I'm sitting in my instructors office, frustrated and disillusioned and angry (as usual) lamenting the fact that I hadn't gotten very good comments and reviews from the nurses on the floor.
"Cranky," she says to me, "Why do you think they say these things?"
"I don't know, Sainted Professor, I guess I just get impatient because I already know half of what they are telling me. Duh, I can't crush an XR drug. Duh Heparin labels can get confusing because they look alike. Duh I have to roll insuling to mix and not shake. Duh I need to check two forms of ID before giving a drug. Duh I have to give insulin sub-q. DC'ing an IV is easy. So is using the little Lovenox pre-filled syringe. But yet they think I don't know and insist on walking me through the steps and it's maddening."
"Cranky, Cranky, Cranky." she says, chuckling. "I was so much like you. You have the technical knowledge, but you're socially retarded."
I recoil. Say what, lady?
She says "You think it's an insult that people think you don't know things. But I'll clue you in on something. There are good nurses and bad nurses. You will encounter both. Both will want to impart knowledge on you because they are RNs and you are not. So let them. The good ones will see that you know what you're doing. The bad ones will get their ego stroked that you make it seem that they know more than you. And either way, you win."
She knows me. She knows that I'm competitive and that I like to win, to stand out, to shine, to be the best. I like recognition. And that, friends and neighbors, is my new ideology. Let them teach me. They will either teach me directly by showing me a procedure I don't know how to do. OR, they will teach me indirectly by showing me how *not* to be, how not to interact, how not to behave.
I'm going to give it a shot.
Wish me luck, only 6 weeks left until school starts.
Sunday, July 5, 2009
Sunday, May 24, 2009
I Need A Job
But I have shit for qualifications.
I can start an IV. But I don't have the piece of paper that says I can.
I can hook you up to an EKG. But I don't have the piece of paper that says I can.
I can give you a bed bath, turn you, clean up your shit, clean your room, change your sheets, transfer you. But I don't have the piece of paper that says I can.
I can hang your IV bag, change the tubing, add your piggyback antibiotic. But I don't have the piece of paper that says I can.
I can give you your pills. But I don't have the piece of paper that says I can.
I can give you a TB test, a vitamin K or heparin injection, give you a tetanus shot, push morphine through your IV, rub nystatin on your rash. But I don't have the piece of paper that says I can.
I can change the dressings on your stage III decubitus ulcer. But I don't have the piece of paper that says I can.
I can play checkers with you, or even think up creative things for the residents to do at the home. But I don't have the piece of paper that says I can.
I can give you 1:1 suicide watch care. I can do a minimental status exam. I can talk to you about your feelings. But I don't have the piece of paper that says I can.
I can do CPR. Hey, I got the papers for that! But I'm not a CNA, MA, LVN, RN, EMT, PT, OT, Surgical Tech, etc.
I can take your vitals too! But I'm not a CNA, MA, LVN, RN, EMT, PT, OT, Surgical Tech, etc.
SO WHAT THE FUCK AM I SUPPOSED TO DO FOR MONEY? Now I can sympathize with people who strip their way through college because it's a total BITCH to have the requisite skills but not the damned piece of paper that says you can do those skills, so finding a job is IMPOSSIBLE.
Rant over. Job search continues.
I can start an IV. But I don't have the piece of paper that says I can.
I can hook you up to an EKG. But I don't have the piece of paper that says I can.
I can give you a bed bath, turn you, clean up your shit, clean your room, change your sheets, transfer you. But I don't have the piece of paper that says I can.
I can hang your IV bag, change the tubing, add your piggyback antibiotic. But I don't have the piece of paper that says I can.
I can give you your pills. But I don't have the piece of paper that says I can.
I can give you a TB test, a vitamin K or heparin injection, give you a tetanus shot, push morphine through your IV, rub nystatin on your rash. But I don't have the piece of paper that says I can.
I can change the dressings on your stage III decubitus ulcer. But I don't have the piece of paper that says I can.
I can play checkers with you, or even think up creative things for the residents to do at the home. But I don't have the piece of paper that says I can.
I can give you 1:1 suicide watch care. I can do a minimental status exam. I can talk to you about your feelings. But I don't have the piece of paper that says I can.
I can do CPR. Hey, I got the papers for that! But I'm not a CNA, MA, LVN, RN, EMT, PT, OT, Surgical Tech, etc.
I can take your vitals too! But I'm not a CNA, MA, LVN, RN, EMT, PT, OT, Surgical Tech, etc.
SO WHAT THE FUCK AM I SUPPOSED TO DO FOR MONEY? Now I can sympathize with people who strip their way through college because it's a total BITCH to have the requisite skills but not the damned piece of paper that says you can do those skills, so finding a job is IMPOSSIBLE.
Rant over. Job search continues.
Tuesday, May 19, 2009
Months and Months of Agony, or as my college calls it: "Nursing 4."
So I stopped posting for a while because of this horrible disease I caught. This disease is called Too-Much-Studying-itis, or Textbook Malaise, and I was debilitated for the entire course of the class. I swear that I worked harder in my life for this fucking C I am getting in Nursing 4 than I ever have in my whole life, childbirth and kicking a drug habit combined.
No amount of studying could bring my test grades above a 77%-- and I failed two exams outright. No amount of reading the chapters 7 times, doing NCLEX-review questions, taking practice exams, crying, or screaming into my pillow seemed to help. In fact, all that BS only exacerbated the problem because by test day I was so frazzled and out of it I couldn't concentrate to put my underwear on correctly, much less tell the difference between a fat embolism and a pulmonary embolism. (Apparently, it's petechial hemmorhages. Go figure I remember that shit now and not 3 hours ago when I took my final.)
I've neglected my family. Neglected my other class. Neglected myself. I studied and slept, with a little self-pitying and sobbing mixed in there for good measure.
But today? Today it's over. Today I can look forward to tomorrow because I know that there won't be another day of this rigorous mind-numbing bullshit until August. I can look forward to sleeping in past 4:15 on Wednesdays and Thursdays (clinical days). I can look forward to weekends of doing stuff with my kid instead of burying my nose in the goddamned Med-Surg textbook that's as wide as my palm and heavier than my 4 year old. I can look forward to actually having a life again. Hooray!
On a related note, can I say that I fucking hate Med-Surg nursing? Not because of the material, but because of the cliquish condescending asshole bitches I work with. I worked with a bunch of paycheck-nurses this rotation, ones who gave me the side-eye and talked down to me and had a perpetual case of bitchface because ... they think I'm arrogant. Really? Arrogant? I'd describe myself as many things but arrogant? The ones I worked with were so excited to have a student because that meant they could completely ignore all their patients and instead get paid to look at AVON catalogs and go downstairs to smoke. They refused to teach (despite working in a TEACHING HOSPITAL) and instead made belittle me for mistakes, openly talk shit about me in front of me, roll their eyes at me, and basically do things that if they had done it in a club or on the street would have otherwise earned them a righteous and painful beat down.
