traumatizedRN

jsevilla950: If you don't have a little bit of "sick humor" in our field, you are going to have a hard time working anywhere. Yes this joke sounds like a stereotype, but so are the "blonde", "redneck" or "republicans" ones. The point is to lighten up, if we can't make fun of ourselves, then we might as well live our lives on top of a morality box inside a glass room. These jokes are not meant to humiliate anyone or devalue their achievements. I have been on both sides of this topic, as all nurses, and if I didn't laugh at myself, I would have died of stress by now.

I had to see it to believe it and yes it is true, you can vomit feces. I had a patient who told me "now I truly know what it to have shi@# breath". Hope to God I never have a bowel obstruction and I never have the feeling of an NG tube going down my throat. I just had a psych pt in 4 point hard restraints who had threatened to kill herself by pulling her femoral Cordis. I had to assist her with a bedpan and I swear she lost a few pounds after her BM; needless to say there were feces all over the bed including her Cordis (which thankfully I had just reinforced with a couple of tegaderms). She kept on smiling the whole time I spent cleaning her, trying my best not to vomit.

I've been living this problem for several years. I work in a monitored trauma unit during the night (currently 5 beds). Several times a week, I am by myself (no NA or clerk) due to the shortage in staffing. All of the patients require vitals Q hour X 4, then Q 2; they are in full spinal precautions, serial labs Q 4, strict I+O, wound cleaning, etc. I do my best to complete all my work prior to change of shift, but most of the time is overwhelming. My manager comes from working in an outpatient diabetic clinic and has never worked the floor with us. Yet, she lectures me about not changing the linen bags, having any supplies in the unit at all (everything is supposed to be locked in the unit next door, including the Pyxis), having a cup of water in the nurse's station, etc. She's the best monday morning quarterback I've ever met. She goes out of her way to find anything that is not of her liking to counsel some of the staff, not really caring about our side of the story whenever any situation arises. Not once can I think of her giving most of us any positive reinforcement (unless you belong to her little click of nurses who are middle age afro american women). I haven't left yet, because I love what I do and work alongside some great nurses and doctors; but her level of professionalism and approach is truly a shame.

You still get both disgusted and amazed with the low pain tolerance that almost all "bad a#$&" gang members have. I wished we could video taped the way they cry and moan and send it to their homies. It is so pathetic and predictable. Along the same line, I find it so funny to see how many guys show up with a broken hand after fighting with their wives/girlfriends and punching a wall. It may look cool and dramatic on TV, but I wonder how many seconds go by until they realize that it was a stupid thing to do.

The second story happened last year. I witnessed a car accident and stopped to help those involved. I called 911 first, and then as I got out of my car, a woman came running behind of me saying very loud that she was a "nurse" and wanted to help. I told her that I was also a nurse and instructed her to help the occupants of one of the cars while I did the same with the others. I have worked trauma for 8 years, but I have never encounter this situation before. I told them not to move or try to get out of the car until professional help arrived; thankfully none of them had any life-threatening injuries. Then I looked at the other car where "supernurse" was, and I saw the driver leaning sideways attempting to reach his glove compartment. I walked there to see why he was doing so and wondering why she was writing something on a piece of paper. When I got there, she proudly presented me with that piece of paper where she had written down their names, DOB, addresses and their private insurance info. When I asked her why she had done that, she replied that she was a medical assistant, but since she had only worked in the front office of a clinic as a receptionist, she figured that the insurance information was vital so the paramedics would know to take the victims to their assigned hospitals. I almost slapped her for making the driver lean sideways to look for his wallet ignoring spinal precautions. The moment she figured out her stupidity, she ran back to her car (which had a stethoscope hanging from the rear view mirror) drove away. I told the police and paramedics about it, but I wasn't able to get her license plate.

I have two funny stories about this topic. A few years ago, I was admitting a patient in her early 20's for a perforated appendicitis. As I was doing the pre-op orders, she asked me if I liked working in a hospital because she was a "nurse" in a medical clinic. I told her several reasons why I liked working in my unit (I work in a level 1 trauma center and at the time, our unit was divided into 6 trauma and 6 surgical beds). When I asked her about her duties in that clinic, I realized that she was a medical assistant. She proceeded to tell me that the one and only difference between RNs and MAs was that the MAs were not allowed to start IVs. I told her that if that was the only difference, then she should be able to explain to me the line of treatment for a perf appy including its anatomical landmarks and surrounding organs, the type of meds used and their possible side effects, fluid resuscitation and types of fluids, nursing interventions and plan of care, etc. Needless to say, she stood quiet for some time until she said "I thought the RNs just did what the doctors told them to do". I told her that if that was the case, why would we have to go to college for 4 years + to obtain our degree. I didn't said that to humiliate her, but to inform herself before coming to those conclusions.

