Thursday, August 24, 2006

It could kill you

So I wrote an entire opus to how I hate my damn job and decided to delete it.
I guess because I don't actually hate my job . I love what I do with my patients and their families.
I hate the politics of my job. I can't stand the military caste system of my job, though it is unspoken. Some nurses still think they are a separate and different profession but it has become obvious that the dream of that is dead.
You cannot declare yourself a profession when your job is to take ORDERS from someone else. The orders are not suggestions from another professional you are collaborating with..They are orders that if not followed can result in job termination.
Nursing is nothing more than doing the grunt work of people who believe they are above such things.

In nursing school we were brainwashed with the notion that we were valid contributors with a voice. In all my years it has been reinforced that anyone who uses that voice is committing professional suicide.
Doctors do not want a nurse telling them their choices are suspect. If you are sweet,charming and worshipful some doctors may actually listen for a moment. If you are in a hurry, blunt or less than flattering they will go against every suggestion you make leaving you frustrated, humiliated and feeling powerless.

If this happens enough you begin to second guess yourself. You start ignoring things you once would have jumped on because you don't have the energy to be made fun of. You begin to feel sad and out of place. Your irritation grows because you no longer know how to address issues with anyone.
You are burning out.
Some times you see it in friends and you suggest they take a little time off, reconsider their choices. Sometimes you don't do enough because you are mired in your own burnout.
Sometimes you just suck and don't take it as seriously as you should because you are a crappy friend.
I was a bad friend, I didn't pay attention when I should have..I thought I had done enough and I brushed off that niggling voice that said maybe you weren't doing so well..And I am a bad friend.
You were a wonderful man and a great nurse. I didn't tell you that enough and now you are gone and I can never tell you.
Like me you loved the job but couldn't do the politics, you were kind and couldn't understand why anyone wouldn't be and I think in some horrible way your innate kindness, the gentleness of your soul led to your soul crushing disappointment.

I lost a good friend and we all lost a great nurse and the saddest thing of all is not one person will change how they hurt one another because of it..Because that is the way it is when it is your job to follow the orders of someone else.

Friday, August 18, 2006


Most of what I do in nursing has never been proven through research. The new buzz words of health care are "evidence based" treatments. Meaning when we do something we have to have some evidence to prove that what we are doing actually works.
Which means research.
So here is a little scenario, after surgery we sit people up on the side of the bed..We call it "dangling" cause well, your feet are dangling off the side of the bed. We do it for a few reasons, first to give your butt a break from laying there, to see how you tolerate sitting up; do you get dizzy? Do you feel like throwing up? This will help us decide how soon to allow you to get out of bed. Dangling for people with chest tubes also allows the chest to drain, sometimes pockets of fluid can gather when you are laying flat, this empties them out and helps us see how quickly you can get your chest tubes out. Dangling also let's us see how your heart and lungs work when stressed a little bit, a good test to see how well you are doing.
So a small thing like dangling is a huge assessment tool but there is NO literature to prove that dangling has any value..No evidence....hmmm
So, do we stop dangling?
After surgery we give everyone a postop bath. I know it seems insane. The patient showers before surgery with a special soap, right before the surgeon cuts the patient is bathed again in an antibacterial paint and after surgery we bath the patient again.
There is no evidence for it but as nurses we know that the soap and the paint itch. Some patients get a nasty, itchy rash from it so we wash it off before it can become an issue. We wash off some spots of dried blood because it's upsetting to the family.
I don't have any research to tell me that what I am doing is right or wrong..Should I stop until I do?

Some research seems so obvious it's almost comical but sometimes research can show us surprising things.
The newest research shows us that surgical site infections are unaffected by all that special soap and paint..A normal shower holds the same risks as being bathed in an antibacterial paint.
Do we stop using the paint?

