themselves honestly out of that box. The writer is now going to have break some rules, a character is going to have to do something completely out of character to salvage the mess and then the viewer has to decide is they are willing to follow a story that has an escape hatch. Once that hatch is constructed you know that no other story line will be authentic because the writers have already shown their willingness to bail to get them out of an honest resolution.
I know they wont deconstruct Meredith, so it will be George that will die, or become an asshole or whatever to get Meredith safely out of his hands sympathy intact and that sucks....
I have to laugh now because I have just completed writing a complaint about fictional characters and that is lame.. and it hasn't even happened..wow I am a pessimist.
But and of course there has to be a but I care about good writing.(whine)

I am getting more and more excited about the World Cup. I loved UEFA though England was terribly disappointing. I am spending all my time watching the Premiership, Italian soccer is just too damn polite for me and I hate to say it but they take too many dives. I hate a diver, it's so pussy.
I don't have a favorite team honestly, I go back and forth. I love certain players..Henri for being so classic, sleek and graceful, Rooney for being a bulldog with terrifying speed..there are so many. We don't get to see the Spanish League here and that sucks. I think Real Madrid is absolutely incredible right now. They had a horrible start this year..embarrassing, but right now? wow. It's weird how we got into soccer..it just crept up on us, one game at a time. Then UEFA and watching countries battle it out. It was such a pageant, the Greeks and Portuguese kicking everyone's ass...I love watching underdogs. hell I was a Buffalo Bills fan for way too long. I know my underdogs. It was so wonderful to finally get a winner.
Soccer isn't your grandfathers game anymore, it's faster and harder. The fan violence has been almost completely eliminated, a sad history. The clubs have eliminated the standing areas. Everyone must have a seat and the security is tight. The penalty for unruly fans has become so high no club can afford even one ass.

I was reading The New York Times (online) today and there was a story about Michael Crichton and George Bush. It seems Mr Crichton doesn't believe in global warming. George Bush doesn't either so they had a nice dinner together to happily agree with each other gleefully. I can see them giggling madly about those dumb scientists being so dumb,cause they are dumb..giggle.
Isn't that just great? A President so stupid he is taking his environmental policy from a really bad writer.
George Bush thinks global warning might,just might exist but human beings have nothing to do with it. He thinks it's just the way the planet feels like, like the Earth got a cold from some other planet. His idea is wait it out, the planet will get over it ....
I agree the planet will ofcourse get over it, the problem is will human beings get over it too?
The polar ice cap is melting. Today New York realized it needed flood gates because the water level strangely is higher....now how did that happen? Could it be that when huge, crazy huge amounts of ice melt that creates water? Then that water goes into lets say the ocean and the ocean gets more full,like a cup and oh now you need flood gates..
So why oh why are the polar ice caps melting? Could it be that it is getting warmer?. Too warm for the ice to stay perfectly frozen, the warm water underneath undermining the ice from below? Why? Maybe because we , human beings are stripping this planet clean. We are digging holes everywhere looking for anything to make a buck on and then stripping the top off the planet for the same reason. Will we stop when the planet is as bald as Captain Picard? When every step we take we run the risk of falling into an abandoned mine? Will we be done then?

George Bush makes me nuts. If it isn't his oh so "Christian" desire to liberate the world from their own cultures at the point of a gun it's his mad desire to stick his head in the sand about the environment. I wonder how soon it will be before he declares that anyone who doesn't believe what he believes is a terrorist...
I worry more now that Cheney has been undermined, yes he is Darth Vader but he has a functioning brain. He will know when to stop..Bush doesn't have a stop button...he is as fervent as any Islamic fundamentalist in his own beliefs. Clashes of religion can only end in disaster for the rest of the world who just want a quiet life and a place to write about their favorite recipes and how their children have finally learned to potty train.

My favorite recipe is an apple pie my husband makes...yum.

Saturday, February 18, 2006

What are you afraid of?

I read a lot of medical blogs, medical students, interns,residents "real doctors", nurses and paramedics.
Over and over I read that a code is a scary thing for doctors in training and new nurses.
That always confuses me.
When a code is called. sometimes code blue sometimes an arbitrary number it means that someone found a patient who was dead.
Dead means they have no pulse and they aren't breathing..dead...all the way dead.
What is the worst thing that can happen to a patient? They die. Nothing a doctor or a nurse can do is worse than that.
You can't make a mistake with a dead person, they are dead. For me there was no anxiety at a code because I knew I couldn't do any wrong to the person lying there. I could only help.
So a code was a chance to help. Sometimes helping meant jumping on their chest and pushing hard, maybe breaking a rib or two to get a good compression and generate a blood pressure. Sometimes it meant breathing for the patient while someone else did the compressions.
Someone gave drugs through a new IV..I do agree that getting an IV on the dead is generally the hardest thing we do in a code.
Codes are simple things grounded in rules.We have decision trees that tell us what to do when..we just follow the directions and hope they will work.
It's not like ER though, I have never saved a person yet when their heart has already stopped.
It's hard to explain to the family..television shows them that all we need to do is pound away,give a few shocks and voila! all is better..that happened once in my career. We felt so ridiculously elated that day. But underneath that elation we knew the cold hard facts..a patient that arrests once cuts their chances at surviving that hospital stay down..way down.
Once you die once, even if we get you back, it seems that death has a hard time taking no for an answer..we hear weeks later that you died after arresting again.It cuts us and we pack that information away for our next code.
Sometimes a patient codes and your job is to be their advocate. We demand that you have a right to your death and that it is beyond the pale to bring you back.

Sometimes we let patients go.