I have worked in the private sector all of my life prior to working for a County facility, and I would get fired if I ever did half of what a lot of my co-workers get away with. Sadly, the ones that abuse the system are the ones that have been there for a long time and know a lot of supervisors who let them get away with it. On top of it, they always say that they will call their union representative to complain about not getting their breaks. Guess what, some of those representatives tend to behave the same way and management doesn't want to get involved with it. I took pictures of some NAs sleeping to show it as proof, instead I was reprimanded for "violating their rights".

I haven't had a regular CNA in my unit for a long time, so I usually get one that is floated to us. A lot of times, I've had CNAs that fall asleep during the shift and when they wake up is just to tell me that they are going to break/lunch. Our shift is exactly 8 hrs (2300 to 0700) so there is no lunch time, just two 15 min breaks; however, it is so funny to hear them say that they get one in other units (sometimes they even tell me that is a 60 min lunch + two 15 min breaks). The best way that I have solved this issue is by telling them at the beginning of the shift that the moment any RN sees them with their eyes closed, I'll write the time next to them and it will automatically count as their break. If you say that loud in front of the other nurses, the NAs will not have any excuses. It's worked most of the time for me.

The good thing about federal loans is the low APR and the length of time to repay them. My identity was stolen when I started my program, so I only qualified for 40%. I had to work full time to pay for the rest, which left me broke X 3 yrs. I attended a private school and each unit was more than $400 and the price rose steadily each year. The great thing about it is that by the time I graduated, 60% of tuition was already paid, and now I only pay $200 per month (X 10 yrs) which is almost nothing compared to how my income increased once I graduated. It may sound silly but stressing about the money right now should be your last concern; try to think of it as a monthly expense like rent or utilities.

When I got accepted in my nursing program 10 yrs ago, I found out that my identity had been stolen and I only qualified for partial loans that covered less than 40% of my tuition. I had to move out of my apartment and stayed in my mother's living room, I sold most of my furniture and had to work full time to be able to cover the rest of my tuition and expenses. Most of the time I had less than $20 in my pocket, and my friends stop inviting me to go out with them because I was always tired and broke. I attended the program at night and did my clinicals on the weekends (12 hrs shifts each day); I'm glad I was able to study a little when I was at work, but did the majority of my work after school (usually after 2200). It was hard, but my classmates provided a lot of support and got me through it. I do not regret one bit that experience, it built my character and formed some great friendships. Don't feel overwhelmed, take it one semester at a time, and I assure you that you will make it all the way. One day in the future, you will be so proud when you get your degree and look back at your accomplishment.

I've worked in trauma for the last 8 years, so I like to think that I'm cool under pressure; however, a few years ago, one of my patients went into respiratory arrest and my NA managed to tilt the crash cart, kicking and spilling a urinal at the same time, contaminating the unit. I freaked out when I saw what he did, as he managed to make a very complex obstacle course between me, my patient, and the rest of my help. I ended up giving mouth to mouth resucitation for a minute until the proper equipment was handed to me. I realized what that meant to me and the patient in regards of potential health problems, but if I were to be on his position, I would expect my nurse to do whatever is necessary to keep me alive. I don't regret what I did, it seemed an acceptable choice in this situation. However, it doesn't mean that I'll do it again. So be supportive, I'd hate to work with someone that would rather just stand there instead of acting.

I understand that everyone has the right to state their opinions, however (with all due respect) if you are a nursing student or a new grad with only a couple of months experience, spare us from your insights about our"sick and cruel" sense of humor and how you are so full of love and compassion for all patients. I dare you to tell me the same after you take care of the 100th drunk driver who ran over and killed innocent pedestrians, or the IVDA with HIV that spat and threw urine at you because the MD refused to prescribe IV Dilaudid, or the baby full of cigarette burns caused by his daddy because "he wouldn't stop crying when the game was on". And for the "experienced" nurses that are offended by our venting, stop acting like if you were angels walking the earth. You know you have felt the same type of frustration with the system, and at one point in your career you wanted to express your feeling to these type of patients/relatives. ER nurses deal with this shift after shift, feeling both physically and mentally abused, going home with their scrubs full of vomit, blood, urine and feces. What is our reward? if we are lucky, 1 out of 40 patients will say thank you. We are not burned out, we are only using humor as a coping mechanism. As a matter of fact, we love what we do. We help total strangers at their worst time of their lives. We don't need anyone's appreciation or recognition, but do not attempt to patronize us.