About the guy that says he killed JonBenet...I say wait and see. I think he may know the person that did this, he may have helped but he may just be a nut looking to be star.
I think he is definitely a pedophile, and definitely crazy.
I do wish that Thailand could keep him. Their prison system is a lot less comfortable than the US . Thailand doesn't believe in coddling their prisoners and maybe twenty years in a Thai prison would help him see the error of his ways..Though most can't really survive twenty years..that wont be a loss though.
I am of the belief that pedophiles that are convicted should be euthanized. There is no treatment for pedophiles except for incarceration and in all honesty there are so many pedophiles now we just don't have the budget. Pedophiles have no value to anyone or anything, I say put them down like the rabid dogs they are. I also don't believe pedophiles get a second kick at the can, you get caught once you get the needle not six months probation..ugh.
Children should have rights and it infuriates me that parents and adults don't care about them. There is always the lame lip service of "children are our future" blah, blah but not a peep about the insane sentences handed down by lenient courts that couldn't care less that grown men are groping children or staring at naked children in the name of art. Where are the parents? Why aren't our leaders being held to account for these ridiculous sentences?
Why? because children have no voice, no rights.
We can all agree that children shouldn't be molested but not enough of us realize pedophiles should be truly punished with their lives for the crime of hurting a child..But damn if you kill a cop! Then you're in trouble buddy... Cops know the risks of their job..What five year old knows that being a five year is damn risky?
Gosh..What the hell is happening to men?
Are pedophiles evil or are we growing them through molestation and abuse? Are pedophiles just growing their own pedophiles?
Am I right in wanting them all dead?

Tuesday, August 15, 2006

the new guys

A couple of times a year we have a new group of doctors come into the unit. They are called fellows. Doctors that have finished their general medical training and are now into their specialties .
We assume the new guys have actually practiced medicine, we have to assume because most of them are foreign,
The joys of working with someone with a rudimentary grasp of the english language are legion.
Actually I lied, there is no joy in this. Most of the time you want to kill yourself.
I have my share of mumblers too. Those that are too damn arrogant to speak up to be heard, always speaking in a whisper..everyone straining desperately to hear. I hate the mumblers and I just assume they are so damn stupid they are scared to speak , they mumble to avoid being outed as morons.
Next is the group that thinks their english is just wonderful but actually they spout meaningless gibberish half the time, the other half they are spouting nouns with no verbs.....bed, needle, monitor...all in a voice filled with desperation..I cannot begin to understand what the hell they want.
Last, the group that doesn't speak any english..and don't think they have to. We just ignore them completely.
What is truly awful is our medical staff leaves these brand new docs all alone to sink or swim. The nursing staff must ofcourse take over and train these docs before they kill someone or themselves.
It is awful to see a perfectly nice person get shoved into the morass of the ICU without a lifeline.
Nurses get a six week orientation with a senior nurse at their side the whole time, a new doc gets nothing .
I try my best to help during the first few days.
This is the time when we discover what kind of a person the new doc is. If they become angry and go after the nurses then we leave them to drown. If they reach out to us we throw them a line and we keep them afloat..We cover their asses for everything because we know the kind ones will eventually settle in and become good, competent ICU docs..And then ofcourse their fellowship will be done and they will leave us. The bad , angry ones never get good, they just get meaner and eventually get hired as staff and we are saddled with them forever.
Just kidding, sometimes the good ones do stay and we love them.

I hate new doctor time, it's scary for the staff because when bad things happen to our patients we want the very best to help us and sometimes we have to accept that best isn't available right away. We have to hope the new guy can keep it together long enough for the best to get there and that is damn scary.

I had a new doc tell me he wasn't going to let anything or anyone in the ICU raise his blood pressure...How do you respond to this? I mean it's an ICU..Scary shit is going to happen, you are going to have to respond quickly and your blood pressure is going to go up..Well hopefully you are going to respond quickly..Not this guy though...And that is scary as hell.

In a time when medical care has become so advanced it's weird to realize that doesn't matter. It's the people who deliver the advanced care that matters.
You can have cutting edge medications and treatments but if your staff can't communicate or has no experience the patient will never see the benefits.

I find I am beginning to grow tired of nursing and healthcare in general. It has become so political and petty. To get good care for your patient you have to ask nicely and make sure you massage the docs ego. Hospital nursing sucks.

Thursday, August 10, 2006

why oh why?