Sometimes a patient is so ill and their is no chance for recovery. We have to explain to a family that we have nothing more to offer.We ask the hard questions.."would he want to live like this?:
What a loaded question.
Loved ones have to go home and search their memories.They have to make an honest,unselfish assessment of the person they love as much as life itself.They then come back to us and say "no, it's time to let them go"
That is my job. I go to each machine and turn it off. I remove the breathing tube and stop the IV medications that are keeping the patient alive. I know in my heart that the patient has already died, that the machines are giving the appearance of life. It is magic of the worst, most painful kind. To pretend that life is still there.
Once the machines are off we all stare at the monitor..watching for the flat line that means it's over. Sometimes it happens so quickly the family is shocked and weirdly embarrassed..to have that magic peeled away so abruptly reveals the selfishness in wanting to keep that patient alive. Some wives have burst into tears and apologized to me, the doctors and their husbands for waiting so long to take the machines away. The suddenness of death is so shocking after that glamour of technology.....they realize with suddeness that we were telling them the truth all along and that is painful.I tell them that no apology is necessary..every person comes to acceptance in their own time, it cannot be rushed.

Sometimes the patient lingers, breathing slowly with no rhythm,gasping and snoring. Sometimes their heart stops and starts again...we move in administering medication to soothe their breathing. We stand vigilant looking for any signs that the patient is distressed. No patient of mine has ever died "hard". All mine have gone peacefully,sometimes quick,sometimes long but never in any pain or distress.

All my families have been there, usually with their pastors. I don't believe in organized religion but my patients do so it is my job to make sure they have someone there at the bedside to help them through their grief.
I do appreciate these representatives of their faith, They are amazingly strong and inspiring for these families. I applaud anything that helps them move towards acceptance.

I wish people especially doctors would stop being so afraid of death. It is a part of being alive. it's not a curse..it just is.
I work hard everyday to keep my patients alive, that is my goal and that is what makes me happy and fulfilled but sometimes patients die( luckily very rarely for me) and I accept that.
I am not the creator of this universe, I do not have godlike powers nor do doctors...we just try to follow the rules the scientists give us and sometimes they help and sometimes they don't. It is not always in our hands. I wish the people who so fervently believe in God would remember that.

I have been playing with some hard subjects lately. My father has recently been diagnosed with cancer, his chance of recovery is excellent but it still shocks.
In my child's mind my father is invincible. He was the one who fixed my cuts, ruled my life.How can he be ill? Then I think, is this what my daughter thinks? She knows I am struggling. I wonder if she is tired of it,as tired as I am.
I find myself not wanting to talk with my father. As if by not talking with him I can pretend he is just fine, that nothing has happened. I want to deny it all. It's not fair I know he is lucky, that I am being silly,overreacting...creating drama where none exists.
It is a habit I burned out of my life.."drama"..I hated it. I hated rushed phonecalls,gossip,halftruths,innuendo. I was so grateful to never hear it again. By calling and rejoining this family I once again enter that world. I don't want to and I think that is another reason keeping me from calling. I stick with emails. They have a coolness to them I don't like but there is a healthy distance .
Family is painful. Trying to accept and understand that my parents struggle with their mortality as much as I do is a hard lesson.
I hate lessons.

I want to add that A&E sucks. What possessed them to recreate the hijacking of the 9/11 jet?
Why would this ever be considered entertainment or is it Arts? I am sitting here listening to a repeat of Larry King talking with the families and I am creeped out. The mothers and fathers talking about the terror and death of their loved ones as if it were a movie they saw when they were kids..It's awful.They are now happily promoting the movie. Think what you will about that.

I watched Crash tonight. I wish it was always that easy. I wish race relations was an easy simple thing. The worst kind of racism is the silent kind. The false acceptance that hides a hateful face.
The person who spends the day in a multicultural world and then comes home and makes jokes to their family. How can you protect yourself from the unsaid?
Sometimes I think despite how we present ourselves to the world Canada is brutally racist. We hide it with language. We say "come to Canada! you can work here and have a great life" .Then you get here and we say "hi, all we need you to do is write these exams,take these courses learn how WE do it" and then we will let you in. "Oh,by the way, this will cost you thousands and thousands of dollars you don't have Good Luck!"
See. it's not name calling, it's worse.It's saying your education is not "real" your training doesn't cut it. You aren't are a real ____ because you are brown or black or yellow..your home country couldn't possibly give you a good education, good training.It's racism hidden in politically correct "meeting the standards" of this white country.
It makes me cringe.
Then we blame them for not being able to pay to "meet our standards".
Canada is well known for being almost impossible to get a license to practice medicine. Is it a good thing? How many of you have to go to a walk in clinic because you can't find a family doctor? How many in the north have no access to doctors at all? And yet we have real doctors driving our taxis and cleaning the floors of our hospitals..They can't afford to "meet the standards" because they are still paying for their immigration.
Why can't we tell the truth on our immigration pages? If you are a person of colour never mind your years of experience ,make sure you know that you can't come to Canada until you pay for the priviledge of working at your profession. It sucks.
Crash didn't show what it looks and feels like in Canada and I don't think it feels like that in America either. I bet they suffer more from the silent prevention, the hoops that are set up that no one can jump. The language that makes it impossible to say "hey, that's racism".
I know that it's just a movie and no movie can break down such a complex problem but it was so..simple.. and it irritated me. All that serendipity was too much. I told you I don't like lessons didn't I? I don't like Sandra Bullock either..was it racist of me to feel a little satisfaction when she fell down the stairs?