But I persevered, because I'm good at what I do. I have not yet had an unsuccessful IV stick out of 8 attempts, which I'm pretty proud of since I just learned how to do them. I'm skilled, I'm compassionate, I'm intelligent and on top of all that I'm confident and self-assured. (Arrogant??)
I'm glad it's over.
Now on to Peds and Advanced Med Surg.
No amount of studying could bring my test grades above a 77%-- and I failed two exams outright. No amount of reading the chapters 7 times, doing NCLEX-review questions, taking practice exams, crying, or screaming into my pillow seemed to help. In fact, all that BS only exacerbated the problem because by test day I was so frazzled and out of it I couldn't concentrate to put my underwear on correctly, much less tell the difference between a fat embolism and a pulmonary embolism. (Apparently, it's petechial hemmorhages. Go figure I remember that shit now and not 3 hours ago when I took my final.)
I've neglected my family. Neglected my other class. Neglected myself. I studied and slept, with a little self-pitying and sobbing mixed in there for good measure.
But today? Today it's over. Today I can look forward to tomorrow because I know that there won't be another day of this rigorous mind-numbing bullshit until August. I can look forward to sleeping in past 4:15 on Wednesdays and Thursdays (clinical days). I can look forward to weekends of doing stuff with my kid instead of burying my nose in the goddamned Med-Surg textbook that's as wide as my palm and heavier than my 4 year old. I can look forward to actually having a life again. Hooray!
On a related note, can I say that I fucking hate Med-Surg nursing? Not because of the material, but because of the cliquish condescending asshole bitches I work with. I worked with a bunch of paycheck-nurses this rotation, ones who gave me the side-eye and talked down to me and had a perpetual case of bitchface because ... they think I'm arrogant. Really? Arrogant? I'd describe myself as many things but arrogant? The ones I worked with were so excited to have a student because that meant they could completely ignore all their patients and instead get paid to look at AVON catalogs and go downstairs to smoke. They refused to teach (despite working in a TEACHING HOSPITAL) and instead made belittle me for mistakes, openly talk shit about me in front of me, roll their eyes at me, and basically do things that if they had done it in a club or on the street would have otherwise earned them a righteous and painful beat down.
But I persevered, because I'm good at what I do. I have not yet had an unsuccessful IV stick out of 8 attempts, which I'm pretty proud of since I just learned how to do them. I'm skilled, I'm compassionate, I'm intelligent and on top of all that I'm confident and self-assured. (Arrogant??)
I'm glad it's over.
Now on to Peds and Advanced Med Surg.
Saturday, January 17, 2009
The Best Healthcare Someone Else Can Pay For.
Braden and White Coat both write about this survey done by the Kaiser Family Foundation. In short, White Coat says,
There was a time where I didn't have any health insurance. I was pregnant, didn't have a job, and couldn't afford COBRA from my last job. I was starting school to go and become a nurse, so I could work part-time at best. My boyfriend at the time (now my husband) was a sergeant in the Army and got Tricare, but we couldn't get married at the time (long story) so I was ass out for care. So what did I do? I applied for Medi-Cal. It's a state service that gave me free (yes, free) medical care while I was pregnant and also for afterwards while I was in school, not working, and not yet married. We couldn't afford private insurance either because I could only work part time while going to school and for us with paying rent and bills and stuff it was too expensive-- and we live like misers, so it's not that I couldn't afford health insurance because we bought fancy cars or big TVs or anything. So I applied for and got Medi-Cal.
Apparently, there's something wrong with that system. Apparently, it's not okay for people to pay taxes and revenue to the state or the government and then expect a little reciprocity when they're down for the count. Because God knows I couldn't have afforded to get medical care for myself or for my child without Medi-Cal's help. And I ended up having a high-risk pregnancy and an emergency delivery via c-section which I never would have been able to pay for.
Now I have Tricare. I'm a military spouse and what I have is tantamount to socialized medicine anyway. But I get statements in the mail, because I'm seeing my doctor for an ongoing shoulder issue, for all the procedures I had done and I'm shocked and appalled. $2600 for an X-ray? $7000 for an MRI? How in the world could I afford this, even now when I'm stable and my husband has a good job and I'm in school? Why do these procedures cost so much? And no wonder people go bankrupt or skip out on their medical bills. When they get a bill for over a million dollars for something like emergency heart surgery with a hospital stay or something, and they make $50k a year, how in God's name are they expected to pay for that? Make payments for the next seventy years??
I should also say that when I was on Medi-Cal I got pretty good care. Not awesome care, not fantastic care, but pretty good care. I couldn't switch my doctor, though, because a) nobody around here was accepting new Medi-Cal patients and b) Medi-Cal would only allow me to switch once, and I already had. My doctor wasn't a great doctor. She spoke very little english-- or maybe very little intelligible english-- and instead of trying to help me with my shoulder she'd give me a pamphlet of exercises and some Vicodin and tell me to come back if it hurt worse. My new doctor, with Tricare, ordered X-rays, an MRI, and then gave me a consult to a PT and an Orthopedic Specialist. We found out I have crepitus related to an issue with my AC joint, impingement, and problems from an old rotator cuff injury that is going to require arthroscopic surgery.
Why was there such a difference in my care? Did I just get a bad doctor? Was it because of my insurance? If my doctor was bad, why didn't I get an opportunity to switch again if I felt that she wasn't being proactive in my care? Why did I not get an XRay or an MRI when I had Medi-Cal?
So even though someone else is paying for it, I have a right to say that I deserve the best care I can get. The ability to pay or who is paying shouldn't have any bearing on what care someone gets in my naive and humble opinion. And it's a sad day when it does. On top of that, I think that it's a great idea to make good medical care readily available to folks who can't afford a $2600 x-ray or a $7000 MRI who need one. And it's not just the poor, the downtrodden, the homeless, the jobless that can't afford it. It's people like me, middle class folks with a stable job, married homeowners with a kid and a dog and the white picket fence who didn't buy out of their price range and now face foreclosure like so many others like me. We live pretty comfortably, in fact. And I still can't afford this crap. What's wrong with state services like Medi-Cal that can help folks out for a couple of years while they look for a job or get to a position where they can afford to either buy insurance privately or are offered it through their job? I know that some folks remain on it forever, that they milk the system, whatever. Is that a reason to get rid of the system? Or a reason to hate the system? To me, it was a pretty good system that helped me out when I needed it. But it's **gasp** SOCIALIZED! OMG! Run for the hills! We're turning into Cuba!
