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Ruby Vee BSN

Crusty Old Bat

Original Member of the Crusty Old Bat Society


Content by Ruby Vee

  1. Ruby Vee

    Remember the Geri-Chair?

    Long ago and in another state, I worked on a med-surg floor of a famous hospital. At that time, patients waited in the hospital for nursing home beds to become available, a wait that could sometimes last a year or more. We had as a patient an elderly Spanish aristocrat I'll call Juan. Although Juan had been in the US for decades, a series of strokes had wiped out his command of the English language, along with most of his inhibitions and common sense. I'm pretty sure he was disoriented and confused, although without speaking Spanish it's difficult to know for sure. He had no family left, no friends, and no visitors. We the staff were his family. Sort of. Juan was a little weary of living in the hospital, and it seems his fondest desire was to escape. And he tried. Often and unsuccessfully. In the end, we put him in a geriatric chair -- a chair with little tiny wheels so we could move it about, a tall back and a big tray on the front of it so you could serve meals or place items for distraction on it. And we put that chair in the nurse's station so someone could watch Juan. Only thing is, it was a very busy unit -- most of the patients were confused, incontinent and on Lactulose -- so the nurses weren't there to watch him. They were with other patients. Juan learned how to scoot that geri chair backward down the hall using only his tippy toes. The brakes, if there were any, no longer worked. And away he'd go. I was there the night the nursing assistants decided to curb Juan's wandering by tying the geri chair to the sink in his room. I was passing meds down the hall when I heard the crash, followed by shouting, and I ran up the hall just in time to see water gushing from the hole in the wall where the sink USED to be. Juan was halfway out of the room, scooting backward in his chair with the chair still tied to the sink and the sink coming along for the ride. I didn't win any points with the nurse manager when I was laughing too hard to explain how the "accident" happened. It may have been my idea to tie Juan's geri chair to the handrail on the walls in the hallway. And for awhile, it worked. Everyone would stop and check on him when they passed him by in the hallway, and he thrived on the attention. This went on for a couple of weeks. But alas -- it was a new building and construction was shoddy. (Remember the sink?) It was late on a Monday night -- the night that the hooker habitually visited, claiming to be a relative, and for a small fee would take care of the needs of any long-term male patient who was interested and could afford her. Juan was sitting in the hall getting more and more agitated, but things were so busy no one stopped by to chat with him. We'd just check him quickly and move on. I was passing meds a couple of rooms away, back toward Juan when I heard the crash and the shouting and screaming. Juan had succeeded in getting away despite being tied to the hand rail. There he was, scooting down the hall with only his tippy toes . . . dragging the handrail and a large chunk of dry wall with him. And there inside the wall, revealed through the gaping hole in the wall, was the hooker servicing her customer. Oh my. I didn't win any more points with the nurse manager by starting to giggle every time the subject came up, and to laugh helplessly when trying to describe how (and why) it happened. The memo came down from above -- no more tying Juan to anything that was supposedly stationary. We'd just have to watch him more carefully from now on. And watch him we did -- for a long time, we watched him. I caught him trying to roll his geri chair onto the freight elevator, and someone else caught him on the GYN-oncology unit, shopping for a Spanish speaking companion. Juan's travels were permanently halted by a medical student from Man's Best Medical School. The MBMS student found Juan, securely Poseyed into his geri chair trying valiently to open the heavy fire door at the top of the stairs. Being a polite kind of guy, the student opened the fire door and held it for Juan so he could scoot the chair through the doorway. (Now why anyone would be stupid enough to do such a thing, I cannot imagine, and medical students -- even those from non-prestigious schools -- are supposed to be intelligent.) Juan scooted the chair backwards through the doorway, right to the head of the stairs and over the top step. Even I, at the nurse's station, could hear the "THUMP-THUMP-Thump-thumping" of the chair bumping down the series of steps. When I arrived at the top of the stairs, there was Juan, still strapped securely to the chair, lying on his back at the bottom of the stairs. The chair back protected his head, and Juan was shouting away in Spanish, seemingly unhurt and undaunted. But his back was broken. If you think any of the previous incident reports were difficult to write, this one was a nightmare! Several weeks later, Juan was back on our unit in a full body cast. But the fall had broken him. He could no longer propel his chair with his tippy toes, and a decub underneath the cast got infected. He got septic, coded and died. We staffed the unit with floats the day of his funeral and everybody went. I still remember Juan and his geri chair fondly, and so help me there are times when I'm trying to tell that story and I laugh so hard I can't finish. To survive in nursing, you have to laugh instead of cry.
  2. Ruby Vee