So back to Mel
Why did Mel admit publicly to the hate he spewed that night? He had the option of keeping his mouth shut. The cop and his superiors went crazy cleaning up that report so that not a hint of crazy showed. Mel has always made a point of supporting the cops , he has given money and his time for their causes so he had to know they would give him some cover. But he blurted out the whole mess in a fit of hungover remorse. Still his first apology was pretty damn generic and covered all the bases. He could have shut up right there. The police had already started the cover up, the buff and shine, so why continue with the apologies?
Was it because he knew he acted like a giant asshole or was it because his publicist knew there was a video of the whole damn thing and every publicist learned from Bill Clinton that it's always best to blurt out your guilt and get straight to the forgiveness part?
Withholding and denying nearly got Clinton to just dump it all out there and hope it goes away?
I think the publicist got it right. The news now talks about rehab and which rabbi will get the honour of straightening out the anti-semitic and everyone seems to have stopped talking about how awful the little bastard is..and by the way he is no taller than Tom Cruise so he suffers from short guy syndrome which may explain everything...
I cannot get to the forgiveness because I think the whole damn "apology" is a staged pr move to save his ass and it is so damn cynical it makes me hate the jerk even more. What is worse is the press has completely bought into it.
Everybody so loves the "redemption" story line they don't get it's all bullshit.

I m thoroughly exhausted by the new world order. Everything is so anti this and anti that.
Environmentalism is trendy..only the rich can afford it though. I went to look at fair trade, environmentally friendly, sustainable , made locally clothes...holy shit..twenty five bucks for a hemp face cloth...sixty nine bucks for a towel...this is why WalMart will win every damn time.
Only the rich can afford to eat locally grown, fair trade, organic food....and by the way this is Canada...the growing season is about five how to I get locally grown, organic vegetables in March? Hmmm?

What is fair trade? Who gets to define it? The buyer or the grower?

everybody thinks it's all so damn simple....the antiglobalization idiots that don't even realize that the very third world countries they are trying to "protect" are actually the ones trying to find their way into the global market, the environmentalists so intent on saving the planet not realizing they are in fact creating a whole new level of consumerism..only for the wealthy ofcourse...the poor cannot afford to buy all the environmentally friendly stuff, they have to shop at grocery stores that import their food and sell it for half the price, they have to shop at WalMart where they can buy towels for six bucks..
The poor are too busy going to work every day they don't have any extra time to save the planet. That is the specialty of priveledged college kids spending their parents money.
The whole thing makes me so cynical.

Worse, thanks BP! Why bother inspecting your own system? Hell it's cold up there and no one really wants to go outside and who cares about some oil spilling? It's not like anyone lives there except you know the natives and hell nobody cares about them anyway right?
Assholes all of you. Your laziness is costing you millions of dollars a day but you don't are swimming in cash.

Going to hell in a hand basket.......why in a hand basket I don't know and what the hell is a hand basket? Is it a large purse of some kind or is it that basket you carry around in the grocery store that never has enough room and kills your arms?
Doesn't matter..we are all going into that handbasket anyway......

Tuesday, August 01, 2006

how many words are there for hot?

I know it is some dumb myth that the Inuit have a bajillion words for snow. I do know they have more than one and that is more than we have for hot.
It's so hot I am sitting here typing and sweating with the fan blowing full blast. I may end up a CSI mystery when I get that pail of ice to put in front of the fan and it melts right into an electrical outlet. I guess that might make me hotter but I doubt it.

I would like to go swimming but it seems the human waste and sludge from a thousand factories over a hundred years has created an e-coli bathtub.
The great news in ecology today is the oceans are literally teeming with bacteria..some we have never seen before. Gosh..want to go for a swim?

I remember heat waves when I was a kid but this seems different. It is the mugginess, the thickness of the breezes and no summer rain at dusk. The storms have been crazy, rain coming down as if I lived in Daytona Beach in March. When I was a teenager we used to drive to Florida for March break along with a few million other Canadians. It used to rain horizontally for a minute or two obscuring the whole world. Now we have those same rains here.
I guess global warming isn't a myth after all.