What I want to be when I grow up

I have no idea.
I wake up and realize half my life is over and I have done very little with it. I try to placate myself with you save lives, you offer care..you are a good nurse but that is ringing empty .
I never thought this would be my life. I had grandiose dreams but I had no ambition.
I was raised by wolves, they struggled to survive and finally when they reached a level of comfort they broke apart scattering their children to the wind. I learned that it was best to be quiet, to not bring on their attention. They could not find an easy truce so they used their children as weapons in a battle that still hasn't ended.
It is impossible to have an adult relationship with your parents or your siblings. At least it is in my family. We carry our hurt and anger forever, my sister has held a grudge full of fury for twenty years. She has grown fat and bitter on it. It is her third child, one she has raised with much more care than her other children.
I have no way of understanding how anyone can be like that and I think there must be someway to fix this but every time I try she vomits bile and I run scared.
I know it's not me but how can you make a friend of this? Half my life is over and I know how fragile this life is. I have seen what unresolved anger can do to families at the end of life. I have witnessed families screaming at each other blaming new wives, old wives for the death of their loved one. It is embarrassing for everyone.I don't want my death to be clouded by old hurts.

I am thinking about death a lot lately. I have been so unwell that I am trying to adjust to my own mortality. I have such pain every day that sometimes I wonder how much longer can I go on like this. How much is too much?
I suffer the pain of the injury and then I suffer from the side effects of the drugs I take to cool the pain. I suffer the anxiety and embarrassment of going to the doctor and saying it's not working. I feel like I need to beg for relief. I sit chastened when the doctor puts limits on my medications. Like a small child I nod eagerly and agree to not take more when it hurts.
I must ration my meds and suffer for hours before I get to take a pill that will give me some relief for a few hours and then I get to do it again and again day after day.
How much is too much?

Why do strangers get to decide how much pain relief I am allowed to have?
I never limit my patients, my patients get the pain relief they need. I don't say to them "your pain is not a good pain , not an accepted pain" I say tell me when you hurt so I can make it better. Tell me as soon as you feel the pain so I can stop it.......

Why can't I find someone like me to help my pain?

I don't want to whine, I want to talk seriously about pain. I want to understand why doctors, nurses, the public are afraid of treating pain. What is so scary?
The drugs are not that frightening and it is well proven that people with pain are not at risk for addiction. Why do you care so much about addiction but nothing about relief? Why are you consumed with worry about mad drug addicts taking them nasty drugs and getting high those bastards?. Every doctor I have had has said to me addiction is not an issue from one corner of their mouth and out the other side whispering don't take too many okay?
I can't live with your fear, I can't live with your contradictions.

Pain is real.It can be measured. We can measure suffering because we are scientists. What kind of monster would measure someone's pain instead of stopping it? Scientists...Scientists
afraid of accusations, afraid of being accused of pushing drugs. So we let your pain bloom and then we measure it..how high is your heart rate?, how high is your blood pressure? are you breathing fast? are you sobbing or have you turned inward hiding in your own subconscious? Sweating,writhing panting and begging..did you pass the test?

Chronic pain sufferers are the pariahs of medical world. No one wants to look after them. As my own doctor said to me "It's so depressing".
I laughed, why yes it is and if it is depressing to you imagine how I feel. No one wants to imagine that.
I think that is the problem..it is a failure of imagination.
If you had to wake every day assaulted by pain,staggering to the drug cupboard and choking the drugs down and then waiting, waiting for relief to come before you can start your day maybe your imagination would expand.
I wish I was creative, I wish I could study a medical text and make magical connections and discover the answer to pain.

I don't want this pain, I am not nurturing it like a child. I do everything I can to divorce it's ass..I try everyday to get it to sign the papers..so far it won't even pick up a pen.
It is not my friend,it's my enemy..we are bitter , we fight and everyday it wins.

All I ask from you my medical partners is a weapon or two..I want a bazooka, nuclear weapons to kill the little bugger. Give me something better than a rubber bat okay?

That is what I want to be when I grow up..I want to be the head of the department of defense. I want to have the power and the weapons to beat the crap out of my pain every time the little terrorist raises his sneaky little head.

Great , I used the word terrorist..know I will be watched by the secret service, just what I need. But that is what it is.There is no better word for it..it lays in wait, probing defenses, watching and waiting causing anxiety and then it strikes..sometimes small, sometimes huge..I never know. There is no defense except vigilance and really great weaponry...I am sorely lacking in the weaponry department.

Friday, February 17, 2006

on sleep

When I began working as a nurse I started on the night shift. As a brand new RN that was the only full time position available and because I didn't have a clue I grabbed it.
I loved the night shift. You are free to do what needs to be done without the interference of every other service. You don't have to stand around and listen to staff doctors filled with self importance torture the residents and fellows for no apparent purpose. At night it's just you and the resident. You work together doggedly fixing as many of the problems you can so both of you can stagger off for an unsatisfying nap.
I learned very early that sleeping on your break for me was a disaster. I woke disoriented and angry.
By five in the morning my nerves were rubbed raw and I couldn't find the patience to talk down my demented patients who were trying desperately to separate themselves from the web of technology holding them to the bed.
I used to feel terribly sorry for these elderly patients,confused and angry wanting nothing more than their freedom. That ended when one of these "poor" souls bit me. They can be terrifying in their violence so I now think nothing of restraining them.
They never cover this in nursing school, tying a patient to the bed against their will. At first I felt like a criminal and I would get the restraints off as fast as humanly possible but over and over again I was the nurse whose patient ripped out their IV or self extubated. I hated looking like a fool and having my patient gasping and turning purple because I thought they needed their freedom more than their life.
I tie people down now and I sometimes don't even think about how awful that is.
I think I would rather have my hands tied down then being drugged into a drooling idiot. At least with restraints the possibility of coming to my senses exists... to be drugged into compliance could mean days of incoherence while I don't cough, my gag sucks so I end up with aspiration pneumonia.
A lot of hospitals are moving away from restraints. Families rant and rave that it is cruel and degrading, ofcourse these are the same families that hire a lawyer and scream their heads off when their demented violent loved one climbs out of bed and breaks a hip. They howl "why didn't we stop it from happening?" and we answer because you made a huge stink about the posey jacket that held grampa in the bed and you demanded that the doctor make an order that said no restraints so tough luck. We have six other patients and we notice you couldn't bother to come in and sit with him so tough damn luck.
When you take away a safe restraint policy and have nothing to replace it with other than check on the patient more often what do you want ? It takes about thirty seconds for a patient to climb out of bed, we could be checking them every five minutes and still they could escape.

