Wednesday, April 13, 2022

Cliques, Classics, and Clunkers

Oldest working RN. 94 years old.
Her last name isn't Nightingale.
But no way in hell I'll be working to that age,
 if I even live that long. Not even if I could.

When I started this gig, back in the late Pliestocene, the nurses TPTB put in the trauma area were all pretty good at their jobs, but with most of them, there was a definite Mean Girls/"Our poop doesn't stink" vibe going on. I was never going to be in The Club, and they let me know it right away, which was part of why I left there after a couple of years. Loved the training, and most of the staff, but I wasn't as impressed with them as they were with themselves, and I could recognize a toxic work environment when I saw it.

It took doing five years of registry, and realizing I was good enough that hospital after hospital asked me to hire in after about two shifts to know deep in my bones that I knew my sh*t, was a badass nurse, and that I really like doing my job. I probably always knew it inside, but that made me realize it out loud, I suppose.

So now, at Last Stop hospital, after several years, I'm finally getting shoved face-first into trauma again. I've been helping out all along, which is what pissed off the Mean Girls Club here from the get-go, and a couple of them still try to power trip, and shoo me away because they think they've got more experience at this. At this phase of my career, it makes me laugh, mainly because inside I'm thinking, "Look, Cupcake, I was doing trauma and kicking ass at it five presidents ago, when you were literally in diapers, and I nailed it then, so you can take your condescension and shove it right up your tailpipe."

Can't say it to their faces, more's the pity, but just like everywhere, time weeds them out, and I'm still around. After only a few years here, I can count the number of people with more time on the shift than me on my thumbs, because the youngling fools always think "the grass is greener", and off they go, face first into the brick wall of Reality.

The unspoken truth that people who last in this profession realize is that everyplace is better, and everyplace sucks harder, than your current job. The key is finding the place that's good enough at what matters, and where the things that suck are things you can tolerate, while still functioning. Some places, that slice of the pie is so huge no one should stay. Others may be not much at all, and someplace, there's a good fit for you. For as long as it lasts.

Because when you find a great place, hospital manglement will inevitably find a way to screw the pooch until it sucks there more than you can handle, or should tolerate. That's when it's time to go. Not a better rate, or massage chairs in the break room, or 27 other dippy reasons for leaving. And the best reason for leaving is that leaving has nothing to do with work at all, but rather with life, family, and important things, realizing that this is a portable job you can do anywhere on the planet, and family and life priorities always come before work.

Nobody on their death bed ever said "If only I'd spent more time at work...".

When I was new, all I worried about was doing things right. At this phase, I'm starting to consider the day when I won't be able to do things right. You want to go out on top of your game, not fighting gravity and the inexorable march of time, so you can leave when you want to, and not because you have to. I'm nowhere close to the latter, but every trauma now reminds me that there but for the grace of God...

That never crossed my mind thirty years ago, but it does now sometimes, and it's pissing me off. 52 is the median age of RNs, and 58 is the average retirement age. And I expect to be doing this way over to the right edge of that bell curve, unless some idiot at the Powerball gets the right numbers for me to leave skidmarks in the parking lot. But I can see the last punchout at the timeclock getting closer each passing year.

Wednesday, February 16, 2022

Basic Nursing Text: Gastropathology, 1st Semester


In other news, axed two more dead blogs from the list.
Probably passed away months ago, since I barely dust the cobwebs off here my ownself.
Nearly everyone in this biz is either too tired, too busy, or too hesitant to talk about it online.

And that's really sad.

At this rate, before I retire, I'll be the best ER nursing blog online.
And about the only one.
Which is how I'll win.
Except that still won't happen, because they're looking for "rah-rah go team! NANDA is spectacular! We ♥ Annual Surveys!" happygas, and I'm severely allergic to that bullsh*t.

But that reminds me, I've gotta knock out my...14th...? ACLS re-cert this month.
O joy.

