The Cynical Nurse Speaks

**VivaLasViejas, ASN, RN**

Not to put too fine a point on things, but......sometimes, nursing really bites.

It bites when you've built a life and a reputation on what you can do with a stethoscope and a nose for the subtlest signs of trouble, and some corporate pooh-bah tells you that your job is on the line---not because you're doing a lousy job caring for your patients, but because you haven't completed enough forms on them to make the Sierra Club call for your head on a recycled glass platter.

It also bites when you have no control over patients' family members.....like the phlebotomist who thinks she's an RN and will loudly declare to the entire floor that you're the worst nurse on the planet and she's having her Auntie moved RIGHT NOW. You know how a lot of nurses take medication for depression or anxiety? I take medication to keep me from slapping stupid people and blaming it on the side effects.

Speaking of depression and anxiety: I wish someone would do a definitive study on how many nurses do take meds for these stress-related conditions. I'd bet a month's salary that a very large minority of nurses have at least a half-empty bottle of Xanax in their medicine cabinets, which, by the way, is actually not a good place to store meds. (The shelf above the refrigerator is where most of mine live...well, except for the metformin, which I forget to take at dinner if it's not on the dining-room table.)

Then there are the silly, amusing, and downright hilarious things that happen in nursing that make it worth NOT drop-kicking the idiots through the goalposts of life (and losing your license in the bargain). Have you ever seen a nurse or aide who can't be bothered to bend over and pick up a used Band-aid off the floor, yet can perform a perfect head-first dive behind the med refrigerator to find the pack of cigarettes she dropped behind it? And you've got to love working the postpartum floor and trying diplomatically to convince a 19-year-old primip to name her new daughter something less apt than "Meadowlark Sunshine" to induce hatred in that same child in the future......like within five minutes of starting first grade.

You also have to hand it to the average nurse manager, whose title tends to reflect her/his distance from the bedside. They just don't get enough credit for their contributions to our profession. Yes, I'm a nursing director myself, and no, I haven't worked a floor shift in over two years; but when you get to the upper echelons, the titles grow more pompous......and the cluelessness is increased exponentially.

Take the person above me on the food chain: she is known as the Regional Director of Clinical Operations. She's a good egg, though, and I'd never talk smack about her, whether here or anywhere else. But if you go above her, you run into the Vice President of Clinical Operations, then the grand-nurse of them all, the National Director of Clinical Operations and Health Services. I've never even met the National Director of Clinical Operations and Health Services. For that matter, I don't really know for sure that she exists. But I'm not taking any chances.

Just a few odd musings on a wet, windy night somewhere in the Pacific Northwest. Which reminds me: have you ever driven to work in the rain........while drinking coffee.....forgetting that you just took 80 mg of Lasix......and then stepped into a puddle upon disembarking? Me neither. Until today. Thank Heaven for the change of clothes I keep in the trunk "just in case".......

amygarside · Oct 25, 2012

Thank you for this story. It gives you a balance view of what nursing is really about.

kmcguirern · Oct 25, 2012

I love the way you tell it like it is. One would be very lucky to have a nurse manager such as you! :)

tnmarie · Oct 25, 2012

Great article (just the right blend of truth, cynicism, and humor) and a good piece for those who think nursing is all rainbows and unicorns. I always carry spare scrubs in the trunk for if a get puked, peed, ect on. Luckily none of the fluids have been self inflicted (but I am still relatively young...I figure it is coming XD). My sister did what I call "the puke and pee" nearly every day while in nursing school because it was so stressful.

I too wish they would do a study about how medicated nurses are. I will tell you 100% of the nurses I saw as patients while doing clinical in MD offices were on anti-anxiety and/or antidepressant meds (though I think I only saw a hand full of nurses). My mom has been on Xanax for years (she is now retired) and my sis is actually going to the MD for anti-anxiety meds soon as well (this is because the nurses she works with have gently suggested she gets some nerve pills, lol).

PS. My sis works in LTC and the nurses there now have to do all the vital signs because they had the audacity to complain that their aids weren't getting the vital signs in a timely manner. Then they wonder why the aids never take the nurses seriously XD. That and feeling chained to a med cart are why I try to avoid LTC even though geriatrics is my thing.

Cheers!

OnlybyHisgraceRN, ASN, RN · Oct 25, 2012

Great article! Yes, I'm one of the nurses that have prescriptions for ativan and lexapro.... Its a shame what I allow nursing to do to me.