If you are so damned concerned about your loved one hire a sitter or better yet how about you give up a little of your own time? You don't want restraints? Fine then come and watch your grampa and keep him in the bed, I actually have to provide medical care to sick people and I am not a babysitter for the demented.

I want to ask families why they brought their eighty five year dementia stricken parent in for major surgery that is guaranteed to render them bedridden and completely incapacitated. These patients drift from sleep to mania back to sleep assaulting nurses , kicking, biting and lunging out of bed and then, exhausted collapse. Why did you do it? Why couldn't you have had a little mercy and let the disease kill them quickly instead of sentencing them to months of pain and terror. They have no capacity for understanding why we are causing them terrible pain. They know only that we are monsters that swoop in unannounced and maim them. We have no names, they don't know what hospital means anymore, they don't understand what operation is.All they know is over and over again they suffer pain and there is no escape.
Then I tie them to the bed so they don't pull out the IV, NG,ET and they can escape for one day the pain 0f reinsertion.
I think the trade off is fair. I save them from being assaulted that day and the price is only their freedom.

Why can't patients make a living will? What stops you from telling your doctor that torture is not a medical option for you?. Before you become demented appoint someone in your family you can trust. Don't pick the cuddly,compassionate family member,they wont have the guts for the difficult decisions..pick the family member that has always been good and cool in a crisis. The one that follows the rules. Make them understand that your living will is the rules of your life and your death.
Have some common sense and choose not to be tied to a bed for the last month of your life.

To family members: If you think it's just the kindest thing in the world to put Old Scruffy down when he can't eat , can't walk and can't make it outside to poop why the hell do you think it's just fine to force grampa to live that way? Does your DOG deserve more compassion than your father?
People deserve dignity and shoving a feeding tube down them while they lay day after day in the bed awash in their own waste completely dependent on strangers with no hope of recovery has no dignity.

What happened to taking your loved ones home to die? We do it in my family. We all work full time but somehow we managed to get together and make a schedule and pool our resources to hire care aides. Is your life just too busy? Or is it once again that ugly entitlement thing..I pay my taxes so do my caring for me..I just don't have the time or the want. I have heard it over and over..you do it, it's your job blah blah blah..well if that is the way you want it
then shut up when we do your job okay?
You want a voice? Then pick up a washcloth, help turn, get bitten and kicked... BE THERE.

wow I feel better, that rant has been coming on for weeks. We are losing nurses to this, they can't stand to be a partner in torture because families refuse to make a compassionate choice.

Thursday, February 16, 2006

A kiss is just a kiss

Or is it? From the New York Times

"either the kiss is a human universal, one of the constellation of innate traits, including language and laughter, that unites us as a species, or is it an invention, like fire or wearing clothes, an idea so good that it was bound to metastasize across the globe."

Too weird to think that all the kissing we do on Valentines Day first started with smelling someone's breath to make sure they weren't sick or weird.
There was once a time our sense of smell was so acute we could recognize illness, we could identify who we were related to...most mammals can still do it.

Why did we start with the tongue though?
Not that it's a bad thing but who started it? We know the Romans found out about it and made it popular as Romans were want to do with anything related to sex but I wish I could have seen the first reaction to it..Holy shit! tongue! ew, ...wait....maybe not ew...and then it was like a game of telephone..

I don't really do Valentines Day..I think there is a cruel edge to it. It separates people and makes them feel "other:. It is too often used as a weapon for teenage girls to torture the less fortunate among them.
We all remember counting how many we got don't we? Looking around to see "how we did".
Love and friendship shouldn't be a competition.

A note for all those that had a crappy Valentines..I spent mine scratching myself into a bleeding pulp and considering how bad some other people had it I consider myself lucky.

A public get well message to Taylor, a nice enough little cat who doesn't deserve the "beedies": get better soon cat

Tuesday, February 14, 2006

The controversy over ads

I don't get it. Well I could understand if it was never ending popups and flashing banners screaming free naked twins!! But text ads that don't do anything unless ,you know. you click on them? Relax.
What I find sadder is when someone actually believes these ads are going to set them free from employment. Like everyone who comes and reads will madly click away out of love and make you bags and bags of money.
I can honestly say I rarely click. Every once in awhile serendipity will strike and I will see an ad for something I want or need and I will go ahead and click. I think it's the same with all of us.
I actually like the little google search ad thing. I wish everyone had one. It's so benign.."hey, oh hi..need to look for something? I can help..if you want me to..no pressure..it's not like I am doing anything else..sigh.."..too bad to get the one you end up with the other weird one but it's on the side kinda hidden..not bothering me.

Dear American Idol
I would have put those assholes right back on the plane to wherever they came from. Why did you pussy out Simon? Because the producers went oooh they are controversial didn't they? and they gutted you. Now I know you are full of shit Simon, you have less power to choose than Paula don't you?
The ridiculous I am a victim of torture and disrespect and kidnapping!! right? right? oh right ..I auditioned and then accepted an invitation that included free airfare , food and a hotel room...all in the hopes of winning millions of dollars.
Those two ignorant, arrogant whining hypocrites should have been shoved off the stage, I would have forced them to find their own way home. I remember seeing some of the children after their auditions sobbing and you threw it away like a brat .
My spirit is broken MY ASS.