So Mel Gibson.....Wow. I know he has been a drunk for a long time but I thought he had some functioning brain cells left..He proved that wrong.
What always baffles me about rich people is why are they wandering around all by themselves?
Why was Mel in a bar till 2am all by himself? Don't these people have any friends? Do they really need to go to a bar and desperately seek attention from strangers?
He was offered a ride home by numerous people but what creeps me out is these people say he was drunk,slurring and unsteady but they let him get in his car and drive away. Where was the bar staff? Drunk people by definition have absolutely no judgment, they are too drunk not to get in their car..If you are busy getting your picture taken and demanding hugs how about showing some humanity and calling the drunk a cab? Asshole fans that don't give a shit except for how much the Enquirer will pay for their cheesy camera phone pictures.
I know Gibson is an anti-semite, hell he was raised by a raving lunatic so I would be shocked if he escaped unscathed but he has managed throughout his career to never spew any of his lunatic ravings outloud even when he was drunk.
I have no idea what opened the flood gates this time but he can't recover from it. No one will want to come any where near that toxic shit. I get that he has a ton of money and a production company all his own but pictures don't get made without writers and actors. What actor in their right mind is going to sign up to star with Mel? What writer is going to want their name beside Mel's in the credits? It would be career suicide.
I loved Mel for a long time, I had posters people, I kept his people magazine cover forever. I stopped loving him after lethal weapon seven thousand. I began to actively dislike him with Passion of the Christ..pretentious much?
Now he seems like a creepy asshole that just needs to go away. He can go hang out with Russell Crowe. They can keep building churches in their backyards and spewing vitriol and drinking nonstop back in Australia. Australia seems like it straightens these guys out. Maybe it's the heat or the people who just wont take their bull..who knows? but Mel needs to go home and get his shit together away from the world.
Obviously he is unwell but the truth is always revealed when you are drunk and Mels truth is he is an asshole that needs a handler and a driver. More importantly he needs a tour of Auschwitz and a good Jewish therapist and maybe he needs to stay the hell away from his nutjob father.

The war
I am at a complete loss. These people are lunatics. Childish assholes that don't care who dies as long as they win. I swear these have to be the most fucking immature people ever to have graced the planet. I know five year old Canadian kids that are more mature.
Is it just too damn hot in the middle east? Does it cause idiocy?
These idiots are fighting over twenty miles of worthless scrubland that wouldn't support two cows. All this "homeland" bs just like the nazis.
The solution is so damn simple it makes you want to fucking cry. Stop shooting at me and I will stop shooting at you..One, two, three stop you assholes. Okay now lets give the damn Palestinians there fifty or so miles of "homeland". Give Lebanon their shit back. There..Everybody stop bitching.
This isn't brain surgery.
Stop engaging Iran, they are like a teenager doing crazy shit for attention..periodically give them a pat on the head and let the new generation fix the problem.
Iran has a wonderful, intelligent younger generation which will soon be ready to make real changes. Give them the time to do their work.
Syria is a worthless terrorist state that exists only to feed extremists to Iraq and Lebanon..maybe someone should have invaded them..George, and left Iraq alone.

To the new extreme fundamentalists..Hi! You crazy born again American freaks!
Take a close look at those Arab suicide bombers..See anything familiar? Yes, that is you looking back...
Tell me truly wouldn't you be first in line to blow up anything that threatened your world view of the Apocalypse?
What if the Muslims took over Jerusalem and blew up all the churches and synagogues? AHHH..I can see you strapping on your explosives vest now...right?
You all want to be first in line to be saved . You are salivating over your copy of revelations , well the Coles notes version anyway and you can't wait...What kind of monster is thrilled and excited about mass slaughter? Well, that would be evangelical Christians..reveling in the "end of times". Hypocrites all.

I have to wonder about how stupid these "exiled" Cubans are. Dancing on the streets because Fidel needed an operation. Maybe you want to have the celebration when something new and different actually happens in Cuba. Having his brother cover him for a few weeks isn't exactly regime change dumbasses. What? You think the brother will take power and knock off Fidel?
They are old, really old. They don't want any changes, hell if they get the wrong breakfast cereal it upsets their whole day. These are two guys that like routine, they want sameness. They haven't changed their uniforms in forty years or their hair....they aren't going to go all wacky now.
They both will be dead soon enough okay? You waited this long, I think you can hang on another few years.

Pamies new book is out..go see her and buy the's funny and damn we need some funny right now.

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