    Ask Me If I'm Safe At Home

    My husband and I shared the same PCP. After my first visit to the practice, no one ever asked me again whether I was safe at home. I wasn’t. But no one asked because everyone had met my husband, the handsome, charming life of the party. The guy that everyone liked. They all “knew” I was safe at home because he was “such a nice guy.” They knew him, you see. A nice guy like him couldn’t possibly be an abuser. They only met Dr. Jekyll. I lived with Mr. Hyde. I’ve written numerous articles on the website about domestic violence, about the ex-husband who strangled me into unconsciousness and left me on the highway with the clothes on my back and my dog. I’ve written about the elephant in the room, what leaving feels like, about starting over again and about the bravest thing I’ve ever done. I lived it; I’m resilient. Thirteen years after I left my abuser, I married again. THIS time I married a friend, someone I had known and worked with for nine years, dated for more than five years. THIS time I was sure I was going to be safe at home because he really loved me. THIS time I knew I had the right person. I had known him for years; I knew all there was to know about him. And we were happy, for a time. For years. And then I got sick and I needed him. Suddenly, he was not the center of attention at all times, because I had to focus on my health; on getting better. And my happy marriage and perfect husband were never the same again. I beat breast cancer, and a serious back injury. I had two joint replacements -- he dropped me off at the hospital for the surgery and had to be BEGGED to come and get me when I was discharged. He had a bad cold, you see. It was such an effort to come to the hospital to get me. I had a post op infection and a fever that registered as “HHH” on our cheap electronic thermometer. AT one point, he actually told me, “I know it must seem strange to you, me whining about my bad cold when you have a potentially lethal post op infection . . . But it’s a really. bad. cold.” After 48 hours of me peeing every 15 minutes, he finally deigned to take me to the doctor. After he took a nice, long nap. My best friend asked me if I was safe at home, and I assured her that I was. I had lived with abuse; I had survived it. I knew what it was like and this wasn’t it. My husband, the man I thought loved me more than anyone on earth except his daughter, only talked to me to nitpick. Or criticize. Or scream at me that I was fat and useless. I was pretty useless -- I’d just had a joint replaced, I had a fever and a CAUTI and was exhausted from trying to get down the stairs to the bathroom every fifteen minutes with my cane and my brand new artificial joint. Eventually, I recovered, but rather than stopping, the screaming and the criticism just escalated. Soon he was having tantrums three or four times a day. I was tiptoeing around him, trying to avoid setting him off and trying to please a man who could not BE pleased. He was always right, he was never wrong and if I dared to disagree with him -- or even failed to agree with him quickly enough -- there was punishment. One day he opened the kitchen cupboards and smashed all of my coffee mugs. There were shards of my coffee mug collection on the floor, in the sink and in the dog’s coat. Another time, he swept everything off the dining room table -- almost everything -- and sent it flying into the next room. Just my stuff, it seems. One time I came home from work to find that he had painted the closet doors, and “somehow” got white paint on every one of my jackets. It was an accident, it just happened. He didn’t mean to. But HIS jackets somehow escaped the carnage. That winter I was always cold because I didn’t have a winter coat. HE was warm enough -- and was I harping on THAT again? He SAID he was sorry that my coats “got paint on them.” It was an accident. Why couldn’t I just get over it? My old friend asked me if I was safe at home, and I assured her that I was. I had lived with domestic violence, I knew what REAL abuse was like, and this wasn’t it. There was no perfect Ruby-shaped dent in the drywall, no purple fingerprints on my neck. I was safe. There was a letter from the mortgage company telling us that we were going to have to find another lender as one of the conditions of our loan was keeping homeowner’s insurance. My husband admitted that he had let the homeowner’s insurance lapse because, and this is really special, he was angry at me. Somehow this became my problem and I had to scramble to get the house insured. He had so many single cars or at-fault accidents that the car insurance was cancelled. I got that reinstated as well, at an exorbitant cost. Then we took a 900-mile car trip to see his daughter graduate from college, and I drove because I was frightened of riding with him. I stopped to go to the bathroom and foolishly left the keys in the car -- he was sleeping. When I came back, he was behind the wheel