Dear House writers
What the hell is wrong with you? A doctor who is in the midst of treating a patient stops to take a drug they know with all their heart is crap.. shoots it up no less and then to treat the symptoms of the crap drug drops acid and overdoses on anti depressants...that is the story line right? RIGHT?
And miraculously because he is superman he doesn't drop dead...
Is this a medical drama or science fiction? You have no idea what you are doing and you obviously have no intention in hiring someone who does so instead you are googling migraine and looking for the most bizarre treatments ever tried...it's not funny, it's scary.
Migraine may seem like bullshit to you but try having one or two and discovering there is NO treatment..a little acid and some anti depressants sounds pretty damn good when the alternative is puking in a soundproofed, darkened room for hours.
Can't wait to hear about the first one who tries it on CNN.
I want to have a sense of humour about this show, it is my first favorite in a long,long time and you are ruining it, ruining this character and you suck.

Dear Anderson Cooper
Amazingly I still like you doing the news but I it's getting less and less every time I see you on Oprah. Stay away from Oprah. Oprah will love you as long as you meet the "Oprah Ideal"..you fuck up she will eat you alive on national TV with a panel of experts..don't worry too much about the experts though, no one has ever heard of them. I think they are just people who paid off a producer so they can hawk their books.

Dr Phil
You don't get a dear because you are an asshole. If you and the wife are still having sex I will ..hell I will gag and then laugh for an hour because having sex with that is about the worst punishment I could thing of.
For a supposed insightful guy didn't you ever wonder why your oldest son is engaged to an oh how does one say this? hmm..girl who takes naked pictures while performing sex acts on her sisters for money and had an ad offering her time as a companion for money...and lets talk about the wife who at one time appeared to be human and now looks so brittle and fake one wonders if she is going to be headline grabber herself one day and not in a good way... and your youngest wants to be a rock star....
and you have the balls to get up every morning and tell other people how to save their families..and you pocket cash for every tragedy..hell you cannot stoop too low..you had your sister in law on to talk about how she felt to be almost murdered and permanently disfigured...
here is a tip..she was pissed and terrified and I don't have a degree in psychology.
Stay off my television at night. Stop feeding us bullshit that Paula Abdul can't find love but you can do it for her. You were so professionally incompetent you missed her actual problem staring you in the face, not surprising since it looks like your wife is almost as heavily medicated.
I got all of this from the neverending commercials , I didn't need to see the show which is a good thing because that would mean I had been lobotomized.

Which takes me to another of my pet bitches..The commercial/trailer. I hate them for television shows. Every time they end up revealing just enough of the plot that makes watching the actual show pointless. I learned everything I know about Dr Phil from the ads. Worse I learned everything I needed to know about the last episode of Greys Anatomy from the ad.
How dumb do these people think we are? We know the writers aren't going to blow up the four main characters so the tension and drama are destroyed...and we feel silly for even buying into the premise a little.
Stop showing dumb trailers!
Movie guys..yes you..if your comedy is so bad you are forced to put every funny moment into a thirty second promo burn the film. Burn it. I don't care if it took you six months...it sucks and you should have enough self preservation to want to save your own career...don't burn it and let the critics and the public stop your career dead. Your choice. We all make bad choices, you don't have to compound them by forcing us to suffer beside you .

In breaking news, I'm sick again. I now have to go to the doctor and have a battery of tests that I am sure will reveal that I am sick. I will get my fifth antibiotic prescription of the year and then obsess that one day I will get something I wont be able to fight off because all these prescriptions have made all my bugs super bugs..resistant to all but the most caustic drugs.
I suck.

Relief and the final chapter

Had a lovely day today. It really made up for yesterdays awfulness.There is something very strange to self control. Being a "professional" deprives you of certain rights. You cannot call people on their behavior. You must remain aloof and above the silliness, even if every inch of you is screaming.
What was wonderful was how completely supportive my manager was. I am lucky to have a manager who is close enough in her career history to remember the bedside and it's challenges.
She wants us to be successful but I am not kidding myself here..the less we lose our minds, the less crap she has to clean up.So it pays off for her to be supportive. I would not want her job, she has a huge staff , doctors , upper management and a budget all to manage, it's a nightmare.