My situation didn't really affect me much. Some days my shoulder hurt like the dickens but I toughed it out and did the exercised my Medi-Cal doctor gave me but I wasn't really that much worse for wear between these two doctors, if that makes sense. But what about someone else? Someone in worse pain than me? Someone with undiagnosed RA? With Chron's Disease? I can't stomach the idea of someone waiting in pain because their medical insurance group sucks too much to get them the care they need.
So yeah. When I had someone else paying for my care I still wanted the best care I could get. I don't think it makes me a horrible person, or a lazy person, or a mooch off the State, or anything of the sort. Surely there are those kinds, but not all of us who need state-supported care are lazy jobless mooches like we're villainized as being by some folks.
Anyway that's my rant. I still respect Braden and White Coat's opinion, even though I disagree.
it seems that most people in the survey want “The best health care someone else can pay for.”
There was a time where I didn't have any health insurance. I was pregnant, didn't have a job, and couldn't afford COBRA from my last job. I was starting school to go and become a nurse, so I could work part-time at best. My boyfriend at the time (now my husband) was a sergeant in the Army and got Tricare, but we couldn't get married at the time (long story) so I was ass out for care. So what did I do? I applied for Medi-Cal. It's a state service that gave me free (yes, free) medical care while I was pregnant and also for afterwards while I was in school, not working, and not yet married. We couldn't afford private insurance either because I could only work part time while going to school and for us with paying rent and bills and stuff it was too expensive-- and we live like misers, so it's not that I couldn't afford health insurance because we bought fancy cars or big TVs or anything. So I applied for and got Medi-Cal.
Apparently, there's something wrong with that system. Apparently, it's not okay for people to pay taxes and revenue to the state or the government and then expect a little reciprocity when they're down for the count. Because God knows I couldn't have afforded to get medical care for myself or for my child without Medi-Cal's help. And I ended up having a high-risk pregnancy and an emergency delivery via c-section which I never would have been able to pay for.
Now I have Tricare. I'm a military spouse and what I have is tantamount to socialized medicine anyway. But I get statements in the mail, because I'm seeing my doctor for an ongoing shoulder issue, for all the procedures I had done and I'm shocked and appalled. $2600 for an X-ray? $7000 for an MRI? How in the world could I afford this, even now when I'm stable and my husband has a good job and I'm in school? Why do these procedures cost so much? And no wonder people go bankrupt or skip out on their medical bills. When they get a bill for over a million dollars for something like emergency heart surgery with a hospital stay or something, and they make $50k a year, how in God's name are they expected to pay for that? Make payments for the next seventy years??
I should also say that when I was on Medi-Cal I got pretty good care. Not awesome care, not fantastic care, but pretty good care. I couldn't switch my doctor, though, because a) nobody around here was accepting new Medi-Cal patients and b) Medi-Cal would only allow me to switch once, and I already had. My doctor wasn't a great doctor. She spoke very little english-- or maybe very little intelligible english-- and instead of trying to help me with my shoulder she'd give me a pamphlet of exercises and some Vicodin and tell me to come back if it hurt worse. My new doctor, with Tricare, ordered X-rays, an MRI, and then gave me a consult to a PT and an Orthopedic Specialist. We found out I have crepitus related to an issue with my AC joint, impingement, and problems from an old rotator cuff injury that is going to require arthroscopic surgery.
Why was there such a difference in my care? Did I just get a bad doctor? Was it because of my insurance? If my doctor was bad, why didn't I get an opportunity to switch again if I felt that she wasn't being proactive in my care? Why did I not get an XRay or an MRI when I had Medi-Cal?
So even though someone else is paying for it, I have a right to say that I deserve the best care I can get. The ability to pay or who is paying shouldn't have any bearing on what care someone gets in my naive and humble opinion. And it's a sad day when it does. On top of that, I think that it's a great idea to make good medical care readily available to folks who can't afford a $2600 x-ray or a $7000 MRI who need one. And it's not just the poor, the downtrodden, the homeless, the jobless that can't afford it. It's people like me, middle class folks with a stable job, married homeowners with a kid and a dog and the white picket fence who didn't buy out of their price range and now face foreclosure like so many others like me. We live pretty comfortably, in fact. And I still can't afford this crap. What's wrong with state services like Medi-Cal that can help folks out for a couple of years while they look for a job or get to a position where they can afford to either buy insurance privately or are offered it through their job? I know that some folks remain on it forever, that they milk the system, whatever. Is that a reason to get rid of the system? Or a reason to hate the system? To me, it was a pretty good system that helped me out when I needed it. But it's **gasp** SOCIALIZED! OMG! Run for the hills! We're turning into Cuba!
My situation didn't really affect me much. Some days my shoulder hurt like the dickens but I toughed it out and did the exercised my Medi-Cal doctor gave me but I wasn't really that much worse for wear between these two doctors, if that makes sense. But what about someone else? Someone in worse pain than me? Someone with undiagnosed RA? With Chron's Disease? I can't stomach the idea of someone waiting in pain because their medical insurance group sucks too much to get them the care they need.
So yeah. When I had someone else paying for my care I still wanted the best care I could get. I don't think it makes me a horrible person, or a lazy person, or a mooch off the State, or anything of the sort. Surely there are those kinds, but not all of us who need state-supported care are lazy jobless mooches like we're villainized as being by some folks.
Anyway that's my rant. I still respect Braden and White Coat's opinion, even though I disagree.
Saturday, January 10, 2009
Tattoos in the Hospital Environment
I have several tattoos. I like my tattoos, they all have a story behind them. No, I'm not one of those weirdos who gets some strange bit of ink and says "Oh, it's representative of the struggle of the whatever and the paradoxical whatever whatever." I had a friend from High School who had a bunch of tattoos like that, some chinese characters that said something totally random and what he claimed were traditional Maori tribal symbols done by a real Maori tribesman but were really done in his buddy's garage and looked like crap. And when prompted to tell me of the Maori tribe he balked, claiming they were from Africa. Okay, fine. I'm all about getting cool-looking tattoos but I can see right through your pathetic attempts to assign meaning other than "I got it cause it looked cool."
Anyway. What I mean is, I can tell you why I got all of them and each of them have a funny story associated with actually going to get them, and the people I went to get them with are special to me. I remember all that crap. And I rather like having them, I enjoy people saying "That's an interesting tattoo" because then I can tell them the funny story and usually have a good laugh.