and raging at me because I stopped to go to the bathroom too often. For the next three hours, he wove in and out of traffic, changing lanes and exceeding the speed limit by 30 mph or more, tailgating, cutting people off, screaming at me the whole time for being fat, ugly and useless. In a deluge, with standing water on the roads and people sliding off the road right and left trying to avoid him. I was terrified, clinging to the armrest and promising God that if I lived through this, I would leave him. When we got to our destination, he dropped me off at the hotel and took off in the car to “see friends.” If there had been an available hotel room or rental car, I would have left him that night. There wasn’t, and I didn’t. And then, in a domestic violence thread on AN, one of our members recommended Patrica Evans’ book about the verbally abusive relationship. And I realized that my happy marriage and perfect husband had deteriorated into a verbally abusive relationship. “It’s not that bad,” I told myself. “I’m strong. I can deal with this. It’s not as if he’s VIOLENT. I lived with that, but he isn’t like that. But maybe it’s time he got back on his Prozac.” In an extreme act of courage -- or perhaps idiocy is more the word -- I brought up the Prozac discussion with my husband, whose depression had always manifested as anger. Get the depression under control, and he’s easier to live with. That was the night he had such a tantrum that I left “walk the dog” and was afraid to go back. Instead, I sat on a park bench in the rain and called the National Domestic Violence Hotline. They asked me if I was safe at home. I thought I probably was -- after all, all he did was scream. And throw things. And smash things. And punch things. And drive recklessly and terrify me. “Abuse is about power and control,” they said. “Verbal abuse can escalate to physical abuse. They can kill you.” But we were on vacation on our boat, in a town too small to have a hotel or an Enterprise. I got back on the boat with him, and we cast off to go to the next town. My husband went to his PCP and asked for anti-depressants. He was referred to a psychiatrist. For Prozac? Or Zoloft? I wasn’t sure he needed that. Turns out I was wrong. He came home from the psychiatrist's office, a study in rage. “That guy doesn’t know a thing,” he raged. “I am NOT a narcissist.” He was kicking the punching bag (a safe enough thing for him to kick, I thought) and I went to “walk the dog.” Only I was too afraid to go back, so I sat on the bench cleverly placed at the school bus stop, and cried. A neighbor lady sat down next to me. I had nodded at her at the mailbox but had never talked to her, unlike my husband who frequently stopped to talk to her and her husband when they were outside. “He’s a narcissist,” she said. “Run.” Who was this woman to tell me my husband is a narcissist? She’s the clinical psychiatrist who lived a house over from us, and who could easily hear his rages through her open windows. She started the domestic violence program in our state -- and in another state. She’s an expert. She knows. “Are you REALLY safe at home?” She asked. “Really?” “No,” I had to admit. I wasn’t really safe at home. Just the other day, my new PCP asked me if I am safe at home, and I assured her that I was. I am, you see. I left my husband, the love of my life, with what I could carry and my dog. I rented a car and drove a thousand miles AWAY. I’m safe here. I’m living with a generous friend who lost her husband to cancer. I have my own bed now, and a bed for my dog. I bought a car last year, and this year the divorce is final. I don’t have much, but what I do have is MINE. I don’t have my house, or my lovely dishes or my leather sofa or any of the things that I once thought were so important. But I have me again, me without the soul-crushing load of abuse. I’m getting my sense of humor back. One day it will be my superpower again, but for now, my superpower is resilience. Really. I am finally safe at home. Ask your patient if she is safe at home. Even if her husband is handsome and charming; even if you KNOW him -- he works at your hospital, he's a good guy. Because perhaps you've only met Dr. Jekyll and she lives with Mr. Hyde.
  3. Ruby Vee

    Women's Right to Choose

    I haven't met any infants or young children who were capable of understanding the circumcision procedure or it's pros and cons. Or who were legally able to decide such things, much less able to sign.
  4. Ruby Vee

    Women's Right to Choose

    Those of us who are pro-choice probably feel that it is up to the parents to weigh the evidence and choose whether to circumcise their sons. It isn't up to me to make that decision for them. Nor is it up to them to decide whether or not I should have an abortion. I'm not pushing to have circumcision made illegal because it's none of my business. Just like my reproductive choices are none of yours.
  5. Ruby Vee

    What might be going on?

