Clementia

About a week ago, someone started a thread to discuss the Brittany Maynard assisted suicide case. The discussion became rather heated, and one of the posters tossed out a comment that disturbed me greatly. This poster suggested that patients with depression should be allowed assisted suicide, because, after all, "depression is terminal" -- meaning, I suppose, that it isn't a condition that can be cured. I didn't want to derail the thread, but I can't let a comment like that pass by unanswered. I would like to know if this poster has any personal experience with depression. I would be willing to bet that he/she has no clue about what depression is really like. I have depression. My mother has severe depression. It runs in my family, and two of my siblings suffer from it as well. We know depression from the inside. It's horribly easy to toss off some flippant comment about depressives being allowed to kill themselves. Depression plays tricks with your mind. There have been times in my life when I really wanted the pain to stop -- even if that meant death. Then the blackness passed, and I was happy to be alive and incredibly grateful I hadn't put a gun in my mouth. Depression may not go away, like a broken leg, but it is NOT terminal. Terminal is cancer, heart failure -- any condition that kills you whether you want to die or not. Depression only kills you if you let it. The last thing depressives like me need to hear is that it's OK to kill yourself if you have a diagnosis of depression. We struggle with suicidal ideation anyway. We don't need encouragement to end it all -- at our blackest points our own brains give us all the suicidal arguments we need. We need someone to encourage us to keep slogging on, someone to tell us that no matter how bad things feel right now, eventually our feelings will change and the world will be bright again. We need a hand to help pull us up out of the pit. To the person that posted that comment, you know who you are -- don't make ignorant, insensitive remarks about someone else's struggle. You don't know what it's like.

I don't care whether Heidi is too inexperienced to know better, too in love to see the probable consequences, or too self-absorbed to care about any consequences. I don't particularly care about any mitigating circumstances in the MD's life, either. Sleeping with a married man is a trashy thing to do; being married and sleeping with another woman is equally trashy. I never thought I'd actually witness people having a serious, drawn-out discussion on whether or not adultery is OK. That's like discussing whether or not it's OK to set fire to your house.

Just to clarify -- I don't believe anyone in a domestic violence situation "deserves" to be harmed, much less "wants" it in some twisted way. I'm just trying to understand the situation, as much as possible, from the insider's point of view.

Some time ago, the topic of spousal abuse came up on this site. A member told us the story of her abusive marriage. When she was eighteen, she met an older man who told her that he had abused other women in the past, but things would be different with her. She married him, and eventually left him because of his abusive behavior. Here's what I don't understand. He told her he had a history of abuse -- that's like a big red flashing sign: "I will end up abusing you, too". Yet she still married him. Why would a woman do that? Please do not reply to this thread by telling me what a hard, cold, unfeeling person I am. I do not want to minimize the difficulties this woman has gone through. I know that it's always easy to condemn someone else when you don't know the whole story. If I had faced the challenges this woman has faced, I might have made the same choice to marry the guy. I'm not trying to look down on anyone. I just don't understand how you could marry a man who basically told you right out that he would beat you -- and then stay with him through years of brutal treatment. Please help me walk in someone else's shoes.

Chevrolet -- Can Hear Every Rod, Valve, Or Lifter Every Time.

My grandmother graduated nursing school in 1947. She used to tell stories of a polio epidemic that hit sometime in the '50's. The hospital where she worked was so full of children in iron lungs that even the hallways were lined with patients...So glad we don't see that so much any more.

Yes! There is a conspiracy! Didn't anyone tell you? We all meet at midnight in the secret war room in the hospital basement... Seriously, though, I hear you. It's terribly frustrating when you work so hard to help patients, using treatments that you know work, only to have everything you do dismissed out of hand by some ignoramus.

I admit that the obese are not my favorite patients. I'm not going to label someone as "bad" or "irresponsible" or "lazy" because they happen to weigh 350 pounds. But when you work on an ortho floor, as I did, then a 350-lb patient who's just had joint surgery means a lot of heavy lifting for the nurses. And no, you cannot always round up 4 or 5 more people to help with a lift or turn, change dressings on ulcers, or clean up C.diff for the fifth time. I worked nights on a 24-bed unit. There were weekend nights when we only had 3 or 4 staff on the floor. The floor beneath us couldn't spare anyone either. When two or three call lights are going off and the larger patient needs something, you end up turning him yourself because there just aren't any other staff members around to help you. This is why I never liked dealing with morbidly obese patients -- because of the high risk of doing a permanent injury to my back.