So anyway, in school they tell us about the evils of tattoos. We aren't allowed to let them show in the clinical setting. The reasoning behind it is ridiculous, IMO. It's because, and I quote, "We may encounter people from the older generation who may not like the fact that you have tattoos showing."
SAY. WHAT? That's your reasoning? That old folks might get pissy? I'm sorry to tell you but old folks can get pissy about the randomest things-- that you're a woman (if you're a little old man), that you're a man (if you're a little old lady), that you're black, indian, punjabi, hispanic, etc (if they're old white folks who grew up in "that generation")... The logic escapes me.
I mean, I know that tattoos are voluntary and you can cover them up when you can't really cover up the fact that you're black, but my whole point is if we can't show tattoos simply by virtue of the fear that we'll piss off old people, I counter with the fact that old people get pissed off at a lot of things, even haircuts! My friend had twists in her hair and this LOM at the care home was all "What the hell you do to your hair, girl? You coloreds and your hair, great googly moogly." Yeah.
So it's not like I have Nazi symbols tattooed on my arm, or "Fuck da Police NWA FO LYFE" or anything like that. It's a flower. A hugely offensive and politically incorrect flower, that now I have to either cover with Coban or with long sleeves at all times. Annoying.
On top of that, I've seen people in the ED or on the med surg floor with entire tattoo sleeves, one girl with blue streaks in her hair, one with a Monroe piercing (http://en.wikipedia.org/wiki/Monroe_piercing)... I've seen so much on the floor that they tell us in school is a HUGE no-no.
It makes no sense to me.
So, what are YOUR opinions on tattoos?
Anyway. What I mean is, I can tell you why I got all of them and each of them have a funny story associated with actually going to get them, and the people I went to get them with are special to me. I remember all that crap. And I rather like having them, I enjoy people saying "That's an interesting tattoo" because then I can tell them the funny story and usually have a good laugh.
So anyway, in school they tell us about the evils of tattoos. We aren't allowed to let them show in the clinical setting. The reasoning behind it is ridiculous, IMO. It's because, and I quote, "We may encounter people from the older generation who may not like the fact that you have tattoos showing."
SAY. WHAT? That's your reasoning? That old folks might get pissy? I'm sorry to tell you but old folks can get pissy about the randomest things-- that you're a woman (if you're a little old man), that you're a man (if you're a little old lady), that you're black, indian, punjabi, hispanic, etc (if they're old white folks who grew up in "that generation")... The logic escapes me.
I mean, I know that tattoos are voluntary and you can cover them up when you can't really cover up the fact that you're black, but my whole point is if we can't show tattoos simply by virtue of the fear that we'll piss off old people, I counter with the fact that old people get pissed off at a lot of things, even haircuts! My friend had twists in her hair and this LOM at the care home was all "What the hell you do to your hair, girl? You coloreds and your hair, great googly moogly." Yeah.
So it's not like I have Nazi symbols tattooed on my arm, or "Fuck da Police NWA FO LYFE" or anything like that. It's a flower. A hugely offensive and politically incorrect flower, that now I have to either cover with Coban or with long sleeves at all times. Annoying.
On top of that, I've seen people in the ED or on the med surg floor with entire tattoo sleeves, one girl with blue streaks in her hair, one with a Monroe piercing (http://en.wikipedia.org/wiki/Monroe_piercing)... I've seen so much on the floor that they tell us in school is a HUGE no-no.
It makes no sense to me.
So, what are YOUR opinions on tattoos?
Thursday, January 8, 2009
On the end... and another beginning
So I took a very long and well-deserved hiatus. I didn't want to even look at my computer or anything nursing related. This past semester left such a horrible taste in my mouth for this profession that I seriously considered quitting and moving on to something different.
But I persevered, I guess. I'm getting ready to start my second semester. My hope is tempered by trepidation.. I hear nothing but awful things about my Beginning Med Surg professor. But, I guess since I heard nothing but nice things about the belligerent evil troll that taught Intro to Med Surg I'm hoping maybe this new prof turns out to be the opposite of all the rumors.
So why did I run away and hide? I'll tell you.
For starters, my last day of clinical was probably one of the most interesting I've ever had. And by interesting I mean simultaneously infuriating, terrifying, anger-inducing, and challenging all in one. I had a patient try and attack me.
This asshole was in for some abdominal pain. (Yes, I, the ever compassionate human-loving nursing student, called a patient an asshole. I figured it was better than calling him what he really was: a coked-up shit for brains cocksucking motherfucker.) So according to him, his abdominal pain was only made better by the gallon of alcohol he drank daily and the coke, opiates, barbiturates, and pot he tested positive for on his tox screen. Figures. Oh, did I mention that the fool was an anabolic steroid abuser as well? His arms were as big around as my thighs. Yeah. He also ran the nurses ragged demanding his medication an hour before it was due, yelling, hollering, and basically being a textbook example of Roid Rage. On top of that, his mommy was there in full-on enabling mode (she knew nothing about the positive tox screen, too, so I had to tread very lightly so as not to violate HIPAA) talking about can you get my (28 year old) baby some pain medicine? He's in desperate pain. Yeah, lots of pain... funny thing though he wasn't diaphoretic, or pale, or shaky, and he claimed it was 10/10. Oh, and when I peeked into the room he was laughing and talking with his girlfriend, and then two seconds after I stepped into the room his pain mysteriously returned, and he began asking for morphine-- three hours before it was due. Yeah, I'm sure you're in a lot of fucking pain. Right. Let me just get right on that. Oh, hey, in addition to your early morphine, would you like me to get you some Ativan too so you can be REALLY high? Okay! Right away! I'm nothing but a glorified waitress anyway, right? :D
So anyway he needed surgery for some problems they found on the CT which IMO were really unrelated to his abdominal pain. I think his "abdominal pain" was caused and not alleviated by the gallon of alcohol he drank. I'm sure his desperate need to manipulate his poor girlfriend into waiting on him hand and foot had something to do with the pain as well. Oh, and of course motivated by his drug-seeking. You should have seen this guy's med reconciliation sheet. But he couldn't have surgery because of his positive tox screen. And I was given the pleasant task of explaining that to him. And, after being called a bitch and summarily dismissed from his room with a wave of the hand, I gave up.
You know, some people just don't want to be saved I guess. They don't want your help. I learned this the hard way trying to help this thankless roided-up loser asshole, and it made me sad. Why in the name of all that is holy are you even in the goddamn hospital in the first place if you don't want any damn help??