    I agree with JKL33 -- it isn't bullying. Unless, of course, there's a pattern of eye rolling but it doesn't seem as though that is the case. I find it disquieting that so many are prepared to jump on the bullying band wagon with scant evidence (she rolled her eyes once a year ago) and even less understanding about the nature of true bullying. True bullying is targeted, over time and it's meant to cause harm. Eye rolling, while not particularly professional, could be just a reaction by someone who is under stress confronted with a trivial request or complaint. Incivility, perhaps, or even rudeness. But not bullying. When someone claims that every interaction they don't like is bullying, that waters down the true bullying that a few -- very few -- of us have actually been subjected to. In fact, it seems as though the OP is being bullied . . . complaints solicited over time that have not been discussed with her until they are all leveled against her in one fell swoop along with threatening her job.
  6. Ruby Vee

    Ask Me If I'm Safe At Home

    Yup. I seem to have a knack for finding the most narcissistic, selfish and abusive man in the room . . . and then marrying him. Not my best quality.
  7. Ruby Vee

    Women's Right to Choose

    That supposes that those very same women want to be pregnant for nine months. That supposes that they want to go through labor, deliver an infant, and then give that infant to someone else to raise. That supposes they want swollen ankles and hemorrhoids and a swollen belly. That supposes they have enough extra energy to deal with the nausea, the fatigue, the back pain . . . and so forth. I'm always amazed how this always escapes the abortion conversation -- it should be the choice of the person who is pregnant whether or not she wants to be pregnant.
  8. Ruby Vee

    Women's Right to Choose

    The unborn child's rights do not trump the rights of the person upon whom it is a parasite. You can believe all you want in the rights of the unborn child, and your absolutely have a right to an opinion. You just don't have the right to inflict YOUR opinion on someone else's body.
  9. Ruby Vee

    Women's Right to Choose

    YAY! Suppose someone wanted you to donate a kidney. You're pro-life, so you're in favor of all life, right? There's a new procedure where you can grow a kidney for them in YOUR abdomen, and when it's fully grown, a simple abdominal surgery will remove the new kidney and implant it into the other person. Win/Win, right? Except there are some side effects. You'll be nauseated much of the time, have strong reactions to smells, be dizzy occasionally, get swollen ankles and fatigue easily. You can't drink alcohol or caffeine and strangers feel entitled to feel your belly at all times. Plus your abdomen will grow and grow. It's a small cost to pay to save someone's life, right? Everyone should do it. You should do it. Nevermind that you're training for a triathlon, and you have a good chance of winning, but this stupid kidney thing is slowing you down significantly. Nevermind that this kidney thing is forcing lifestyle changes upon you that you don't want. And you don't get paid for the kidney -- you get to pay for the privilege of growing it. And you don't have health insurance. Some people don't want to grow kidneys for other people. It's not up to you whether they do so or not.
  10. Ruby Vee

    What might be going on?

    They're trying to tell you that you're at the top of your pay scale and they're trying to trim the staffing budget. I hope you have a copy of that satisfactory yearly evaluation. If not, try to get one.
  11. Ruby Vee

    Women's Right to Choose

    My opinion on the topic is pretty simple. If you don't believe in abortion, don't have one. You do NOT get to make that choice for someone else. And if you don't have a uterus and therefore cannot be faced with the decision, please shut up about how horrible you believe it is to end a pregnancy. You don't get to choose because you aren't pregnant. Or likely to become so. When I was first sexually active, way back in the dinosaur days before Roe v. Wade, there was a saying going around that "If men could become pregnant, abortion would be a sacrament." If men don't believe in abortion, perhaps they should refrain from having sex with women with whom they don't wish to reproduce, use condoms and take responsibility for the offspring produced from the rare condom failure.
  12. Ruby Vee