It sounds to me like the OP is simply frustrated with patients who are rude and demanding, and who don't choose to realize that one nurse cannot give meds to fifteen or twenty people at the exact same time. Admonitions to "put yourself in the patient's shoes" seem a little unnecessary, especially since we've all pulled our hair out at one time or another over patients who get on our last nerve. I was an ortho/surg nurse for seven years, and I'm pretty familiar with the common narcotics. Even after major hip surgery, narcotics were never scheduled, always PRN. I agree that a nurse can't really fight a patient's addiction -- that's the patient's issue to deal with -- but I know how demeaning it is to feel that all you are doing is feeding someone's narc habit. There are better ways to deal with chronic pain than to rely on q 4 hour narcotics.

I think the units I've worked on wouldn't have a problem with someone who was transitioning, as long as that person did a good job as a nurse or aide. Myself, I admit I would find the whole situation unusual (but then I'm from a small-town Midwestern background where pretty much everyone was white, straight, and Catholic or Lutheran.) Personally I judge other nurses by how good they are at what they do, not by their sexuality or choice of lifestyles. I think the advice to keep drama out of the workplace is worth taking. Not that you shouldn't talk about your life or what you did over the weekend -- it's just that drama and work do not mix. (And I would say the same thing to anyone going through a big messy life situation, whether that be transitioning, divorce, nervous breakdown, etc. etc. So it's not just your particular situation I'm talking about.) Of course I don't know you, but judging by the tone of your posts, you sound like someone I would enjoy working with. Best of luck to you!

I never address anyone as "honey" -- or as "ma'am" or "sir" if I can help it. I just look directly at the person and say something like, "Hello, what can I do for you?" It's respectful, doesn't step on anyone's toes, and keeps me from having to remember everyone's names. It does drive me batty when people address patients as "hon", especially elderly patients. It just seems so disrespectful to use that name to someone old enough to be your mother, or grandmother.

How do you boil water in a styrofoam cup (without a microwave)? You get a fire going, then push aside some of the burning wood so you have a clear spot next to the fire. Fill the Styrofoam cup almost to the brim with water, then set it in the clear spot you've created. The water in the cup will keep the Styrofoam from burning (although the rim above the water will melt) and when the water is hot you just coax the cup out of the fire with tongs or a cunningly handled stick, and drop in your tea bag.

I believe in special creation. That said, it would be nice to see how origins relate to nursing in the first place. Whether you believe that you were created by God, evolved from a soup of sterile chemicals, or emerged from sea ice under the licking tongue of a giant cow, what bearing does your belief have on how you do patient care?

Hmmm... Big plastic garbage bags (emergency ponchos/shelter/storage, etc.) Isolation gowns, to keep me warm and shield me from spattering blood and gore. Masks to filter out the toxins floating in the tainted air. Blankets. Bottles of irrigation solution-- sterile water and saline. (Sealed bottles -- they'll stay clean until I need them for drinking water.) IV tubing. (Tie things down, stake things out.) Styrofoam cups. (You can boil water in these, if you know what you're doing.) Scissors/scalpels, the larger the better. (Never, never travel without a knife.) Rubber gloves. (Emergency water carriers.) Basic meds from Pyxis. (Tylenol, antibiotics, narcs to trade for food.) Bandages and basic first aid supplies, of course. Toothbrush, comb, basic toiletries. Extra socks. Packaged and canned food from the patient kitchenette. Playing cards, to take my mind off the grim realities of survival. Phone book from a patient nightstand. (Tinder.) Glass disc from the face of the manual sphygmomanometer. (I'll use it as a burning glass to start a fire with.) Hand sanitizer. (For sanitizing. Also, alcohol burns hot.) Needles, roll bandages, and sterile clear dressings to use as fasteners. A weapon might pose a problem. If I'm going to get creative, perhaps I'll rig up a blow gun from drinking straws and shoot needles into my enemies' eyes. If I'm going to be predictable yet effective, I'll steal a crutch from the supply room and use it as a club. Actually, an even better club would be a length of traction bar from one of the orthopedic beds. This is fun! Can I take along an annoying family member/visitor to use as zombie bait?