So to make a long story short I told my charge nurse, who told the nurse manager, who told the social worker. The social worker is a former marine drill instructor. Needless to say when he took me by the arm and led me into the patient's room to confront him and tell him that he could go to another hospital if he wanted to be verbally abusive to the nurses, all hell broke loose and the proverbial shit hit the proverbial fan.
He came up out of the bed and screamed "I didn't call you a fucking bitch, you fucking bitch!" Nice. Then he ripped his IV out of his arm and came at me like he was going to attack me. The social worker grabbed him before he got me though.
Now. There's an old me and a new me. The new me is trying very hard to conduct herself in a professional and courteous manner. The new me is trying to actually become the consummate professional woman, wife and mother. The old me, on the other hand, can get ghetto in 2.2 nanoseconds and has absolutely no problem with busting somebody in the face with my clipboard. But the new me took over and I ran from the room. Looking back I'm kind of sad because I would have loved nothing more than to have busted this punk in the face, but my training and good sense saved the day (and my future license.)
So, that was that. He left AMA and I sat in the lounge and shook with fear, frustration, and anger. What a great last day, huh?
**********************************
Then, after all that, I had finals. My theory professor, the belligerent evil troll, composed such a BS final that I was sure I was going to fail it. Not because I'm not smart, or that I'm knowledge-deficient, or that I'm not suited for this profession, but rather because it was un-in-fucking-telligible. The questions, as usual, were vague and had nothing to do with the material we covered in lecture- which, BTW, matched nothing in the $750 worth of textbooks the bitch made us buy. On top of that she gave us a case scenario that was absolutely confusing. Now, I know patients aren't going to rise up out of the bed and tell us "My potassium is low because of blah blah blah due to blah blah blah happening with this organ..." whatever. But at the very least we can ask questions and we can get help from more experienced nurses if we're stuck, lost, confused, or whatever. But when you go ask this woman for help or clarification she makes the shittiest most insulting comments to you, making you feel two inches tall and retarded. I passed the class by the grace of God and dumb luck.
Next rotation is Psych, which I'm excited about in a way, but I'm not really looking forward to. The only good thing is that we don't have to wear those hideous ciel blue scrubs.
I know I seem that I'm complaining a lot, but I was so excited about starting nursing school and all this first semester has done is show me the shitty side of nursing. Honestly, does it get better? Will I feel happier in this profession with a little autonomy and some smart motivated non-hostile coworkers?
I expected people in this profession to be nothing short of brilliant. Come to find out the women I worked with at Small Community Hospital were mediocre at best, who didn't care about anything but the paycheck, who felt threatened when a student dared to know more about malaria than they did.
Maybe I should have just gone to med school and become a doctor. Ugh.
Hopefully next semester will bring me out of my funk.
But I persevered, I guess. I'm getting ready to start my second semester. My hope is tempered by trepidation.. I hear nothing but awful things about my Beginning Med Surg professor. But, I guess since I heard nothing but nice things about the belligerent evil troll that taught Intro to Med Surg I'm hoping maybe this new prof turns out to be the opposite of all the rumors.
So why did I run away and hide? I'll tell you.
For starters, my last day of clinical was probably one of the most interesting I've ever had. And by interesting I mean simultaneously infuriating, terrifying, anger-inducing, and challenging all in one. I had a patient try and attack me.
This asshole was in for some abdominal pain. (Yes, I, the ever compassionate human-loving nursing student, called a patient an asshole. I figured it was better than calling him what he really was: a coked-up shit for brains cocksucking motherfucker.) So according to him, his abdominal pain was only made better by the gallon of alcohol he drank daily and the coke, opiates, barbiturates, and pot he tested positive for on his tox screen. Figures. Oh, did I mention that the fool was an anabolic steroid abuser as well? His arms were as big around as my thighs. Yeah. He also ran the nurses ragged demanding his medication an hour before it was due, yelling, hollering, and basically being a textbook example of Roid Rage. On top of that, his mommy was there in full-on enabling mode (she knew nothing about the positive tox screen, too, so I had to tread very lightly so as not to violate HIPAA) talking about can you get my (28 year old) baby some pain medicine? He's in desperate pain. Yeah, lots of pain... funny thing though he wasn't diaphoretic, or pale, or shaky, and he claimed it was 10/10. Oh, and when I peeked into the room he was laughing and talking with his girlfriend, and then two seconds after I stepped into the room his pain mysteriously returned, and he began asking for morphine-- three hours before it was due. Yeah, I'm sure you're in a lot of fucking pain. Right. Let me just get right on that. Oh, hey, in addition to your early morphine, would you like me to get you some Ativan too so you can be REALLY high? Okay! Right away! I'm nothing but a glorified waitress anyway, right? :D
So anyway he needed surgery for some problems they found on the CT which IMO were really unrelated to his abdominal pain. I think his "abdominal pain" was caused and not alleviated by the gallon of alcohol he drank. I'm sure his desperate need to manipulate his poor girlfriend into waiting on him hand and foot had something to do with the pain as well. Oh, and of course motivated by his drug-seeking. You should have seen this guy's med reconciliation sheet. But he couldn't have surgery because of his positive tox screen. And I was given the pleasant task of explaining that to him. And, after being called a bitch and summarily dismissed from his room with a wave of the hand, I gave up.
You know, some people just don't want to be saved I guess. They don't want your help. I learned this the hard way trying to help this thankless roided-up loser asshole, and it made me sad. Why in the name of all that is holy are you even in the goddamn hospital in the first place if you don't want any damn help??
So to make a long story short I told my charge nurse, who told the nurse manager, who told the social worker. The social worker is a former marine drill instructor. Needless to say when he took me by the arm and led me into the patient's room to confront him and tell him that he could go to another hospital if he wanted to be verbally abusive to the nurses, all hell broke loose and the proverbial shit hit the proverbial fan.
He came up out of the bed and screamed "I didn't call you a fucking bitch, you fucking bitch!" Nice. Then he ripped his IV out of his arm and came at me like he was going to attack me. The social worker grabbed him before he got me though.
Now. There's an old me and a new me. The new me is trying very hard to conduct herself in a professional and courteous manner. The new me is trying to actually become the consummate professional woman, wife and mother. The old me, on the other hand, can get ghetto in 2.2 nanoseconds and has absolutely no problem with busting somebody in the face with my clipboard. But the new me took over and I ran from the room. Looking back I'm kind of sad because I would have loved nothing more than to have busted this punk in the face, but my training and good sense saved the day (and my future license.)
So, that was that. He left AMA and I sat in the lounge and shook with fear, frustration, and anger. What a great last day, huh?