So the final accident: I was at work and was turning a patient and got a weird seconds long sharp pain in what I thought was my hip. It went away and I forgot about it until the next turn. It began to plague me, my leg began to be painful all the time, finally I started to have pain so overwhelming it left me screaming. I went to the ER where they filled me with drugs and sent me for an MRI.
I had ruptured two discs and worse a part of the exploded disc was trapping the nerve..this was what was causing the pain. Everyone wanted to treat the problem conservatively, my family doctor, my neurologist and my neurosurgeon.
I was sent to the Pain clinic and started on oxycontin. I hated it. I have always had weird reactions to pain medications and the oxycontin was no different. Because it is a synthetic morphine( all narcotics or opiates are broken down by the body into morphine) the "synthetic" ingredients made me itchy, agitated and full of a feeling of foreboding and doom. The hair on the back of my neck would stand up hours after taking it. It made me so anxious the pain was worse.
So we stopped it and started Gabapenten. Gabapenten is an anti-epilepsy drug that has a side effect of relieving neuropathic(nerve) pain. Because what I had was nerve inflammation it was a life saver for me. I was switched from the oxycontin to real morphine and a muscle relaxant and a anti depressant were also added.
Anti-depressants also work on nerve pathways, they can soothe irritated and irritable pathways helping the gabapenten do it's job even better. Because I was having grotesque charlie horses the muscle relaxant was added. With my cramps there was no actual muscle contraction, the nerve itself was sending out the message of charlie horse, so even though the muscle wasn't contracting my brain was receiving the message that it was. The muscle relaxants did nothing and were soon stopped.
Obviously I couldn't work, at this point I couldn't walk farther than the bathroom and I couldn't sit or ride in a car. To see the doctor I would have to near anesthetize myself to make it.
I was a zombie, literally drooling...my husband would lean over and wipe the drool and my tears.
I cried a lot, every day.
My pain specialist was an asshole who thought my MRI was mild and easily recoverable. I just needed a "little steroid" . The way to get that steroid into me was to inject it into my spine.
I went to the little mini OR and lay on my back with no sedation and the only pain medication was what I took before I got there. The doctor injected through a large needle into the epidural space.. steroids.
The first time I made it home before I got so sick I thought I was going to die and honestly I didn't really care. I could feel my breathing get shallower and shallower, my temp spiking,shaking and sweating like some junkie detoxing after ten years of heroin abuse.It lasted three days and when I came out of it I was happy to be alive but my pain was unchanged. It had now been three months.
I was waiting for disability to start, waiting for workers comp..knowing that soon my income would be cut in half.
I was desperate so I submitted to my second epidural, it was a terrible mistake that landed me in the hospital. I was allergic to steroids. I was lucky I hadn't died.
I bounced back and in my ever increasing desperation I began to try whatever drug my doctors recommended.
I had good success with gabapenten, it's side effects are generally benign. You get fat and you suffer with "brain fog". You feel mildly confused and weirdly detached from your surroundings,I was clumsier than I had ever been but honestly the trade off was worth it.
I added Topamax, a drug that works like gabapenten but helps you lose weight not gain, it had better research, better clinical trials. Within three days I had sunk into a suicidal depression, a known side effect I ignored. It was the longest twenty fours waiting for that drug to wear off.
The depression was so acute and so bizarre because intellectually I knew my feelings were ridiculous and drug induced but still the feelings were real. I alternated between laughter and sobbing,wanting to die and feeling incredulous at the very thought.
It was now six months in . I had found a balance with three drugs and was now completely unwilling even rigid about trying anything else. But I wasn't getting any better and every day I was losing more and more mobility and still unable to work. I went on like this for many more months until my neurosurgeon finally re-entered the picture for a follow up appointment.
He was blunt, I had failed conservative treatment and I could not avoid nerve rescuing surgery.
The surgery was a piece of cake. The recovery is still in progress three years later. I am back at work again but my pain is a permanent partner. We waited too long and the damage can not be reversed.
Chronic pain
chronic meaning all the time, I am never without pain. Think on that.
My pain is a sensation of being burned . If you have ever had frostbite and the sensation when your skin begins to warm and then overwhelming burning begins and then thankfully for you it ends, for me it just goes on. The drugs turn the volume down. It hurts but not enough to stop you. Since the surgery I have been freed of my worst pain, the charlie horse, it would make me scream and it happened almost every day until my surgery and has never happened since. That is why I say my surgery was a success. Sometimes all a doctor can do is fix the worst of it, you have to learn to come to terms with what is left.
I think I have come to terms with dignity and perseverance. I am damn proud of how hard I worked in physiotherapy to be able to reclaim my job.
I am also deeply thankful that my manager and my hospital had faith in me and took me back when I said I was ready.
So, that is my disaster and this is my adventure. Trying to make the best of a life with chronic pain. The wonderful people at brainTalk were a huge part o my recovery, they reminded me that suffering is universal and to be blunt about it..it's boring. Surviving and reaching out and helping is where it all gets interesting

Sunday, February 12, 2006

Part 3

So,after the head thing and the boob thing I got sick.Terrible cramps and stomach pain with nausea. I went to the emergency room and nothing interesting showed up and they said "it's just gastro" and sent me home.
Two weeks later it got worse and back I went to the emergency room. This time all the tests screamed something is wrong. I was prepped for surgery and everyone's hopes were pinned to a bad appendix and not a blocked bowel. Hilariously I had the same anesthetist. I had just seen him three weeks prior for my lumpectomy. We exchanged some good gossip about our respective hospitals and in I went.
Luckily it was a sad,beat up appendix that was causing all the angst. My bowels were cheerful and healthy.
Appendicitis is a tricky thing. It is usually a teenagers affliction. Some common signs are right sided belly pain that gets worse when pressure is first applied and then released. On release the pain will spike.Some have pain at the bellybutton. Usually nausea is present but not always. You almost always will have a temperature. Your white cells will be increased, showing that your immune system has been triggered by infection.
Our newest gold standard is the CT . Historically a lot of perfectly innocent appendix have been ripped from their homes as surgeons hate to open someone up and not cut something. Because your appendix serves no purpose it will always get blamed even if innocent. No surgeon wants to come back to the patient and say "well we opened you up, made a really big scar and found nothing..sorry!" Better to take the appendix and say "hey! it could have been him, he looked really guilty"
My appendix was not innocent, according to witnesses he was a nasty piece of work that deserved his fate.
So a CT will now diagnose appendicitis, seems pretty expensive but it's better to avoid any surgery if you can.
I cannot believe how much better I felt after dumping my appendix.
Nurses are prone to irritable bowel,chronic constipation etc etc because we work shifts and we eat badly in the middle of the night. I had blamed my job for my bad gut and it had been my appendix the entire time.
So this was the beginning of a really bad year and it wasn't even March yet.
I guess I don't need to say I was feeling pretty discouraged and maybe a little cursed..I had no idea what was coming.