Tuesday, February 1, 2022

110 Hours Of Training


I loves me the kids that work for the local ambulance companies, most trying to become firefighter/paramedics, doctors, nurses, physician assistants, etc., but no matter what the Department of Transportation says, sometimes the brevity of their medical training leaves some rather largish gaps in knowledge and competence.

Case in point:

The other night, Local Ambo Co. crew brings in Mrs. Older Than Dirt from the local convalescent warehouse, for intractable pain.

Medic: "She's having intractable pain from an L-12 fracture."

ER Doc: *blinks*

ER nurse: "L-12?? Are you sure...?"

Medic: *looks at paperwork* "Oh, yes, definitely. Fracture at L-12!"

ER Nurse: "L-12...I see. Did she grow a TAIL...?" 



Tuesday, January 25, 2022

It Could Happen To Anyone

 A friend of mine who's a nurse caught COVID. Unfortunately for him he died, but even worse, he went to Hell. But as will come as no surprise to those who work in this profession, after he got to Hell, it was more than two weeks before he realized he wasn't still at work.

Sunday, November 14, 2021

Yellow Feet


Those pink feet tell you this photo was posed with a live person.
Ask me how I know.

Some people think fixed and dilated pupils is how you know someone's dead. Others will tell you it's flat brain waves, or asystole on the EKG monitor.

They're wrong.

I was reminded of this fact by the real actual everything-proof acme of you looking down at your own body from outside it, and knowing things are bad.

As someone observed at his own son's funeral, "Being dead is like being stupid. Everyone knows it but you."

But I've gotten pulses back from asystole. It's rare, but not unheard of. I've even seen patients recover from what everyone in the room thought was certain death. Some of them even walked out the front door some days later, to the astonishment of the doctors and staff.

But nobody - NOBODY - who comes in with feet the color of parchment, ever comes back.

I'm pretty sure while the spirit of the former person hovers around, while we all push drugs and do compressions, Death, courtesy of Terry Pratchett, shows up to put the final stamp of approval.

"Wow, I look pretty bad, I wonder if I'll..."


"Are you sure? I mean, I was pretty young and healthy and..."


"Wow! Why are they so yellow?"


"Oh. OH! Yeegads! So I'm really...?"


And no matter how many more rounds of epi, and bicarb, and calcium, and whatnot, we give,  nor how hard the tech is pumping your rib cage to circulate them around, once we see the parchment yellow Feet Of Death, it's because we just can't squeeze enough blood through your corpse to turn your tootsies that lovely shade of rose pink they ought to be, and would be, if you hadn't already toddled off with Death at some point annoyingly prior.

One minute you were coming home from a party, and the next thing you know, some bony-handed gentleman is dropping you off at the reception desk at the Pearly Gates.

And all the king's horses, and all the king's men, can't undo the rude unhinging of the mechanism of life visited upon you by Fate, Physics, and Physiology.

We're all really sorry about that. Hand to God, we are. But there's just some things we can't fix, and your fate was sealed long before you got to our back door, no matter how much everyone, including people we haven't even met yet, wish it were not so.

I really fucking hate that. I thought, long ago, that one day I might have gotten over it.

But this many decades in, I'm afraid that's just never going to happen. And I suppose if it ever does, that's the signal it's time to get out of this business for good.

It was a long night. It'll be better after I finally get some sleep.

Better still, after I spend a long, quiet day in the park enjoying fresh air, warm sunshine, and a brilliant blue sky, and see the things you can no longer see, and go to the places you will never again go.

But in the pitch darkness of 3 AM, it's just cold. And the only thing making it easier for me is knowing I'll never hear the moans and wails when your parents are located, and get the call no one wants to make, nor be there when the sheet comes back, and they see it's really you there on that table.

Seeing your yellow feet is bad enough. I'm oh so glad I don't have to see the whole show in this tragedy. And I'm really hoping it doesn't cross my mind again tomorrow night.

Sufficient unto each day are the troubles thereof.

O, you can just bet they are.