**********************************
Then, after all that, I had finals. My theory professor, the belligerent evil troll, composed such a BS final that I was sure I was going to fail it. Not because I'm not smart, or that I'm knowledge-deficient, or that I'm not suited for this profession, but rather because it was un-in-fucking-telligible. The questions, as usual, were vague and had nothing to do with the material we covered in lecture- which, BTW, matched nothing in the $750 worth of textbooks the bitch made us buy. On top of that she gave us a case scenario that was absolutely confusing. Now, I know patients aren't going to rise up out of the bed and tell us "My potassium is low because of blah blah blah due to blah blah blah happening with this organ..." whatever. But at the very least we can ask questions and we can get help from more experienced nurses if we're stuck, lost, confused, or whatever. But when you go ask this woman for help or clarification she makes the shittiest most insulting comments to you, making you feel two inches tall and retarded. I passed the class by the grace of God and dumb luck.
Next rotation is Psych, which I'm excited about in a way, but I'm not really looking forward to. The only good thing is that we don't have to wear those hideous ciel blue scrubs.
I know I seem that I'm complaining a lot, but I was so excited about starting nursing school and all this first semester has done is show me the shitty side of nursing. Honestly, does it get better? Will I feel happier in this profession with a little autonomy and some smart motivated non-hostile coworkers?
I expected people in this profession to be nothing short of brilliant. Come to find out the women I worked with at Small Community Hospital were mediocre at best, who didn't care about anything but the paycheck, who felt threatened when a student dared to know more about malaria than they did.
Maybe I should have just gone to med school and become a doctor. Ugh.
Hopefully next semester will bring me out of my funk.
Wednesday, November 12, 2008
I heard that nurses eat their young
But I never in my life thought it would be this bad.
So. Because I am who I am, I stand out. I'm noticed. Because of this I'm scrutinized and sometimes folks just flat out don't like me. I know this, and I continue to be who I am because I rather like myself. I'm not bitchy, I'm not rude or mean, I'm not hateful. I propose ideas and solutions to problems, I'm assertive, and I'm confident. And I know I'm smart. (I think this is the part that fucks me up sometimes. I'm not "intellectually humble." Oh well.)
The other week I had a guy who was rule out malaria. The nurses were all "Well they didn't find it in his blood." I said "Did you try drawing labs when he had a fever?" "No." "Oh, well here's the thing about malaria, blah blah blah sciencey shit blah blah and so you can only catch it out in the bloodstream when the patient has a fever." They were all "Whatever." They weren't buying it. Later on, the infectious disease doctor basically said rather loudly (she's a loud lady) to my instructor in conversation about my patient "Well they can't isolate the parasite in a blood smear but they haven't drawn labs when he had a fever." My prof said "Oh, Mary mentioned that. They never drew labs then?" And I got dirty looks, especially from BlockHead the charge nurse.
I also printed out for malaria guy all the info pertinent to all the diseases he was being tested for (EBV, CMV, WNV,etc.) and gave them to him. He asked for them, since his diagnosis was up in the air, and I gave them to him. With the express permission and blessing of my prof who praised me for being proactive and up front with the patient. I, acting on her instruction, placed the info in the patient's chart as we do with all teaching materials. BlockHead, the charge nurse, got pissy. She said "It's not up to you to diagnose the patient. And we don't put teaching materials in charts." My professor said I was right for doing it but to ignore it. I did, but strangely enough there was a bunch of stuff in my pneumonia patient's chart today and I took it to her and said "Hey, there's teaching info in here, why did BlockHead give me shitty looks about the malaria guy two weeks ago?" And My professor had no answer.
So then today pneumonia guy was supposed to get the pneumococcal vaccine. There was some question as to whether or not he had had it. He told me he wanted it, I told him I would try my best to make that happen for him. So the order he had previously had been canceled, so getting a new order required a call to the DR. This Dr has a reputation for being a jockstrap. So I tell my nurse "Hey, I'll call the Dr, take a load off your shoulders. I'd like to do it." And she's all "Noooooooooo. He'll yell at you." I said Okay, fine. So then BlockHead comes up to me later and was all "You can't call the Dr." I said "Oh, okay but if it's a question of him yelling at me, I'm not worried, I can handle it." And she's all No. And I said Okay, oh and by the way I arranged an isolation cart from central supply for my MRSA guy (I had two patients both in the same room and pneumonia guy's roommate had been diagnosed with MRSA and needed isolation.) When you move him let me know so I can take the cart down there." And she kind of rolled her eyes and sighed really heavy and walked away. ... O..kaaaaay, weird.
So guess what? Today I get called into the NURSE MANAGER'S OFFICE. Yep, the nurse in charge of the entire floor bitched me out, with My professor standing right there, about me not knowing my place and how I'm a usurper and there's a certain procedure we need to follow when calling the Doctor and it's not my place and I can't be doing whatever I wanted to do-- she referenced Malaria guy and said BlockHead told her I diagnosed the patient (lie!!) and that it's not my job to do that, I'm "just a student." BlockHead apparently told her that I bugged her about calling the doctor even after she told me that there was a certain procedure to follow and that I couldn't (lie!). I got bitched out for that too, and I couldn't even defend myself, the Nurse Manager refused to hear my side.
Then she told me that I have lost a lot of respect on the floor and it's going to take a long time for me to build it back up. Huh? How did I lose respect?
Since when did being smart and confident amount to a character flaw? I'm not going to fucking resign myself to mediocrity (the nurses on my floor are mediocre at best, doing just what they need to do to get by and nothing more) just so I don't make waves and step on toes. I have to kiss ass, basically, and I've never done that, ever.
My professor tells me not to worry about it, but in the next breath she says Nursing is a small world and I'm bound to encounter these people again. She says she knows I'm smart and she thinks I'm awesome but that I have to be unobtrusively smart. I have to just do what's expected of me and not shine because it'll leave me up to hard criticism. And that the nurses on the floor are threatened because I'm challenging status quo. She said that when she first got to the hospital nobody liked her either because she and I are exactly alike, and that it took her a long time to gain respect of the nurses.
That sucks that intelligence and confidence and assertiveness are detriments in the nursing world. And that BlockHead the charge nurse lacks the professional ethics to treat me properly as a student in a learning environment in a teaching hospital and to tell the whole truth to the Nurse Manager... the fact that BlockHead felt the need to "tattle" on me in the first place is a bunch of BS too.
So sorry for the novel but I had to get it all out, I'm still pretty steamed about it because I'm so disappointed.
Fucking bitch nurses. It's bad to be smart and proactive or to stand out or to show your skills, you should just put your head down and shuffle along never bucking the status quo, never going the extra mile... never doing any of that stuff they're teaching in nursing school. And the being smart part, I mean damn how can these people who have had basically the same education as me who should for all intents and purposes, know all of the things I know NOT know about malaria? Didn't they take Micro too? The only thing they should be feeling is shame that they lack a basic comprehensive knowledge abut the profession they chose.