Steemart · Oct 25, 2012

Wow, you nailed it right on the head sister! I found your comment regarding medicating our nurses good timing for me. I am an injured RN of ten years and have been going through another "flare" up with my back injury. I am currently being treated by a work comp physician who was sixteen years old in high school and working on getting his drivers license when I was his current age of 33 y.o. This physician is one year out on practicing his field and is supposed to be a pain and rehab specialist. In our first meeting he brought up the "depression" card almost immediately and that I just needed to get "back to work", and at that the second meeting he asked if everything was "o.k." at home, meaning is my marriage stable. Needless to say, I directed my care by suggesting to him the often missed diagnosis for another area of my back that could be the current problem. I was able to have my epidural approved by the work comp insurance and the results proved my case and gave validation as the current source of my pain problem. So, in closing I say keep your drugs in check nurses or the next thing they will say is that the pain medication they prescribed you has become a "dependency" issue or that the only way you can be a functioning nurse is to be on anti-depressants or anti-anxiety meds.

NurseDirtyBird · Oct 25, 2012

The only reason my bottle of Vitamin A is full is because I recently got a refill.

FranEMTnurse, CNA, LPN, EMT-I · Oct 25, 2012

Once again, you have done an expert job in describing what real nursing is all about. Thank you for your humorous but very factual article. I was entertained.

echoRNC711, BSN · Oct 25, 2012

I loved your post (probably a little more than I should.)I have been advocating for yrs that in the interest of stress reduction management should support nurse by allowing us to use 3 explotives a week directly to those "special pts "Now,(caution ) don't be tempted to use them up on your first day because I assure you later in the week you will regret it. So wait it out, because a worthier pt is coming your way if you can just contain your zeal.

Alternatively we could have a "truth " day where like Dr Phil suggests we "tell it like it is "

"No, Mr X, I didn't forget to make rounds in your room .Your suspicion is correct I just don't like you" or

Mr X I placed a sign onyour door "THE most important patient " that way we can save yourself the 10 minute rumination and use your energy to get well."

Pills,alcohol, no thanks. Me, I own my psychosis proudly and also focus on QUALITY care. Experience has taught me to LISTEN and give pt what they need. Your patients will LOVE you for it and pt surveys will reflect your attentiveness .So how do you do that?.... Easy. Here's how.

To the family member who asks will their dad, who was wheeled out of open heart surgery 1 hr ago, "be discharged today? " "Oh Yes, but its a little nippy out did you bring in his jacket?"

To the post op day post CABG pt who I am assisting out of bed "Yes, Mr X I know my boob just pumped into you as I was "carrying " your 300lb body out of the bed and Yes, you are absolutely right.I WANT you! Let me just skoot the foley out of the way so I can gain better access "

To the woman who asks can her vented mom get a shower. "Absolutely, I have already measured the shower stall so I know the vent will fit "

To the demented pt whose daughter says her mom said I took her sweater. "Yes,your right, I DID steal your mother's sweater. The crusted sputum and food particles on it brings out the color of my eyes so beautifully ".

To the pt daughter who reports that her comatose mother with no brain stem activity reports her mother smiling. " Yes, sure.She is such a joker. We all love having her here."

To the pt who "knows" 3 shots of morphine is "not enough" ''You know,you are right. Your chest IS still moving so you could probably take a little more."

To management 'Thanks for noticing that my cubicle was short on tissues.Your one hell of a team player.When I'm done with this pt hemorrhage I will attend to his wet nose that you attentively noticed ".

To the supervisor who is sending me another admission "Thanks for helping me reached my goal weight in 1 single shift."

To the diabetic pt who just polished off 1/2 a box of chocolate and is sporting a 300 + sugar "Not to worry Mr. X that's what they made Insulin for.Would you mind if I have one of your chocolates? I guess everyone loves a little sugar. Me too!! "

So yeah, I'm happy. What's wrong with you people,.....Well clearly the only thing we are missing is the "right" kind of attitude!!

**VivaLasViejas, ASN, RN** · Oct 25, 2012

BWAAAHAHAHAHAHA!!! I love your sense of humor, echo! :roflmao:

echoRNC711, BSN · Oct 25, 2012

Well its laugh or go mad VivaLasViejas.

I'm an over achiever so I choose both! :yes:

**VivaLasViejas, ASN, RN** · Oct 25, 2012

I'm with you on that one, echo......also got a kick out of your line about owning your psychosis :roflmao: Things were so bad one day last week that when swing shift was coming in, I threw my arms out in front of them and invited them to "join the IN-SA-NI-TAAAAAAAAAAAY!!" They all looked at me as if I'd suddenly sprouted three heads.....and I didn't even miss a beat. I guess I own my psychosis too.

The Cynical Nurse Speaks

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