    Ask Me If I'm Safe At Home

    The answer does matter -- so you're right, ask as if it matters and know how to respond if the answer is no. It isn't that difficult for a medical practice to have a list of domestic violence shelters in the area or the phone number for the National Domestic Violence Hotline. For the record, though, even the asking might make someone stop and think about her situation, even if she doesn't answer that she isn't safe, or even if she doesn't have the opportunity to give a truthful answer because the abuser is sitting right next to her. Every little bit helps.
  13. I've enjoyed the "Reasons Nurses Get Fired" thread. A member suggested another thread on why nurses don't get fired. So I'll bite . . . Nurse did not get fired for having sex with patient's husband while patient was on hospice, dying. Nurse is now openly dating patient's widower. Nurse did not get fired for dating frequent flyer patient, even after being on "Ice Road Truckers" or "Deadliest Catch" or one of those shows (I'll confess to not knowing the difference) with him. Nurse manager did not get fired for having a drawer full of boxes of Morphine 10 mg. tubexes. Hundreds of boxes of 10 tubexes each. Instead, staff was investigated by FBI and DEA (which really riled up the neighbors as I lived on a military base at the time, and everyone was worried that it was their security clearance under investigation.) Instead, nurse manager was "demoted" to nursing supervisor on days, and was forbidden from carrying the narcotics keys. Next?
  14. Ruby Vee

    How do you handle touchy/feely coworkers?

    You don't know if there's been a problem of complaints. Disciplinary matters are confidential. The "casual toucher" may have been asked several times to cease and desist. Casual touching may be grooming behavior . . . the toucher is grooming the touchee to ignore or disregard her boundaries paving the way for less casual touching. If someone wants not to be touched, has communicated that desire to the toucher and the toucher fails to cease and desist, that touching is no longer casual, but problematic.
  15. Ruby Vee

    What are the top 10 debatable nursing issues? And GO!

    Oh no -- I hope you're wearing your flame retardant suit. While it is OK to bash fat people and old people on this site, bashing millennials will get you in trouble!
  16. Ruby Vee

    Littman Plum tubing

    If you are truly that particular about purples, you should probably go see one in person. Personally, I think the more loud or obnoxious the color, the less likely your scope will grow legs and run away.
  17. Ruby Vee

    How do you handle touchy/feely coworkers?

    Exactly. The person doing the touching and feeling is the one who has the apologizing to do.
  18. Ruby Vee

    LTC vs Hospital for first-semester clinical

    I had my first clinical experience in LTC. It's pretty basic stuff, and most of the patients are thrilled to be assigned to a student -- someone to talk to -- as opposed to a hospital where folks are upset because they're sick/had surgery/are in the hospital. I learned how to give a bed bath from a really sweet older gentleman who had obviously taught students before, and I really appreciated it. The pace was slower which gave me more time to focus as opposed to in a hospital, where you have to get done now so the patient can go to surgery/radiology/transfer out.
  19. Ruby Vee

    Secretly breaking contract

    Snark is never attractive. The fact that some might disagree with you does not mean they cannot see another point of view. But your crack about honesty being in short supply -- and applying it to those who disagree with you -- is both below the belt and unattractive.
  20. Ruby Vee