Sucks ass.
So. Because I am who I am, I stand out. I'm noticed. Because of this I'm scrutinized and sometimes folks just flat out don't like me. I know this, and I continue to be who I am because I rather like myself. I'm not bitchy, I'm not rude or mean, I'm not hateful. I propose ideas and solutions to problems, I'm assertive, and I'm confident. And I know I'm smart. (I think this is the part that fucks me up sometimes. I'm not "intellectually humble." Oh well.)
The other week I had a guy who was rule out malaria. The nurses were all "Well they didn't find it in his blood." I said "Did you try drawing labs when he had a fever?" "No." "Oh, well here's the thing about malaria, blah blah blah sciencey shit blah blah and so you can only catch it out in the bloodstream when the patient has a fever." They were all "Whatever." They weren't buying it. Later on, the infectious disease doctor basically said rather loudly (she's a loud lady) to my instructor in conversation about my patient "Well they can't isolate the parasite in a blood smear but they haven't drawn labs when he had a fever." My prof said "Oh, Mary mentioned that. They never drew labs then?" And I got dirty looks, especially from BlockHead the charge nurse.
I also printed out for malaria guy all the info pertinent to all the diseases he was being tested for (EBV, CMV, WNV,etc.) and gave them to him. He asked for them, since his diagnosis was up in the air, and I gave them to him. With the express permission and blessing of my prof who praised me for being proactive and up front with the patient. I, acting on her instruction, placed the info in the patient's chart as we do with all teaching materials. BlockHead, the charge nurse, got pissy. She said "It's not up to you to diagnose the patient. And we don't put teaching materials in charts." My professor said I was right for doing it but to ignore it. I did, but strangely enough there was a bunch of stuff in my pneumonia patient's chart today and I took it to her and said "Hey, there's teaching info in here, why did BlockHead give me shitty looks about the malaria guy two weeks ago?" And My professor had no answer.
So then today pneumonia guy was supposed to get the pneumococcal vaccine. There was some question as to whether or not he had had it. He told me he wanted it, I told him I would try my best to make that happen for him. So the order he had previously had been canceled, so getting a new order required a call to the DR. This Dr has a reputation for being a jockstrap. So I tell my nurse "Hey, I'll call the Dr, take a load off your shoulders. I'd like to do it." And she's all "Noooooooooo. He'll yell at you." I said Okay, fine. So then BlockHead comes up to me later and was all "You can't call the Dr." I said "Oh, okay but if it's a question of him yelling at me, I'm not worried, I can handle it." And she's all No. And I said Okay, oh and by the way I arranged an isolation cart from central supply for my MRSA guy (I had two patients both in the same room and pneumonia guy's roommate had been diagnosed with MRSA and needed isolation.) When you move him let me know so I can take the cart down there." And she kind of rolled her eyes and sighed really heavy and walked away. ... O..kaaaaay, weird.
So guess what? Today I get called into the NURSE MANAGER'S OFFICE. Yep, the nurse in charge of the entire floor bitched me out, with My professor standing right there, about me not knowing my place and how I'm a usurper and there's a certain procedure we need to follow when calling the Doctor and it's not my place and I can't be doing whatever I wanted to do-- she referenced Malaria guy and said BlockHead told her I diagnosed the patient (lie!!) and that it's not my job to do that, I'm "just a student." BlockHead apparently told her that I bugged her about calling the doctor even after she told me that there was a certain procedure to follow and that I couldn't (lie!). I got bitched out for that too, and I couldn't even defend myself, the Nurse Manager refused to hear my side.
Then she told me that I have lost a lot of respect on the floor and it's going to take a long time for me to build it back up. Huh? How did I lose respect?
Since when did being smart and confident amount to a character flaw? I'm not going to fucking resign myself to mediocrity (the nurses on my floor are mediocre at best, doing just what they need to do to get by and nothing more) just so I don't make waves and step on toes. I have to kiss ass, basically, and I've never done that, ever.
My professor tells me not to worry about it, but in the next breath she says Nursing is a small world and I'm bound to encounter these people again. She says she knows I'm smart and she thinks I'm awesome but that I have to be unobtrusively smart. I have to just do what's expected of me and not shine because it'll leave me up to hard criticism. And that the nurses on the floor are threatened because I'm challenging status quo. She said that when she first got to the hospital nobody liked her either because she and I are exactly alike, and that it took her a long time to gain respect of the nurses.
That sucks that intelligence and confidence and assertiveness are detriments in the nursing world. And that BlockHead the charge nurse lacks the professional ethics to treat me properly as a student in a learning environment in a teaching hospital and to tell the whole truth to the Nurse Manager... the fact that BlockHead felt the need to "tattle" on me in the first place is a bunch of BS too.
So sorry for the novel but I had to get it all out, I'm still pretty steamed about it because I'm so disappointed.
Fucking bitch nurses. It's bad to be smart and proactive or to stand out or to show your skills, you should just put your head down and shuffle along never bucking the status quo, never going the extra mile... never doing any of that stuff they're teaching in nursing school. And the being smart part, I mean damn how can these people who have had basically the same education as me who should for all intents and purposes, know all of the things I know NOT know about malaria? Didn't they take Micro too? The only thing they should be feeling is shame that they lack a basic comprehensive knowledge abut the profession they chose.
Sucks ass.
Tuesday, November 4, 2008
Clinical October 29th
Well, today I got a firsthand look at how flipping bitchy nurses can be. All the info I printed out for my patient about his disease diagnostic tests went into the chart per protocol (any teaching or info you give the PT goes in the chart). But some nurses, one in particular, questioned why I had put it in the chart. Well, that's logical enough, of course they'd ask me why I put it in there. But the subtle but present nastiness and attitude I got from that one nurse in particular got my temper riled up. She insisted that all I would do was confuse him, implying that my skills were deficient somehow and that I was only going to confuse a normal, methodical, logical adult. I knew my patient because I sat down and got to know him and I knew that if I explained it a certain way he'd get it, he was a very intelligent individual. But the snide condescending tone really got to me. And then she told me that it's not up to me to make a diagnosis, that I'm not a doctor. Well, no shit sherlock. I'm not a doctor. You see anything in there about me making a diagnosis or telling him he's got any one of those diseases? No. But that doesn't preclude me from educating my patient. I tried to explain that to her she remained pretty rude so I let it go. Surprising, for me, because I'm the type of person to tell someone off if they piss me off. Maybe I'm learning to control my temper after all.