Just a note that I believe I had the worst day of my career today. It had nothing to do with my patient who was lovely. The family was a nightmare. I have never been met with such hostility and belligerence..ever. Never in my career have I had to ask a family to leave because I thought if they didn't I would start screaming at them. Being far,far away from them I can feel sorry and embarrassed for them.They were pathetic but being subjected to them was an assault. In the real world they would have been arrested but in the hospital world we make up excuses and accept behavior that would get you beat up if you were a civilian.
What demon possesses people when they enter a hospital? What logic are you using that says: I will piss off every member of the healthcare team, I will insult all their colleagues , slag their workplace and their manager and expect the very best care available anywhere?
I am a human being, if you verbally assault me I am not going to be inclined to offer you anything more than a frigid politeness , you are going to get over the top nursing care (because I know you are desperate to sue and I am covering my ass completely and ridiculously) but I wont waste a moments compassion on you and all information will have to wait until a doctor is willing to talk to you. The doctors don't want to talk to you either so don't expect anything but required politeness there. So, congratulations dumbass you have made this experience ten times worse and even more tragically the patient will be subjected to more tests, invasive or otherwise because all of us are covering our behinds. We know all you want to do is sue someone, anyone and it wont be us. How sad is that? Pretty damn sad in my opinion.
I know it would never happen in the US, only in Canada do we have this nasty personal entitlement crap.

Saturday, February 11, 2006

helping others

I meant to make a post earlier about Schuyler. She is a little girl with a nasty genetic disorder that has stolen her voice. Her parents are lovely people who work hard and do the best they can in pretty hard circumstances.
I understand that a lot of people feel very uncomfortable about so called "welfare" blogs. I think that is a really harsh term really.
The internet is a really huge place and we can collectively do a lot of good. I believe it is a wonderful thing to come together and help a little girl be able to communicate. I think it is a fine thing to reach out to the community and say help me help my child.
We are all not Bill Gates, a lot of us live on the edge, one paycheque away from disaster struggling to do the best we can in normal circumstances.
We are not obliged to contribute, we can help in lots of ways.
Schuyler is a cool kid and I added the link for anyone that wants to read a well written, funny, sometimes heartbreaking blog about a really cool dad trying to make the world an accessible place for his kid.
Genetic disorders are terrifying to all of us. Some DNA code gets misplaced and because the world is a mysterious place you meet and marry someone carrying the same broken code you do. The odds are incredible but it happens.
It reminds you that a big part of lives are governed by dumb luck.

oh well

I watched the winter olympics opening ceremonies. All I can say is huh?
It was pretty but Pavarotti was the only exciting moment. Damn that man gives me chills. Not in the "he is hot" way cause no but that voice is so beautiful.
The Canadian hats were great but the mongolians had us beat. Those were truly great hats.
I watched that godawful Dakota Fanning/Robert Deniro "scary" movie on TV . That kid needs to get someone to at least skim the scripts because fancy co-stars will not a career make.
How many times can that kid be in peril and never get the axe?
I am having a wicked bout of insomnia right know. I love to sleep but the getting there part is harder and harder lately.
I need to quit smoking,start working out and eat some fruit and vegetables....soon.
I have a plan but just like getting to sleep it's hard to get started.

Thursday, February 09, 2006

Part 2

So after recovering from my weird brain thing that left me with permanent partial numbness of a thumb my new doctor (yes I dumped the old one) did a full physical. For all the women out there commence the stirrup wince. I passed the PAP but failed the breast exam. I had two lumps that in all honesty I had never noticed.
I do practice self exam and I follow the rules, check in the shower before or after your period and I felt nothing. Once the doctor pointed them out I couldn't understand how I had missed them.
So I needed a mammogram and an ultrasound.
The mammogram was not that bad,for me. I have a fair sized breast..women with small breasts have a much harder time of it.
So, I let the nice woman I had never met before grope my breasts and then flatten them into pancakes. I had four different views....I was a little worried they were going to stay flat after that but I can report they recovered their post breast feeding unperkiness with little effort.
Next was the ultrasound. This was really strange, completely painless but there is a lot of manipulating going on and I didn't know how to behave. It's kinda funny, this stranger groping,pushing, pulling but it's scary too.
The second lump turned out to be nothing..some wayward fat that had settled, nothing new for me. The second was a problem that only a surgeon would be able to fix, I was told.
I went for my needle biopsy completely uneducated and unprepared.
Denial is a powerful thing and I was becoming good at it. I had no idea what was going to happen.Anyone with half a brain would have known needle was a big clue.
The first sign of trouble was the two nurses standing around with nothing to do. Nurses never have nothing to do.
The surgeon came in, was very friendly, told me to put the gown on and lay down.
I did what I was told like a zombie. One nurse went to the left side and took my hand and the other nurse took the right . I look up and the doc has a needle and some gauze with a little betadine. He takes down the gown,exposes the offender,gropes around til he finds the lump and says this may hurt.
This is when the nurses leaned down and grabbed my shoulders and held me to the bed. He then stabbed me in the breast with that damn needle and I said "Holy shit" really loud.
It probably lasted less than five seconds but it was a really long five seconds.
I started to cry and I asked " why the hell did he do that?" He was kind in his explanation; freezing breast tissue will make the lump flatten out and disappear making it impossible to biopsy so the attack the patient with a needle method was how he chose to get around that.
I was furious. I felt stupid, humiliated and very angry.
I left without saying a word because I was afraid to show my anger to the man who may be responsible for removing my breast. I felt like a fucking victim.
The biopsy results came back "ambiguous" just like every other test I had before it. I needed a lumpectomy.
The lumpectomy was a breeze..they knock you out to do it and give you pain meds after. I have a tiny scar and a clean bill of health. All that for a funky little cyst that wasn't bothering anyone, least of all me.

