and now that i have your attention........
could we please declare a ban on this phrase? at least among nurses.
we all know the situation. you run your glutes off all 12 hours of your shift. you ate no solid food the entire shift, not even able to have time to scavenge some saltines and some grape jelly packets from the bottom of the fridge. you came in with a liter bottle of water at 0600...here it is, 19:50 and there is maybe 120 cc missing. which is possibly a good thing, since you have not urinated since....well, 0600 am.
you got to work early, because agency has to check out a beeper & locater. then you trudge to another part of the building, to check out your phone...if they have them. if not you will be trekking downstairs later, to check one out when they come in from the night crew. then you trek to another part of the building to sign in and then go to the floor.....where, oh, goodie!! i'm floated.
per usual, i get the usual complement of patients that regular staff are burned out on. they try to give me a nitro drip, and get snotty when i refuse...as i am not checked off on tele. there are the usual snide comments about "where do we get these agency nurses". so the assignments change...as few of the regulars have gotten in yet (despite being after 0700), there are not the usual turf wars to change patients.
i get my patients and run. mds tell a patient that he is to be discharged after the neurologist reviews his am mri. the md in question of course writes no dc order, no dc notes and doesn't fill out the med rec that i had sitting right on the chart.
at 0900 the phone torture begins.....it reminds me of the old chinese water torture we talked about as kids. you know, where they tied the prisoner down, and had him under a slowly dripping faucet until he goes insane. yeah, that one.
over the next 2 hours, every single friend, relative, member of the pt's country club....will call the nurse (that's right me) on my direct line (because this hospital believes in "customer service" write the number on the patient board. i am asked (at least every 5-15 minutes) such thing as:
- when will harveeey get his mri? well, can't it happen early since he will get to do home? don't you date someone down there that will pull strings? oh don't tell me that, a lovely girl like you with a good job??? pshhttt! i can put a call in to mr. management c. bigmoola - you know the cfo. i fell the other day, playing tennis - could you look at it? well, why not? i have never heard anything so ridiculous. by the way i have a headache - could you give me tylenol? why not....just because i not a patient.......
i will answer the same questions over .....and over....and over until harvveey goes to mri. meantime, i will be juggling my med cart (the broken one of course that you have to kick a special way to get the bottom drawers out. at least every 10 minutes i will be throwing my body over the screen because the visitors have to harass me in the hall, i wouldn't want a violation of hipaa, now would we. of course that does not take care of the ones that insist on trailing me into the hall, while i attempt to get am meds out.
the day goes on.... i dc someone and admit someone within 15 minutes to the same room. and down the hall, there is a lovely russian couple, one of the poorer patients (there are very few poor here). he is dying, with a peg and tube feeds, a needs a very complicated dressing of bilateral heel wounds. the wife has bathed him and stays at his side with love in her eyes. i try to crush his pills and give a tube bolus feed, meanwhile answering the phone. and the calls go like this:
- "harvey is back.....how long will it take to get the neuro to read it....why so long....harveeeeyyy is waaaiiting to dc'd. well, could we take his mri films to the neuros office.....why not????? harvvveyyy doesn't care if we see them. hipaa, schmippa, such a silly thing.
- in addition to make my life, oh so much easier, they gave some patients the wrong phone and they are calling me instead of their nurse. and getting upset, when i won't take the time to fluff thier pillow/bend their straw, retrieve their book/ kiss their booboo/ sit done and play mahjong.
- when i suggest that they use their call light, they refuse...they never have to use the call light. they want me to hunt their nurse down.....and as i know no one on this floor, yeah, that's gonna happen.
the neuro sees the films, but of course also writes no dc order nor check that med rec. - which means i get to play phone tag across palm beach county, where every md has two or more offices to get a dc order and med dc orders.
- meantime the phone version of chinese water torture continues. harrrrrvvveyy.....harrrrvvvveeyyy.....harvvveyyy
then an administrator in a pristine pinstriped suit, pearls and a clipboard stops me somewhere between tossing my body over a computer screen, juggling tube feed cans, an iv start kit, and drying up iv reglan. and the conversation goes like this.
"caroladybelle" you know that we are implimenting are new "care" practice model in addition to our "strive for 5" customer service model. what does care stand for? that's right, connect, acknowledge, resolve, excelllllllll!. now if a patient come up to you and says "this food is ^&*%, can't you girls cook better than this?".....what is the appropriate care response?
(it is really good that i did community theatre - otherwise i would never be able to keep a straight face)
"that's a good girl, caroladybelle, you really know your customer service phrases."
(go out into world and sin, no more, 'belle)
i get haaarrrrvveeeeyyy dc'd after contacting all four of his mds. it is 1830 and i am coming into the home stretch. i chart, give meds, and a md comes in at 1900 to dc another of my patients, one of the hospital "benefactors".
- "now remember, team, if someone is a hospital benefactor or shows their card, be sure to give them the vip care that they deserve" and don't forget to give them a very personable thankyou!!!".
but will i get off work on time.....nooooo.
you see, from 1900 to 2030, the assignment will be changed at least 4 times. and i will give report on some of the same patients to 4 different nurses. and i collect my things.........
.....it dawns on me that i have not done the heel dressing change on my russian patient. i feel terribly guilty that i have been so busy with hhhharrrrvvveyy and the benefactor, that here was a patient that i could truly "nurse" and i didn't do it.
so i put down my things and i get my supplies and i go to the room. the wife, weak and elderly, holds his flaccid leg up, while i gently treat it and dress it. we talk about russia and there immigration here. and as i finish, clean up and prepare to leave, she hands me something and tells me not to share it.
i look and it is a small box of godiva....and my hands start to shake...i blow it off as hypoglycemia and try to decline the gift. she tells me that i am the nicest nurse, that i have worked so hard and i must take it. i do, even though i know how much it must cost. and my hands shake more.
i thank her and start to leave, when i see the wife of the benefactor outside my room, heels tapping impatiently.
she is angry about how long it is taking to dc him. i explain that another nurse will be doing that. i gather my things. it is 2130, and i have not eaten and had little to drink. i have not urinated in......... i do not know when. and as i leave, i hear
"what is wrong with these nurses? they are so lazy and only want to get off on time .
nurses just don't care anymore....it's awful"
i go out in the elevator, i return my phone. i go to the other end to return my locater, i return my beeper. i make it to my car.
and i start to cry.............................