The fact that you were told "no one else would hire you" and that you were a "bad nurse" pegs that place as abusive just by itself, without even having to consider all the appallingly unsafe practices you describe. I find it disturbing that a superior would say such things to you. I know that in today's economy, we sometimes have to take whatever job is available...but no one should have to put up with such a toxic work environment. I am glad to hear you're out of there, and I wish you all the best in finding a place that's safe and that will appreciate your skills and experience.

So you're a student nurse about to give your very first Lovenox shot. You sashay into the patient's room and, while casually making small talk with them, lift their shirt and jam in the injection. Patient gives you a relieved smile -- "Why, that didn't hurt at all!" You glance down at the syringe in your hand and realize you never uncapped the needle.

My favorite was the little old man with dementia who kept calling me into his room on night shift. He was absolutely convinced that there were bad guys roaming the halls, just waiting to catch us nurses and murder us brutally. I finally told him that the cops were on the way and that we all had safe places to hide, and he calmed down and went to sleep. It was really touching that he was so worried about us.

My husband and I had been having a run of car trouble. When one car wasn't in the shop, the other one was. On top of all that, we were short of cash because I was staying home with a brand new baby. A friend of ours walked up to me one night at church and said, "Um...do you want a car?" They gave us a big used vehicle in great condition. We figured it had to be worth over a thousand dollars, and they just gave it to us. It was the one time in my life when I was so surprised I felt dizzy and had to sit down.

I'm a Christian, and I think you were right not to participate. No one should be pressured into a religious ceremony they don't want to be part of. And look at it this way -- if the family requests another nurse, it doesn't mean you're a bad nurse, it just means you don't have to deal with their intrusive ways again. Everybody wins!

I left because when depression meets burnout, the result is not a pretty sight. I was blessed with funny, helpful, positive, supportive co-workers, decent hours and pay, and nurse managers who kept close tabs on all of us and weren't above pitching in when we needed help. It was the nursing itself that got to me -- the 15% of patients who are whiny/needy/demanding/difficult/unable to listen to a thing you say. I just felt that I was required to give and give and give, and eventually I ran out of inner resources to draw from. If I ever have to go back to nursing, I'll find a job where I don't have to deal directly with any patients, ever.

Upon entering any public building, one of your first actions is to look for the AED. You assess elderly passersby in Walmart. "Hmmm...uneven gait, favoring left leg...looks like bone-on-bone DJD to me...I'll see you on my unit after your hip replacement, ma'am/sir."

By the way, a sincere "I am very sorry to bother you, doctor, but..." goes a long way too.

Always call, no matter whether the doc is "nice" or not (by the way, sometimes the tetchiest docs are also the best surgeons). But only call for truly important issues, and always make sure you have all the pertinent information ready to hand. At my hospital we were lucky -- we had hospitalists we could text-page, and a very good NP who made rounds at night. It was relatively seldom that we had to wake up the surgeons. Besides, for some reason I have a soft voice that sounds very young and frightened on the phone. Maybe that's why I never got yelled at, even when calling docs who had a nasty reputation. I guess I just sounded too scared to be hollered at!

Call off if you're still sick, and don't feel guilty about it. You can't give your patients the best care if you are ill yourself. Besides, what if you pass your illness on to your patients? If the manager gives you grief, perhaps a doctor's note might help. Feel better!

The glassy-eyed smile of relief as you walk past their station. Coupled with the overly-cheerful, "Hiii, Clementia...boy am I glad to see you." "They're on contact precautions and there's a bucket of Go-Lytely by the bedside..." "I called for three units of blood and it's not here yet." "Tonight you're starting with six patients!" (It's still a PM shift -- I get to work at 7 pm -- and I usually have no more than 5.)