So what did I do wrong this time?
I did everything wrong. I should have got a second opinion on my mammogram and ultrasound. I didn't. I did no research on needle biopsy. I could have had pain medication and sedation, it was never offered and I never asked.
Hell,I was frozen,speechless. I should have got a second opinion on the biopsy or arranged for a second one under sedation for a better sample. I could have avoided surgery.
I did none of these things because once a doctor said you have two lumps in your breast I stopped being a nurse and became a patient. And I am a good little patient, never complain or bother the doctors...I knew better but I was afraid they would label me a "problem" and my care would suffer. I have seen enough of doctors to know they hate being questioned or challenged.
I should have stood up and fought for my right to compassionate, informed care.
Don't let it happen to you. Despite the statistics you hear on TV breast cancer is relatively rare. Almost all lumps in the breast are in fact benign.
If your doc says you have a lump think cyst first, not cancer, don't panic and freeze like I did. If you think" it's a cyst" you will behave like a rational person and get educated and ask questions and get a second opinion.
If you find a lump or your partner does get it checked out immediately, it will take two hours of your life max to get an answer.
If you ignore it and it grows? well, you should have pulled your head out of the sand earlier but it's still not too late..go get it fixed..do it now.
Breasts do not define who we are, they are nice ornamentation that's all. Don't let a little lump turn you into a deer in the headlights.

What do nurses really do?

From medscape:
"What do nurses do? They save lives, prevent complications,prevent suffering and save money.
So why do nurses have such a hard time explaining such compelling facts and acts?
It is because they have been educated and socialized to focus on their virtues rather than their knowledge and their concrete everyday practice."
"They've been taught to wear their hearts and not their brains on their sleeves as they memorize and then rehearse the virtue script of modern nursing"

"Although many studies, conducted by nursing, medical, and public health researchers, have documented the links between nursing care and lower rates of nosocomial infections, falls, pressure ulcers, deep vein thrombosis, pulmonary embolism, and deaths, most promotional campaigns and many stories nurses themselves tell about their work ignore these data."

"Instead, nurses focus on their honesty and trustworthiness, their holism and humanism, their compassion, and their caring. The problem is that when they focus on caring, they often sentimentalize and trivialize the complex skills they must acquire through education and experience. They often fail to explain that caring is a learned skill and not simply a result of hormones or individual inclination. After all, knowing when to talk to a patient about a difficult issue, when to provide sensitive information, when to move in close to hold a hand or move away at a respectful distance all are complex decisions a nurse makes. To make these decisions, nurses use equally complex skills and knowledge they have mastered. But all too often nurses make these skills and knowledge invisible or describe nursing practice in terms that are far too limited."

"Nurses are still talking about themselves -- or allowing themselves to be talked about -- in the most highly gendered, almost religious terms and allowing themselves to be portrayed with the most highly gendered, almost religious images. Indeed, as Nelson and I argue, with the best intentions in the world, many modern nursing organizations and nurses reproduce and reinforce traditional images of nursing as self-sacrificing, devotional, altruistic, anonymous, and silent work.[1] Just think of one of the jingles in the recent Johnson & Johnson image campaign:

You're always there when someone needs you
You work your magic quietly
You're not in it for the glory
The care you give comes naturally.

"Here is what I think nurses do. Using their considerable knowledge, they protect patients from the risks and consequences of illness, disability, and infirmity, as well as from the risks and consequences of the treatment of illness. They also protect patients from the risks that occur when illness and vulnerability make it difficult, impossible, or even lethal for patients to perform the activities of daily living -- ordinary acts like breathing, turning, going to the toilet, coughing, or swallowing.

Even the most emotional work nurses do is a form of rescue. When nurses construct a relationship with patients or their families, they are rescuing patients from social isolation, terror, or the stigma of illness or helping family members cope with their loved ones' illnesses."

Topics in Advanced Practice Nursing eJournal. 2006;6(1) ©2006 Medscape

So that is what nurses do. Yes it is true we sentimentalize our jobs but I think we do it because it gives us POWER. Nursing on the whole is a powerless profession.
We take orders from doctors, we take orders from patients and family and we take orders from management. We don't get to give any orders to anyone but housekeeping and hell, they don't listen to us.
By talking about how much care we provide and notice that a nursing action is always called providing care we promote the image of the gently smiling, handholding sweet little thing. People LIKE nice people, people respect the image.
Using and manipulating the image is what creates a form of power currency that gives us room to work, room to offer suggestions to the health care team.
I believe if nursing drops the pretense doctors would relegate us from the backseat into the trunk. I know some nurses and I am one of them who are not nice handholders, we are agressive tenancious advocates for our patients and we pay for it. Doctors will fight us every step because we are not deferential enough.
I respect the author of this paper , they want a change but change can only come when all the members of the health care team are on board.
Patients have an entirely different agenda, they want health care, they want to be cared for by compassionate professionals.
If I spent any time telling my patients hey! I am a smart,well educated , highly skilled professional they would nod and say hey!Get me a drink of water and some pain medication nurse.

Intellectually I am sure patients will feel better knowing we are highly skilled but the bottom line with patients is how quickly and kindly they are they cared for. They expect their nurse to be nice to them, to show kindness at every step even if they are angry,belligerent,violent,foul mouthed and hysterical.
You want to shock a patient? Tell them they have to treat their nurse with respect.
It nevers occurs to them that the person caring for them has any feelings at all.

I think the goal should be to educate the public on respect for health care providers.
Respect for them as living human beings, once they get that maybe we can slowly introduce the idea that nurses are highly skilled, highly educated professionals.

Baby steps here people!

Nursing is a cool job but there are limitations to it and knowing that is education.

  • Google News
  • Edit-Me
  • Edit-Me
  • copyright harleynalice 2006