BUT. It kind of makes me feel like I don't want to stand out or go the extra mile because it will only meet with feelings of resentment from the other nurses. I've been in the situation so many times, like during group projects in Foreign Relations Class or even during class itself my professor regularly praised me on my level of critical thinking and political analysis (not to toot my own horn, here, just trying to make a point) and I overheard girls in the bathroom saying the only reason I got A's in that class was because I was fucking with the professor. Or in Philosophy with Dr. S (the one that people thought ate students livers for breakfast) who regularly told me that I was really good at Logic or whatever, students snidely said "Well, of course, you're his favorite." It couldn't be that I was smart and had a passion for the subject, they had to tarnish my success because they couldn't handle their mediocrity. And I brushed it off because I thought I wasn't ever going to see those people again, but now in this job with as catty as I've been told and witnessed firsthand nurses can be it makes me afraid to shine or stand out because it would make the workplace tense. So how do you be an excellent kick-ass nurse and not have the whole staff hate and resent you?
Anyway, off my soapbox.
I had a great day today, my patient was a delight and a pleasure to work with. That's all I can really ask for.
BUT. It kind of makes me feel like I don't want to stand out or go the extra mile because it will only meet with feelings of resentment from the other nurses. I've been in the situation so many times, like during group projects in Foreign Relations Class or even during class itself my professor regularly praised me on my level of critical thinking and political analysis (not to toot my own horn, here, just trying to make a point) and I overheard girls in the bathroom saying the only reason I got A's in that class was because I was fucking with the professor. Or in Philosophy with Dr. S (the one that people thought ate students livers for breakfast) who regularly told me that I was really good at Logic or whatever, students snidely said "Well, of course, you're his favorite." It couldn't be that I was smart and had a passion for the subject, they had to tarnish my success because they couldn't handle their mediocrity. And I brushed it off because I thought I wasn't ever going to see those people again, but now in this job with as catty as I've been told and witnessed firsthand nurses can be it makes me afraid to shine or stand out because it would make the workplace tense. So how do you be an excellent kick-ass nurse and not have the whole staff hate and resent you?
Anyway, off my soapbox.
I had a great day today, my patient was a delight and a pleasure to work with. That's all I can really ask for.
Clinical October 28th
This week lo and behold, I had a patient who was lucid and coherent and able to communicate with me! Hooray! And an added bonus, if you could call it a bonus, was that he was a rule out Malaria. MALARIA!!!!! OMFG I loved Micro so much and I just gobbled up every tiny shred of information in that class and was hungry for more. I thought it was so neat the way bacteria and viruses work in the body. I liked Malaria a lot when we covered parasites, so I remember much of what I learned about it so that made this particular patient REALLY interesting.
So, this gentleman had traveled to a far distand land and gotten eaten alive by mosquitoes. He refused malaria prophylaxis (duh moment) because he told me point blank that he didn't like to ingest any strange foreign substance concocted by the Pharm industry (his words) and that's also the reaon he refused a flu shot. Hmm. Okay, so I thought "Teaching moment!!" but he wasn't having any of it.
Anyhow, they didn't find any malaria but the ID doctor said that's what it was. Imagine, a malaria case in such a teensy little town. What's next? Dengue Fever? Lassa virus? Hanta virus? Yikes!!
I had a bitchy moment though, when getting report from the night nurse she kept asking why the patient was on a cardiac prudent diet--- because one of the diseases he was being ruled out for causes some problems with GI absorption of fat, if I remember right from my PDA and from the Diagnostic Labs book, and also perhaps also with the temperature fluctuations and the stress level perhaps she was concerned about his heart, I answered. And got "the look." The "shut up, student" look. Okay, I can handle that, it's bound to happen sooner or later but I kept a stiff upper lip and let it go.
I had a really good time talking with the patient and his wife about his job, about his stress, about the importance of the flu shot, about how I felt it would be a good idea to let others who are going to the faraway country for business to remember to take malaria prophylaxis and use DEET bug spray AND wear long sleeves while in the country. Plus I printed out a whole bunch of info for him about the three diseases he was being tested for besides Malaria (Epstein-Barr, Cytomegalovirus, and West Nile.) It felt good to know what I was talking about -- remember I LOVED Micro-- and feel confident in myself and my knowledge. My patient loved it because he's very methodical and a little OCD like me and he and his wife really appreciated me sitting and talking to them. He told me that I was the first nurse who actually sat down with him and asked him questions and answered his own to the best of my ability. I found that strange but predictable. The nurses all have 5 patients and they don't have the time to sit and chat like me. But still, the patient shouldn't tell me that I was the first one to even talk to him for longer than 5 minutes. That's pretty bad.
So, this gentleman had traveled to a far distand land and gotten eaten alive by mosquitoes. He refused malaria prophylaxis (duh moment) because he told me point blank that he didn't like to ingest any strange foreign substance concocted by the Pharm industry (his words) and that's also the reaon he refused a flu shot. Hmm. Okay, so I thought "Teaching moment!!" but he wasn't having any of it.
Anyhow, they didn't find any malaria but the ID doctor said that's what it was. Imagine, a malaria case in such a teensy little town. What's next? Dengue Fever? Lassa virus? Hanta virus? Yikes!!
I had a bitchy moment though, when getting report from the night nurse she kept asking why the patient was on a cardiac prudent diet--- because one of the diseases he was being ruled out for causes some problems with GI absorption of fat, if I remember right from my PDA and from the Diagnostic Labs book, and also perhaps also with the temperature fluctuations and the stress level perhaps she was concerned about his heart, I answered. And got "the look." The "shut up, student" look. Okay, I can handle that, it's bound to happen sooner or later but I kept a stiff upper lip and let it go.
I had a really good time talking with the patient and his wife about his job, about his stress, about the importance of the flu shot, about how I felt it would be a good idea to let others who are going to the faraway country for business to remember to take malaria prophylaxis and use DEET bug spray AND wear long sleeves while in the country. Plus I printed out a whole bunch of info for him about the three diseases he was being tested for besides Malaria (Epstein-Barr, Cytomegalovirus, and West Nile.) It felt good to know what I was talking about -- remember I LOVED Micro-- and feel confident in myself and my knowledge. My patient loved it because he's very methodical and a little OCD like me and he and his wife really appreciated me sitting and talking to them. He told me that I was the first nurse who actually sat down with him and asked him questions and answered his own to the best of my ability. I found that strange but predictable. The nurses all have 5 patients and they don't have the time to sit and chat like me. But still, the patient shouldn't tell me that I was the first one to even talk to him for longer than 5 minutes. That's pretty bad.
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