    Being bullied at work

    I'm not living under a rock, and I've read the many threads on bullying. Most of them, however, are not about actual bullying. A new poster misinterprets plain old negative feedback as bullying. A new grad says her preceptor didn't invite her to eat lunch, and complains that "she wanted to eat with her friend from the other ICU," and calls that bullying. Oh, and the charge nurse never says "hello" first. (REALLY?) Someone cannot get along with anyone at her job -- or the previous four jobs since she graduated a year ago -- and conclude that clouds of mean people are following her around. That kind of stuff comes up all of the time here, and people jump on the thread and advise the OP that all older nurses are just mean bullies and she should quit. It kinda takes the meaning away from someone who has truly been bullied. And there are a few. I've caught myself snapping at someone a time or two, but that is not bullying. I probably snapped at more than a few folks when I was dealing with breast cancer (mine), my mother's Alzheimer's, my father's heart disease and my husband's mental health issues. Fortunately my colleagues cut me a lot of slack. Just as I stop and wonder (at least if I'm my best self, I do) what is going on with someone who approaches me in the hallway to unload on me. Did she just lose a patient in the OR? Not cool to take it out on your colleagues, but sometimes it happens. Is he going through a nasty divorce? Again, not cool, but sometimes you just cannot help snapping at the person who interrupts your phone call from your lawyer for the 5th time to ask a question that the unit secretary sitting right there and NOT doing anything could have answered better anyway. If you have negative interactions with someone, rather than jump on the bully bandwagon, stop and think -- is this typical of them? If so, is it only you, or is it everyone? If it's only you, is there a reason? I made a careless negative remark to someone I knew shared my opinion one time in the break room, and inadvertently offended a nurse sitting there who held the opposite opinion. Turns out she was my evaluator, and I got the worst review I've ever had. It wasn't a consistent and systematic attempt to control or break me, and it was my own danged fault. Not bullying. She didn't like me because I made that remark, which she disagreed with, and she thought I was making fun of her. (I wasn't -- wasn't even aware she was sitting there, and didn't know of her opinion anyway.) It was a long time before she'd accept my apology . . . but it wasn't bullying. There are a lot of posts and a lot of threads here about bullying, but most of them are nothing like bullying.
  21. Ruby Vee

    How do you handle touchy/feely coworkers?

    I like this!
  22. Ruby Vee

    New grad nurse needs help giving report

    Brain sheet! (And don't use a paper towel unless you're OK with sometimes using it to dry your hands. Ask me how I know this!) There are examples of brain sheets somewhere on this forum -- maybe someone here remembers where. Start with something that goes by systems -- when you've had some practice with that, you'll be able to put it into SBAR formula. And then ask your preceptor to spend a few minutes with you toward the end of shift to help you pick out the most important things to pass on. ER nurses don't care about the spouse's pudding choice, but if you ever transfer to ICU that does get passed on. Sadly.
  23. Ruby Vee

    New grad nurse needs help giving report

    The issue these days is that if you try to tell new people in a helpful, educational way, they often don't see it as helpful or educational. Then they run to management and complain that they're being bullied. People don't know how to take negative feedback . . . so they just conclude that any interaction that they don't like must be bullying. We see it on this forum all the time.
  24. Ruby Vee

    New Nurse..Lost a pt. I didn't know ID hurt so deeply

    I lost my first patient in my first clinical. He was in his 90s, a nice old man who was looking forward to dying and joining the rest of his family, some of whom died in the Holocaust. It was then that I realized that death is a part of life; we all die. It is much more difficult when the patient is younger and healthier. Did you get a chance to talk to any other members of the team after your patient died? Sometimes they can help you to put it into perspective. It's not too late to talk to the charge nurse or perhaps the providers to get their take on what happened. It is better and more helpful to ask them right away, while it is still fresh in everyone's mind, but whatever you can do. I've also found that journaling helps. I do mine on my computer now, but I used to use a really nice notebook. Set a timer for 20 minutes, or whatever you think you can manage, and then write until the timer goes off. If you don't know what to say, write that. "I don't know what to say. I don't know what to say." Before you know it, you will find yourself writing about things that are bothering you. It's a great way to process your feelings.
  25. Ruby Vee

    Reasons nurses get fired

    One could argue that the best friend had no business posting such a thing on social media, even with the patient's permission because either way, it LOOKS like a HIPAA violation. A friend of mine had her father (Alzheimer's) living with her. When he was discharged from the hospital after a major surgery, my friend's daughter picked him up and took him home. Discharge instructions were given to the patient, even though the Alzheimer's was noted on the chart. When my friend got home from work, she had no idea what meds her father was supposed to be getting -- the same ones as pre-op? Had they changed them? Dad had misplaced his written instructions and could not remember having been in the hospital in the first place. My friend called the doctor, but he didn't call back . . . is she accessed Dad's chart. And got fired. Even though Dad, before the Alzheimer's was so advanced that he couldn't make decisions, had appointed my friend as POA. There's a procedure for a POA to see the chart, and it doesn't include accessing the chart from home. My friend DID know better; she just didn't know they would actually fire her. Could be because she was at the top of the pay scale. . . .